Discrimination and prediction of the origin of Chinese and Korean soybeans using Fourier transform infrared spectrometry (FT-IR) with multivariate statistical analysis

PubMed Central

Lee, Byeong-Ju; Zhou, Yaoyao; Lee, Jae Soung; Shin, Byeung Kon; Seo, Jeong-Ah; Lee, Doyup; Kim, Young-Suk

2018-01-01

The ability to determine the origin of soybeans is an important issue following the inclusion of this information in the labeling of agricultural food products becoming mandatory in South Korea in 2017. This study was carried out to construct a prediction model for discriminating Chinese and Korean soybeans using Fourier-transform infrared (FT-IR) spectroscopy and multivariate statistical analysis. The optimal prediction models for discriminating soybean samples were obtained by selecting appropriate scaling methods, normalization methods, variable influence on projection (VIP) cutoff values, and wave-number regions. The factors for constructing the optimal partial-least-squares regression (PLSR) prediction model were using second derivatives, vector normalization, unit variance scaling, and the 4000–400 cm–1 region (excluding water vapor and carbon dioxide). The PLSR model for discriminating Chinese and Korean soybean samples had the best predictability when a VIP cutoff value was not applied. When Chinese soybean samples were identified, a PLSR model that has the lowest root-mean-square error of the prediction value was obtained using a VIP cutoff value of 1.5. The optimal PLSR prediction model for discriminating Korean soybean samples was also obtained using a VIP cutoff value of 1.5. This is the first study that has combined FT-IR spectroscopy with normalization methods, VIP cutoff values, and selected wave-number regions for discriminating Chinese and Korean soybeans. PMID:29689113

[Validation of the Montgomery-Åsberg Depression Rating Scale (MADRS) in Colombia].

PubMed

Cano, Juan Fernando; Gomez Restrepo, Carlos; Rondón, Martín

2016-01-01

To adapt and to validate the Montgomery-Åsberg Depression Rating Scale (MADRS) in Colombia. Observational study for scale validation. Validity criteria were used to determine the severity cut-off points of the tool. Taking into account sensitivity and specificity values, those cut points were contrasted with ICD-10 criteria for depression severity. A a factor analysis was performed. The internal consistencY was determined with the same sample of patients used for the validity criteria. Inter-rater reliability was assessed by evaluating the 22 records of the patients that consented to a video interview. Sensitivity to change was established through a second application of the scale in 28 subjects after a lapse of 14 to 28 days. The study was performed in Bogotá, the tool was applied in 150 patients suffering from major depressive disorder. The cut-off point for moderate depression was 20 (sensitivity, 98%; specificity, 96%), and the cut-off point for severe depression was 34 (sensitivity, 98%; specificity, 92%). The tool appears as a unidimensional scale, which possesses a good internal consistency with (α=.9168). The findings of inter-rater reliability evaluation showed the scale as highly reliable (intraclass correlation coefficient=.9833). The instrument has a good sensitivity to change. The Colombian version of the Montgomery-Åsberg Depression Rating Scale has good psychometric properties and can be used in clinical practice and in clinical research in the field of depressive disorder. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Systematic monitoring of male circumcision scale-up in Nyanza, Kenya: exploratory factor analysis of service quality instrument and performance ranking.

PubMed

Omondi Aduda, Dickens S; Ouma, Collins; Onyango, Rosebella; Onyango, Mathews; Bertrand, Jane

2014-01-01

Considerable conceptual and operational complexities related to service quality measurements and variability in delivery contexts of scaled-up medical male circumcision, pose real challenges to monitoring implementation of quality and safety. Clarifying latent factors of the quality instruments can enhance contextual applicability and the likelihood that observed service outcomes are appropriately assessed. To explore factors underlying SYMMACS service quality assessment tool (adopted from the WHO VMMC quality toolkit) and; determine service quality performance using composite quality index derived from the latent factors. Using a comparative process evaluation of Voluntary Medical Male Circumcision Scale-Up in Kenya site level data was collected among health facilities providing VMMC over two years. Systematic Monitoring of the Medical Male Circumcision Scale-Up quality instrument was used to assess availability of guidelines, supplies and equipment, infection control, and continuity of care services. Exploratory factor analysis was performed to clarify quality structure. Fifty four items and 246 responses were analyzed. Based on Eigenvalue >1.00 cut-off, factors 1, 2 & 3 were retained each respectively having eigenvalues of 5.78; 4.29; 2.99. These cumulatively accounted for 29.1% of the total variance (12.9%; 9.5%; 6.7%) with final communality estimates being 13.06. Using a cut-off factor loading value of ≥0.4, fifteen items loading on factor 1, five on factor 2 and one on factor 3 were retained. Factor 1 closely relates to preparedness to deliver safe male circumcisions while factor two depicts skilled task performance and compliance with protocols. Of the 28 facilities, 32% attained between 90th and 95th percentile (excellent); 45% between 50th and 75th percentiles (average) and 14.3% below 25th percentile (poor). the service quality assessment instrument may be simplified to have nearly 20 items that relate more closely to service outcomes. Ranking of facilities and circumcision procedure using a composite index based on these items indicates that majority performed above average.

Ultrahigh vertical resolution radar measurements in the lower stratosphere at Arecibo

NASA Technical Reports Server (NTRS)

Ierkic, H. M.; Perillat, P.; Woodman, R. F.

1990-01-01

The paper reports on heretofore unprecedented observations of the turbulent layers in the lower stratosphere using the Arecibo 2380-MHz radar. Spectral profiles with about 20 m height and 15 s time resolutions at altitudes in the range 16-19 km are used to parametrize relevant characteristics of the turbulence, namely, vertical widths, distributions, lifetimes, and cutoffs height. These measurements validate previous deconvolved estimates and are free from contaminating factors like shear or beam broadening and partial reflections. Some theoretical predictions are verified, in particular those relating to the height of cutoff and the outer scale of the turbulence.

Shifts in Summertime Precipitation Accumulation Distributions over the US

NASA Astrophysics Data System (ADS)

Martinez-Villalobos, C.; Neelin, J. D.

2016-12-01

Precipitation accumulations, i.e., the amount of precipitation integrated over the course of an event, is a variable with both important physical and societal implications. Previous observational studies show that accumulation distributions have a characteristic shape, with an approximately power law decrease at first, followed by a sharp decrease at a characteristic large event cutoff scale. This cutoff scale is important as it limits the biggest accumulation events. Stochastic prototypes show that the resulting distributions, and importantly the large event cutoff scale, can be understood as a result of the interplay between moisture loss by precipitation and changes in moisture sinks/sources due to fluctuations in moisture divergence over the course of a precipitation event. The strength of this fluctuating moisture sink/source term is expected to increase under global warming, with both theory and climate model simulations predicting a concomitant increase in the large event cutoff scale. This cutoff scale increase has important consequences as it implies an approximately exponential increase for the largest accumulation events. Given its importance, in this study we characterize and track changes in the distribution of precipitation events accumulations over the contiguous US. Accumulation distributions are calculated using hourly precipitation data from 1700 stations, covering the 1974-2013 period over May-October. The resulting distributions largely follow the aforementioned shape, with individual cutoff scales depending on the local climate. An increase in the large event cutoff scale over this period is observed over several regions over the US, most notably over the eastern third of the US. In agreement with the increase in the cutoff, almost exponential increases in the highest accumulation percentiles occur over these regions, with increases in the 99.9 percentile in the Northeast of 70% for example. The relationship to changes in daily precipitation that have previously been noted and to changes in the moisture budget over this period are examined.

Shifts in Summertime Precipitation Accumulation Distributions over the US

NASA Astrophysics Data System (ADS)

Martinez-Villalobos, C.; Neelin, J. D.

2017-12-01

Precipitation accumulations, i.e., the amount of precipitation integrated over the course of an event, is a variable with both important physical and societal implications. Previous observational studies show that accumulation distributions have a characteristic shape, with an approximately power law decrease at first, followed by a sharp decrease at a characteristic large event cutoff scale. This cutoff scale is important as it limits the biggest accumulation events. Stochastic prototypes show that the resulting distributions, and importantly the large event cutoff scale, can be understood as a result of the interplay between moisture loss by precipitation and changes in moisture sinks/sources due to fluctuations in moisture divergence over the course of a precipitation event. The strength of this fluctuating moisture sink/source term is expected to increase under global warming, with both theory and climate model simulations predicting a concomitant increase in the large event cutoff scale. This cutoff scale increase has important consequences as it implies an approximately exponential increase for the largest accumulation events. Given its importance, in this study we characterize and track changes in the distribution of precipitation events accumulations over the contiguous US. Accumulation distributions are calculated using hourly precipitation data from 1700 stations, covering the 1974-2013 period over May-October. The resulting distributions largely follow the aforementioned shape, with individual cutoff scales depending on the local climate. An increase in the large event cutoff scale over this period is observed over several regions over the US, most notably over the eastern third of the US. In agreement with the increase in the cutoff, almost exponential increases in the highest accumulation percentiles occur over these regions, with increases in the 99.9 percentile in the Northeast of 70% for example. The relationship to changes in daily precipitation that have previously been noted and to changes in the moisture budget over this period are examined.

Universal Quake Statistics: From Compressed Nanocrystals to Earthquakes.

PubMed

Uhl, Jonathan T; Pathak, Shivesh; Schorlemmer, Danijel; Liu, Xin; Swindeman, Ryan; Brinkman, Braden A W; LeBlanc, Michael; Tsekenis, Georgios; Friedman, Nir; Behringer, Robert; Denisov, Dmitry; Schall, Peter; Gu, Xiaojun; Wright, Wendelin J; Hufnagel, Todd; Jennings, Andrew; Greer, Julia R; Liaw, P K; Becker, Thorsten; Dresen, Georg; Dahmen, Karin A

2015-11-17

Slowly-compressed single crystals, bulk metallic glasses (BMGs), rocks, granular materials, and the earth all deform via intermittent slips or "quakes". We find that although these systems span 12 decades in length scale, they all show the same scaling behavior for their slip size distributions and other statistical properties. Remarkably, the size distributions follow the same power law multiplied with the same exponential cutoff. The cutoff grows with applied force for materials spanning length scales from nanometers to kilometers. The tuneability of the cutoff with stress reflects "tuned critical" behavior, rather than self-organized criticality (SOC), which would imply stress-independence. A simple mean field model for avalanches of slipping weak spots explains the agreement across scales. It predicts the observed slip-size distributions and the observed stress-dependent cutoff function. The results enable extrapolations from one scale to another, and from one force to another, across different materials and structures, from nanocrystals to earthquakes.

Universal Quake Statistics: From Compressed Nanocrystals to Earthquakes

PubMed Central

Uhl, Jonathan T.; Pathak, Shivesh; Schorlemmer, Danijel; Liu, Xin; Swindeman, Ryan; Brinkman, Braden A. W.; LeBlanc, Michael; Tsekenis, Georgios; Friedman, Nir; Behringer, Robert; Denisov, Dmitry; Schall, Peter; Gu, Xiaojun; Wright, Wendelin J.; Hufnagel, Todd; Jennings, Andrew; Greer, Julia R.; Liaw, P. K.; Becker, Thorsten; Dresen, Georg; Dahmen, Karin A.

2015-01-01

Slowly-compressed single crystals, bulk metallic glasses (BMGs), rocks, granular materials, and the earth all deform via intermittent slips or “quakes”. We find that although these systems span 12 decades in length scale, they all show the same scaling behavior for their slip size distributions and other statistical properties. Remarkably, the size distributions follow the same power law multiplied with the same exponential cutoff. The cutoff grows with applied force for materials spanning length scales from nanometers to kilometers. The tuneability of the cutoff with stress reflects “tuned critical” behavior, rather than self-organized criticality (SOC), which would imply stress-independence. A simple mean field model for avalanches of slipping weak spots explains the agreement across scales. It predicts the observed slip-size distributions and the observed stress-dependent cutoff function. The results enable extrapolations from one scale to another, and from one force to another, across different materials and structures, from nanocrystals to earthquakes. PMID:26572103

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

Uhl, Jonathan T.; Pathak, Shivesh; Schorlemmer, Danijel

Slowly-compressed single crystals, bulk metallic glasses (BMGs), rocks, granular materials, and the earth all deform via intermittent slips or “quakes”. We find that although these systems span 12 decades in length scale, they all show the same scaling behavior for their slip size distributions and other statistical properties. Remarkably, the size distributions follow the same power law multiplied with the same exponential cutoff. The cutoff grows with applied force for materials spanning length scales from nanometers to kilometers. The tuneability of the cutoff with stress reflects “tuned critical” behavior, rather than self-organized criticality (SOC), which would imply stress-independence. A simplemore » mean field model for avalanches of slipping weak spots explains the agreement across scales. It predicts the observed slip-size distributions and the observed stressdependent cutoff function. In conclusion, the results enable extrapolations from one scale to another, and from one force to another, across different materials and structures, from nanocrystals to earthquakes.« less

The Worksite Health Promotion Capacity Instrument (WHPCI): development, validation and approaches for determining companies' levels of health promotion capacity.

PubMed

Jung, Julia; Nitzsche, Anika; Neumann, Melanie; Wirtz, Markus; Kowalski, Christoph; Wasem, Jürgen; Stieler-Lorenz, Brigitte; Pfaff, Holger

2010-09-13

The Worksite Health Promotion Capacity Instrument (WHPCI) was developed to assess two key factors for effective worksite health promotion: collective willingness and the systematic implementation of health promotion activities in companies. This study evaluates the diagnostic qualities of the WHPCI based on its subscales Health Promotion Willingness and Health Promotion Management, which can be used to place companies into four different categories based on their level of health promotion capacity. Psychometric evaluation was conducted using exploratory factor and reliability analyses with data taken from a random sample of managers from n = 522 German information and communication technology (ICT) companies. Receiver operating characteristic (ROC) analyses were conducted to determine further diagnostic qualities of the instrument and to establish the cut-off scores used to determine each company's level of health promotion capacity. The instrument's subscales, Health Promotion Willingness and Health Promotion Management, are based on one-dimensional constructs, each with very good reliability (Cronbach's alpha = 0.83/0.91). ROC analyses demonstrated satisfactory diagnostic accuracy with an area under the curve (AUC) of 0.76 (SE = 0.021; 95% CI 0.72-0.80) for the Health Promotion Willingness scale and 0.81 (SE = 0.021; 95% CI 0.77-0.86) for the Health Promotion Management scale. A cut-off score with good sensitivity (71%/76%) and specificity (69%/75%) was determined for each scale. Both scales were found to have good predictive power and exhibited good efficiency. Our findings indicate preliminary evidence for the validity and reliability of both subscales of the WHPCI. The goodness of each cut-off score suggests that the scales are appropriate for determining companies' levels of health promotion capacity. Support in implementing (systematic) worksite health promotion can then be tailored to each company's needs based on their current capacity level.

Psychometric validation of the Columbia-Suicide Severity rating scale in Spanish-speaking adolescents.

PubMed

Serrani Azcurra, Daniel

2017-12-30

Adolescent suicide is a major public health issue, and early and accurate detection is of great concern. There are many reliable instruments for this purpose, such as the Columbia-Suicide severity rating scale (C-SSRS), but no validation exists for Spanish speaking Latin American adolescents. To assess psychometric properties and cut-off scores of the C-SSRS in Spanish speaking adolescents. Exploratory assessment with principal component analysis (PCA) and Varimax rotation, and confirmatory analysis (CFA) were performed on two groups with 782 and 834 participants respectively (N=1616). Mean age was 24.8 years. A Receiver operator analysis was applied to distinguish between control and suicide-risk subgroups adolescents. Promax rotation yielded two 10-items factors, for suicide ideation and behavior respectively. C-SSRS was positively correlated with other suicide risk scales, such as Beck Depression Inventory-II, Suicidal Behaviors Questionnaire-Revised, or PHQ-9. Confirmatory factor analysis yielded a two-factor solution as the best goodness of fit model. C-SSRS showed adequate ability to detect suicide risk group with positive predictive value of 68.3%. ROC analyses showed cutoff scores of ≥ 6 and ≥ 4 for suicide ideation and behavior scales respectively. This research offers data supporting psychometric validity and reliability of C-SSRS in nonclinical Spanish-speaking students. Added benefits are flexible scoring and management easiness. This questionnaire yields data on distinct aspects of suicidality, being more parsimonious than separate administration of a bunch of questionnaires.

Psychometric validation of the Columbia-Suicide Severity rating scale in Spanish-speaking adolescents

PubMed Central

2017-01-01

Abstract Introduction: Adolescent suicide is a major public health issue, and early and accurate detection is of great concern. There are many reliable instruments for this purpose, such as the Columbia-Suicide severity rating scale (C-SSRS), but no validation exists for Spanish speaking Latin American adolescents. Objetive: To assess psychometric properties and cut-off scores of the C-SSRS in Spanish speaking adolescents. Methods: Exploratory assessment with principal component analysis (PCA) and Varimax rotation, and confirmatory analysis (CFA) were performed on two groups with 782 and 834 participants respectively (N=1616). Mean age was 24.8 years. A Receiver operator analysis was applied to distinguish between control and suicide-risk subgroups adolescents. Results: Promax rotation yielded two 10-items factors, for suicide ideation and behavior respectively. C-SSRS was positively correlated with other suicide risk scales, such as Beck Depression Inventory-II, Suicidal Behaviors Questionnaire-Revised, or PHQ-9. Confirmatory factor analysis yielded a two-factor solution as the best goodness of fit model. C-SSRS showed adequate ability to detect suicide risk group with positive predictive value of 68.3%. ROC analyses showed cutoff scores of ≥ 6 and ≥ 4 for suicide ideation and behavior scales respectively Conclusion: This research offers data supporting psychometric validity and reliability of C-SSRS in nonclinical Spanish-speaking students. Added benefits are flexible scoring and management easiness. This questionnaire yields data on distinct aspects of suicidality, being more parsimonious than separate administration of a bunch of questionnaires. PMID:29662259

Earthquake Scaling Relations

NASA Astrophysics Data System (ADS)

Jordan, T. H.; Boettcher, M.; Richardson, E.

2002-12-01

Using scaling relations to understand nonlinear geosystems has been an enduring theme of Don Turcotte's research. In particular, his studies of scaling in active fault systems have led to a series of insights about the underlying physics of earthquakes. This presentation will review some recent progress in developing scaling relations for several key aspects of earthquake behavior, including the inner and outer scales of dynamic fault rupture and the energetics of the rupture process. The proximate observations of mining-induced, friction-controlled events obtained from in-mine seismic networks have revealed a lower seismicity cutoff at a seismic moment Mmin near 109 Nm and a corresponding upper frequency cutoff near 200 Hz, which we interpret in terms of a critical slip distance for frictional drop of about 10-4 m. Above this cutoff, the apparent stress scales as M1/6 up to magnitudes of 4-5, consistent with other near-source studies in this magnitude range (see special session S07, this meeting). Such a relationship suggests a damage model in which apparent fracture energy scales with the stress intensity factor at the crack tip. Under the assumption of constant stress drop, this model implies an increase in rupture velocity with seismic moment, which successfully predicts the observed variation in corner frequency and maximum particle velocity. Global observations of oceanic transform faults (OTFs) allow us to investigate a situation where the outer scale of earthquake size may be controlled by dynamics (as opposed to geologic heterogeneity). The seismicity data imply that the effective area for OTF moment release, AE, depends on the thermal state of the fault but is otherwise independent of fault's average slip rate; i.e., AE ~ AT, where AT is the area above a reference isotherm. The data are consistent with β = 1/2 below an upper cutoff moment Mmax that increases with AT and yield the interesting scaling relation Amax ~ AT1/2. Taken together, the OTF relations imply that the seismic productivity for small earthquakes (frequency per unit area) should scale as AT-1/4, which we verify using seismicity catalogs based on both surface-wave and body-wave magnitude. These scaling relations place fundamental constraints on the dynamics of strike-slip faulting on the mid-ocean ridge system.

Scale of attitudes toward alcohol - Spanish version: evidences of validity and reliability 1

PubMed Central

Ramírez, Erika Gisseth León; de Vargas, Divane

2017-01-01

ABSTRACT Objective: validate the Scale of attitudes toward alcohol, alcoholism and individuals with alcohol use disorders in its Spanish version. Method: methodological study, involving 300 Colombian nurses. Adopting the classical theory, confirmatory factor analysis was applied without prior examination, based on the strong historical evidence of the factorial structure of the original scale to determine the construct validity of this Spanish version. To assess the reliability, Cronbach’s Alpha and Mc Donalid’s Omega coefficients were used. Results: the confirmatory factor analysis indicated the good fit of the scale model in a four-factor distribution, with a cut-off point at 3.2, demonstrating 66.7% of sensitivity. Conclusions: the Scale of attitudes toward alcohol, alcoholism and individuals with alcohol use disorders in Spanish presented robust psychometric qualities, affirming that the instrument possesses a solid factorial structure and reliability and is capable of precisely measuring the nurses’ atittudes towards the phenomenon proposed. PMID:28793126

Neutrino Masses in the Landscape and Global-Local Dualities in Eternal Inflation

NASA Astrophysics Data System (ADS)

Mainemer Katz, Dan

In this dissertation we study two topics in Theoretical Cosmology: one more formal, the other more phenomenological. We work in the context of eternally inflating cosmologies. These arise in any fundamental theory that contains at least one stable or metastable de Sitter vacuum. Each topic is presented in a different chapter: Chapter 1 deals with the measure problem in eternal inflation. Global-local duality is the equivalence of seemingly different regulators in eternal inflation. For example, the light- cone time cutoff (a global measure, which regulates time) makes the same predictions as the causal patch (a local measure that cuts off space). We show that global-local duality is far more general. It rests on a redundancy inherent in any global cutoff: at late times, an attractor regime is reached, characterized by the unlimited exponential self-reproduction of a certain fundamental region of spacetime. An equivalent local cutoff can be obtained by restricting to this fundamental region. We derive local duals to several global cutoffs of interest. The New Scale Factor Cutoff is dual to the Short Fat Geodesic, a geodesic of fixed infinitesimal proper width. Vilenkin's CAH Cutoff is equivalent to the Hubbletube, whose width is proportional to the local Hubble volume. The famous youngness problem of the Proper Time Cutoff can be readily understood by considering its local dual, the Incredible Shrinking Geodesic. The chapter closely follows our paper. Chapter 2 deals with the question of whether neutrino masses could be anthropically explained. The sum of active neutrino masses is well constrained, 58 meV ≤ mupsilon [is approximately less than] 0.23 eV, but the origin of this scale is not well understood. Here we investigate the possibility that it arises by environmental selection in a large landscape of vacua. Earlier work had noted the detrimental effects of neutrinos on large scale structure. However, using Boltzmann codes to compute the smoothed density contrast on Mpc scales, we find that dark matter halos form abundantly for mupsilon [is approximately greater than] 10eV. This finding rules out an anthropic origin of mupsilon, unless a different catastrophic boundary can be identified. Here we argue that galaxy formation becomes inefficient for mupsilon [is approximately greater than] 10 eV. We show that in this regime, structure forms late and is dominated by cluster scales, as in a top-down scenario. This is catastrophic: baryonic gas will cool too slowly to form stars in an abundance comparable to our universe. With this novel cooling boundary, we find that the anthropic prediction for mupsilon agrees at better than 2sigma with current observational bounds. A degenerate hierarchy is mildly preferred. The chapter closely follows our paper.

NMR permeability estimators in 'chalk' carbonate rocks obtained under different relaxation times and MICP size scalings

NASA Astrophysics Data System (ADS)

Rios, Edmilson Helton; Figueiredo, Irineu; Moss, Adam Keith; Pritchard, Timothy Neil; Glassborow, Brent Anthony; Guedes Domingues, Ana Beatriz; Bagueira de Vasconcellos Azeredo, Rodrigo

2016-07-01

The effect of the selection of different nuclear magnetic resonance (NMR) relaxation times for permeability estimation is investigated for a set of fully brine-saturated rocks acquired from Cretaceous carbonate reservoirs in the North Sea and Middle East. Estimators that are obtained from the relaxation times based on the Pythagorean means are compared with estimators that are obtained from the relaxation times based on the concept of a cumulative saturation cut-off. Select portions of the longitudinal (T1) and transverse (T2) relaxation-time distributions are systematically evaluated by applying various cut-offs, analogous to the Winland-Pittman approach for mercury injection capillary pressure (MICP) curves. Finally, different approaches to matching the NMR and MICP distributions using different mean-based scaling factors are validated based on the performance of the related size-scaled estimators. The good results that were obtained demonstrate possible alternatives to the commonly adopted logarithmic mean estimator and reinforce the importance of NMR-MICP integration to improving carbonate permeability estimates.

Interannual variability of cut-off low systems over the European sector: The role of blocking and the Northern Hemisphere circulation modes

NASA Astrophysics Data System (ADS)

Nieto, R.; Gimeno, L.; de La Torre, L.; Ribera, P.; Barriopedro, D.; García-Herrera, R.; Serrano, A.; Gordillo, A.; Redaño, A.; Lorente, J.

2007-04-01

An earlier developed multidecadal database of Northern Hemisphere cut-off low systems (COLs), covering a 41 years period (from 1958 to 1998) is used to study COLs interannual variability in the European sector (25°-47.5° N, 50° W-40° E) and the major factors controlling it. The study focus on the influence on COLs interannual variability, of larger scale phenomena such as blocking events and other main circulation modes defined over the Euro-Atlantic region. It is shown that there is a very large interannual variability in the COLs occurrence at the annual and seasonal scales, although without significant trends. The influence of larger scale phenomena is seasonal dependent, with the positive phase of the NAO favoring autumn COL development, while winter COL occurrence is mostly related to blocking events. During summer, the season when more COLs occur, no significant influences were found.

Can cosmic shear shed light on low cosmic microwave background multipoles?

PubMed

Kesden, Michael; Kamionkowski, Marc; Cooray, Asantha

2003-11-28

The lowest multipole moments of the cosmic microwave background (CMB) are smaller than expected for a scale-invariant power spectrum. One possible explanation is a cutoff in the primordial power spectrum below a comoving scale of k(c) approximately equal to 5.0 x 10(-4) Mpc(-1). Such a cutoff would increase significantly the cross correlation between the large-angle CMB and cosmic-shear patterns. The cross correlation may be detectable at >2sigma which, combined with the low CMB moments, may tilt the balance between a 2sigma result and a firm detection of a large-scale power-spectrum cutoff. The cutoff also increases the large-angle cross correlation between the CMB and the low-redshift tracers of the mass distribution.

The Social Interaction Phobia Scale: Continued support for the psychometric validity of the SIPS using clinical and non-clinical samples.

PubMed

Menatti, Alison R; Weeks, Justin W; Carleton, R Nicholas; Morrison, Amanda S; Heimberg, Richard G; Hope, Debra A; Blanco, Carlos; Schneier, Franklin R; Liebowitz, Michael R

2015-05-01

The present study sought to extend findings supporting the psychometric validity of a promising measure of social anxiety (SA) symptoms, the Social Interaction Phobia Scale (SIPS; Carleton et al., 2009). Analyses were conducted using three samples: social anxiety disorder (SAD) patients, generalized anxiety disorder (GAD) patients, and healthy controls. SIPS scores of SAD patients demonstrated internal consistency and construct validity, and the previously demonstrated three-factor structure of the SIPS was replicated. Further, the SIPS total score uniquely predicted SA symptoms, and SIPS scores were significantly higher for SAD patients than GAD patients or controls. Two cut-off scores that discriminated SAD patients from GAD patients and from healthy controls were identified. The current study is the first to replicate the SIPS three-factor model in a large, treatment-seeking sample of SAD patients and establish a cut-off score discriminating SAD from GAD patients. Findings support the SIPS as a valid, SAD-specific assessment instrument. Copyright © 2015 Elsevier Ltd. All rights reserved.

Boltzmann brains and the scale-factor cutoff measure of the multiverse

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

De Simone, Andrea; Guth, Alan H.; Linde, Andrei

2010-09-15

To make predictions for an eternally inflating 'multiverse', one must adopt a procedure for regulating its divergent spacetime volume. Recently, a new test of such spacetime measures has emerged: normal observers - who evolve in pocket universes cooling from hot big bang conditions - must not be vastly outnumbered by 'Boltzmann brains' - freak observers that pop in and out of existence as a result of rare quantum fluctuations. If the Boltzmann brains prevail, then a randomly chosen observer would be overwhelmingly likely to be surrounded by an empty world, where all but vacuum energy has redshifted away, rather thanmore » the rich structure that we observe. Using the scale-factor cutoff measure, we calculate the ratio of Boltzmann brains to normal observers. We find the ratio to be finite, and give an expression for it in terms of Boltzmann brain nucleation rates and vacuum decay rates. We discuss the conditions that these rates must obey for the ratio to be acceptable, and we discuss estimates of the rates under a variety of assumptions.« less

A Cutoff in the X-Ray Fluctuation Power Density Spectrum of the Seyfert 1 Galaxy NGC 3516

NASA Technical Reports Server (NTRS)

Edelson, Rick; Nandra, Kirpal

1999-01-01

During 1997 March-July, RXTE observed the bright, strongly variable Seyfert 1 galaxy NGC 3516 once every approx. 12.8 hr for 4.5 months and nearly continuously (with interruptions due to SAA passage but not Earth occultation) for a 4.2 day period in the middle. These were followed by ongoing monitoring once every approx. 4.3 days. These data are used to construct the first well-determined X-ray fluctuation power density spectrum (PDS) of an active galaxy to span more than 4 decades of usable temporal frequency. The PDS shows no signs of any strict or quasi-periodicity, but does show a progressive flattening of the power-low slope from -1.74 at short time scales to -0.73 at longer time scales. This is the clearest observation to date of the long-predicted cutoff in the PDS. The characteristic variability time scale corresponding to this cutoff temporal frequency is approx. 1 month. Although it is unclear how this time scale may be interpreted in terms of a physical size or process, there are several promising candidate models. The PDS appears similar to those seen for Galactic black hole candidates such as Cyg X-1, suggesting that these two classes of objects with very different luminosities and putative black hole masses (differing by more than a factor of 10(exp 5)) may have similar X-ray generation processes and structures.

Clinical Scales Do Not Reliably Identify Acute Ischemic Stroke Patients With Large-Artery Occlusion.

PubMed

Turc, Guillaume; Maïer, Benjamin; Naggara, Olivier; Seners, Pierre; Isabel, Clothilde; Tisserand, Marie; Raynouard, Igor; Edjlali, Myriam; Calvet, David; Baron, Jean-Claude; Mas, Jean-Louis; Oppenheim, Catherine

2016-06-01

It remains debated whether clinical scores can help identify acute ischemic stroke patients with large-artery occlusion and hence improve triage in the era of thrombectomy. We aimed to determine the accuracy of published clinical scores to predict large-artery occlusion. We assessed the performance of 13 clinical scores to predict large-artery occlusion in consecutive patients with acute ischemic stroke undergoing clinical examination and magnetic resonance or computed tomographic angiography ≤6 hours of symptom onset. When no cutoff was published, we used the cutoff maximizing the sum of sensitivity and specificity in our cohort. We also determined, for each score, the cutoff associated with a false-negative rate ≤10%. Of 1004 patients (median National Institute of Health Stroke Scale score, 7; range, 0-40), 328 (32.7%) had an occlusion of the internal carotid artery, M1 segment of the middle cerebral artery, or basilar artery. The highest accuracy (79%; 95% confidence interval, 77-82) was observed for National Institute of Health Stroke Scale score ≥11 and Rapid Arterial Occlusion Evaluation Scale score ≥5. However, these cutoffs were associated with false-negative rates >25%. Cutoffs associated with an false-negative rate ≤10% were 5, 1, and 0 for National Institute of Health Stroke Scale, Rapid Arterial Occlusion Evaluation Scale, and Cincinnati Prehospital Stroke Severity Scale, respectively. Using published cutoffs for triage would result in a loss of opportunity for ≥20% of patients with large-artery occlusion who would be inappropriately sent to a center lacking neurointerventional facilities. Conversely, using cutoffs reducing the false-negative rate to 10% would result in sending almost every patient to a comprehensive stroke center. Our findings, therefore, suggest that intracranial arterial imaging should be performed in all patients with acute ischemic stroke presenting within 6 hours of symptom onset. © 2016 American Heart Association, Inc.

Universal Quake Statistics: From Compressed Nanocrystals to Earthquakes

DOE PAGES

Uhl, Jonathan T.; Pathak, Shivesh; Schorlemmer, Danijel; ...

2015-11-17

Slowly-compressed single crystals, bulk metallic glasses (BMGs), rocks, granular materials, and the earth all deform via intermittent slips or “quakes”. We find that although these systems span 12 decades in length scale, they all show the same scaling behavior for their slip size distributions and other statistical properties. Remarkably, the size distributions follow the same power law multiplied with the same exponential cutoff. The cutoff grows with applied force for materials spanning length scales from nanometers to kilometers. The tuneability of the cutoff with stress reflects “tuned critical” behavior, rather than self-organized criticality (SOC), which would imply stress-independence. A simplemore » mean field model for avalanches of slipping weak spots explains the agreement across scales. It predicts the observed slip-size distributions and the observed stressdependent cutoff function. In conclusion, the results enable extrapolations from one scale to another, and from one force to another, across different materials and structures, from nanocrystals to earthquakes.« less

Gauge-invariance and infrared divergences in the luminosity distance

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

Biern, Sang Gyu; Yoo, Jaiyul, E-mail: sgbiern@physik.uzh.ch, E-mail: jyoo@physik.uzh.ch

2017-04-01

Measurements of the luminosity distance have played a key role in discovering the late-time cosmic acceleration. However, when accounting for inhomogeneities in the Universe, its interpretation has been plagued with infrared divergences in its theoretical predictions, which are in some cases used to explain the cosmic acceleration without dark energy. The infrared divergences in most calculations are artificially removed by imposing an infrared cut-off scale. We show that a gauge-invariant calculation of the luminosity distance is devoid of such divergences and consistent with the equivalence principle, eliminating the need to impose a cut-off scale. We present proper numerical calculations ofmore » the luminosity distance using the gauge-invariant expression and demonstrate that the numerical results with an ad hoc cut-off scale in previous calculations have negligible systematic errors as long as the cut-off scale is larger than the horizon scale. We discuss the origin of infrared divergences and their cancellation in the luminosity distance.« less

Natural Covariant Planck Scale Cutoffs and the Cosmic Microwave Background Spectrum.

PubMed

Chatwin-Davies, Aidan; Kempf, Achim; Martin, Robert T W

2017-07-21

We calculate the impact of quantum gravity-motivated ultraviolet cutoffs on inflationary predictions for the cosmic microwave background spectrum. We model the ultraviolet cutoffs fully covariantly to avoid possible artifacts of covariance breaking. Imposing these covariant cutoffs results in the production of small, characteristically k-dependent oscillations in the spectrum. The size of the effect scales linearly with the ratio of the Planck to Hubble lengths during inflation. Consequently, the relative size of the effect could be as large as one part in 10^{5}; i.e., eventual observability may not be ruled out.

Investigating sensitivity, specificity, and area under the curve of the Clinical COPD Questionnaire, COPD Assessment Test, and Modified Medical Research Council scale according to GOLD using St George's Respiratory Questionnaire cutoff 25 (and 20) as reference.

PubMed

Tsiligianni, Ioanna G; Alma, Harma J; de Jong, Corina; Jelusic, Danijel; Wittmann, Michael; Schuler, Michael; Schultz, Konrad; Kollen, Boudewijn J; van der Molen, Thys; Kocks, Janwillem Wh

2016-01-01

In the GOLD (Global initiative for chronic Obstructive Lung Disease) strategy document, the Clinical COPD Questionnaire (CCQ), COPD Assessment Test (CAT), or modified Medical Research Council (mMRC) scale are recommended for the assessment of symptoms using the cutoff points of CCQ ≥1, CAT ≥10, and mMRC scale ≥2 to indicate symptomatic patients. The current study investigates the criterion validity of the CCQ, CAT and mMRC scale based on a reference cutoff point of St George's Respiratory Questionnaire (SGRQ) ≥25, as suggested by GOLD, following sensitivity and specificity analysis. In addition, areas under the curve (AUCs) of the CCQ, CAT, and mMRC scale were compared using two SGRQ cutoff points (≥25 and ≥20). Two data sets were used: study A, 238 patients from a pulmonary rehabilitation program; and study B, 101 patients from primary care. Receiver-operating characteristic (ROC) curves were used to assess the correspondence between the recommended cutoff points of the questionnaires. Sensitivity, specificity, and AUC scores for cutoff point SGRQ ≥25 were: study A, 0.99, 0.43, and 0.96 for CCQ ≥1, 0.92, 0.48, and 0.89 for CAT ≥10, and 0.68, 0.91, and 0.91 for mMRC ≥2; study B, 0.87, 0.77, and 0.9 for CCQ ≥1, 0.76, 0.73, and 0.82 for CAT ≥10, and 0.21, 1, and 0.81 for mMRC ≥2. Sensitivity, specificity, and AUC scores for cutoff point SGRQ ≥20 were: study A, 0.99, 0.73, and 0.99 for CCQ ≥1, 0.91, 0.73, and 0.94 for CAT ≥10, and 0.66, 0.95, and 0.94 for mMRC ≥2; study B, 0.8, 0.89, and 0.89 for CCQ ≥1, 0.69, 0.78, and 0.8 for CAT ≥10, and 0.18, 1, and 0.81 for mMRC ≥2. Based on data from these two different samples, this study showed that the suggested cutoff point for the SGRQ (≥25) did not seem to correspond well with the established cutoff points of the CCQ or CAT scales, resulting in low specificity levels. The correspondence with the mMRC scale seemed satisfactory, though not optimal. The SGRQ threshold of ≥20 corresponded slightly better than SGRQ ≥25, recently suggested by GOLD 2015, with the established cutoff points for the CCQ, CAT, and mMRC scale.

[Development of competency to stand trial rating scale in offenders with mental disorders].

PubMed

Chen, Xiao-Bing; Cai, Wei-Xiong

2013-04-01

According with Chinese legal system, to develop a competency to stand trial rating scale in offenders with mental disorders. Proceeding from the juristical elements, 15 items were extracted and formulated a preliminary instrument named the competency to stand trial rating scale in offenders with mental disorders. The item analysis included six aspects, which were critical ratio, item-total correlation, corrected item-total correlation, alpha value if item deleted, communalities of items, and factor loading. The Logistic regression equation and cut-off score of ROC curve were used to explore the diagnostic efficiency. The data of critical ratio of extreme group were 18.390-46.763; item-total correlation, 0.639-0.952; corrected item-total correlation, 0.582-0.944; communalities of items, 0.377-0.916; and factor loadings, 0.614-0.957. Seven items were included in the regression equation and the accuracy of back substitution test was 96.0%. The score of 33 was ascertained as the cut-off score by ROC fitting curve, the overlapping ratio compared with the expertise was 95.8%. The sensibility and the specificity were 0.938 and 0.966, respectively, while the positive and negative likelihood ratios were 27.67 and 0.06, respectively. With all items satisfied the requirement of homogeneity test, the rating scale has a reasonable construct and excellent diagnostic efficiency.

The German version of the Anorectic Behavior Observation Scale (ABOS).

PubMed

Salbach-Andrae, Harriet; Klinkowski, Nora; Holzhausen, Martin; Frieler, Katja; Bohnekamp, Inga; Thiels, Cornelia; Bender, Caroline; Vandereycken, Walter

2009-05-01

To assess the performance of the German version of the Anorectic Behavior Observation Scale (ABOS) as a parent-report screening instrument for eating disorders (ED) in their children. Parents of 101 ED female patients (80 with Anorexia Nervosa; 21 with Bulimia Nervosa) and of 121 age- and socioeconomic status (SES)-matched female controls completed the ABOS. Confirmatory factor analysis supported the original three-factor structure model of the ABOS. Cronbach's alpha coefficients indicated good internal consistency for the three factors and the total score in the total sample. The best cut-off point (100% sensitivity and specificity) in the German version was >or=23. The ABOS may be a useful additional instrument for assessing ED.

Factor solutions of the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS) in a Swedish population.

PubMed

Mörtberg, Ewa; Reuterskiöld, Lena; Tillfors, Maria; Furmark, Tomas; Öst, Lars-Göran

2017-06-01

Culturally validated rating scales for social anxiety disorder (SAD) are of significant importance when screening for the disorder, as well as for evaluating treatment efficacy. This study examined construct validity and additional psychometric properties of two commonly used scales, the Social Phobia Scale and the Social Interaction Anxiety Scale, in a clinical SAD population (n = 180) and in a normal population (n = 614) in Sweden. Confirmatory factor analyses of previously reported factor solutions were tested but did not reveal acceptable fit. Exploratory factor analyses (EFA) of the joint structure of the scales in the total population yielded a two-factor model (performance anxiety and social interaction anxiety), whereas EFA in the clinical sample revealed a three-factor solution, a social interaction anxiety factor and two performance anxiety factors. The SPS and SIAS showed good to excellent internal consistency, and discriminated well between patients with SAD and a normal population sample. Both scales showed good convergent validity with an established measure of SAD, whereas the discriminant validity of symptoms of social anxiety and depression could not be confirmed. The optimal cut-off score for SPS and SIAS were 18 and 22 points, respectively. It is concluded that the factor structure and the additional psychometric properties of SPS and SIAS support the use of the scales for assessment in a Swedish population.

[Application of the Children's Impact of Event Scale (Chinese Version) on a rapid assessment of posttraumatic stress disorder among children from the Wenchuan earthquake area].

PubMed

Zhao, Gao-feng; Zhang, Qiang; Pang, Yan; Ren, Zheng-jia; Peng, Dan; Jiang, Guo-guo; Liu, Shan-ming; Chen, Ying; Geng, Ting; Zhang, Shu-sen; Yang, Yan-chun; Deng, Hong

2009-11-01

To explore the reliability and validity of the Children's Impact of Event Scale (Chinese version, CRIES-13) and to determine the value and the optimal cutoff point of the score of CRIES-13 in screening posttraumatic stress disorder (PTSD), so as to provide evidence for PTSD prevention and identify children at risk in Wenchuan earthquake areas. A total of 253 children experienced the Wenchuan earthquake were tested through Stratified random cluster sampling. The authors examined CRIES-13's internal consistency, discriminative validity and predictive value of the cut-off. PTSD was assessed with the DSM-IV criteria. Area under the curve while sensitivity, specificity and Youden index were computed based on the receiver operating characteristic curve analysis. Optimal cutoff point was determined by the maximum of Youden index. 20.9% of the subjects were found to have met the DSM-IV criteria for PTSD 7 months after the Wenchuan earthquake accident. The Cronbach's coefficient of CRIES-13 was 0.903 and the mean inter-item correlation coefficients ranged from 0.283 to 0.689, the correlation coefficient of the three factors with the total scale scores ranged from 0.836 to 0.868 while the correlation coefficient among the three factors ranged from 0.568 to 0.718, PTSD cases indicated much higher scores than non-PTSD cases, the Youden index reached maximum value when the total score approached 18 in CRIES-13 with sensitivity and specificity as 81.1% and 76.5% respectively. Consistency check showed that there were no significant differences between the results of CRIES-13 score >/= 32 and clinical diagnosis (Kappa = 0.529) from the screening program. CRIES-13 appeared to be a reliable and valid measure for assessing the posttraumatic stress symptoms among children after the earthquake accident in the Wenchuan area. The CRIES-13 seemed to be a useful self-rating diagnostic instrument for survivors with PTSD symptoms as a clinical concern by using a 18 cut-off in total score. Consistency check showed that there was no significant difference between the screening result of CRIES-13 score >/= 32 and clinical diagnosis.

Measuring posttraumatic stress following childbirth: a critical evaluation of instruments.

PubMed

Stramrood, Claire A I; Huis In 't Veld, Elisabeth M J; Van Pampus, Maria G; Berger, Leonard W A R; Vingerhoets, Ad J J M; Schultz, Willibrord C M Weijmar; Van den Berg, Paul P; Van Sonderen, Eric L P; Paarlberg, K Marieke

2010-03-01

To evaluate instruments used to assess posttraumatic stress disorder (PTSD) following childbirth with both quantitative (reliability analysis and factor analysis) and qualitative (comparison of operationalization) techniques. An unselected population of 428 women completed the Traumatic Event Scale-B (TES-B) and the PTSD Symptom Scale-Self Report (PSS-SR) 2-6 months after delivery. Assessment of internal consistency yielded similar results for the TES-B and PSS-SR (Cronbach's alpha = 0.87 and 0.82, respectively). Factor analysis revealed two rather than three DSM-IV symptom categories for both instruments: childbirth-related factors (re-experiencing/ avoidance) and symptoms of depression and anxiety (numbing/hyperarousal). Although the TES-B and the PSS-SR sum-scores show a strong relationship (Spearmans rho = 0.78), agreement between the instruments on the identification of PTSD cases is low (kappa = 0.24); discrepancy between TES-B and PSS-SR is largely due to differences in instruction to respondents, formulation of items, answer categories, and cut-off values. Large operationalization differences between TES-B and PSS-SR have been identified, i.e., in the formulation of questions, answer categories, cut-off values and instructions to respondents. Comparison between studies using different instruments for measuring PTSD following childbirth should be done with utmost caution.

Affective stress responses during leisure time: Validity evaluation of a modified version of the Stress-Energy Questionnaire.

PubMed

Hadžibajramović, Emina; Ahlborg, Gunnar; Håkansson, Carita; Lundgren-Nilsson, Åsa; Grimby-Ekman, Anna

2015-12-01

Psychosocial stress at work is one of the most important factors behind increasing sick-leave rates. In addition to work stressors, it is important to account for non-work-related stressors when assessing stress responses. In this study, a modified version of the Stress-Energy Questionnaire (SEQ), the SEQ during leisure time (SEQ-LT) was introduced for assessing the affective stress response during leisure time. The aim of this study was to investigate the internal construct validity of the SEQ-LT. A second aim was to define the cut-off points for the scales, which could indicate high and low levels of leisure-time stress and energy, respectively. Internal construct validity of the SEQ-LT was evaluated using a Rasch analysis. We examined the unidimensionality and other psychometric properties of the scale by the fit to the Rasch model. A criterion-based approach was used for classification into high and low stress/energy levels. The psychometric properties of the stress and energy scales of the SEQ-LT were satisfactory, having accommodated for local dependency. The cut-off point for low stress was proposed to be in the interval between 2.45 and 3.02 on the Rasch metric score; while for high stress, it was between 3.65 and 3.90. The suggested cut-off points for the low and high energy levels were values between 1.73-1.97 and 2.66-3.08, respectively. The stress and energy scale of the SEQ-LT satisfied the measurement criteria defined by the Rasch analysis and it provided a useful tool for non-work-related assessment of stress responses. We provide guidelines on how to interpret the scale values. © 2015 the Nordic Societies of Public Health.

The suicide assessment scale: an instrument assessing suicide risk of suicide attempters.

PubMed

Niméus, A; Alsén, M; Träskman-Bendz, L

2000-11-01

The Suicide Assessment Scale (SUAS), a scale constructed to measure suicidality over time, was administered to 191 suicide attempters. Its predictive validity was tested. SUAS ratings were compared to ratings from other scales, and related to age and psychiatric diagnoses including co-morbidity. Eight patients committed suicide within 12 months after the SUAS assessment. Apart from advanced age, high scores in the SUAS were significant predictors of suicide. From a receiver operating characteristic (ROC) analysis, we identified cutoff SUAS scores which alone and in combination with certain diagnostic and demographic factors are of apparent value in the clinical evaluation of suicide risk after a suicide attempt.

The validity of military screening for mental health problems: diagnostic accuracy of the PCL, K10 and AUDIT scales in an entire military population.

PubMed

Searle, Amelia K; Van Hooff, Miranda; McFarlane, Alexander C; Davies, Christopher E; Fairweather-Schmidt, A Kate; Hodson, Stephanie E; Benassi, Helen; Steele, Nicole

2015-03-01

Depression, alcohol use disorders and post-traumatic stress disorder (PTSD) are serious issues among military personnel due to their impact on operational capability and individual well-being. Several military forces screen for these disorders using scales including the Kessler Psychological Distress Scale (K10), Alcohol Use Disorders Identification Test (AUDIT), and Post-traumatic Stress Disorder Checklist (PCL). However, it is unknown whether established cutoffs apply to military populations. This study is the first to test the diagnostic accuracy of these three scales in a population-based military cohort. A large sample of currently-serving Australian Defence Force (ADF) Navy, Army and Air Force personnel (n = 24,481) completed the K10, AUDIT and PCL-C (civilian version). Then, a stratified sub-sample (n = 1798) completed a structured diagnostic interview detecting 30-day disorder. Data were weighted to represent the ADF population (n = 50,049). Receiver operating characteristic (ROC) analyses suggested all three scales had acceptable sensitivity and specificity, with areas under the curve from 0.75 to 0.93. AUDIT and K10 screening cutoffs closely paralleled established cutoffs, whereas the PCL-C screening cutoff resembled that recommended for US military personnel. These self-report scales represent a cost-effective and clinically-useful means of screening personnel for disorder. Military populations may need lower cutoffs than civilians to screen for PTSD. Copyright © 2014 John Wiley & Sons, Ltd.

Phase transitions triggered by quantum fluctuations in the inflationary universe

NASA Technical Reports Server (NTRS)

Nagasawa, Michiyasu; Yokoyama, Junichi

1991-01-01

The dynamics of a second-order phase transition during inflation, which is induced by time-variation of spacetime curvature, is studied as a natural mechanism to produce topological defects of typical grand unification scales such as cosmic strings or global textures. It is shown that their distribution is almost scale-invariant with small- and large-scale cutoffs. Also discussed is how these cutoffs are given.

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

PubMed Central

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

2014-01-01

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

Validation of Montgomery-Åsberg Rating Scale and Cornell Scale for Depression in Dementia in Brazilian elderly patients.

PubMed

Portugal, Maria da Glória; Coutinho, Evandro Silva Freire; Almeida, Cloyra; Barca, Maria Lage; Knapskog, Anne-Brita; Engedal, Knut; Laks, Jerson

2012-08-01

There are few studies on validation of depression scales in the elderly in Latin America. This study aimed to assess the validity of Montgomery-Åsberg. Depression Rating Scale (MADRS) and Cornell Scale for Depression in Dementia (CSDD) in Brazilian elderly outpatients. A convenience sample of 95 outpatients was diagnosed for dementia and depression according to DSM-IV-TR, ICD-10, and PDC-dAD criteria. Receiver Operating Curves (ROC) were used to calculate the area under the curve (AUC) and to assess MADRS and CSDD cut-offs for each diagnostic criterion. Dementia was diagnosed in 71 of 95 patients. Depression was diagnosed in 35, 30, and 51 patients by ICD-10, DSM-IV, and PDC-dAD, respectively. MADRS cut-off score of 10 correctly diagnosed 67.4% and 66.3% patients as depressed according to DSM-IV and ICD-10. A cut-off of 9 correctly identified 74.7% by PDC-dAD criteria; a CSDD cut-off score of 13 best recognized depression according to DSM-IV and ICD-10. A score of 11 diagnosed depression according to PDC-dAD, while MADRS = 9 recognized depression in dementia. CSDD was more efficient in showing depression in mild than in moderate/severe dementia according to DSM-IV/ICD-10. PDC-dAD behaved nicely for any severity stage. MADRS and CSDD cut-offs of 10 and 13 were the optimal ones to diagnose depression in elderly, respectively. CSDD cut-offs are higher than those found in other countries. Other Latin American studies are needed to compare results with our study.

Global warming precipitation accumulation increases above the current-climate cutoff scale

PubMed Central

Sahany, Sandeep; Stechmann, Samuel N.; Bernstein, Diana N.

2017-01-01

Precipitation accumulations, integrated over rainfall events, can be affected by both intensity and duration of the storm event. Thus, although precipitation intensity is widely projected to increase under global warming, a clear framework for predicting accumulation changes has been lacking, despite the importance of accumulations for societal impacts. Theory for changes in the probability density function (pdf) of precipitation accumulations is presented with an evaluation of these changes in global climate model simulations. We show that a simple set of conditions implies roughly exponential increases in the frequency of the very largest accumulations above a physical cutoff scale, increasing with event size. The pdf exhibits an approximately power-law range where probability density drops slowly with each order of magnitude size increase, up to a cutoff at large accumulations that limits the largest events experienced in current climate. The theory predicts that the cutoff scale, controlled by the interplay of moisture convergence variance and precipitation loss, tends to increase under global warming. Thus, precisely the large accumulations above the cutoff that are currently rare will exhibit increases in the warmer climate as this cutoff is extended. This indeed occurs in the full climate model, with a 3 °C end-of-century global-average warming yielding regional increases of hundreds of percent to >1,000% in the probability density of the largest accumulations that have historical precedents. The probabilities of unprecedented accumulations are also consistent with the extension of the cutoff. PMID:28115693

Global warming precipitation accumulation increases above the current-climate cutoff scale

NASA Astrophysics Data System (ADS)

Neelin, J. David; Sahany, Sandeep; Stechmann, Samuel N.; Bernstein, Diana N.

2017-02-01

Precipitation accumulations, integrated over rainfall events, can be affected by both intensity and duration of the storm event. Thus, although precipitation intensity is widely projected to increase under global warming, a clear framework for predicting accumulation changes has been lacking, despite the importance of accumulations for societal impacts. Theory for changes in the probability density function (pdf) of precipitation accumulations is presented with an evaluation of these changes in global climate model simulations. We show that a simple set of conditions implies roughly exponential increases in the frequency of the very largest accumulations above a physical cutoff scale, increasing with event size. The pdf exhibits an approximately power-law range where probability density drops slowly with each order of magnitude size increase, up to a cutoff at large accumulations that limits the largest events experienced in current climate. The theory predicts that the cutoff scale, controlled by the interplay of moisture convergence variance and precipitation loss, tends to increase under global warming. Thus, precisely the large accumulations above the cutoff that are currently rare will exhibit increases in the warmer climate as this cutoff is extended. This indeed occurs in the full climate model, with a 3 °C end-of-century global-average warming yielding regional increases of hundreds of percent to >1,000% in the probability density of the largest accumulations that have historical precedents. The probabilities of unprecedented accumulations are also consistent with the extension of the cutoff.

Global warming precipitation accumulation increases above the current-climate cutoff scale

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

Neelin, J. David; Sahany, Sandeep; Stechmann, Samuel N.

Precipitation accumulations, integrated over rainfall events, can be affected by both intensity and duration of the storm event. Thus, although precipitation intensity is widely projected to increase under global warming, a clear framework for predicting accumulation changes has been lacking, despite the importance of accumulations for societal impacts. Theory for changes in the probability density function (pdf) of precipitation accumulations is presented with an evaluation of these changes in global climate model simulations. We show that a simple set of conditions implies roughly exponential increases in the frequency of the very largest accumulations above a physical cutoff scale, increasing withmore » event size. The pdf exhibits an approximately power-law range where probability density drops slowly with each order of magnitude size increase, up to a cutoff at large accumulations that limits the largest events experienced in current climate. The theory predicts that the cutoff scale, controlled by the interplay of moisture convergence variance and precipitation loss, tends to increase under global warming. Thus, precisely the large accumulations above the cutoff that are currently rare will exhibit increases in the warmer climate as this cutoff is extended. This indeed occurs in the full climate model, with a 3 °C end-of-century global-average warming yielding regional increases of hundreds of percent to >1,000% in the probability density of the largest accumulations that have historical precedents. The probabilities of unprecedented accumulations are also consistent with the extension of the cutoff.« less

Global warming precipitation accumulation increases above the current-climate cutoff scale.

PubMed

Neelin, J David; Sahany, Sandeep; Stechmann, Samuel N; Bernstein, Diana N

2017-02-07

Precipitation accumulations, integrated over rainfall events, can be affected by both intensity and duration of the storm event. Thus, although precipitation intensity is widely projected to increase under global warming, a clear framework for predicting accumulation changes has been lacking, despite the importance of accumulations for societal impacts. Theory for changes in the probability density function (pdf) of precipitation accumulations is presented with an evaluation of these changes in global climate model simulations. We show that a simple set of conditions implies roughly exponential increases in the frequency of the very largest accumulations above a physical cutoff scale, increasing with event size. The pdf exhibits an approximately power-law range where probability density drops slowly with each order of magnitude size increase, up to a cutoff at large accumulations that limits the largest events experienced in current climate. The theory predicts that the cutoff scale, controlled by the interplay of moisture convergence variance and precipitation loss, tends to increase under global warming. Thus, precisely the large accumulations above the cutoff that are currently rare will exhibit increases in the warmer climate as this cutoff is extended. This indeed occurs in the full climate model, with a 3 °C end-of-century global-average warming yielding regional increases of hundreds of percent to >1,000% in the probability density of the largest accumulations that have historical precedents. The probabilities of unprecedented accumulations are also consistent with the extension of the cutoff.

Global warming precipitation accumulation increases above the current-climate cutoff scale

DOE PAGES

Neelin, J. David; Sahany, Sandeep; Stechmann, Samuel N.; ...

2017-01-23

Precipitation accumulations, integrated over rainfall events, can be affected by both intensity and duration of the storm event. Thus, although precipitation intensity is widely projected to increase under global warming, a clear framework for predicting accumulation changes has been lacking, despite the importance of accumulations for societal impacts. Theory for changes in the probability density function (pdf) of precipitation accumulations is presented with an evaluation of these changes in global climate model simulations. We show that a simple set of conditions implies roughly exponential increases in the frequency of the very largest accumulations above a physical cutoff scale, increasing withmore » event size. The pdf exhibits an approximately power-law range where probability density drops slowly with each order of magnitude size increase, up to a cutoff at large accumulations that limits the largest events experienced in current climate. The theory predicts that the cutoff scale, controlled by the interplay of moisture convergence variance and precipitation loss, tends to increase under global warming. Thus, precisely the large accumulations above the cutoff that are currently rare will exhibit increases in the warmer climate as this cutoff is extended. This indeed occurs in the full climate model, with a 3 °C end-of-century global-average warming yielding regional increases of hundreds of percent to >1,000% in the probability density of the largest accumulations that have historical precedents. The probabilities of unprecedented accumulations are also consistent with the extension of the cutoff.« less

Elongation cutoff technique armed with quantum fast multipole method for linear scaling.

PubMed

Korchowiec, Jacek; Lewandowski, Jakub; Makowski, Marcin; Gu, Feng Long; Aoki, Yuriko

2009-11-30

A linear-scaling implementation of the elongation cutoff technique (ELG/C) that speeds up Hartree-Fock (HF) self-consistent field calculations is presented. The cutoff method avoids the known bottleneck of the conventional HF scheme, that is, diagonalization, because it operates within the low dimension subspace of the whole atomic orbital space. The efficiency of ELG/C is illustrated for two model systems. The obtained results indicate that the ELG/C is a very efficient sparse matrix algebra scheme. Copyright 2009 Wiley Periodicals, Inc.

The Efficacy of Self-Report Measures in Predicting Social Phobia in African American Adults.

PubMed

Chapman, L Kevin; Petrie, Jenny M; Richards, Allyn

2015-03-01

Empirical literature pertaining to anxiety in African Americans has been relatively sparse. More recent studies indicate that the construct of social fear is different in African Americans than in non-Hispanic Whites. Although some of these studies have examined factor structure utilizing self-report measures of anxiety in African American samples, none to date have examined the clinical utility of these measures in predicting anxiety diagnoses, particularly social phobia. A total of sixty-five African American adults from the community completed the Fear Survey Schedule-Second Edition (FSS-II), Social Anxiety Interaction Scale (SIAS), Social Phobia Scale (SPS), and Albany Panic and Phobia Questionnaire (APPQ). The Anxiety Disorder Interview Schedule-Fourth Edition (ADIS-IV) was administered to all participants to specify differential diagnoses of anxiety and related disorders. Twenty-three African American adults were diagnosed with social phobia leaving 42 diagnostic controls. Results suggest that the social anxiety factors were highly predictive of a social phobia diagnosis (AUC=.84 to .90; CI .73-.98, p<.01) and sensitivity and specificity rates revealed optimal cutoff scores for each measure. The optimal cutoff scores reveal the clinical utility of the social fear factor from these measures in screening for social phobia in African Americans. Future direction and implications are discussed. Psychinfo, PubMed, Medline. © 2015 National Medical Association. Published by Elsevier Inc. All rights reserved.

Attention checklist: a rating scale for mildly mentally handicapped adolescents.

PubMed

Das, J P; Melnyk, L

1989-06-01

A check list for attentional deficits without reference to hyperactive behavior observed in the classroom was constructed, and teachers' ratings were factor analyzed. The check-list rating was compared to a widely used rating scale for attention deficit-hyperactive disorder (AD-HD), the Abbreviated Conners Rating Scale. Both scales were given to 15 teachers to rate 100 mildly mentally handicapped adolescent students. Analysis showed that 33% of the mentally handicapped students were rated above 1.5 on the Conners Scale, which is the cut-off for hyperactivity. This is much higher than the prevalence of hyperactivity in regular classrooms. The two sets of ratings correlated strongly (.84). Check-list items were grouped under one factor explaining 70.7% of variance and so are recommended for use in discriminating attentional deficit in mentally handicapped as well as in regular class students. The high correlation with ratings on the Conners Scale suggests that AD-HD is a unitary syndrome with attention being most problematic for children labeled hyperactive.

Italian version of the organic brain syndrome and the depression scales from the CARE: evaluation of their performance in geriatric institutions.

PubMed

Spagnoli, A; Foresti, G; MacDonald, A; Williams, P

1987-05-01

The Organic Brain Syndrome (OBS) and the Depression (D) scales derived from the Comprehensive Assessment and Referral Evaluation (CARE) were translated into Italian and used in a survey of geriatric institutions in Milan. During the survey validity and reliability tests of the scales were conducted. Inter-rater reliability (total score weighted kappa) was highly satisfactory for both scales (0.96 for OBS and 0.83 for D scale). Reliability was assessed three times during the survey and showed good stability for both scales, with a slight but significant trend towards reduction over time for the D scale. Reliability of the D scale was significantly lower when the subjects interviewed scored highly on the OBS scale (severe cognitive impairment). Criterion validity was highly satisfactory both for the OBS scale (cut-off point 4/5: sensitivity 77%, specificity 96%, positive predictive value 91%) and the D scale (cut-off point 10/11: sensitivity 95%, specificity 92%, positive predictive value 84%). Results are discussed with special reference to longitudinal assessment of reliability, the choice of the cut-off point, and the context-dependent properties of questionnaires.

Alexithymia in the German general population.

PubMed

Franz, Matthias; Popp, Kerstin; Schaefer, Ralf; Sitte, Wolfgang; Schneider, Christine; Hardt, Jochen; Decker, Oliver; Braehler, Elmar

2008-01-01

The Toronto-Alexithymia-Scale (TAS-20) is used worldwide as a valid measurement of alexithymia. Until now, population-based standardization and cut-off values of the German TAS-20 version have not been available. This study provides these by means of a representative German sample and by investigating the factorial structure of the TAS-20. Data were generated from a representative random sample of the German general population (1,859 subjects aged between 20 and 69). The TAS-20 sum score was normally distributed. The mean value was 49.5 (SD=9.3) in men and 48.2 (SD=9.2) in women. Divorce, single and low social status were associated with enhanced sum scores. Ten percent of the population exceeded the TAS-20 sum score threshold of >or=61. The 66th percentile reached 53 for men and 52 for women. Factor analysis identified three factors that match the scales of the English original version. An additional fourth factor ("importance of emotional introspection") was extracted. Total explanation of variance by these four factors was 52.27%. The sum score of the German TAS-20 version is suited for the standardized measure of alexithymia. For selecting alexithymic individuals in experimental studies, the cut-off >or=61 is possibly too restrictive. Therefore, we propose the 66th percentile for the identification of high alexithymics. The TAS-20 sum score is associated with important socio-demographic variables. The factorial structure is reliable; the fourth factor ("importance of emotional introspection") provides differentiation of content and allows for enhanced explanation of variance.

Determining the cut-off point of osteoporosis based on the osteoporosis self-assessment tool, body mass index and weight in Taiwanese young adult women.

PubMed

Chang, Shu Fang; Yang, Rong Sen

2014-09-01

To examine the cut-off point of the osteoporosis self-assessment tool, age, weight and body mass index for osteoporosis among young adult Taiwanese women, using a large-scale health examination database containing bone mineral density tests. The cut-off points of osteoporosis risk factors identified earlier focus on menopausal or senior Caucasian and Asian women. However, young adult Asian women have seldom been identified. A retrospective historical cohort study. Using the 2009-2011 health examination database of a large-scale medical centre in northern Taiwan, this study investigated young adult Asian women (i.e. range in age from 30-49 years) in Taiwan who had received dual-energy X-ray absorptiometry test. This study also explored the cut-off point, sensitivity, specificity and diagnostic accuracy of receiver operating characteristics of osteoporosis among young adult females in Taiwan. This study collected 2454 young adult Asian women in Taiwan. Cochran-Armitage analysis results indicated that the prevalence of osteoporosis increased with decreasing weight, body mass index and osteoporosis self-assessment method quartiles. According to the results of receiver operating characteristics, weight, body mass index and osteoporosis self-assessment tool approaches can generally be used as indicators to predict osteoporosis among young adult Asian women. Results of this study demonstrate that Taiwanese women contracting osteoporosis tend to be young and underweight, as well as having a low body mass index and osteoporosis self-assessment scores. Those results further suggest that the assessment indicators for cut-off points are appropriately suitable for young adult women in Taiwan. Early detection is the only available means of preventing osteoporosis. Professional nurses should apply convenient and accurate assessment procedures to help young adult women to adopt preventive strategies against osteoporosis early, thus eliminating the probability of osteoporotic fracture. © 2013 John Wiley & Sons Ltd.

A psychometric investigation of the hypersexual disorder screening inventory among highly sexually active gay and bisexual men: an item response theory analysis.

PubMed

Parsons, Jeffrey T; Rendina, H Jonathon; Ventuneac, Ana; Cook, Karon F; Grov, Christian; Mustanski, Brian

2013-12-01

The Hypersexual Disorder Screening Inventory (HDSI) was designed as an instrument for the screening of hypersexuality by the American Psychiatric Association's taskforce for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. Our study sought to conduct a psychometric analysis of the HDSI, including an investigation of its underlying structure and reliability utilizing item response theory (IRT) modeling, and an examination of its polythetic scoring criteria in comparison to a standard dimensionally based cutoff score. We examined a diverse group of 202 highly sexually active gay and bisexual men in New York City. We conducted psychometric analyses of the HDSI, including both confirmatory factor analysis of its structure and IRT analysis of the item and scale reliabilities. We utilized the HDSI. The HDSI adequately fit a single-factor solution, although there was evidence that two of the items may measure a second factor that taps into sex as a form of coping. The scale showed evidence of strong reliability across much of the continuum of hypersexuality, and results suggested that, in addition to the proposed polythetic scoring criteria, a cutoff score of 20 on the severity index might be used for preliminary classification of HD. The HDSI was found to be highly reliable, and results suggested that a unidimensional, quantitative conception of hypersexuality with a clinically relevant cutoff score may be more appropriate than a qualitative syndrome comprised of multiple distinct clusters of problems. However, we also found preliminary evidence that three clusters of symptoms may constitute an HD syndrome as opposed to the two clusters initially proposed. Future research is needed to determine which of these issues are characteristic of the hypersexuality and HD constructs themselves and which are more likely to be methodological artifacts of the HDSI. © 2013 International Society for Sexual Medicine.

Improving discrimination in antepartum depression screening using the Edinburgh Postnatal Depression Scale.

PubMed

Venkatesh, Kartik K; Kaimal, Anjali J; Castro, Victor M; Perlis, Roy H

2017-05-01

Universal screening of pregnant women for postpartum depression has recently been recommended; however, optimal application of depression screening tools in stratifying risk has not been defined. The current study examines new approaches to improve the ability of the Edinburgh Postnatal Depression Scale (EPDS) to stratify risk for postpartum depression, including alternate cut points, use of a continuous measure, and incorporation of other putative risk factors. An observational cohort study of 4939 women screened both antepartum and postpartum with a negative EPDS screen antepartum(i.e. EPDS<10). The primary outcome was a probable postpartum major depressive episode(EPDS cut-off ≥10). Area under the receiver operating characteristics curve(AUC), sensitivity, specificity, and predictive values were calculated. 287 women(5.8%) screened positive for postpartum depression. An antepartum EPDS cut-off<5 optimally identified women with a low risk of postpartum depression with a negative predictive value of 97.6%; however, overall discrimination was modest(AUC 0.66, 95%CI: 0.64-0.69); sensitivity was 78.7%, and specificity was 53.8%, and the positive predictive value was low at 9.5%. The negative predictive values were similar(>95%) at all antepartum EPDS cut-off values from 4 to 8. Discrimination was improved(AUC ranging from 0.70 to 0.73) when the antepartum EPDS was combined with a prior history of major depressive disorder before pregnancy. An inability to assess EPDS subscales and a relatively low prevalence of depression in this cohort. Though an antepartum EPDS cut-off score <5 yielded the greatest discrimination identifying women at low risk for postpartum depression, the negative predictive value was insufficient to substitute for postpartum screening. Copyright © 2017. Published by Elsevier B.V.

[A Screening-Tool for Three Dimensions of Work-Related Behavior and Experience Patterns in the Psychosomatic Rehabilitation - A Proposal for a Short-Form of the Occupational Stress and Coping Inventory (AVEM-3D)].

PubMed

Beierlein, V; Köllner, V; Neu, R; Schulz, H

2016-12-01

Objectives: The assessment of work pressures is of particular importance in psychosomatic rehabilitation. An established questionnaire is the Occupational Stress and Coping Inventory (German abbr. AVEM), but it is quite long and with regard to scoring time-consuming in routine clinical care. It should therefore be tested, whether a shortened version of the AVEM can be developed, which is able to assess the formerly described three second-order factors of the AVEM, namely Working Commitment, Resilience, and Emotions, sufficiently reliable and valid, and which also may be used for screening of patients with prominent work-related behavior and experience patterns. Methods: Data were collected at admission from consecutive samples of three hospitals of psychosomatic rehabilitation ( N  = 10,635 patients). The sample was randomly divided in two subsamples (design and validation sample). Using exploratory principal component analyses in the design sample, items with the highest factor loadings for the three new scales were selected and evaluated psychometrically using the validation sample. Possible Cut-off values ought to be derived from distribution patterns of scores in the scales. Relationships with sociodemographic, occupational and diagnosis-related characteristics, as well as with patterns of work-related experiences and behaviors are examined. Results: The three performed principal component analyses explained in the design sample on the respective first factor between 31 % and 34 % of the variance. The selected 20 items were assigned to the 3-factor structure in the validation sample as expected. The three new scales are sufficiently reliable with values of Cronbach's α between 0,84 and 0,88. The naming of the three new scales is based on the names of the secondary factors. Cut-off values for the identification of distinctive patient-reported data are proposed. Conclusion: Main advantages of the proposed shortened version AVEM-3D are that with a considerable smaller number of items the three main dimensions of relevant work-related behavior and experience patterns can be reliably measured. The proposed measure is simple and economic to use and interpret. Based on the present sample we provide means and standard deviations as reference at admission of psychosomatic rehabilitation. As a limitation it should be mentioned that further evaluation of reliability, validity and sensitivity to change restricted to the items of the shortened version is necessary. The practicability and validity of the proposed cut-off values cannot yet be conclusively assessed. Finally, the validity of the AVEM-3D in groups of indications other than psychosomatic patients and in healthy persons remains to be examined. © Georg Thieme Verlag KG Stuttgart · New York.

Amount of balance necessary for the independence of transfer and stair-climbing in stroke inpatients.

PubMed

Fujita, Takaaki; Sato, Atsushi; Ohashi, Yuji; Nishiyama, Kazutaka; Ohashi, Takuro; Yamane, Kazuhiro; Yamamoto, Yuichi; Tsuchiya, Kenji; Otsuki, Koji; Tozato, Fusae

2018-05-01

The purpose of this study was to clarify the amount of balance necessary for the independence of transfer and stair-climbing in stroke patients. This study included 111 stroke inpatients. Simple and multiple regression analyses were conducted to establish the association between the FIM ® instrument scores for transfer or stair-climbing and Berg Balance Scale. Furthermore, receiver operating characteristic curves were used to elucidate the amount of balance necessary for the independence of transfer and stair-climbing. Simple and multiple regression analyses showed that the FIM ® instrument scores for transfer and stair-climbing were strongly associated with Berg Balance Scale. On comparison of the independent and supervision-dependent groups, Berg Balance Scale cut-off values for transfer and stair-climbing were 41/40 and 54/53 points, respectively. On comparison of the independent-supervision and dependent groups, the cut-off values for transfer and stair-climbing were 30/29 and 41/40 points, respectively. The calculated cut-off values indicated the amount of balance necessary for the independence of transfer and stair-climbing, with and without supervision, in stroke patients. Berg Balance Scale has a good discriminatory ability and cut-off values are clinically useful to determine the appropriate independence levels of transfer and stair-climbing in hospital wards. Implications for rehabilitation The Berg Balance Scale's (BBS) strong association with transfer and stair-climbing independence and performance indicates that establishing cut-off values is vitally important for the established use of the BBS clinically. The cut-off values calculated herein accurately demonstrate the level of balance necessary for transfer and stair-climbing independence, with and without supervision, in stroke patients. These criteria should be employed clinically for determining the level of independence for transfer and stair-climbing as well as for setting balance training goals aimed at improving transfer and stair-climbing.

Comparative Performance of Patient Health Questionnaire-9 and Edinburgh Postnatal Depression Scale for Screening Antepartum Depression

PubMed Central

Zhong, Qiuyue; Gelaye, Bizu; Rondon, Marta; Sánchez, Sixto E; García, Pedro J; Sánchez, Elena; Barrios, Yasmin V; Simon, Gregory E.; Henderson, David C.; Cripe, Swee May; Williams, Michelle A

2014-01-01

Objective We sought to evaluate the psychometric properties of two widely used screening scales: the Patient Health Questionnaire (PHQ-9) and Edinburgh Postnatal Depression Scale (EPDS) among pregnant Peruvian women. Methods This cross-sectional study included 1,517 women receiving prenatal care from February 2012 to March 2013. A structured interview was used to collect data using PHQ-9 and EPDS. We examined reliability, construct and concurrent validity between two scales using internal consistency indices, factor structures, correlations, and Cohen’s kappa. Results Both scales had good internal consistency (Cronbach’s alpha > 0.8). Correlation between PHQ-9 and EPDS scores was fair (rho=0.52). Based on exploratory factor analysis (EFA), both scales yielded a two-factor structure. EFA including all items from PHQ-9 and EPDS yielded four factors, namely, “somatization”, “depression and suicidal ideation”, “anxiety and depression”, and “anhedonia”. The agreement between the two scales was generally fair at different cutoff scores with the highest Cohen’s kappa being 0.46. Conclusions Both the PHQ-9 and EPDS are reliable and valid scales for antepartum depression assessment. The PHQ-9 captures somatic symptoms, while EPDS detects depressive symptoms comorbid with anxiety during early pregnancy. Our findings suggest simultaneous administration of both scales may improve identification of antepartum depressive disorders in clinical settings. PMID:24766996

Comparative performance of Patient Health Questionnaire-9 and Edinburgh Postnatal Depression Scale for screening antepartum depression.

PubMed

Zhong, Qiuyue; Gelaye, Bizu; Rondon, Marta; Sánchez, Sixto E; García, Pedro J; Sánchez, Elena; Barrios, Yasmin V; Simon, Gregory E; Henderson, David C; Cripe, Swee May; Williams, Michelle A

2014-06-01

We sought to evaluate the psychometric properties of two widely used screening scales: the Patient Health Questionnaire (PHQ-9) and Edinburgh Postnatal Depression Scale (EPDS) among pregnant Peruvian women. This cross-sectional study included 1517 women receiving prenatal care from February 2012 to March 2013. A structured interview was used to collect data using PHQ-9 and EPDS. We examined reliability, construct and concurrent validity between two scales using internal consistency indices, factor structures, correlations, and Cohen׳s kappa. Both scales had good internal consistency (Cronbach׳s alpha>0.8). Correlation between PHQ-9 and EPDS scores was fair (rho=0.52). Based on exploratory factor analysis (EFA), both scales yielded a two-factor structure. EFA including all items from PHQ-9 and EPDS yielded four factors, namely, "somatization", "depression and suicidal ideation", "anxiety and depression", and "anhedonia". The agreement between the two scales was generally fair at different cutoff scores with the highest Cohen׳s kappa being 0.46. Both the PHQ-9 and EPDS are reliable and valid scales for antepartum depression assessment. The PHQ-9 captures somatic symptoms, while EPDS detects depressive symptoms comorbid with anxiety during early pregnancy. Our findings suggest simultaneous administration of both scales may improve identification of antepartum depressive disorders in clinical settings. Copyright © 2014 Elsevier B.V. All rights reserved.

The life of a meander bend: Connecting shape and dynamics via analysis of a numerical model

NASA Astrophysics Data System (ADS)

Schwenk, Jon; Lanzoni, Stefano; Foufoula-Georgiou, Efi

2015-04-01

Analysis of bend-scale meandering river dynamics is a problem of theoretical and practical interest. This work introduces a method for extracting and analyzing the history of individual meander bends from inception until cutoff (called "atoms") by tracking backward through time the set of two cutoff nodes in numerical meander migration models. Application of this method to a simplified yet physically based model provides access to previously unavailable bend-scale meander dynamics over long times and at high temporal resolutions. We find that before cutoffs, the intrinsic model dynamics invariably simulate a prototypical cutoff atom shape we dub simple. Once perturbations from cutoffs occur, two other archetypal cutoff planform shapes emerge called long and round that are distinguished by a stretching along their long and perpendicular axes, respectively. Three measures of meander migration—growth rate, average migration rate, and centroid migration rate—are introduced to capture the dynamic lives of individual bends and reveal that similar cutoff atom geometries share similar dynamic histories. Specifically, through the lens of the three shape types, simples are seen to have the highest growth and average migration rates, followed by rounds, and finally longs. Using the maximum average migration rate as a metric describing an atom's dynamic past, we show a strong connection between it and two metrics of cutoff geometry. This result suggests both that early formative dynamics may be inferred from static cutoff planforms and that there exists a critical period early in a meander bend's life when its dynamic trajectory is most sensitive to cutoff perturbations. An example of how these results could be applied to Mississippi River oxbow lakes with unknown historic dynamics is shown. The results characterize the underlying model and provide a framework for comparisons against more complex models and observed dynamics.

At-risk and intervention thresholds of occupational stress using a visual analogue scale

PubMed Central

Pereira, Bruno; Moustafa, Farès; Naughton, Geraldine; Lesage, François-Xavier; Lambert, Céline

2017-01-01

Background The visual analogue scale (VAS) is widely used in clinical practice by occupational physicians to assess perceived stress in workers. However, a single cut-off (black-or-white decision) inadequately discriminates between workers with and without stress. We explored an innovative statistical approach to distinguish an at-risk population among stressed workers, and to establish a threshold over which an action is urgently required, via the use of two cut-offs. Methods Participants were recruited during annual work medical examinations by a random sample of workers from five occupational health centres. We previously proposed a single cut-off of VAS stress in comparison with the Perceived Stress Scale (PSS14). Similar methodology was used in the current study, along with a gray zone approach. The lower limit of the gray zone supports sensitivity (“at-risk” threshold; interpreted as requiring closer surveillance) and the upper limit supports specificity (i.e. “intervention” threshold–emergency action required). Results We included 500 workers (49.6% males), aged 40±11 years, with a PSS14 score of 3.8±1.4 and a VAS score of 4.0±2.4. Using a receiver operating characteristic curve and the PSS cut-off score of 7.2, the optimal VAS threshold was 6.8 (sensitivity = 0.89, specificity = 0.87). The lower and upper thresholds of the gray zone were 5 and 8.2, respectively. Conclusions We identified two clinically relevant cut-offs on the VAS of stress: a first cut-off of 5.0 for an at-risk population, and a second cut-off of 8.2 over which an action is urgently required. Future investigations into the relationships between this upper threshold and deleterious events are required. PMID:28586383

A Practical Guide to Assessing Adult Firesetters' Fire-Specific Treatment Needs Using the Four Factor Fire Scales.

PubMed

Ó Ciardha, Caoilte; Tyler, Nichola; Gannon, Theresa A

2015-01-01

Practitioners working with offenders who have set fires have access to very few measures examining fire-specific treatment needs (e.g., fire interest, fire attitudes). In this article we examine the new Four Factor Fire Scales (Ó Ciardha et al., 2015), which may be used by practitioners to examine fire-specific treatment needs for offenders who have set deliberate fires. We present a standardized scoring procedure when using these scales, as well as an associated scoring template for practitioner use. Norm data are based on male and female firesetters (n = 378) and nonfiresetters (n = 187) recruited from 19 prison establishments (including six female establishments, one young offender institution) and 12 secure mixed-gender mental health settings. We present a full overview of all data we have collected to date relating to the Four Factor Fire Scales across prison, mental health, and young offending participants. For each population, we present mean scores as well as associated cutoff scores and reliable change indices to aid practitioners in their interpretation of scores. The Four Factor Fire Scales provide professionals working in the area with a robust template for administering, scoring, and interpreting the fire-specific factors currently identified as playing a role in deliberate firesetting behavior. Strengths and limitations of the measure are discussed.

[An exploratory study on the diagnostic cutoff value of International HIV-associated Dementia Scale in minority ethnic groups with different educational levels, in Guangxi].

PubMed

Zhao, Ting-ting; Feng, Qi-ming; Liang, Hao; Tang, Xian-yan; Wei, Bo

2011-11-01

Using Intelligence Scale of Mini Mental State Estimated (MMSE) as the gold standard to determine the relevance of International HIV-associated Dementia Scale (IHDS) in minority ethnic areas in Guangxi populations with different cultural values. Corresponding boundary value related to the authenticity and reliability on IHDS were also evaluated. 200 patients with HIV infection were randomly selected from the minority ethnic groups in Guangxi. For each infected person, MMSE and IHDS blind scale were tested at the same period. Using the results from MMSE scale test as the gold standard, ROC curve and IHDS scale in Guangxi minority populations with different education levels which related to the diagnosis of dementia-HIV values were determined. The value of a specific sector under the IHDS sensitivity, specificity, and internal consistency coefficients was also evaluated. When considering the infected person did not differ on their educational level, the IHDS scale diagnostic cutoff appeared as 8.25, while IHDS sensitivity as 0.925, specificity as 0.731 and Kappa as 0.477 (P < 0.001). When considering the extent of cultural differences did influence the prevalence of infection, the different education groups showed different IHDS diagnostic cutoff values. People with high school, secondary school or higher education levels, the IHDS diagnosis appeared to be 8.25, when sensitivity was 0.917, specificity was 0.895 and Kappa was 0.722 (P < 0.001). People with only primary education level, the IHDS appeared to be 7.25. When sensitivity was 0.875, specificity was 0.661 and Kappa was 0.372 (P < 0.001). The IHDS diagnostic sector in Guangxi minority groups was lower than the internationally recommended level of diagnostic cutoff value (IHDS ≤ 10 points). When using IHDS to perform the HIV related dementia screening program, in the minority areas of Guangxi, culture context, the degree and difference of HIV infection should be considered, especially in using IHDS diagnostic cutoff values.

Use of the Childhood Autism Rating Scale (CARS) for Children with High Functioning Autism or Asperger Syndrome

ERIC Educational Resources Information Center

Mayes, Susan Dickerson; Calhoun, Susan L.; Murray, Michael J.; Morrow, Jill D.; Yurich, Kirsten K. L.; Cothren, Shiyoko; Purichia, Heather; Mahr, Fauzia; Bouder, James N.; Petersen, Christopher

2012-01-01

The authors of the "Childhood Autism Rating Scale" (CARS) state in the manual that the best cutoff score for distinguishing low functioning autism (LFA) from intellectual disability is 30 for children and 28 for adolescents and adults. This study determined that a cutoff score of 25.5 was most accurate in differentiating between high functioning…

The Italian version of the Inventory of Interpersonal Problems Personality Disorders Scales (IIP-47): psychometric properties and clinical usefulness as a screening measure.

PubMed

Ubbiali, Alessandro; Chiorri, Carlo; Donati, Deborah

2011-08-01

The Inventory of Interpersonal Problems-47 (IIP-47) is a brief and valid self-report measure for screening Personality Disorders (PDs). This study examined internal consistency, factor structure, criterion validity, temporal stability, and operating characteristics of the Italian version of the IIP-47 in two independent samples: PD subjects (n = 120) and nonclinical subjects (n = 475). Alpha coefficients ranged from .70 to .90. Multiple-Group Confirmatory Factor Analyses showed that the five-correlated-factor model reported in literature had the highest measurement invariance across the two groups. Criterion validity was supported by correlations among IIP-47 scale scores and scores on established measures of personality dimensions and pathology. Test-retest indices ranged from .71 to .95. PD subjects scored significantly higher than nonclinical subjects on all IIP-47 scales and cut-off scores for different levels of specificity and sensibility are reported. It is concluded that the psychometric properties of the original IIP-47 were preserved in its Italian version.

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

PubMed Central

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

2014-01-01

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

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

PubMed

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

2014-12-01

To investigate validity of widely recommended anthropometric and total fat percentage cut-off points in screening for cardiovascular risk factors in women of different ages. A population-based sample of 1002 Swedish women aged 38, 50, 75 (younger, middle-aged and elderly, respectively) underwent anthropometry, health examinations and blood tests. Total fat was estimated (bioimpedance) in 670 women. Sensitivity, specificity of body mass index (BMI; ≥25 and ≥30), waist circumference (WC; ≥80 cm and ≥88 cm) and total fat percentage (TF; ≥35%) cut-off points for cardiovascular risk factors (dyslipidaemias, hypertension and hyperglycaemia) were calculated for each age. Cut-off points yielding high sensitivity together with modest specificity were considered valid. Women reporting hospital admission for cardiovascular disease were excluded. The sensitivity of WC ≥80 cm for one or more risk factors was ~60% in younger and middle-aged women, and 80% in elderly women. The specificity of WC ≥80 cm for one or more risk factors was 69%, 57% and 40% at the three ages (p < .05 for age trends). WC ≥80 cm yielded ~80% sensitivity for two or more risk factors across all ages. However, specificity decreased with increasing age (p < .0001), being 33% in elderly. WC ≥88 cm provided better specificity in elderly women. BMI and TF % cut-off points were not better than WC. Validity of recommended anthropometric cut-off points in screening asymptomatic women varies with age. In younger and middle-age, WC ≥80 cm yielded high sensitivity and modest specificity for two or more risk factors, however, sensitivity for one or more risk factor was less than optimal. WC ≥88 cm showed better validity than WC ≥80 cm in elderly. Our results support age-specific screening cut-off points for women. © 2014 the Nordic Societies of Public Health.

Screening for anxiety and depression: reassessing the utility of the Zung scales.

PubMed

Dunstan, Debra A; Scott, Ned; Todd, Anna K

2017-09-08

While the gold standard for the diagnosis of mental disorders remains the structured clinical interview, self-report measures continue to play an important role in screening and measuring progress, as well as being frequently employed in research studies. Two widely-used self-report measures in the area of depression and anxiety are Zung's Self-Rating Depression Scale (SDS) and Self Rating Anxiety Scale (SAS). However, considerable confusion exists in their application, with clinical cut-offs often applied incorrectly. This study re-examines the credentials of the Zung scales by comparing them with the Depression Anxiety Stress Scale (DASS) in terms of their ability to predict clinical diagnoses of anxiety and depression made using the Patient Health Questionnaire (PHQ). A total sample of 376 adults, of whom 87 reported being in receipt of psychological treatment, completed the two-page version of the PHQ relating to depression and anxiety, together with the SDS, the SAS and the DASS. Overall, although the respective DASS scales emerged as marginally stronger predictors of PHQ diagnoses of anxiety and depression, the Zung indices performed more than acceptably in comparison. The DASS also had an advantage in discriminative ability. Using the current recommended cut-offs for all scales, the DASS has the edge on specificity, while the Zung scales are superior in terms of sensitivity. There are grounds to consider making the Zung cut-offs more conservative, and doing this would produce comparable numbers of 'Misses' and 'False Positives' to those obtained with the DASS. Given these promising results, further research is justified to assess the Zung scales ability against full clinical diagnoses and to further explore optimum cut-off levels.

Optimal waist circumference cut-off values for predicting cardiovascular risk factors in a multi-ethnic Malaysian population.

PubMed

Cheong, Kee C; Ghazali, Sumarni M; Hock, Lim K; Yusoff, Ahmad F; Selvarajah, Sharmini; Haniff, Jamaiyah; Zainuddin, Ahmad Ali; Ying, Chan Y; Lin, Khor G; Rahman, Jamalludin A; Shahar, Suzana; Mustafa, Amal N

2014-01-01

Previous studies have proposed the lower waist circumference (WC) cutoffs be used for defining abdominal obesity in Asian populations. To determine the optimal cut-offs of waist circumference (WC) in predicting cardiovascular (CV) risk factors in the multi-ethnic Malaysian population. We analysed data from 32,703 respondents (14,980 men and 17,723 women) aged 18 years and above who participated in the Third National Health and Morbidity Survey in 2006. Gender-specific logistic regression analyses were used to examine associations between WC and three CV risk factors (diabetes mellitus, hypertension, and hypercholesterolemia). The Receiver Operating Characteristic (ROC) curves were used to determine the cut-off values of WC with optimum sensitivity and specificity for detecting these CV risk factors. The odds ratio for having diabetes mellitus, hypertension, and hypercholesterolemia, or at least one of these risks, increased significantly as the WC cut-off point increased. Optimal WC cut-off values for predicting the presence of diabetes mellitus, hypertension, hypercholesterolemia and at least one of the three CV risk factors varied from 81.4 to 85.5 cm for men and 79.8 to 80.7 cm for women. Our findings indicate that WC cut-offs of 81 cm for men and 80 cm for women are appropriate for defining abdominal obesity and for recommendation to undergo cardiovascular risk screening and weight management in the Malaysian adult population. © 2014 Asian Oceanian Association for the Study of Obesity . Published by Elsevier Ltd. All rights reserved.

Validation of the Internet Gaming Disorder Scale - Short-Form (IGDS9-SF) in an Italian-speaking sample.

PubMed

Monacis, Lucia; Palo, Valeria de; Griffiths, Mark D; Sinatra, Maria

2016-12-01

Background and aims The inclusion of Internet Gaming Disorder (IGD) in Section III of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders has increased the interest of researchers in the development of new standardized psychometric tools for the assessment of such a disorder. To date, the nine-item Internet Gaming Disorder Scale - Short-Form (IGDS9-SF) has only been validated in English, Portuguese, and Slovenian languages. Therefore, the aim of this investigation was to examine the psychometric properties of the IGDS9-SF in an Italian-speaking sample. Methods A total of 757 participants were recruited to the present study. Confirmatory factor analysis and multi-group analyses were applied to assess the construct validity. Reliability analyses comprised the average variance extracted, the standard error of measurement, and the factor determinacy coefficient. Convergent and criterion validities were established through the associations with other related constructs. The receiver operating characteristic curve analysis was used to determine an empirical cut-off point. Results Findings confirmed the single-factor structure of the instrument, its measurement invariance at the configural level, and the convergent and criterion validities. Satisfactory levels of reliability and a cut-off point of 21 were obtained. Discussion and conclusions The present study provides validity evidence for the use of the Italian version of the IGDS9-SF and may foster research into gaming addiction in the Italian context.

Validation of the Internet Gaming Disorder Scale – Short-Form (IGDS9-SF) in an Italian-speaking sample

PubMed Central

Monacis, Lucia; de Palo, Valeria; Griffiths, Mark D.; Sinatra, Maria

2016-01-01

Background and aims The inclusion of Internet Gaming Disorder (IGD) in Section III of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders has increased the interest of researchers in the development of new standardized psychometric tools for the assessment of such a disorder. To date, the nine-item Internet Gaming Disorder Scale – Short-Form (IGDS9-SF) has only been validated in English, Portuguese, and Slovenian languages. Therefore, the aim of this investigation was to examine the psychometric properties of the IGDS9-SF in an Italian-speaking sample. Methods A total of 757 participants were recruited to the present study. Confirmatory factor analysis and multi-group analyses were applied to assess the construct validity. Reliability analyses comprised the average variance extracted, the standard error of measurement, and the factor determinacy coefficient. Convergent and criterion validities were established through the associations with other related constructs. The receiver operating characteristic curve analysis was used to determine an empirical cut-off point. Results Findings confirmed the single-factor structure of the instrument, its measurement invariance at the configural level, and the convergent and criterion validities. Satisfactory levels of reliability and a cut-off point of 21 were obtained. Discussion and conclusions The present study provides validity evidence for the use of the Italian version of the IGDS9-SF and may foster research into gaming addiction in the Italian context. PMID:27876422

Factor structure and factorial invariance of the State-Trait Anxiety Inventory for Chinese children and adolescents.

PubMed

Cao, Yang; Liu, Zhengkui

2015-06-01

As previous research utilizing Spielberger's State-Trait Anxiety Inventory (Form Y; STAI-Y) has mostly involved adults or clinical groups, there have been relatively few reports assessing adolescents. This study is the first using data for children and adolescents in mainland China, from a large-scale cross-sectional survey in Beijing (Sample 1) and a longitudinal survey from the Wenchuan 512 earthquake (Sample 2), to clarify the factor structure and factorial invariance of the STAI-Y, Mandarin Chinese version. As a result, only in Sample 1 did a comparison of 11 confirmatory factor analysis models indicate the best goodness-of-fit indices shown by a two-factor structure for both state and trait anxiety, with both models reaching the selected cutoff criteria. These two optimal models were used in a subsequent simultaneous confirmatory factor analysis to test four conditions of factorial invariance, using eight participant groups divided on the basis of sex and school grade (fourth, fifth, sixth, and seventh to ninth). The two-factor structure state and trait anxiety models achieved the cutoff criteria for factorial invariance, with the exception of male fourth graders. Further, it was clearly shown that in comparison with the early stage of puberty, as puberty advanced the absence of state and trait anxiety gradually decreased, while scores for the presence of anxiety gradually increased. At the same time, in the case of Sample 2, which had experienced a traumatic event, as the goodness-of-fit indices for none of the 11 models reached the cutoff criteria, the factor scores showed arbitrariness and a lack of objectivity. The authors conclude that cognitive structure with regard to the STAI-Y may change with traumatic experience or the development of secondary sex characteristics at the onset of or in the stage of puberty. Also, computing the scores according to the STAI-Y manual is problematic. © 2014 The Institute of Psychology, Chinese Academy of Sciences and Wiley Publishing Asia Pty Ltd.

Berg Balance Scale score at admission can predict walking suitable for community ambulation at discharge from inpatient stroke rehabilitation.

PubMed

Louie, Dennis R; Eng, Janice J

2018-01-10

This retrospective cohort study identified inpatient rehabilitation admission variables that predict walking ability at discharge and established Berg Balance Scale cut-off scores to predict the extent of improvement in walking. Participants (n=123) were assessed for various cognitive and physical outcomes at admission to inpatient stroke rehabilitation. Multivariate logistic regression identified admission predictors of regaining community ambulation (gait speed ≥0.8 m/s) or unassisted ambulation (no physical assistance) after 4 weeks. Receiver operating characteristic curve analysis identified cut-off admission Berg Balance Scale scores. Mini-Mental State Examination (odds ratio (OR) 1.60, 95% confidence interval (95% CI) 1.19-2.14) was a significant predictor when coupled with admission walking speed for regaining community ambulation speed; stroke type (haemorrhagic/ischaemic) was a significant predictor (OR=0.19, 95% CI 0.05-0.77) when coupled with Berg Balance Scale (OR 1.14, 95% CI 1.09-1.20). Only Berg Balance Scale was a significant predictor of regaining unassisted ambulation (OR 1.11, 95% CI 1.05-1.17). A cut-off Berg Balance Scale score of 29 on admission predicts that an individual will go on to achieve community walking speed (n=123, area under the curve (AUC)=0.88, 95% CI 0.81-0.95); a cut-off score of 12 predicts a non-ambulator to regain unassisted ambulation (n=84, AUC 0.73, 95% CI 0.62-0.84). The Berg Balance Scale can be used at rehabilitation admission to predict the degree of improvement in walking for patients with stroke.

Morphodynamic Responses of a River-Floodplain System to a Chute Cutoff: Numerical Experiments to Investigate the Role of Multiple Active Factors

NASA Astrophysics Data System (ADS)

Li, Z.; Garcia, M. H.

2017-12-01

Unlike neck cutoffs, which are caused by meander migration to an over-mature stage, a chute cutoff is governed by many more factors. A chute cutoff always occurs when there is over-bank flow caused by floods. During this process, the river-floodplain system characteristics will determine the newly formed cutoff channel location and extent. Hence, a comprehensive study of the influence which different active factors have on a cutoff channel is necessary. Numerical experiments are well suited in this case because of the possibility of studying a large number of scenarios and also the practical and econocmical challenges of collecting high quality data during floods in the field. Numerical simulations were performed using the open TELEMAC-MASCARET modeling suite, which can solve the two-dimensional Shallow Water Equations, the three-dimensional, Reynolds-averaged Navier-Stokes equations (RANS). It can also be coupled with sediment transport equations. It is implemented on unstructured meshes using the Finite Element Method (FEM). The modeling results show the great detail the morphodynamic response attributed to each active factor (flow magnitude, sediment erosive properties, channel sinuosity, etc.), as well as paving the way and showing how to use the dimensionless relations obtained with the numerical experiments.

Evaluation of APRI and FIB-4 for noninvasive assessment of significant fibrosis and cirrhosis in HBeAg-negative CHB patients with ALT ≤ 2 ULN

PubMed Central

Li, Qiang; Ren, Xiaojing; Lu, Chuan; Li, Weixia; Huang, Yuxian; Chen, Liang

2017-01-01

Abstract To evaluate the performance of aspartate transaminase-to-platelet ratio index (APRI) and fibrosis index based on four factors (FIB-4) to predict significant fibrosis and cirrhosis in hepatitis B virus e antigen (HBeAg)-negative chronic hepatitis B (CHB) patients with alanine transaminase (ALT) ≤ twice the upper limit of normal (2 ULN). Histologic and laboratory data of 236 HBeAg-negative CHB patients with ALT ≤ 2 ULN were analyzed. Predicted fibrosis stage, based on established scales and cut-offs for APRI and FIB-4, was compared with METAVIR scores obtained from liver biopsy. In this study, the areas under the receiver operating characteristic curves (AUROCs) of APRI were lower than that of FIB-4 (0.62 vs 0.69; P = 0.019) for diagnosing significant fibrosis; however APRI and FIB-4 were comparable for diagnosing cirrhosis (0.77 vs 0.81; P = 0.374). When the cut-off proposed by WHO HBV guideline for APRI (>2.0) was used, no cirrhotic patients were correctly predicted. For FIB-4, the WHO proposed cut-off of 3.25 correctly identified significant fibrosis 83% of the time; but for APRI, the WHO proposed cut-off of 1.5 identified significant fibrosis 56%. In ruling out significant fibrosis, the WHO proposed APRI cut-off of 0.5 had a predictive value of 39%, and the FIB-4 cut-off of 1.45 correctly identified lack of significant fibrosis in 47% of the patients. In this study, based on ROC analysis, the optimal cut-offs were 0.46 and 0.65 for APRI, and 1.05 and 1.29 for FIB-4, for diagnosing significant fibrosis and cirrhosis, respectively. When the new cut-off of APRI (>0.65) was used, 82% of the cirrhotic patients were correctly predicted. In ruling out significant fibrosis, the new APRI cut-off (<0.46) had a predictive value of 80%, and new FIB-4 cut-off (<1.05) correctly identified lack of significant fibrosis in 84% of the patients. The WHO guidelines proposed cut-offs might be higher for HBeAg-negative CHB patients with ALT ≤2 ULN, and might underestimate the proportion of significant fibrosis and cirrhosis. A new set of cut-offs should be used to predict significant fibrosis and cirrhosis in this specific population. PMID:28328813

Evaluation of APRI and FIB-4 for noninvasive assessment of significant fibrosis and cirrhosis in HBeAg-negative CHB patients with ALT ≤ 2 ULN: A retrospective cohort study.

PubMed

Li, Qiang; Ren, Xiaojing; Lu, Chuan; Li, Weixia; Huang, Yuxian; Chen, Liang

2017-03-01

To evaluate the performance of aspartate transaminase-to-platelet ratio index (APRI) and fibrosis index based on four factors (FIB-4) to predict significant fibrosis and cirrhosis in hepatitis B virus e antigen (HBeAg)-negative chronic hepatitis B (CHB) patients with alanine transaminase (ALT) ≤ twice the upper limit of normal (2 ULN).Histologic and laboratory data of 236 HBeAg-negative CHB patients with ALT ≤ 2 ULN were analyzed. Predicted fibrosis stage, based on established scales and cut-offs for APRI and FIB-4, was compared with METAVIR scores obtained from liver biopsy.In this study, the areas under the receiver operating characteristic curves (AUROCs) of APRI were lower than that of FIB-4 (0.62 vs 0.69; P = 0.019) for diagnosing significant fibrosis; however APRI and FIB-4 were comparable for diagnosing cirrhosis (0.77 vs 0.81; P = 0.374). When the cut-off proposed by WHO HBV guideline for APRI (>2.0) was used, no cirrhotic patients were correctly predicted. For FIB-4, the WHO proposed cut-off of 3.25 correctly identified significant fibrosis 83% of the time; but for APRI, the WHO proposed cut-off of 1.5 identified significant fibrosis 56%. In ruling out significant fibrosis, the WHO proposed APRI cut-off of 0.5 had a predictive value of 39%, and the FIB-4 cut-off of 1.45 correctly identified lack of significant fibrosis in 47% of the patients. In this study, based on ROC analysis, the optimal cut-offs were 0.46 and 0.65 for APRI, and 1.05 and 1.29 for FIB-4, for diagnosing significant fibrosis and cirrhosis, respectively. When the new cut-off of APRI (>0.65) was used, 82% of the cirrhotic patients were correctly predicted. In ruling out significant fibrosis, the new APRI cut-off (<0.46) had a predictive value of 80%, and new FIB-4 cut-off (<1.05) correctly identified lack of significant fibrosis in 84% of the patients.The WHO guidelines proposed cut-offs might be higher for HBeAg-negative CHB patients with ALT ≤2 ULN, and might underestimate the proportion of significant fibrosis and cirrhosis. A new set of cut-offs should be used to predict significant fibrosis and cirrhosis in this specific population.

Derivation and Cross-Validation of Cutoff Scores for Patients With Schizophrenia Spectrum Disorders on WAIS-IV Digit Span-Based Performance Validity Measures.

PubMed

Glassmire, David M; Toofanian Ross, Parnian; Kinney, Dominique I; Nitch, Stephen R

2016-06-01

Two studies were conducted to identify and cross-validate cutoff scores on the Wechsler Adult Intelligence Scale-Fourth Edition Digit Span-based embedded performance validity (PV) measures for individuals with schizophrenia spectrum disorders. In Study 1, normative scores were identified on Digit Span-embedded PV measures among a sample of patients (n = 84) with schizophrenia spectrum diagnoses who had no known incentive to perform poorly and who put forth valid effort on external PV tests. Previously identified cutoff scores resulted in unacceptable false positive rates and lower cutoff scores were adopted to maintain specificity levels ≥90%. In Study 2, the revised cutoff scores were cross-validated within a sample of schizophrenia spectrum patients (n = 96) committed as incompetent to stand trial. Performance on Digit Span PV measures was significantly related to Full Scale IQ in both studies, indicating the need to consider the intellectual functioning of examinees with psychotic spectrum disorders when interpreting scores on Digit Span PV measures. © The Author(s) 2015.

Factors predictive of obstructive sleep apnea in patients undergoing pre-operative evaluation for bariatric surgery and referred to a sleep laboratory for polysomnography

PubMed Central

Duarte, Ricardo Luiz de Menezes; Magalhães-da-Silveira, Flavio José

2015-01-01

Objective: To identify the main predictive factors for obtaining a diagnosis of obstructive sleep apnea (OSA) in patients awaiting bariatric surgery. Methods: Retrospective study of consecutive patients undergoing pre-operative evaluation for bariatric surgery and referred for in-laboratory polysomnography. Eight variables were evaluated: sex, age, neck circumference (NC), BMI, Epworth Sleepiness Scale (ESS) score, snoring, observed apnea, and hypertension. We employed ROC curve analysis to determine the best cut-off value for each variable and multiple linear regression to identify independent predictors of OSA severity. Results: We evaluated 1,089 patients, of whom 781 (71.7%) were female. The overall prevalence of OSA-defined as an apnea/hypopnea index (AHI) ≥ 5.0 events/h-was 74.8%. The best cut-off values for NC, BMI, age, and ESS score were 42 cm, 42 kg/m2, 37 years, and 10 points, respectively. All eight variables were found to be independent predictors of a diagnosis of OSA in general, and all but one were found to be independent predictors of a diagnosis of moderate/severe OSA (AHI ≥ 15.0 events/h), the exception being hypertension. We devised a 6-item model, designated the NO-OSAS model (NC, Obesity, Observed apnea, Snoring, Age, and Sex), with a cut-off value of ≥ 3 for identifying high-risk patients. For a diagnosis of moderate/severe OSA, the model showed 70.8% accuracy, 82.8% sensitivity, and 57.9% specificity. Conclusions: In our sample of patients awaiting bariatric surgery, there was a high prevalence of OSA. At a cut-off value of ≥ 3, the proposed 6-item model showed good accuracy for a diagnosis of moderate/severe OSA. PMID:26578136

Early Childhood Adversity and its Associations With Anxiety, Depression, and Distress in Women With Breast Cancer.

PubMed

McFarland, Daniel C; Andreotti, Charissa; Harris, Kirk; Mandeli, John; Tiersten, Amy; Holland, Jimmie

2016-01-01

Certain vulnerability factors have been found to place patients at risk for depression and anxiety, especially within the context of medical illness. We sought to describe the relationships among early childhood adversity (ECA) and anxiety, depression and distress in patients with breast cancer. Patients with breast cancer (stages 0-IV) were assessed for ECA (i.e., the Risky Families Questionnaire subscales include Abuse/Neglect/Chaotic Home Environment), distress (i.e., Distress Thermometer and Problem List), anxiety (Hospital Anxiety and Depression Scale-Anxiety), depression (Hospital Anxiety and Depression Scale-Depression), meeting standardized cut-off thresholds for distress (Distress Thermometer and Problem List ≥4 or ≥7)/anxiety (Hospital Anxiety and Depression Scale-Anxiety ≥8)/depression (Hospital Anxiety and Depression Scale-Depression ≥8) and demographic factors. A total of 125 participants completed the study (78% response rate). ECA was associated with depression (p <0.001), anxiety (p = 0.001), and distress (p = 0.006), meeting cut-off threshold criteria for distress (p = 0.024), anxiety (p = 0.048), and depression (p = 0.001). On multivariate analysis, only depression (p = 0.04) and emotional issues (i.e., component of Distress Thermometer and Problem List) (p = 0.001) were associated with ECA. Neglect, but not Abuse and Chaotic Home Environment, was associated with depression (β = 0.442, p < 0.001), anxiety (β = 0.342, p = 0.002), and self-identified problems with family (β = 0.288, p = 0.022), emotion (β = 0.345, p = 0.004), and physical issues (β = 0.408, p < 0.001). ECA and neglect are associated with multiple psychologic symptoms, but most specifically depression in the setting of breast cancer. ECA contributes to psychologic burden as a vulnerability factor. ECA may help to explain individual patient trajectories and influence the provision of patient-centered care for psychologic symptoms in patients with breast cancer. Copyright © 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

The integral inventory for depression, a new, self-rated clinimetric instrument for the emotional and painful dimensions in major depressive disorder.

PubMed

Dueñas, Héctor; Lara, Carmen; Walton, Richard J; Granger, Renee E; Dossenbach, Martin; Raskin, Joel

2011-09-01

To assess the reliability and validity of the Integral Inventory for Depression (IID) scale using post hoc analyses of data from a multi-country study (ClinicalTrials.gov: NCT00561509) of patients with major depressive disorder (MDD). Patients (N = 1629) completed the IID (comprising two separate dimensions for emotional and physically painful symptoms; maximum score of 65) and a reference scale (16-item Quick Inventory of Depressive Symptomatology Self-Report) at baseline and at follow-up (8 and 24 weeks). Physicians rated MDD symptoms using the Clinical Global Impressions of Severity scale at each visit. Inter-item correlation, internal consistency, external validity, factor structure, and exploratory analysis of an optimal severity cut-off point were assessed. The IID displayed two distinct dimensions (i.e. painful and emotional) with little item redundancy and good internal consistency (Cronbach's α > 0.83 at each visit). The IID displayed good external validity (Pearson's correlations coefficients >0.60 at each visit) and statistically significant agreement (McNemar's test; P < 0.001 at follow-up) with the reference scale. Results suggest that a cut-off score of ≤24 had adequate precision (>80%) to identify patients with and without moderate MDD. Results suggest that the IID may be a reliable and valid tool for assessing emotional and painful symptoms of MDD.

Use of the Bayley Scales of Infant and Toddler Development, Third Edition, to Assess Developmental Outcome in Infants and Young Children in an Urban Setting in South Africa.

PubMed

Ballot, Daynia E; Ramdin, Tanusha; Rakotsoane, David; Agaba, Faustine; Davies, Victor A; Chirwa, Tobias; Cooper, Peter A

2017-01-01

The Bayley Scales of Infant and Toddler Development (III) is a tool developed in a Western setting. To evaluate the development of a group of inner city children in South Africa with no neonatal risk factors using the Bayley Scales of Infant and Toddler Development (III), to determine an appropriate cut-off to define developmental delay, and to establish variation in scores done in the same children before and after one year of age. Cohort follow-up study. 74 children had at least one Bayley III assessment at a mean age of 19.4 months (95% CI 18.4 to 20.4). The mean composite cognitive score was 92.2 (95% CI 89.4 to 95.0), the mean composite language score was 94.8 (95% CI 92.5 to 97.1), and mean composite motor score was 98.8 (95% CI 96.8 to 101.0). No child had developmental delay using a cut-off score of 70. In paired assessments above and below one year of age, the cognitive score remained unchanged, the language score decreased significantly ( p = 0.001), and motor score increased significantly ( p = 0.004) between the two ages. The Bayley Scales of Infant and Toddler Development (III) is a suitable tool for assessing development in urban children in southern Africa.

Psychometric properties of the Florence CyberBullying-CyberVictimization Scales.

PubMed

Palladino, Benedetta Emanuela; Nocentini, Annalaura; Menesini, Ersilia

2015-02-01

The present study tried to answer the research need for empirically validated and theoretically based instruments to assess cyberbullying and cybervictimization. The psychometric properties of the Florence CyberBullying-CyberVictimization Scales (FCBVSs) were analyzed in a sample of 1,142 adolescents (Mage=15.18 years; SD=1.12 years; 54.5% male). For both cybervictimization and cyberbullying, results support a gender invariant model involving 14 items and four factors covering four types of behaviors (written-verbal, visual, impersonation, and exclusion). The second-order confirmatory factor analysis confirmed that a "global," second-order measure of cyberbullying and cybervictimization fits the data well. Overall, the scales showed good validity (construct, concurrent, and convergent) and reliability (internal consistency and test-retest). In addition, using the global key question measure as a criterion, ROC analyses, determining the ability of a test to discriminate between groups, allowed us to identify cutoff points to classify respondents as involved/not involved starting from the continuum measure derived from the scales.

Classification of walking ability of household walkers versus community walkers based on K-BBS, gait velocity and upright motor control.

PubMed

Joa, K L; Kwon, S Y; Choi, J W; Hong, S E; Kim, C H; Jung, H Y

2015-10-01

Few guidelines are available to assist clinicians with assessment of whether a patient is a household or community walker. To assess the Korean Berg balance scale (K-BBS) and gait velocity cut-off points of a household walker versus a community walker and evaluate which combinations of the three scales (K-BBS, upright motor control test (UMCT), and gait velocity) best assessed walking ability. Cross-sectional study. Outpatient. A total of 124 stroke patients with walking difficulty. Participants were classified into one of six walking classifications (three household walkers and three community walkers) and K-BBS, UMCT, and gait velocity were evaluated. The optimal cut-off scores for walking classification were determined based on received operator characteristic (ROC) analyses. The cut-off value of K-BBS for dividing the household walker versus the community walker was 42 points. The cut-off value of gait velocity was 48 m/s for the community walker. The area under the ROC curve of the combined K-BBS and gait velocity values was larger than that of each individual scale and those of the other combined scales. The results suggest that K-BBS, gait velocity, and UMCT are useful instruments for classifying household ambulation and community ambulation. The authors recommend K-BBS as single scale and K-BBS and gait velocity as combined scales for evaluating community ambulation in stroke patients In this report, we have some clinical implication. We recommend 3 outcome measures to assess walking ability about home or community; K-BBS (>42 points), gait speed (>48 m/min), UMCT (strong grade in either knee flexion of extension). Suggesting cut-off points of Korean Berg balance scale, gait velocity, and level of upright motor control test for community ambulation could be used as outcome measures to evaluate patient's actual performance level. It is also important to combine several scales for determining walking classification. We suggest to evaluate walking ability by combining K-BBS and UMCT to best predict community ambulation.

Establishing a clinically relevant cutoff to the Dependency Scale from the dimensional clinical personality inventory.

PubMed

Carvalho, Lucas de F; Pianowski, Giselle; Filho, Nelson H

2017-05-01

The Clinical Dimensional Personality Inventory (IDCP) is a 163-item self-report tool developed for the assessment of 12 dimensions of personality pathology. One of the scales comprising the instrument-the Dependency scale-is intended to provide psychometric information on traits closely related to the Dependent Personality Disorder (DPD). In the present study, we used both Item Response Theory modeling and Receiver Operating Characteristic curve analysis to establishing a clinically meaningful cutoff for the IDCP Dependency Scale. Participants were 2.481 adults, comprised by outpatients diagnosed with DPD, outpatients diagnosed with other PDs, and adults from the general population. The Wright's item map graphing technique revealed that outpatients were located at the very high levels in the latent scale continuum of the Dependency Scale, with a very large effect size for the mean difference between patients and non-patients. The ROC curve analysis supported a cutoff at 2.3 points in the Dependency Scale, which yielded 0.86 of sensitivity and 0.79 of specificity. Findings from the present investigation suggest the IDCP Dependency Scale is useful as a screening tool of the core features of the DPD. We address potential clinical applications for the instrument, and discuss limitations from the present study. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Assessing PTSD in the military: Validation of a scale distributed to Danish soldiers after deployment since 1998.

PubMed

Karstoft, Karen-Inge; Andersen, Søren B; Nielsen, Anni B S

2017-06-01

Since 1998, soldiers deployed to war zones with the Danish Defense (≈31,000) have been invited to fill out a questionnaire on post-mission reactions. This provides a unique data source for studying the psychological toll of war. Here, we validate a measure of PTSD-symptoms from the questionnaire. Soldiers from two cohorts deployed to Afghanistan with the International Security Assistance Force (ISAF) in 2009 (ISAF7, N = 334) and 2013 (ISAF15, N = 278) filled out a standard questionnaire (Psychological Reactions following International Missions, PRIM) concerning a range of post-deployment reactions including symptoms of PTSD (PRIM-PTSD). They also filled out a validated measure of PTSD-symptoms in DSM-IV, the PTSD-checklist (PCL). We tested reliability of PRIM-PTSD by estimating Cronbach's alpha, and tested validity by correlating items, clusters, and overall scale with corresponding items in the PCL. Furthermore, we conducted two confirmatory factor analytic models to test the factor structure of PRIM-PTSD, and tested measurement invariance of the selected model. Finally, we established a screening and a clinical cutoff score by application of ROC analysis. We found high internal consistency of the PRIM-PTSD (Cronbach's alpha = 0.88; both cohorts), strong item-item (0.48-0.83), item-cluster (0.43-0.72), cluster-cluster (0.71-0.82) and full-scale (0.86-0.88) correlations between PRIM-PTSD and PCL. The factor analyses showed adequate fit of a one-factor model, which was also found to display strong measurement invariance across cohorts. ROC curve analysis established cutoff scores for screening (sensitivity = 1, specificity = 0.93) and clinical use (sensitivity = 0.71, specificity = 0.98). In conclusion, we find that PRIM-PTSD is a valid measure for assessing PTSD-symptoms in Danish soldiers following deployment. © 2017 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Cultural adaptation into Spanish of the generalized anxiety disorder-7 (GAD-7) scale as a screening tool

PubMed Central

2010-01-01

Background Generalized anxiety disorder (GAD) is a prevalent mental health condition which is underestimated worldwide. This study carried out the cultural adaptation into Spanish of the 7-item self-administered GAD-7 scale, which is used to identify probable patients with GAD. Methods The adaptation was performed by an expert panel using a conceptual equivalence process, including forward and backward translations in duplicate. Content validity was assessed by interrater agreement. Criteria validity was explored using ROC curve analysis, and sensitivity, specificity, predictive positive value and negative value for different cut-off values were determined. Concurrent validity was also explored using the HAM-A, HADS, and WHO-DAS-II scales. Results The study sample consisted of 212 subjects (106 patients with GAD) with a mean age of 50.38 years (SD = 16.76). Average completion time was 2'30''. No items of the scale were left blank. Floor and ceiling effects were negligible. No patients with GAD had to be assisted to fill in the questionnaire. The scale was shown to be one-dimensional through factor analysis (explained variance = 72%). A cut-off point of 10 showed adequate values of sensitivity (86.8%) and specificity (93.4%), with AUC being statistically significant [AUC = 0.957-0.985); p < 0.001]. The scale significantly correlated with HAM-A (0.852, p < 0.001), HADS (anxiety domain, 0.903, p < 0.001), and WHO-DAS II (0.696, p > 0.001). Limitations Elderly people, particularly those very old, may need some help to complete the scale. Conclusion After the cultural adaptation process, a Spanish version of the GAD-7 scale was obtained. The validity of its content and the relevance and adequacy of items in the Spanish cultural context were confirmed. PMID:20089179

The Dutch Social Interaction Anxiety Scale and the Social Phobia Scale: Reliability, Validity, and Clinical Utility

PubMed Central

Tielen, Deirdre; Wollmann, Lisa

2014-01-01

The social interaction anxiety scale (SIAS) and the social phobia scale (SPS) assess anxiety in social interactions and fear of scrutiny by others. This study examines the psychometric properties of the Dutch versions of the SIAS and SPS using data from a large group of patients with social phobia and a community-based sample. Confirmatory factor analysis revealed that the SIAS is unidimensional, whereas the SPS is comprised of three subscales. The internal consistency of the scales and subscales was good. The concurrent and discriminant validity was supported and the scales were well able to discriminate between patients and community-based respondents. Cut-off values with excellent sensitivity and specificity are presented. Of all self-report measures included, the SPS was the most sensitive for treatment effects. Normative data are provided which can be used to assess whether clinically significant change has occurred in individual patients. PMID:24701560

The dutch social interaction anxiety scale and the social phobia scale: reliability, validity, and clinical utility.

PubMed

de Beurs, Edwin; Tielen, Deirdre; Wollmann, Lisa

2014-01-01

The social interaction anxiety scale (SIAS) and the social phobia scale (SPS) assess anxiety in social interactions and fear of scrutiny by others. This study examines the psychometric properties of the Dutch versions of the SIAS and SPS using data from a large group of patients with social phobia and a community-based sample. Confirmatory factor analysis revealed that the SIAS is unidimensional, whereas the SPS is comprised of three subscales. The internal consistency of the scales and subscales was good. The concurrent and discriminant validity was supported and the scales were well able to discriminate between patients and community-based respondents. Cut-off values with excellent sensitivity and specificity are presented. Of all self-report measures included, the SPS was the most sensitive for treatment effects. Normative data are provided which can be used to assess whether clinically significant change has occurred in individual patients.

Lower NIH stroke scale scores are required to accurately predict a good prognosis in posterior circulation stroke.

PubMed

Inoa, Violiza; Aron, Abraham W; Staff, Ilene; Fortunato, Gilbert; Sansing, Lauren H

2014-01-01

The NIH stroke scale (NIHSS) is an indispensable tool that aids in the determination of acute stroke prognosis and decision making. Patients with posterior circulation (PC) strokes often present with lower NIHSS scores, which may result in the withholding of thrombolytic treatment from these patients. However, whether these lower initial NIHSS scores predict better long-term prognoses is uncertain. We aimed to assess the utility of the NIHSS at presentation for predicting the functional outcome at 3 months in anterior circulation (AC) versus PC strokes. This was a retrospective analysis of a large prospectively collected database of adults with acute ischemic stroke. Univariate and multivariate analyses were conducted to identify factors associated with outcome. Additional analyses were performed to determine the receiver operating characteristic (ROC) curves for NIHSS scores and outcomes in AC and PC infarctions. Both the optimal cutoffs for maximal diagnostic accuracy and the cutoffs to obtain >80% sensitivity for poor outcomes were determined in AC and PC strokes. The analysis included 1,197 patients with AC stroke and 372 with PC stroke. The median initial NIHSS score for patients with AC strokes was 7 and for PC strokes it was 2. The majority (71%) of PC stroke patients had baseline NIHSS scores ≤4, and 15% of these 'minor' stroke patients had a poor outcome at 3 months. ROC analysis identified that the optimal NIHSS cutoff for outcome prediction after infarction in the AC was 8 and for infarction in the PC it was 4. To achieve >80% sensitivity for detecting patients with a subsequent poor outcome, the NIHSS cutoff for infarctions in the AC was 4 and for infarctions in the PC it was 2. The NIHSS cutoff that most accurately predicts outcomes is 4 points higher in AC compared to PC infarctions. There is potential for poor outcomes in patients with PC strokes and low NIHSS scores, suggesting that thrombolytic treatment should not be withheld from these patients based solely on the NIHSS. © 2014 S. Karger AG, Basel. © 2014 S. Karger AG, Basel.

Renormalization group and Ward identities for infrared QED4

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

Mastropietro, Vieri

2007-10-15

A regularized version of Euclidean QED4 in the Feynman gauge is considered, with a fixed ultraviolet cutoff, photon mass of the size of the cutoff, and any value, including zero, of the electron mass. We will prove that the Schwinger functions are expressed by convergent series for small values of the charge and verify the Ward identities, up to corrections which are small for momentum scales far from the ultraviolet cutoff.

A fully covariant information-theoretic ultraviolet cutoff for scalar fields in expanding Friedmann Robertson Walker spacetimes

NASA Astrophysics Data System (ADS)

Kempf, A.; Chatwin-Davies, A.; Martin, R. T. W.

2013-02-01

While a natural ultraviolet cutoff, presumably at the Planck length, is widely assumed to exist in nature, it is nontrivial to implement a minimum length scale covariantly. This is because the presence of a fixed minimum length needs to be reconciled with the ability of Lorentz transformations to contract lengths. In this paper, we implement a fully covariant Planck scale cutoff by cutting off the spectrum of the d'Alembertian. In this scenario, consistent with Lorentz contractions, wavelengths that are arbitrarily smaller than the Planck length continue to exist. However, the dynamics of modes of wavelengths that are significantly smaller than the Planck length possess a very small bandwidth. This has the effect of freezing the dynamics of such modes. While both wavelengths and bandwidths are frame dependent, Lorentz contraction and time dilation conspire to make the freezing of modes of trans-Planckian wavelengths covariant. In particular, we show that this ultraviolet cutoff can be implemented covariantly also in curved spacetimes. We focus on Friedmann Robertson Walker spacetimes and their much-discussed trans-Planckian question: The physical wavelength of each comoving mode was smaller than the Planck scale at sufficiently early times. What was the mode's dynamics then? Here, we show that in the presence of the covariant UV cutoff, the dynamical bandwidth of a comoving mode is essentially zero up until its physical wavelength starts exceeding the Planck length. In particular, we show that under general assumptions, the number of dynamical degrees of freedom of each comoving mode all the way up to some arbitrary finite time is actually finite. Our results also open the way to calculating the impact of this natural UV cutoff on inflationary predictions for the cosmic microwave background.

Psychometric properties and osteoprotective behaviors among type 2 diabetic patients: osteoporosis self-efficacy scale Malay version (OSES-M).

PubMed

Abdulameer, S A; Syed Sulaiman, S A; Hassali, M A; Subramaniam, K; Sahib, M N

2013-03-01

In type 2 diabetic patients (T2DM), only 22 % have normal bone mineral density and almost three quarters of the sample population had low self-efficacy towards osteoporosis. These results reflect the need for screening and educational programs to increase the awareness of T2DM towards osteoporosis. Our aim was to translate and examine the psychometric properties of the Malay version of the osteoporosis self-efficacy scale (OSES-M) among T2DM and to determine the best cut-off value with optimum sensitivity and specificity. In addition, to assess factors that affects diabetic patients' osteoporosis self-efficacy. A standard "forward-backward" procedure was used to translate the OSES into Malay language, which was then validated with a convenience sample of 250 T2DM. The sensitivity and specificity of the OSES-M was calculated using receiver operating characteristic curve analysis. Bivariate and multivariate approaches were used to examine multiple independent variables on each dependent variable. The mean score of OSES-M was 731.74 ± 197.15. Fleiss' kappa, content validity ratio range, and content validity index were 0.99, 0.75-1, and 0.96, respectively. Two factors were extracted from exploratory factor analysis and were confirmed through confirmatory factor analysis. Internal consistency and test-retest reliability were 0.92 and 0.86, respectively. The optimum cut-off point of OSES-M to predict osteoporosis/osteopenia was 858. Regression analysis revealed that knowledge, health belief, and some demographic data had an impact on OSES-M. The results show that the OSES-M is a reliable and valid instrument for measuring osteoporosis self-efficacy in the Malaysian clinical setting.

Reliability, validity and factor structure of the CES-D in Iranian elderly.

PubMed

Malakouti, Seyed Kazem; Pachana, Nancy A; Naji, Borzooyeh; Kahani, Shamsoddin; Saeedkhani, Mozhdeh

2015-12-01

In developing countries such as Iran, elder populations are growing. Due to the high prevalence of depressive disorders among elders, reliable screening instruments for this population are required. The main purpose of this study was to determine the reliability and validity of the Farsi version of the Center for Epidemiological Studies-Depression Scale-10 (CES-D) among Iranian elderly persons. The investigators created the Farsi version of the CES-D-10 by translation and back translation. Two hundred and four cases aged 59 and above completed the questionnaire. The reliability and validity of the translated CES-D-10 was established through comparison with the Composite International Diagnostic Interview (CIDI), a recognized gold standard method for diagnosing major depressive disorder. We used a receiver operating curve (ROC) to determine the optimum cutoff score. The Farsi version of the CED-D-10 displayed acceptable psychometric characteristics, as reflected in internal consistency with Cronbach's alpha, split-half coefficients and test-retest reliability of 0.85, 0.65 and 0.49, respectively. Factor analysis and the varimax rotation resulted in two factors including 'depression' and 'interpersonal relationships'. The Depression factor (introduced as CES-D-8 of the scale) had significant correlation with the 10 items form (r=0.99) with 0.87 alpha coefficient. The ROC showed that the optimum cutoff point is 5 with sensitivity of 82% and specificity of 70%, and positive and negative predictive values of 26% and 98%, respectively, for both of the forms. Both the 10 and 8 items form of the Farsi version have desirable characteristics to be useful as a screening instrument for depressive disorders in Iranian elders, especially in urban areas. Copyright © 2015 Elsevier B.V. All rights reserved.

Cut-Off Points for Mild, Moderate, and Severe Pain on the Numeric Rating Scale for Pain in Patients with Chronic Musculoskeletal Pain: Variability and Influence of Sex and Catastrophizing.

PubMed

Boonstra, Anne M; Stewart, Roy E; Köke, Albère J A; Oosterwijk, René F A; Swaan, Jeannette L; Schreurs, Karlein M G; Schiphorst Preuper, Henrica R

2016-01-01

Objectives: The 0-10 Numeric Rating Scale (NRS) is often used in pain management. The aims of our study were to determine the cut-off points for mild, moderate, and severe pain in terms of pain-related interference with functioning in patients with chronic musculoskeletal pain, to measure the variability of the optimal cut-off points, and to determine the influence of patients' catastrophizing and their sex on these cut-off points. Methods: 2854 patients were included. Pain was assessed by the NRS, functioning by the Pain Disability Index (PDI) and catastrophizing by the Pain Catastrophizing Scale (PCS). Cut-off point schemes were tested using ANOVAs with and without using the PSC scores or sex as co-variates and with the interaction between CP scheme and PCS score and sex, respectively. The variability of the optimal cut-off point schemes was quantified using bootstrapping procedure. Results and conclusion: The study showed that NRS scores ≤ 5 correspond to mild, scores of 6-7 to moderate and scores ≥8 to severe pain in terms of pain-related interference with functioning. Bootstrapping analysis identified this optimal NRS cut-off point scheme in 90% of the bootstrapping samples. The interpretation of the NRS is independent of sex, but seems to depend on catastrophizing. In patients with high catastrophizing tendency, the optimal cut-off point scheme equals that for the total study sample, but in patients with a low catastrophizing tendency, NRS scores ≤ 3 correspond to mild, scores of 4-6 to moderate and scores ≥7 to severe pain in terms of interference with functioning. In these optimal cut-off schemes, NRS scores of 4 and 5 correspond to moderate interference with functioning for patients with low catastrophizing tendency and to mild interference for patients with high catastrophizing tendency. Theoretically one would therefore expect that among the patients with NRS scores 4 and 5 there would be a higher average PDI score for those with low catastrophizing than for those with high catastrophizing. However, we found the opposite. The fact that we did not find the same optimal CP scheme in the subgroups with lower and higher catastrophizing tendency may be due to chance variability.

Cut-Off Points for Mild, Moderate, and Severe Pain on the Numeric Rating Scale for Pain in Patients with Chronic Musculoskeletal Pain: Variability and Influence of Sex and Catastrophizing

PubMed Central

Boonstra, Anne M.; Stewart, Roy E.; Köke, Albère J. A.; Oosterwijk, René F. A.; Swaan, Jeannette L.; Schreurs, Karlein M. G.; Schiphorst Preuper, Henrica R.

2016-01-01

Objectives: The 0–10 Numeric Rating Scale (NRS) is often used in pain management. The aims of our study were to determine the cut-off points for mild, moderate, and severe pain in terms of pain-related interference with functioning in patients with chronic musculoskeletal pain, to measure the variability of the optimal cut-off points, and to determine the influence of patients’ catastrophizing and their sex on these cut-off points. Methods: 2854 patients were included. Pain was assessed by the NRS, functioning by the Pain Disability Index (PDI) and catastrophizing by the Pain Catastrophizing Scale (PCS). Cut-off point schemes were tested using ANOVAs with and without using the PSC scores or sex as co-variates and with the interaction between CP scheme and PCS score and sex, respectively. The variability of the optimal cut-off point schemes was quantified using bootstrapping procedure. Results and conclusion: The study showed that NRS scores ≤ 5 correspond to mild, scores of 6–7 to moderate and scores ≥8 to severe pain in terms of pain-related interference with functioning. Bootstrapping analysis identified this optimal NRS cut-off point scheme in 90% of the bootstrapping samples. The interpretation of the NRS is independent of sex, but seems to depend on catastrophizing. In patients with high catastrophizing tendency, the optimal cut-off point scheme equals that for the total study sample, but in patients with a low catastrophizing tendency, NRS scores ≤ 3 correspond to mild, scores of 4–6 to moderate and scores ≥7 to severe pain in terms of interference with functioning. In these optimal cut-off schemes, NRS scores of 4 and 5 correspond to moderate interference with functioning for patients with low catastrophizing tendency and to mild interference for patients with high catastrophizing tendency. Theoretically one would therefore expect that among the patients with NRS scores 4 and 5 there would be a higher average PDI score for those with low catastrophizing than for those with high catastrophizing. However, we found the opposite. The fact that we did not find the same optimal CP scheme in the subgroups with lower and higher catastrophizing tendency may be due to chance variability. PMID:27746750

Classifying post-stroke fatigue: Optimal cut-off on the Fatigue Assessment Scale.

PubMed

Cumming, Toby B; Mead, Gillian

2017-12-01

Post-stroke fatigue is common and has debilitating effects on independence and quality of life. The Fatigue Assessment Scale (FAS) is a valid screening tool for fatigue after stroke, but there is no established cut-off. We sought to identify the optimal cut-off for classifying post-stroke fatigue on the FAS. In retrospective analysis of two independent datasets (the '2015' and '2007' studies), we evaluated the predictive validity of FAS score against a case definition of fatigue (the criterion standard). Area under the curve (AUC) and sensitivity and specificity at the optimal cut-off were established in the larger 2015 dataset (n=126), and then independently validated in the 2007 dataset (n=52). In the 2015 dataset, AUC was 0.78 (95% CI 0.70-0.86), with the optimal ≥24 cut-off giving a sensitivity of 0.82 and specificity of 0.66. The 2007 dataset had an AUC of 0.83 (95% CI 0.71-0.94), and applying the ≥24 cut-off gave a sensitivity of 0.84 and specificity of 0.67. Post-hoc analysis of the 2015 dataset revealed that using only the 3 most predictive FAS items together ('FAS-3') also yielded good validity: AUC 0.81 (95% CI 0.73-0.89), with sensitivity of 0.83 and specificity of 0.75 at the optimal ≥8 cut-off. We propose ≥24 as a cut-off for classifying post-stroke fatigue on the FAS. While further validation work is needed, this is a positive step towards a coherent approach to reporting fatigue prevalence using the FAS. Copyright © 2017 Elsevier Inc. All rights reserved.

Utility of the Personality Assessment Inventory for Detecting Malingered ADHD in College Students.

PubMed

Musso, Mandi W; Hill, Benjamin D; Barker, Alyse A; Pella, Russell D; Gouvier, Wm Drew

2016-09-01

The purpose of the current study is to examine the utility of the Personality Assessment Inventory (PAI) for detecting feigned ADHD in college students. A sample of 238 undergraduate students was recruited and asked to simulate ADHD (ADHD simulators) or respond honestly (controls) on the PAI. Archival data (n = 541) from individuals diagnosed with clinical ADHD, no diagnosis, learning disorder, mood/anxiety, comorbid ADHD-mood/anxiety, or suspect effort were used. Few individuals scored above the cutoffs on PAI validity scales. When alternative cutoff scores were examined, cutoffs of ≥77 on the Negative Impression Management (NIM) scale, ≥3 on the Malingering Index (MAL), and ≥1 on the Rogers Discriminant Function (RDF) yielded excellent specificity in all groups and sensitivities of .33, .30, and .20, respectively. Individuals who were asked to simulate ADHD easily manipulate the PAI; however, alternative cutoff scores proposed for PAI validity indices may improve the detection of feigned ADHD symptoms. © The Author(s) 2014.

Factor Structure of Hospital Anxiety and Depression Scale in Malaysian patients with coronary artery disease.

PubMed

Kaur, Satpal; Zainal, Nor Zuraida; Low, Wah Yun; Ramasamy, Ravindran; Sidhu, Jaideep Singh

2015-05-01

The Hospital Anxiety and Depression Scale (HADS) is a common screening instrument used to determine the levels of anxiety and depression experienced by a patient and has been extensively used in patients with coronary artery disease (CAD). This study aimed to establish the factor structure of HADS in a Malaysian sample of 189 patients with CAD. Factor analysis of HADS using principal component analysis with varimax rotation yielded 3 factors. Confirmatory factor analysis supported the use of HADS in assessing 3 distinct dimensions of psychological distress--namely, anxiety, anhedonia, and psychomotor retardation. The HADS showed good internal consistency and was found to be a valid measure of psychological distress among Malaysian patients with CAD. However, low mean scores on the original 2 factors--that is, anxiety and depression--and also on the 2 depression subscales--anhedonia and psychomotor retardation--suggests that the recommended cutoff score to screen for psychological distress among CAD patients be reevaluated. Further research to determine the generalizability and consistency for the tridimensional structure of the HADS in Malaysia is recommended. © 2014 APJPH.

Validation of the UNESP-Botucatu unidimensional composite pain scale for assessing postoperative pain in cattle.

PubMed

de Oliveira, Flávia Augusta; Luna, Stelio Pacca Loureiro; do Amaral, Jackson Barros; Rodrigues, Karoline Alves; Sant'Anna, Aline Cristina; Daolio, Milena; Brondani, Juliana Tabarelli

2014-09-06

The recognition and measurement of pain in cattle are important in determining the necessity for and efficacy of analgesic intervention. The aim of this study was to record behaviour and determine the validity and reliability of an instrument to assess acute pain in 40 cattle subjected to orchiectomy after sedation with xylazine and local anaesthesia. The animals were filmed before and after orchiectomy to record behaviour. The pain scale was based on previous studies, on a pilot study and on analysis of the camera footage. Three blinded observers and a local observer assessed the edited films obtained during the preoperative and postoperative periods, before and after rescue analgesia and 24 hours after surgery. Re-evaluation was performed one month after the first analysis. Criterion validity (agreement) and item-total correlation using Spearman's coefficient were employed to refine the scale. Based on factor analysis, a unidimensional scale was adopted. The internal consistency of the data was excellent after refinement (Cronbach's α coefficient = 0.866). There was a high correlation (p < 0.001) between the proposed scale and the visual analogue, simple descriptive and numerical rating scales. The construct validity and responsiveness were confirmed by the increase and decrease in pain scores after surgery and rescue analgesia, respectively (p < 0.001). Inter- and intra-observer reliability ranged from moderate to very good. The optimal cut-off point for rescue analgesia was > 4, and analysis of the area under the curve (AUC = 0.963) showed excellent discriminatory ability. The UNESP-Botucatu unidimensional pain scale for assessing acute postoperative pain in cattle is a valid, reliable and responsive instrument with excellent internal consistency and discriminatory ability. The cut-off point for rescue analgesia provides an additional tool for guiding analgesic therapy.

The diagnostic value of the numeric pain rating scale in older postoperative patients.

PubMed

van Dijk, Jacqueline F M; Kappen, Teus H; van Wijck, Albert J M; Kalkman, Cor J; Schuurmans, Marieke J

2012-11-01

To measure the diagnostic value of the Numeric Rating Scale by comparing it to a Verbal Rating Scale in older patients. Pain management in older patients is an important challenge because of their greater susceptibility to adverse effects of analgesics. Nurses play an important role in applying guidelines for postoperative pain treatment. However, effective pain management is dependent upon valid and reliable pain assessment. Cross-sectional study. In total, 2674 older patients scored their postoperative pain on an 11-point numeric rating scale (NRS) and an adjective scale (VRS) including no pain, little pain, painful but bearable, considerable pain and terrible pain. The diagnostic value of different NRS cut-off values for administering analgesics is determined by an ROC curve. Sensitivity of NRS > 3 for 'unbearable' pain in older patients was 72% with a specificity of 97·2%. With a cut-off point NRS > 4, sensitivity increased to 83%, while specificity was 96·7%. With a cut-off point NRS > 5, sensitivity was 94%, while specificity was 85%. A high proportion (75%) of older old patients (≥ 75 years) with 'painful but bearable' considers NRS 4, 5 and 6 to this VRS category. Using an NRS cut-off point > 3 or > 4, a large group of older patients with 'bearable' pain would incorrectly classified as 'unbearable'. When we make the assumption that bearable pain means no wish for additional analgesics, this misclassification might result in overtreatment with analgesics, while 3% would be undertreated. With NRS cut-off point > 5, 6% have a risk of overtreatment and 15% of undertreatment. Nurses should not rely solely on the NRS score in determining pain treatment; they need to communicate with older patients about their pain, the need for analgesics and eventual misconceptions about analgesics. © 2012 Blackwell Publishing Ltd.

The Italian version of the 92-item Prodromal Questionnaire: Concurrent validity with the SIPS and factor analysis in a sample of 258 outpatients aged 11-36years.

PubMed

Kotzalidis, Georgios D; Solfanelli, Andrea; Piacentino, Daria; Savoja, Valeria; Fiori Nastro, Paolo; Curto, Martina; Lindau, Juliana Fortes; Masillo, Alice; Brandizzi, Martina; Fagioli, Francesca; Raballo, Andrea; Gebhardt, Eva; Preti, Antonio; D'Alema, Marco; Fucci, Maria Rosa; Miletto, Roberto; Andropoli, Daniela; Leccisi, Donato; Girardi, Paolo; Loewy, Rachel L; Schultze-Lutter, Frauke

2017-11-01

Current early screeners for psychosis-risk states have still to prove ability in identifying at-risk individuals. Among screeners, the 92-item Prodromal Questionnaire (PQ-92) is often used. We aimed to assess the validity of its Italian translation in a large Italian adolescent and young adult help-seeking sample. We included all individuals aged 12-36years seeking help at psychiatric mental health services in a large semirural Roman area (534,600 population) who accepted to participate. Participants completed the Italian version of the PQ-92 and were subsequently assessed with the Structured Interview of Prodromal/Psychosis-Risk Syndromes (SIPS). We examined diagnostic accuracy (sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios) and content, concurrent, and convergent validity between PQ-92 and SIPS using Cronbach's alpha, Cohen's kappa, and Spearman's rho, respectively. We tested the validity of adopted cut-offs through Receiver Operating Characteristic (ROC) curves plotted against SIPS diagnoses and the instrument's factor-structure through Principal Component Analysis. PQ-92 showed high internal consistency, acceptable diagnostic accuracy and concurrent validity, and excellent convergent validity. ROC analyses pointed to scores of 18 on the Positive subscale and 36 on the total PQ-92 as best cut-offs. The Scree-test identified a four-factor solution as fitting best. Psychometric properties of Italian PQ-92 were satisfactory. Optimal cut-offs were confirmed at ≥18 on the positive subscale, but at ≥36 on the total scale was able to identify more SIPS-positive cases. Copyright © 2017 Elsevier B.V. All rights reserved.

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

PubMed

Al-Lawati, Jawad A; Jousilahti, Pekka

2008-01-01

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

Factors associated with fall-related fractures in Parkinson's disease.

PubMed

Cheng, Kuei-Yueh; Lin, Wei-Che; Chang, Wen-Neng; Lin, Tzu-Kong; Tsai, Nai-Wen; Huang, Chih-Cheng; Wang, Hung-Chen; Huang, Yung-Cheng; Chang, Hsueh-Wen; Lin, Yu-Jun; Lee, Lian-Hui; Cheng, Ben-Chung; Kung, Chia-Te; Chang, Ya-Ting; Su, Chih-Min; Chiang, Yi-Fang; Su, Yu-Jih; Lu, Cheng-Hsien

2014-01-01

Fall-related fracture is one of the most disabling features of idiopathic Parkinson's disease (PD). A better understanding of the associated factors is needed to predict PD patients who will require treatment. This prospective study enrolled 100 adult idiopathic PD patients. Stepwise logistic regressions were used to evaluate the relationships between clinical factors and fall-related fracture. Falls occurred in 56 PD patients, including 32 with fall-related fractures. The rate of falls in the study period was 2.2 ± 1.4 per 18 months. The percentage of osteoporosis was 34% (19/56) and 11% in PD patients with and without falls, respectively. Risk factors associated with fall-related fracture were sex, underlying knee osteoarthritis, mean Unified Parkinson's Disease Rating Scale score, mean Morse fall scale, mean Hoehn and Yahr stage, and exercise habit. By stepwise logistic regression, sex and mean Morse fall scale were independently associated with fall-related fracture. Females had an odds ratio of 3.8 compared to males and the cut-off value of the Morse fall scale for predicting fall-related fracture was 72.5 (sensitivity 72% and specificity 70%). Higher mean Morse fall scales (>72.5) and female sex are associated with higher risk of fall-related fractures. Preventing falls in the high-risk PD group is an important safety issue and highly relevant for their quality of life. Copyright © 2013 Elsevier Ltd. All rights reserved.

Parent-child relationship disorders. Part I. Parental overprotection and the development of the Parent Protection Scale.

PubMed

Thomasgard, M; Metz, W P; Edelbrock, C; Shonkoff, J P

1995-08-01

There is a spectrum of parental protective behaviors promoting child safety and security, ranging from neglect to overprotection. This paper describes the development and psychometric properties of a new measure of parental protective behaviors toward children age 2 to 10 years, the Parent Protection Scale (PPS). Items were selected to represent key dimensions of protective behaviors. Factor analyses suggested four subscales: Supervision, Separation Problems, Dependence, and Control. The PPS has acceptable internal consistency, test-retest reliability, and clinical validity. Norms by child age in the form of cutoff points corresponding to +1 SD were determined. Clinical and research uses for the PPS are noted.

Using Hospital Anxiety and Depression Scale (HADS) on patients with epilepsy: Confirmatory factor analysis and Rasch models.

PubMed

Lin, Chung-Ying; Pakpour, Amir H

2017-02-01

The problems of mood disorders are critical in people with epilepsy. Therefore, there is a need to validate a useful tool for the population. The Hospital Anxiety and Depression Scale (HADS) has been used on the population, and showed that it is a satisfactory screening tool. However, more evidence on its construct validity is needed. A total of 1041 people with epilepsy were recruited in this study, and each completed the HADS. Confirmatory factor analysis (CFA) and Rasch analysis were used to understand the construct validity of the HADS. In addition, internal consistency was tested using Cronbachs' α, person separation reliability, and item separation reliability. Ordering of the response descriptors and the differential item functioning (DIF) were examined using the Rasch models. The HADS showed that 55.3% of our participants had anxiety; 56.0% had depression based on its cutoffs. CFA and Rasch analyses both showed the satisfactory construct validity of the HADS; the internal consistency was also acceptable (α=0.82 in anxiety and 0.79 in depression; person separation reliability=0.82 in anxiety and 0.73 in depression; item separation reliability=0.98 in anxiety and 0.91 in depression). The difficulties of the four-point Likert scale used in the HADS were monotonically increased, which indicates no disordering response categories. No DIF items across male and female patients and across types of epilepsy were displayed in the HADS. The HADS has promising psychometric properties on construct validity in people with epilepsy. Moreover, the additive item score is supported for calculating the cutoff. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Validation of the English version of the UNESP-Botucatu multidimensional composite pain scale for assessing postoperative pain in cats

PubMed Central

2013-01-01

Background A scale validated in one language is not automatically valid in another language or culture. The purpose of this study was to validate the English version of the UNESP-Botucatu multidimensional composite pain scale (MCPS) to assess postoperative pain in cats. The English version was developed using translation, back-translation, and review by individuals with expertise in feline pain management. In sequence, validity and reliability tests were performed. Results Of the three domains identified by factor analysis, the internal consistency was excellent for ‘pain expression’ and ‘psychomotor change’ (0.86 and 0.87) but not for ‘physiological variables’ (0.28). Relevant changes in pain scores at clinically distinct time points (e.g., post-surgery, post-analgesic therapy), confirmed the construct validity and responsiveness (Wilcoxon test, p < 0.001). Favorable correlation with the IVAS scores (p < 0.001) and moderate to very good agreement between blinded observers and ‘gold standard’ evaluations, supported criterion validity. The cut-off point for rescue analgesia was > 7 (range 0–30 points) with 96.5% sensitivity and 99.5% specificity. Conclusions The English version of the UNESP-Botucatu-MCPS is a valid, reliable and responsive instrument for assessing acute pain in cats undergoing ovariohysterectomy, when used by anesthesiologists or anesthesia technicians. The cut-off point for rescue analgesia provides an additional tool for guiding analgesic therapy. PMID:23867090

Validation of the English version of the UNESP-Botucatu multidimensional composite pain scale for assessing postoperative pain in cats.

PubMed

Brondani, Juliana T; Mama, Khursheed R; Luna, Stelio P L; Wright, Bonnie D; Niyom, Sirirat; Ambrosio, Jennifer; Vogel, Pamela R; Padovani, Carlos R

2013-07-17

A scale validated in one language is not automatically valid in another language or culture. The purpose of this study was to validate the English version of the UNESP-Botucatu multidimensional composite pain scale (MCPS) to assess postoperative pain in cats. The English version was developed using translation, back-translation, and review by individuals with expertise in feline pain management. In sequence, validity and reliability tests were performed. Of the three domains identified by factor analysis, the internal consistency was excellent for 'pain expression' and 'psychomotor change' (0.86 and 0.87) but not for 'physiological variables' (0.28). Relevant changes in pain scores at clinically distinct time points (e.g., post-surgery, post-analgesic therapy), confirmed the construct validity and responsiveness (Wilcoxon test, p < 0.001). Favorable correlation with the IVAS scores (p < 0.001) and moderate to very good agreement between blinded observers and 'gold standard' evaluations, supported criterion validity. The cut-off point for rescue analgesia was > 7 (range 0-30 points) with 96.5% sensitivity and 99.5% specificity. The English version of the UNESP-Botucatu-MCPS is a valid, reliable and responsive instrument for assessing acute pain in cats undergoing ovariohysterectomy, when used by anesthesiologists or anesthesia technicians. The cut-off point for rescue analgesia provides an additional tool for guiding analgesic therapy.

The Positive Thinking Skills Scale: A screening measure for early identification of depressive thoughts.

PubMed

Bekhet, Abir K; Garnier-Villarreal, Mauricio

2017-12-01

Depression is currently considered the second leading cause of disability worldwide. Positive thinking is a cognitive process that helps individuals to deal with problems more effectively, and has been suggested as a useful strategy for coping with adversity, including depression. The Positive Thinking Skills Scale (PTSS) is a reliable and valid measure that captures the frequency of use of positive thinking skills that can help in the early identification of the possibility of developing depressive thoughts. However, no meaningful cutoff score has been established for the PTSS. To establish a cutoff score for the PTSS for early identification of risk for depression. This study used a receiver operating characteristic (ROC) curve to establish a PTSS cutoff score for risk for depression, using the Center for Epidemiological Studies-Depression Scale (CES-D) as the gold standard measure. In a sample of 109 caregivers, the ROC showed that the cutoff score of PTSS that best classify the participants is 13.5. With this PTSS score, 77.8% of the subjects with low CES-D are classify correctly, and 69.6% of the subjects with high CES-D are classify correctly. Since the PTSS score should be integer numbers, functionally the cutoff would be 13. The study showed that a cut off score of 13 is a point at which referral, intervention, or treatment would be recommended. Consequently, this can help in the early identification of depressive symptoms that might develop because of the stress of caregiving. Copyright © 2017 Elsevier Inc. All rights reserved.

Normal, Problematic and Compulsive Consumption of Sexually Explicit Media: Clinical Findings using the Compulsive Pornography Consumption (CPC) Scale among Men who have Sex with Men

PubMed Central

Rosser, B. R. Simon; Noor, Syed WB; Iantaffi, Alex

2015-01-01

To assess problematic sexually explicit media (SEM) consumption, and to identify clinically meaningful cut-off points, we examined clinical correlates using the new Compulsive Pornography Consumption (CPC) scale among 1165 participating MSM. Building on scale practices in measuring compulsive sexual behavior, two cut-off points were identified. While most (76-80%) MSM do not report compulsive symptoms, about 16-20% report levels of problematic SEM consumption, including 7% with extreme scores consistent with DSM criteria for compulsive disorders. Demographic, sexual, and HIV risk differences were identified between the three groups. Researchers and clinicians are encouraged to consider using the CPC scale for comprehensive assessment of compulsive sexual behavior. PMID:26167109

Eleven Years of Data on the Jefferson Scale of Empathy-Medical Student Version (JSE-S): Proxy Norm Data and Tentative Cutoff Scores.

PubMed

Hojat, Mohammadreza; Gonnella, Joseph S

2015-01-01

This study was designed to provide typical descriptive statistics, score distributions and percentile ranks of the Jefferson Scale of Empathy-Medical Student version (JSE-S) of male and female medical school matriculants to serve as proxy norm data and tentative cutoff scores. The participants were 2,637 students (1,336 women and 1,301 men) who matriculated at Sidney Kimmel (formerly Jefferson) Medical College between 2002 and 2012, and completed the JSE at the beginning of medical school. Information extracted from descriptive statistics, score distributions and percentile ranks for male and female matriculants were used to develop proxy norm data and tentative cutoff scores. The score distributions of the JSE tended to be moderately skewed and platykurtic. Women obtained a significantly higher mean score (116.2 ± 9.7) than men (112.3 ± 10.8) on the JSE-S (t2,635 = 9.9, p < 0.01). It was suggested that percentile ranks can be used as proxy norm data. The tentative cutoff score to identify low scorers was ≤ 95 for men and ≤ 100 for women. Our findings provide norm data and cutoff scores for admission decisions under certain conditions and for identifying students in need of enhancing their empathy. © 2015 S. Karger AG, Basel.

Screening of depression in cardiology: A study on 617 cardiovascular patients.

PubMed

Tesio, Valentina; Marra, Sebastiano; Molinaro, Stefania; Torta, Riccardo; Gaita, Fiorenzo; Castelli, Lorys

2017-10-15

Depression screening in the cardiovascular disease (CVD) care setting is under-performed, also because the issue of the optimal screening tools cut-off is still open. We analysed which HADS (Hospital Anxiety and Depression Scale) total score cut-off value shows the best properties in two groups of 357 Acute Coronary Syndrome (ACS) and 260 Chronic Coronary Artery Disease (CAD) hospitalized patients. A Receiver Operating Characteristics (ROC) curve was plotted for both groups using the Montgomery-Asberg Depression Rating Scale (MADRS) as the criterion. Accuracy, positive (PPV) and negative (NPV) predictive values were computed for different cut-off scores. The ROC curves confirmed the excellent/very good accuracy of the HADS in both groups, with an area under the curve of 0.911 for the ACS and 0.893 for the CAD patients. The cut-off of 14 showed the best compromise between high sensitivity and good specificity in both groups, with high negative predicted values (95.5% and 92.4%, respectively). Using a cut-off value of 14, the HADS could be considered a good screening tool to identify hospitalized CAD and ACS patients requiring a more accurate depression assessment, in order to promptly plan the most appropriate treatment strategies and prevent the negative effects of depression in CVD patients. Copyright © 2017 Elsevier B.V. All rights reserved.

Integrating channel form and processes in the Gangetic plains rivers: Implications for geomorphic diversity

NASA Astrophysics Data System (ADS)

Roy, N. G.; Sinha, R.

2018-02-01

Geomorphic diversity at a variety of spatial and temporal scales has been studied in the western Ganga plains (WGP), India, to isolate the dominating factors at each scale that have the potential to cause major geomorphic change. The Ganga River and its major tributaries draining the WGP have been investigated in terms of longitudinal, cross-sectional, and planform morphology to assess the influence of potential controls such as climate, geology, topography, land use, hydrology, and sediment transport. These data were then compared with those from the rivers draining the eastern Ganga plains (EGP) to understand the geomorphic diversity across the Ganga plains and the causal factors. Our investigations suggest that in-channel geomorphic diversity over decadal scale in rivers with low width-to-depth (W/D) ratio is caused by periodic incision/aggradation, but it is driven by channel avulsion in rivers characterized by high W/D ratio. Similarly, planform (reach-scale) parameters such as sinuosity and braid-channel-ratio are influenced by intrinsic factors such as changes in hydrological conditions and morphodynamics (cutoffs, small-scale avulsion) that are in turn impacted by natural and human-induced factors. Finally, we have isolated the climatic and hydrologic effects on the longitudinal profile concavity of alluvial trunk channels in tectonically stable and unstable landscapes. We demonstrate that the rivers flowing through a tectonically stable landscape are graded in nature where higher discharge tends to create more concave longitudinal profiles compared to those in tectonically unstable landscape at 103-year scale.

Prevalence and risk factors with overweight and obesity among Vietnamese adults: Caucasian and Asian cut-offs.

PubMed

Trinh, Oanh T H; Nguyen, Nguyen D; Phongsavan, Philayrath; Dibley, Michael J; Bauman, Adrian E

2009-01-01

To determine the prevalence and factors associated with overweight/obesity among adults in Ho Chi Minh City (HCMC) using Caucasian and Asian cut-offs. A cross-sectional survey. In 2005, 1,971 adults aged 25-64 years in HCMC were randomly selected using a proportional to population size sampling method to estimate the prevalence of overweight and obesity, measured by body mass index (BMI) and waist circumference. Multivariable logistic models were used to examine associations between overweight/obesity and socioeconomic status, health-related behaviors, and biochemical indices of chronic disease risk. The prevalence of overweight and obesity using the Caucasian BMI cut-offs were 13.9% and 1.8% respectively, and those with the Asian BMI cut-offs were 27.5% and 5.7%, respectively. The abdominal adiposity rates were higher than the BMI overweight and obesity rates in women, but not in men. Increasing age, low education, high household wealth index, high levels of sitting and reclining time, cholesterol and high blood pressure were significantly associated with overweight and obesity. Current smoking and sedentary leisure time was significantly negatively associated with this status in men. Associations between overweight/obesity and metabolic disorders were evident using both cut-offs. Asian cut-offs identified more risk factors and therefore could be considered for defining at-risk groups. The results highlight the importance of intervention programs to prevent overweight/obesity in young adults.

Optimal cutoff of the waist-to-hip ratio for detecting cardiovascular risk factors among Han adults in Xinjiang.

PubMed

Li, Shuang-Shuang; Pan, Shuo; Ma, Yi-Tong; Yang, Yi-Ning; Ma, Xiang; Li, Xiao-Mei; Fu, Zhen-Yan; Xie, Xiang; Liu, Fen; Chen, You; Chen, Bang-Dang; Yu, Zi-Xiang; He, Chun-Hui; Zheng, Ying-Ying; Abudukeremu, Nuremanguli; Abuzhalihan, Jialin; Wang, Yong-Tao

2014-07-29

The optimal cutoff of the waist-to-hip ratio (WHR) among Han adults in Xinjiang, which is located in the center of Asia, is unknown. We aimed to examine the relationship between different WHRs and cardiovascular risk factors among Han adults in Xinjiang, and determine the optimal cutoff of the WHR. The Cardiovascular Risk Survey was conducted from October 2007 to March 2010. A total of 14618 representative participants were selected using a four-stage stratified sampling method. A total of 5757 Han participants were included in the study. The present statistical analysis was restricted to the 5595 Han subjects who had complete anthropometric data. The sensitivity, specificity, and distance on the receiver operating characteristic (ROC) curve in each WHR level were calculated. The shortest distance in the ROC curves was used to determine the optimal cutoff of the WHR for detecting cardiovascular risk factors. In women, the WHR was positively associated with systolic blood pressure, diastolic blood pressure, and serum concentrations of serum total cholesterol. The prevalence of hypertension and hypertriglyceridemia increased as the WHR increased. The same results were not observed among men. The optimal WHR cutoffs for predicting hypertension, diabetes, dyslipidemia and ≥ two of these risk factors for Han adults in Xinjiang were 0.92, 0.92, 0.91, 0.92 in men and 0.88, 0.89, 0.88, 0.89 in women, respectively. Higher cutoffs for the WHR are required in the identification of Han adults aged ≥ 35 years with a high risk of cardiovascular diseases in Xinjiang.

Teacher ratings of DSM-III-R symptoms for the disruptive behavior disorders.

PubMed

Pelham, W E; Gnagy, E M; Greenslade, K E; Milich, R

1992-03-01

Ratings were collected on a rating scale comprised of the DSM-III-R diagnostic criteria for disruptive behavior disorders. Teacher ratings were obtained for 931 boys in regular classrooms in grades K through 8 from around North America. Means and standard deviations for attention-deficit hyperactivity disorder (ADHD), oppositional-defiant disorder (ODD), and conduct disorder (CD) scales are reported by age. Frequencies of DSM-III-R symptoms are reported by age, and suggested diagnostic cutoffs are discussed. A factor analysis revealed three factors: one reflecting ODD and several CD symptoms, one on which ADHD symptoms of inattention loaded, and one comprised of ADHD impulsivity/overactivity symptoms. Conditional probability analyses revealed that several hallmark symptoms of ADHD had very poor predictive power, whereas combinations of symptoms from the two ADHD factors had good predictive power. Combinations of ODD symptoms also had very high predictive power. The limited utility of teacher ratings in assessing symptoms of conduct disorder in this age range is discussed.

[Validation of a cutoff point for the short version of the Depression Scale of the Center for Epidemiologic Studies in older Mexican adults].

PubMed

Salinas-Rodríguez, Aarón; Manrique-Espinoza, Betty; Acosta-Castillo, Gilberto Isaac; Franco-Núñez, Aurora; Rosas-Carrasco, Oscar; Gutiérrez-Robledo, Luis Miguel; Sosa-Ortiz, Ana Luisa

2014-01-01

To identify a valid cutoff point associated with Center for Epidemiologic Studies, Depression Scale (CES-D) of seven items, which allows the classification of older adults according to presence/absence of clinically significant depressive symptoms. Screening study with 229 older adults residing in two states of Mexico (Morelos and Tlaxcala), which were part of the sample from the National Survey of Health and Nutrition, 2012. We estimated the sensitivity and specificity associated with the selected cutoff points using the diagnostic criteria of ICD-10 (International Classification of Diseases, 10th revision) and DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, fourth edition). The cutoff point estimated was CES-D=5. According to the ICD-10 sensitivity and specificity were 83.3 and 90.2%, and ROC was 87%. Using DSM-IV, the values were 85, 83.2, and 84%, respectively. The short version of the CES-D can be used as a screening test to identify probable cases of older adults with clinically significant depressive symptoms.

In-Flight Measurement of the Absolute Energy Scale of the Fermi Large Area Telescope

NASA Technical Reports Server (NTRS)

Ackermann, M.; Ajello, M.; Allafort, A.; Atwood, W. B.; Axelsson, M.; Baldini, L.; Barbielini, G; Bastieri, D.; Bechtol, K.; Bellazzini, R.;

In-Flight Measurement of the Absolute Energy Scale of the Fermi Large Area Telescope

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

Ackermann, M.; /Stanford U., HEPL /SLAC /KIPAC, Menlo Park; Ajello, M.

The Large Area Telescope (LAT) on-board the Fermi Gamma-ray Space Telescope is a pair-conversion telescope designed to survey the gamma-ray sky from 20 MeV to several hundreds of GeV. In this energy band there are no astronomical sources with sufficiently well known and sharp spectral features to allow an absolute calibration of the LAT energy scale. However, the geomagnetic cutoff in the cosmic ray electron-plus-positron (CRE) spectrum in low Earth orbit does provide such a spectral feature. The energy and spectral shape of this cutoff can be calculated with the aid of a numerical code tracing charged particles in themore » Earth's magnetic field. By comparing the cutoff value with that measured by the LAT in different geomagnetic positions, we have obtained several calibration points between {approx}6 and {approx}13 GeV with an estimated uncertainty of {approx}2%. An energy calibration with such high accuracy reduces the systematic uncertainty in LAT measurements of, for example, the spectral cutoff in the emission from gamma ray pulsars.« less

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

PubMed

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

2016-02-01

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

Cutoffs and cardiovascular risk factors associated with neck circumference among community-dwelling elderly adults: a cross-sectional study.

PubMed

Coelho, Hélio José; Sampaio, Ricardo Aurélio Carvalho; Gonçalvez, Ivan de Oliveira; Aguiar, Samuel da Silva; Palmeira, Rafael; Oliveira, José Fernando de; Asano, Ricardo Yukio; Sampaio, Priscila Yukari Sewo; Uchida, Marco Carlos

2016-01-01

In elderly people, measurement of several anthropometric parameters may present complications. Although neck circumference measurements seem to avoid these issues, the cutoffs and cardiovascular risk factors associated with this parameter among elderly people remain unknown. This study was developed to identify the cutoff values and cardiovascular risk factors associated with neck circumference measurements among elderly people. Cross-sectional study conducted in two community centers for elderly people. 435 elderly adults (371 women and 64 men) were recruited. These volunteers underwent morphological evaluations (body mass index and waist, hip, and neck circumferences) and hemodynamic evaluations (blood pressure values and heart rate). Receiver operating characteristic curve analyses were used to determine the predictive validity of cutoff values for neck circumference, for identifying overweight/obesity. Multivariate analysis was used to identify cardiovascular risk factors associated with large neck circumference. Cutoff values for neck circumference (men = 40.5 cm and women = 35.7 cm), for detection of obese older adults according to body mass index, were identified. After a second analysis, large neck circumference was shown to be associated with elevated body mass index in men; and elevated body mass index, blood pressure values, prevalence of type 2 diabetes and hypertension in women. The data indicate that neck circumference can be used as a screening tool to identify overweight/obesity in older people. Moreover, large neck circumference values may be associated with cardiovascular risk factors.

Microscopic study of spin cut-off factors of nuclear level densities

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

Gholami, M.; Kildir, M.; Behkami, A. N.

Level densities and spin cut-off factors have been investigated within the microscopic approach based on the BCS Hamiltonian. In particular, the spin cut-off parameters have been calculated at neutron binding energies over a large range of nuclear mass using the BCS theory. The spin cut-off parameters {sigma}{sup 2}(E) have also been obtained from the Gilbert and Cameron expression and from rigid body calculations. The results were compared with their corresponding macroscopic values. It was found that the values of {sigma}{sup 2}(E) did not increase smoothly with A as expected based on macroscopic theory. Instead, the values of {sigma}{sup 2}(E) showmore » structure reflecting the angular momentum of the shell model orbitals near the Fermi energy.« less

Clinical utility and validation of the Couple's Communicative Evaluation Scale.

PubMed

West, Craig E

2005-10-01

This study assessed the validity and clinical utility of a new test, the Couple's Communicative Evaluation Scale. With 24 couples from a variety of resources, e.g., churches, newspaper, and colleges, a discriminant analysis using the Dyadic Adjustment Scale, indicated that satisfied couples could be discriminated from issatisfied couples with 91-96% accuracy. Significant differences on the scale were found for means between 7 distressed and 16 nondistressed couples using the satisfaction/dissatisfaction cutoff score of 200 on the Dyadic Adjustment Scale and significant differences on the individual scales were found for means between 16 distressed and 31 nondistressed individuals using the satisfaction/dissatisfaction cutoff score of 100 on the Dyadic Adjustment Scale. Demographic variables, e.g., age, marriage length, were statistically significant. Scale scores were highly correlated with those on the Dyadic Adjustment Scale, indicating good validity. Using all 400 items, an alpha of .99 indicated good internal consistency for the verbal, nonverbal, and listening communication scores.

Validation and application of the Chinese version of the 10-item Connor-Davidson Resilience Scale (CD-RISC-10) among parents of children with cancer diagnosis.

PubMed

Ye, Zeng Jie; Qiu, Hong Zhong; Li, Peng Fei; Chen, Peng; Liang, Mu Zi; Liu, Mei Ling; Yu, Yuan Liang; Wang, Shu Ni; Quan, Xiao Ming

2017-04-01

Parents of children diagnosed with cancer often experience considerable emotional distress for their children with negative emotions, such as disbelief, depression, anxiety, hope and shock. Resilience is defined as the psychological characteristics that promote positive adaptation in the face of stress and adversity, which has been demonstrated to relate to positive coping and less psychological distress. Thus, a quick screening tool to evaluate the levels of resilience of parents with cancer-diagnosed children is urgently required. The Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were used to evaluate the CD-RISC-10 using a sample size of 500 parents. Velicer's Minimum Average Partial (MAP) Test and a parallel analysis were also supplemented to confirm the EFA-derived structure of the scale. The participants were given the 10-item Kessler Psychological Distress Scale (K-10), Perceived Social Support Scale (PSSS) and Medical Coping Modes Questionnaire (MCMQ) to test the associates with CD-RISC-10 and obtain the cut-off of the scale. The Chinese version of CD-RISC-10 has good psychometric properties and retains its single dimension in the original English version, which can explain 49.602% of the total variance. The CFA demonstrates the fit indices of a one-order model: Chi-Square = 39.987, CMIN/DF = 1.333, P < 0.001, TLI = 0.914, CFI = 0.981, GFI = 0.962, NFI = 0.926, IFI = 0.979, RFI = 0.889, RMR = 0.042, and RMSEA = 0.041. The CD-RISC presents statistical associations with other scales, and the cut-off is 25.5. The Chinese version of the CD-RISC-10, which is reliable, valid and easy to use, is suitable for clinical settings. The CD-RISC-10 enables a quick understanding of the level of resilience of the parents when their children undergo treatment, which can be the most important indicator to their psychological health. Copyright © 2017 Elsevier Ltd. All rights reserved.

Combined use of the postpartum depression screening scale (PDSS) and Edinburgh postnatal depression scale (EPDS) to identify antenatal depression among Chinese pregnant women with obstetric complications.

PubMed

Zhao, Ying; Kane, Irene; Wang, Jing; Shen, Beibei; Luo, Jianfeng; Shi, Shenxun

2015-03-30

The purpose of the present study was to evaluate antenatal depression screening employing two scales: the Postpartum Depression Screening Scale (PDSS) and Edinburgh Postnatal Depression Scale (EPDS) for the population of Chinese pregnant women with obstetric complications. A convenience sample of 842 Chinese pregnant women with complications participated in this study. The PDSS total score correlated strongly with the EPDS total score (r=0.652, p=0.000). Each tool performed extremely well for detecting major and major/minor depressions with PDSS resulting in a better psychometric performance than EPDS (p<0.01). If combined use, the recommended EPDS cut-off score was 8/9 for major depression, at which the sensitivity (71.6%) and specificity (87.6%) were the best, and the recommended PDSS cut-off score was 79/80 for major depression, along with its best sensitivity (86.4%) and specificity (100%). The study concluded that EPDS and PDSS appear to be reliable assessments for major and minor depression among the Chinese pregnant women with obstetric complications. Combined use of these tools should consider lower cutoff scores to reduce the misdiagnosis and improve the screening validity. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Hierarchical Formation of Dark Matter Halos near the Cutoff Scale and Their Impact on Indirect Detections

NASA Astrophysics Data System (ADS)

Ishiyama, Tomoaki

2015-08-01

The smallest dark matter halos are formed first in the early universe. We present results of very large cosmological N-body simulations of the hierarchical formation and evolution of halos over a wide mass range, beginning from the formation of the smallest halos. In the largest simulation, the motions of 40963 particles in comoving boxes of side lengths 400 pc and 200 pc were followed. The particle masses were 3.4 Χ 10-11 M⊙ and 4.3 Χ 10-12 M⊙, ensuring that halos at the cutoff scale were represented by ˜30,000 and ˜230,000 particles, respectively. We found that the central density cusp is much steeper in these halos than in larger halos (dwarf-galaxy-sized to cluster-sized halos), and scales as ρ ∝ r(-1.5—1.3). The cusp slope gradually becomes shallower as the halo mass increases. The slope of halos 50 times more massive than the smallest halo is approximately -1.3. No strong correlation exists between inner slope and the collapse epoch. The cusp slope of halos above the cutoff scale seems to be reduced primarily due to major merger processes. The concentration, estimated at the present universe, is predicted to be 60—70, consistent with theoretical models and earlier simulations, and ruling out simple power law mass-concentration relations. Such halos could still exist in the present universe with the same steep density profiles. Strongly depending on the subhalo mass function and the adopted concentration model, the steeper inner cusps of halos near the cutoff scale enhance the annihilation luminosity of a Milky Way sized halo between 12 to 67%.

Diagnostic performance and optimal cut-off scores of the Massachusetts youth screening instrument-second version in a sample of Swiss youths in welfare and juvenile justice institutions.

PubMed

Dölitzsch, Claudia; Leenarts, Laura E W; Schmeck, Klaus; Fegert, Jorg M; Grisso, Thomas; Schmid, Marc

2017-02-08

There is a growing consensus about the importance of mental health screening of youths in welfare and juvenile justice institutions. The Massachusetts Youth Screening Instrument-second version (MAYSI-2) was specifically designed, normed and validated to assist juvenile justice facilities in the United States of America (USA), in identifying youths with potential emotional or behavioral problems. However, it is not known if the USA norm-based cut-off scores can be used in Switzerland. Therefore, the primary purpose of the current study was to estimate the diagnostic performance and optimal cut-off scores of the MAYSI-2 in a sample of Swiss youths in welfare and juvenile justice institutions. As the sample was drawn from the French-, German- and Italian-speaking parts of Switzerland, the three languages were represented in the total sample of the current study and consequently we could estimate the diagnostic performance and the optimal cut-off scores of the MAYSI-2 for the language regions separately. The other main purpose of the current study was to identify potential gender differences in the diagnostic performance and optimal cut-off scores. Participants were 297 boys and 149 girls (mean age = 16.2, SD = 2.5) recruited from 64 youth welfare and juvenile justice institutions (drawn from the French-, German- and Italian-speaking parts of Switzerland). The MAYSI-2 was used to screen for mental health or behavioral problems that could require further evaluation. Psychiatric classification was based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present and Lifetime version (K-SADS-PL). The MAYSI-2 scores were submitted into Receiver-Operating Characteristic (ROC) analyses to estimate the diagnostic performance and optimal 'caution' cut-off scores of the MAYSI-2. The ROC analyses revealed that nearly all homotypic mappings of MAYSI-2 scales onto (cluster of) psychiatric disorders revealed above chance level accuracy. The optimal 'caution' cut-off scores derived from the ROC curve for predicting (cluster of) psychiatric disorders were, for several MAYSI-2 scales, comparable to the USA norm-based 'caution' cut-off scores. For some MAYSI-2 scales, however, higher optimal 'caution' cut-off scores were found. With adjusted optimal 'caution' cut-off scores, the MAYSI-2 screens potential emotional or behavioral problems well in a sample of Swiss youths in welfare and juvenile justice institutions. However, as for choosing the optimal 'caution' cut off score for the MAYSI-2, both language as well as gender seems to be of importance. The results of this study point to a compelling need to test the diagnostic performance and optimal 'caution' cut-off scores of the MAYSI-2 more elaborately in larger differentiated language samples in Europe.

Survey and analysis for impact factors of psychological distress in HIV-infected pregnant women who continue pregnancy.

PubMed

Qin, Shouxue; Tan, Yanping; Lu, Bingyan; Cheng, Yuqing; Nong, Yanli

2018-05-15

The objective of this study is to explore the psychological distress of HIV-infected pregnant women who continue pregnancy, and analyze the possible influencing factors. A total of 194 HIV-infected pregnant women who continue pregnancy were enrolled for this study by a convenient sampling method during June 2012-August 2016. Participants completed questionnaires including Hospital Anxiety and Depression Scale (HADS), Berger HIV Stigma Scale (BHSS), Distress Thermometer (DT) and Problem List (PL), and to determine the cut-off value of DT in the group. The positive detection rate of psychological distress in the HIV-infected pregnant women who continue pregnancy was 69.1%, and the highest frequency of PL was the emotional problems. The positive detection rate of anxiety was 60.8%, the positive detection rate of depression was 54.1%, and the discrimination score was 113.16 ± 19.21. Spearman relevant analysis showed that psychological distress score was positively correlated with anxiety, depression and discrimination score (p < .001). Multiple linear regression analysis showed that relationship between husband and wife, family misfortune, Medicaid, chronic disease or high-risk pregnancy, viral load, CD 4 + T cell count, infection and confidentiality could affect the psychological distress (p < .05). The ideal cut-off value of DT in the group was 5. HIV-infected pregnant women who continue pregnancy have higher incidence of psychological distress, and the psychological distress is not inferior to cancer patients. The influencing factors are mainly related to the infection and pregnancy characteristics, and have nothing to do with the general social demographic characteristics. The DT can be used as a screening tool to quickly identify psychological distress of the group.

Screening for Adolescent Problematic Internet Use: Validation of the Problematic and Risky Internet Use Screening Scale (PRIUSS).

PubMed

Jelenchick, Lauren A; Eickhoff, Jens; Zhang, Chong; Kraninger, Kristina; Christakis, Dimitri A; Moreno, Megan A

2015-01-01

Problematic Internet use (PIU) is an emerging health concern that lacks screening measures validated for use with adolescents and young adults. This study aimed to validate the Problematic and Risky Internet Use Screening Scale (PRIUSS) for use with older adolescents and to increase its clinical utility by determining scoring guidelines and assessing the relationship between PIU and other mental health conditions. This cross-sectional survey study took place at a large, public Midwestern university among 330 older adolescents aged 18 to 25 years. Confirmatory factor analysis and Spearman's correlations were used to assess the PRIUSS' structural and construct validity, respectively. A risk-based scoring cutoff was estimated using a Bayesian latent class modeling approach to computing a receiver operating characteristic curve. The confirmatory factor analysis indices for the 3-factor model indicated an acceptable fit (goodness-of-fit index 0.89, root mean square error of approximation 0.07). A cutoff of 25 (sensitivity 0.80, 95% confidence interval [CI] 0.47-0.99; specificity 0.79, 95% CI 0.73-0.84) is proposed for identifying those at risk for PIU. Participants at risk for PIU were at significantly greater odds of also reporting symptoms of attention-deficit/hyperactivity disorder (odds ratio [OR] 2.36 95% CI 1.21-4.62, P = .009), depression (OR 3.25, 95% CI 1.65-6.42, P = .008), and social anxiety (OR 3.77, 95% CI 2.06-6.89, P < .000). The PRIUSS demonstrated validity as a PIU screening instrument for adolescents and young adults. Screening for PIU may also help to identify those at high reciprocal risk for other mental health conditions. Copyright © 2015. Published by Elsevier Inc.

Factor structure and criterion validity across the full scale and ten short forms of the CES-D among Chinese adolescents.

PubMed

Yang, Wenhui; Xiong, Ge; Garrido, Luis Eduardo; Zhang, John X; Wang, Meng-Cheng; Wang, Chong

2018-04-16

We systematically examined the factor structure and criterion validity across the full scale and 10 short forms of the Center for Epidemiological Studies Depression Scale (CES-D) with Chinese youth. Participants were 5,434 Chinese adolescents in Grades 7 to 12 who completed the full CES-D; 612 of them further completed a structured diagnostic interview with the major depressive disorder (MDD) module of the Kiddie Schedule for Affective Disorder and Schizophrenia for School-age Children. Using a split-sample approach, a series of 4-, 3-, 2-, and 1-factor models were tested using exploratory structural equation modeling and cross-validated using confirmatory factor analysis; the dimensionality was also evaluated by parallel analysis in conjunction with the scree test and aided by factor mixture analysis. The results indicated that a single-factor model of depression with a wording method factor fitted the data well, and was the optimal structure underlying the scores of the full and shortened CES-D. Additionally, receiver operating characteristic curve analyses for MDD case detection showed that the CES-D full-scale scores accurately detected MDD youth (area under the curve [AUC] = .84). Furthermore, the short-form scores produced comparable AUCs with the full scale (.82 to .85), as well as similar levels of sensitivity and specificity when using optimal cutoffs. These findings suggest that depression among Chinese adolescents can be adequately measured and screened for by a single-factor structure underlying the CES-D scores, and that the short forms provide a viable alternative to the full instrument. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The dynamics of an experimental gravel bed meander with constant discharge and sediment supply

NASA Astrophysics Data System (ADS)

Braudrick, C. A.; Dietrich, W.; Sklar, L. S.

2012-12-01

As rivers meander, channel migration and cutoffs introduce continuous and episodic changes, respectively, in local boundary shear stress and bedload flux. These changes must affect the local and reach scale channel dynamics, but assessing their influence is limited by complications associated with varying discharge as well as challenging spatial and time scales. Here we explore the dynamics of a scaled-down gravel bed meandering river with constant discharge and sediment supply in a 6.1 m by 17 m long experimental flume at UC Berkeley's Richmond Field Station. The experiments are similar to Braudrick et al. (2009), but with constant rather than varying sediment supply. The flume was filled with a sorted sand with D50 of 0.85 mm, and had an initial 40 cm wide channel with a sinuosity of 1.1. Alfalfa sprouts provided bank and floodplain strength. The alfalfa was seeded by hand throughout the floodplain while a low flow provided irrigation during the 7-day alfalfa growth period. Sand (model gravel) and a lightweight plastic sediment (model sand) were fed independently from the upstream end of the flume at constant rates of 1.8 and 5 kg/hr, respectively. Despite the steady input conditions the experimental channel was quite dynamic as channel migration and bend morphology varied spatially and temporally. The sinuosity in the downstream 10 m of the flume (away from the inlet condition) increased from 1.1 to about 1.6 over the first 75 hours of the experiment, when 3 cutoffs in 29 hours decreased the sinuosity back to just over the initial value. Bank erosion was fastest when curvature was low at the beginning of the experiment and following cutoffs, and slowed once sinuosity increased. Once curvature increased the bends became asymmetric as bank erosion occurred almost exclusively at the bend apex. As the channel migrated, the local sinuosity increased, which decreasing the water surface slope and hence shear stress. The lower shear stress caused subsequent channel migration and also sediment transport to decrease. Consequently, the channel aggraded, forcing water onto the floodplain and further reducing the shear stress in the channel. While the channel was aggrading, most of the sediment flux out the bottom of the flume was the suspended model sand. Cutoffs occurred when the overbank flow was sufficient to alter floodplain strength either by eroding a path around alfalfa, or by limiting alfalfa growth in floodplain areas inundated during the low flow used to irrigate the alfalfa between the runs. Comparing the duration of these experiments to time in the field strongly depends on whether the timescale of interest is set by the flow or by sediment transport. Assuming a scaling factor between 0.01 and 0.02 and that flood flows occur approximately 8 days/year, this 120 hour experiments represent 4-6 years of field time using Froude similarity to scale time from the laboratory to the field, or 220-622 years assuming sediment transport similarity. This experiment showed decreased shear stress due to channel migration limited sediment transport, and that cutoffs were a function of both in-channel and floodplain processes.

Appropriate body mass index and waist circumference cutoffs for middle and older age group in Thailand: data of 19,621 participants from Thai epidemiologic stroke (TES) study.

PubMed

Samsen, Maiyadhaj; Hanchaiphiboolkul, Suchat; Puthkhao, Pimchanok; Tantirittisak, Tasanee; Towanabut, Somchai

2012-09-01

To determine the appropriate body mass index (BMI) and waist circumference (WC) cutoff point for identification of at least one cardiovascular risk factor (hypertension, dyslipidemia, and type 2 diabetes) in Thailand, and to compare the discrimination ability of BMI with that of WC for discrimination of at least one cardiovascular risk factor. Baseline health survey data of participants of Thai Epidemiologic Stroke (TES) Study, who were free from stroke, enrolled from five geographic regions around the country, were studied as cross-sectional analysis. Receiver operating characteristics curve (ROC) analysis was performed to determine the appropriate cutoff points of BMI and WC in identifying those with presence of at least one cardiovascular risk factors. The BMI or WC value with the shortest distance on the ROC curve was considered to be appropriate cutoffs. Comparing the ability of BMI in discrimination of at least one cardiovascular risk factor with that of WC was performed by comparing ROC area under curve (AUC). Among 19,621 (6,608 men and 13,013 women) participants with age range of 45 to 80 years, the average age was 59.8 years for men and 58.5 years for women. The appropriate cutoff point of BMI was 23 kg/m2 in men and 24 kg/m2 in women. The cutoffs of WC were 80 cm and 78 cm in men and women, respectively. In both gender, waist circumference (WC) (AUC in men = 0.684; 95% CI, 0.672-0.695, AUC in women = 0.673; 95% CI, 0.665-0.681) was significantly (p < 0.001) better than BMI (AUC in men = 0.667; 95% CI, 0.656-0.679, AUC in women = 0.636; 95% CI, 0.628-0.644) in discrimination of at least one cardiovascular risk factor. In Thai adults aged 45 to 80 years, the cutoff points of BMI should be 23 kg/m2 in men and 24 kg/m2 in women. For WC, 80 cm and 78 cm should be considered to be appropriate cutoffs for men and women, respectively. Waist circumference (WC) as a simple obesity index should be advocated for public health screening.

Insensitivity of Hawking radiation to an invariant Planck-scale cutoff

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

Agullo, Ivan; Departamento de Fisica Teorica and IFIC, Centro Mixto Universidad de Valencia-CSIC, Facultad de Fisica, Universidad de Valencia, Burjassot-46100, Valencia; Navarro-Salas, Jose

2009-08-15

A disturbing aspect of Hawking's derivation of black hole radiance is the need to invoke extreme conditions for the quantum field that originates the emitted quanta. It is widely argued that the derivation requires the validity of the conventional relativistic field theory to arbitrarily high, trans-Planckian scales. We stress in this note that this is not necessarily the case if the question is presented in a covariant way. We point out that Hawking radiation is immediately robust against an invariant Planck-scale cutoff. This important feature of Hawking radiation is relevant for a quantum gravity theory that preserves, in some way,more » the Lorentz symmetry.« less

Eigenvalue equation and core-mode cutoff of weakly guiding tapered fiber as three layer optical waveguide and used as biochemical sensor.

PubMed

Linslal, C L; Mohan, P M S; Halder, A; Gangopadhyay, T K

2012-06-01

The core-mode cutoff plays a major role in evanescent field absorption based sensors. A method has been proposed to calculate the core-mode cutoff by solving the eigenvalue equations of a weakly guiding three layer optical waveguide graphically. The variation of normalized waveguide parameter (V) is also calculated with different wavelengths at core-mode cutoff. At the first step, theoretical analysis of tapered fiber parameters has been performed for core-mode cutoff. The taper angle of an adiabatic tapered fiber is also analyzed using the length-scale criterion. Secondly, single-mode tapered fiber has been developed to make a precision sensor element suitable for chemical detection. Finally, the sensor element has been used to detect absorption peak of ethylenediamine. Results are presented in which an absorption peak at 1540 nm is observed.

Interrelationship of Cytokines, Hypothalamic-Pituitary-Adrenal Axis Hormones, and Psychosocial Variables in the Prediction of Preterm Birth

PubMed Central

Pearce, B.D.; Grove, J.; Bonney, E.A.; Bliwise, N.; Dudley, D.J.; Schendel, D.E.; Thorsen, P.

2010-01-01

Background/Aims To examine the relationship of biological mediators (cytokines, stress hormones), psychosocial, obstetric history, and demographic factors in the early prediction of preterm birth (PTB) using a comprehensive logistic regression model incorporating diverse risk factors. Methods In this prospective case-control study, maternal serum biomarkers were quantified at 9–23 weeks’ gestation in 60 women delivering at <37 weeks compared to 123 women delivering at term. Biomarker data were combined with maternal sociodemographic factors and stress data into regression models encompassing 22 preterm risk factors and 1st-order interactions. Results Among individual biomarkers, we found that macrophage migration inhibitory factor (MIF), interleukin-10, C-reactive protein (CRP), and tumor necrosis factor-α were statistically significant predictors of PTB at all cutoff levels tested (75th, 85th, and 90th percentiles). We fit multifactor models for PTB prediction at each biomarker cutoff. Our best models revealed that MIF, CRP, risk-taking behavior, and low educational attainment were consistent predictors of PTB at all biomarker cutoffs. The 75th percentile cutoff yielded the best predicting model with an area under the ROC curve of 0.808 (95% CI 0.743–0.874). Conclusion Our comprehensive models highlight the prominence of behavioral risk factors for PTB and point to MIF as a possible psychobiological mediator. PMID:20160447

Interrelationship of cytokines, hypothalamic-pituitary-adrenal axis hormones, and psychosocial variables in the prediction of preterm birth.

PubMed

Pearce, B D; Grove, J; Bonney, E A; Bliwise, N; Dudley, D J; Schendel, D E; Thorsen, P

2010-01-01

To examine the relationship of biological mediators (cytokines, stress hormones), psychosocial, obstetric history, and demographic factors in the early prediction of preterm birth (PTB) using a comprehensive logistic regression model incorporating diverse risk factors. In this prospective case-control study, maternal serum biomarkers were quantified at 9-23 weeks' gestation in 60 women delivering at <37 weeks compared to 123 women delivering at term. Biomarker data were combined with maternal sociodemographic factors and stress data into regression models encompassing 22 preterm risk factors and 1st-order interactions. Among individual biomarkers, we found that macrophage migration inhibitory factor (MIF), interleukin-10, C-reactive protein (CRP), and tumor necrosis factor-alpha were statistically significant predictors of PTB at all cutoff levels tested (75th, 85th, and 90th percentiles). We fit multifactor models for PTB prediction at each biomarker cutoff. Our best models revealed that MIF, CRP, risk-taking behavior, and low educational attainment were consistent predictors of PTB at all biomarker cutoffs. The 75th percentile cutoff yielded the best predicting model with an area under the ROC curve of 0.808 (95% CI 0.743-0.874). Our comprehensive models highlight the prominence of behavioral risk factors for PTB and point to MIF as a possible psychobiological mediator. Copyright (c) 2010 S. Karger AG, Basel.

Double burden: a cross-sectional survey assessing factors associated with underweight and overweight status in Danang, Vietnam

PubMed Central

2013-01-01

Background Many low- to middle-income countries are faced with an increasing prevalence of overweight/obesity while that for underweight remains high, a duality termed “double burden”; both are key risk factors for chronic diseases. This cross-sectional study assesses the prevalence and factors for underweight and overweight/obesity among adults in Danang, Vietnam, using WHO standard and suggested Asian-specific BMI cut-offs. Methods In 2010, 1713 residents age ≥35 years from 900 households in 6 of 56 urban, rural and mixed urban–rural communes in Danang were selected using multistage-cluster sampling methodology to participate; 1621 qualified adults enrolled. Participants completed a health survey based on WHO STEPwise Approach to Chronic Disease Risk Factor Surveillance and additional questions on chest pain and stroke symptoms. Anthropometric and other measurements were conducted. Relative risk regression was used to identify independent risk factors for underweight or overweight/obesity according to WHO standard cut-offs and suggested Asian-specific cut-offs (<18.5 kg/m2 or 23–27.49 kg/m2; and ≥27.5 kg/m2). Results We observed 12.4% prevalence of underweight and 16.0% for overweight/obesity using WHO standard. The prevalence of overweight/obesity doubled (33.7%) when Asian-specific cut-offs were applied. For both definitions, rural communes had the highest prevalence of underweight while urban communes had the highest prevalence of overweight/obesity. Being underweight was associated with less urbanization. Factors independently associated with being underweight included older age, rural living, current smoking, and lower systolic pressure. Factors independently associated with Asian-specific BMI definition for being overweight/obese included older age, urbanization, higher systolic pressure, and diabetes. Age was not an independent factor with WHO standard cut-offs; however, myocarial infarction and diabetes showed strong associations. Conclusions The double burden of underweight and overweight/obesity observed in Danang is consistent with patterns found for large cities in Vietnam that are undergoing rapid economic growth and urbanization of lifestyle. Factors independently associated with underweight and overweight/obesity status by WHO standard and Asian-specific definitions include urbanization and modifiable lifestyle factors. Further studies are needed to define ethnic specific BMI cut-offs for Vietnam and to explore strategies to reduce the rising prevalence of overweight/obesity. PMID:23316727

How little pain and disability do patients with low back pain have to experience to feel that they have recovered?

PubMed Central

Maher, Christopher G.; Herbert, Robert D.; Hancock, Mark J.; Hush, Julia M.; Smeets, Robert J.

2010-01-01

Epidemiological and clinical studies of people with low back pain (LBP) commonly measure the incidence of recovery. The pain numerical rating scale (NRS), scores from 0 to 10, and Roland Morris disability questionnaire (RMDQ), scores from 0 to 24, are two instruments often used to define recovery. On both scales higher scores indicate greater severity. There is no consensus, however, on the cutoff scores on these scales that classify people as having recovered. The aim of this study was to determine which cutoff scores most accurately classify those who had recovered from LBP. Subjects from four clinical studies were categorized as ‘recovered’ or ‘unrecovered’ according to their self-rating on a global perceived effect scale. Odd ratios were calculated for scores of 0, 1, 2, 3 and 4 on the NRS and RMDQ to predict perceived recovery. Scores of 0 on the NRS and ≤2 on the RMDQ most accurately identify patients who consider themselves completely recovered. The diagnostic odds ratio (OR) for predicting recovery was 43.9 for a score of 0 on the NRS and 17.6 for a score of ≤2 on the RMDQ. There was no apparent effect of LBP duration or length of follow-up period on the optimal cutoff score. OR for the NRS were generally higher than those for RMDQ. Cutoffs of 0 on the NRS and 2 on the RMDQ most accurately classify subjects as recovered from LBP. Subjects consider pain more than disability when determining their recovery status. PMID:20229120

Cutoffs of Short-Term Heart Rate Variability Parameters in Brazilian Adolescents Male.

PubMed

Farah, Breno Quintella; Christofaro, Diego Giulliano Destro; Cavalcante, Bruno Remígio; Andrade-Lima, Aluísio; Germano-Soares, Antonio Henrique; Vanderlei, Luiz Carlos Marques; Lanza, Fernanda Cordoba; Ritti-Dias, Raphael Mendes

2018-05-15

A low heart rate variability (HRV) has been associated with cardiovascular risk factors in adolescents. However, no cut-off points are known for HRV parameters in this age group, making it difficult to use in clinical practice. Thus, the aims of the current study were to establish cutoffs of HRV parameters and to examine their association with cardiovascular risk in Brazilian adolescents male. For this reason, this cross-sectional study included 1152 adolescent boys (16.6 ± 1.2 years old). HRV measures of time (SD of all RR intervals, root mean square of the squared differences between adjacent normal RR intervals, and the percentage of adjacent intervals over 50 ms), frequency domains [low (LF) and high (HF) frequency], and Poincaré plot (SD1, SD2 and SD1/SD2 ratio) were assessed. Cardiovascular risk was assessed by sum of abdominal obesity, high blood pressure, overweight, and low physical activity level. The proposed cutoffs showed moderate to high sensitivity, specificity, and area under curve values (p < 0.05). HRV frequency parameters were statistically superior when compared to time-domain and Poincaré plot parameters. The binary logistic regression analysis indicated that all proposed HRV cutoffs were independently associated with a clustering of cardiovascular risk factors, with greater magnitude of HF and SD1/SD2 ratio (two or more risk factors: OR = 3.59 and 95% CI 1.76-7.34). In conclusion, proposed HRV cutoffs have moderate to high sensitivity in detecting of the cardiovascular risk factor and HRV frequency-domain were better discriminants of cardiovascular risk than time-domain and Poincaré plot parameters.

Optimal cutoff of the waist-to-hip ratio for detecting cardiovascular risk factors among Han adults in Xinjiang

PubMed Central

2014-01-01

Background The optimal cutoff of the waist-to-hip ratio (WHR) among Han adults in Xinjiang, which is located in the center of Asia, is unknown. We aimed to examine the relationship between different WHRs and cardiovascular risk factors among Han adults in Xinjiang, and determine the optimal cutoff of the WHR. Methods The Cardiovascular Risk Survey was conducted from October 2007 to March 2010. A total of 14618 representative participants were selected using a four-stage stratified sampling method. A total of 5757 Han participants were included in the study. The present statistical analysis was restricted to the 5595 Han subjects who had complete anthropometric data. The sensitivity, specificity, and distance on the receiver operating characteristic (ROC) curve in each WHR level were calculated. The shortest distance in the ROC curves was used to determine the optimal cutoff of the WHR for detecting cardiovascular risk factors. Results In women, the WHR was positively associated with systolic blood pressure, diastolic blood pressure, and serum concentrations of serum total cholesterol. The prevalence of hypertension and hypertriglyceridemia increased as the WHR increased. The same results were not observed among men. The optimal WHR cutoffs for predicting hypertension, diabetes, dyslipidemia and ≥ two of these risk factors for Han adults in Xinjiang were 0.92, 0.92, 0.91, 0.92 in men and 0.88, 0.89, 0.88, 0.89 in women, respectively. Conclusions Higher cutoffs for the WHR are required in the identification of Han adults aged ≥ 35 years with a high risk of cardiovascular diseases in Xinjiang. PMID:25074400

[Psychometric attributes of Scales for Outcomes in Parkinson's Disease-Cognition (SCOPA-Cog), Castilian language].

PubMed

Martínez-Martín, P; Frades-Payo, B; Rodríguez-Blázquez, C; Forjaz, M J; de Pedro-Cuesta, J

To test the psychometric attributes of the Scales for Outcomes in Parkinson's Disease-Cognition (SCOPA-Cog), in Castilian language. It is a multicenter, cross-sectional study carried out on 387 Parkinson's disease (PD) patients. They were 70% in Hoehn and Yahr stages 2 or 3; their mean age was 65,8 years and they underwent the disease for 8,1 years. Rater-based -SCOPA-Motor, modified Parkinson's Psychosis Rating Scale, Clinical Impression of Severity Index for PD (CISI-PD), Cumulative Illness Rating Scale-Geriatrics- and self-administered -SCOPA-Autonomic, SCOPA-Sleep, SCOPA-Psychosocial, Hospital Anxiety and Depression Scale, EuroQoL- assessments were applied. For SCOPA-Cog, the following psychometric attributes were analysed: acceptability, internal consistency, dimensionality, construct validity, and precision. A cut-off point for dementia and SCOPA-Cog score's predictors were explored. SCOPA-Cog was free from floor and ceiling effect. The internal consistency was satisfactory (alpha = 0,83) and the item-total correlation resulted equal or upper than 0,45. Two factors were identified (52% of variance), one of them formed by 3 out of the 4 memory-related items. The correlation with other measures was weak (rS < 0,35), except for the CISI-PD's item 'cognitive state' (rS = 0,51). SCOPA-Cog scored significantly different for Hoehn and Yahr stages and for patients grouped by age, age at onset of PD, and education. The standard error of measurement was 3,02. A cut-off point 19/20 reached 76% sensitivity and specificity for dementia. Age and age at onset of PD resulted the strongest predictors. SCOPA-Cog is a consistent, valid, and precise measure for assessment of the cognitive disorder in PD.

Protein docking by the interface structure similarity: how much structure is needed?

PubMed

Sinha, Rohita; Kundrotas, Petras J; Vakser, Ilya A

2012-01-01

The increasing availability of co-crystallized protein-protein complexes provides an opportunity to use template-based modeling for protein-protein docking. Structure alignment techniques are useful in detection of remote target-template similarities. The size of the structure involved in the alignment is important for the success in modeling. This paper describes a systematic large-scale study to find the optimal definition/size of the interfaces for the structure alignment-based docking applications. The results showed that structural areas corresponding to the cutoff values <12 Å across the interface inadequately represent structural details of the interfaces. With the increase of the cutoff beyond 12 Å, the success rate for the benchmark set of 99 protein complexes, did not increase significantly for higher accuracy models, and decreased for lower-accuracy models. The 12 Å cutoff was optimal in our interface alignment-based docking, and a likely best choice for the large-scale (e.g., on the scale of the entire genome) applications to protein interaction networks. The results provide guidelines for the docking approaches, including high-throughput applications to modeled structures.

Cancer patients' reluctance to discuss psychological distress with their physicians was not associated with underrecognition of depression by physicians: a preliminary study.

PubMed

Okuyama, Toru; Endo, Chiharu; Seto, Takashi; Kato, Masashi; Seki, Nobuhiko; Akechi, Tatsuo; Furukawa, Toshiaki A; Eguchi, Kenji; Hosaka, Takashi

2009-06-01

To investigate the association between cancer patients' reluctance for emotional disclosure to their physician and underrecognition of depression by physicians. Randomly selected ambulatory patients with lung cancer were evaluated by the Hospital Depression and Anxiety Scale (HADS), and those with scores over the validated cutoff value for adjustment disorder or major depressive disorder were included in this analysis. The data set included the responses to the 13-item questionnaire to assess four possible concerns of patients in relation to emotional disclosure to the treating physician ("no perceived need to disclose emotions," "fear of the negative impact of emotional disclosure," "negative attitude toward emotional disclosure," "hesitation to disturb the physician with emotional disclosure"). The attending physicians rated the severity of depression in each patient using 3-point Likert scales (0 [absent] to 2 [clinical]). Depression was considered to be underrecognized when the patients had a HADS score above the cutoff value, but in whom the depression rating by the attending physician was 0. The HADS score was over the cutoff value in the 60 patients. The mean age was 65.1 +/- 10.0, and 82% had advanced cancer (Stage IIIb or IV or recurrence). Depression was underrecognized in 44 (73%) patients. None of the four factors related to reluctance for emotional disclosure was associated with the underrecognition of depression by the physicians. None of the demographic or cancer-related variables were associated with depression underrecognition by physicians. The results did not support the assumption that patients' reluctance for emotional disclosure is associated with the underrecognition of depression by physicians.

Accuracy of body fat percent and adiposity indicators cut off values to detect metabolic risk factors in a sample of Mexican adults

PubMed Central

2014-01-01

Background Although body fat percent (BF%) may be used for screening metabolic risk factors, its accuracy compared to BMI and waist circumference is unknown in a Mexican population. We compared the classification accuracy of BF%, BMI and WC for the detection of metabolic risk factors in a sample of Mexican adults; optimized cutoffs as well as sensitivity and specificity at commonly used BF% and BMI international cutoffs were estimated. We also estimated conditional BF% means at BMI international cutoffs. Methods We performed a cross-sectional analysis of data on body composition, anthropometry and metabolic risk factors(high glucose, high triglycerides, low HDL cholesterol and hypertension) from 5,100 Mexican men and women. The association between BMI, WC and BF%was evaluated with linear regression models. The BF%, BMI and WC optimal cutoffs for the detection of metabolic risk factors were selected at the point where sensitivity was closest to specificity. Areas under the ROC Curve (AUC) were compared among classifiers using a non-parametric method. Results After adjustment for WC, a 1% increase in BMI was associated with a BF% rise of 0.05 percentage points (p.p.) in men (P < 0.05) and 0.25 p.p. in women (P < 0.001). At BMI = 25.0 predicted BF% was 27.6 ± 0.16 (mean ± SE) in men and 41.2 ± 0.07 in women. Estimated BF% cutoffs for detection of metabolic risk factors were close to 30.0 in men and close to 44.0 in women. In men WC had higher AUC than BF% for the classification of all conditions whereas BMI had higher AUC than BF% for the classification of high triglycerides and hypertension. In womenBMI and WC had higher AUC than BF% for the classification of all metabolic risk factors. Conclusions BMI and WC were more accurate than BF% for classifying the studied metabolic disorders. International BF% cutoffs had very low specificity and thus produced a high rate of false positives in both sexes. PMID:24721260

Eleven Years of Data on the Jefferson Scale of Empathy-Medical Student Version (JSE-S): Proxy Norm Data and Tentative Cutoff Scores

PubMed Central

Hojat, Mohammadreza; Gonnella, Joseph S.

2015-01-01

Objective This study was designed to provide typical descriptive statistics, score distributions and percentile ranks of the Jefferson Scale of Empathy-Medical Student version (JSE-S) of male and female medical school matriculants to serve as proxy norm data and tentative cutoff scores. Subjects and Methods The participants were 2,637 students (1,336 women and 1,301 men) who matriculated at Sidney Kimmel (formerly Jefferson) Medical College between 2002 and 2012, and completed the JSE at the beginning of medical school. Information extracted from descriptive statistics, score distributions and percentile ranks for male and female matriculants were used to develop proxy norm data and tentative cutoff scores. Results The score distributions of the JSE tended to be moderately skewed and platykurtic. Women obtained a significantly higher mean score (116.2 ± 9.7) than men (112.3 ± 10.8) on the JSE-S (t2,635 = 9.9, p < 0.01). It was suggested that percentile ranks can be used as proxy norm data. The tentative cutoff score to identify low scorers was ≤95 for men and ≤100 for women. Conclusions Our findings provide norm data and cutoff scores for admission decisions under certain conditions and for identifying students in need of enhancing their empathy. PMID:25924560

Improving Predictions with Reliable Extrapolation Schemes and Better Understanding of Factorization

NASA Astrophysics Data System (ADS)

More, Sushant N.

New insights into the inter-nucleon interactions, developments in many-body technology, and the surge in computational capabilities has led to phenomenal progress in low-energy nuclear physics in the past few years. Nonetheless, many calculations still lack a robust uncertainty quantification which is essential for making reliable predictions. In this work we investigate two distinct sources of uncertainty and develop ways to account for them. Harmonic oscillator basis expansions are widely used in ab-initio nuclear structure calculations. Finite computational resources usually require that the basis be truncated before observables are fully converged, necessitating reliable extrapolation schemes. It has been demonstrated recently that errors introduced from basis truncation can be taken into account by focusing on the infrared and ultraviolet cutoffs induced by a truncated basis. We show that a finite oscillator basis effectively imposes a hard-wall boundary condition in coordinate space. We accurately determine the position of the hard-wall as a function of oscillator space parameters, derive infrared extrapolation formulas for the energy and other observables, and discuss the extension of this approach to higher angular momentum and to other localized bases. We exploit the duality of the harmonic oscillator to account for the errors introduced by a finite ultraviolet cutoff. Nucleon knockout reactions have been widely used to study and understand nuclear properties. Such an analysis implicitly assumes that the effects of the probe can be separated from the physics of the target nucleus. This factorization between nuclear structure and reaction components depends on the renormalization scale and scheme, and has not been well understood. But it is potentially critical for interpreting experiments and for extracting process-independent nuclear properties. We use a class of unitary transformations called the similarity renormalization group (SRG) transformations to systematically study the scale dependence of factorization for the simplest knockout process of deuteron electrodisintegration. We find that the extent of scale dependence depends strongly on kinematics, but in a systematic way. We find a relatively weak scale dependence at the quasi-free kinematics that gets progressively stronger as one moves away from the quasi-free region. Based on examination of the relevant overlap matrix elements, we are able to qualitatively explain and even predict the nature of scale dependence based on the kinematics under consideration.

Financial Distress Prediction Using Discrete-time Hazard Model and Rating Transition Matrix Approach

NASA Astrophysics Data System (ADS)

Tsai, Bi-Huei; Chang, Chih-Huei

2009-08-01

Previous studies used constant cut-off indicator to distinguish distressed firms from non-distressed ones in the one-stage prediction models. However, distressed cut-off indicator must shift according to economic prosperity, rather than remains fixed all the time. This study focuses on Taiwanese listed firms and develops financial distress prediction models based upon the two-stage method. First, this study employs the firm-specific financial ratio and market factors to measure the probability of financial distress based on the discrete-time hazard models. Second, this paper further focuses on macroeconomic factors and applies rating transition matrix approach to determine the distressed cut-off indicator. The prediction models are developed by using the training sample from 1987 to 2004, and their levels of accuracy are compared with the test sample from 2005 to 2007. As for the one-stage prediction model, the model in incorporation with macroeconomic factors does not perform better than that without macroeconomic factors. This suggests that the accuracy is not improved for one-stage models which pool the firm-specific and macroeconomic factors together. In regards to the two stage models, the negative credit cycle index implies the worse economic status during the test period, so the distressed cut-off point is adjusted to increase based on such negative credit cycle index. After the two-stage models employ such adjusted cut-off point to discriminate the distressed firms from non-distressed ones, their error of misclassification becomes lower than that of one-stage ones. The two-stage models presented in this paper have incremental usefulness in predicting financial distress.

Waist circumference cut-off points for identification of abdominal obesity among the tunisian adult population.

PubMed

Bouguerra, R; Alberti, H; Smida, H; Salem, L B; Rayana, C B; El Atti, J; Achour, A; Gaigi, S; Slama, C B; Zouari, B; Alberti, K G M M

2007-11-01

Waist circumference (WC) is a convenient measure of abdominal adipose tissue. It itself is a cardiovascular disease (CVD) and diabetes-risk factor and is strongly linked to other CVD risk factors. There are, however, ethnic differences in the relationship of WC to the other risk factors. The aim of this study was to determine the optimal cut-off points of WC and body mass index (BMI) at which cardiovascular risk factors can be identified with maximum sensitivity and specificity in a representative sample of the Tunisian adult population and to investigate any correlation between WC and BMI. We used a sample of the Tunisian National Nutrition Survey, a cross-sectional population-based survey, conducted in 1996 on a large nationally representative sample, which included 3435 adults (1244 men and 2191 women) of 20 years or older. WC, BMI, blood pressure and fasting blood measurements (plasma glucose, total cholesterol, triglycerides) were recorded. Receiver operating characteristic (ROC) curve analysis was used to identify optimal cut-off values of WC and BMI to identify with maximum sensitivity and specificity the detection of high blood pressure, hyperglycaemia, high blood cholesterol and hypertriglyceridaemia. ROC curve analysis suggested WC cut-off points of 85 cm in men and 85 cm in women for the optimum detection of high blood pressure, diabetes and dyslipidaemia. The optimum BMI cut-off points for predicting cardiovascular risk factors were 24 kg/m(2) in men and 27 kg/m(2) in women. The cut-off points recommended for the Caucasian population differ from those appropriate for the Tunisian population. The data show a continuous increase in odds ratios of each cardiovascular risk factor, with increasing level of WC and BMI. WC exceeding 85 cm in men and 79 cm in women correctly identified subjects with a BMI of >/=25 kg/m(2), sensitivity of >90% and specificity of >83%. Based on the ROC analysis, we suggest a WC of 85 cm for both men and women as appropriate cut-off points to identify central obesity for the purposes of CVD and diabetes-risk detection among Tunisians. WCs of 85 cm in men and 79 cm in women were the most sensitive and specific to identify most subjects with a BMI >/=25 kg/m(2).

Effect of filter type on the statistics of energy transfer between resolved and subfilter scales from a-priori analysis of direct numerical simulations of isotropic turbulence

NASA Astrophysics Data System (ADS)

Buzzicotti, M.; Linkmann, M.; Aluie, H.; Biferale, L.; Brasseur, J.; Meneveau, C.

2018-02-01

The effects of different filtering strategies on the statistical properties of the resolved-to-subfilter scale (SFS) energy transfer are analysed in forced homogeneous and isotropic turbulence. We carry out a-priori analyses of the statistical characteristics of SFS energy transfer by filtering data obtained from direct numerical simulations with up to 20483 grid points as a function of the filter cutoff scale. In order to quantify the dependence of extreme events and anomalous scaling on the filter, we compare a sharp Fourier Galerkin projector, a Gaussian filter and a novel class of Galerkin projectors with non-sharp spectral filter profiles. Of interest is the importance of Galilean invariance and we confirm that local SFS energy transfer displays intermittency scaling in both skewness and flatness as a function of the cutoff scale. Furthermore, we quantify the robustness of scaling as a function of the filtering type.

University student depression inventory (USDI): confirmatory factor analysis and review of psychometric properties.

PubMed

Romaniuk, Madeline; Khawaja, Nigar G

2013-09-25

The 30-item USDI is a self-report measure that assesses depressive symptoms among university students. It consists of three correlated three factors: lethargy, cognitive-emotional and academic motivation. The current research used confirmatory factor analysis to asses construct validity and determine whether the original factor structure would be replicated in a different sample. Psychometric properties were also examined. Participants were 1148 students (mean age 22.84 years, SD=6.85) across all faculties from a large Australian metropolitan university. Students completed a questionnaire comprising of the USDI, the depression anxiety stress scale (DASS) and Life Satisfaction Scale (LSS). The three correlated factor model was shown to be an acceptable fit to the data, indicating sound construct validity. Internal consistency of the scale was also demonstrated to be sound, with high Cronbach alpha values. Temporal stability of the scale was also shown to be strong through test-retest analysis. Finally, concurrent and discriminant validity was examined with correlations between the USDI and DASS subscales as well as the LSS, with sound results further supporting the construct validity of the scale. Cut-off points were also developed to aid total score interpretation. Response rates are unclear. In addition, the representativeness of the sample could be improved potentially through targeted recruitment (i.e. reviewing the online sample statistics during data collection, examining the representativeness trends and addressing particular faculties within the university that were underrepresented). The USDI provides a valid and reliable method of assessing depressive symptoms found among university students. © 2013 Elsevier B.V. All rights reserved.

Specificity and sensitivity of the Beck Hopelessness Scale for suicidal ideation among adolescents entering early intervention service.

PubMed

Granö, Niklas; Oksanen, Jorma; Kallionpää, Santeri; Roine, Mikko

2017-01-01

Previous studies have shown an association between hopelessness and suicidal behaviour in clinical populations. The aim of the study was to investigate sensitivity, specificity, and predictive validity of the Beck Hopelessness Scale (BHS) for suicidal ideation in adolescents who show early risk signs on the psychiatric disorder continuum. Three-hundred and two help-seeking adolescents (mean age = 15.5 years) who were entering an early intervention team at Helsinki University Central Hospital, Finland, completed questionnaires of BHS and suicidal ideation, derived from Beck Depression Inventory (BDI-II). Results suggest that a BHS cut-off score ≥8 (sensitivity = 0.70, specificity = 0.76) or cut-off score ≥9 (sensitivity = 0.63, specificity = 0.80) may be useful to detect suicidal ideation with BHS in help-seeking adolescents population. Results remain mainly the same in a separate analysis with adolescents at risk for psychosis. The results support previous cut-off points for BHS in identification of suicidal ideation. The results suggest also that lower cut-off scores may be useful in sense of sensitivity, especially in clinical settings.

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

NASA Astrophysics Data System (ADS)

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

2017-10-01

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

Properties of infrared extrapolations in a harmonic oscillator basis

DOE PAGES

Coon, Sidney A.; Kruse, Michael K. G.

2016-02-22

Here, the success and utility of effective field theory (EFT) in explaining the structure and reactions of few-nucleon systems has prompted the initiation of EFT-inspired extrapolations to larger model spaces in ab initio methods such as the no-core shell model (NCSM). In this contribution, we review and continue our studies of infrared (ir) and ultraviolet (uv) regulators of NCSM calculations in which the input is phenomenological NN and NNN interactions fitted to data. We extend our previous findings that an extrapolation in the ir cutoff with the uv cutoff above the intrinsic uv scale of the interaction is quite successful,more » not only for the eigenstates of the Hamiltonian but also for expectation values of operators, such as r 2, considered long range. The latter results are obtained with Hamiltonians transformed by the similarity renormalization group (SRG) evolution. On the other hand, a possible extrapolation of ground state energies in the uv cutoff when the ir cutoff is below the intrinsic ir scale is not robust and does not agree with the ir extrapolation of the same data or with independent calculations using other methods.« less

Relationship between the caregiver's report on the patient's spontaneous-speech and the Brief Aphasia Evaluation.

PubMed

Vigliecca, Nora Silvana

2017-11-09

To study the relationship between the caregiver's perception about the patient's impairment in spontaneous speech, according to an item of four questions administered by semi-structured interview, and the patient's performance in the Brief Aphasia Evaluation (BAE). 102 right-handed patients with focal brain lesions of different types and location were examined. BAE is a valid and reliable instrument to assess aphasia. The caregiver's perception was correlated with the item of spontaneous speech, the total score and the three main factors of the BAE: Expression, Comprehension and Complementary factors. The precision (sensitivity/ specificity) about the caregiver's perception of the patient's spontaneous speech was analyzed with reference to the presence or absence of disorder, according to the professional, on the BAE item of spontaneous speech. The studied correlation was satisfactory, being greater (higher than 80%) for the following indicators: the item of spontaneous speech, the Expression factor and the total score of the scale; the correlation was a little smaller (higher than 70%) for the Comprehension and Complementary factors. Comparing two cut-off points that evaluated the precision of the caregiver's perception, satisfactory results were observed in terms of sensitivity and specificity (>70%) with likelihood ratios higher than three. By using the median as the cut-off point, more satisfactory diagnostic discriminations were obtained. Interviewing the caregiver specifically on the patient's spontaneous speech, in an abbreviated form, provides relevant information for the aphasia diagnosis.

Psychometric properties and clinical utility of the Scale for Suicidal Ideation (SSI) in adolescents

PubMed Central

Holi, Matti M; Pelkonen, Mirjami; Karlsson, Linnea; Kiviruusu, Olli; Ruuttu, Titta; Heilä, Hannele; Tuisku, Virpi; Marttunen, Mauri

2005-01-01

Background Accurate assessment of suicidality is of major importance in both clinical and research settings. The Scale for Suicidal Ideation (SSI) is a well-established clinician-rating scale but its suitability to adolescents has not been studied. The aim of this study was to evaluate the reliability and validity, and to test an appropriate cutoff threshold for the SSI in a depressed adolescent outpatient population and controls. Methods 218 adolescent psychiatric outpatient clinic patients suffering from depressive disorders and 200 age- and sex-matched school-attending controls were evaluated by the SSI for presence and severity of suicidal ideation. Internal consistency, discriminative-, concurrent-, and construct validity as well as the screening properties of the SSI were evaluated. Results Cronbach's α for the whole SSI was 0.95. The SSI total score differentiated patients and controls, and increased statistically significantly in classes with increasing severity of suicidality derived from the suicidality items of the K-SADS-PL diagnostic interview. Varimax-rotated principal component analysis of the SSI items yielded three theoretically coherent factors suggesting construct validity. Area under the receiver operating characteristic (ROC) curve was 0.84 for the whole sample and 0.80 for the patient sample. The optimal cutoff threshold for the SSI total score was 3/4 yielding sensitivity of 75% and specificity of 88.9% in this population. Conclusions SSI appears to be a reliable and a valid measure of suicidal ideation for depressed adolescents. PMID:15691388

Psychometric properties and clinical utility of the Scale for Suicidal Ideation (SSI) in adolescents.

PubMed

Holi, Matti M; Pelkonen, Mirjami; Karlsson, Linnea; Kiviruusu, Olli; Ruuttu, Titta; Heilä, Hannele; Tuisku, Virpi; Marttunen, Mauri

2005-02-03

Accurate assessment of suicidality is of major importance in both clinical and research settings. The Scale for Suicidal Ideation (SSI) is a well-established clinician-rating scale but its suitability to adolescents has not been studied. The aim of this study was to evaluate the reliability and validity, and to test an appropriate cutoff threshold for the SSI in a depressed adolescent outpatient population and controls. 218 adolescent psychiatric outpatient clinic patients suffering from depressive disorders and 200 age- and sex-matched school-attending controls were evaluated by the SSI for presence and severity of suicidal ideation. Internal consistency, discriminative-, concurrent-, and construct validity as well as the screening properties of the SSI were evaluated. Cronbach's alpha for the whole SSI was 0.95. The SSI total score differentiated patients and controls, and increased statistically significantly in classes with increasing severity of suicidality derived from the suicidality items of the K-SADS-PL diagnostic interview. Varimax-rotated principal component analysis of the SSI items yielded three theoretically coherent factors suggesting construct validity. Area under the receiver operating characteristic (ROC) curve was 0.84 for the whole sample and 0.80 for the patient sample. The optimal cutoff threshold for the SSI total score was 3/4 yielding sensitivity of 75% and specificity of 88.9% in this population. SSI appears to be a reliable and a valid measure of suicidal ideation for depressed adolescents.

A Visual Analog Scale to assess anxiety in children during anesthesia induction (VAS-I): Results supporting its validity in a sample of day care surgery patients.

PubMed

Berghmans, Johan M; Poley, Marten J; van der Ende, Jan; Weber, Frank; Van de Velde, Marc; Adriaenssens, Peter; Himpe, Dirk; Verhulst, Frank C; Utens, Elisabeth

2017-09-01

The modified Yale Preoperative Anxiety Scale is widely used to assess children's anxiety during induction of anesthesia, but requires training and its administration is time-consuming. A Visual Analog Scale, in contrast, requires no training, is easy-to-use and quickly completed. The aim of this study was to evaluate a Visual Analog Scale as a tool to assess anxiety during induction of anesthesia and to determine cut-offs to distinguish between anxious and nonanxious children. Four hundred and one children (1.5-16 years) scheduled for daytime surgery were included. Children's anxiety during induction was rated by parents and anesthesiologists on a Visual Analog Scale and by a trained observer on the modified Yale Preoperative Anxiety Scale. Psychometric properties assessed were: (i) concurrent validity (correlations between parents' and anesthesiologists' Visual Analog Scale and modified Yale Preoperative Anxiety Scale scores); (ii) construct validity (differences between subgroups according to the children's age and the parents' anxiety as assessed by the State-Trait Anxiety Inventory); (iii) cross-informant agreement using Bland-Altman analysis; (iv) cut-offs to distinguish between anxious and nonanxious children (reference: modified Yale Preoperative Anxiety Scale ≥30). Correlations between parents' and anesthesiologists' Visual Analog Scale and modified Yale Preoperative Anxiety Scale scores were strong (0.68 and 0.73, respectively). Visual Analog Scale scores were higher for children ≤5 years compared to children aged ≥6. Visual Analog Scale scores of children of high-anxious parents were higher than those of low-anxious parents. The mean difference between parents' and anesthesiologists' Visual Analog Scale scores was 3.6, with 95% limits of agreement (-56.1 to 63.3). To classify anxious children, cut-offs for parents (≥37 mm) and anesthesiologists (≥30 mm) were established. The present data provide preliminary data for the validity of a Visual Analog Scale to assess children's anxiety during induction. © 2017 John Wiley & Sons Ltd.

Distress or no distress, that's the question: A cutoff point for distress in a working population

PubMed Central

van Rhenen, Willem; van Dijk, Frank JH; Schaufeli, Wilmar B; Blonk, Roland WB

2008-01-01

Background The objective of the present study is to establish an optimal cutoff point for distress measured with the corresponding scale of the 4DSQ, using the prediction of sickness absence as a criterion. The cutoff point should result in a measure that can be used as a credible selection instrument for sickness absence in occupational health practice and in future studies on distress and mental disorders. Methods Distress is measured using the Four Dimensional Symptom Questionnaire (4DSQ), a 50-item self-report questionnaire, in a working population with and without sickness absence due to distress. Sensitivity and specificity were compared for various potential cutoff points, and a receiver operating characteristics analysis was conducted. Results and conclusion A distress cutoff point of ≥11 was defined. The choice was based on a challenging specificity and negative predictive value and indicates a distress level at which an employee is presumably at risk for subsequent sick leave on psychological grounds. The defined distress cutoff point is appropriate for use in occupational health practice and in studies of distress in working populations. PMID:18205912

Distress or no distress, that's the question: A cutoff point for distress in a working population.

PubMed

van Rhenen, Willem; van Dijk, Frank Jh; Schaufeli, Wilmar B; Blonk, Roland Wb

2008-01-18

The objective of the present study is to establish an optimal cutoff point for distress measured with the corresponding scale of the 4DSQ, using the prediction of sickness absence as a criterion. The cutoff point should result in a measure that can be used as a credible selection instrument for sickness absence in occupational health practice and in future studies on distress and mental disorders. Distress is measured using the Four Dimensional Symptom Questionnaire (4DSQ), a 50-item self-report questionnaire, in a working population with and without sickness absence due to distress. Sensitivity and specificity were compared for various potential cutoff points, and a receiver operating characteristics analysis was conducted. A distress cutoff point of >/=11 was defined. The choice was based on a challenging specificity and negative predictive value and indicates a distress level at which an employee is presumably at risk for subsequent sick leave on psychological grounds. The defined distress cutoff point is appropriate for use in occupational health practice and in studies of distress in working populations.

Sensitivity and Specificity Analysis: Use of Emoticon for Screening of Depression in Elderly in Singapore.

PubMed

Tan, Laurence; Toh, Hui Jin; Sim, Lai Kiow; Low, James Alvin

2018-03-01

The current screening tools for depression can be tedious to administer, especially in the elderly population with hearing impairment and/or limited proficiency in English language. To look at the feasibility of using emoticon as a screening and assessment tool for depression in the elderly. Cross-sectional study. A total of 77 elderly patients completed the study from June 2014 to August 2015 in a general geriatric outpatient clinic of an acute care hospital in Singapore. Patients rated their mood using an emoticon scale, which ranges from 1 ( most happy face) to 7 ( most sad face). Depression was assessed using the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) criteria as the gold standard. Sensitivity and specificity for depression were calculated for the cutoff scores from 1 to 7 on the emoticon scale. The sensitivity percentages were low across all cutoff scores. The specificity was more than 90% for the cutoff score of 5 and above on the emoticon scale. However, all the patients who had depression diagnosed using the DSM-IV criteria did not have emoticon scores of 5 and above. The emoticon scale was easy to use, but its effectiveness in the screening of depression in the elderly needs to be explored further. The inability to use the emoticon scale as a tool may be the lack of measurements in the other domains of the DSM-IV criteria (sleep, energy, appetite, etc.), rather than failure of the emoticon scale to assess mood.

Statistics of the relative velocity of particles in bidisperse turbulent suspensions

NASA Astrophysics Data System (ADS)

Bhatnagar, Akshay; Gustavsson, Kristian; Mehlig, Bernhard; Mitra, Dhrubaditya

2017-11-01

We calculate the joint probability distribution function (JPDF) of relative distances (R) and velocities (V with longitudinal component VR) of a pair of bidisperse heavy inertial particles in homogeneous and isotropic turbulent flows using direct numerical simulations (DNS). A recent paper (J. Meibohm, et. al. 2017), using statistical-model simulations and mathematical analysis of an one-dimensional white-noise model, has shown that the JPDF, P (R ,VR) , for two particles with Stokes numbers, St1 and St2 , can be interpreted in terms of StM , the harmonic mean of St1 and St2 and θ ≡ | St1 - St2 | / (St1 + St2) . For small θ there emerges a small-scale cutoff Rc and a small-velocity cutoff Vc such that for VR <

Differences in MMPI-2 FBS and RBS scores in brain injury, probable malingering, and conversion disorder groups: a preliminary study.

PubMed

Peck, C P; Schroeder, R W; Heinrichs, R J; Vondran, E J; Brockman, C J; Webster, B K; Baade, L E

2013-01-01

This study examined differences in raw scores on the Symptom Validity Scale and Response Bias Scale (RBS) from the Minnesota Multiphasic Personality Inventory-2 in three criterion groups: (i) valid traumatic brain injured, (ii) invalid traumatic brain injured, and (iii) psychogenic non-epileptic seizure disorders. Results indicate that a >30 raw score cutoff for the Symptom Validity Scale accurately identified 50% of the invalid traumatic brain injured group, while misclassifying none of the valid traumatic brain injured group and 6% of the psychogenic non-epileptic seizure disorder group. Using a >15 RBS raw cutoff score accurately classified 50% of the invalid traumatic brain injured group and misclassified fewer than 10% of the valid traumatic brain injured and psychogenic non-epileptic seizure disorder groups. These cutoff scores used conjunctively did not misclassify any members of the psychogenic non-epileptic seizure disorder or valid traumatic brain injured groups, while accurately classifying 44% of the invalid traumatic brain injured individuals. Findings from this preliminary study suggest that the conjunctive use of the Symptom Validity Scale and the RBS from the Minnesota Multiphasic Personality Inventory-2 may be useful in differentiating probable malingering from individuals with brain injuries and conversion disorders.

[Personalizing the reference level: gold standard to evaluate the quality of service perceived].

PubMed

Rodrigo-Rincón, I; Reyes-Pérez, M; Martínez-Lozano, M E

2014-01-01

To know the cutoff point at which in-house Nuclear Medicine Department (MND) customers consider that the quality of service is good (personalized cutoff). We conducted a survey of the professionals who had requested at least 5 tests to the Nuclear Medicine Department. A total of 71 doctors responded (response rate: 30%). A question was added to the questionnaire for the user to establish a cutoff point for which they would consider the quality of service as good. The quality non-conformities, areas of improvement and strong points of the six questions measuring the quality of service (Likert scale 0 to 10) were compared with two different thresholds: personalized cutoff and one proposed by the service itself a priori. Test statistics: binomial and Student's t-test for paired data. A cutoff value of 7 was proposed by the service as a reference while 68.1% of respondents suggested a cutoff above 7 points (mean 7.9 points). The 6 elements of perceived quality were considered strong points with the cutoff proposed by the MND, while there were 3 detected with the personalized threshold. Thirteen percent of the answers were nonconformities with the service cutoff versus 19.2% with the personalized one, the differences being statistically significant (difference 95% CI 6.44%:0,83-12.06). The final image of the perceived quality of an in-house customer is different when using the cutoff established by the Department versus the personalized cutoff given by the respondent. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

Screening instruments for a population of older adults: The 10-item Kessler Psychological Distress Scale (K10) and the 7-item Generalized Anxiety Disorder Scale (GAD-7).

PubMed

Vasiliadis, Helen-Maria; Chudzinski, Veronica; Gontijo-Guerra, Samantha; Préville, Michel

2015-07-30

Screening tools that appropriately detect older adults' mental disorders are of great public health importance. The present study aimed to establish cutoff scores for the 10-item Kessler Psychological Distress (K10) and the 7-item Generalized Anxiety Disorder (GAD-7) scales when screening for depression and anxiety. We used data from participants (n = 1811) in the Enquête sur la Santé des Aînés-Service study. Depression and anxiety were measured using DSM-V and DSM-IV criteria. Receiver operating characteristic (ROC) curve analysis provided an area under the curve (AUC) of 0.767 and 0.833 for minor and for major depression when using K10. A cutoff of 19 was found to balance sensitivity (0.794) and specificity (0.664) for minor depression, whereas a cutoff of 23 was found to balance sensitivity (0.692) and specificity (0.811) for major depression. When screening for an anxiety with GAD-7, ROC analysis yielded an AUC of 0.695; a cutoff of 5 was found to balance sensitivity (0.709) and specificity (0.568). No significant differences were found between subgroups of age and gender. Both K10 and GAD-7 were able to discriminate between cases and non-cases when screening for depression and anxiety in an older adult population of primary care service users. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Thin-ideal internalization: How much is too much?

PubMed

Schaefer, Lauren M; Burke, Natasha L; Thompson, J Kevin

2018-03-16

Internalization of the thin-ideal is a risk factor for eating disorders that frequently persists into recovery and increases patient risk for relapse. Addressing thin-ideal internalization as a core element of eating disorder prevention and treatment produces significant reductions in eating pathology. However, research has not yet quantified levels of thin-ideal internalization that may signal increased versus decreased risk for disordered eating. To address this gap in the literature, receiver operating characteristic (ROC) curve analysis was used to identify a thin-ideal internalization cutoff score that signified clinically-meaningful eating disorder pathology. 787 college women (age M = 20.17, SD = 2.41; BMI M = 23.58, SD = 5.29) were classified as "healthy" (N = 717) or those with significant disordered eating (N = 70) using established clinical cutoffs for the Eating Disorder Examination-Questionnaire. ROC curve analysis was used to test the performance of the Sociocultural Attitudes Towards Appearance Questionnaire-4 (SATAQ-4) Internalization: Thin/Low Body Fat subscale in predicting disordered eating status, and to identify a cutoff score that maximized sensitivity and specificity to discriminate between healthy and disordered eating samples. Mean SATAQ-4 internalization scores were 3.29 (SD = 0.92) and 4.27 (SD = 0.62) for healthy and disordered eating participants, respectively. The SATAQ-4 internalization scores were good predictors of disordered eating status (area under the curve = 0.81, 95% CI: 0.76-0.86). The optimal cutoff of 3.78 (measured on a 1-5 Likert scale) yielded a sensitivity of 0.81 and specificity of 0.64. Overall, results provide preliminary support for the discriminant validity of SATAQ-4 thin internalization scores and suggest that even moderate levels of thin-ideal internalization may be predictive of clinically-significant eating pathology. It may be important for prevention and intervention work to actively seek to reduce internalization levels below this clinical cutoff, though future work is needed to bear this out.

Exploring optimum cut-off scores to screen for probable posttraumatic stress disorder within a sample of UK treatment-seeking veterans

PubMed Central

Murphy, Dominic; Ross, Jana; Ashwick, Rachel; Armour, Cherie; Busuttil, Walter

2017-01-01

ABSTRACT Background: Previous research exploring the psychometric properties of the scores of measures of posttraumatic stress disorder (PTSD) suggests there is variation in their functioning depending on the target population. To date, there has been little study of these properties within UK veteran populations. Objective: This study aimed to determine optimally efficient cut-off values for the Impact of Event Scale-Revised (IES-R) and the PTSD Checklist for DSM-5 (PCL-5) that can be used to assess for differential diagnosis of presumptive PTSD. Methods: Data from a sample of 242 UK veterans assessed for mental health difficulties were analysed. The criterion-related validity of the PCL-5 and IES-R were evaluated against the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). Kappa statistics were used to assess the level of agreement between the DSM-IV and DSM-5 classification systems. Results: The optimal cut-off scores observed within this sample were 34 or above on the PCL-5 and 46 or above on the IES-R. The PCL-5 cut-off is similar to the previously reported values, but the IES-R cut-off identified in this study is higher than has previously been recommended. Overall, a moderate level of agreement was found between participants screened positive using the DSM-IV and DSM-5 classification systems of PTSD. Conclusions: Our findings suggest that the PCL-5 and IES-R can be used as brief measures within veteran populations presenting at secondary care to assess for PTSD. The use of a higher cut-off for the IES-R may be helpful for differentiating between veterans who present with PTSD and those who may have some sy`mptoms of PTSD but are sub-threshold for meeting a diagnosis. Further, the use of more accurate optimal cut-offs may aid clinicians to better monitor changes in PTSD symptoms during and after treatment. PMID:29435200

Exploring optimum cut-off scores to screen for probable posttraumatic stress disorder within a sample of UK treatment-seeking veterans.

PubMed

Murphy, Dominic; Ross, Jana; Ashwick, Rachel; Armour, Cherie; Busuttil, Walter

2017-01-01

Background : Previous research exploring the psychometric properties of the scores of measures of posttraumatic stress disorder (PTSD) suggests there is variation in their functioning depending on the target population. To date, there has been little study of these properties within UK veteran populations. Objective : This study aimed to determine optimally efficient cut-off values for the Impact of Event Scale-Revised (IES-R) and the PTSD Checklist for DSM-5 (PCL-5) that can be used to assess for differential diagnosis of presumptive PTSD. Methods : Data from a sample of 242 UK veterans assessed for mental health difficulties were analysed. The criterion-related validity of the PCL-5 and IES-R were evaluated against the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). Kappa statistics were used to assess the level of agreement between the DSM-IV and DSM-5 classification systems. Results : The optimal cut-off scores observed within this sample were 34 or above on the PCL-5 and 46 or above on the IES-R. The PCL-5 cut-off is similar to the previously reported values, but the IES-R cut-off identified in this study is higher than has previously been recommended. Overall, a moderate level of agreement was found between participants screened positive using the DSM-IV and DSM-5 classification systems of PTSD. Conclusions : Our findings suggest that the PCL-5 and IES-R can be used as brief measures within veteran populations presenting at secondary care to assess for PTSD. The use of a higher cut-off for the IES-R may be helpful for differentiating between veterans who present with PTSD and those who may have some sy`mptoms of PTSD but are sub-threshold for meeting a diagnosis. Further, the use of more accurate optimal cut-offs may aid clinicians to better monitor changes in PTSD symptoms during and after treatment.

The Alcohol Use Disorders Identification Test (AUDIT): Exploring the Factor Structure and Cutoff Thresholds in a Representative Post-Conflict Population in Northern Uganda.

PubMed

Blair, Alden Hooper; Pearce, Margo Ellen; Katamba, Achilles; Malamba, Samuel S; Muyinda, Herbert; Schechter, Martin T; Spittal, Patricia M

2017-05-01

Despite increased use of the Alcohol Use Disorders Identification Test (AUDIT) in sub-Saharan Africa, few studies have assessed its underlying conceptual framework, and none have done so in post-conflict settings. Further, significant inconsistencies exist between definitions used for problematic consumption. Such is the case in Uganda, facing one of the highest per-capita alcohol consumption levels regionally, which is thought to be hindering rebuilding in the North after two decades of civil war. This study explores the impact of varying designation cutoff thresholds in the AUDIT as well as its conceptual factor structure in a representative sample of the population. In all, 1720 Cango Lyec Project participants completed socio-economic and mental health questionnaires, provided blood samples and took the AUDIT. Participant characteristics and consumption designations were compared at AUDIT summary score thresholds of ≥3, ≥5 and ≥8. Confirmatory factor analyses (CFA) explored one-, two- and three-factor level models overall and by sex with relative and absolute fit indicators. There were no significant differences in participant demographic characteristics between thresholds. At higher cutoffs, the test increased in specificity to identify those with hazardous drinking, disordered drinking and suffering from alcohol-related harms. All conceptual models indicated good fit, with three-factor models superior overall and within both sexes. In Northern Uganda, a three-factor AUDIT model best explores alcohol use in the population and is appropriate for use in both sexes. Lower cutoff thresholds are recommended to identify those with potentially disordered drinking to best plan effective interventions and treatments. A CFA of the AUDIT showed good fit for one-, two, and three-factor models overall and by sex in a representative sample in post-conflict Northern Uganda. A three-plus total AUDIT cutoff score is suggested to screen for hazardous drinking in this or similar populations. © The Author 2016. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Large-Angular-Scale Clustering as a Clue to the Source of UHECRs

NASA Astrophysics Data System (ADS)

Berlind, Andreas A.; Farrar, Glennys R.

We explore what can be learned about the sources of UHECRs from their large-angular-scale clustering (referred to as their "bias" by the cosmology community). Exploiting the clustering on large scales has the advantage over small-scale correlations of being insensitive to uncertainties in source direction from magnetic smearing or measurement error. In a Cold Dark Matter cosmology, the amplitude of large-scale clustering depends on the mass of the system, with more massive systems such as galaxy clusters clustering more strongly than less massive systems such as ordinary galaxies or AGN. Therefore, studying the large-scale clustering of UHECRs can help determine a mass scale for their sources, given the assumption that their redshift depth is as expected from the GZK cutoff. We investigate the constraining power of a given UHECR sample as a function of its cutoff energy and number of events. We show that current and future samples should be able to distinguish between the cases of their sources being galaxy clusters, ordinary galaxies, or sources that are uncorrelated with the large-scale structure of the universe.

Robust inference for responder analysis: Innovative clinical trial design using a minimum p-value approach.

PubMed

Lin, Yunzhi

2016-08-15

Responder analysis is in common use in clinical trials, and has been described and endorsed in regulatory guidance documents, especially in trials where "soft" clinical endpoints such as rating scales are used. The procedure is useful, because responder rates can be understood more intuitively than a difference in means of rating scales. However, two major issues arise: 1) such dichotomized outcomes are inefficient in terms of using the information available and can seriously reduce the power of the study; and 2) the results of clinical trials depend considerably on the response cutoff chosen, yet in many disease areas there is no consensus as to what is the most appropriate cutoff. This article addresses these two issues, offering a novel approach for responder analysis that could both improve the power of responder analysis and explore different responder cutoffs if an agreed-upon common cutoff is not present. Specifically, we propose a statistically rigorous clinical trial design that pre-specifies multiple tests of responder rates between treatment groups based on a range of pre-specified responder cutoffs, and uses the minimum of the p-values for formal inference. The critical value for hypothesis testing comes from permutation distributions. Simulation studies are carried out to examine the finite sample performance of the proposed method. We demonstrate that the new method substantially improves the power of responder analysis, and in certain cases, yields power that is approaching the analysis using the original continuous (or ordinal) measure.

The English version of the four-dimensional symptom questionnaire (4DSQ) measures the same as the original Dutch questionnaire: a validation study.

PubMed

Terluin, Berend; Smits, Niels; Miedema, Baukje

2014-12-01

Translations of questionnaires need to be carefully validated to assure that the translation measures the same construct(s) as the original questionnaire. The four-dimensional symptom questionnaire (4DSQ) is a Dutch self-report questionnaire measuring distress, depression, anxiety and somatization. To evaluate the equivalence of the English version of the 4DSQ. 4DSQ data of English and Dutch speaking general practice attendees were analysed and compared. The English speaking group consisted of 205 attendees, aged 18-64 years, in general practice, in Canada whereas the Dutch group consisted of 302 general practice attendees in the Netherlands. Differential item functioning (DIF) analysis was conducted using the Mantel-Haenszel method and ordinal logistic regression. Differential test functioning (DTF; i.e., the scale impact of DIF) was evaluated using linear regression analysis. DIF was detected in 2/16 distress items, 2/6 depression items, 2/12 anxiety items, and 1/16 somatization items. With respect to mean scale scores, the impact of DIF on the scale level was negligible for all scales. On the anxiety scale DIF caused the English speaking patients with moderate to severe anxiety to score about one point lower than Dutch patients with the same anxiety level. The English 4DSQ measures the same constructs like the original Dutch 4DSQ. The distress, depression and somatization scales can employ the same cut-off points as the corresponding Dutch scales. However, cut-off points of the English 4DSQ anxiety scale should be lowered by one point to retain the same meaning as the Dutch anxiety cut-off points.

Exploratory structural equation modeling of personality data.

PubMed

Booth, Tom; Hughes, David J

2014-06-01

The current article compares the use of exploratory structural equation modeling (ESEM) as an alternative to confirmatory factor analytic (CFA) models in personality research. We compare model fit, factor distinctiveness, and criterion associations of factors derived from ESEM and CFA models. In Sample 1 (n = 336) participants completed the NEO-FFI, the Trait Emotional Intelligence Questionnaire-Short Form, and the Creative Domains Questionnaire. In Sample 2 (n = 425) participants completed the Big Five Inventory and the depression and anxiety scales of the General Health Questionnaire. ESEM models provided better fit than CFA models, but ESEM solutions did not uniformly meet cutoff criteria for model fit. Factor scores derived from ESEM and CFA models correlated highly (.91 to .99), suggesting the additional factor loadings within the ESEM model add little in defining latent factor content. Lastly, criterion associations of each personality factor in CFA and ESEM models were near identical in both inventories. We provide an example of how ESEM and CFA might be used together in improving personality assessment. © The Author(s) 2014.

Psychometric evaluation of the Persian version of the Templer's Death Anxiety Scale in cancer patients.

PubMed

Soleimani, Mohammad Ali; Yaghoobzadeh, Ameneh; Bahrami, Nasim; Sharif, Saeed Pahlevan; Sharif Nia, Hamid

2016-10-01

In this study, 398 Iranian cancer patients completed the 15-item Templer's Death Anxiety Scale (TDAS). Tests of internal consistency, principal components analysis, and confirmatory factor analysis were conducted to assess the internal consistency and factorial validity of the Persian TDAS. The construct reliability statistic and average variance extracted were also calculated to measure construct reliability, convergent validity, and discriminant validity. Principal components analysis indicated a 3-component solution, which was generally supported in the confirmatory analysis. However, acceptable cutoffs for construct reliability, convergent validity, and discriminant validity were not fulfilled for the three subscales that were derived from the principal component analysis. This study demonstrated both the advantages and potential limitations of using the TDAS with Persian-speaking cancer patients.

Zinc status and cognitive function of pregnant women in Southern Ethiopia

PubMed Central

Stoecker, BJ; Abebe, Y; Hubbs-Tait, L; Kennedy, TS; Gibson, RS; Arbide, I; Teshome, A; Westcott, J; Krebs, NF; Hambidge, KM

2015-01-01

The relation between zinc status and cognitive function was examined in a cross-sectional study in the Sidama area of Southern Ethiopia. Pregnant women >24 weeks of gestation from three adjacent rural villages volunteered to participate. Mean (s.d.) plasma zinc of 99 women was 6.97 (1.07) μmol/l (below the cutoff of 7.6 μmol/l indicative of zinc deficiency at this stage of gestation). The Raven’s Coloured Progressive Matrices (CPM) test was administered individually. Scores for the Raven’s scale A, which is the simplest scale, ranged from 4 to 10 of a possible 12. Women with plasma zinc <7.6 μmol/l had significantly lower Raven’s CPM scale A scores than women with plasma zinc concentrations >7.6 μmol/l. Plasma zinc and maternal age and education predicted 17% of the variation in Raven’s CPM scale A scores. We conclude that zinc deficiency is a major factor affecting cognition in these pregnant women. PMID:19190668

Rasch analysis of the carers quality of life questionnaire for parkinsonism.

PubMed

Pillas, Marios; Selai, Caroline; Schrag, Anette

2017-03-01

To assess the psychometric properties of the Carers Quality of Life Questionnaire for Parkinsonism using a Rasch modeling approach and determine the optimal cut-off score. We performed a Rasch analysis of the survey answers of 430 carers of patients with atypical parkinsonism. All of the scale items demonstrated acceptable goodness of fit to the Rasch model. The scale was unidimensional and no notable differential item functioning was detected in the items regarding age and disease type. Rating categories were functioning adequately in all scale items. The scale had high reliability (.95) and construct validity and a high degree of precision, distinguishing between 5 distinct groups of carers with different levels of quality of life. A cut-off score of 62 was found to have the optimal screening accuracy based on Hospital Anxiety and Depression Scale subscores. The results suggest that the Carers Quality of Life Questionnaire for Parkinsonism is a useful scale to assess carers' quality of life and allows analyses requiring interval scaling of variables. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.

The Prominent Role of the Upstream Conditions on the Large-scale Motions of a Turbulent Channel Flow

NASA Astrophysics Data System (ADS)

Castillo, Luciano; Dharmarathne, Suranga; Tutkun, Murat; Hutchins, Nicholas

2017-11-01

In this study we investigate how upstream perturbations in a turbulent channel flow impact the downstream flow evolution, especially the large-scale motions. Direct numerical simulations were carried out at a friction Reynolds number, Reτ = 394 . Spanwise varying inlet blowing perturbations were imposed at 1 πh from the inlet. The flow field is decomposed into its constituent scales using proper orthogonal decomposition. The large-scale motions and the small-scale motions of the flow field are separated at a cut-off mode number, Mc. The cut-off mode number is defined as the number of the mode at which the fraction of energy recovered is 55 % . It is found that Reynolds stresses are increased due to blowing perturbations and large-scale motions are responsible for more than 70 % of the increase of the streamwise component of Reynolds normal stress. Surprisingly, 90 % of Reynolds shear stress is due to the energy augmentation of large-scale motions. It is shown that inlet perturbations impact the downstream flow by means of the LSM.

The psychometric properties of the 10-item Kessler Psychological Distress Scale (K10) in Canadian military personnel

PubMed Central

Zamorski, Mark A.; Colman, Ian

2018-01-01

The psychometric properties of the ten-item Kessler Psychological Distress scale (K10) have been extensively explored in civilian populations. However, documentation of its psychometric properties in military populations is limited, and there is no universally accepted cut-off score on the K10 to distinguish clinical vs. sub-clinical levels of distress. The objective of this study was to examine the psychometric properties of the K10 in Canadian Armed Forces personnel. Data on 6700 Regular Forces personnel were obtained from the 2013 Canadian Forces Mental Health Survey. The internal consistency and factor structure of the K10 (range, 0–40) were examined using confirmatory factor analysis (CFA). Receiver Operating Characteristic (ROC) analysis was used to select optimal cut-offs for the K10, using the presence/absence of any of four past-month disorders as the outcome (posttraumatic stress disorder, major depressive episode, generalized anxiety disorder, and panic disorder). Cronbach’s alpha (0.88) indicated a high level of internal consistency of the K10. Results from CFA indicated that a single-factor 10-item construct had an acceptable overall fit: root mean square error of approximation (RMSEA) = 0.05; 90% confidence interval (CI):0.05–0.06, comparative fit index (CFI) = 0.99, Tucker-Lewis Index (TLI) = 0.99, weighted root mean square residual (WRMR) = 2.06. K10 scores were strongly associated with both the presence and recency of all four measured disorders. The area under the ROC curve was 0.92, demonstrating excellent predictive value for past-30-day disorders. A K10 score of 10 or greater was optimal for screening purposes (sensitivity = 86%; specificity = 83%), while a score of 17 or greater (sensitivity = 53%; specificity = 97%) was optimal for prevalence estimation of clinically significant psychological distress, in that it resulted in equal numbers of false positives and false negatives. Our results suggest that K10 scale has satisfactory psychometric properties for use as a measure of non-specific psychological distress in the military population. PMID:29698459

Clinically significant changes in the emotional condition of relatives of patients with severe traumatic brain injury during sub-acute rehabilitation.

PubMed

Norup, Anne; Kristensen, Karin Spangsberg; Poulsen, Ingrid; Nielsen, Christina Löfvquist; Mortensen, Erik Lykke

2013-09-01

To investigate clinically significant change in the emotional condition of relatives of patients with severe traumatic brain injury during sub-acute rehabilitation. Participants were 62 pairs of relatives and patients. Relatives completed the anxiety and depression scales from the Symptom Checklist-90-R (SCL-90-R) when the patients were admitted to sub-acute rehabilitation and at discharge. Improvement in emotional condition was investigated using the following criteria: (i) statistically reliable improvement; and (ii) clinically significant change (CSC). At admission, 53.2% and 58.1% of relatives had scores above cut-off values on the anxiety and depression scales, respectively. On the anxiety scale 69.7% of these experienced a reliable improvement according to the Reliable Change Index (RCI) and 45.5% also obtained CSC, as their end-point was below the cut-off value. On the depression scale the corresponding figures were 44.4% and 41.7%, respectively. When comparing relatives with and without CSC, we found that CSC in symptoms of anxiety was associated with significantly better functional improvement during rehabilitation and a shorter period of post-traumatic amnesia in the patients. Of the relatives who reported scores above cut-off values on the anxiety and depression scales at patient's admission, approximately 40% experienced CSC in anxiety and depression during the patient's rehabilitation. Relatives of patients experiencing improvement during inpatient rehabilitation are more likely to experience CSC in anxiety.

Evaluation of depressive symptoms in patients with coronary artery disease using the Montgomery Åsberg Depression Rating Scale.

PubMed

Bunevicius, Adomas; Staniute, Margarita; Brozaitiene, Julija; Pommer, Antoinette M; Pop, Victor J M; Montgomery, Stuart A; Bunevicius, Robertas

2012-09-01

The aim of this study was to evaluate, in patients with coronary artery disease (CAD), factor structure and psychometric properties of the Montgomery Åsberg Depression Rating Scale (MADRS) to identify patients with current major depressive episode (MDE). The construct validity of the MADRS against self-rating scales was also evaluated. Consecutive 522 CAD patients at admission to the cardiac rehabilitation program were interviewed for the severity of depressive symptoms using the MADRS and for current MDE using the structured MINI International Neuropsychiatric Interview. Also, all patients completed the Hospital Anxiety and Depression Scale and the Beck Depression Inventory-II. The MADRS had one-factor structure and high internal consistency (Cronbach's coefficient α=0.82). Confirmative factor analysis indicated an adequate fit: comparative fit index=0.95, normed fit index=0.91, and root mean square error of approximation=0.07. At a cut-off value of 10 or higher, the MADRS had good psychometric properties for the identification of current MDE (positive predictive value=42%, with sensitivity=88% and specificity=85%). There was also a moderate to strong correlation of MADRS scores with scores on self-rating depression scales. In sum, in CAD patients undergoing rehabilitation, the MADRS is a unidimensional instrument with high internal consistency and can be used for the identification of depressed CAD patients. The association between MADRS and self-rating depression scores is moderate to strong. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Re-adjusting the cut-off score of the Korean version of the Childhood Autism Rating Scale for high-functioning individuals with autism spectrum disorder.

PubMed

Kwon, Hyuk-Jin; Yoo, Hee-Jeong; Kim, Joo-Hyun; Noh, Dong-Hyun; Sunwoo, Hyun-Jung; Jeon, Ye Seul; Lee, Sang-Youn; Jo, Ye-Ul; Bong, Gui-Young

2017-10-01

The current cut-off score of the Korean version of the Childhood Autism Rating Scale (K-CARS) does not seem to be sensitive enough to precisely diagnose high-functioning autism. The aim of this study was to identify the optimal cut-off score of K-CARS for diagnosing high-functioning individuals with autism spectrum disorders (ASD). A total of 329 participants were assessed by the Korean versions of the Autism Diagnostic Interview - Revised (K-ADI-R), Autism Diagnostic Observation Schedule (K-ADOS), and K-CARS. IQ and Social Maturity Scale scores were also obtained. The true positive and false negative rates of K-CARS were 77.2% and 22.8%, respectively. Verbal IQ (VIQ) and Social Quotient (SQ) were significant predictors of misclassification. The false negative rate increased to 36.0% from 19.8% when VIQ was >69.5, and the rate increased to 44.1% for participants with VIQ > 69.5 and SQ > 75.5. In addition, if SQ was >83.5, the false negative rate increased to 46.7%, even if the participant's VIQ was ≤69.5. Optimal cut-off scores were 28.5 (for VIQ ≤ 69.5 and SQ ≤ 75.5), 24.25 (for VIQ > 69.5 and SQ > 75.5), and 24.5 (for SQ > 83.5), respectively. The likelihood of a false negative error increases when K-CARS is used to diagnose high-functioning autism and Asperger's syndrome. For subjects with ASD and substantial verbal ability, the cut-off score for K-CARS should be re-adjusted and/or supplementary diagnostic tools might be needed to enhance diagnostic accuracy for ASD. © 2017 The Authors. Psychiatry and Clinical Neurosciences © 2017 Japanese Society of Psychiatry and Neurology.

Screening for postnatal depression in Chinese-speaking women using the Hong Kong translated version of the Edinburgh Postnatal Depression Scale.

PubMed

Chen, Helen; Bautista, Dianne; Ch'ng, Ying Chia; Li, Wenyun; Chan, Edwin; Rush, A John

2013-06-01

The Edinburgh Postnatal Depression Scale (EPDS) may not be a uniformly valid postnatal depression (PND) screen across populations. We evaluated the performance of a Chinese translation of 10-item (HK-EPDS) and six-item (HK-EPDS-6) versions in post-partum women in Singapore. Chinese-speaking post-partum obstetric clinic patients were recruited for this study. They completed the HK-EPDS, from which we derived the six-item HK-EPDS-6. All women were clinically assessed for PND based on Diagnostic and Statistical Manual, Fourth Edition-Text Revision criteria. Receiver-operator curve (ROC) analyses and likelihood ratio computations informed scale cutoff choices. Clinical fitness was judged by thresholds for internal consistency [α ≥ 0.70] and for diagnostic performance by true-positive rate (>85%), false-positive rate (≤10%), positive likelihood ratio (>1), negative likelihood ratio (<0.2), area under the ROC curve (AUC, ≥90%) and effect size (≥0.80). Based on clinical interview, prevalence of PND was 6.2% in 487 post-partum women. HK-EPDS internal consistency was 0.84. At 13 or more cutoff, the true-positive rate was 86.7%, false-positive rate 3.3%, positive likelihood ratio 26.4, negative likelihood ratio 0.14, AUC 94.4% and effect size 0.81. For the HK-EPDS-6, internal consistency was 0.76. At 8 or more cutoff, we found a true-positive rate of 86.7%, false-positive rate 6.6%, positive likelihood ratio 13.2, negative likelihood ration 0.14, AUC 92.9% and effect size 0.98. The HK-EPDS (cutoff ≥13) and HK-EPDS6 (cutoff ≥8) are fit for PND screening for general population post-partum women. The brief six-item version appears to be clinically suitable for quick screening in Chinese speaking women. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

The COMFORT-behavior scale is useful to assess pain and distress in 0- to 3-year-old children with Down syndrome.

PubMed

Valkenburg, Abraham J; Boerlage, Anneke A; Ista, Erwin; Duivenvoorden, Hugo J; Tibboel, Dick; van Dijk, Monique

2011-09-01

Many pediatric intensive care units use the COMFORT-Behavior scale (COMFORT-B) to assess pain in 0- to 3-year-old children. The objective of this study was to determine whether this scale is also valid for the assessment of pain in 0- to 3-year-old children with Down syndrome. These children often undergo cardiac or intestinal surgery early in life and therefore admission to a pediatric intensive care unit. Seventy-six patients with Down syndrome were included and 466 without Down syndrome. Pain was regularly assessed with the COMFORT-B scale and the pain Numeric Rating Scale (NRS). For either group, confirmatory factor analyses revealed a 1-factor model. Internal consistency between COMFORT-B items was good (Cronbach's α=0.84-0.87). Cutoff values for the COMFORT-B set at 17 or higher discriminated between pain (NRS pain of 4 or higher) and no pain (NRS pain below 4) in both groups. We concluded that the COMFORT-B scale is also valid for 0- to 3-year-old children with Down syndrome. This makes it even more useful in the pediatric intensive care unit setting, doing away with the need to apply another instrument for those children younger than 3. Copyright © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Psychometric properties of the Revised Chen Internet Addiction Scale (CIAS-R) in Chinese adolescents.

PubMed

Mak, Kwok-Kei; Lai, Ching-Man; Ko, Chih-Hung; Chou, Chien; Kim, Dong-Il; Watanabe, Hiroko; Ho, Roger C M

2014-10-01

The Revised Chen Internet Addiction Scale (CIAS-R) was developed to assess Internet addiction in Chinese populations, but its psychometric properties in adolescents have not been examined. This study aimed to evaluate the factor structure and psychometric properties of CIAS-R in Hong Kong Chinese adolescents. 860 Grade 7 to 13 students (38 % boys) completed the CIAS-R, the Young's Internet Addiction Test (IAT), and the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) in a survey. The prevalence of Internet addiction as assessed by CIAS-R was 18 %. High internal consistency and inter-item correlations were reported for the CIAS-R. Results from the confirmatory factor analysis suggested a four-factor structure of Compulsive Use and Withdrawal, Tolerance, Interpersonal and Health-related Problems, and Time Management Problems. Moreover, results of hierarchical multiple regression supported the incremental validity of the CIAS-R to predict mental health outcomes beyond the effects of demographic differences and self-reported time spent online. The CIAS is a reliable and valid measure of internet addiction problems in Hong Kong adolescents. Future study is warranted to validate the cutoffs of the CIAS-R for identification of adolescents with Internet use problems who may have mental health needs.

Cutoff size need not strongly influence molecular dynamics results for solvated polypeptides.

PubMed

Beck, David A C; Armen, Roger S; Daggett, Valerie

2005-01-18

The correct treatment of van der Waals and electrostatic nonbonded interactions in molecular force fields is essential for performing realistic molecular dynamics (MD) simulations of solvated polypeptides. The most computationally tractable treatment of nonbonded interactions in MD utilizes a spherical distance cutoff (typically, 8-12 A) to reduce the number of pairwise interactions. In this work, we assess three spherical atom-based cutoff approaches for use with all-atom explicit solvent MD: abrupt truncation, a CHARMM-style electrostatic shift truncation, and our own force-shifted truncation. The chosen system for this study is an end-capped 17-residue alanine-based alpha-helical peptide, selected because of its use in previous computational and experimental studies. We compare the time-averaged helical content calculated from these MD trajectories with experiment. We also examine the effect of varying the cutoff treatment and distance on energy conservation. We find that the abrupt truncation approach is pathological in its inability to conserve energy. The CHARMM-style shift truncation performs quite well but suffers from energetic instability. On the other hand, the force-shifted spherical cutoff method conserves energy, correctly predicts the experimental helical content, and shows convergence in simulation statistics as the cutoff is increased. This work demonstrates that by using proper and rigorous techniques, it is possible to correctly model polypeptide dynamics in solution with a spherical cutoff. The inherent computational advantage of spherical cutoffs over Ewald summation (and related) techniques is essential in accessing longer MD time scales.

2:1 for naturalness at the LHC?

NASA Astrophysics Data System (ADS)

Arkani-Hamed, Nima; Blum, Kfir; D'Agnolo, Raffaele Tito; Fan, JiJi

2013-01-01

A large enhancement of a factor of 1.5 - 2 in Higgs production and decay in the diphoton channel, with little deviation in the ZZ channel, can only plausibly arise from a loop of new charged particles with large couplings to the Higgs. We show that, allowing only new fermions with marginal interactions at the weak scale, the required Yukawa couplings for a factor of 2 enhancement are so large that the Higgs quartic coupling is pushed to large negative values in the UV, triggering an unacceptable vacuum instability far beneath the 10 TeV scale. An enhancement by a factor of 1.5 can be accommodated if the charged particles are lighter than 150 GeV, within reach of discovery in almost all cases in the 8 TeV run at the LHC, and in even the most difficult cases at 14 TeV. Thus if the diphoton enhancement survives further scrutiny, and no charged particles beneath 150 GeV are found, there must be new bosons far beneath the 10 TeV scale. This would unambiguously rule out a large class of fine-tuned theories for physics beyond the Standard Model, including split SUSY and many of its variants, and provide strong circumstantial evidence for a natural theory of electroweak symmetry breaking at the TeV scale. Alternately, theories with only a single fine-tuned Higgs and new fermions at the weak scale, with no additional scalars or gauge bosons up to a cutoff much larger than the 10 TeV scale, unambiguously predict that the hints for a large diphoton enhancement in the current data will disappear.

Psychometric properties of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5) in veterans.

PubMed

Bovin, Michelle J; Marx, Brian P; Weathers, Frank W; Gallagher, Matthew W; Rodriguez, Paola; Schnurr, Paula P; Keane, Terence M

2016-11-01

This study examined the psychometric properties of the posttraumatic stress disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5; Weathers, Litz, et al., 2013b) in 2 independent samples of veterans receiving care at a Veterans Affairs Medical Center (N = 468). A subsample of these participants (n = 140) was used to define a valid diagnostic cutoff score for the instrument using the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5; Weathers, Blake, et al., 2013) as the reference standard. The PCL-5 test scores demonstrated good internal consistency (α = .96), test-retest reliability (r = .84), and convergent and discriminant validity. Consistent with previous studies (Armour et al., 2015; Liu et al., 2014), confirmatory factor analysis revealed that the data were best explained by a 6-factor anhedonia model and a 7-factor hybrid model. Signal detection analyses using the CAPS-5 revealed that PCL-5 scores of 31 to 33 were optimally efficient for diagnosing PTSD (κ(.5) = .58). Overall, the findings suggest that the PCL-5 is a psychometrically sound instrument that can be used effectively with veterans. Further, by determining a valid cutoff score using the CAPS-5, the PCL-5 can now be used to identify veterans with probable PTSD. However, findings also suggest the need for research to evaluate cluster structure of DSM-5. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

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

NASA Astrophysics Data System (ADS)

Hu, Junzhi; Zhou, Jiyong; Li, Siyuan

2017-06-01

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

Young Athletes Cleared for Sports Participation After Anterior Cruciate Ligament Reconstruction: How Many Actually Meet Recommended Return-to-Sport Criterion Cutoffs?

PubMed

Toole, Allison R; Ithurburn, Matthew P; Rauh, Mitchell J; Hewett, Timothy E; Paterno, Mark V; Schmitt, Laura C

2017-11-01

Study Design Prospective cohort study. Background While meeting objective criterion cutoffs is recommended prior to return to sports following anterior cruciate ligament (ACL) reconstruction, the number of young athletes who meet recommended cutoffs and the impact of cutoffs on longitudinal sports participation are unknown. Objectives To test the hypothesis that a higher proportion of young athletes who meet recommended cutoffs will maintain the same level of sports participation over the year following return-to-sport clearance compared to those who do not meet recommended cutoffs. Methods At the time of return-to-sport clearance, the International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC), quadriceps and hamstring strength limb symmetry index (LSI), and single-leg hop test LSI were assessed. Proportions of participants who met individual (IKDC score of 90 or greater; strength and hop test LSIs of 90% or greater) and combined cutoffs were calculated. Proportions of participants who continued at the same level of sports participation over the year following return-to-sport clearance (assessed using the Tegner activity scale) were compared between those who met and did not meet cutoffs. Results Participants included 115 young athletes (88 female). The proportions meeting individual cutoffs ranged from 43.5% to 78.3%. The proportions meeting cutoffs for all hop tests, all strength tests, and all combined measures were 53.0%, 27.8%, and 13.9%, respectively. A higher proportion of participants who met cutoffs for both strength tests maintained the same level of sports participation over the year following return-to-sport clearance than those who did not (81.3% versus 60.2%, P = .02). Conclusion The proportions of young athletes after ACL reconstruction recently cleared for return to sports who met the combined criterion cutoffs were low. Those who met the criterion cutoffs for both strength tests maintained the same level of sports participation at higher proportions than those who did not. Level of Evidence Prognosis, level 2b. J Orthop Sports Phys Ther 2017;47(11):825-833. Epub 7 Oct 2017. doi:10.2519/jospt.2017.7227.

Rasch Analysis of the Geriatric Depression Scale--Short Form

ERIC Educational Resources Information Center

Chiang, Karl S.; Green, Kathy E.; Cox, Enid O.

2009-01-01

Purpose: The purpose of this study was to examine scale dimensionality, reliability, invariance, targeting, continuity, cutoff scores, and diagnostic use of the Geriatric Depression Scale-Short Form (GDS-SF) over time with a sample of 177 English-speaking U.S. elders. Design and Methods: An item response theory, Rasch analysis, was conducted with…

A priori testing of subgrid-scale models for large-eddy simulation of the atmospheric boundary layer

NASA Astrophysics Data System (ADS)

Juneja, Anurag; Brasseur, James G.

1996-11-01

Subgrid-scale models are generally developed assuming homogeneous isotropic turbulence with the filter cutoff lying in the inertial range. In the surface layer and capping inversion regions of the atmospheric boundary layer, the turbulence is strongly anisotropic and, in general, influenced by both buoyancy and shear. Furthermore, the integral scale motions are under-resolved in these regions. Herein we perform direct numerical simulations of shear and buoyancy-generated homogeneous anisotropic turbulence to compute and analyze the actual subgrid-resolved-scale (SGS-RS) dynamics as the filter cutoff moves into the energy-containing scales. These are compared with the SGS-RS dynamics predicted by Smagorinsky-based models with a focus on motivating improved closures. We find that, in general, the underlying assumption of such models, that the anisotropic part of the subgrid stress tensor be aligned with the resolved strain rate tensor, is a poor approximation. Similarly, we find poor alignment between the actual and predicted stress divergence, and find low correlations between the actual and modeled subgrid-scale contribution to the pressure and pressure gradient. Details will be given in the talk.

Methodological issues in the design of a rheumatoid arthritis activity score and its cut-offs.

PubMed

Collignon, Olivier

2014-01-01

Activity of rheumatoid arthritis (RA) can be evaluated using several scoring scales based on clinical features. The most widely used one is the Disease Activity Score involving 28 joint counts (DAS28) for which cut-offs were proposed to help physicians classify patients. However, inaccurate scoring can lead to inappropriate medical decisions. In this article some methodological issues in the design of such a score and its cut-offs are highlighted in order to further propose a strategy to overcome them. As long as the issues reviewed in this article are not addressed, results of studies based on standard disease activity scores such as DAS28 should be considered with caution.

Early Childhood Adversity and Its Associations with Anxiety, Depression, and Distress in Women with Breast Cancer

PubMed Central

McFarland, Daniel C; Andreotti, Charissa; Harris, Kirk; Mandeli, John; Tiersten, Amy; Holland, Jimmie

2016-01-01

Introduction Certain vulnerability factors have been found to place patients at risk for depression and anxiety, especially within the context of medical illness. Early childhood adversity (ECA) primes adults to become more vulnerable to depression by enhancing their reactivity to stress; this relationship is not adequately described in patients with breast cancer. Methods Breast cancer patients (Stage 0-IV) were assessed for ECA (i.e., the Risky Families Questionnaire [RFQ]-subscales include Abuse/Neglect/Chaotic Home Environment), distress (i.e., Distress Thermometer and Problem List [DT&PL]), anxiety (Hospital Anxiety and Depression Scale-Anxiety [HADS-A]), depression (Hospital Anxiety and Depression Scale-Depression [HADS-D]), meeting standardized cut-off thresholds for distress (DT&PL ≥4 or ≥7)/anxiety (HADS-A ≥8)/depression (HADS-D ≥8), and demographic factors. Results One hundred twenty-five participants completed the study (78% response rate). ECA was associated with depression (p<.001), anxiety (p=.001), and distress (p=.006) and with meeting cut-off threshold criteria for distress (p=.024), anxiety (p=.048), and depression (p=.001). On Multivariate analysis, only depression (p=.04) and emotional issues (i.e, component of DT&PL)(p=.001) were associated with ECA. Neglect, but not Abuse and Chaotic Home Environment, was associated with depression (β=.442, p<.001), anxiety (β=.342, p=.002), and self-identified problems with family (β−.288, p=.022), emotion (β=.345, p=.004), and physical issues (β=.408, p<.001). Conclusion ECA and neglect are associated with multiple psychological symptoms but most specifically depression in the setting of breast cancer. ECA contributes to psychological burden as a vulnerability factor. ECA may help to explain individual patient trajectories and influence the provision of patient centered care for psychological symptoms in patients with breast cancer. PMID:26876888

Correlation between UV and IR cutoffs in quantum field theory and large extra dimensions

NASA Astrophysics Data System (ADS)

Cortés, J. L.

1999-04-01

A recently conjectured relationship between UV and IR cutoffs in an effective field theory without quantum gravity is generalized in the presence of large extra dimensions. Estimates for the corrections to the usual calculation of observables within quantum field theory are used to put very stringent limits, in some cases, on the characteristic scale of the additional compactified dimensions. Implications for the cosmological constant problem are also discussed.

Radiative Kähler moduli stabilization

NASA Astrophysics Data System (ADS)

Kobayashi, Tatsuo; Omoto, Naoya; Otsuka, Hajime; Tatsuishi, Takuya H.

2018-05-01

We propose a new type of Kähler moduli stabilization mechanisms in type IIB superstring theory on Calabi-Yau manifolds with the positive Euler number. The overall Kähler modulus can be perturbatively stabilized by radiative corrections due to sparticles. Its minimum is the anti-de Sitter vacuum, where supersymmetry is broken. We can uplift it to the de Sitter vacuum by introducing anti-D-branes, keeping the modulus stabilized. Although our numerical results depend on the choice of the cutoff scale and degeneracies of sparticles, at any rate there exist the parameter spaces where the masses of Kaluza-Klein and stringy modes are larger than the cutoff scale. Furthermore, this stabilization scenario predicts an ultralight axion.

Development and Standardization of the Diagnostic Adaptive Behavior Scale: Application of Item Response Theory to the Assessment of Adaptive Behavior.

PubMed

Tassé, Marc J; Schalock, Robert L; Thissen, David; Balboni, Giulia; Bersani, Henry Hank; Borthwick-Duffy, Sharon A; Spreat, Scott; Widaman, Keith F; Zhang, Dalun; Navas, Patricia

2016-03-01

The Diagnostic Adaptive Behavior Scale (DABS) was developed using item response theory (IRT) methods and was constructed to provide the most precise and valid adaptive behavior information at or near the cutoff point of making a decision regarding a diagnosis of intellectual disability. The DABS initial item pool consisted of 260 items. Using IRT modeling and a nationally representative standardization sample, the item set was reduced to 75 items that provide the most precise adaptive behavior information at the cutoff area determining the presence or not of significant adaptive behavior deficits across conceptual, social, and practical skills. The standardization of the DABS is described and discussed.

Estimates of success in patients with sciatica due to lumbar disc herniation depend upon outcome measure.

PubMed

Haugen, Anne Julsrud; Grøvle, Lars; Brox, Jens Ivar; Natvig, Bård; Keller, Anne; Soldal, Dag; Grotle, Margreth

2011-10-01

The objectives were to estimate the cut-off points for success on different sciatica outcome measures and to determine the success rate after an episode of sciatica by using these cut-offs. A 12-month multicenter observational study was conducted on 466 patients with sciatica and lumbar disc herniation. The cut-off values were estimated by ROC curve analyses using Completely recovered or Much better on a 7-point global change scale as external criterion for success. The cut-off values (references in brackets) at 12 months were leg pain VAS 17.5 (0-100), back pain VAS 22.5 (0-100), Sciatica Bothersomeness Index 6.5 (0-24), Maine-Seattle Back Questionnaire 4.5 (0-12), and the SF-36 subscales bodily pain 51.5, and physical functioning 81.7 (0-100, higher values indicate better health). In conclusion, the success rates at 12 months varied from 49 to 58% depending on the measure used. The proposed cut-offs may facilitate the comparison of success rates across studies.

Spanish validation of the 10-item Connor-Davidson Resilience Scale (CD-RISC 10) with non-professional caregivers.

PubMed

Blanco, Vanessa; Guisande, María Adelina; Sánchez, María Teresa; Otero, Patricia; Vázquez, Fernando L

2017-11-08

Despite the importance of resilience in populations under stress, and the fact that the 10-item version Connor-Davidson Resilience Scale (CD-RISC 10) is the shortest instrument for reliable and valid evaluation of resilience, there are no data on their psychometric properties in non-professional caregivers. The aim of this study was to analyze the psychometric properties and factorial structure of the spanish version of the CD-RISC 10 in non-professional caregivers. Independently trained assessors evaluated resilience, self-esteem, social support, emotional distress and depression in a sample of 294 caregivers (89.8% women, mean age 55.3 years). The internal consistency of CD-RISC 10 was α = .86. A single factor was found that accounted for 44.7% of the total variance. Confirmatory factor analysis corroborated this unifactorial model. The CD-RISC 10 was significantly correlated with the self-esteem (r = .416, p < .001) and social support (r = .228, p < .001) scales, and the emotional distress scale (r = -.311, p < .001), though this was an inverse relationship. A score ≤ 23 was a suitable cut-off point for discriminating caregivers with depression (sensitivity = 70.0%, specificity = 68.2%). The CD-RISC 10 is a reliable and valid instrument to evaluate resilience in the caregiver population.

New type of hill-top inflation

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

Barvinsky, A.O.; Department of Physics, Tomsk State University,Lenin Ave. 36, Tomsk 634050; Department of Physics and Astronomy, Pacific Institue for Theoretical Physics,University of British Columbia, 6224 Agricultural Road, Vancouver, BC V6T 1Z1

2016-01-20

We suggest a new type of hill-top inflation originating from the initial conditions in the form of the microcanonical density matrix for the cosmological model with a large number of quantum fields conformally coupled to gravity. Initial conditions for inflation are set up by cosmological instantons describing underbarrier oscillations in the vicinity of the inflaton potential maximum. These periodic oscillations of the inflaton field and cosmological scale factor are obtained within the approximation of two coupled oscillators subject to the slow roll regime in the Euclidean time. This regime is characterized by rapid oscillations of the scale factor on themore » background of a slowly varying inflaton, which guarantees smallness of slow roll parameters ϵ and η of the following inflation stage. A hill-like shape of the inflaton potential is shown to be generated by logarithmic loop corrections to the tree-level asymptotically shift-invariant potential in the non-minimal Higgs inflation model and R{sup 2}-gravity. The solution to the problem of hierarchy between the Planckian scale and the inflation scale is discussed within the concept of conformal higher spin fields, which also suggests the mechanism bringing the model below the gravitational cutoff and, thus, protecting it from large graviton loop corrections.« less

New type of hill-top inflation

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

Barvinsky, A.O.; Nesterov, D.V.; Kamenshchik, A.Yu., E-mail: barvin@td.lpi.ru, E-mail: Alexander.Kamenshchik@bo.infn.it, E-mail: nesterov@td.lpi.ru

2016-01-01

We suggest a new type of hill-top inflation originating from the initial conditions in the form of the microcanonical density matrix for the cosmological model with a large number of quantum fields conformally coupled to gravity. Initial conditions for inflation are set up by cosmological instantons describing underbarrier oscillations in the vicinity of the inflaton potential maximum. These periodic oscillations of the inflaton field and cosmological scale factor are obtained within the approximation of two coupled oscillators subject to the slow roll regime in the Euclidean time. This regime is characterized by rapid oscillations of the scale factor on themore » background of a slowly varying inflaton, which guarantees smallness of slow roll parameters ε and η of the following inflation stage. A hill-like shape of the inflaton potential is shown to be generated by logarithmic loop corrections to the tree-level asymptotically shift-invariant potential in the non-minimal Higgs inflation model and R{sup 2}-gravity. The solution to the problem of hierarchy between the Planckian scale and the inflation scale is discussed within the concept of conformal higher spin fields, which also suggests the mechanism bringing the model below the gravitational cutoff and, thus, protecting it from large graviton loop corrections.« less

Optimal waist circumference cutoff value for defining the metabolic syndrome in postmenopausal Latin American women.

PubMed

Blümel, Juan E; Legorreta, Deborah; Chedraui, Peter; Ayala, Felix; Bencosme, Ascanio; Danckers, Luis; Lange, Diego; Espinoza, Maria T; Gomez, Gustavo; Grandia, Elena; Izaguirre, Humberto; Manriquez, Valentin; Martino, Mabel; Navarro, Daysi; Ojeda, Eliana; Onatra, William; Pozzo, Estela; Prada, Mariela; Royer, Monique; Saavedra, Javier M; Sayegh, Fabiana; Tserotas, Konstantinos; Vallejo, Maria S; Zuñiga, Cristina

2012-04-01

The aim of this study was to determine an optimal waist circumference (WC) cutoff value for defining the metabolic syndrome (METS) in postmenopausal Latin American women. A total of 3,965 postmenopausal women (age, 45-64 y), with self-reported good health, attending routine consultation at 12 gynecological centers in major Latin American cities were included in this cross-sectional study. Modified guidelines of the US National Cholesterol Education Program, Adult Treatment Panel III were used to assess METS risk factors. Receiver operator characteristic curve analysis was used to obtain an optimal WC cutoff value best predicting at least two other METS components. Optimal cutoff values were calculated by plotting the true-positive rate (sensitivity) against the false-positive rate (1 - specificity). In addition, total accuracy, distance to receiver operator characteristic curve, and the Youden Index were calculated. Of the participants, 51.6% (n = 2,047) were identified as having two or more nonadipose METS risk components (excluding a positive WC component). These women were older, had more years since menopause onset, used hormone therapy less frequently, and had higher body mass indices than women with fewer metabolic risk factors. The optimal WC cutoff value best predicting at least two other METS components was determined to be 88 cm, equal to that defined by the Adult Treatment Panel III. A WC cutoff value of 88 cm is optimal for defining METS in this postmenopausal Latin American series.

Maximally efficient two-stage screening: Determining intellectual disability in Taiwanese military conscripts.

PubMed

Chien, Chia-Chang; Huang, Shu-Fen; Lung, For-Wey

2009-01-27

The purpose of this study was to apply a two-stage screening method for the large-scale intelligence screening of military conscripts. We collected 99 conscripted soldiers whose educational levels were senior high school level or lower to be the participants. Every participant was required to take the Wisconsin Card Sorting Test (WCST) and the Wechsler Adult Intelligence Scale-Revised (WAIS-R) assessments. Logistic regression analysis showed the conceptual level responses (CLR) index of the WCST was the most significant index for determining intellectual disability (ID; FIQ ≤ 84). We used the receiver operating characteristic curve to determine the optimum cut-off point of CLR. The optimum one cut-off point of CLR was 66; the two cut-off points were 49 and 66. Comparing the two-stage window screening with the two-stage positive screening, the area under the curve and the positive predictive value increased. Moreover, the cost of the two-stage window screening decreased by 59%. The two-stage window screening is more accurate and economical than the two-stage positive screening. Our results provide an example for the use of two-stage screening and the possibility of the WCST to replace WAIS-R in large-scale screenings for ID in the future.

Maximally efficient two-stage screening: Determining intellectual disability in Taiwanese military conscripts

PubMed Central

Chien, Chia-Chang; Huang, Shu-Fen; Lung, For-Wey

2009-01-01

Objective: The purpose of this study was to apply a two-stage screening method for the large-scale intelligence screening of military conscripts. Methods: We collected 99 conscripted soldiers whose educational levels were senior high school level or lower to be the participants. Every participant was required to take the Wisconsin Card Sorting Test (WCST) and the Wechsler Adult Intelligence Scale-Revised (WAIS-R) assessments. Results: Logistic regression analysis showed the conceptual level responses (CLR) index of the WCST was the most significant index for determining intellectual disability (ID; FIQ ≤ 84). We used the receiver operating characteristic curve to determine the optimum cut-off point of CLR. The optimum one cut-off point of CLR was 66; the two cut-off points were 49 and 66. Comparing the two-stage window screening with the two-stage positive screening, the area under the curve and the positive predictive value increased. Moreover, the cost of the two-stage window screening decreased by 59%. Conclusion: The two-stage window screening is more accurate and economical than the two-stage positive screening. Our results provide an example for the use of two-stage screening and the possibility of the WCST to replace WAIS-R in large-scale screenings for ID in the future. PMID:21197345

Optimal cut-off levels to define obesity: body mass index and waist circumference, and their relationship to cardiovascular disease, dyslipidaemia, hypertension and diabetes in Malaysia.

PubMed

Zaher, Zaki Morad Mohd; Zambari, Robayaah; Pheng, Chan Siew; Muruga, Vadivale; Ng, Bernard; Appannah, Geeta; Onn, Lim Teck

2009-01-01

Many studies in Asia have demonstrated that Asian populations may require lower cut-off levels for body mass index (BMI) and waist circumference to define obesity and abdominal obesity respectively, compared to western populations. Optimal cut-off levels for body mass index and waist circumference were determined to assess the relationship between the two anthropometric- and cardiovascular indices. Receiver operating characteristics analysis was used to determine the optimal cut-off levels. The study sample included 1833 subjects (mean age of 44+/-14 years) from 93 primary care clinics in Malaysia. Eight hundred and seventy two of the subjects were men and 960 were women. The optimal body mass index cut-off values predicting dyslipidaemia, hypertension, diabetes mellitus, or at least one cardiovascular risk factor varied from 23.5 to 25.5 kg/m2 in men and 24.9 to 27.4 kg/m2 in women. As for waist circumference, the optimal cut-off values varied from 83 to 92 cm in men and from 83 to 88 cm in women. The optimal cut-off values from our study showed that body mass index of 23.5 kg/m2 in men and 24.9 kg/m2 in women and waist circumference of 83 cm in men and women may be more suitable for defining the criteria for overweight or obesity among adults in Malaysia. Waist circumference may be a better indicator for the prediction of obesity-related cardiovascular risk factors in men and women compared to BMI. Further investigation using a bigger sample size in Asia needs to be done to confirm our findings.

Transverse vetoes with rapidity cutoff in SCET

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

Hornig, Andrew; Kang, Daekyoung; Makris, Yiannis

We consider di-jet production in hadron collisions where a transverse veto is imposed on radiation for (pseudo-)rapidities in the central region only, where this central region is defined with rapidity cutoff. For the case where the transverse measurement (e.g., transverse energy or min p T for jet veto) is parametrically larger relative to the typical transverse momentum beyond the cutoff, the cross section is insensitive to the cutoff parameter and is factorized in terms of collinear and soft degrees of freedom. The virtuality for these degrees of freedom is set by the transverse measurement, as in typical transverse-momentum dependent observablesmore » such as Drell-Yan, Higgs production, and the event shape broadening. This paper focuses on the other region, where the typical transverse momentum below and beyond the cutoff is of similar size. In this region the rapidity cutoff further resolves soft radiation into (u)soft and soft-collinear radiation with different rapidities but identical virtuality. This gives rise to rapidity logarithms of the rapidity cutoff parameter which we resum using renormalization group methods. We factorize the cross section in this region in terms of soft and collinear functions in the framework of soft-collinear effective theory, then further refactorize the soft function as a convolution of the (u)soft and soft-collinear functions. All these functions are calculated at one-loop order. As an example, we calculate a differential cross section for a specific partonic channel, qq ' → qq ' , for the jet shape angularities and show that the refactorization allows us to resum the rapidity logarithms and significantly reduce theoretical uncertainties in the jet shape spectrum.« less

Transverse vetoes with rapidity cutoff in SCET

DOE PAGES

Hornig, Andrew; Kang, Daekyoung; Makris, Yiannis; ...

2017-12-11

We consider di-jet production in hadron collisions where a transverse veto is imposed on radiation for (pseudo-)rapidities in the central region only, where this central region is defined with rapidity cutoff. For the case where the transverse measurement (e.g., transverse energy or min p T for jet veto) is parametrically larger relative to the typical transverse momentum beyond the cutoff, the cross section is insensitive to the cutoff parameter and is factorized in terms of collinear and soft degrees of freedom. The virtuality for these degrees of freedom is set by the transverse measurement, as in typical transverse-momentum dependent observablesmore » such as Drell-Yan, Higgs production, and the event shape broadening. This paper focuses on the other region, where the typical transverse momentum below and beyond the cutoff is of similar size. In this region the rapidity cutoff further resolves soft radiation into (u)soft and soft-collinear radiation with different rapidities but identical virtuality. This gives rise to rapidity logarithms of the rapidity cutoff parameter which we resum using renormalization group methods. We factorize the cross section in this region in terms of soft and collinear functions in the framework of soft-collinear effective theory, then further refactorize the soft function as a convolution of the (u)soft and soft-collinear functions. All these functions are calculated at one-loop order. As an example, we calculate a differential cross section for a specific partonic channel, qq ' → qq ' , for the jet shape angularities and show that the refactorization allows us to resum the rapidity logarithms and significantly reduce theoretical uncertainties in the jet shape spectrum.« less

Experimental investigation of density behaviors in front of the lower hybrid launcher in experimental advanced superconducting tokamak

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

Zhang, L.; Ding, B. J.; Li, M. H.

2013-06-15

A triple Langmuir probe is mounted on the top of the Lower Hybrid (LH) antenna to measure the electron density near the LH grills in Experimental Advanced Superconducting Tokamak. In this work, the LH power density ranges from 2.3 MWm{sup −2} to 10.3 MWm{sup −2} and the rate of puffing gas varies from 1.7 × 10{sup 20} el/s to 14 × 10{sup 20} el/s. The relation between the edge density (from 0.3 × n{sub e-cutoff} to 20 × n{sub e-cutoff}, where n{sub e-cutoff} is the cutoff density, n{sub e-cutoff} = 0.74 × 10{sup 17} m{sup −3} for 2.45 GHz lowermore » hybrid current drive) near the LH grill and the LH power reflection coefficients is investigated. The factors, including the gap between the LH grills and the last closed magnetic flux surface, line-averaged density, LH power, edge safety factor, and gas puffing, are analyzed. The experiments show that injection of LH power is beneficial for increasing edge density. Gas puffing is beneficial for increasing grill density but excess gas puffing is unfavorable for coupling and current drive.« less

Optimal cut-off of homeostasis model assessment of insulin resistance (HOMA-IR) for the diagnosis of metabolic syndrome: third national surveillance of risk factors of non-communicable diseases in Iran (SuRFNCD-2007).

PubMed

Esteghamati, Alireza; Ashraf, Haleh; Khalilzadeh, Omid; Zandieh, Ali; Nakhjavani, Manouchehr; Rashidi, Armin; Haghazali, Mehrdad; Asgari, Fereshteh

2010-04-07

We have recently determined the optimal cut-off of the homeostatic model assessment of insulin resistance for the diagnosis of insulin resistance (IR) and metabolic syndrome (MetS) in non-diabetic residents of Tehran, the capital of Iran. The aim of the present study is to establish the optimal cut-off at the national level in the Iranian population with and without diabetes. Data of the third National Surveillance of Risk Factors of Non-Communicable Diseases, available for 3,071 adult Iranian individuals aging 25-64 years were analyzed. MetS was defined according to the Adult Treatment Panel III (ATPIII) and International Diabetes Federation (IDF) criteria. HOMA-IR cut-offs from the 50th to the 95th percentile were calculated and sensitivity, specificity, and positive likelihood ratio for MetS diagnosis were determined. The receiver operating characteristic (ROC) curves of HOMA-IR for MetS diagnosis were depicted, and the optimal cut-offs were determined by two different methods: Youden index, and the shortest distance from the top left corner of the curve. The area under the curve (AUC) (95%CI) was 0.650 (0.631-0.670) for IDF-defined MetS and 0.683 (0.664-0.703) with the ATPIII definition. The optimal HOMA-IR cut-off for the diagnosis of IDF- and ATPIII-defined MetS in non-diabetic individuals was 1.775 (sensitivity: 57.3%, specificity: 65.3%, with ATPIII; sensitivity: 55.9%, specificity: 64.7%, with IDF). The optimal cut-offs in diabetic individuals were 3.875 (sensitivity: 49.7%, specificity: 69.6%) and 4.325 (sensitivity: 45.4%, specificity: 69.0%) for ATPIII- and IDF-defined MetS, respectively. We determined the optimal HOMA-IR cut-off points for the diagnosis of MetS in the Iranian population with and without diabetes.

Optimal Transport Destination for Ischemic Stroke Patients With Unknown Vessel Status: Use of Prehospital Triage Scores.

PubMed

Schlemm, Eckhard; Ebinger, Martin; Nolte, Christian H; Endres, Matthias; Schlemm, Ludwig

2017-08-01

Patients with acute ischemic stroke (AIS) and large vessel occlusion may benefit from direct transportation to an endovascular capable comprehensive stroke center (mothership approach) as opposed to direct transportation to the nearest stroke unit without endovascular therapy (drip and ship approach). The optimal transport strategy for patients with AIS and unknown vessel status is uncertain. The rapid arterial occlusion evaluation scale (RACE, scores ranging from 0 to 9, with higher scores indicating higher stroke severity) correlates with the National Institutes of Health Stroke Scale and was developed to identify patients with large vessel occlusion in a prehospital setting. We evaluate how the RACE scale can help to inform prehospital triage decisions for AIS patients. In a model-based approach, we estimate probabilities of good outcome (modified Rankin Scale score of ≤2 at 3 months) as a function of severity of stroke symptoms and transport times for the mothership approach and the drip and ship approach. We use these probabilities to obtain optimal RACE cutoff scores for different transfer time settings and combinations of treatment options (time-based eligibility for secondary transfer under the drip and ship approach, time-based eligibility for thrombolysis at the comprehensive stroke center under the mothership approach). In our model, patients with AIS are more likely to benefit from direct transportation to the comprehensive stroke center if they have more severe strokes. Values of the optimal RACE cutoff scores range from 0 (mothership for all patients) to >9 (drip and ship for all patients). Shorter transfer times and longer door-to-needle and needle-to-transfer (door out) times are associated with lower optimal RACE cutoff scores. Use of RACE cutoff scores that take into account transport times to triage AIS patients to the nearest appropriate hospital may lead to improved outcomes. Further studies should examine the feasibility of translation into clinical practice. © 2017 American Heart Association, Inc.

Development and validation study of the Smartphone Overuse Screening Questionnaire.

PubMed

Lee, Han-Kyeong; Kim, Ji-Hae; Fava, Maurizio; Mischoulon, David; Park, Jae-Hyun; Shim, Eun-Jung; Lee, Eun-Ho; Lee, Ji Hyeon; Jeon, Hong Jin

2017-11-01

The aim of this study was to develop a screening questionnaire that could distinguish individuals at high risk of smartphone overuse from casual users. The reliability, validity, and diagnostic ability of the Smartphone Overuse Screening Questionnaire (SOS-Q) were evaluated. Preliminary items were assessed by 50 addiction experts on-line, and 28 questions were selected. A total of 158 subjects recruited from six community centers for internet addiction participated in this study. The SOS-Q, Young's internet addiction scale, Korean scale for internet addiction, and Smartphone Scale for Smartphone Addiction (S-Scale) were used to assess the concurrent validity. Construct validity was supported by a six-factor model using an exploratory factor analysis. The internal consistency and the item-total correlations were favorable (α = 0.95, r = 0.35-0.81). The test-retest reliability was moderate (r = 0.70). The SOS-Q showed superior concurrent validity with the highest correlation between the S-Scale (r = 0.76). Receiver operating characteristic curve analysis revealed an area under the curve of 0.877. A cut-off point of 49 effectively categorized addiction high-risk group with a sensitivity of 0.81 and specificity of 0.86. Overall, the current study supports the use of SOS-Q as both a primary and supplementary measurement tool in a variety of settings. Copyright © 2017 Elsevier B.V. All rights reserved.

The Koukopoulos Mixed Depression Rating Scale (KMDRS): An International Mood Network (IMN) validation study of a new mixed mood rating scale.

PubMed

Sani, Gabriele; Vöhringer, Paul A; Barroilhet, Sergio A; Koukopoulos, Alexia E; Ghaemi, S Nassir

2018-05-01

It has been proposed that the broad major depressive disorder (MDD) construct is heterogenous. Koukopoulos has provided diagnostic criteria for an important subtype within that construct, "mixed depression" (MxD), which encompasses clinical pictures characterized by marked psychomotor or inner excitation and rage/anger, along with severe depression. This study provides psychometric validation for the first rating scale specifically designed to assess MxD symptoms cross-sectionally, the Koukopoulos Mixed Depression Rating Scale (KMDRS). 350 patients from the international mood network (IMN) completed three rating scales: the KMDRS, Montgomery-Asberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS). KMDRS' psychometric properties assessed included Cronbach's alpha, inter-rater reliability, factor analysis, predictive validity, and Receiver Operator Curve analysis. Internal consistency (Cronbach's alpha = 0.76; 95% CI 0.57, 0.94) and interrater reliability (kappa = 0.73) were adequate. Confirmatory factor analysis identified 2 components: anger and psychomotor excitation (80% of total variance). Good predictive validity was seen (C-statistic = 0.82 95% CI 0.68, 0.93). Severity cut-off scores identified were as follows: none (0-4), possible (5-9), mild (10-15), moderate (16-20) and severe (> 21) MxD. Non DSM-based diagnosis of MxD may pose some difficulties in the initial use and interpretation of the scoring of the scale. Moreover, the cross-sectional nature of the evaluation does not verify the long-term stability of the scale. KMDRS was a reliable and valid instrument to assess MxD symptoms. Copyright © 2018 Elsevier B.V. All rights reserved.

Validity of the International HIV Dementia Scale as assessed in a socioeconomically underdeveloped region of Southern China: assessing the influence of educational attainment.

PubMed

Dang, Chao; Wei, Bo; Long, JianXiong; Zhou, MengXiao; Han, XinXin; Zhao, TingTing

2015-04-01

In 2012, more than 80,000 cases of HIV infection were recorded in the Southern Chinese minority autonomous region of Guangxi Zhuang, where the occurrence of HIV-associated dementia remains high. The International HIV Dementia Scale is a relatively simple-to-administer screening scale for HIV-associated neurocognitive disorders. However, clinical experience in utilizing the scale with large Chinese samples is currently lacking, especially among individuals with limited formal schooling. In this study, a full neuropsychological evaluation the gold standard was conducted to identify the incidence/prevalence of HIV-associated neurocognitive disorders in a socioeconomically underdeveloped region of Southern China and to locate the optimal cut-off scale value using receiver operating characteristic curves. The highest Youden index of the scale was 0.450, with a corresponding cut-off point of 7.25. The sensitivity and specificity were 0.737 and 0.713, respectively. These results suggest that the scale is an effective and feasible screening tool for HIV-associated neurocognitive disorders in poorer regions of China with fewer well-educated residents. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Cutoffs, Norms, and Patterns of Comorbid Difficulties in Children with Developmental Disabilities on the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT-Part 2)

ERIC Educational Resources Information Center

Matson, Johnny L.; Fodstad, Jill C.; Mahan, Sara

2009-01-01

Behavioral symptoms of comorbid psychopathology of 651 children 17-37 months of age who were at risk for developmental disabilities were studied using the BISCUIT-Part 2. In Study 1, norms and cutoff scores were established for this new scale on this sample. In Study 2, frequency of response on the 52 items measured was reported. Problems in…

Complementarity in the multiverse

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

Bousso, Raphael

2009-06-15

In the multiverse, as in AdS space, light cones relate bulk points to boundary scales. This holographic UV-IR connection defines a preferred global time cutoff that regulates the divergences of eternal inflation. An entirely different cutoff, the causal patch, arises in the holographic description of black holes. Remarkably, I find evidence that these two regulators define the same probability measure in the multiverse. Initial conditions for the causal patch are controlled by the late-time attractor regime of the global description.

The psychometric properties, sensitivity and specificity of the geriatric anxiety inventory, hospital anxiety and depression scale, and rating anxiety in dementia scale in aged care residents.

PubMed

Creighton, Alexandra S; Davison, Tanya E; Kissane, David W

2018-02-22

Limited research has been conducted into the identification of a valid and reliable screening measure for anxiety in aged care settings, despite it being one of the most common psychological conditions. This study aimed to determine an appropriate anxiety screening tool for aged care by comparing the reliability and validity of three commonly used measures and identifying specific cut-offs for the identification of generalized anxiety disorder (GAD). One-hundred and eighty nursing home residents (M age = 85.39 years) completed the GAI, HADS-A, and RAID, along with a structured diagnostic interview. Twenty participants (11.1%) met DSM-5 criteria for GAD. All measures had good psychometric properties , although reliability estimates for the HADS-A were sub-optimal. Privileging sensitivity , the GAI cut-off score of 9 gave sensitivity of 90.0% and specificity of 86.3%; HADS-A cut-off of 6 gave sensitivity of 90.0% and specificity of 80.6%; and RAID cut-off of 11 gave sensitivity of 85.0% and specificity of 72.5%. While all three measures had adequate reliability, validity, and cut-scores with high levels of sensitivity and specificity to detect anxiety within aged care, the GAI was the most consistently reliable and valid measure for screening for GAD.

Congruence between Polysomnography Obstructive Sleep Apnea and the Pediatric Sleep Questionnaire: Fatigue and Health-Related Quality of Life in Juvenile Idiopathic Arthritis

PubMed Central

Ward, Teresa M.; Chen, Maida Lynn; Landis, Carol A.; Ringold, Sarah; Beebe, Dean W.; Pike, Kenneth C.; Wallace, Carol A.

2016-01-01

Purpose To examine the congruence between polysomnography obstructive apnea hypopnea index (OAHI) and parent reported obstructive sleep apnea (OSA) symptoms in 6-to-11 year-old children with juvenile idiopathic arthritis (JIA) and controls; and to compare fatigue and quality of life in JIA and control children based on OAHI and OSA symptoms. Methods Sixty-eight children with JIA and 75 controls and a parent participated. Children underwent one night of polysomnography in a sleep laboratory. Parents completed the sleep-related breathing disorders scale - Pediatric Sleep Questionnaire (PSQ), and both children and parents completed the Pediatric Quality of Life Generic Core Scale and the Multidimensional Fatigue scale. Results In JIA, 86% who met the OAHI clinical criteria for OSA (≥ 1.5) were above the PSQ OSA symptom cut-off score with a sensitivity of 0.86 and a specificity of 0.28. In the control group, 63% who met the OAHI clinical criteria for OSA, were above the PSQ OSA symptom cut-off score, with a sensitivity of 0.63 and a specificity of 0.42. All children above both the clinical criteria for OAHI and OSA symptom cut-off score had the most impaired quality of life and greater fatigue compared to those below both the clinical criteria for OAHI and the OSA symptom cut-off score. Conclusion Children who meet clinical criteria for OSA and also scored high on a parent reported screening tool for OSA symptoms had the most impaired quality of life and more fatigue. The PSQ has potential to identify children at risk for OSA. PMID:27987106

Reduced bispectrum seeded by helical primordial magnetic fields

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

Hortúa, Héctor Javier; Castañeda, Leonardo, E-mail: hjhortuao@unal.edu.co, E-mail: lcastanedac@unal.edu.co

In this paper, we investigate the effects of helical primordial magnetic fields (PMFs) on the cosmic microwave background (CMB) reduced bispectrum. We derive the full three-point statistics of helical magnetic fields and numerically calculate the even contribution in the collinear configuration. We then numerically compute the CMB reduced bispectrum induced by passive and compensated PMF modes on large angular scales. There is a negative signal on the bispectrum due to the helical terms of the fields and we also observe that the biggest contribution to the bispectrum comes from the non-zero IR cut-off for causal fields, unlike the two-point correlationmore » case. For negative spectral indices, the reduced bispectrum is enhanced by the passive modes. This gives a lower value of the upper limit for the mean amplitude of the magnetic field on a given characteristic scale. However, high values of IR cut-off in the bispectrum, and the helical terms of the magnetic field relaxes this bound. This demonstrates the importance of the IR cut-off and helicity in the study of the nature of PMFs from CMB observations.« less

Development of short-form and screening cutoff point of the Smartphone Addiction Inventory (SPAI-SF).

PubMed

Lin, Yu-Hsuan; Pan, Yuan-Chien; Lin, Sheng-Hsuan; Chen, Sue-Huei

2017-06-01

Smartphone addiction is considered a form of technological addiction that has attracted increasing attention. The present study developed and validated the short-form Smartphone Addiction Inventory (SPAI-SF) and established cutoff point for screening smartphone addiction based on diagnostic criteria established by psychiatric interview. A total of 268 participants completed an online survey that collected demographic data, smartphone use behaviours, and responses to the 26-item SPAI. Each participant also completed a psychiatric interview. Confirmatory factor analysis (CFA) revealed that the 10-item SPAI-SF replicated the structure of original 26-item SPAI accurately, yielding a four-factor model consisting of compulsive behaviour, functional impairment, withdrawal, and tolerance. For maximal diagnostic accuracy, a cutoff point of 24/25 best discriminated cases of smartphone addiction from diagnostic negatives. The present findings suggest that both the 26-item SPAI and SPAI-SF manifest the four constructs of behavioural addiction and the characteristics of smartphone addiction. The cutoff point determined by psychiatrists' diagnostic interview will be useful for clinical screening and epidemiologic research. Copyright © 2016 John Wiley & Sons, Ltd.

Velocity-Resolved LES (VR-LES) technique for simulating turbulent transport of high Schmidt number passive scalars

NASA Astrophysics Data System (ADS)

Verma, Siddhartha; Blanquart, Guillaume; P. K. Yeung Collaboration

2011-11-01

Accurate simulation of high Schmidt number scalar transport in turbulent flows is essential to studying pollutant dispersion, weather, and several oceanic phenomena. Batchelor's theory governs scalar transport in such flows, but requires further validation at high Schmidt and high Reynolds numbers. To this end, we use a new approach with the velocity field fully resolved, but the scalar field only partially resolved. The grid used is fine enough to resolve scales up to the viscous-convective subrange where the decaying slope of the scalar spectrum becomes constant. This places the cutoff wavenumber between the Kolmogorov scale and the Batchelor scale. The subgrid scale terms, which affect transport at the supergrid scales, are modeled under the assumption that velocity fluctuations are negligible beyond this cutoff wavenumber. To ascertain the validity of this technique, we performed a-priori testing on existing DNS data. This Velocity-Resolved LES (VR-LES) technique significantly reduces the computational cost of turbulent simulations of high Schmidt number scalars, and yet provides valuable information of the scalar spectrum in the viscous-convective subrange.

Validation of the Expanded Versions of the Adult ADHD Self-Report Scale v1.1 Symptom Checklist and the Adult ADHD Investigator Symptom Rating Scale.

PubMed

Silverstein, Michael J; Faraone, Stephen V; Alperin, Samuel; Leon, Terry L; Biederman, Joseph; Spencer, Thomas J; Adler, Lenard A

2018-02-01

The aim of this study is to validate the Adult ADHD Self-Report Scale (ASRS) and Adult ADHD Investigator Symptom Rating Scale (AISRS) expanded versions, including executive function deficits (EFDs) and emotional dyscontrol (EC) items, and to present ASRS and AISRS pilot normative data. Two patient samples (referred and primary care physician [PCP] controls) were pooled together for these analyses. Final analysis included 297 respondents, 171 with adult ADHD. Cronbach's alphas were high for all sections of the scales. Examining histograms of ASRS 31-item and AISRS 18-item total scores for ADHD controls, 95% cutoff scores were 70 and 23, respectively; histograms for pilot normative sample suggest cutoffs of 82 and 26, respectively. (a) ASRS- and AISRS-expanded versions have high validity in assessment of core 18 adult ADHD Diagnostic and Statistical Manual of Mental Disorders ( DSM) symptoms and EFD and EC symptoms. (b) ASRS (31-item) scores 70 to 82 and AISRS (18-item) scores from 23 to 26 suggest a high likelihood of adult ADHD.

Quantum-shutter approach to tunneling time scales with wave packets

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

Yamada, Norifumi; Garcia-Calderon, Gaston; Villavicencio, Jorge

2005-07-15

The quantum-shutter approach to tunneling time scales [G. Garcia-Calderon and A. Rubio, Phys. Rev. A 55, 3361 (1997)], which uses a cutoff plane wave as the initial condition, is extended to consider certain type of wave packet initial conditions. An analytical expression for the time-evolved wave function is derived. The time-domain resonance, the peaked structure of the probability density (as the function of time) at the exit of the barrier, originally found with the cutoff plane wave initial condition, is studied with the wave packet initial conditions. It is found that the time-domain resonance is not very sensitive to themore » width of the packet when the transmission process occurs in the tunneling regime.« less

Make dark matter charged again

NASA Astrophysics Data System (ADS)

Agrawal, Prateek; Cyr-Racine, Francis-Yan; Randall, Lisa; Scholtz, Jakub

2017-05-01

We revisit constraints on dark matter that is charged under a U(1) gauge group in the dark sector, decoupled from Standard Model forces. We find that the strongest constraints in the literature are subject to a number of mitigating factors. For instance, the naive dark matter thermalization timescale in halos is corrected by saturation effects that slow down isotropization for modest ellipticities. The weakened bounds uncover interesting parameter space, making models with weak-scale charged dark matter viable, even with electromagnetic strength interaction. This also leads to the intriguing possibility that dark matter self-interactions within small dwarf galaxies are extremely large, a relatively unexplored regime in current simulations. Such strong interactions suppress heat transfer over scales larger than the dark matter mean free path, inducing a dynamical cutoff length scale above which the system appears to have only feeble interactions. These effects must be taken into account to assess the viability of darkly-charged dark matter. Future analyses and measurements should probe a promising region of parameter space for this model.

Recommended aerobic fitness level for metabolic health in children and adolescents: a study of diagnostic accuracy.

PubMed

Adegboye, Amanda R A; Anderssen, Sigmund A; Froberg, Karsten; Sardinha, Luis B; Heitmann, Berit L; Steene-Johannessen, Jostein; Kolle, Elin; Andersen, Lars B

2011-07-01

To define the optimal cut-off for low aerobic fitness and to evaluate its accuracy to predict clustering of risk factors for cardiovascular disease in children and adolescents. Study of diagnostic accuracy using a cross-sectional database. European Youth Heart Study including Denmark, Portugal, Estonia and Norway. 4500 schoolchildren aged 9 or 15 years. Aerobic fitness was expressed as peak oxygen consumption relative to bodyweight (mlO(2)/min/kg). Risk factors included in the composite risk score (mean of z-scores) were systolic blood pressure, triglyceride, total cholesterol/HDL-cholesterol ratio, insulin resistance and sum of four skinfolds. 14.5% of the sample, with a risk score above one SD, were defined as being at risk. Receiver operating characteristic analysis was used to define the optimal cut-off for sex and age-specific distribution. In girls, the optimal cut-offs for identifying individuals at risk were: 37.4 mlO(2)/min/kg (9-year-old) and 33.0 mlO(2)/min/kg (15-year-old). In boys, the optimal cut-offs were 43.6 mlO(2)/min/kg (9-year-old) and 46.0 mlO(2)/min/kg (15-year-old). Specificity (range 79.3-86.4%) was markedly higher than sensitivity (range 29.7-55.6%) for all cut-offs. Positive predictive values ranged from 19% to 41% and negative predictive values ranged from 88% to 90%. The diagnostic accuracy for identifying children at risk, measured by the area under the curve (AUC), was significantly higher than what would be expected by chance (AUC >0.5) for all cut-offs. Aerobic fitness is easy to measure, and is an accurate tool for screening children with clustering of cardiovascular risk factors. Promoting physical activity in children with aerobic fitness level lower than the suggested cut-points might improve their health.

Return to Work: A Cut-Off of FIM Gain with Montebello Rehabilitation Factor Score in Order to Identify Predictive Factors in Subjects with Acquired Brain Injury.

PubMed

Franceschini, Marco; Massimiani, Maria Pia; Paravati, Stefano; Agosti, Maurizio

2016-01-01

Return to work (RTW) for people with acquired brain injury (ABI) represents a main objective of rehabilitation: this work presents a strong correlation between personal well-being and quality of life. The aim of this study is to investigate the prognostic factors that can predict RTW after ABI (traumatic or non- traumatic aetiology) in patients without disorders of consciousness (e.g. coma, vegetative or minimally conscious state) at the beginning of their admission to rehabilitation. At the end of a 6-month follow-up after discharge, data were successfully collected in 69 patients. The rehabilitation effectiveness (functional Recovery) between admission and discharge was assessed by Functional Independent Measure (FIM) gain, through the Montebello Rehabilitation Factor Score (MRFS), which was obtained as follows: (discharge FIM-admission FIM)/(Maximum possible FIM-Admission FIM) x 100. The cut-off value (criterion) deriving from MRFS, which helped identify RTW patients, resulted in .659 (sn 88.9%; sp 52.4%). Considering the Mini Mental State Examination (MMSE) and the MRFS data, the multivariable binary logistic regression analysis presented 62.96% of correct RTW classification cases, 80.95% of non-RTW leading to an overall satisfactory predictability of 73.91%. The results of the present study suggest that occupational therapy intervention could modify cut-off in patients with an MFRS close to target at the end of an in-hospital rehabilitative program thus developing their capabilities and consequently surpassing cut-off itself.

Development and Validation Study of the Internet Overuse Screening Questionnaire

PubMed Central

Lee, Han-Kyeong; Lee, Hae-Woo; Han, Joo Hyun; Park, Subin; Ju, Seok-Jin; Choi, Kwanwoo; Lee, Ji Hyeon; Jeon, Hong Jin

2018-01-01

Objective Concerns over behavioral and emotional problems caused by excessive internet usage have been developed. This study intended to develop and a standardize questionnaire that can efficiently identify at-risk internet users through their internet usage habits. Methods Participants (n=158) were recruited at six I-will-centers located in Seoul, South Korea. From the initial 36 questionnaire item pool, 28 preliminary items were selected through expert evaluation and panel discussions. The construct validity, internal consistency, and concurrent validity were examined. We also conducted Receiver Operating Curve (ROC) analysis to assess diagnostic ability of the Internet Overuse Screening-Questionnaire (IOS-Q). Results The exploratory factor analysis yielded a five factor structure. Four factors with 17 items remained after items that had unclear factor loading were removed. The Cronbach’s alpha for the IOS-Q total score was 0.91, and test-retest reliability was 0.72. The correlation between Young’s internet addiction scale and K-scale supported concurrent validity. ROC analysis showed that the IOS-Q has superior diagnostic ability with the Area Under the Curve of 0.87. At the cut-off point of 25.5, the sensitivity was 0.93 and specificity was 0.86. Conclusion Overall, this study supports the use of IOS-Q for internet addiction research and for screening high-risk individuals. PMID:29669406

Evaluating the Bulk Lorentz Factors of Outflow Material: Lessons Learned from the Extremely Energetic Outburst GRB 160625B

NASA Astrophysics Data System (ADS)

Wang, Yuan-Zhu; Wang, Hao; Zhang, Shuai; Liang, Yun-Feng; Jin, Zhi-Ping; He, Hao-Ning; Liao, Neng-Hui; Fan, Yi-Zhong; Wei, Da-Ming

2017-02-01

GRB 160625B is an extremely bright outburst with well-monitored afterglow emission. The geometry-corrected energy is high, up to ˜5.2 × 1052 erg or even ˜8 × 1052 erg, rendering it the most energetic GRB prompt emission recorded so far. We analyzed the time-resolved spectra of the prompt emission and found that in some intervals there were likely thermal-radiation components and the high energy emission was characterized by significant cutoff. The bulk Lorentz factors of the outflow material are estimated accordingly. We found out that the Lorentz factors derived in the thermal-radiation model are consistent with the luminosity-Lorentz factor correlation found in other bursts, as well as in GRB 090902B for the time-resolved thermal-radiation components, while the spectral cutoff model yields much lower Lorentz factors that are in tension with the constraints set by the electron pair Compton scattering process. We then suggest that these spectral cutoffs are more likely related to the particle acceleration process and that one should be careful in estimating the Lorentz factors if the spectrum cuts at a rather low energy (e.g., ˜tens of MeV). The nature of the central engine has also been discussed, and a stellar-mass black hole is favored.

CosmoCalc: An Excel add-in for cosmogenic nuclide calculations

NASA Astrophysics Data System (ADS)

Vermeesch, Pieter

2007-08-01

As dating methods using Terrestrial Cosmogenic Nuclides (TCN) become more popular, the need arises for a general-purpose and easy-to-use data reduction software. The CosmoCalc Excel add-in calculates TCN production rate scaling factors (using Lal, Stone, Dunai, and Desilets methods); topographic, snow, and self-shielding factors; and exposure ages, erosion rates, and burial ages and visualizes the results on banana-style plots. It uses an internally consistent TCN production equation that is based on the quadruple exponential approach of Granger and Smith (2000). CosmoCalc was designed to be as user-friendly as possible. Although the user interface is extremely simple, the program is also very flexible, and nearly all default parameter values can be changed. To facilitate the comparison of different scaling factors, a set of converter tools is provided, allowing the user to easily convert cut-off rigidities to magnetic inclinations, elevations to atmospheric depths, and so forth. Because it is important to use a consistent set of scaling factors for the sample measurements and the production rate calibration sites, CosmoCalc defines the production rates implicitly, as a function of the original TCN concentrations of the calibration site. The program is best suited for 10Be, 26Al, 3He, and 21Ne calculations, although basic functionality for 36Cl and 14C is also provided. CosmoCalc can be downloaded along with a set of test data from http://cosmocalc.googlepages.com.

Screening for anxiety and depression in dialysis patients: comparison of the Hospital Anxiety and Depression Scale and the Beck Depression Inventory.

PubMed

Preljevic, Valjbona T; Østhus, Tone Brit Hortemo; Sandvik, Leiv; Opjordsmoen, Stein; Nordhus, Inger Hilde; Os, Ingrid; Dammen, Toril

2012-08-01

Although anxiety and depression are frequent comorbid disorders in dialysis patients, they remain underrecognized and often untreated. The aim of the study was to evaluate the Hospital Anxiety and Depression Scale (HADS), the Beck Depression Inventory (BDI) and a truncated version of the BDI, the Cognitive Depression Index (CDI), as screening tools for anxiety and depression in dialysis patients. A total of 109 participants (69.7% males), from four dialysis centers, completed the self-report symptom scales HADS and BDI. Depression and anxiety disorders were diagnosed with the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I). The sensitivity, specificity, positive and negative predictive value, overall agreement, kappa and receiver operating characteristic (ROC) curves were assessed. Depressive disorders were found in 22% of the patients based on the SCID-I, while anxiety disorders occurred in 17%. The optimal screening cut-off score for depression was ≥ 7 for the HADS depression subscale (HADS-D), ≥ 14 for the HADS-total, ≥ 11 for the CDI and ≥ 17 for the BDI. The optimal screening cut-off for anxiety was ≥ 6 for the HADS anxiety subscale (HADS-A) and ≥ 14 for the HADS-total. At cut-offs commonly used in clinical practice for depression screening (HADS-D: 8; BDI: 16), the BDI performed slightly better than HADS-D. The BDI, CDI and HADS demonstrated acceptable performance as screening tools for depression, as did the HADS-A for anxiety, in our sample of dialysis patients. The recommended cut-off scores for each instrument were: ≥ 17 for BDI, ≥ 11 for CDI, ≥ 7 for HADS depression subscale, ≥ 6 for HADS anxiety subscale and ≥ 14 for HADS total. The CDI did not perform better than the BDI in our study. Lower cut-off for the HADS-A than recommended in medically ill patients may be considered when screening for anxiety in dialysis patients. Copyright © 2012 Elsevier Inc. All rights reserved.

Attention deficit hyperactivity disorder: From parents to children.

PubMed

Vélez-van-Meerbeke, A; Talero-Gutiérrez, C; Zamora-Miramón, I; Guzmán-Ramírez, G M

2017-04-01

Multiple studies of attention deficit hyperactivity disorder (ADHD) have recognised a heritability factor in that a higher frequency of the disorder is observed in children with an affected relative. Our aim was to determine the association between ADHD symptoms in young children enrolled in five schools in Bogota and a history of ADHD symptoms in their parents using the Wender-Utah Rating Scale. Case-control study of participants selected according to DSM-IV criteria for ADHD and the Behavioral Assessment System for Children (BASC) completed by parents and teachers; the WISC-IV scale was used to exclude children with cognitive deficit. Parents completed the Wender-Utah Rating Scale to retrospectively identify any ADHD symptoms in childhood. A score of 36 was used as a cutoff point. The study included 202 children: 117 cases and 85 controls. A positive history of ADHD symptoms in childhood was identified for 16% of 175 mothers and 20.6% of 141 fathers. The presence of symptoms in either parent, especially the mother, constitutes a significant risk factor for ADHD in children and this relationship persists after controlling for different variables. If both parents have the disorder, the risk tends to increase. Although ADHD has been linked to a genetic component, other environmental factors may be involved in the disorder. Copyright © 2015 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Detection of depression in acute schizophrenia: sensitivity and specificity of 2 standard observer rating scales.

PubMed

Müller, Matthias J; Müller, Kay-Maria; Fellgiebel, Andreas

2006-05-01

To compare the psychometric properties of the Calgary Depression Rating Scale (CDRS) and the Hamilton Depression Rating Scale (HDRS) for severity assessment of depression in acute schizophrenia. During clinical routine treatment, we investigated 119 inpatients with acute schizophrenia, using the CDRS, the HDRS, and a global 4-point Depression Severity Scale (DEP-SEV). We compared CDRS and HDRS sum scores regarding their diagnostic accuracy, with global severity of depression as the criterion. We estimated sensitivity and specificity on the basis of receiver operating characteristic curves. According to global clinical ratings (DEP-SEV), 31% of patients had no depression, 19% had mild, 31% had moderate, and 19% had severe depression. Sensitivity was significantly higher (P < 0.05) for the CDRS than for the HDRS to assess mild (0.94 vs 0.76, cut-off 3 vs 10 points) or severe depression (1.00 vs 0.78, cut-off 11 vs 22 points); specificity was comparably high (> or = 0.88) for both scales. Despite the fact that both scales were effective in separating mild, moderate, and severe depression, significant advantages emerged for the CDRS to detect mild or severe depression in schizophrenia.

Symptom Reporting Patterns of US Military Service Members with a History of Concussion According to Duty Status.

PubMed

Lu, Lisa H; Cooper, Doug B; Reid, Matthew W; Khokhar, Bilal; Tsagaratos, Jennifer E; Kennedy, Jan E

2018-03-28

To compare symptom reporting patterns of service members with a history of concussion based on work status: full duty, limited duty, or in the Medical Evaluation Board (MEB)/disability process. Retrospective analysis of 181 service members with a history of concussion (MEB n = 56; limited duty n = 62; full duty n = 63). Neurobehavioral Symptom Inventory (NSI) Validity-10 cutoff (>22) and Mild Brain Injury Atypical Symptoms Scale (mBIAS) cutoffs (≥10 and ≥8) were used to evaluate potential over-reporting of symptoms. The MEB group displayed significantly higher NSI scores and significantly higher proportion scored above the mBIAS ≥10 cutoff (MEB = 15%; limited duty = 3%; full duty = 5%). Validity-10 cutoff did not distinguish between groups. MEB but not limited duty status was associated with increased risk of over-reporting symptoms in service members with a history of concussion. Results support the use of screening measures for over-reporting in the MEB/disability samples.

The Hubble IR cutoff in holographic ellipsoidal cosmologies

NASA Astrophysics Data System (ADS)

Cataldo, Mauricio; Cruz, Norman

2018-01-01

It is well known that for spatially flat FRW cosmologies, the holographic dark energy disfavors the Hubble parameter as a candidate for the IR cutoff. For overcoming this problem, we explore the use of this cutoff in holographic ellipsoidal cosmological models, and derive the general ellipsoidal metric induced by a such holographic energy density. Despite the drawbacks that this cutoff presents in homogeneous and isotropic universes, based on this general metric, we developed a suitable ellipsoidal holographic cosmological model, filled with a dark matter and a dark energy components. At late time stages, the cosmic evolution is dominated by a holographic anisotropic dark energy with barotropic equations of state. The cosmologies expand in all directions in accelerated manner. Since the ellipsoidal cosmologies given here are not asymptotically FRW, the deviation from homogeneity and isotropy of the universe on large cosmological scales remains constant during all cosmic evolution. This feature allows the studied holographic ellipsoidal cosmologies to be ruled by an equation of state ω =p/ρ , whose range belongs to quintessence or even phantom matter.

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

PubMed

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

2017-08-01

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

Sensitivity and specificity of the Beck Depression Inventory in cardiologic inpatients: how useful is the conventional cut-off score?

PubMed

Forkmann, Thomas; Vehren, Thomas; Boecker, Maren; Norra, Christine; Wirtz, Markus; Gauggel, Siegfried

2009-10-01

The Beck Depression Inventory (BDI) is widely used for depression screening in various patient populations. However, there are still insufficient data about its sensitivity and specificity in nonpsychiatric patients. Furthermore, some research suggests that somatic BDI items heighten its sum score artificially in physically ill patients. The aim of the present study was to validate the conventional BDI cut-off score by examination of its sensitivity and specificity in a mixed sample of cardiac inpatients and compare it to a modified "cognitive-emotional" BDI (BDI(c/e)) after exclusion of somatic items. A total of 126 cardiologic inpatients were assessed. Receiver operating characteristic curves (ROC) were calculated for total BDI (BDI(t)) and BDI(c/e). Screening performance of cut-off scores was evaluated using the Youden Index (Y). With the application of the conventional BDI cut-off score, ROC analysis revealed a moderate overall screening performance with Y=52.6 and an area under the curve (AUC) of 0.83. In contrast, Y improved to 57.5 at a cut-off score of >9, but screening performance was still not optimal. BDI(c/e) showed also a moderate screening performance (AUC=.82); Y was maximized at a cut-off score of >8 (Y=0.53.5). Again, no cut-off score provided optimal screening performance. The BDI cannot be recommended as a formal screening instrument in cardiac inpatients since no cut-off score for either BDI(t) or BDI(c/e) combined both sufficiently high sensitivity and specificity. However, the shorter BDI(c/e) could be used as alternative to BDI(t) which may be confounded in physically ill patients. Generally, researchers should consider using alternative screening instruments (e.g., the Hospital Anxiety and Depression Scale) instead.

Psychometric properties of the Geriatric Anxiety Inventory (GAI) and its short-form (GAI-SF) in a clinical and non-clinical sample of older adults.

PubMed

Johnco, Carly; Knight, Ashleigh; Tadic, Dusanka; Wuthrich, Viviana M

2015-07-01

The Geriatric Anxiety Inventory is a 20-item geriatric-specific measure of anxiety severity. While studies suggest good internal consistency and convergent validity, divergent validity from measures of depression are weak. Clinical cutoffs have been developed that vary across studies due to the small clinical samples used. A six-item short form (GAI-SF) has been developed, and while this scale is promising, the research assessing the psychometrics of this scale is limited. This study examined the psychometric properties of GAI and GAI-SF in a large sample of 197 clinical geriatric participants with a comorbid anxiety and unipolar mood disorder, and a non-clinical control sample (N = 59). The internal consistency and convergent validity with other measures of anxiety was adequate for GAI and GAI-SF. Divergent validity from depressive symptoms was good in the clinical sample but weak in the total and non-clinical samples. Divergent validity from cognitive functioning was good in all samples. The one-factor structure was replicated for both measures. Receiver Operating Characteristic analyses indicated that the GAI is more accurate at identifying clinical status than the GAI-SF, although the sensitivity and specificity for the recommended cutoffs was adequate for both measures. Both GAI and GAI-SF show good psychometric properties for identifying geriatric anxiety. The GAI-SF may be a useful alternative screening measure for identifying anxiety in older adults.

Cognitive and physical functions related to the level of supervision and dependence in the toileting of stroke patients.

PubMed

Sato, Atsushi; Okuda, Yutaka; Fujita, Takaaki; Kimura, Norihiko; Hoshina, Noriyuki; Kato, Sayaka; Tanaka, Shigenari

2016-01-01

This study aimed to clarify which cognitive and physical factors are associated with the need for toileting assistance in stroke patients and to calculate cut-off values for discriminating between independent supervision and dependent toileting ability. This cross-sectional study included 163 first-stroke patients in nine convalescent rehabilitation wards. Based on their FIM Ⓡ instrument score for toileting, the patients were divided into an independent-supervision group and a dependent group. Multiple logistic regression analysis and receiver operating characteristic analysis were performed to identify factors related to toileting performance. The Minimental State Examination (MMSE); the Stroke Impairment Assessment Set (SIAS) score for the affected lower limb, speech, and visuospatial functions; and the Functional Assessment for Control of Trunk (FACT) were analyzed as independent variables. The multiple logistic regression analysis showed that the FIM Ⓡ instrument score for toileting was associated with the SIAS score for the affected lower limb function, MMSE, and FACT. On receiver operating characteristic analysis, the SIAS score for the affected lower limb function cut-off value was 8/7 points, the MMSE cut-off value was 25/24 points, and the FACT cut-off value was 14/13 points. Affected lower limb function, cognitive function, and trunk function were related with the need for toileting assistance. These cut-off values may be useful for judging whether toileting assistance is needed in stroke patients.

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

PubMed

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

2016-02-01

Epidemiological cut-off values were developed for application to antibiotic susceptibility data for Flavobacterium psychrophilum generated by standard CLSI test protocols. The MIC values for ten antibiotic agents against Flavobacterium psychrophilum were determined in two laboratories. For five antibiotics, the data sets were of sufficient quality and quantity to allow the setting of valid epidemiological cut-off values. For these agents, the cut-off values, calculated by the application of the statistically based normalized resistance interpretation method, were ≤16 mg L(-1) for erythromycin, ≤2 mg L(-1) for florfenicol, ≤0.025 mg L(-1) for oxolinic acid (OXO), ≤0.125 mg L(-1) for oxytetracycline and ≤20 (1/19) mg L(-1) for trimethoprim/sulphamethoxazole. For ampicillin and amoxicillin, the majority of putative wild-type observations were 'off scale', and therefore, statistically valid cut-off values could not be calculated. For ormetoprim/sulphadimethoxine, the data were excessively diverse and a valid cut-off could not be determined. For flumequine, the putative wild-type data were extremely skewed, and for enrofloxacin, there was inadequate separation in the MIC values for putative wild-type and non-wild-type strains. It is argued that the adoption of OXO as a class representative for the quinolone group would be a valid method of determining susceptibilities to these agents. © 2014 John Wiley & Sons Ltd.

Validity of Simpson-Angus Scale (SAS) in a naturalistic schizophrenia population.

PubMed

Janno, Sven; Holi, Matti M; Tuisku, Katinka; Wahlbeck, Kristian

2005-03-17

Simpson-Angus Scale (SAS) is an established instrument for neuroleptic-induced parkinsonism (NIP), but its statistical properties have been studied insufficiently. Some shortcomings concerning its content have been suggested as well. According to a recent report, the widely used SAS mean score cut-off value 0.3 of for NIP detection may be too low. Our aim was to evaluate SAS against DSM-IV diagnostic criteria for NIP and objective motor assessment (actometry). Ninety-nine chronic institutionalised schizophrenia patients were evaluated during the same interview by standardised actometric recording and SAS. The diagnosis of NIP was based on DSM-IV criteria. Internal consistency measured by Cronbach's alpha, convergence to actometry and the capacity for NIP case detection were assessed. Cronbach's alpha for the scale was 0.79. SAS discriminated between DSM-IV NIP and non-NIP patients. The actometric findings did not correlate with SAS. ROC-analysis yielded a good case detection power for SAS mean score. The optimal threshold value of SAS mean score was between 0.65 and 0.95, i.e. clearly higher than previously suggested threshold value. We conclude that SAS seems a reliable and valid instrument. The previously commonly used cut-off mean score of 0.3 has been too low resulting in low specificity, and we suggest a new cut-off value of 0.65, whereby specificity could be doubled without loosing sensitivity.

Validity of Simpson-Angus Scale (SAS) in a naturalistic schizophrenia population

PubMed Central

Janno, Sven; Holi, Matti M; Tuisku, Katinka; Wahlbeck, Kristian

2005-01-01

Background Simpson-Angus Scale (SAS) is an established instrument for neuroleptic-induced parkinsonism (NIP), but its statistical properties have been studied insufficiently. Some shortcomings concerning its content have been suggested as well. According to a recent report, the widely used SAS mean score cut-off value 0.3 of for NIP detection may be too low. Our aim was to evaluate SAS against DSM-IV diagnostic criteria for NIP and objective motor assessment (actometry). Methods Ninety-nine chronic institutionalised schizophrenia patients were evaluated during the same interview by standardised actometric recording and SAS. The diagnosis of NIP was based on DSM-IV criteria. Internal consistency measured by Cronbach's α, convergence to actometry and the capacity for NIP case detection were assessed. Results Cronbach's α for the scale was 0.79. SAS discriminated between DSM-IV NIP and non-NIP patients. The actometric findings did not correlate with SAS. ROC-analysis yielded a good case detection power for SAS mean score. The optimal threshold value of SAS mean score was between 0.65 and 0.95, i.e. clearly higher than previously suggested threshold value. Conclusion We conclude that SAS seems a reliable and valid instrument. The previously commonly used cut-off mean score of 0.3 has been too low resulting in low specificity, and we suggest a new cut-off value of 0.65, whereby specificity could be doubled without loosing sensitivity. PMID:15774006

Psychological distress of residents in Kawauchi village, Fukushima Prefecture after the accident at Fukushima Daiichi Nuclear Power Station: the Fukushima Health Management Survey.

PubMed

Yoshida, Koji; Shinkawa, Tetsuko; Urata, Hideko; Nakashima, Kanami; Orita, Makiko; Yasui, Kiyotaka; Kumagai, Atsushi; Ohtsuru, Akira; Yabe, Hirooki; Maeda, Masaharu; Hayashida, Naomi; Kudo, Takashi; Yamashita, Shunichi; Takamura, Noboru

2016-01-01

To shed light on the mental health of evacuees after the accident at Fukushima Daiichi Nuclear Power Station (FDNPS), we evaluate the results of the Fukushima Health Management Survey (FHMS) of the residents at Kawauchi village in Fukushima, which is located less than 30 km from the FDNPS. We conducted the cross-sectional study within the framework of the FHMS. Exposure values were "anorexia," "subjective feelings about health," "feelings about sleep satisfaction," and "bereavement caused by the disaster," confounding variables were "age" and "sex," and outcome variables were "K6 points." We collected data from the FHMS, and employed the Kessler Psychological Distress Scale (K6) and the posttraumatic stress disorder (PTSD) Checklist Stressor-Specific Version (PCL-S) to carry out the research. A total of 13 or greater was the cut-off for identifying serious mental illness using the K6 scale. The study subjects included residents (n = 542) of over 30 years of age from Kawauchi village, and data were used from the period of January 1, 2012 to October 31, 2012. A total of 474 residents (87.5%) scored less than 13 points in the K6 and 68 (12.6%) scored 13 points or more. The proportion of elderly residents (over 65 years old) among people with K6 score above the cut-off was higher than that among people with K6 score below the cut-off (44.1 vs 31.0%, p < 0.05). In addition, the proportion of residents with anorexia and mental illness among people with K6 score above the cut-off was higher than among people with K6 score below the cut-off (p < 0.001 and p < 0.05, respectively). The amount of residents who scored 44 points or more in the PCL-S among people with K6 score above the cut-off was also considerably higher than among people with K6 score below the cut-off (79.4 vs 12.9%, p < 0.001). Interestingly, the proportion of residents who scored more than among people with K6 score above the cut-off and the among people with PCL-S score above the cut-off in Kawauchi was higher than in previous studies in other locations. These results suggest that there are severe mental health problems, such as depression and PTSD, among adults as a consequence of the accident at the FDNPS. Our study showed that residents who lived in the evacuation zone before the disaster are at high risk psychological distress. To facilitate local residents' recovery from Fukushima, there is a need to continue providing them with physical and mental support, as well as communication regarding the health risks of radiation.

Efficient Schmidt number scaling in dissipative particle dynamics

NASA Astrophysics Data System (ADS)

Krafnick, Ryan C.; García, Angel E.

2015-12-01

Dissipative particle dynamics is a widely used mesoscale technique for the simulation of hydrodynamics (as well as immersed particles) utilizing coarse-grained molecular dynamics. While the method is capable of describing any fluid, the typical choice of the friction coefficient γ and dissipative force cutoff rc yields an unacceptably low Schmidt number Sc for the simulation of liquid water at standard temperature and pressure. There are a variety of ways to raise Sc, such as increasing γ and rc, but the relative cost of modifying each parameter (and the concomitant impact on numerical accuracy) has heretofore remained undetermined. We perform a detailed search over the parameter space, identifying the optimal strategy for the efficient and accuracy-preserving scaling of Sc, using both numerical simulations and theoretical predictions. The composite results recommend a parameter choice that leads to a speed improvement of a factor of three versus previously utilized strategies.

Development and validation of optimal cut-off value in inter-arm systolic blood pressure difference for prediction of cardiovascular events.

PubMed

Hirono, Akira; Kusunose, Kenya; Kageyama, Norihito; Sumitomo, Masayuki; Abe, Masahiro; Fujinaga, Hiroyuki; Sata, Masataka

2018-01-01

An inter-arm systolic blood pressure difference (IAD) is associated with cardiovascular disease. The aim of this study was to develop and validate the optimal cut-off value of IAD as a predictor of major adverse cardiac events in patients with arteriosclerosis risk factors. From 2009 to 2014, 1076 patients who had at least one cardiovascular risk factor were included in the analysis. We defined 700 randomly selected patients as a development cohort to confirm that IAD was the predictor of cardiovascular events and to determine optimal cut-off value of IAD. Next, we validated outcomes in the remaining 376 patients as a validation cohort. The blood pressure (BP) of both arms measurements were done simultaneously using the ankle-brachial blood pressure index (ABI) form of automatic device. The primary endpoint was the cardiovascular event and secondary endpoint was the all-cause mortality. During a median period of 2.8 years, 143 patients reached the primary endpoint in the development cohort. In the multivariate Cox proportional hazards analysis, IAD was the strong predictor of cardiovascular events (hazard ratio: 1.03, 95% confidence interval: 1.01-1.05, p=0.005). The receiver operating characteristic curve revealed that 5mmHg was the optimal cut-off point of IAD to predict cardiovascular events (p<0.001). In the validation cohort, the presence of a large IAD (IAD ≥5mmHg) was significantly associated with the primary endpoint (p=0.021). IAD is significantly associated with future cardiovascular events in patients with arteriosclerosis risk factors. The optimal cut-off value of IAD is 5mmHg. Copyright © 2017 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Effects of the change in cutoff values for human epidermal growth factor receptor 2 status by immunohistochemistry and fluorescence in situ hybridization: a study comparing conventional brightfield microscopy, image analysis-assisted microscopy, and interobserver variation.

PubMed

Atkinson, Roscoe; Mollerup, Jens; Laenkholm, Anne-Vibeke; Verardo, Mark; Hawes, Debra; Commins, Deborah; Engvad, Birte; Correa, Adrian; Ehlers, Charlotte Cort; Nielsen, Kirsten Vang

2011-08-01

New guidelines for HER2 testing have been introduced. To evaluate the difference in HER2 assessment after introduction of new cutoff levels for both immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) and to compare interobserver agreement and time to score between image analysis and conventional microscopy. Samples from 150 patients with breast cancer were scored by 7 pathologists using conventional microscopy, with a cutoff of both 10% and 30% IHC-stained cells, and using automated microscopy with image analysis. The IHC results were compared individually and to HER2 status as determined by FISH, using both the approved cutoff of 2.0 and the recently introduced cutoff of 2.2. High concordance was found in IHC scoring among the 7 pathologists. The 30% cutoff led to slightly fewer positive IHC observations. Introduction of a FISH equivocal zone affected 4% of the FISH scores. If cutoff for FISH is kept at 2.0, no difference in patient selection is found between the 10% and the 30% IHC cutoff. Among the 150 breast cancer samples, the new 30% IHC and 2.2 FISH cutoff levels resulted in one case without a firm diagnosis because both IHC and FISH were equivocal. Automated microscopy and image analysis-assisted IHC led to significantly better interobserver agreement among the 7 pathologists, with an increase in mean scoring time of only about 30 seconds per slide. The change in cutoff levels led to a higher concordance between IHC and FISH, but fewer samples were classified as HER2 positive.

Validation of the Epworth Sleepiness Scale for Children and Adolescents using Rasch analysis.

PubMed

Janssen, Kitty C; Phillipson, Sivanes; O'Connor, Justen; Johns, Murray W

2017-05-01

A validated measure of daytime sleepiness for adolescents is needed to better explore emerging relationships between sleepiness and the mental and physical health of adolescents. The Epworth Sleepiness Scale (ESS) is a widely used scale for daytime sleepiness in adults but contains references to alcohol and driving. The Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD) has been proposed as the official modified version of the ESS for children and adolescents. This study describes the psychometric analysis of the ESS-CHAD as a measure of daytime sleepiness for adolescents. The ESS-CHAD was completed by 297 adolescents, 12-18 years old, from two independent schools in Victoria, Australia. Exploratory factor analysis and Rasch analysis was conducted to determine the validity of the scale. Exploratory factor analysis and Rasch analysis indicated that ESS-CHAD has internal validity and a unidimensional structure with good model fit. Rasch analysis of four subgroups based on gender and year-level were consistent with the overall results. The results were consistent with published ESS results, which strongly indicates that the changes to the scale do not affect the scale's capacity to measure daytime sleepiness. It is concluded that the ESS-CHAD is a reliable and internally valid measure of daytime sleepiness in adolescents 12-18 years old. Further studies are needed to establish the internal validity of the ESS-CHAD for children under 12 years, and to establish external validity and accurate cut-off points for children and adolescents. Copyright © 2017 Elsevier B.V. All rights reserved.

Agreement between two cutoff points for physical activity and associated factors in young individuals☆

PubMed Central

Coledam, Diogo Henrique Constantino; Ferraiol, Philippe Fanelli; Pires, Raymundo; Ribeiro, Edinéia Aparecida Gomes; Ferreira, Marco Antonio Cabral; de Oliveira, Arli Ramos

2014-01-01

Objective: To analyze the agreement between two cutoff points for physical activity (300 and 420 minutes/week) and associated factors in youth. Methods: The study enrolled 738 adolescents of Londrina city, Paraná, Southern Brazil. The following variables were collected by a self report questionnaire: presence of moderate to vigorous physical activity, gender, age, father and mother education level, with whom the adolescent lives, number of siblings, physical activity perception, participation in Physical Education classes, facilities available to physical activity practice and sedentary behavior. Prevalence of physical activity between criterions were compared using McNemar test and the agreement was analysed by Kappa index. Multivariate analysis was performed using Poisson regression with robust variance adjustment was applied. Results: The prevalence for physical activity was significantly different: 22,3% for 300 minutes/week and 12,8% for 420 minutes/week (p<0,05), but the agreement was strong (k=0,82, p<0,001). The variables gender, father education, physical activity perception and sedentary behavior were associated to physical activity in both analyzed criteria. Participation in Physical Education class and facilities available to physical activity practice were associated to physical activity only with 300 minutes/week cutoff point. Conclusion: Caution is suggested regarding cutoffs use for physical activity in epidemiological studies, considering they can result in differences in prevalence of physical activity and its associated factors. PMID:25479852

Healthy Chilean Adolescents with HOMA-IR ≥ 2.6 Have Increased Cardiometabolic Risk: Association with Genetic, Biological, and Environmental Factors

PubMed Central

Burrows, R.; Correa-Burrows, P.; Reyes, M.; Blanco, E.; Albala, C.; Gahagan, S.

2015-01-01

Objective. To determine the optimal cutoff of the homeostasis model assessment-insulin resistance (HOMA-IR) for diagnosis of the metabolic syndrome (MetS) in adolescents and examine whether insulin resistance (IR), determined by this method, was related to genetic, biological, and environmental factors. Methods. In 667 adolescents (16.8 ± 0.3 y), BMI, waist circumference, glucose, insulin, adiponectin, diet, and physical activity were measured. Fat and fat-free mass were assessed by dual-energy X-ray absorptiometry. Family history of type 2 diabetes (FHDM) was reported. We determined the optimal cutoff of HOMA-IR to diagnose MetS (IDF criteria) using ROC analysis. IR was defined as HOMA-IR values above the cutoff. We tested the influence of genetic, biological, and environmental factors on IR using logistic regression analyses. Results. Of the participants, 16% were obese and 9.4 % met criteria for MetS. The optimal cutoff for MetS diagnosis was a HOMA-IR value of 2.6. Based on this value, 16.3% of participants had IR. Adolescents with IR had a significantly higher prevalence of obesity, abdominal obesity, fasting hyperglycemia, and MetS compared to those who were not IR. FHDM, sarcopenia, obesity, and low adiponectin significantly increased the risk of IR. Conclusions. In adolescents, HOMA-IR ≥ 2.6 was associated with greater cardiometabolic risk. PMID:26273675

Healthy Chilean Adolescents with HOMA-IR ≥ 2.6 Have Increased Cardiometabolic Risk: Association with Genetic, Biological, and Environmental Factors.

PubMed

Burrows, R; Correa-Burrows, P; Reyes, M; Blanco, E; Albala, C; Gahagan, S

2015-01-01

To determine the optimal cutoff of the homeostasis model assessment-insulin resistance (HOMA-IR) for diagnosis of the metabolic syndrome (MetS) in adolescents and examine whether insulin resistance (IR), determined by this method, was related to genetic, biological, and environmental factors. In 667 adolescents (16.8 ± 0.3 y), BMI, waist circumference, glucose, insulin, adiponectin, diet, and physical activity were measured. Fat and fat-free mass were assessed by dual-energy X-ray absorptiometry. Family history of type 2 diabetes (FHDM) was reported. We determined the optimal cutoff of HOMA-IR to diagnose MetS (IDF criteria) using ROC analysis. IR was defined as HOMA-IR values above the cutoff. We tested the influence of genetic, biological, and environmental factors on IR using logistic regression analyses. Of the participants, 16% were obese and 9.4 % met criteria for MetS. The optimal cutoff for MetS diagnosis was a HOMA-IR value of 2.6. Based on this value, 16.3% of participants had IR. Adolescents with IR had a significantly higher prevalence of obesity, abdominal obesity, fasting hyperglycemia, and MetS compared to those who were not IR. FHDM, sarcopenia, obesity, and low adiponectin significantly increased the risk of IR. In adolescents, HOMA-IR ≥ 2.6 was associated with greater cardiometabolic risk.

The Swedish validation of Edinburgh Postnatal Depression Scale (EPDS) during pregnancy.

PubMed

Rubertsson, Christine; Börjesson, Karin; Berglund, Anna; Josefsson, Ann; Sydsjö, Gunilla

2011-12-01

Around 10-15% of women suffer from depressive illness during pregnancy or the first year postpartum. Depression during pregnancy constitutes a risk for prenatal stress and preterm birth. No validated screening instrument for detecting depression during pregnancy was available in Swedish. We aimed to validate the Edinburgh Postnatal Depression Scale (EPDS) against DSM-IV criteria for depression during pregnancy, establish a reliable cut-off and estimate the correlation between the EPDS and HAD-S (Hospital Anxiety and Depression Scale). In a population-based community sample of 1175 pregnant women, 918 women (78%) answered questionnaires with the EPDS and HAD-S. In all, 121 were interviewed using the PRIME-MD (Primary Care Evaluation of Mental disorders) for diagnosing depression. Women were interviewed in mean gestational week 13 (range 8-21). For the EPDS, a receiver operating characteristic (ROC) curve was calculated for prediction of depression. Pearson's correlation coefficient was used to investigate the association between EPDS and HAD-S scores. The optimal cut-off score on the EPDS scale for detecting depression was ≥13 (standard error coefficient of 1.09 and c-statistics of 0.84) giving a sensitivity of 77% and specificity of 94%. The EPDS scores correlated strongly with the HAD-S, Pearson's correlation was 0.83 (P < 0.0001). This study confirms that the EPDS is a valid screening instrument for detection of depressive symptoms during pregnancy. The EPDS shows persuasive measuring outcomes with an optimal cut-off at ≥13. Healthcare for pregnant women should consider screening procedures and follow-up routines for depressive symptoms.

The Impact of Frictional Healing on Stick-Slip Recurrence Interval and Stress Drop: Implications for Earthquake Scaling

NASA Astrophysics Data System (ADS)

Im, Kyungjae; Elsworth, Derek; Marone, Chris; Leeman, John

2017-12-01

Interseismic frictional healing is an essential process in the seismic cycle. Observations of both natural and laboratory earthquakes demonstrate that the magnitude of stress drop scales with the logarithm of recurrence time, which is a cornerstone of the rate and state friction (RSF) laws. However, the origin of this log linear behavior and short time "cutoff" for small recurrence intervals remains poorly understood. Here we use RSF laws to demonstrate that the back-projected time of null-healing intrinsically scales with the initial frictional state θi. We explore this behavior and its implications for (1) the short-term cutoff time of frictional healing and (2) the connection between healing rates derived from stick-slip sliding versus slide-hold-slide tests. We use a novel, continuous solution of RSF for a one-dimensional spring-slider system with inertia. The numerical solution continuously traces frictional state evolution (and healing) and shows that stick-slip cutoff time also scales with frictional state at the conclusion of the dynamic slip process θi (=Dc/Vpeak). This numerical investigation on the origins of stick-slip response is verified by comparing laboratory data for a range of peak slip velocities. Slower slip motions yield lesser magnitude of friction drop at a given time due to higher frictional state at the end of each slip event. Our results provide insight on the origin of log linear stick-slip evolution and suggest an approach to estimating the critical slip distance on faults that exhibit gradual accelerations, such as for slow earthquakes.

Anthropometric cutoff values for predicting metabolic syndrome in a Saudi community: from the SAUDI-DM study.

PubMed

Al-Rubean, Khalid; Youssef, Amira M; AlFarsi, Yousuf; Al-Sharqawi, Ahmad H; Bawazeer, Nahla; AlOtaibi, Mohammad T; AlRumaih, Fahd Issa; Zaidi, Muhammad Shoaib

2017-01-01

The prevalence of metabolic syndrome varies widely by ethnicity and by the criteria used in its definition. To identify the optimal cutoff values for waist circumference (WC), waist-to-hip ratio (WHR) and body mass index (BMI) for identifying metabolic syndrome among the Saudi population. Nationwide household cross-sectional population-based survey. Thirteen health sectors in Saudi Arabia. We used data for subjects in the Saudi Abnormal Glucose Metabolism and Diabetes Impact Study (SAUDI-DM), which was conducted from 2007 to 2009. Using International Diabetes Federation (IDF) criteria, metabolic syndrome and its different components were assessed using anthropometric measurements, blood pressure, fasting plasma glucose, triglycerides and HDL cholesterol. Receiver operating characteristic (ROC) curves were generated to assess sensitivity and specificity for different cutoff values of WC, WHR, and BMI. The Youden index was used to calculate the optimal cutoff value for each anthropometric measurement. Optimal cutoff value for WC, WHR, and BMI for identifying the risk of metabolic syndrome. The prevalence of two or more risk factors for metabolic syndrome was observed in 43.42% of the total cohort of 12126 study participants >=18 years of age. The presence of two or more risk factors were significantly higher among men (46.81%) than women (40.53%) (P < .001). The optimal cutoff values for WC, WHR, and BMI were 92 cm, 0.89, and 25 kg/m2 for men and 87 cm, 0.81 and 28 kg/m2 for women for identifying the risk of metabolic syndrome. The prevalence of elevated triglycerides, blood pressure, and fasting plasma glucose significantly increased with age for both genders. The proposed WC cutoff values were better than WHR and BMI in predicting metabolic syndrome and could be used for screening people at high risk for metabolic syndrome in the Saudi population. No direct measure of body fatness and fat distribution, cross-sectional design.

The impact of wave number selection and spin up time when using spectral nudging for dynamical downscaling applications

NASA Astrophysics Data System (ADS)

Gómez, Breogán; Miguez-Macho, Gonzalo

2017-04-01

Nudging techniques are commonly used to constrain the evolution of numerical models to a reference dataset that is typically of a lower resolution. The nudged model retains some of the features of the reference field while incorporating its own dynamics to the solution. These characteristics have made nudging very popular in dynamic downscaling applications that cover from shot range, single case studies, to multi-decadal regional climate simulations. Recently, a variation of this approach called Spectral Nudging, has gained popularity for its ability to maintain the higher temporal and spatial variability of the model results, while forcing the large scales in the solution with a coarser resolution field. In this work, we focus on a not much explored aspect of this technique: the impact of selecting different cut-off wave numbers and spin-up times. We perform four-day long simulations with the WRF model, daily for three different one-month periods that include a free run and several Spectral Nudging experiments with cut-off wave numbers ranging from the smallest to the largest possible (full Grid Nudging). Results show that Spectral Nudging is very effective at imposing the selected scales onto the solution, while allowing the limited area model to incorporate finer scale features. The model error diminishes rapidly as the nudging expands over broader parts of the spectrum, but this decreasing trend ceases sharply at cut-off wave numbers equivalent to a length scale of about 1000 km, and the error magnitude changes minimally thereafter. This scale corresponds to the Rossby Radius of deformation, separating synoptic from convective scales in the flow. When nudging above this value is applied, a shifting of the synoptic patterns can occur in the solution, yielding large model errors. However, when selecting smaller scales, the fine scale contribution of the model is damped, thus making 1000 km the appropriate scale threshold to nudge in order to balance both effects. Finally, we note that longer spin-up times are needed for model errors to stabilize when using Spectral Nudging than with Grid Nudging. Our results suggest that this time is between 36 and 48 hours.

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

PubMed

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

2014-01-01

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

A New Factor in UK Students' University Attainment: The Relative Age Effect Reversal?

ERIC Educational Resources Information Center

Roberts, Simon J.; Stott, Tim

2015-01-01

Purpose: The purpose of this paper is to study relative age effects (RAEs) in a selected sample of university students. The majority of education systems across the globe adopt age-related cut-off points for eligibility. This strategy has received criticism for (dis)advantaging those older children born closer to the "cut-off" date for…

Limits of linearity and detection for some drugs of abuse.

PubMed

Needleman, S B; Romberg, R W

1990-01-01

The limits of linearity (LOL) and detection (LOD) are important factors in establishing the reliability of an analytical procedure for accurately assaying drug concentrations in urine specimens. Multiple analyses of analyte over an extended range of concentrations provide a measure of the ability of the analytical procedure to correctly identify known quantities of drug in a biofluid matrix. Each of the seven drugs of abuse gives linear analytical responses from concentrations at or near their LOD to concentrations several-fold higher than those generally encountered in the drug screening laboratory. The upper LOL exceeds the Department of Navy (DON) cutoff values by factors of approximately 2 to 160. The LOD varies from 0.4 to 5.0% of the DON cutoff value for each drug. The limit of quantitation (LOQ) is calculated as the LOD + 7 SD. The range for LOL is greater for drugs analyzed with deuterated internal standards compared with those using conventional internal standards. For THC acid, cocaine, PCP, and morphine, LOLs are 8 to 160-fold greater than the defined cutoff concentrations. For the other drugs, the LOL's are only 2 to 4-fold greater than the defined cutoff concentrations.

Return to Work: A Cut-Off of FIM Gain with Montebello Rehabilitation Factor Score in Order to Identify Predictive Factors in Subjects with Acquired Brain Injury

PubMed Central

2016-01-01

Return to work (RTW) for people with acquired brain injury (ABI) represents a main objective of rehabilitation: this work presents a strong correlation between personal well-being and quality of life. The aim of this study is to investigate the prognostic factors that can predict RTW after ABI (traumatic or non- traumatic aetiology) in patients without disorders of consciousness (e.g. coma, vegetative or minimally conscious state) at the beginning of their admission to rehabilitation. At the end of a 6-month follow-up after discharge, data were successfully collected in 69 patients. The rehabilitation effectiveness (functional Recovery) between admission and discharge was assessed by Functional Independent Measure (FIM) gain, through the Montebello Rehabilitation Factor Score (MRFS), which was obtained as follows: (discharge FIM—admission FIM)/(Maximum possible FIM—Admission FIM) x 100. The cut-off value (criterion) deriving from MRFS, which helped identify RTW patients, resulted in .659 (sn 88.9%; sp 52.4%). Considering the Mini Mental State Examination (MMSE) and the MRFS data, the multivariable binary logistic regression analysis presented 62.96% of correct RTW classification cases, 80.95% of non-RTW leading to an overall satisfactory predictability of 73.91%. The results of the present study suggest that occupational therapy intervention could modify cut-off in patients with an MFRS close to target at the end of an in-hospital rehabilitative program thus developing their capabilities and consequently surpassing cut-off itself. PMID:27780215

Quantification of human epidermal growth factor receptor 2 immunohistochemistry using the Ventana Image Analysis System: correlation with gene amplification by fluorescence in situ hybridization: the importance of instrument validation for achieving high (>95%) concordance rate.

PubMed

Dennis, Jake; Parsa, Rezvaneh; Chau, Donnie; Koduru, Prasad; Peng, Yan; Fang, Yisheng; Sarode, Venetia Rumnong

2015-05-01

The use of computer-based image analysis for scoring human epidermal growth factor receptor 2 (HER2) immunohistochemistry (IHC) has gained a lot of interest recently. We investigated the performance of the Ventana Image Analysis System (VIAS) in HER2 quantification by IHC and its correlation with fluorescence in situ hybridization (FISH). We specifically compared the 3+ IHC results using the manufacturer's machine score cutoffs versus laboratory-defined cutoffs with the FISH assay. Using the manufacturer's 3+ cutoff (VIAS score; 2.51 to 3.5), 181/536 (33.7%) were scored 3+, and FISH was positive in 147/181 (81.2%), 2 (1.1%) were equivocal, and 32 (17.6%) were FISH (-). Using the laboratory-defined 3+ cutoff (VIAS score 3.5), 52 (28.7%) cases were downgraded to 2+, of which 29 (55.7%) were FISH (-), and 23 (44.2%) were FISH (+). With the revised cutoff, there were improvements in the concordance rate from 89.1% to 97.0% and in the positive predictive value from 82.1% to 97.6%. The false-positive rate for 3+ decreased from 9.0% to 0.8%. Six of 175 (3.4%) IHC (-) cases were FISH (+). Three cases with a VIAS score 3.5 showed polysomy of chromosome 17. In conclusion, the VIAS may be a valuable tool for assisting pathologists in HER2 scoring; however, the positive cutoff defined by the manufacturer is associated with a high false-positive rate. This study highlights the importance of instrument validation/calibration to reduce false-positive results.

Which population groups should be targeted for cardiovascular prevention? A modelling study based on the Norwegian Hordaland Health Study (HUSK).

PubMed

Brekke, Mette; Rekdal, Magne; Straand, Jørund

2007-06-01

To assess level of cardiovascular risk factors in a non-selected, middle-aged population. To estimate the proportion target for risk intervention according to present guidelines and according to different cut-off levels for two risk algorithms. Population survey, modelling study. The Norwegian Hordaland Health Study (HUSK) 1997-99. A total of 22 289 persons born in 1950-57. Own and relatives' cardiovascular morbidity, antihypertensive and lipid-lowering treatment, smoking, blood pressure, cholesterol. Framingham and Systematic Coronary Risk Evaluation (SCORE) algorithms. The European guidelines on CVD prevention in clinical practice were applied to estimate size of risk groups. Some 9.7% of men and 7.6% of women had CVD, diabetes mellitus, a high level of one specific risk factor, or received lipid-lowering or antihypertensive treatment. Applying a SCORE (60 years) cut-off level at 5% to the rest of the population selected 52.4% of men and 0.8% of women into a primary prevention group, while a cut-off level at 8% included 22.0% and 0.06% respectively. A cut-off level for the Framingham score (60 years) of 20% selected 43.6% of men and 4.7% of women, while a cut-off level of 25% selected 25.6% of men and 1.8% of women. The findings illustrate how choices regarding risk estimation highly affect the size of the target population. Modelling studies are important when preparing guidelines, to address implications for resource allocation and risk of medicalization. The population share to be targeted for primary prevention ought to be estimated, including the impact of various cut-off points for risk algorithms on the size of the risk population.

Positive Affect, Negative Affect, and Physiological Hyperarousal among Referred and Nonreferred Youths

ERIC Educational Resources Information Center

Laurent, Jeff; Joiner, Thomas E., Jr.; Catanzaro, Salvatore J.

2011-01-01

The Positive and Negative Affect Scale for Children (PANAS-C) and the Physiological Hyperarousal Scale for Children (PH-C) seem ideal measures for school mental health screenings, because they are theory based, psychometrically sound, and brief. This study provides descriptive information and preliminary cutoff scores in an effort to increase the…

Strong coupling constant from Adler function in lattice QCD

NASA Astrophysics Data System (ADS)

Hudspith, Renwick J.; Lewis, Randy; Maltman, Kim; Shintani, Eigo

2016-09-01

We compute the QCD coupling constant, αs, from the Adler function with vector hadronic vacuum polarization (HVP) function. On the lattice, Adler function can be measured by the differential of HVP at two different momentum scales. HVP is measured from the conserved-local vector current correlator using nf = 2 + 1 flavor Domain Wall lattice data with three different lattice cutoffs, up to a-1 ≈ 3.14 GeV. To avoid the lattice artifact due to O(4) symmetry breaking, we set the cylinder cut on the lattice momentum with reflection projection onto vector current correlator, and it then provides smooth function of momentum scale for extracted HVP. We present a global fit of the lattice data at a justified momentum scale with three lattice cutoffs using continuum perturbation theory at 𝒪(αs4) to obtain the coupling in the continuum limit at arbitrary scale. We take the running to Z boson mass through the appropriate thresholds, and obtain αs(5)(MZ) = 0.1191(24)(37) where the first is statistical error and the second is systematic one.

Peccei-Quinn relaxion

NASA Astrophysics Data System (ADS)

Jeong, Kwang Sik; Shin, Chang Sub

2018-01-01

The relaxation mechanism, which solves the electroweak hierarchy problem without relying on TeV scale new physics, crucially depends on how a Higgs-dependent back-reaction potential is generated. In this paper, we suggest a new scenario in which the scalar potential induced by the QCD anomaly is responsible both for the relaxation mechanism and the Peccei-Quinn mechanism to solve the strong CP problem. The key idea is to introduce the relaxion and the QCD axion whose cosmic evolutions become quite different depending on an inflaton-dependent scalar potential. Our scheme raises the cutoff scale of the Higgs mass up to 107 GeV, and allows reheating temperature higher than the electroweak scale as would be required for viable cosmology. In addition, the QCD axion can account for the observed dark matter of the universe as produced by the conventional misalignment mechanism. We also consider the possibility that the couplings of the Standard Model depend on the inflaton and become stronger during inflation. In this case, the relaxation can be implemented with a sub-Planckian field excursion of the relaxion for a cutoff scale below 10 TeV.

Dimensional and categorical approaches to hypochondriasis.

PubMed

Hiller, W; Rief, W; Fichter, M M

2002-05-01

The DSM-IV definition of hypochondriasis is contrasted with hypochondriacal dimensions as provided by the Whiteley Index (WI) and Illness Attitude Scales (IAS). Exploratory factor analysis was conducted on self-report data from 570 patients with mental and psychophysiological disorders. Of these, 319 were additionally diagnosed according to DSM-IV by structured interviews. The three 'classic' factors of the WI labelled disease phobia, somatic symptoms and disease conviction were confirmed. The IAS consisted of two dimensions indicating health anxiety and illness behaviour. The overall scores of both instruments were highly correlated (0.80). Optimal cut-off points for case identification yielded sensitivity/specificity rates of 71/80% (WI) and 72/79% (IAS). The IAS was superior to the WI when patients with hypochondriacal disorder were to be discriminated from non-hypochondriacal somatizers. Largest group differences were found for scales related to affective components (health anxieties), smallest for illness behaviours. Affective components of hypochondriasis explained more variance of diagnostic group membership than somatization symptoms. The subscales of disease phobia (WI) and health anxiety (IAS) were most sensitive to treatment-related changes. The self-rating scales are valid for screening, case definition and dimensional assessment of hypochondriacal disorder, including the differentiation between hypochondriasis and somatization. The existence of distinguishable affective and cognitive components was confirmed.

[Severe intimate partner violence risk prediction scale-revised].

PubMed

Echeburúa, Enrique; Amor, Pedro Javier; Loinaz, Ismael; de Corral, Paz

2010-11-01

The aim of this study was to describe the psychometric properties of the Severe Intimate Partner Violence Risk Prediction Scale and to revise it in order to ponderate the 20 items according to their discriminant capacity and to solve the missing item problem. The sample for this study consisted of 450 male batterers who were reported to the police station. The victims were classified as high-risk (18.2%), moderate-risk (45.8%) and low-risk (36%), depending on the cutoff scores in the original scale. Internal consistency (Cronbach's alpha=.72) and interrater reliability (r=.73) were acceptable. The point biserial correlation coefficient between each item and the corrected total score of the 20-item scale was calculated to determine the most discriminative items, which were associated with the context of intimate partner violence in the last month, with the male batterer's profile and with the victim's vulnerability. A revised scale (EPV-R) with new cutoff scores and indications on how to deal with the missing items were proposed in accordance with these results. This easy-to-use tool appears to be suitable to the requirements of criminal justice professionals and is intended for use in safety planning. Implications of these results for further research are discussed.

Examining the validity and reliability of the Taita symptom checklist using Rasch analysis.

PubMed

Chen, Yun-Ling; Pan, Ay-Woan; Chung, LyInn; Chen, Tsyr-Jang

2015-03-01

The Taita symptom checklist (TSCL) is a standardized self-rating psychiatric symptom scale for outpatients with mental illness in Taiwan. This study aimed to examine the validity and reliability of the TSCL using Rasch analysis. The TSCL was given to 583 healthy people and 479 people with mental illness. Rasch analysis was used to examine the appropriateness of the rating scale, the unidimensionality of the scale, the differential item functioning across sex and diagnosis, and the Rasch cut-off score of the scale. Rasch analysis confirmed that the revised 37 items with a three-point rating scale of the TSCL demonstrated good internal consistency and met criteria for unidimensionality. The person and item reliability indices were high. The TSCL could reliably measure healthy participants and patients with mental illness. Differential item functioning due to sex or psychiatric diagnosis was evident for three items. A Rasch cut-off score for TSCL was produced for detecting participants' psychiatric symptoms based on an eight-level classification. The TSCL is a reliable and valid assessment to evaluate the participants' perceived disturbance of psychiatric symptoms based on Rasch analysis. Copyright © 2013. Published by Elsevier B.V.

Programmable Gain Amplifiers with DC Suppression and Low Output Offset for Bioelectric Sensors

PubMed Central

Carrera, Albano; de la Rosa, Ramón; Alonso, Alonso

2013-01-01

DC-offset and DC-suppression are key parameters in bioelectric amplifiers. However, specific DC analyses are not often explained. Several factors influence the DC-budget: the programmable gain, the programmable cut-off frequencies for high pass filtering and, the low cut-off values and the capacitor blocking issues involved. A new intermediate stage is proposed to address the DC problem entirely. Two implementations were tested. The stage is composed of a programmable gain amplifier (PGA) with DC-rejection and low output offset. Cut-off frequencies are selectable and values from 0.016 to 31.83 Hz were tested, and the capacitor deblocking is embedded in the design. Hence, this PGA delivers most of the required gain with constant low output offset, notwithstanding the gain or cut-off frequency selected. PMID:24084109

The Pathological Buying Screener: Development and Psychometric Properties of a New Screening Instrument for the Assessment of Pathological Buying Symptoms

PubMed Central

Trotzke, Patrick; Mitchell, James E.; de Zwaan, Martina

2015-01-01

The study was designed to develop a new screening instrument for pathological buying (PB), and to examine its psychometric properties in a large-scale sample. By using a facet theoretical approach and based on literature as well as on clinical experience, a 20-item Pathological Buying Screener (PBS) was developed and administered to a representative German sample (n = 2,539). Valid data were available from 2,403 participants who were subjects for three subsequent empirical studies. The first study explored the factor structure using exploratory factor analyses in a subsample of 498 participants. Based on factor loadings, a 13-item version with the two factors loss of control / consequences and excessive buying behavior was revealed. This two-factor model was confirmed in study 2 by confirmatory factor analysis performed on another subsample (n = 1,905). Study 3 investigated age and gender effects and convergent validity of the PBS using the Compulsive Buying Scale (CBS) in the full sample (N = 2,403). The total PBS score was adequately correlated with the CBS score. Hierarchical regression analyses with the CBS score as the dependent variable and the two PBS factors as the predictors indicated an own incremental validity of the two factors in participants ≤ 65 years. The reliability of the total score as well as of the two subscales was good to excellent. Overall, the PBS represents a useful measure for PB. Future studies are needed to replicate the two-factor structure in clinical samples and to define a valid cutoff for PB. PMID:26488872

The Pathological Buying Screener: Development and Psychometric Properties of a New Screening Instrument for the Assessment of Pathological Buying Symptoms.

PubMed

Müller, Astrid; Trotzke, Patrick; Mitchell, James E; de Zwaan, Martina; Brand, Matthias

2015-01-01

The study was designed to develop a new screening instrument for pathological buying (PB), and to examine its psychometric properties in a large-scale sample. By using a facet theoretical approach and based on literature as well as on clinical experience, a 20-item Pathological Buying Screener (PBS) was developed and administered to a representative German sample (n = 2,539). Valid data were available from 2,403 participants who were subjects for three subsequent empirical studies. The first study explored the factor structure using exploratory factor analyses in a subsample of 498 participants. Based on factor loadings, a 13-item version with the two factors loss of control / consequences and excessive buying behavior was revealed. This two-factor model was confirmed in study 2 by confirmatory factor analysis performed on another subsample (n = 1,905). Study 3 investigated age and gender effects and convergent validity of the PBS using the Compulsive Buying Scale (CBS) in the full sample (N = 2,403). The total PBS score was adequately correlated with the CBS score. Hierarchical regression analyses with the CBS score as the dependent variable and the two PBS factors as the predictors indicated an own incremental validity of the two factors in participants ≤ 65 years. The reliability of the total score as well as of the two subscales was good to excellent. Overall, the PBS represents a useful measure for PB. Future studies are needed to replicate the two-factor structure in clinical samples and to define a valid cutoff for PB.

A comparison of the diagnostic power of the Full Outline of Unresponsiveness scale and the Glasgow coma scale in the discharge outcome prediction of patients with traumatic brain injury admitted to the intensive care unit

PubMed Central

Gorji, Mohammad Ali Heidari; Hoseini, Seyed Hosein; Gholipur, Afshin; Mohammadpur, Reza Ali

2014-01-01

Background and Aim: This study aimed to determine whether the Full Outline of Unresponsiveness (FOUR) score is an accurate predictorof discharge outcome in traumatic brain injury (TBI) patients and to compare its performanceto Glasgow coma scale (GCS). Materials and Methods: Thisis diagnostic study conducted prospectively on 53 TBI patients admitted to ICU of education hospitals of Medical Science University of Mazandaran during February 2013 to June 2013. Data collection was done with a checklist including biographic, clinical information and outcome. The FOUR score and GCS were determined by the researcher in the first 24 hours. Outcomes considered as in-hospital mortality and poor neurologic outcome (Glasgow Outcome Scale (GOS) 1-3) in discharge time from the hospital. Results: In terms of predictive power for in-hospital mortality, the area under the receiver operating characteristic (ROC) curve was 0/92 (95% CI. 0/81-0/97) for FOUR score and 0/96 (95% CI. 0/87-0/99) for GCS. In terms of predictive power of poor neurologic outcome, the area under the ROC curve was 0/95 (95% CI. 0/86-0/99) for FOUR score and 0/90 (95% CI.0/79-0/96) for GCS as evidenced by GOS 1-3. The cut-off of 6 showed sensitivity and specificity of total four score predicting poor outcome at 0/86 and 0/87 while the cut-off of 4 showed the value of in hospital mortality at 0/90 and 0/90. The total GCS score showed sensitivity and specificity 0/100 and 0/61 at cut-off 7 in predicting poor outcome while in predicting mortality at cut-off of 4 this range was 0/100 and 0/92. Conclusion: The FOUR score is an accurate predictor of discharge outcome in TBI patients. Thus, researchers recommend for therapeutic Schematizationto use in neurosurgical patients at admission day. PMID:24843331

Psychometric testing of a Mandarin Chinese Version of the Clinically Useful Depression Outcome Scale for patients diagnosed with type 2 diabetes mellitus.

PubMed

Hsu, Lan-Fang; Kao, Ching-Chiu; Wang, Mei-Yeh; Chang, Chun-Jen; Tsai, Pei-Shan

2014-12-01

The Clinically Useful Depression Outcome Scale (CUDOS) is a self-report instrument that assesses symptoms and the severity of depression, but its psychometric properties in patients with type 2 diabetes mellitus in Chinese-Speaking populations are unknown. To examine the psychometric properties of the Mandarin Chinese version of the CUDOS (CUDOS-Chinese). A methodological research design. Endocrinology and metabolism outpatient clinics at 2 university-affiliated hospitals in northern Taiwan. Two-hundred and fourteen type 2 diabetic patients with the mean age of 62.6 years were enrolled, and two-hundred and twelve of them completed the study. Internal consistency, test-retest reliability, concurrent, and contrasted-groups validity were assessed. A receiver operating characteristic curve analysis was performed to assess sensitivity and specificity. Construct validity by means of confirmatory factor analysis was conducted. Internal consistency (Cronbach α of total scale and four subscales=0.93, 0.80, 0.66, 0.80, and 0.83, respectively), test-retest reliability (intra-class correlation coefficients of total scale and four subscales=0.92, 0.89, 0.94, 0.89, and 0.91, respectively), and strong correlations with the Beck Depression Inventory-II (r=0.87) suggested good reliability and validity. The confirmatory factor analysis supported a four-factor model. A cut-off score of 19/20 yielded 77.8% sensitivity and 75.6% specificity. The CUDOS-Chinese demonstrated satisfactory validity and reliability for detecting depression in type 2 diabetic patients in Taiwan. Copyright © 2014 Elsevier Ltd. All rights reserved.

Detection of suboptimal effort with symbol span: development of a new embedded index.

PubMed

Young, J Christopher; Caron, Joshua E; Baughman, Brandon C; Sawyer, R John

2012-03-01

Developing embedded indicators of suboptimal effort on objective neurocognitive testing is essential for detecting increasingly sophisticated forms of symptom feigning. The current study explored whether Symbol Span, a novel Wechsler Memory Scale-fourth edition measure of supraspan visual attention, could be used to discriminate adequate effort from suboptimal effort. Archival data were collected from 136 veterans classified into Poor Effort (n = 42) and Good Effort (n = 94) groups based on symptom validity test (SVT) performance. The Poor Effort group had significantly lower raw scores (p < .001) and age-corrected scaled scores (p < .001) than the Good Effort group on the Symbol Span test. A raw score cutoff of <14 produced 83% specificity and 50% sensitivity for detection of Poor Effort. Similarly, sensitivity was 52% and specificity was 84% when employing a cutoff of <7 for Age-Corrected Scale Score. Collectively, present results suggest that Symbol Span can effectively differentiate veterans with multiple failures on established free-standing and embedded SVTs.

Assessment of gross motor skills of at-risk infants: predictive validity of the Alberta Infant Motor Scale.

PubMed

Darrah, J; Piper, M; Watt, M J

1998-07-01

The Alberta Infant Motor Scale (AIMS) is a norm-referenced measure of infant gross motor development. The objectives of this study were: (1) to establish the best cut-off scores on the AIMS for predictive purposes, and (2) to compare the predictive abilities of the AIMS with those of the Movement Assessment of Infants (MAI) and the Peabody Developmental Gross Motor Scale (PDGMS). One hundred and sixty-four infants were assessed at 4 and 8 months adjusted ages on the three measures. A pediatrician assessed each infant's gross motor development at 18 months as normal, suspicious, or abnormal. For the AIMS, two different cut-off points were identified: the 10th centile at 4 months and the 5th centile at 8 months. The MAI provided the best specificity rates at 4 months while the AIMS was superior in specificity at 8 months. Sensitivity rates were comparable between the two tests. The PDGMS in general demonstrated poor predictive abilities.

Inattention symptoms and the diagnosis of comorbid attention-deficit/hyperactivity disorder among youth with generalized anxiety disorder.

PubMed

Elkins, R Meredith; Carpenter, Aubrey L; Pincus, Donna B; Comer, Jonathan S

2014-12-01

Generalized anxiety disorder (GAD) and attention-deficit/hyperactivity disorder (ADHD) commonly co-occur in childhood. Inattention symptoms can be hallmarks of both conditions, however assessment tools of inattention may not effectively distinguish between the two conditions. The present study used receiver operating characteristic (ROC) analyses to examine the high-end specificity of the Attention Problems Scale of the Child Behavior Checklist (CBCL) for detecting comorbid ADHD among youth with GAD (N=46). Results support the utility of the Attention Problems Scale for accurately distinguishing between the two groups (AUC=.84, SE=.06). Specifically, a cut score of 63 achieved the most favorable values across diagnostic utility indices; 74% of GAD youth with ADHD scored above this cutoff and 91% of GAD youth without ADHD scored below this cutoff. Findings provide support for the use of the CBCL Attention Problems Scale to supplement diagnostic interviews and identify inattention associated with ADHD among GAD youth. Copyright © 2014 Elsevier Ltd. All rights reserved.

Realising effective theories of tribrid inflation: are there effects from messenger fields?

NASA Astrophysics Data System (ADS)

Antusch, Stefan; Nolde, David

2015-09-01

Tribrid inflation is a variant of supersymmetric hybrid inflation in which the inflaton is a matter field (which can be charged under gauge symmetries) and inflation ends by a GUT-scale phase transition of a waterfall field. These features make tribrid inflation a promising framework for realising inflation with particularly close connections to particle physics. Superpotentials of tribrid inflation involve effective operators suppressed by some cutoff scale, which is often taken as the Planck scale. However, these operators may also be generated by integrating out messenger superfields with masses below the Planck scale, which is in fact quite common in GUT and/or flavour models. The values of the inflaton field during inflation can then lie above this mass scale, which means that for reliably calculating the model predictions one has to go beyond the effective theory description. We therefore discuss realisations of effective theories of tribrid inflation and specify in which cases effects from the messenger fields are expected, and under which conditions they can safely be neglected. In particular, we point out how to construct realisations where, despite the fact that the inflaton field values are above the messenger mass scale, the predictions for the observables are (to a good approximation) identical to the ones calculated in the effective theory treatment where the messenger mass scale is identified with the (apparent) cutoff scale.

Can the Hospital Anxiety and Depression (HAD) Scale be used on Chinese elderly in general practice?

PubMed

Lam, C L; Pan, P C; Chan, A W; Chan, S Y; Munro, C

1995-06-01

A study was carried out in a general practice in Hong Kong to find out if the Hospital Anxiety and Depression (HAD) Scale could be used to detect psychological problems in Chinese elderly. The HAD Scale was translated into Cantonese and administered by an interviewer to 298 Chinese aged 60 or above before their doctor consultations. The acceptance rate of the Scale was 96% and each interview took only 5-10 min to complete. All 298 elderly understood and completed the HAD Scale. Validation of the results of the HAD Scale by the Clinical Interview Schedule (CIS) was done on a random sample of 100 elderly. Relative operating characteristic (ROC) analysis showed that the optimal cut-off points of the HAD Scale was a depression score of 6 and an anxiety score of 3. The sensitivity was 80%, specificity was 90%, OMR (overall misclassification rate) was 12%, positive predictive value was 67% and negative predictive value was 95%. Thirty-six per cent of the elderly had scores above these cut-off points. More females than males had high anxiety scores. Nearly half of those with positive HAD scores were not known to have any psychological illness. The HAD Scale has great potential to be used as a screening instrument for psychological illnesses in Cantonese-speaking Chinese elderly all over the world.

Realising effective theories of tribrid inflation: are there effects from messenger fields?

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

Antusch, Stefan; Max-Planck-Institut für Physik; Nolde, David

2015-09-22

Tribrid inflation is a variant of supersymmetric hybrid inflation in which the inflaton is a matter field (which can be charged under gauge symmetries) and inflation ends by a GUT-scale phase transition of a waterfall field. These features make tribrid inflation a promising framework for realising inflation with particularly close connections to particle physics. Superpotentials of tribrid inflation involve effective operators suppressed by some cutoff scale, which is often taken as the Planck scale. However, these operators may also be generated by integrating out messenger superfields with masses below the Planck scale, which is in fact quite common in GUTmore » and/or flavour models. The values of the inflaton field during inflation can then lie above this mass scale, which means that for reliably calculating the model predictions one has to go beyond the effective theory description. We therefore discuss realisations of effective theories of tribrid inflation and specify in which cases effects from the messenger fields are expected, and under which conditions they can safely be neglected. In particular, we point out how to construct realisations where, despite the fact that the inflaton field values are above the messenger mass scale, the predictions for the observables are (to a good approximation) identical to the ones calculated in the effective theory treatment where the messenger mass scale is identified with the (apparent) cutoff scale.« less

Realising effective theories of tribrid inflation: are there effects from messenger fields?

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

Antusch, Stefan; Nolde, David, E-mail: stefan.antusch@unibas.ch, E-mail: david.nolde@unibas.ch

2015-09-01

Tribrid inflation is a variant of supersymmetric hybrid inflation in which the inflaton is a matter field (which can be charged under gauge symmetries) and inflation ends by a GUT-scale phase transition of a waterfall field. These features make tribrid inflation a promising framework for realising inflation with particularly close connections to particle physics. Superpotentials of tribrid inflation involve effective operators suppressed by some cutoff scale, which is often taken as the Planck scale. However, these operators may also be generated by integrating out messenger superfields with masses below the Planck scale, which is in fact quite common in GUTmore » and/or flavour models. The values of the inflaton field during inflation can then lie above this mass scale, which means that for reliably calculating the model predictions one has to go beyond the effective theory description. We therefore discuss realisations of effective theories of tribrid inflation and specify in which cases effects from the messenger fields are expected, and under which conditions they can safely be neglected. In particular, we point out how to construct realisations where, despite the fact that the inflaton field values are above the messenger mass scale, the predictions for the observables are (to a good approximation) identical to the ones calculated in the effective theory treatment where the messenger mass scale is identified with the (apparent) cutoff scale.« less

Importance of the cutoff value in the quadratic adaptive integrate-and-fire model.

PubMed

Touboul, Jonathan

2009-08-01

The quadratic adaptive integrate-and-fire model (Izhikevich, 2003 , 2007 ) is able to reproduce various firing patterns of cortical neurons and is widely used in large-scale simulations of neural networks. This model describes the dynamics of the membrane potential by a differential equation that is quadratic in the voltage, coupled to a second equation for adaptation. Integration is stopped during the rise phase of a spike at a voltage cutoff value V(c) or when it blows up. Subsequently the membrane potential is reset, and the adaptation variable is increased by a fixed amount. We show in this note that in the absence of a cutoff value, not only the voltage but also the adaptation variable diverges in finite time during spike generation in the quadratic model. The divergence of the adaptation variable makes the system very sensitive to the cutoff: changing V(c) can dramatically alter the spike patterns. Furthermore, from a computational viewpoint, the divergence of the adaptation variable implies that the time steps for numerical simulation need to be small and adaptive. However, divergence of the adaptation variable does not occur for the quartic model (Touboul, 2008 ) and the adaptive exponential integrate-and-fire model (Brette & Gerstner, 2005 ). Hence, these models are robust to changes in the cutoff value.

Examination of the Mild Brain Injury Atypical Symptom Scale and the Validity-10 Scale to detect symptom exaggeration in US military service members.

PubMed

Lange, Rael T; Brickell, Tracey A; French, Louis M

2015-01-01

The purpose of this study was to examine the clinical utility of two validity scales designed for use with the Neurobehavioral Symptom Inventory (NSI) and the PTSD Checklist-Civilian Version (PCL-C); the Mild Brain Injury Atypical Symptoms Scale (mBIAS) and Validity-10 scale. Participants were 63 U.S. military service members (age: M = 31.9 years, SD = 12.5; 90.5% male) who sustained a mild traumatic brain injury (MTBI) and were prospectively enrolled from Walter Reed National Military Medical Center. Participants were divided into two groups based on the validity scales of the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF): (a) symptom validity test (SVT)-Fail (n = 24) and (b) SVT-Pass (n = 39). Participants were evaluated on average 19.4 months postinjury (SD = 27.6). Participants in the SVT-Fail group had significantly higher scores (p < .05) on the mBIAS (d = 0.85), Validity-10 (d = 1.89), NSI (d = 2.23), and PCL-C (d = 2.47), and the vast majority of the MMPI-2-RF scales (d = 0.69 to d = 2.47). Sensitivity, specificity, and predictive power values were calculated across the range of mBIAS and Validity-10 scores to determine the optimal cutoff to detect symptom exaggeration. For the mBIAS, a cutoff score of ≥8 was considered optimal, which resulted in low sensitivity (.17), high specificity (1.0), high positive predictive power (1.0), and moderate negative predictive power (.69). For the Validity-10 scale, a cutoff score of ≥13 was considered optimal, which resulted in moderate-high sensitivity (.63), high specificity (.97), and high positive (.93) and negative predictive power (.83). These findings provide strong support for the use of the Validity-10 as a tool to screen for symptom exaggeration when administering the NSI and PCL-C. The mBIAS, however, was not a reliable tool for this purpose and failed to identify the vast majority of people who exaggerated symptoms.

The effect of Interaction Anxiousness Scale and Brief Social Phobia Scale for screening social anxiety disorder in college students: a study on discriminative validity.

PubMed

Cao, Jianqin; Yang, Jinwei; Zhou, Yuqiu; Chu, Fuliu; Zhao, Xiwu; Wang, Weiren; Wang, Yunlong; Peng, Tao

2016-12-01

Social anxiety disorder (SAD) is one of the most prevalent mental health problems, but there is little research concerning the effective screening instruments in practice. This study was designed to examine the discriminative validity of Interaction Anxiousness Scale (IAS) and Brief Social Phobia Scale (BSPS) for the screening of SAD through the compared and combined analysis. Firstly, 421 Chinese undergraduates were screened by the IAS and BSPS. Secondly, in the follow-up stage, 248 students were interviewed by the Structured Clinical Interview for DSM-IV. Receiver operating characteristic (ROC) analysis was used, and the related psychometric characters were checked. The results indicated that the ROC in these two scales demonstrated discrimination is in satisfactory level (range: 0.7-0.8). However, the highest agreement (92.17%) was identified when a cut-off point of 50 measured by the IAS and a cut-off point of 34 by the BSPS were combined, also with higher PPV, SENS, SPEC and OA than that reached when BSPS was used individually, as well as PPV, SPEC and OA in IAS. The findings indicate that the combination of these two scales is valid as the general screening instrument for SAD in maximizing the discriminative validity.

Large-scale exact diagonalizations reveal low-momentum scales of nuclei

NASA Astrophysics Data System (ADS)

Forssén, C.; Carlsson, B. D.; Johansson, H. T.; Sääf, D.; Bansal, A.; Hagen, G.; Papenbrock, T.

2018-03-01

Ab initio methods aim to solve the nuclear many-body problem with controlled approximations. Virtually exact numerical solutions for realistic interactions can only be obtained for certain special cases such as few-nucleon systems. Here we extend the reach of exact diagonalization methods to handle model spaces with dimension exceeding 1010 on a single compute node. This allows us to perform no-core shell model (NCSM) calculations for 6Li in model spaces up to Nmax=22 and to reveal the 4He+d halo structure of this nucleus. Still, the use of a finite harmonic-oscillator basis implies truncations in both infrared (IR) and ultraviolet (UV) length scales. These truncations impose finite-size corrections on observables computed in this basis. We perform IR extrapolations of energies and radii computed in the NCSM and with the coupled-cluster method at several fixed UV cutoffs. It is shown that this strategy enables information gain also from data that is not fully UV converged. IR extrapolations improve the accuracy of relevant bound-state observables for a range of UV cutoffs, thus making them profitable tools. We relate the momentum scale that governs the exponential IR convergence to the threshold energy for the first open decay channel. Using large-scale NCSM calculations we numerically verify this small-momentum scale of finite nuclei.

On the entanglement entropy of quantum fields in causal sets

NASA Astrophysics Data System (ADS)

Belenchia, Alessio; Benincasa, Dionigi M. T.; Letizia, Marco; Liberati, Stefano

2018-04-01

In order to understand the detailed mechanism by which a fundamental discreteness can provide a finite entanglement entropy, we consider the entanglement entropy of two classes of free massless scalar fields on causal sets that are well approximated by causal diamonds in Minkowski spacetime of dimensions 2, 3 and 4. The first class is defined from discretised versions of the continuum retarded Green functions, while the second uses the causal set’s retarded nonlocal d’Alembertians parametrised by a length scale l k . In both cases we provide numerical evidence that the area law is recovered when the double-cutoff prescription proposed in Sorkin and Yazdi (2016 Entanglement entropy in causal set theory (arXiv:1611.10281)) is imposed. We discuss in detail the need for this double cutoff by studying the effect of two cutoffs on the quantum field and, in particular, on the entanglement entropy, in isolation. In so doing, we get a novel interpretation for why these two cutoff are necessary, and the different roles they play in making the entanglement entropy on causal sets finite.

Is alcohol binge drinking in early and late pregnancy associated with behavioural and emotional development at age 7 years?

PubMed

Niclasen, Janni; Andersen, Anne-Marie Nybo; Strandberg-Larsen, Katrine; Teasdale, Thomas William

2014-12-01

The purpose of this study was to investigate associations of maternal binge drinking in early and late pregnancy with child behavioural and emotional development at age seven. It was hypothesised that late exposure is associated with more negative outcomes than early exposure. Differences were expected on the continuous outcome measures, but not on above cutoff scale scores. Data were derived from the Danish National Birth Cohort. Three exposure groups were defined according to binge drinking from three interviews regarding binge episodes in early, middle and late pregnancy. A 'no binge' group included women with no binge episodes reported in any of the interviews, the 'early bingers' reported episodes in the first interview only, and the 'late bingers' in the last part of pregnancy only. The outcome measure was the Strengths and Difficulties Questionnaire (SDQ) used as continuous externalising/internalising scores and above cutoff hyperactivity/inattention, conduct, emotional and peer problems scores. Only women with full information concerning binge drinking from the three interviews, together with full-scale SDQ information on their children at age seven and being term-born, were included in the study (N = 37,315). After adjustment for maternal education, psychiatric diagnoses, age and smoking, children exposed to binge drinking in early and late pregnancy had significantly higher mean externalizing scores at age seven than unexposed children, an effect albeit much less for early binge drinking (relative change in mean 1.02, CI 1.00-1.05) than for late binge drinking (relative change in mean 1.21, CI 1.04-1.42). No associations were observed for any of the above cutoff outcomes. Exposure to binge drinking in early and late pregnancy is associated with elevated externalising scores, particularly so in late pregnancy. No increased risk for any of the above cutoff scale scores was observed.

Validation of the Maslach Burnout Inventory-General Survey on a Representative Sample of Dominican Teachers: Normative Data.

PubMed

Tomás, José M; de Los Santos, Saturnino; Alonso-Andres, Alicia; Fernández, Irene

2016-11-22

Burnout is characterized by emotional exhaustion, depersonalization and lack of personal accomplishment (Bakke, Demerouti, & Sanz-Vergel, 2014). Several instruments for its measurement exist, but the most widely used scale for measuring its dimensions, by far, is the Maslach Burnout Inventory (MBI) in its different versions. Among the available versions of the scale, the MBI-General Survey was developed to measure three dimensions of burnout (cynicism, personal accomplishment, and emotional exhaustion) regardless of the type of work. The aim of this research is to offer evidence on the psychometric properties of the MBI-GS for its use in the Dominican Republic and other Caribbean Spanish-speaking countries, using representative sample of Dominican teachers. The factorial validity was studied through confirmatory factor analysis. Several competing models were proved in order to test the dimensionality of the scale. The confirmatory analyses shown that the original three-factor structure had a superior fit, but item eleven was removed in order to get an excellent fit χ2(87) = 211.19, p < .001, CFI = .98, RMSEA = .038 90% CI [.032-.045]. Regarding internal consistency, the CRI´s are well above the cut-off criteria of .7 (CRI's ranged from .74 to .86). Concerning criterion-related validity, the three factors were correlated in the expected direction. Professional efficacy, a dimension of burnout measured in the opposite direction, was positively correlated with the three factors of work engagement, also as expected. This version was found to be a psychometrically sound measure of the three core dimensions of burnout.

Validity of the posttraumatic stress disorders (PTSD) checklist in pregnant women.

PubMed

Gelaye, Bizu; Zheng, Yinnan; Medina-Mora, Maria Elena; Rondon, Marta B; Sánchez, Sixto E; Williams, Michelle A

2017-05-12

The PTSD Checklist-civilian (PCL-C) is one of the most commonly used self-report measures of PTSD symptoms, however, little is known about its validity when used in pregnancy. This study aims to evaluate the reliability and validity of the PCL-C as a screen for detecting PTSD symptoms among pregnant women. A total of 3372 pregnant women who attended their first prenatal care visit in Lima, Peru participated in the study. We assessed the reliability of the PCL-C items using Cronbach's alpha. Criterion validity and performance characteristics of PCL-C were assessed against an independent, blinded Clinician-Administered PTSD Scale (CAPS) interview using measures of sensitivity, specificity and receiver operating characteristics (ROC) curves. We tested construct validity using exploratory and confirmatory factor analytic approaches. The reliability of the PCL-C was excellent (Cronbach's alpha =0.90). ROC analysis showed that a cut-off score of 26 offered optimal discriminatory power, with a sensitivity of 0.86 (95% CI: 0.78-0.92) and a specificity of 0.63 (95% CI: 0.62-0.65). The area under the ROC curve was 0.75 (95% CI: 0.71-0.78). A three-factor solution was extracted using exploratory factor analysis and was further complemented with three other models using confirmatory factor analysis (CFA). In a CFA, a three-factor model based on DSM-IV symptom structure had reasonable fit statistics with comparative fit index of 0.86 and root mean square error of approximation of 0.09. The Spanish-language version of the PCL-C may be used as a screening tool for pregnant women. The PCL-C has good reliability, criterion validity and factorial validity. The optimal cut-off score obtained by maximizing the sensitivity and specificity should be considered cautiously; women who screened positive may require further investigation to confirm PTSD diagnosis.

Predictive validity and reliability of the Braden scale for risk assessment of pressure ulcers in an intensive care unit.

PubMed

Lima-Serrano, M; González-Méndez, M I; Martín-Castaño, C; Alonso-Araujo, I; Lima-Rodríguez, J S

2018-03-01

Contribution to validation of the Braden scale in patients admitted to the ICU, based on an analysis of its reliability and predictive validity. An analytical, observational, longitudinal prospective study was carried out. Intensive Care Unit, Hospital Virgen del Rocío, Seville (Spain). Patients aged 18years or older and admitted for over 24hours to the ICU were included. Patients with pressure ulcers upon admission were excluded. A total of 335 patients were enrolled in two study periods of one month each. None. The presence of gradei-iv pressure ulcers was regarded as the main or dependent variable. Three categories were considered (demographic, clinical and prognostic) for the remaining variables. The incidence of patients who developed pressure ulcers was 8.1%. The proportion of gradei andii pressure ulcer was 40.6% and 59.4% respectively, highlighting the sacrum as the most frequently affected location. Cronbach's alpha coefficient in the assessments considered indicated good to moderate reliability. In the three evaluations made, a cutoff point of 12 was presented as optimal in the assessment of the first and second days of admission. In relation to the assessment of the day with minimum score, the optimal cutoff point was 10. The Braden scale shows insufficient predictive validity and poor precision for cutoff points of both 18 and 16, which are those accepted in the different clinical scenarios. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

Annoyance from transportation noise: relationships with exposure metrics DNL and DENL and their confidence intervals.

PubMed Central

Miedema, H M; Oudshoorn, C G

2001-01-01

We present a model of the distribution of noise annoyance with the mean varying as a function of the noise exposure. Day-night level (DNL) and day-evening-night level (DENL) were used as noise descriptors. Because the entire annoyance distribution has been modeled, any annoyance measure that summarizes this distribution can be calculated from the model. We fitted the model to data from noise annoyance studies for aircraft, road traffic, and railways separately. Polynomial approximations of relationships implied by the model for the combinations of the following exposure and annoyance measures are presented: DNL or DENL, and percentage "highly annoyed" (cutoff at 72 on a scale of 0-100), percentage "annoyed" (cutoff at 50 on a scale of 0-100), or percentage (at least) "a little annoyed" (cutoff at 28 on a scale of 0-100). These approximations are very good, and they are easier to use for practical calculations than the model itself, because the model involves a normal distribution. Our results are based on the same data set that was used earlier to establish relationships between DNL and percentage highly annoyed. In this paper we provide better estimates of the confidence intervals due to the improved model of the relationship between annoyance and noise exposure. Moreover, relationships using descriptors other than DNL and percentage highly annoyed, which are presented here, have not been established earlier on the basis of a large dataset. PMID:11335190

Hyperammonaemia and associated factors in unprovoked convulsive seizures: A cross-sectional study.

PubMed

Sato, Kenichiro; Arai, Noritoshi; Omori, Aki; Hida, Ayumi; Kimura, Akio; Takeuchi, Sousuke

2016-12-01

Hyperammonaemia is frequently observed in patients who have experienced convulsive seizures. Although excessive muscle contraction is presumed to be responsible for the elevated levels of ammonia, the underlying mechanism is poorly understood. The present study aimed to identify the independent factors associated with ammonia elevation using large-scale multivariate analysis. We conducted a cross-sectional study involving 379 adult patients who had been transported to our emergency department and treated for unprovoked convulsive seizures between August 2010 and September 2015. Elevation of venous plasma ammonia levels was set as the primary endpoint, and patients' clinical and laboratory data were obtained. Those with severe liver dysfunction, known hepatic encephalopathy, or convulsions due to cardiovascular or psychogenic causes, and those taking valproate were excluded. Using a cut-off value of 50μg/dL, 183 patients (48.3%) were found to have elevated levels of plasma ammonia. Four factors were identified as independent variables associated with hyperammonaemia following seizures: elevated venous lactate, lowered venous pH, sex (male), and longer duration of convulsion. The results of the present study revealed independent factors associated with hyperammonaemia following unprovoked convulsive seizures in a larger scale and with more plausible statistical analysis. The authors further suggest that the excessive skeletal muscle contraction and/or respiratory failure during/after convulsive seizure may be the primary mechanism of hyperammonaemia. Copyright © 2016. Published by Elsevier Ltd.

The Examination of Patient-Reported Outcomes and Postural Control Measures in Patients With and Without a History of ACL Reconstruction: A Case Control Study.

PubMed

Hoch, Johanna M; Sinnott, Cori W; Robinson, Kendall P; Perkins, William O; Hartman, Jonathan W

2018-03-01

There is a lack of literature to support the diagnostic accuracy and cut-off scores of commonly used patient-reported outcome measures (PROMs) and clinician-oriented outcomes such as postural-control assessments (PCAs) when treating post-ACL reconstruction (ACLR) patients. These scores could help tailor treatments, enhance patient-centered care and may identify individuals in need of additional rehabilitation. To determine if differences in 4-PROMs and 3-PCAs exist between post-ACLR and healthy participants, and to determine the diagnostic accuracy and cut-off scores of these outcomes. Case control. Laboratory. A total of 20 post-ACLR and 40 healthy control participants. The participants completed 4-PROMs (the Disablement in the Physically Active Scale [DPA], The Fear-Avoidance Belief Questionnaire [FABQ], the Knee Osteoarthritis Outcomes Score [KOOS] subscales, and the Tampa Scale of Kinesiophobia [TSK-11]) and 3-PCAs (the Balance Error Scoring System [BESS], the modified Star Excursion Balance Test [SEBT], and static balance on an instrumented force plate). Mann-Whitney U tests examined differences between groups. Receiver operating characteristic (ROC) curves were employed to determine sensitivity and specificity. The Area Under the Curve (AUC) was calculated to determine the diagnostic accuracy of each instrument. The Youdin Index was used to determine cut-off scores. Alpha was set a priori at P < 0.05. There were significant differences between groups for all PROMs (P < 0.05). There were no differences in PCAs between groups. The cut-off scores should be interpreted with caution for some instruments, as the scores may not be clinically applicable. Post-ACLR participants have decreased self-reported function and health-related quality of life. The PROMs are capable of discriminating between groups. Clinicians should consider using the cut-off scores in clinical practice. Further use of the instruments to examine detriments after completion of standard rehabilitation may be warranted.

Psychological distress of residents in Kawauchi village, Fukushima Prefecture after the accident at Fukushima Daiichi Nuclear Power Station: the Fukushima Health Management Survey

PubMed Central

Yoshida, Koji; Shinkawa, Tetsuko; Urata, Hideko; Nakashima, Kanami; Orita, Makiko; Yasui, Kiyotaka; Kumagai, Atsushi; Ohtsuru, Akira; Yabe, Hirooki; Maeda, Masaharu; Hayashida, Naomi; Kudo, Takashi; Yamashita, Shunichi

2016-01-01

Background To shed light on the mental health of evacuees after the accident at Fukushima Daiichi Nuclear Power Station (FDNPS), we evaluate the results of the Fukushima Health Management Survey (FHMS) of the residents at Kawauchi village in Fukushima, which is located less than 30 km from the FDNPS. Methods We conducted the cross-sectional study within the framework of the FHMS. Exposure values were “anorexia,” “subjective feelings about health,” “feelings about sleep satisfaction,” and “bereavement caused by the disaster,” confounding variables were “age” and “sex,” and outcome variables were “K6 points.” We collected data from the FHMS, and employed the Kessler Psychological Distress Scale (K6) and the posttraumatic stress disorder (PTSD) Checklist Stressor-Specific Version (PCL-S) to carry out the research. A total of 13 or greater was the cut-off for identifying serious mental illness using the K6 scale. The study subjects included residents (n = 542) of over 30 years of age from Kawauchi village, and data were used from the period of January 1, 2012 to October 31, 2012. Results A total of 474 residents (87.5%) scored less than 13 points in the K6 and 68 (12.6%) scored 13 points or more. The proportion of elderly residents (over 65 years old) among people with K6 score above the cut-off was higher than that among people with K6 score below the cut-off (44.1 vs 31.0%, p < 0.05). In addition, the proportion of residents with anorexia and mental illness among people with K6 score above the cut-off was higher than among people with K6 score below the cut-off (p < 0.001 and p < 0.05, respectively). The amount of residents who scored 44 points or more in the PCL-S among people with K6 score above the cut-off was also considerably higher than among people with K6 score below the cut-off (79.4 vs 12.9%, p < 0.001). Interestingly, the proportion of residents who scored more than among people with K6 score above the cut-off and the among people with PCL-S score above the cut-off in Kawauchi was higher than in previous studies in other locations. Conclusions These results suggest that there are severe mental health problems, such as depression and PTSD, among adults as a consequence of the accident at the FDNPS. Our study showed that residents who lived in the evacuation zone before the disaster are at high risk psychological distress. To facilitate local residents’ recovery from Fukushima, there is a need to continue providing them with physical and mental support, as well as communication regarding the health risks of radiation. PMID:27635326

Development and psychometric properties of the parent version of the Profile of Neuropsychiatric Symptoms (PONS) in children and adolescents.

PubMed

Santosh, Paramala; Gringras, Paul; Baird, Gillian; Fiori, Federico; Sala, Regina

2015-05-19

The use of neuropsychiatric Patient Centred Outcome Measures (PCOMs) in routine child mental health and paediatric services is very time consuming and often requires multiple scales being completed as no single scale covers all areas of psychopathology. The use of a web-based programme can overcome these problems and contribute to improved use of PCOMs in clinical practice. We aim to develop a web-based scale (using HealthTracker™) to screen and identify young people with significant neuropsychiatric symptoms to enable early intervention. Qualitative development of the Profile of Neuropsychiatric Symptoms (PONS) and quantitative evaluation of the psychometric properties of the PONS scale (parent version). Parents of 929 from the general population and 147 with neuropsychiatric disorders (5-18 years old) completed the PONS online. In addition, those children with neuropsychiatric disorders were assessed for the presence of current and lifetime psychiatric disorders using the Development and Well-Being Assessment (DAWBA). The PONS scale (parent version) consists of 30 symptom domains rated on a 7-point scale for both frequency and impairment. We found an intra-class correlation coefficient for single measures was 0.44 (0.42-0.46 95 % CI, F = 22.84, p ≤ 0.0001) and for average measures was 0.96 (0.95-0.96 95 % CI, F = 22.84, p ≤ 0.0001). The factor analysis showed a 4-factor model: Neurodevelopmental Disability; Behavioural and Emotional Dysregulation; Psychoses and Personality Dysfunction; and Anxiety and Depression. The receiver operating characteristic area for the 4-factors was 0.96 (SE = 0.006; 0.95-0.97 95 % CI). The PONS scale (parent version) is a web-based PCOM on the HealthTracker™ system that is a rapid, engaging measure that has excellent reliability and validity. The system allows for automated scoring and immediate feedback of statistical cut-off points and assists clinicians with diagnostic decision-making and optimises use of clinician time.

Identifying the time scale of synchronous movement: a study on tropical snakes.

PubMed

Lindström, Tom; Phillips, Benjamin L; Brown, Gregory P; Shine, Richard

2015-01-01

Individual movement is critical to organismal fitness and also influences broader population processes such as demographic stochasticity and gene flow. Climatic change and habitat fragmentation render the drivers of individual movement especially critical to understand. Rates of movement of free-ranging animals through the landscape are influenced both by intrinsic attributes of an organism (e.g., size, body condition, age), and by external forces (e.g., weather, predation risk). Statistical modelling can clarify the relative importance of those processes, because externally-imposed pressures should generate synchronous displacements among individuals within a population, whereas intrinsic factors should generate consistency through time within each individual. External and intrinsic factors may vary in importance at different time scales. In this study we focused on daily displacement of an ambush-foraging snake from tropical Australia (the Northern Death Adder Acanthophis praelongus), based on a radiotelemetric study. We used a mixture of spectral representation and Bayesian inference to study synchrony in snake displacement by phase shift analysis. We further studied autocorrelation in fluctuations of displacement distances as "one over f noise". Displacement distances were positively autocorrelated with all considered noise colour parameters estimated as >0. We show how the methodology can reveal time scales of particular interest for synchrony and found that for the analysed data, synchrony was only present at time scales above approximately three weeks. We conclude that the spectral representation combined with Bayesian inference is a promising approach for analysis of movement data. Applying the framework to telemetry data of A. praelongus, we were able to identify a cut-off time scale above which we found support for synchrony, thus revealing a time scale where global external drivers have a larger impact on the movement behaviour. Our results suggest that for the considered study period, movement at shorter time scales was primarily driven by factors at the individual level; daily fluctuations in weather conditions had little effect on snake movement.

The diagnostic efficiency of the extended German Brøset Violence Checklist to assess the risk of violence.

PubMed

Rechenmacher, Josef; Müller, Gerhard; Abderhalden, Christoph; Schulc, Eva

2014-01-01

The prevention of aggression and violence of patients is part of the challenge for the psychiatric inpatient care. Resources needed are a systematic risk assessment and taking preventive measures according to the risk. The extended Brøset Violence Checklist (BVC-CH) is an assessment instrument for the short-term assessment of the risk of violence for physical attacks toward medical staff and other patients. Until now, the instrument was only validated in the context of the development phase of the instrument. The aim of this study was to investigate how valid the BVC-CH scale is for adult psychiatry in acute inpatient care facilities. In a prospective cohort study, 232 consecutively admitted patients were assessed using the BVC-CH. The calculation of the predictive values was based on a contingency table. The discriminatory power of the instrument and the determination of the cutoff point were done using the receiver operating characteristic (ROC) curve analysis. Physical attacks were registered with the Staff Observation of Aggression Scale-Revised (SOAS-R). The sensitivity was 58.8% and the specificity was 96.8% by a cutoff point of > or = 7. By choosing a cutoff point of > or = 6, the sensitivity was 64.7% and the specificity was 95.1%. A value of .93 was determined for the area under the curve receiver operating characteristic (AUC(ROC)). Overall, the BVC-CH is a valid instrument for the short-term prediction of physical attacks. Further research of the BVC-CH is recommended but in particular for the cutoff point.

Optimal Cut-Off Points on the Health Anxiety Inventory, Illness Attitude Scales and Whiteley Index to Identify Severe Health Anxiety

PubMed Central

Hedman, Erik; Lekander, Mats; Ljótsson, Brjánn; Lindefors, Nils; Rück, Christian; Andersson, Gerhard; Andersson, Erik

2015-01-01

Background Health anxiety can be viewed as a dimensional phenomenon where severe health anxiety in form of DSM-IV hypochondriasis represents a cut-off where the health anxiety becomes clinically significant. Three of the most reliable and used self-report measures of health anxiety are the Health Anxiety Inventory (HAI), the Illness Attitude Scales (IAS) and the Whiteley Index (WI). Identifying the optimal cut-offs for classification of presence of a diagnosis of severe health anxiety on these measures has several advantages in clinical and research settings. The aim of this study was therefore to investigate the HAI, IAS and WI as proximal diagnostic instruments for severe health anxiety defined as DSM-IV hypochondriasis. Methods We investigated sensitivity, specificity and predictive value on the HAI, IAS and WI using a total of 347 adult participants of whom 158 had a diagnosis of severe health anxiety, 97 had obsessive-compulsive disorder and 92 were healthy non-clinical controls. Diagnostic assessments were conducted using the Anxiety Disorder Interview Schedule. Results Optimal cut-offs for identifying a diagnosis of severe health anxiety was 67 on the HAI, 47 on the IAS, and 5 on the WI. Sensitivity and specificity were high, ranging from 92.6 to 99.4%. Positive and negative predictive values ranged from 91.6 to 99.4% using unadjusted prevalence rates. Conclusions The HAI, IAS and WI have very good properties as diagnostic indicators of severe health anxiety and can be used as cost-efficient proximal estimates of the diagnosis. PMID:25849477

The Generalized Anxiety Disorder Screener (GAD-7) and the anxiety module of the Hospital and Depression Scale (HADS-A) as screening tools for generalized anxiety disorder among cancer patients.

PubMed

Esser, Peter; Hartung, Tim J; Friedrich, Michael; Johansen, Christoffer; Wittchen, Hans-Ulrich; Faller, Hermann; Koch, Uwe; Härter, Martin; Keller, Monika; Schulz, Holger; Wegscheider, Karl; Weis, Joachim; Mehnert, Anja

2018-06-01

Anxiety in cancer patients may represent a normal psychological reaction. To detect patients with pathological levels, appropriate screeners with established cut-offs are needed. Given that previous research is sparse, we investigated the diagnostic accuracy of 2 frequently used screening tools in detecting generalized anxiety disorder (GAD). We used data of a multicenter study including 2141 cancer patients. Diagnostic accuracy was investigated for the Generalized Anxiety Disorder Screener (GAD-7) and the anxiety module of the Hospital Anxiety and Depression Scale (HADS-A). GAD, assessed with the Composite International Diagnostic Interview for Oncology, served as a reference standard. Overall accuracy was measured with the area under the receiver operating characteristics curve (AUC). The AUC of the 2 screeners were statistically compared. We also calculated accuracy measures for selected cut-offs. Diagnostic accuracy could be interpreted as adequate for both screeners, with an identical AUC of .81 (95% CI: .79-.82). Consequently, the 2 screeners did not differ in their performance (P = .86). The best balance between sensitivity and specificity was found for cut-offs ≥7 (GAD-7) and ≥8 (HADS-A). The officially recommended thresholds for the GAD-7 (≥ 10) and the HADS-A (≥11) showed low sensitivities of 55% and 48%, respectively. The GAD-7 and HADS-A showed AUC of adequate diagnostic accuracy and hence are applicable for GAD screening in cancer patients. Nevertheless, the choice of optimal cut-offs should be carefully evaluated. Copyright © 2018 John Wiley & Sons, Ltd.

So Tired: Predictive Utility of Baseline Sleep Screening in a Longitudinal Observational Survey Cohort of First-Year Residents.

PubMed

Zebrowski, Jonathan P; Pulliam, Samantha J; Denninger, John W; Berkowitz, Lori R

2018-06-01

Sleep impairment is highly prevalent among resident physicians and is associated with both adverse patient outcomes and poor resident mental and physical health. Risk factors for sleep problems during residency are less clear, and no screening model exists to identify residents at risk for sleep impairment. The objective of this study was to assess change in resident sleep during training and to evaluate utility of baseline sleep screening in predicting future sleep impairment. This is a prospective observational repeated-measures survey study. The participants comprised PGY-1 residents across multiple specialties at Partners HealthCare hospitals. Main measures used for this study were demographic queries and two validated scales: the Pittsburgh Sleep Quality Index (PSQI), measuring sleep quality, and the Epworth Sleepiness Scale (ESS), measuring excessive daytime sleepiness. Two hundred eighty-one PGY-1 residents completed surveys at residency orientation, and 153 (54%) completed matched surveys 9 months later. Mean nightly sleep time decreased from 7.6 to 6.5 hours (p < 0.001). Mean PSQI score increased from 3.6 to 5.2 (p < 0.001), and mean ESS score increased from 7.2 to 10.4 (p < 0.001). The proportion of residents exceeding the scales' clinical cutoffs increased over time from 15 to 40% on the PSQI (p < 0.001) and from 26 to 59% on the ESS (p < 0.001). Baseline normal sleep was not protective: 68% of residents with normal scores on both scales at baseline exceeded the clinical cutoff on at least one scale at follow-up. Greater age and fewer children increased follow-up PSQI score (p < 0.001) but not ESS score. During PGY-1 training, residents experience worsening sleep duration, quality of sleep, and daytime sleepiness. Residents with baseline impaired sleep tend to remain impaired. Moreover, many residents with baseline normal sleep experience sleep deterioration over time. Sleep screening at residency orientation may identify some, but not all, residents who will experience sleep impairment during training.

Effects of Scale, Question Location, Order of Response Alternatives, and Season on Self-Reported Noise Annoyance Using ICBEN Scales: A Field Experiment.

PubMed

Brink, Mark; Schreckenberg, Dirk; Vienneau, Danielle; Cajochen, Christian; Wunderli, Jean-Marc; Probst-Hensch, Nicole; Röösli, Martin

2016-11-23

The type of noise annoyance scale and aspects of its presentation such as response format or location within a questionnaire and other contextual factors may affect self-reported noise annoyance. By means of a balanced experimental design, the effect of type of annoyance question and corresponding scale (5-point verbal vs. 11-point numerical ICBEN (International Commission on Biological Effects of Noise) scale), presentation order of scale points (ascending vs. descending), question location (early vs. late within the questionnaire), and survey season (autumn vs. spring) on reported road traffic noise annoyance was investigated in a postal survey with a stratified random sample of 2386 Swiss residents. Our results showed that early appearance of annoyance questions was significantly associated with higher annoyance scores. Questionnaires filled out in autumn were associated with a significantly higher annoyance rating than in the springtime. No effect was found for the order of response alternatives. Standardized average annoyance scores were slightly higher using the 11-point numerical scale whereas the percentage of highly annoyed respondents was higher based on the 5-point scale, using common cutoff points. In conclusion, placement and presentation of annoyance questions within a questionnaire, as well as the time of the year a survey is carried out, have small but demonstrable effects on the degree of self-reported noise annoyance.

Effects of Scale, Question Location, Order of Response Alternatives, and Season on Self-Reported Noise Annoyance Using ICBEN Scales: A Field Experiment

PubMed Central

Brink, Mark; Schreckenberg, Dirk; Vienneau, Danielle; Cajochen, Christian; Wunderli, Jean-Marc; Probst-Hensch, Nicole; Röösli, Martin

2016-01-01

The type of noise annoyance scale and aspects of its presentation such as response format or location within a questionnaire and other contextual factors may affect self-reported noise annoyance. By means of a balanced experimental design, the effect of type of annoyance question and corresponding scale (5-point verbal vs. 11-point numerical ICBEN (International Commission on Biological Effects of Noise) scale), presentation order of scale points (ascending vs. descending), question location (early vs. late within the questionnaire), and survey season (autumn vs. spring) on reported road traffic noise annoyance was investigated in a postal survey with a stratified random sample of 2386 Swiss residents. Our results showed that early appearance of annoyance questions was significantly associated with higher annoyance scores. Questionnaires filled out in autumn were associated with a significantly higher annoyance rating than in the springtime. No effect was found for the order of response alternatives. Standardized average annoyance scores were slightly higher using the 11-point numerical scale whereas the percentage of highly annoyed respondents was higher based on the 5-point scale, using common cutoff points. In conclusion, placement and presentation of annoyance questions within a questionnaire, as well as the time of the year a survey is carried out, have small but demonstrable effects on the degree of self-reported noise annoyance. PMID:27886110

Isotretinoin was not associated with depression or anxiety: A twelve-week study

PubMed Central

Suarez, Bella; Serrano, Ana; Cova, Yves; Baptista, Trino

2016-01-01

AIM: To investigate the frequency and severity of depression and/or anxiety in isotretinoin (ITT)-treated subjects and in a non-ITT control group. METHODS: Sixty consecutively-admitted non-psychiatric outpatients with acne were assigned to either ITT at a fixed dose of 30 mg/d (n = 36) or “other treatment” group (OT; n = 24). The Zung depression or anxiety scales (with cut-off points), two locally developed scales for depression (GeDepr) and anxiety (Ansilet) (without cut-off points) and clinical global impression scales of acne severity were administered at baseline and at weeks 6 and 12 of treatment. Data was analyzed with the chi-squared test and covariance analysis. RESULTS: Gender distribution, age, marital status and education level did not differ between both treatment groups. The frequency of depression, as defined by the Zung scale cut-off points was similar in the ITT and in the non-ITT groups: Weeks 6 and 12: 8.3% in both groups, P = 0.9. The frequency of anxiety was similar in the groups as well: Week 6: ITT = 8.3%; OT = 0.0%, P > 0.05; week 12: ITT = 11.1%, OT = 4.2%, P > 0.05. The scores in both scales’ sets did not differ between the treatment groups at any evaluation time point (P > 0.05). Five ITT-treated subjects (13.8%) and two from the OT-treated group (8.3%) developed clinically significant anxiety and/or depression during treatment (P > 0.05). CONCLUSION: Our study confirms the safety of ITT regarding psychological side effects in regular dermatological patients. Susceptible subjects may exist but their identification requires additional strategies. PMID:27014604

High sensitivity of p-modes near the acoustic cutoff frequency to solar model parameters

NASA Technical Reports Server (NTRS)

Guenther, D. B.

1991-01-01

The p-mode frequencies of low l have been calculated for solar models with initial helium mass fraction varying from Y = 0.2753-0.2875. The differences in frequency of the p-modes in the frequency range, 2500-4500 microHz, do not exceed 1-5 microHz among the models. But in the vicinity of the acoustic cutoff frequency, near 5000 microHz the p-mode frequency differences are enhanced by a factor of 4. The enhanced sensitivity of p-modes near the acoustic cutoff frequency was further tested by calculating and comparing p-mode frequencies of low l for two solar models one incorporating the Eddington T-tau relation and the other the Krishna Swamy T-tau relation. Again, it is found that p-modes with frequencies near the acoustic cutoff frequency show a significant increase in sensitivity to the different T-tau relations, compared to lower frequency p-modes. It is noted that frequencies above the acoustic cutoff frequency are complex, hence, cannot be modeled by the adiabatic pulsation code (assumes real eigenfrequencies) used in these calculations.

Distribution in energies and acceleration times in DSA, and their effect on the cut-off

NASA Astrophysics Data System (ADS)

Brooks, A.; Protheroe, R. J.

2001-08-01

We have conducted Monte Carlo simulations of diffusive shock acceleration (DSA) to determine the distribution of times since injection taken to reach energy E > E0. This distribution of acceleration times for the case of momentum dependent diffusion is compared with that given by Drury and Forman (1983) based on extrapolation of the exact result (Toptygin 1980) for the case of the diffusion coefficient being independent of momentum. As a result of this distribution we find, as suggested by Drury et al. (1999), that Monte Carlo simulations result in smoother cut-offs and pile-ups in spectra of accelerated particles than expected from simple "box model" treatments of shock acceleration (e.g., Protheroe and Stanev 1999, Drury et al. 1999). This is particularly so for the case synchrotron pile-ups, which we find are replaced by a small bump at an energy about a factor of 2 below the expected cut-off, followed by a smooth cut-off with particles extending to energies well beyond the expected cut-off energy.

Handgrip Strength Cutoff Points to Identify Mobility Limitation in Community-dwelling Older People and Associated Factors.

PubMed

Vasconcelos, K S de Souza; Dias, J M Domingues; Bastone, A de Carvalho; Vieira, R Alvarenga; Andrade, A C de Souza; Perracini, M Rodrigues; Guerra, R Oliveira; Dias, R Corrêa

2016-03-01

Sarcopenia is defined as a progressive and generalized loss of skeletal muscle mass and strength. The specific threshold of muscle weakness that leads to mobility limitations has not been identified. To determine the best cutoff point of handgrip strength for identifying mobility limitation and to investigate the factors associated with muscle weakness and mobility limitation in community-dwelling older people. Transversal study. Cities of Belo Horizonte, Barueri and Santa Cruz in Brazil. 1374 community-dwelling older people from the Frailty study in Brazilian older people (FIBRA Study). Outcomes included muscle weakness determined according to gender-specific handgrip strength cutoff points generated by Receiver Operating Characteristic curves, mobility limitation defined as a gait speed ≤ 0.8 m/s; and a combination of both muscle weakness and mobility limitation. Associated factors included socio-demographic variables, lifestyle, anthropometrics, health conditions, use of health services and disability. The cutoff points of handgrip strength with the best balancing between sensitivity and specificity for mobility limitation were 25.8 kgf for men (sensitivity 69%, specificity 73%) and 17.4 kgf (sensitivity 60%, specificity 66%) for women. Age and disability in instrumental activities of daily living were associated with all outcomes. Women had greater odds of mobility limitation than men. Physical inactivity, body fat, diabetes, depression, sleeping disturbances, number of medications and occurrence of falls remained as significant associated factors in the final model. Handgrip strength can be a useful tool to identify mobility limitation in clinical practice. Interventions to prevent or minimize impacts of sarcopenia should stimulate physical activity and improvement of body composition in addition to the management of chronic diseases and disabilities.

Proposal for new selection criteria considering pre-transplant muscularity and visceral adiposity in living donor liver transplantation.

PubMed

Hamaguchi, Yuhei; Kaido, Toshimi; Okumura, Shinya; Kobayashi, Atsushi; Shirai, Hisaya; Yao, Siyuan; Yagi, Shintaro; Kamo, Naoko; Okajima, Hideaki; Uemoto, Shinji

2018-04-01

The significance of pre-operative body composition has recently attracted much attention in various diseases. However, cut-off values for these parameters remain undetermined, and these factors are not currently included in selection criteria for recipients of living donor liver transplantation (LDLT). Using computed tomography of 657 donors for LDLT, skeletal muscle mass, muscle quality, and visceral adiposity were evaluated by using skeletal muscle mass index (SMI), intramuscular adipose tissue content (IMAC), and visceral-to-subcutaneous adipose tissue area ratio (VSR). Sex-specific cut-offs for SMI, IMAC, and VSR were determined, and correlations with outcomes after LDLT in 277 recipients were examined with the aim of establishing new selection criteria for LDLT. On the basis of younger donor data, we determined sex-specific cut-off values for low SMI, high IMAC, and high VSR (mean ± 2 standard deviations). Patients with all three factors showed the lowest survival rate after LDLT (1 year survival rate, 41.2%; P < 0.001). On multivariate analysis, low SMI (P = 0.002), high IMAC (P = 0.002), and high VSR (P = 0.001) were identified as independent risk factors for mortality after LDLT. Based on these findings, we have excluded patients showing all three factors (low SMI, high IMAC, and high VSR) as candidates for LDLT since October 2016. Using cut-off values determined from healthy donors, we have established new selection criteria for LDLT including body composition, which should improve post-transplant outcomes. © 2018 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society on Sarcopenia, Cachexia and Wasting Disorders.

[Total serum calcium and corrected calcium as severity predictors in acute pancreatitis].

PubMed

Gutiérrez-Jiménez, A A; Castro-Jiménez, E; Lagunes-Córdoba, R

2014-01-01

To evaluate total serum calcium (TC) and albumin-corrected calcium (ACC) as prognostic severity factors in acute pancreatitis (AP). Ninety-six patients were included in the study. They were diagnosed with AP and admitted to the Hospital Regional de Veracruz within the time frame of January 2010 to December 2012. AP severity was determined through the updated Atlanta Classification (2013). TC and ACC values were measured in the first 24hours of admittance and the percentages of sensitivity (S), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), and negative likelihood ratio (LR-) were calculated through ROC curves and contingency tables. In accordance with the updated Atlanta Classification, 70 patients presented with mild AP, 17 with moderately severe AP, and 9 with severe AP. Of the patient total, 61.5% were women, and 69.8% presented with biliary etiology. The maximum TC cut-off point was 7.5mg/dL, with values of S, 67%; Sp, 82%; PPV, 27%, and NPV, 96%. The maximum ACC cut-off point was 7.5mg/dL, with values of S, 67%; Sp, 90%; PPV, 40%; NPV, 96%. Both had values similar to those of the Ranson and APACHE II prognostic scales. TC and ACC, measured within the first 24hours, are useful severity predictors in acute pancreatitis, with sensitivity and predictive values comparable or superior to those of the conventional prognostic scales. Copyright © 2013 Asociación Mexicana de Gastroenterología. Published by Masson Doyma México S.A. All rights reserved.

Variability of the Magnetic Field Power Spectrum in the Solar Wind at Electron Scales

NASA Astrophysics Data System (ADS)

Roberts, Owen Wyn; Alexandrova, O.; Kajdič, P.; Turc, L.; Perrone, D.; Escoubet, C. P.; Walsh, A.

2017-12-01

At electron scales, the power spectrum of solar-wind magnetic fluctuations can be highly variable and the dissipation mechanisms of the magnetic energy into the various particle species is under debate. In this paper, we investigate data from the Cluster mission’s STAFF Search Coil magnetometer when the level of turbulence is sufficiently high that the morphology of the power spectrum at electron scales can be investigated. The Cluster spacecraft sample a disturbed interval of plasma where two streams of solar wind interact. Meanwhile, several discontinuities (coherent structures) are seen in the large-scale magnetic field, while at small scales several intermittent bursts of wave activity (whistler waves) are present. Several different morphologies of the power spectrum can be identified: (1) two power laws separated by a break, (2) an exponential cutoff near the Taylor shifted electron scales, and (3) strong spectral knees at the Taylor shifted electron scales. These different morphologies are investigated by using wavelet coherence, showing that, in this interval, a clear break and strong spectral knees are features that are associated with sporadic quasi parallel propagating whistler waves, even for short times. On the other hand, when no signatures of whistler waves at ∼ 0.1{--}0.2{f}{ce} are present, a clear break is difficult to find and the spectrum is often more characteristic of a power law with an exponential cutoff.

Evaluating the Bulk Lorentz Factors of Outflow Material: Lessons Learned from the Extremely Energetic Outburst GRB 160625B

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

Wang, Yuan-Zhu; Wang, Hao; Zhang, Shuai

2017-02-10

GRB 160625B is an extremely bright outburst with well-monitored afterglow emission. The geometry-corrected energy is high, up to ∼5.2 × 10{sup 52} erg or even ∼8 × 10{sup 52} erg, rendering it the most energetic GRB prompt emission recorded so far. We analyzed the time-resolved spectra of the prompt emission and found that in some intervals there were likely thermal-radiation components and the high energy emission was characterized by significant cutoff. The bulk Lorentz factors of the outflow material are estimated accordingly. We found out that the Lorentz factors derived in the thermal-radiation model are consistent with the luminosity-Lorentz factormore » correlation found in other bursts, as well as in GRB 090902B for the time-resolved thermal-radiation components, while the spectral cutoff model yields much lower Lorentz factors that are in tension with the constraints set by the electron pair Compton scattering process. We then suggest that these spectral cutoffs are more likely related to the particle acceleration process and that one should be careful in estimating the Lorentz factors if the spectrum cuts at a rather low energy (e.g., ∼tens of MeV). The nature of the central engine has also been discussed, and a stellar-mass black hole is favored.« less

Make dark matter charged again

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

Agrawal, Prateek; Cyr-Racine, Francis-Yan; Randall, Lisa

2017-05-01

We revisit constraints on dark matter that is charged under a U(1) gauge group in the dark sector, decoupled from Standard Model forces. We find that the strongest constraints in the literature are subject to a number of mitigating factors. For instance, the naive dark matter thermalization timescale in halos is corrected by saturation effects that slow down isotropization for modest ellipticities. The weakened bounds uncover interesting parameter space, making models with weak-scale charged dark matter viable, even with electromagnetic strength interaction. This also leads to the intriguing possibility that dark matter self-interactions within small dwarf galaxies are extremely large,more » a relatively unexplored regime in current simulations. Such strong interactions suppress heat transfer over scales larger than the dark matter mean free path, inducing a dynamical cutoff length scale above which the system appears to have only feeble interactions. These effects must be taken into account to assess the viability of darkly-charged dark matter. Future analyses and measurements should probe a promising region of parameter space for this model.« less

A modified fall risk assessment tool that is specific to physical function predicts falls in community-dwelling elderly people.

PubMed

Hirase, Tatsuya; Inokuchi, Shigeru; Matsusaka, Nobuou; Nakahara, Kazumi; Okita, Minoru

2014-01-01

Developing a practical fall risk assessment tool to predict the occurrence of falls in the primary care setting is important because investigators have reported deterioration of physical function associated with falls. Researchers have used many performance tests to predict the occurrence of falls. These performance tests predict falls and also assess physical function and determine exercise interventions. However, the need for such specialists as physical therapists to accurately conduct these tests limits their use in the primary care setting. Questionnaires for fall prediction offer an easy way to identify high-risk fallers without requiring specialists. Using an existing fall assessment questionnaire, this study aimed to identify items specific to physical function and determine whether those items were able to predict falls and estimate physical function of high-risk fallers. The analysis consisted of both retrospective and prospective studies and used 2 different samples (retrospective, n = 1871; prospective, n = 292). The retrospective study and 3-month prospective study comprised community-dwelling individuals aged 65 years or older and older adults using community day centers. The number of falls, risk factors for falls (15 risk factors on the questionnaire), and physical function determined by chair standing test (CST) and Timed Up and Go Test (TUGT) were assessed. The retrospective study selected fall risk factors related to physical function. The prospective study investigated whether the number of selected risk factors could predict falls. The predictive power was determined using the area under the receiver operating characteristic curve. Seven of the 15 risk factors were related to physical function. The area under the receiver operating characteristic curve for the sum of the selected risk factors of previous falls plus the other risk factors was 0.82 (P = .00). The best cutoff point was 4 risk factors, with sensitivity and specificity of 84% and 68%, respectively. The mean values for the CST and TUGT at the best cutoff point were 12.9 and 12.5 seconds, respectively. In the retrospective study, the values for the CST and TUGT corresponding to the best cutoff point from the prospective study were 13.2 and 11.4 seconds, respectively. This study confirms that a screening tool comprising 7 fall risk factors can be used to predict falls. The values for the CST and TUGT corresponding to the best cutoff point for the selected 7 risk factors determined in our prospective study were similar to the cutoff points for the CST and TUGT in previous studies for fall prediction. We propose that the sum of the selected risk factors of previous falls plus the other risk factors may be identified as the estimated value for physical function. These findings may contribute to earlier identification of high-risk fallers and intervention for fall prevention.

Scoring the DSM-IV personality disorders using the Five-Factor Model: development and validation of normative scores for North American, French, and Dutch-Flemish samples.

PubMed

Miller, Joshua D; Lynam, Donald R; Rolland, Jean-Pierre; De Fruyt, Filip; Reynolds, Sarah K; Pham-Scottez, Alexandra; Baker, Spencer R; Bagby, R Michael

2008-10-01

Five-Factor Model (FFM) personality disorder (PD) counts have demonstrated significant convergent and discriminant validity with DSM-IV PD symptoms. However, these FFM PD counts are of limited clinical use without normative data because it is difficult to determine what a specific score means with regard to the relative level of elevation. The current study presents data from three large normative samples that can be used as norms for the FFM PD counts in the respective countries: United States (N = 1,000), France (N = 801), and Belgium-Netherlands (N = 549). The present study also examines the performance, with regard to diagnostic efficiency, of statistically-defined cut-offs at 1.5 standard deviations above the mean (T > or = 65) versus previously identified cut-offs using receiver-operator characteristics (ROC) analyses. These cut-offs are tested in three clinical samples-one from each of the aforementioned countries. In general, the T > or = 65 cut-offs performed similarly to those identified using ROC analyses and manifested properties relevant to a screening instrument. These normative data allow FFM data to be used in a flexible and comprehensive manner, which may include scoring this type of personality data in order to screen for DSM-IV PD constructs.

Reliability Design for Neutron Induced Single-Event Burnout of IGBT

NASA Astrophysics Data System (ADS)

Shoji, Tomoyuki; Nishida, Shuichi; Ohnishi, Toyokazu; Fujikawa, Touma; Nose, Noboru; Hamada, Kimimori; Ishiko, Masayasu

Single-event burnout (SEB) caused by cosmic ray neutrons leads to catastrophic failures in insulated gate bipolar transistors (IGBTs). It was found experimentally that the incident neutron induced SEB failure rate increases as a function of the applied collector voltage. Moreover, the failure rate increased sharply with an increase in the applied collector voltage when the voltage exceeded a certain threshold value (SEB cutoff voltage). In this paper, transient device simulation results indicate that impact ionization at the n-drift/n+ buffer boundary is a crucially important factor in the turning-on of the parasitic pnp transistor, and eventually latch-up of the parasitic thyristor causes SEB. In addition, the device parameter dependency of the SEB cutoff voltage was analytically derived from the latch-up condition of the parasitic thyristor. As a result, it was confirmed that reducing the current gain of the parasitic transistor, such as by increasing the n-drift region thickness d was effective in increasing the SEB cutoff voltage. Furthermore, `white' neutron-irradiation experiments demonstrated that suppressing the inherent parasitic thyristor action leads to an improvement of the SEB cutoff voltage. It was confirmed that current gain optimization of the parasitic transistor is a crucial factor for establishing highly reliable design against chance failures.

Exclusive QCD processes, quark-hadron duality, and the transition to perturbative QCD

NASA Astrophysics Data System (ADS)

Corianò, Claudio; Li, Hsiang-nan; Savkli, Cetin

1998-07-01

Experiments at CEBAF will scan the intermediate-energy region of the QCD dynamics for the nucleon form factors and for Compton Scattering. These experiments will definitely clarify the role of resummed perturbation theory and of quark-hadron duality (QCD sum rules) in this regime. With this perspective in mind, we review the factorization theorem of perturbative QCD for exclusive processes at intermediate energy scales, which embodies the transverse degrees of freedom of a parton and the Sudakov resummation of the corresponding large logarithms. We concentrate on the pion and proton electromagnetic form factors and on pion Compton scattering. New ingredients, such as the evolution of the pion wave function and the complete two-loop expression of the Sudakov factor, are included. The sensitivity of our predictions to the infrared cutoff for the Sudakov evolution is discussed. We also elaborate on QCD sum rule methods for Compton Scattering, which provide an alternative description of this process. We show that, by comparing the local duality analysis to resummed perturbation theory, it is possible to describe the transition of exclusive processes to perturbative QCD.

Frequent attendance in primary care: comparison and implications of different definitions

PubMed Central

Luciano, Juan V; Fernández, Ana; Pinto-Meza, Alejandra; Luján, Leila; Bellón, Juan A; García-Campayo, Javier; Peñarrubia, María T; Fernández, Rita; Sanavia, Marta; Blanco, María E; Haro, Josep M; Palao, Diego J; Serrano-Blanco, Antoni

2010-01-01

Background The diversity of definitions of frequent attendance in the literature hampers comparison of their precision, validity, and associated factors. Aim To examine different definitions of frequent attendance in order to identify the sociodemographic and clinical factors associated with frequent attendance in primary care, according to each definition. Design of study One-phase cross-sectional study. Setting Seventy-seven primary care centres in Catalonia, Spain. Method A total of 3815 primary care patients were interviewed between October 2005 and March 2006. Three definitions of frequent attendance were tested: (1) frequent attenders as the top 25% and the top 10% consulting patients; (2) frequent attenders as the top 25% and the top 10% consulting patients stratified by age and sex; and (3) frequent attenders as the top 25% and the top 10% consulting patients stratified by the presence of physical/mental conditions (patients with only mental disorders, with only chronic physical conditions, with comorbid conditions, and with no condition). Multilevel logistic regressions were used. Results The following factors were systematically related to frequent attender status: being on sick leave, being born outside of Spain, reporting mental health problems as the main reason for consulting, and having arthritis/rheumatism, or bronchitis. Major depression was related to frequent attendance in two of the three definitions. The factor ‘GP’ was related to frequent attendance when the top decile cut-off point was used. The models with a 10% cut-off point were more discriminative than those with a 25% cut-off point: the area under the receiver operating characteristic curve for models with a 25% cut-off and a 10% cut-off ranged between 0.71 (95% confidence interval [CI] = 0.70 to 0.73) and 0.75 (95% CI = 0.74 to 0.77) and between 0.79 (95% CI = 0.78 to 0.81) and 0.85 (95% CI = 0.83 to 0.86), respectively. Conclusion The way frequent attendance is defined is of crucial importance. It is recommended that a more discriminative definition of frequent attendance is used (the top 10%). PMID:20132693

Depression Case Finding in Individuals with Dementia: A Systematic Review and Meta-Analysis.

PubMed

Goodarzi, Zahra S; Mele, Bria S; Roberts, Derek J; Holroyd-Leduc, Jayna

2017-05-01

To compare the diagnostic accuracy of depression case finding tools with a criterion standard in the outpatient setting among adults with dementia. Systematic review and meta-analysis. Studies of older outpatients with dementia. Elderly outpatients (clinic and long-term care) with dementia (N = 3,035). Prevalence of major depression and diagnostic accuracy measures including sensitivity, specificity, and likelihood ratios. From the 11,539 citations, 20 studies were included for qualitative synthesis and 15 for a meta-analysis. Tools included were the Montgomery Åsberg Depression Rating Scale, Cornell Scale for Depression in Dementia (CSDD), Geriatric Depression Scale (GDS), Center for Epidemiologic Studies Depression Scale (CES-D), Hamilton Depression Rating Scale (HDRS), Single Question, Nijmegen Observer-Rated Depression Scale, and Even Briefer Assessment Scale-Depression. The pooled prevalence of depression in individuals with dementia was 30.3% (95% CI = 22.1-38.5). The average age was 75.2 (95% CI = 71.7-78.7), and mean Mini-Mental State Examination scores ranged from 11.2 to 24. The diagnostic accuracy of the individual tools was pooled for the best-reported cutoffs and for each cutoff, if available. The CSDD had a sensitivity of 0.84 (95% CI = 0.73-0.91) and a specificity of 0.80 (95% CI = 0.65-0.90), the 30-item GDS (GDS-30) had a sensitivity of 0.62 (95% CI = 0.45-0.76) and a specificity 0.81 (95% CI = 0.75-0.85), and the HDRS had a sensitivity of 0.86 (95% CI = 0.63-0.96) and a specificity of 0.84 (95% CI = 0.76-0.90). Summary statistics for all tools across best-reported cutoffs had significant heterogeneity. There are many validated tools for the detection of depression in individuals with dementia. Tools that incorporate a physician interview with patient and collateral histories, the CSDD and HDRS, have higher sensitivities, which would ensure fewer false-negatives. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

An investigation of normal urine with a creatinine concentration under the cutoff of 20 mg/dL for specimen validity testing in a toxicology laboratory.

PubMed

Holden, Brad; Guice, Erica A

2014-05-01

In clinical and forensic toxicology laboratories, one commonly used method for urine specimen validity testing is creatinine concentration. In this study, workplace guidelines are examined to determine their relevance to forensic and clinical toxicology samples. Specifically, it investigates the occurrence of urine creatinine concentrations under 20 mg/dL and notes potential issues with factors influencing creatinine concentration by utilizing a simple, novel method consisting of cation-paring high-pressure liquid chromatography in tandem with ultraviolet detection to determine the creatinine concentration in 3019 donors. Of the 4227 sample population in this study, 209 (4.94%) were below the cutoff value of 20 mg/dL for dilute urine. Because there are many factors that can influence the urinary creatinine concentration, samples that have creatinine under the 20 mg/dL cutoff do not always implicate sample adulteration. © 2014 American Academy of Forensic Sciences.

Reliability of the Spanish version of the Composite Scale of Morningness.

PubMed

Adan, A; Caci, H; Prat, G

2005-11-01

The aim of this study was to examine the reliability of the Spanish version of Composite Scale of Morningness (CSM) and its ability to measure the circadian typology. Voluntary and unpaid psychology students (N= 391; 132 men and 259 women), aged between 17 and 33, completed the questionnaire between the months of September and December. The total score was independent of age and gender, with a close to normal distribution and a non-significant negative skewness. The internal consistency was high (Cronbach's alpha= 0.87) and factor analysis extracted three factors labeled Time of Retiring (items 2 and 7), Activity Planning (items 8, 9, and 13) and Morning Affect (items 3-6, and 10-12). With the 10th and 90th percentiles as cut-off scores, scorers below 22 (N= 40; 10.2%) are classified as evening-types and scorers above 39 as morning-types (N= 28; 7.2%). The Spanish questionnaire shares most of the good psychometric properties of other versions of the CSM, and thus can be used for Spanish-speaking student samples. Nevertheless, further studies of normative data in workers and aged subjects are needed in order to validate CSM.

Holographic multiverse and the measure problem

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

Vilenkin, Alexander, E-mail: vilenkin@cosmos.phy.tufts.edu

2011-06-01

We discuss the duality, conjectured in earlier work, between the wave function of the multiverse and a 3D Euclidean theory on the future boundary of spacetime. In particular, we discuss the choice of the boundary metric and the relation between the UV cutoff scale ξ on the boundary and the hypersurface Σ on which the wave function is defined in the bulk. We propose that in the limit ξ → 0 this hypersurface should be used as the cutoff surface in the multiverse measure. Furthermore, we argue that in the inflating regions of spacetime with a slowly varying Hubble ratemore » H the hypersurfaces Σ are surfaces of constant comoving apparent horizon (CAH). Finally, we introduce a measure prescription (called CAH+) which appears to have no pathological features and coincides with the constant CAH cutoff in regions of slowly varying H.« less

Percentage of body fat cutoffs by sex, age, and race-ethnicity in the US adult population from NHANES 1999-2004.

PubMed

Heo, Moonseong; Faith, Myles S; Pietrobelli, Angelo; Heymsfield, Steven B

2012-03-01

To date, there is no consensus regarding adult cutoffs of percentage of body fat or estimated cutoffs on the basis of nationally representative samples with rigorous body-composition measurements. We developed cutoffs of percentage of body fat on the basis of the relation between dual-energy x-ray absorptiometry-measured fat mass and BMI (in kg/m(2)) stratified by sex, age, and race-ethnicity by using 1999-2004 NHANES data. A simple regression (percentage of body fat = β(0) + β(1) × 1 ÷ BMI) was fit for each combination of sex (men and women), 3 age groups (18-29, 30-49, and 50-84 y of age), and 3 race-ethnicity groups (non-Hispanic whites, non-Hispanic blacks, and Mexican Americans). Model fitting included a consideration of complex survey design and multiple imputations. Cutoffs of percentage of body fat were computed that corresponded to BMI cutoffs of 18.5, 25, 30, 35, and 40 on the basis of estimated prediction equations. R(2) ranged from 0.54 to 0.72 for men (n = 6544) and 0.58 to 0.79 for women (n = 6362). In men, the percentage of body fat that corresponded to a BMI of 18.5, 25, 30, 35, and 40 across age and racial-ethnic groups ranged from 12.2% to 19.0%, 22.6% to 28.0%, 27.5% to 32.3%, 31.0% to 35.3%, and 33.6% to 37.6%, respectively; the corresponding ranges in women were from 24.6% to 32.3%, 35.0% to 40.2%, 39.9% to 44.1%, 43.4% to 47.1%, and 46.1% to 49.4%, respectively. The oldest age group had the highest cutoffs of percentage of body fat. Non-Hispanic blacks had the lowest cutoffs of percentage of body fat. Cutoffs of percentage of body fat were higher in women than in men. Cutoffs of percentage of body fat that correspond to the current US BMI cutoffs are a function of sex, age, and race-ethnicity. These factors should be taken into account when considering the appropriateness of levels of percentage of body fat.

Variations in the short wavelength cut-off of the solar UV spectra.

PubMed

Parisi, A V; Turner, J

2006-03-01

Cloud and solar zenith angle (SZA) are two major factors that influence the magnitude of the biologically damaging UV (UVBD) irradiances for humans. However, the effect on the short wavelength cut-off due to SZA and due to clouds has not been investigated for biologically damaging UV for cataracts. This research aims to investigate the influence of cloud and SZA on the short wavelength cut-off of the spectral UVBD for cataracts. The spectral biologically damaging UV for cataracts on a horizontal plane was calculated by weighting the spectral UV measured with a spectroradiometer with the action spectrum for the induction of cataracts in a porcine lens. The UV spectra were obtained on an unshaded plane at a latitude of 29.5 degrees S. The cut-off wavelength (lambdac) was defined as the wavelength at which the biologically damaging spectral irradiance was 0.1% of the maximum biologically damaging irradiance for that scan. For the all sky conditions, the short wavelength cut-off ranged by 12 nm for the SZA range of 5 to 80 degrees and the maximum in the spectral UVBD ranged by 15 nm. Similarly, for the cloud free cases, the short wavelength cut-off ranged by 9 nm for the same SZA range. Although, cloud has a large influence on the magnitude of the biologically damaging UV for cataracts, the influence of cloud on the short wavelength cut-off for the biologically damaging UV for cataracts is less than the influence of the solar zenith angle.

The Smartphone Addiction Scale: Development and Validation of a Short Version for Adolescents

PubMed Central

Kwon, Min; Kim, Dai-Jin; Cho, Hyun; Yang, Soo

2013-01-01

Objective This study was designed to investigate the revised and short version of the smartphone addiction scale and the proof of its validity in adolescents. In addition, it suggested cutting off the values by gender in order to determine smartphone addiction and elaborate the characteristics of smartphone usage in adolescents. Method A set of questionnaires were provided to a total of 540 selected participants from April to May of 2013. The participants consisted of 343 boys and 197 girls, and their average age was 14.5 years old. The content validity was performed on a selection of shortened items, while an internal-consistency test was conducted for the verification of its reliability. The concurrent validity was confirmed using SAS, SAPS and KS-scale. Receiver operating characteristics analysis was conducted to suggest cut-off. Results The 10 final questions were selected using content validity. The internal consistency and concurrent validity of SAS were verified with a Cronbach's alpha of 0.911. The SAS-SV was significantly correlated with the SAS, SAPS and KS-scale. The SAS-SV scores of gender (p<.001) and self-evaluation of smartphone addiction (p<.001) showed significant difference. The ROC analysis results showed an area under a curve (AUC) value of 0.963(0.888–1.000), a cut-off value of 31, sensitivity value of 0.867 and specificity value of 0.893 in boys while an AUC value of 0.947(0.887–1.000), a cut-off value of 33, sensitivity value of 0.875, and a specificity value of 0.886 in girls. Conclusions The SAS-SV showed good reliability and validity for the assessment of smartphone addiction. The smartphone addiction scale short version, which was developed and validated in this study, could be used efficiently for the evaluation of smartphone addiction in community and research areas. PMID:24391787

The smartphone addiction scale: development and validation of a short version for adolescents.

PubMed

Kwon, Min; Kim, Dai-Jin; Cho, Hyun; Yang, Soo

2013-01-01

This study was designed to investigate the revised and short version of the smartphone addiction scale and the proof of its validity in adolescents. In addition, it suggested cutting off the values by gender in order to determine smartphone addiction and elaborate the characteristics of smartphone usage in adolescents. A set of questionnaires were provided to a total of 540 selected participants from April to May of 2013. The participants consisted of 343 boys and 197 girls, and their average age was 14.5 years old. The content validity was performed on a selection of shortened items, while an internal-consistency test was conducted for the verification of its reliability. The concurrent validity was confirmed using SAS, SAPS and KS-scale. Receiver operating characteristics analysis was conducted to suggest cut-off. The 10 final questions were selected using content validity. The internal consistency and concurrent validity of SAS were verified with a Cronbach's alpha of 0.911. The SAS-SV was significantly correlated with the SAS, SAPS and KS-scale. The SAS-SV scores of gender (p<.001) and self-evaluation of smartphone addiction (p<.001) showed significant difference. The ROC analysis results showed an area under a curve (AUC) value of 0.963(0.888-1.000), a cut-off value of 31, sensitivity value of 0.867 and specificity value of 0.893 in boys while an AUC value of 0.947(0.887-1.000), a cut-off value of 33, sensitivity value of 0.875, and a specificity value of 0.886 in girls. The SAS-SV showed good reliability and validity for the assessment of smartphone addiction. The smartphone addiction scale short version, which was developed and validated in this study, could be used efficiently for the evaluation of smartphone addiction in community and research areas.

Detecting the severity of perinatal anxiety with the Perinatal Anxiety Screening Scale (PASS).

PubMed

Somerville, Susanne; Byrne, Shannon L; Dedman, Kellie; Hagan, Rosemary; Coo, Soledad; Oxnam, Elizabeth; Doherty, Dorota; Cunningham, Nadia; Page, Andrew C

2015-11-01

The Perinatal Anxiety Screening Scale (PASS; Somerville et al., 2014) reliably identifies perinatal women at risk of problematic anxiety when a clinical cut-off score of 26 is used. This study aimed to identify a severity continuum of anxiety symptoms with the PASS to enhance screening, treatment and research for perinatal anxiety. Antenatal and postnatal women (n=410) recruited from the antenatal clinics and mental health services at an obstetric hospital completed the Edinburgh Postnatal Depression Scale (EPDS), the Depression, Anxiety and Stress Scale (DASS-21), the Spielberg State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory II (BDI), and the PASS. The women referred to mental health services were assessed to determine anxiety diagnoses via a diagnostic interview conducted by an experienced mental health professional from the Department of Psychological Medicine - King Edward Memorial Hospital. Three normative groups for the PASS, namely minimal anxiety, mild-moderate anxiety, and severe anxiety, were identified based on the severity of anxiety indicated on the standardised scales and anxiety diagnoses. Two cut-off points for the normative groups were calculated using the Jacobson-Truax method (Jacobson and Truax, 1991) resulting in three severity ranges: 'minimal anxiety'; 'mild-moderate anxiety'; and 'severe anxiety'. The most frequent diagnoses in the study sample were adjustment disorder, mixed anxiety and depression, generalised anxiety, and post-traumatic stress disorder. This may limit the generalisability of the severity range results to other anxiety diagnoses including obsessive compulsive disorder and specific phobia. Severity ranges for the PASS add value to having a clinically validated cut-off score in the detection and monitoring of problematic perinatal anxiety. The PASS can now be used to identify risk of an anxiety disorder and the severity ranges can indicate developing risk for early referrals for further assessments, prioritisation of access to resources and tracking of clinically significant deterioration, improvement or stability in anxiety over time. Crown Copyright © 2015. Published by Elsevier B.V. All rights reserved.

SFN-SIQ, SFNSL and skin biopsy of 55 cases with small fibre involvement.

PubMed

Sun, Bo; Li, Yifan; Liu, Lizhi; Chen, Zhaohui; Ling, Li; Yang, Fei; Liu, Jiexiao; Liu, Hong; Huang, Xusheng

2018-05-01

Purpose/aim of the study: To date, there are no validated screening scales for small fibre neuropathy. This study investigated the small-fibre neuropathy and the symptom inventory questionnaire as well as the small fibre neuropathy screening list for small fibre neuropathy diagnosis. Fifty-five patients were divided into small fibre neuropathy and mixed fibre damage groups. Relevant scales, nerve conduction studies and skin biopsies were performed. Relationships between the intraepidermal nerve fibre density and different scales as well as the diagnostic and cut-off values (score at which Youden's index is largest) were determined. Compared with healthy Chinese participants, 20 patients were diagnosed with small fibre neuropathy. Intraepidermal nerve fibre density was moderately and highly correlated with the small fibre neuropathy-symptom inventory questionnaire and small fibre neuropathy screening list, respectively. The diagnostic values were moderate and high for the small fibre neuropathy-symptom inventory questionnaire (cut-off value = 5, sensitivity = 80%, specificity = 81.8%) and small fibre neuropathy screening list (cut-off value = 8, sensitivity = 94.1%, specificity = 90.9%), respectively. There were no significant differences in the visual analogue scale between the small fibre neuropathy group, mixed small and large fibre neuropathy group, pure large fibre neuropathy group and the normal group. Small fibre neuropathy-symptom inventory questionnaire and small fibre neuropathy screening list represent potential small fibre neuropathy screening tools. Abbreviations EMG electromyography ENA anti-extractable nuclear antigens ESR erythrocyte sedimentation rate IENFD intraepidermal nerve fibre density IGT impaired glucose tolerance NCS nerve conduction studies NDS neuropathy disability score OGTT oral glucose tolerance test PGP protein gene product PN peripheral neuropathy ROC receiver operating characteristic curve ROC-AUC area under the ROC curve SFN small fibre neuropathy SFN-SIQ small-fibre neuropathy and symptom inventory questionnaire SFNSL small fibre neuropathy screening list VAS visual analogue scale WHO World Health Organization.

Using the Childhood Autism Rating Scale to Diagnose Autism Spectrum Disorders

ERIC Educational Resources Information Center

Chlebowski, Colby; Green, James A.; Barton, Marianne L.; Fein, Deborah

2010-01-01

This study investigated the childhood autism rating scale (CARS) as a tool for ASD diagnoses for 2-year-old (n = 376) and 4-year-old (n = 230) children referred for possible autism. The cut-off score to distinguish autistic disorder from PDD-NOS was 32 in the 2-year-old sample (consistent with Lord in "J Child Psychol Psychiatry Allied…

Defining Treatment Response and Remission in Child Anxiety: Signal Detection Analysis Using the Pediatric Anxiety Rating Scale

ERIC Educational Resources Information Center

Caporino, Nicole E.; Brodman, Douglas M.; Kendall, Philip C.; Albano, Anne Marie; Sherrill, Joel; Piacentini, John; Sakolsky, Dara; Birmaher, Boris; Compton, Scott N.; Ginsburg, Golda; Rynn, Moira; McCracken, James; Gosch, Elizabeth; Keeton, Courtney; March, John; Walkup, John T.

2013-01-01

Objective: To determine optimal Pediatric Anxiety Rating Scale (PARS) percent reduction and raw score cut-offs for predicting treatment response and remission among children and adolescents with anxiety disorders. Method: Data were from a subset of youth (N = 438; 7-17 years of age) who participated in the Child/Adolescent Anxiety Multimodal Study…

Identifying the source of super-high energetic electrons in the presence of pre-plasma in laser–matter interaction at relativistic intensities

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

Wu, D.; Krasheninnikov, S. I.; Luan, S. X.

The generation of super-high energetic electrons influenced by pre-plasma in relativistic intensity laser–matter interaction is studied in a one-dimensional slab approximation with particle-in-cell simulations. Different pre-plasma scale lengths and laser intensities are considered, showing an increase in both particle number and cut-off kinetic energy of electrons with the increase of pre-plasma scale length and laser intensity, the cut-off kinetic energy greatly exceeding the corresponding laser ponderomotive energy. A two-stage electron acceleration model is proposed to explain the underlying physics. The first stage is attributed to the synergetic acceleration by longitudinal electric field and counter-propagating laser pulses, and a scaling lawmore » is obtained with efficiency depending on the pre-plasma scale length and laser intensity. These electrons pre-accelerated in the first stage could build up an intense electrostatic potential barrier with maximal value several times as large as the initial electron kinetic energy. Some of the energetic electrons could be further accelerated by reflection off the electrostatic potential barrier, with their finial kinetic energies significantly higher than the values pre-accelerated in the first stage.« less

Identifying the source of super-high energetic electrons in the presence of pre-plasma in laser–matter interaction at relativistic intensities

DOE PAGES

Wu, D.; Krasheninnikov, S. I.; Luan, S. X.; ...

2016-10-03

The generation of super-high energetic electrons influenced by pre-plasma in relativistic intensity laser–matter interaction is studied in a one-dimensional slab approximation with particle-in-cell simulations. Different pre-plasma scale lengths and laser intensities are considered, showing an increase in both particle number and cut-off kinetic energy of electrons with the increase of pre-plasma scale length and laser intensity, the cut-off kinetic energy greatly exceeding the corresponding laser ponderomotive energy. A two-stage electron acceleration model is proposed to explain the underlying physics. The first stage is attributed to the synergetic acceleration by longitudinal electric field and counter-propagating laser pulses, and a scaling lawmore » is obtained with efficiency depending on the pre-plasma scale length and laser intensity. These electrons pre-accelerated in the first stage could build up an intense electrostatic potential barrier with maximal value several times as large as the initial electron kinetic energy. Some of the energetic electrons could be further accelerated by reflection off the electrostatic potential barrier, with their finial kinetic energies significantly higher than the values pre-accelerated in the first stage.« less

Validation of a new scale to assess olfactory dysfunction in patients with Parkinson's disease.

PubMed

Millar Vernetti, Patricio; Perez Lloret, Santiago; Rossi, Malco; Cerquetti, Daniel; Merello, Marcelo

2012-05-01

BAKCKGROUND: Olfactory dysfunction is present in up to 90% of Parkinson's disease (PD) patients. It is usually evaluated by means of objective standardized tests; however no self-administered scales have been developed for olfactory dysfunction bedside assessment. We present validation of a new scale to assess this symptom in PD patients. Seventy-five PD patients and 25 control subjects were evaluated using a Hyposmia Rating Scale developed in-house, combined with the extended Sniffin' Sticks test. Total score of the 6-item Hyposmia Rating Scale showed significant correlation with threshold, discrimination, identification and total Sniffin' Sticks test scores (r = 0.53; r = 0.60; r = 0.57; r = 0.65 respectively, p < 0.001 for all values). Area under the curve of the receiver operating curve for the ability of Hyposmia Rating Scale to discriminate patients with Sniffin' Sticks test total scores below or above the cut-off point was 80 ± 6% (p < 0.001). Considering Sniffin' Sticks test as the gold standard method for olfactory dysfunction detection, an affirmative response to a single screening question about smelling ability problems showed 35% sensitivity (95%CI = 23-47%) and 100% specificity. The best cut-off point for Hyposmia Rating Scale was 22.5 with a sensitivity of 70% (60-81%) and a specificity of 85% (65-100%). The Hyposmia Rating Scale here presented may offer a simple, cost-effective, time-saving and reliable approach to evaluate olfactory dysfunction in PD patients. Copyright © 2011. Published by Elsevier Ltd.

Positive affect, negative affect, and physiological hyperarousal among referred and nonreferred youths.

PubMed

Laurent, Jeff; Joiner, Thomas E; Catanzaro, Salvatore J

2011-12-01

The Positive and Negative Affect Scale for Children (PANAS-C) and the Physiological Hyperarousal Scale for Children (PH-C) seem ideal measures for school mental health screenings, because they are theory based, psychometrically sound, and brief. This study provides descriptive information and preliminary cutoff scores in an effort to increase the practical utility of the measures. Scores on the PANAS-C Positive Affect (PA) and Negative Affect (NA) scales and the PH-C were compared for a general sample of schoolchildren (n = 226), a group of students referred for special education services (n = 83), and youths on an inpatient psychiatric unit (n = 37). Expected patterns of scores emerged for the general school and referred school samples, although only scores on the PH-C were statistically significantly different. Differences in scores between the general school and inpatient samples were significant for all 3 scales. Differences in scores between the referred school and inpatient samples were significant for the NA scale and the PH-C but not for the PA scale. In addition, we used traditional self-report measures to form groups of normal, anxious, depressed, and mixed anxious and depressed youths. Again, predicted general patterns of PA, NA and PH scores were supported, although statistical differences were not always evident. In particular, scores on the PH-C for the anxious and depressed groups were inconsistent with predictions. Possible reasons related to sample and scale issues are discussed. Finally, preliminary cutoff scores were proposed for the PANAS-C scales and the PH-C.

Development and application of a particle-particle particle-mesh Ewald method for dispersion interactions.

PubMed

Isele-Holder, Rolf E; Mitchell, Wayne; Ismail, Ahmed E

2012-11-07

For inhomogeneous systems with interfaces, the inclusion of long-range dispersion interactions is necessary to achieve consistency between molecular simulation calculations and experimental results. For accurate and efficient incorporation of these contributions, we have implemented a particle-particle particle-mesh Ewald solver for dispersion (r(-6)) interactions into the LAMMPS molecular dynamics package. We demonstrate that the solver's O(N log N) scaling behavior allows its application to large-scale simulations. We carefully determine a set of parameters for the solver that provides accurate results and efficient computation. We perform a series of simulations with Lennard-Jones particles, SPC/E water, and hexane to show that with our choice of parameters the dependence of physical results on the chosen cutoff radius is removed. Physical results and computation time of these simulations are compared to results obtained using either a plain cutoff or a traditional Ewald sum for dispersion.

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

PubMed

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

2017-01-01

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

Masking Misfit in Confirmatory Factor Analysis by Increasing Unique Variances: A Cautionary Note on the Usefulness of Cutoff Values of Fit Indices

ERIC Educational Resources Information Center

Heene, Moritz; Hilbert, Sven; Draxler, Clemens; Ziegler, Matthias; Buhner, Markus

2011-01-01

Fit indices are widely used in order to test the model fit for structural equation models. In a highly influential study, Hu and Bentler (1999) showed that certain cutoff values for these indices could be derived, which, over time, has led to the reification of these suggested thresholds as "golden rules" for establishing the fit or other aspects…

What does the Cantril Ladder measure in adolescence?

PubMed

Mazur, Joanna; Szkultecka-Dębek, Monika; Dzielska, Anna; Drozd, Mariola; Małkowska-Szkutnik, Agnieszka

2018-01-01

The Cantril Scale (CS) is a simple visual scale which makes it possible to assess general life satisfaction. The result may depend on the health, living, and studying conditions, and quality of social relations. The objective of this study is to identify key factors influencing the CS score in Polish adolescents. The survey comprised 1,423 parent-child pairs (54% girls; age range: 10-17; 67.3% urban inhabitants; 89.4% of parents were mothers). Linear and logistic models were estimated; the latter used alternative divisions into "satisfied" and "dissatisfied" with life. In addition to age and gender, child-reported KIDSCREEN-52 quality of life indexes were taken into account, along with some information provided by parents - child physical (CSHCN) and mental (SDQ) health, and family socio-economic conditions. According to the linear model, nine independent predictors, including six dimensions of KIDSCREEN-52, explain 47.2% of the variability of life satisfaction on the Cantril Scale. Self-perception was found to have a dominating influence (Δ R 2 = 0.301, p < 0.001). Important CS predictors also included Psychological Well-being (Δ R 2 = 0.088, p < 0.001) and Parent Relations (Δ R 2 = 0.041, p < 0.001). The impact of socioeconomic factors was more visible in boys and in older adolescents. According to logistic models, the key factors enhancing the chance of higher life satisfaction are Moods and Emotions (cut-off point CS > 5) and School Environment (CS > 8 points). None of the models indicated a relationship between the CS and physical health. The Cantril Scale can be considered a useful measurement tool in a broad approach to psychosocial adolescent health.

Validity and reliability of the Spanish-language version of the self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) pain scale.

PubMed

López-de-Uralde-Villanueva, I; Gil-Martínez, A; Candelas-Fernández, P; de Andrés-Ares, J; Beltrán-Alacreu, H; La Touche, R

2016-12-08

The self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) scale is a tool designed to identify patients with pain with neuropathic features. To assess the validity and reliability of the Spanish-language version of the S-LANSS scale. Our study included a total of 182 patients with chronic pain to assess the convergent and discriminant validity of the S-LANSS; the sample was increased to 321 patients to evaluate construct validity and reliability. The validated Spanish-language version of the ID-Pain questionnaire was used as the criterion variable. All participants completed the ID-Pain, the S-LANSS, and the Numerical Rating Scale for pain. Discriminant validity was evaluated by analysing sensitivity, specificity, and the area under the receiver operating characteristic curve (AUC). Construct validity was assessed with factor analysis and by comparing the odds ratio of each S-LANSS item to the total score. Convergent validity and reliability were evaluated with Pearson's r and Cronbach's alpha, respectively. The optimal cut-off point for S-LANSS was ≥12 points (AUC=.89; sensitivity=88.7; specificity=76.6). Factor analysis yielded one factor; furthermore, all items contributed significantly to the positive total score on the S-LANSS (P<.05). The S-LANSS showed a significant correlation with ID-Pain (r=.734, α=.71). The Spanish-language version of the S-LANSS is valid and reliable for identifying patients with chronic pain with neuropathic features. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Sensitivity and specificity of the Distress Thermometer in screening for distress in long-term nasopharyngeal cancer survivors.

PubMed

Hong, J S; Tian, J

2013-12-01

The Distress Thermometer (dt) is a screening tool recommended to quickly identify cancer patients with distress. Our study aimed to examine the sensitivity and specificity of the dt in detecting psychological distress in long-term Chinese nasopharyngeal cancer (npc) survivors. Data for the 442 participating npc survivors were collected through a self-administered questionnaire based on the dt and the Hospital Anxiety and Depression Scale (hads). The hads was used to define cases of psychological distress. Positive and negative groups were defined based on 4 hads criteria (Anxiety, Depression, Anxiety or Depression, and overall score). Receiver operating characteristic (roc) curves were used to examine the ability of all possible cut-off values of the dt to detect positive and negative cases. For each roc curve, the area under the curve (auc) was used as an indicator of the overall accuracy of the dt to identify positive cases of distress. The positive auc values [with 95% confidence intervals (ci)] for the 4 hads criteria were 0.715 (95% ci: 0.667 to 0.764), 0.714 (95% ci: 0.661 to 0.768), 0.724 (95% ci: 0.677 to 0.771), and 0.724 (95% ci: 0.664 to 0.775) respectively. At a cut-off score of 4, the sensitivity of the dt to the four hads criteria was, respectively, 0.366 (95% ci: 0.296 to 0.436), 0.448 (95% ci: 0.364 to 0.532), 0.362 (95% ci: 0.299 to 0.425), and 0.421 (95% ci: 0.339 to 0.502), and the specificity of the dt to the 4 hads criteria was, respectively, 0.860 (95% ci: 0.818 to 0.902), 0.860 (95% ci: 0.821 to 0.899), 0.854 (95% ci: 0.814 to 0.894), and 0.854 (95% ci: 0.814 to 0.894). At a cut-off score of 5, the corresponding sensitivities were lower than those at the cut-off score of 4. All potential cut-off scores showed poor sensitivity (<0.90). The roc analysis showed poor discrimination. No potential dt cut-off score had an acceptable sensitivity. The dt showed poor sensitivity in npc survivors. Thus, the dt might not be a valid scale for psychological distress screening in long-term Chinese npc survivors.

Sensitivity and specificity of the Distress Thermometer in screening for distress in long-term nasopharyngeal cancer survivors

PubMed Central

Hong, J.S.; Tian, J.

2013-01-01

Background The Distress Thermometer (dt) is a screening tool recommended to quickly identify cancer patients with distress. Our study aimed to examine the sensitivity and specificity of the dt in detecting psychological distress in long-term Chinese nasopharyngeal cancer (npc) survivors. Methods Data for the 442 participating npc survivors were collected through a self-administered questionnaire based on the dt and the Hospital Anxiety and Depression Scale (hads). The hads was used to define cases of psychological distress. Positive and negative groups were defined based on 4 hads criteria (Anxiety, Depression, Anxiety or Depression, and overall score). Receiver operating characteristic (roc) curves were used to examine the ability of all possible cut-off values of the dt to detect positive and negative cases. For each roc curve, the area under the curve (auc) was used as an indicator of the overall accuracy of the dt to identify positive cases of distress. Results The positive auc values [with 95% confidence intervals (ci)] for the 4 hads criteria were 0.715 (95% ci: 0.667 to 0.764), 0.714 (95% ci: 0.661 to 0.768), 0.724 (95% ci: 0.677 to 0.771), and 0.724 (95% ci: 0.664 to 0.775) respectively. At a cut-off score of 4, the sensitivity of the dt to the four hads criteria was, respectively, 0.366 (95% ci: 0.296 to 0.436), 0.448 (95% ci: 0.364 to 0.532), 0.362 (95% ci: 0.299 to 0.425), and 0.421 (95% ci: 0.339 to 0.502), and the specificity of the dt to the 4 hads criteria was, respectively, 0.860 (95% ci: 0.818 to 0.902), 0.860 (95% ci: 0.821 to 0.899), 0.854 (95% ci: 0.814 to 0.894), and 0.854 (95% ci: 0.814 to 0.894). At a cut-off score of 5, the corresponding sensitivities were lower than those at the cut-off score of 4. All potential cut-off scores showed poor sensitivity (<0.90). Conclusions The roc analysis showed poor discrimination. No potential dt cut-off score had an acceptable sensitivity. The dt showed poor sensitivity in npc survivors. Thus, the dt might not be a valid scale for psychological distress screening in long-term Chinese npc survivors. PMID:24311958

Spanish Adaptation and Validation of the Outcome Questionnaire OQ-30.2

PubMed Central

Errázuriz, Paula; Opazo, Sebastián; Behn, Alex; Silva, Oscar; Gloger, Sergio

2017-01-01

This study assessed the psychometric properties of a Spanish version of the Shortened Outcome Questionnaire (OQ-30.2, Lambert et al., 2004) validated with a sample of 546 patients in an outpatient mental health clinic and 100 non-clinical adults in Chile. Our results show that this measure has similar normative data to the original measure, with a cutoff score for the Chilean population set at 43.36, and the reliable change index at 14. This Spanish OQ-30.2 has good internal consistency (α = 0.90), has concurrent validity with the Depressive, Anxious, and Somatoform disorders measuring scale (Alvarado and Vera, 1991), and is sensitive to change during psychotherapy. Consistent with previous studies, factorial analyses showed that both, the one-factor solution for a general scale and the three-factor solution containing three theoretical scales yielded poor fit estimates. Overall, our results are similar to past research on the OQ-45 and the OQ-30. The short version has adequate psychometric properties, comparable to those of the OQ-45, but provides a gain in application time that could be relevant in the setting of psychotherapy research with large samples, frequent assessments over time, and/or samples that may require more assistance completing items (e.g., low-literacy). We conclude that this measure will be a valuable instrument for research and clinical practice. PMID:28559857

Psychometric Adaptation of the Beck Hopelessness Scale as a Self-Rated Suicide Risk Screening Instrument Among Nigerian University Students.

PubMed

Aloba, Olutayo; Awe, Oluwatosin; Adelola, Aderopo; Olatunji, Philemon; Aloba, Tolulope

2018-03-01

Globally, suicide is the most important cause of mortality among adolescents and young adults. The factor that correlates most significantly with suicide is hopelessness. The aim is to explore the psychometric adaptation of the Beck Hopelessness Scale (BHS) as a suicide risk evaluation tool among Nigerian university students. A total of 554 Nigerian students completed the BHS and the Depression Anxiety Stress Scale (DASS). Suicide risk level among them was determined by interviewing them with the Mini International Neuropsychiatric Interview Suicidality module. Cronbach's alpha for the 16-item BHS was 0.87. It exhibited satisfactory concurrent validity with the Mini International Neuropsychiatric Interview (MINI) Suicidality module and the subscales of the DASS among the students. The 2-factor model of the BHS-16 exhibited satisfactory indices of fitness (goodness of fit index = 0.930; parsimonious goodness of fit index = 0.601; comparative fit index = 0.934; incremental fit index = 0.936; Tucker-Lewis index = 0.910; root mean square error of approximation = 0.059; χ 2 / df = 1.9). Receiver operating characteristics curve indicated that the best cutoff score for those categorized as high suicide risk was 7 (sensitivity 0.700, specificity 0.908, AUC = 0.897). The BHS has satisfactory psychometric properties as a suicide risk screening tool among Nigerian university students.

A scale for assessing the severity of arousal disorders.

PubMed

Arnulf, Isabelle; Zhang, Bin; Uguccioni, Ginevra; Flamand, Mathilde; Noël de Fontréaux, Alix; Leu-Semenescu, Smaranda; Brion, Agnès

2014-01-01

Arousal disorders may have serious health consequences. To develop a scale assessing the severity of arousal disorders (Paris Arousal Disorders Severity Scale, PADSS). University hospital. Controlled study. Consecutive patients (older than 15 y), with sleepwalking (SW) and/or sleep terrors (ST), subjects with previous SW/ST, normal controls and patients with rapid eye movement sleep behavior disorder. The self-rated scale listed 17 parasomniac behaviors (PADSS-A), assessed their frequency from never to twice or more per night (PADSS-B) and evaluated the consequences (PADSS-C: disturbed sleep, injuries, fatigue, and psychological consequences). The clinimetric properties and face validity of the scale were tested. Half of the 73 patients with SW/ST (more men than women) had injured themselves or others, whereas 15% had concomitant sexsomnia and 23% had amnestic eating behaviors. The total PADSS score (range: 0-50) was 19.4 ± 6.3 (range: 8-36) in this group, 11.7 ± 5.9 in 26 subjects with previous SW/ST, 8.8 ± 3.2 in 26 patients with RBD, and 2.0 ± 3.5 in 53 normal controls (P < 0.05). The PADSS demonstrated high sensitivity (83.6%), specificity (87.8%), internal consistency, and test-retest reliability (0.79). The best cutoff for the total score was at 13/14. Exploratory factor analysis revealed two components: wandering and violence/handling. The complexity of behaviors emerging from N3 sleep (scored on videopolysomnography) positively correlated with scores for the PADSS-total, PADSS-A, PADSS-C, and the "violence/handling" factor. This scale had reasonable psychometric properties and could be used for screening and stratifying patients and for evaluating the effects of treatments.

Substructure of fuzzy dark matter haloes

NASA Astrophysics Data System (ADS)

Du, Xiaolong; Behrens, Christoph; Niemeyer, Jens C.

2017-02-01

We derive the halo mass function (HMF) for fuzzy dark matter (FDM) by solving the excursion set problem explicitly with a mass-dependent barrier function, which has not been done before. We find that compared to the naive approach of the Sheth-Tormen HMF for FDM, our approach has a higher cutoff mass and the cutoff mass changes less strongly with redshifts. Using merger trees constructed with a modified version of the Lacey & Cole formalism that accounts for suppressed small-scale power and the scale-dependent growth of FDM haloes and the semi-analytic GALACTICUS code, we study the statistics of halo substructure including the effects from dynamical friction and tidal stripping. We find that if the dark matter is a mixture of cold dark matter (CDM) and FDM, there will be a suppression on the halo substructure on small scales which may be able to solve the missing satellites problem faced by the pure CDM model. The suppression becomes stronger with increasing FDM fraction or decreasing FDM mass. Thus, it may be used to constrain the FDM model.

Contribution of large-scale midlatitude disturbances to hourly precipitation extremes in the United States

NASA Astrophysics Data System (ADS)

Barbero, Renaud; Abatzoglou, John T.; Fowler, Hayley J.

2018-02-01

Midlatitude synoptic weather regimes account for a substantial portion of annual precipitation accumulation as well as multi-day precipitation extremes across parts of the United States (US). However, little attention has been devoted to understanding how synoptic-scale patterns contribute to hourly precipitation extremes. A majority of 1-h annual maximum precipitation (AMP) across the western US were found to be linked to two coherent midlatitude synoptic patterns: disturbances propagating along the jet stream, and cutoff upper-level lows. The influence of these two patterns on 1-h AMP varies geographically. Over 95% of 1-h AMP along the western coastal US were coincident with progressive midlatitude waves embedded within the jet stream, while over 30% of 1-h AMP across the interior western US were coincident with cutoff lows. Between 30-60% of 1-h AMP were coincident with the jet stream across the Ohio River Valley and southeastern US, whereas a a majority of 1-h AMP over the rest of central and eastern US were not found to be associated with either midlatitude synoptic features. Composite analyses for 1-h AMP days coincident to cutoff lows and jet stream show that an anomalous moisture flux and upper-level dynamics are responsible for initiating instability and setting up an environment conducive to 1-h AMP events. While hourly precipitation extremes are generally thought to be purely convective in nature, this study shows that large-scale dynamics and baroclinic disturbances may also contribute to precipitation extremes on sub-daily timescales.

Validity of the Malay version of the Internet Addiction Test: a study on a group of medical students in Malaysia.

PubMed

Guan, Ng Chong; Isa, Saramah Mohammed; Hashim, Aili Hanim; Pillai, Subash Kumar; Harbajan Singh, Manveen Kaur

2015-03-01

The use of the Internet has been increasing dramatically over the decade in Malaysia. Excessive usage of the Internet has lead to a phenomenon called Internet addiction. There is a need for a reliable, valid, and simple-to-use scale to measure Internet addiction in the Malaysian population for clinical practice and research purposes. The aim of this study was to validate the Malay version of the Internet Addiction Test, using a sample of 162 medical students. The instrument displayed good internal consistency (Cronbach's α = .91), parallel reliability (intraclass coefficient = .88, P < .001), and concurrent validity with the Compulsive Internet Use Scale (Pearson's correlation = .84, P < .001). Receiver operating characteristic analysis showed that 43 was the optimal cutoff score to discriminate students with and without Internet dependence. Principal component analysis with varimax rotation identified a 5-factor model. The Malay version of the Internet Addiction Test appeared to be a valid instrument for assessing Internet addiction in Malaysian university students. © 2012 APJPH.

Validation of the Edinburgh Postnatal Depression Scale (EPDS) for screening of major depressive episode among adults from the general population.

PubMed

Matijasevich, Alicia; Munhoz, Tiago N; Tavares, Beatriz Franck; Barbosa, Ana Paula Pereira Neto; da Silva, Diego Mello; Abitante, Morgana Sonza; Dall'Agnol, Tatiane Abreu; Santos, Iná S

2014-10-08

Standardized questionnaires designed for the identification of depression are useful for monitoring individual as well as population mental health. The Edinburgh Postnatal Depression Scale (EPDS) has originally been developed to assist primary care health professionals to detect postnatal depression, but several authors recommend its use outside of the postpartum period. In Brazil, the use of the EPDS for screening depression outside the postpartum period and among non-selected populations has not been validated. The present study aimed to assess the validity of the EPDS as a screening instrument for major depressive episode (MDE) among adults from the general population. This is a validation study that used a population-based sampling technique to select the participants. The study was conducted in the city of Pelotas, Brazil. Households were randomly selected by two stage conglomerates with probability proportional to size. EPDS was administered to 447 adults (≥20 years). Approximately 17 days later, participants were reinterviewed by psychiatrics and psychologists using a structured diagnostic interview (Mini International Neuropsychiatric Interview, MINI). We calculated the sensitivity and specificity of each cutoff point of EPDS, and values were plotted as a receiver operator characteristic curve. The best cutoff point for screening depression was ≥8, with 80.0% (64.4 - 90.9%) sensitivity and 87.0% (83.3 - 90.1%) specificity. Among women the best cutoff point was ≥8 too with values of sensitivity and specificity of 84.4% (67.2 - 94.7%) and 81.3% (75.5 - 86.1%), respectively. Among men, the best cutoff point was ≥7 (75% sensitivity and 89% specificity). The EPDS was shown to be suitable for screening MDE among adults in the community.

Short Berg Balance Scale, BBS-9, as a predictor of fall risk among the aged: a prospective 12-month follow-up study.

PubMed

Hohtari-Kivimäki, Ulla; Salminen, Marika; Vahlberg, Tero; Kivelä, Sirkka-Liisa

2013-12-01

The aim of this study was to assess the adequacy of the short, 9-item Berg Balance Scale (BBS-9) to predict fall risk among the community-dwelling aged. The subjects (n = 519) were derived from the participants in a multifactorial fall prevention intervention conducted in Pori, Finland. Receiver operating characteristic (ROC) analysis was used to determine the cut-off score for BBS-9 (range 0-36) to classify aged people with a fall risk during a 12-month follow-up. Logistic regression was used to analyse the relationship of potential confounders with fall risk. The association between the cut-off score for BBS-9 and fall risk was tested using the Chi-square test. In determining the cut-off score of BBS-9 to classify fall risk, the highest sensitivity (0.51) and specificity (0.57) (when both presumed to be above 0.50) sum score was within the limit range 32 scores or below. The area under curve (AUC) was significantly better in the model adjusted for significant confounders (vision and the number of regularly used drugs) (AUC = 0.64) than in the unadjusted model (AUC = 0.57) (p = 0.045). Among patients who scored 32 or below in BBS-9 the incidence of multiple falls was 20.0 %, whereas among those who scored 33-36 it was 15.7 %. BBS-9 with the cut-off score of 32/33 together with data on vision and the number of regularly used drugs predicted moderately the risk of falling among the community-dwelling aged.

Detecting depression among adolescents in Santiago, Chile: sex differences.

PubMed

Araya, Ricardo; Montero-Marin, Jesus; Barroilhet, Sergio; Fritsch, Rosemarie; Gaete, Jorge; Montgomery, Alan

2013-04-23

Depression among adolescents is common but most cases go undetected. Brief questionnaires offer an opportunity to identify probable cases but properly validated cut-off points are often unavailable, especially in non-western countries. Sex differences in the prevalence of depression become marked in adolescence and this needs to be accounted when establishing cut-off points. This study involved adolescents attending secondary state schools in Santiago, Chile. We compared the self-reported Beck Depression Inventory-II with a psychiatric interview to ascertain diagnosis. General psychometric features were estimated before establishing the criterion validity of the BDI-II. The BDI-II showed good psychometric properties with good internal consistency, a clear unidimensional factorial structure, and good capacity to discriminate between cases and non-cases of depression. Optimal cut-off points to establish caseness for depression were much higher for girls than boys. Sex discrepancies were primarily explained by differences in scores among those with depression rather than among those without depression. It is essential to validate scales with the populations intended to be used with. Sex differences are often ignored when applying cut-off points, leading to substantial misclassification. Early detection of depression is essential if we think that early intervention is a clinically important goal.

Optimal cutoffs of obesity measures in relation to cancer risk in postmenopausal women in the Women's Health Initiative Study.

PubMed

Heo, Moonseong; Kabat, Geoffrey C; Strickler, Howard D; Lin, Juan; Hou, Lifang; Stefanick, Marcia L; Anderson, Garnet L; Rohan, Thomas E

2015-03-01

Obesity is a risk factor for several cancers in postmenopausal women. We attempted to determine cutoffs of adiposity measures in relation to risk of obesity-related cancers among postmenopausal women and to examine the effects of hormone therapy (HT) use on the cutoffs, neither of which has been broadly studied. We used data from the Women's Health Initiative cohort (n=144,701) and applied Cox-proportional hazards regressions to each combination of 17 cancer types and 6 anthropometric measures (weight, body mass index [BMI], weight to height ratio, waist circumference, waist to hip ratio [WHR], and waist to height ratio). Interactions between the anthropometric measures and HT use were also examined. Cutoffs were determined by applying a grid search followed by a two-fold cross validation method. Survival ROC analysis of 5- and 10-year incidence followed. Breast, colorectal, colon, endometrium, kidney, and all cancers combined were significantly positively associated with all six anthropometric measures, whereas lung cancer among ever smokers was significantly inversely associated with all measures except WHR. The derived cutoffs of each obesity measure varied across cancers (e.g., BMI cutoffs for breast and endometrium cancers were 30 kg/m(2) and 34 kg/m(2), respectively), and also depended on HT use. The Youden indices of the cutoffs for predicting 5- and 10-year cancer incidence were higher among HT never users. Using a panel of different anthropometric measures, we derived optimal cut-offs categorizing populations into high- and low-risk groups, which differed by cancer type and HT use. Although the discrimination abilities of these risk categories were generally poor, the results of this study could serve as a starting point from which to determine adiposity cutoffs for inclusion in risk prediction models for specific cancer types.

Solar-cycle dependence of a model turbulence spectrum using IMP and ACE observations over 38 years

NASA Astrophysics Data System (ADS)

Burger, R. A.; Nel, A. E.; Engelbrecht, N. E.

2014-12-01

Ab initio modulation models require a number of turbulence quantities as input for any reasonable diffusion tensor. While turbulence transport models describe the radial evolution of such quantities, they in turn require observations in the inner heliosphere as input values. So far we have concentrated on solar minimum conditions (e.g. Engelbrecht and Burger 2013, ApJ), but are now looking at long-term modulation which requires turbulence data over at a least a solar magnetic cycle. As a start we analyzed 1-minute resolution data for the N-component of the magnetic field, from 1974 to 2012, covering about two solar magnetic cycles (initially using IMP and then ACE data). We assume a very simple three-stage power-law frequency spectrum, calculate the integral from the highest to the lowest frequency, and fit it to variances calculated with lags from 5 minutes to 80 hours. From the fit we then obtain not only the asymptotic variance at large lags, but also the spectral index of the inertial and the energy, as well as the breakpoint between the inertial and energy range (bendover scale) and between the energy and cutoff range (cutoff scale). All values given here are preliminary. The cutoff range is a constraint imposed in order to ensure a finite energy density; the spectrum is forced to be either flat or to decrease with decreasing frequency in this range. Given that cosmic rays sample magnetic fluctuations over long periods in their transport through the heliosphere, we average the spectra over at least 27 days. We find that the variance of the N-component has a clear solar cycle dependence, with smaller values (~6 nT2) during solar minimum and larger during solar maximum periods (~17 nT2), well correlated with the magnetic field magnitude (e.g. Smith et al. 2006, ApJ). Whereas the inertial range spectral index (-1.65 ± 0.06) does not show a significant solar cycle variation, the energy range index (-1.1 ± 0.3) seems to be anti-correlated with the variance (Bieber et al. 1993, JGR); both indices show close to normal distributions. In contrast, the variance (e.g. Burlaga and Ness, 1998, JGR), and both the bendover scale (see Ruiz et al. 2014, Solar Physics) and cutoff scale appear to be log-normal distributed.

[Prevalence of and factors related to depression in high school students].

PubMed

Eskin, Mehmet; Ertekin, Kamil; Harlak, Hacer; Dereboy, Ciğdem

2008-01-01

The study aimed at investigating the prevalence of and factors related to depression in high school students. A total of 805 (n = 367 girls; n = 438 boys) first year students from three high schools in the city of Aydin filled in a self-report questionnaire that contained questions about socio-demographics, academic achievement and religious belief. It included also a depression rating scale, social support scale, problem solving inventory and an assertiveness scale. T-tests, chi-square tests, Pearson moment products correlation coefficients, and logistic regression analysis were used to analyze the data. 141 students (17.5%) scored on and above the cut-off point on the Children Depression Inventory (CDI). In the first regression analyses low self-esteem, low grade point average (GPA) and low perceived social support from friends in boys, and low self-esteem, low paternal educational level and low social support from friends were the predictors of girls' depression. When self-esteem scores were excluded, low GPA, low perceived social support from friends and family, and inefficient problem solving skills were predictors of depression in boys; low perceived social support from friends and family, low paternal educational level, and inefficient problem solving skills were the independent predictors of depression in girls. Depression is prevalent in high school students. Low self-esteem, low perceived social support from peers and family, and inefficient problem solving skills appears to be risk factors for adolescent depression. Low GPA for boys and low paternal education for girls were gender specific risk factors. Psychosocial interventions geared for increasing self-esteem, social support and problem solving skills may be effective in the prevention and treatment of adolescent depression.

Development and Standardization of the Diagnostic Adaptive Behavior Scale: Application of Item Response Theory to the Assessment of Adaptive Behavior

ERIC Educational Resources Information Center

Tassé, Marc J.; Schalock, Robert L.; Thissen, David; Balboni, Giulia; Bersani, Henry, Jr.; Borthwick-Duffy, Sharon A.; Spreat, Scott; Widaman, Keith F.; Zhang, Dalun; Navas, Patricia

2016-01-01

The Diagnostic Adaptive Behavior Scale (DABS) was developed using item response theory (IRT) methods and was constructed to provide the most precise and valid adaptive behavior information at or near the cutoff point of making a decision regarding a diagnosis of intellectual disability. The DABS initial item pool consisted of 260 items. Using IRT…

Identifying the necessary and sufficient number of risk factors for predicting academic failure.

PubMed

Lucio, Robert; Hunt, Elizabeth; Bornovalova, Marina

2012-03-01

Identifying the point at which individuals become at risk for academic failure (grade point average [GPA] < 2.0) involves an understanding of which and how many factors contribute to poor outcomes. School-related factors appear to be among the many factors that significantly impact academic success or failure. This study focused on 12 school-related factors. Using a thorough 5-step process, we identified which unique risk factors place one at risk for academic failure. Academic engagement, academic expectations, academic self-efficacy, homework completion, school relevance, school safety, teacher relationships (positive relationship), grade retention, school mobility, and school misbehaviors (negative relationship) were uniquely related to GPA even after controlling for all relevant covariates. Next, a receiver operating characteristic curve was used to determine a cutoff point for determining how many risk factors predict academic failure (GPA < 2.0). Results yielded a cutoff point of 2 risk factors for predicting academic failure, which provides a way for early identification of individuals who are at risk. Further implications of these findings are discussed. PsycINFO Database Record (c) 2012 APA, all rights reserved.

WaLIDD score, a new tool to diagnose dysmenorrhea and predict medical leave in university students

PubMed Central

Teherán, Aníbal A; Piñeros, Luis Gabriel; Pulido, Fabián; Mejía Guatibonza, María Camila

2018-01-01

Background Dysmenorrhea is a frequent and misdiagnosed symptom affecting the quality of life in young women. A working ability, location, intensity, days of pain, dysmenorrhea (WaLIDD) score was designed to diagnose dysmenorrhea and to predict medical leave. Methods This cross-sectional design included young medical students, who completed a self-administered questionnaire that contained the verbal rating score (VRS; pain and drug subscales) and WaLIDD scales. The correlation between scales was established through Spearman test. The area under the receiver operating characteristic (ROC) curve, sensitivity, specificity, and likelihood ratio (LR +/−) were evaluated to diagnose students availing medical leave due to dysmenorrhea; moreover, to predict medical leave in students with dysmenorrhea, a binary logistic regression was performed. Results In all, 585 students, with a mean age of 21 years and menarche at 12 years, participated. Most of them had regular cycles, 5 days of menstrual blood flow and 1–2 days of lower abdominal pain. The WaLIDD scale presented an adequate internal consistency and strong correlation with VRS subscales. With a cutoff of >6 for WaLIDD and 2 for VRS subscales (drug subscale and pain subscale) to identify students with dysmenorrhea, these scales presented an area under the curve (AUC) ROC of 0.82, 0.62, and 0.67, respectively. To identify students taking medical leave due to dysmenorrhea, WaLIDD (cutoff >9) and VRS subscales (cutoff >2) presented an AUC ROC of 0.97, 0.68, and 0.81; moreover, the WaLIDD scale showed a good LR +14.2 (95% CI, 13.5–14.9), LR −0.00 (95% CI, undefined), and predictive risk (OR 5.38; 95% CI, 1.78–16.2). Conclusion This research allowed a comparison between two multidimensional scales regarding their capabilities, one previously validated and a new one, to discriminate among the general population of medical students, among those with dysmenorrhea or those availing medical leave secondary to dysmenorrhea. WaLIDD score showed a larger effect size than the pain and drug score in the students. In addition, this study demonstrated the ability to predict this combination of events. PMID:29398923

Screening for current opioid misuse and associated risk factors among patients with chronic nonalcoholic pancreatitis pain.

PubMed

Barth, Kelly S; Balliet, Wendy; Pelic, Christine M; Madan, Alok; Malcolm, Robert; Adams, David; Morgan, Katherine; Owczarski, Stefanie; Borckardt, Jeffrey J

2014-08-01

The objective of this study is to assess clinical variables that may be associated with risk for opioid misuse in individuals with chronic pancreatitis. This study utilized a descriptive, quasi-experimental, cross sectional design. Three hundred seven individuals with nonalcoholic chronic pancreatitis engaged in chronic opioid therapy for pain presented to an outpatient specialty clinic at an academic medical center. Participants completed the Current Opioid Misuse Measure (COMM), Brief Pain Inventory (BPI), Short Form (SF)-12 Quality of Life Measure, Center for Epidemiological Studies 10-item Depression Scale (CESD), and a single item asking about current alcohol use. Mean scores on the CESD, COMM, BPI, SF-12, and factors associated with opioid misuse measures from regression analyses were the outcome measures. Mean scores on the CESD, COMM, BPI pain-on-average item, and the SF-12 physical and psychological quality of life factors (t scores) were 11.2 (standard deviation [SD] = 6.7), 8.5 (SD = 7.3), 4.8 (SD = 2.8), 39.7 (SD = 7.0), and 45 (SD = 9.0), respectively. Descriptive analyses revealed that 55% of participants scored above the clinical cutoff for depression on the CESD, and 39% scored above the cutoff for opioid misuse concerns on the COMM. Regression analyses identified several factors associated with higher opioid misuse measure scores, including increased depressive symptoms from the CESD (β = 0.38, P < 0.0001), increased pain rating at the time of the office visit (β = 0.16, P = 0.03), impairment of psychological quality of life (β = -0.27, P = 0.001) and endorsement of alcohol use (β = 0.16, P = 0.03). These factors accounted for 37% of the variance in current opioid misuse scores. Depression, quality of life, pain intensity and alcohol use may be good candidate variables for prospective studies to determine clinical risk factors for opioid misuse among patients with pancreatitis. Wiley Periodicals, Inc.

A Lymph Node Ratio of 10% Is Predictive of Survival in Stage III Colon Cancer: A French Regional Study

PubMed Central

Sabbagh, Charles; Mauvais, François; Cosse, Cyril; Rebibo, Lionel; Joly, Jean-Paul; Dromer, Didier; Aubert, Christine; Carton, Sophie; Dron, Bernard; Dadamessi, Innocenti; Maes, Bernard; Perrier, Guillaume; Manaouil, David; Fontaine, Jean-François; Gozy, Michel; Panis, Xavier; Foncelle, Pierre Henri; de Fresnoy, Hugues; Leroux, Fabien; Vaneslander, Pierre; Ghighi, Caroline; Regimbeau, Jean-Marc

2014-01-01

Lymph node ratio (LNR) (positive lymph nodes/sampled lymph nodes) is predictive of survival in colon cancer. The aim of the present study was to validate the LNR as a prognostic factor and to determine the optimum LNR cutoff for distinguishing between “good prognosis” and “poor prognosis” colon cancer patients. From January 2003 to December 2007, patients with TNM stage III colon cancer operated on with at least of 3 years of follow-up and not lost to follow-up were included in this retrospective study. The two primary endpoints were 3-year overall survival (OS) and disease-free survival (DFS) as a function of the LNR groups and the cutoff. One hundred seventy-eight patients were included. There was no correlation between the LNR group and 3-year OS (P = 0.06) and a significant correlation between the LNR group and 3-year DFS (P = 0.03). The optimal LNR cutoff of 10% was significantly correlated with 3-year OS (P = 0.02) and DFS (P = 0.02). The LNR was not an accurate prognostic factor when fewer than 12 lymph nodes were sampled. Clarification and simplification of the LNR classification are prerequisites for use of this system in randomized control trials. An LNR of 10% appears to be the optimal cutoff. PMID:25058763

A lymph node ratio of 10% is predictive of survival in stage III colon cancer: a French regional study.

PubMed

Sabbagh, Charles; Mauvais, François; Cosse, Cyril; Rebibo, Lionel; Joly, Jean-Paul; Dromer, Didier; Aubert, Christine; Carton, Sophie; Dron, Bernard; Dadamessi, Innocenti; Maes, Bernard; Perrier, Guillaume; Manaouil, David; Fontaine, Jean-François; Gozy, Michel; Panis, Xavier; Foncelle, Pierre Henri; de Fresnoy, Hugues; Leroux, Fabien; Vaneslander, Pierre; Ghighi, Caroline; Regimbeau, Jean-Marc

2014-01-01

Lymph node ratio (LNR) (positive lymph nodes/sampled lymph nodes) is predictive of survival in colon cancer. The aim of the present study was to validate the LNR as a prognostic factor and to determine the optimum LNR cutoff for distinguishing between "good prognosis" and "poor prognosis" colon cancer patients. From January 2003 to December 2007, patients with TNM stage III colon cancer operated on with at least of 3 years of follow-up and not lost to follow-up were included in this retrospective study. The two primary endpoints were 3-year overall survival (OS) and disease-free survival (DFS) as a function of the LNR groups and the cutoff. One hundred seventy-eight patients were included. There was no correlation between the LNR group and 3-year OS (P=0.06) and a significant correlation between the LNR group and 3-year DFS (P=0.03). The optimal LNR cutoff of 10% was significantly correlated with 3-year OS (P=0.02) and DFS (P=0.02). The LNR was not an accurate prognostic factor when fewer than 12 lymph nodes were sampled. Clarification and simplification of the LNR classification are prerequisites for use of this system in randomized control trials. An LNR of 10% appears to be the optimal cutoff.

Studies of cluster X-ray sources, energy spectra for the Perseus, Virgo, and Coma clusters

NASA Technical Reports Server (NTRS)

Kellogg, E.; Baldwin, J. R.; Koch, D.

1975-01-01

Final Uhuru X-ray differential-energy spectra are presented for the Perseus, Virgo, and Coma clusters. Power-law and isothermal bremsstrahlung model spectra with low-energy cutoffs are given, and the energy-dependent Gaunt factor is calculated for the bremsstrahlung. The spectra, which are best fits to the Uhuru data between 2 and 10 keV, are compared with previous observations of these sources in the energy range from 0.1 to 100 keV. The problem of parameter estimation is discussed, error bars with 68% confidence are given for the independently determined slope and cutoff parameters, and the 68% confidence limits are plotted for the fitted spectral functions. The data for Perseus above 20 keV marginally favor the bremsstrahlung fit, those for Virgo between 0.25 and 1.0 keV clearly favor that curve, and those for Coma indicate a low-energy turnover or cutoff. Implications of such a cutoff are briefly discussed.

Improved cross-calibration of Thomson scattering and electron cyclotron emission with ECH on DIII-D.

PubMed

Brookman, M W; Austin, M E; McLean, A G; Carlstrom, T N; Hyatt, A W; Lohr, J

2016-11-01

Thomson scattering produces n e profiles from measurement of scattered laser beam intensity. Rayleigh scattering provides a first calibration of the relation n e ∝ I TS , which depends on many factors (e.g., laser alignment and power, optics, and measurement systems). On DIII-D, the n e calibration is adjusted against an absolute n e from the density-driven cutoff of the 48 channel 2nd harmonic X-mode electron cyclotron emission system. This method has been used to calibrate Thomson n e from the edge to near the core (r/a > 0.15). Application of core electron cyclotron heating improves the quality of cutoff and depth of its penetration into the core, and also changes underlying MHD activity, minimizing crashes which confound calibration. Less fueling is needed as "ECH pump-out" generates a plasma ready to take up gas. On removal of gyrotron power, cutoff penetrates into the core as channels fall successively and smoothly into cutoff.

Intra-abdominal fat measurement by ultrasonography: association with anthropometry and metabolic syndrome in adolescents.

PubMed

Novais, Rommel L R; Café, Ana Carolina C; Morais, Aisha A; Bila, Wendell C; Santos, Gilson D da S; Lopes, Carlos Alexandre de O; Belo, Vinícius S; Romano, Márcia Christina C; Lamounier, Joel A

2018-04-27

To associate intra-abdominal fat thickness measured by ultrasonography to the factors related to metabolic syndrome and to determine cutoff points of intra-abdominal fat measurement associated with a greater chance of metabolic syndrome in adolescents. This was a cross-sectional study, with 423 adolescents from public schools. Intra-abdominal fat was measured by ultrasonography. Anthropometric data were collected, and biochemical analyses were performed. Intra-abdominal fat was measured by ultrasonography, showing a statistically significant association with the diagnosis of metabolic syndrome (p=0.037), body mass index (p<0.001), elevated triglyceride levels (p=0.012), decreased plasma HDL levels (p=0.034), and increased systemic blood pressure values (p=0.023). Cutoff values of intra-abdominal fat thickness measurements were calculated by ultrasound to estimate the individuals most likely to develop metabolic syndrome. In the logistic regression models, the cutoff values that showed the highest association with metabolic syndrome in males were 4.50, 5.35, 5.46, 6.24, and 6.50cm for the ages of 14, 15, 16, 17, and 18/19 years, respectively. In the female gender, the cutoff values defined for the same age groups were 4.46, 4.55, 4.45, 4.90, and 6.46cm. In an overall analysis using the ROC curve, without gender and age stratification, the cut-off of 3.67cm showed good sensitivity, but low specificity. Ultrasonography is a useful method to estimate intra-abdominal adipose tissue in adolescents, which is associated with the main factors related to obesity and metabolic syndrome. Copyright © 2018 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Censored Glauber Dynamics for the Mean Field Ising Model

NASA Astrophysics Data System (ADS)

Ding, Jian; Lubetzky, Eyal; Peres, Yuval

2009-11-01

We study Glauber dynamics for the Ising model on the complete graph on n vertices, known as the Curie-Weiss Model. It is well known that at high temperature ( β<1) the mixing time is Θ( nlog n), whereas at low temperature ( β>1) it is exp ( Θ( n)). Recently, Levin, Luczak and Peres considered a censored version of this dynamics, which is restricted to non-negative magnetization. They proved that for fixed β>1, the mixing-time of this model is Θ( nlog n), analogous to the high-temperature regime of the original dynamics. Furthermore, they showed cutoff for the original dynamics for fixed β<1. The question whether the censored dynamics also exhibits cutoff remained unsettled. In a companion paper, we extended the results of Levin et al. into a complete characterization of the mixing-time for the Curie-Weiss model. Namely, we found a scaling window of order 1/sqrt{n} around the critical temperature β c =1, beyond which there is cutoff at high temperature. However, determining the behavior of the censored dynamics outside this critical window seemed significantly more challenging. In this work we answer the above question in the affirmative, and establish the cutoff point and its window for the censored dynamics beyond the critical window, thus completing its analogy to the original dynamics at high temperature. Namely, if β=1+ δ for some δ>0 with δ 2 n→∞, then the mixing-time has order ( n/ δ)log ( δ 2 n). The cutoff constant is (1/2+[2(ζ2 β/ δ-1)]-1), where ζ is the unique positive root of g( x)=tanh ( β x)- x, and the cutoff window has order n/ δ.

Dynamic interaction between fetal adversity and a genetic score reflecting dopamine function on developmental outcomes at 36 months.

PubMed

Bischoff, Adrianne R; Pokhvisneva, Irina; Léger, Étienne; Gaudreau, Hélène; Steiner, Meir; Kennedy, James L; O'Donnell, Kieran J; Diorio, Josie; Meaney, Michael J; Silveira, Patrícia P

2017-01-01

Fetal adversity, evidenced by poor fetal growth for instance, is associated with increased risk for several diseases later in life. Classical cut-offs to characterize small (SGA) and large for gestational age (LGA) newborns are used to define long term vulnerability. We aimed at exploring the possible dynamism of different birth weight cut-offs in defining vulnerability in developmental outcomes (through the Bayley Scales of Infant and Toddler Development), using the example of a gene vs. fetal adversity interaction considering gene choices based on functional relevance to the studied outcome. 36-month-old children from an established prospective birth cohort (Maternal Adversity, Vulnerability, and Neurodevelopment) were classified according to birth weight ratio (BWR) (SGA ≤0.85, LGA >1.15, exploring a wide range of other cut-offs) and genotyped for polymorphisms associated with dopamine signaling (TaqIA-A1 allele, DRD2-141C Ins/Ins, DRD4 7-repeat, DAT1-10- repeat, Met/Met-COMT), composing a score based on the described function, in which hypofunctional variants received lower scores. There were 251 children (123 girls and 128 boys). Using the classic cut-offs (0.85 and 1.15), there were no statistically significant interactions between the neonatal groups and the dopamine genetic score. However, when changing the cut-offs, it is possible to see ranges of BWR that could be associated with vulnerability to poorer development according to the variation in the dopamine function. The classic birth weight cut-offs to define SGA and LGA newborns should be seen with caution, as depending on the outcome in question, the protocols for long-term follow up could be either too inclusive-therefore most costly, or unable to screen true vulnerabilities-and therefore ineffective to establish early interventions and primary prevention.

Longer biopsy cores do not increase prostate cancer detection rate: A large-scale cohort study refuting cut-off values indicated in the literature

PubMed Central

Yılmaz, Hasan; Yavuz, Ufuk; Üstüner, Murat; Çiftçi, Seyfettin; Yaşar, Hikmet; Müezzinoğlu, Bahar; Uslubaş, Ali Kemal; Dillioğlugil, Özdal

2017-01-01

Objective Only a few papers in the literature aimed to evaluate biopsy core lengths. Additionally, studies evaluated the core length with different approaches. We aimed to determine whether prostate cancer (PCa) detection is affected from core lengths according to three different approaches in a large standard cohort and compare our cut-off values with the published cut-offs. Material and methods We retrospectively analyzed 1,523 initial consecutive transrectal ultrasound-guided 12-core prostate biopsies. Biopsies were evaluated with respect to total core length (total length of each patients’ core) average core length (total core length divided by total number of cores in each patient), and mean core length (mean length of all cores pooled), and compared our cut-off values with the published cut-offs. The prostate volumes were categorized into four groups (<30, 30–59.99, 60–119.99, ≥120 cm3) and PCa detection rates in these categories were examined. Results PCa was found in 41.5% patients. There was no difference between benign and malignant mean core lengths of the pooled cores (p>0.05). Total core length and average core length were not significantly associated with PCa in multivariate logistic regression analyses (p>0.05). The core lengths (mean, average and total core lengths) increased (p<0.001) and PCa rates decreased (p<0.001) steadily with increasing prostate volume categories. PCa percentages decreased in all categories above the utilized cut-offs for mean (p>0.05), average (p<0.05), and total core lengths (p>0.05). Conclusion There was no difference between mean core lengths of benign and malignant cores. Total core length and average core length were not significantly associated with PCa. Contrary to the cut-offs used for mean and average core lengths in the published studies, PCa rates decrease as these core lengths increase. Larger studies are necessary for the determination and acceptance of accurate cut-offs. PMID:28861301

Comparative evaluation of H&H and WFNS grading scales with modified H&H (sans systemic disease): A study on 1000 patients with subarachnoid hemorrhage.

PubMed

Aggarwal, Ashish; Dhandapani, Sivashanmugam; Praneeth, Kokkula; Sodhi, Harsimrat Bir Singh; Pal, Sudhir Singh; Gaudihalli, Sachin; Khandelwal, N; Mukherjee, Kanchan K; Tewari, M K; Gupta, Sunil Kumar; Mathuriya, S N

2018-01-01

The comparative studies on grading in subarachnoid hemorrhage (SAH) had several limitations such as the unclear grading of Glasgow Coma Scale 15 with neurological deficits in World Federation of Neurosurgical Societies (WFNS), and the inclusion of systemic disease in Hunt and Hess (H&H) scales. Their differential incremental impacts and optimum cut-off values for unfavourable outcome are unsettled. This is a prospective comparison of prognostic impacts of grading schemes to address these issues. SAH patients were assessed using WFNS, H&H (including systemic disease), modified H&H (sans systemic disease) and followed up with Glasgow Outcome Score (GOS) at 3 months. Their performance characteristics were analysed as incremental ordinal variables and different grading scale dichotomies using rank-order correlation, sensitivity, specificity, positive predictive value, negative predictive value, Youden's J and multivariate analyses. A total of 1016 patients were studied. As univariate incremental variable, H&H sans systemic disease had the best negative rank-order correlation coefficient (-0.453) with respect to lower GOS (p < 0.001). As univariate dichotomized category, WFNS grades 3-5 had the best performance index of 0.39 to suggest unfavourable GOS with a specificity of 89% and sensitivity of 51%. In multivariate incremental analysis, H&H sans systemic disease had the greatest adjusted incremental impact of 0.72 (95% confidence interval (CI) 0.54-0.91) against a lower GOS as compared to 0.6 (95% CI 0.45-0.74) and 0.55 (95% CI 0.42-0.68) for H&H and WFNS grades, respectively. In multivariate categorical analysis, H&H grades 4-5 sans systemic disease had the greatest impact on unfavourable GOS with an adjusted odds ratio of 6.06 (95% CI 3.94-9.32). To conclude, H&H grading sans systemic disease had the greatest impact on unfavourable GOS. Though systemic disease is an important prognostic factor, it should be considered distinctly from grading. Appropriate cut-off values suggesting unfavourable outcome for H&H and WFNS were 4-5 and 3-5, respectively, indicating the importance of neurological deficits in addition to level of consciousness.

Intelligence test at preschool-age predicts reading difficulty among school-aged very low birth weight infants in Japan.

PubMed

Takeuchi, Akihito; Ogino, Tatsuya; Koeda, Tatsuya; Oka, Makio; Yorifuji, Takashi; Takayanagi, Toshimitsu; Sato, Kazuo; Sugino, Noriko; Bonno, Motoki; Nakamura, Makoto; Kageyama, Misao

2018-05-21

To elucidate whether the results of an intelligence test at preschool age are predictive of reading difficulty (RD) at school age among very low birth weight infants (VLBWI). Subjects were 48 Japanese children whose birth weight was <1500 g and who regularly visited a follow-up clinic. All subjects completed the Wechsler Intelligence Scale for Children-III (WISC-III) during the last grade of kindergarten, and four reading tasks during the second to fourth grade of elementary school. All participants had a full-scale intelligence quotient score of 85 or higher. Subjects with a standard deviation reading time score greater than 2.0 in two or more tasks were considered to have RD. We evaluated the associations between each WISC-III score and RD using logistic regression analyses. Furthermore, we performed receiver operating characteristic (ROC) analysis to determine a cutoff WISC-III score predictive of RD. In the mutually-adjusted model, the adjusted odds ratio per 1 score increase of freedom from distractibility (FD) was 0.832 (95% confidence interval: 0.720-0.962). In the ROC analysis, an FD score of <95.5 was chosen as the cutoff value for predicting RD (sensitivity, 0.77; specificity, 0.74). The present study indicated that a lower FD score at preschool age, which was associated with deficits in verbal working memory and attention, is a risk factor for RD at school age among Japanese VLBWI. Further investigation is desired to clarify the cognitive deficits underlying RD in Japanese-speaking preterm children, and to establish appropriate interventions for these children. Copyright © 2018 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Demographics and Personality Factors Associated with Burnout among Nurses in a Singapore Tertiary Hospital

PubMed Central

Dhaliwal, Satvinder S.; Ayre, Tracy Carol; Uthaman, Thendral; Fong, Kuan Yok; Tien, Choo Eng; Zhou, Huaqiong; Della, Phillip

2016-01-01

Background. The aim of the study was to evaluate the prevalence and extent of burnout among nurses in Singapore and investigate the influence of demographic factors and personal characteristics on the burnout syndrome. Methods. A cross-sectional survey design was adopted. All registered nurses working in Singapore General Hospital were approached to participate. A questionnaire eliciting data on demographics, burnout (measured using the Maslach Burnout Inventory, MBI), and personality profile (measured using the NEO Five-Factor Inventory, NEO-FFI) was used. Results. 1830 nurses out of 3588 responded (response rate: 51%). Results from 1826 respondents were available for analysis. The MBI identified 39% to have high emotional exhaustion (EE, cut-off score of >27), 40% having high depersonalization (DP, cut-off score of >10), and 59% having low personal accomplishment (PA, cut-off score of <33). In multivariable analysis, age, job grade, and neuroticism were significantly associated with each of the 3 components of the MBI. Staff nurses less than 30 years with high to very high neuroticism were more likely to experience high EE, high DP, and low PA. Conclusion. Younger nurses in Singapore are at increased risk of burnout. Personality traits also played a significant role in the experience of burnout. PMID:27478835

Mild pulmonary emphysema a risk factor for interstitial lung disease when using cetuximab for squamous cell carcinoma of the head and neck.

PubMed

Okamoto, Isaku; Tsukahara, Kiyoaki; Sato, Hiroki; Motohashi, Ray; Yunaiyama, Daisuke; Shimizu, Akira

2017-12-01

Interstitial lung disease (ILD) is an occasionally fatal adverse event associated with cetuximab (Cmab) therapy. Our objective was to clarify to what degree pulmonary emphysema is a risk factor in the treatment of head and neck cancer with Cmab through a retrospective analysis. Subjects were 116 patients who were administered Cmab for head and neck squamous cell carcinoma. The degree of pulmonary emphysema before initiating treatment with Cmab was visually assessed retrospectively, with scoring according to the Goddard classification used in Japanese chronic obstructive pulmonary disease (COPD) guidelines for chest computed tomography (CT). Scoring was conducted by two diagnostic radiologists and mean scores were used. Cutoffs for the development and nondevelopment of ILD were examined by receiver operating characteristic (ROC) analysis and Fisher's exact test. Values of p < .05 were considered to indicate a significant difference. Among the 116 patients, 11 (9.5%) developed ILD, and 105 (90.5%) did not. In ROC analysis, the optimal Goddard score cut-off of <3.0 offered 55% sensitivity and 81% specificity (p = .015). With a cutoff of <3.0, even very mild pulmonary emphysema would represent a risk factor for ILD when using Cmab.

Validity of the language development survey in infants born preterm.

PubMed

Beaulieu-Poulin, Camille; Simard, Marie-Noëlle; Babakissa, Hélène; Lefebvre, Francine; Luu, Thuy Mai

2016-07-01

Preterm infants are at greater risk of language delay. Early identification of language delay is essential to improve functional outcome in these children. To examine the concurrent validity of Rescorla's Language Development Survey and the Bayley Scales of Infant and Toddler Development (Bayley-III) at 18months corrected age in preterm infants. Test accuracy study. 189 preterm infants born <29weeks were assessed at 18months. The Language Development Survey, a parent-reported screening instrument, was administered in French concurrently with the Language Scales of the Bayley-III. Receiver-Operating-Characteristics curves were used to determine optimal cut-off score on the Language Development Survey to identify Bayley-III score <85. Sensitivity, specificity, positive and negative predictive values, and κ coefficient were calculated. Using Rescorla's original cut-off scores of ≤10 words for boys and ≤24 for girls, sensitivity was 76% and 88% for boys and girls, respectively, and specificity was 73% and 52% for boys and girls, respectively, in identifying language delay as per the Bayley-III. The optimal threshold was ≤10 words for both boys and girls. In girls, lowering the cut-off score decreased sensitivity (79%), but improved specificity (82%), thus lowering the number of false-positives. Our findings support using the Language Development Survey as an expressive language screener in preterm infants. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Accuracy of the 15-item Geriatric Depression Scale (GDS-15) in a community-dwelling oldest-old sample: the Pietà Study.

PubMed

Dias, Filipi Leles da Costa; Teixeira, Antônio Lúcio; Guimarães, Henrique Cerqueira; Barbosa, Maira Tonidandel; Resende, Elisa de Paula França; Beato, Rogério Gomes; Carmona, Karoline Carvalho; Caramelli, Paulo

2017-01-01

Late-life depression (LLD) is common, but remains underdiagnosed. Validated screening tools for use with the oldest-old in clinical practice are still lacking, particularly in developing countries. To evaluate the accuracy of a screening tool for LLD in a community-dwelling oldest-old sample. We evaluated 457 community-dwelling elderly subjects, aged ≥75 years and without dementia, with the Geriatric Depression Scale (GDS-15). Depression diagnosis was established according to DSM-IV criteria following a structured psychiatric interview with the Mini International Neuropsychiatric Interview (MINI). Fifty-two individuals (11.4%) were diagnosed with major depression. The area under the receiver operating characteristic (ROC) curve was 0.908 (p<0.001). Using a cut-off score of 5/6 (not depressed/depressed), 84 (18.4%) subjects were considered depressed by the GDS-15 (kappa coefficient = 53.8%, p<0.001). The 4/5 cut-off point achieved the best combination of sensitivity (86.5%) and specificity (82.7%) (Youden's index = 0.692), with robust negative (0.9802) and reasonable positive predictive values (0.3819). GDS-15 showed good accuracy as a screening tool for major depression in this community-based sample of low-educated oldest-old individuals. Our findings support the use of the 4/5 cut-off score, which showed the best diagnostic capacity.

Thermal cut-off response modelling of universal motors

NASA Astrophysics Data System (ADS)

Thangaveloo, Kashveen; Chin, Yung Shin

2017-04-01

This paper presents a model to predict the thermal cut-off (TCO) response behaviour in universal motors. The mathematical model includes the calculations of heat loss in the universal motor and the flow characteristics around the TCO component which together are the main parameters for TCO response prediction. In order to accurately predict the TCO component temperature, factors like the TCO component resistance, the effect of ambient, and the flow conditions through the motor are taken into account to improve the prediction accuracy of the model.

Determining an anthropometric surrogate measure for identifying low birth weight babies in Uganda: a hospital-based cross sectional study.

PubMed

Elizabeth, Nabiwemba L; Christopher, Orach Garimoi; Patrick, Kolsteren

2013-04-12

Achieving Millennium Development Goal 4 is dependent on significantly reducing neonatal mortality. Low birth weight is an underlying factor in most neonatal deaths. In developing countries the missed opportunity for providing life saving care is mainly a result of failure to identify low birth weight newborns. This study aimed at identifying a reliable anthropometric measurement for screening low birth weight and determining an operational cut-off point in the Uganda setting. This simple measurement is required because of lack of weighing scales in the community, and sometimes in the health facilities. This was a hospital-based cross-sectional study. Two midwives weighed 706 newborns and measured their foot length, head, chest, thigh and mid-upper arm circumferences within 24 hours after birth.Data was analysed using STATA version 10.0. Correlation with birth weight using Pearson's correlation coefficient and Receiver Operating Characteristics curve analysis were done to determine the measure that best predicts birth weight. Sensitivity and specificity were calculated for a range of measures to obtain operational cut-off points; and Likelihood Ratios and Diagnostic Odds Ratio were determined for each cut-off point. Birth weights ranged from 1370-5350 grams with a mean of 3050 grams (SD 0.53) and 85 (12%) babies weighed less than 2500 grams. All anthropometric measurements had a positive correlation with birth weight, with foot length showing the strongest (r = 0.76) and thigh circumference the weakest (r = 0.62) correlations. Foot length had the highest predictive value for low birth weight (AUC = 0.97) followed by mid-upper arm circumference (AUC = 0.94). Foot length and chest circumference had the highest sensitivity (94%) and specificity (90%) respectively for screening low birth weight babies at the selected cut-off points. Chest circumference had a significantly higher positive likelihood ratio (8.7) than any other measure, and foot length had the lowest negative likelihood ratio. Chest circumference and foot length had diagnostic odds ratios of 97% and 77% respectively. Foot length was easier to measure and it involved minimal exposure of the baby to cold. A cut-off of foot length 7.9 cm had sensitivity of 94% and specificity of 83% for predicting low birth weight. This study suggests foot length as the most appropriate predictor for low birth weight in comparison to chest, head, mid-upper arm and thigh circumference in the Uganda setting. Use of low cost and easy to use tools to identify low birth weight babies by village health teams could support community efforts to save newborns.

Properties of Nuclei up to A = 16 using Local Chiral Interactions

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

Lonardoni, Diego; Carlson, Joseph; Gandolfi, Stefano

Here, we report accurate quantum Monte Carlo calculations of nuclei up to A = 16 based on local chiral two- and three-nucleon interactions up to next-to-next-to-leading order. We examine the theoretical uncertainties associated with the chiral expansion and the cutoff in the theory, as well as the associated operator choices in the three-nucleon interactions. While in light nuclei the cutoff variation and systematic uncertainties are rather small, in 16O these can be significant for large coordinate-space cutoffs. Overall, we show that chiral interactions constructed to reproduce properties of very light systems and nucleon-nucleon scattering give an excellent description of bindingmore » energies, charge radii, and form factors for all these nuclei, including open-shell systems in A = 6 and 12.« less

Properties of Nuclei up to A = 16 using Local Chiral Interactions

DOE PAGES

Lonardoni, Diego; Carlson, Joseph; Gandolfi, Stefano; ...

2018-03-22

Here, we report accurate quantum Monte Carlo calculations of nuclei up to A = 16 based on local chiral two- and three-nucleon interactions up to next-to-next-to-leading order. We examine the theoretical uncertainties associated with the chiral expansion and the cutoff in the theory, as well as the associated operator choices in the three-nucleon interactions. While in light nuclei the cutoff variation and systematic uncertainties are rather small, in 16O these can be significant for large coordinate-space cutoffs. Overall, we show that chiral interactions constructed to reproduce properties of very light systems and nucleon-nucleon scattering give an excellent description of bindingmore » energies, charge radii, and form factors for all these nuclei, including open-shell systems in A = 6 and 12.« less

Wavelength and intensity dependence of recollision-enhanced multielectron effects in high-order harmonic generation

NASA Astrophysics Data System (ADS)

Abanador, Paul M.; Mauger, François; Lopata, Kenneth; Gaarde, Mette B.; Schafer, Kenneth J.

2018-04-01

Using a model molecular system (A2) with two active electrons restricted to one dimension, we examine high-order harmonic generation (HHG) enhanced by rescattering. Our results show that even at intensities well below the single ionization saturation, harmonics generated from the cation (A2+ ) can be significantly enhanced due to the rescattering of the electron that is initially ionized. This two-electron effect is manifested by the appearance of a secondary plateau and cutoff in the HHG spectrum, extending beyond the predicted cutoff in the single active electron approximation. We use our molecular model to investigate the wavelength dependence of rescattering enhanced HHG, which was first reported in a model atomic system [I. Tikhomirov, T. Sato, and K. L. Ishikawa, Phys. Rev. Lett. 118, 203202 (2017), 10.1103/PhysRevLett.118.203202]. We demonstrate that the HHG yield in the secondary cutoff is highly sensitive to the available electron rescattering energies as indicated by a dramatic scaling with respect to driving wavelength.

Theory of high-order harmonic generation for gapless graphene

NASA Astrophysics Data System (ADS)

Zurrón, Óscar; Picón, Antonio; Plaja, Luis

2018-05-01

We study the high-harmonic spectrum emitted by a single-layer graphene, irradiated by an ultrashort intense infrared laser pulse. We show the emergence of the typical non-perturbative spectral features, harmonic plateau and cut-off, for mid-infrared driving fields, at fluences below the damage threshold. In contrast to previous works, using THz drivings, we demonstrate that the harmonic cut-off frequency saturates with the intensity. Our results are derived from the numerical integration of the time-dependent Schrödinger equation using a nearest neighbor tight-binding description of graphene. We also develop a saddle-point analysis that reveals a mechanism for harmonic emission in graphene different from that reported in atoms, molecules and finite gap solids. In graphene, the first step is initiated by the non-diabatic crossing of the valence band electron trajectories through the Dirac points, instead of tunneling ionization/excitation. We include a complete identification of the trajectories contributing to any particular high harmonic and reproduce the harmonic cut-off scaling with the driving intensity.

Ballistic range experiments on superbooms generated by refraction

NASA Technical Reports Server (NTRS)

Sanai, M.; Toong, T.-Y.; Pierce, A. D.

1976-01-01

The enhanced sonic boom or supersonic boom generated as a result of atmospheric refraction in threshold Mach number flights was recreated in a ballistic range by firing projectiles at low supersonic speeds into a stratified medium obtained by slowly injecting carbon dioxide into air. The range was equipped with a fast-response dynamic pressure transducer and schlieren photographic equipment, and the sound speed variation with height was controlled by regulating the flow rate of the CO2. The schlieren observations of the resulting flow field indicate that the generated shocks are reflected near the sonic cutoff altitude where local sound speed equals body speed, provided such an altitude exists. Maximum shock strength occurs very nearly at the point where the incident and reflected shocks join, indicating that the presence of the reflected shock may have an appreciable effect on the magnitude of the focus factor. The largest focus factor detected was 1.7 and leads to an estimate that the constant in the Guiraud-Thery scaling law should have a value of 1.30.

Confirming, Validating, and Norming the Factor Structure of Systemic Therapy Inventory of Change Initial and Intersession.

PubMed

Pinsof, William M; Zinbarg, Richard E; Shimokawa, Kenichi; Latta, Tara A; Goldsmith, Jacob Z; Knobloch-Fedders, Lynne M; Chambers, Anthony L; Lebow, Jay L

2015-09-01

Progress or feedback research tracks and feeds back client progress data throughout the course of psychotherapy. In the effort to empirically ground psychotherapeutic practice, feedback research is both a complement and alternative to empirically supported manualized treatments. Evidence suggests that tracking and feeding back progress data with individual or nonsystemic feedback systems improves outcomes in individual and couple therapy. The research reported in this article pertains to the STIC(®) (Systemic Therapy Inventory of Change)-the first client-report feedback system designed to empirically assess and track change within client systems from multisystemic and multidimensional perspectives in individual, couple, and family therapy. Clients complete the STIC Initial before the first session and the shorter STIC Intersession before every subsequent session. This study tested and its results supported the hypothesized factor structure of the six scales that comprise both STIC forms in a clinical outpatient sample and in a normal, random representative sample of the U.S. This study also tested the STIC's concurrent validity and found that its 6 scales and 40 of its 41 subscales differentiated the clinical and normal samples. Lastly, the study derived clinical cut-offs for each scale and subscale to determine whether and how much a client's score falls in the normal or clinical range. Beyond supporting the factorial and concurrent validity of both STIC forms, this research supported the reliabilities of the six scales (Omegahierarchical ) as well as the reliabilities of most subscales (alpha and rate-rerate). This article delineates clinical implications and directions for future research. © 2015 Family Process Institute.

A longitudinal study investigating how stroke severity, disability, and physical function the first week post-stroke are associated with walking speed six months post-stroke.

PubMed

Aaslund, Mona Kristin; Moe-Nilssen, Rolf; Gjelsvik, Bente Bassøe; Bogen, Bård; Næss, Halvor; Hofstad, Håkon; Skouen, Jan Sture

2017-12-01

To investigate to which degree stroke severity, disability, and physical function the first week post-stroke are associated with preferred walking speed (PWS) at 6 months. Longitudinal observational study. Participants were recruited from a stroke unit and tested within the first week (baseline) and at 6 months post-stroke. Outcome measures were the National Institutes of Health Stroke Scale (NIHSS), the Barthel Index (BI), modified Rankin Scale (mRS), PWS, Postural Assessment Scale for Stroke (PASS), and the Trunk Impairment Scale modified-Norwegian version. Multiple regression models were used to explore which variables best predict PWS at 6 months, and the Receiver Operating Characteristics (ROC) curves to determine the cutoffs. A total of 132 participants post-stroke were included and subdivided into two groups based on the ability to produce PWS at baseline. For the participants that could produce PWS at baseline (WSB group), PASS, PWS, and age at baseline predicted PWS at 6 months with an explained variance of 0.77. For the participants that could not produce a PWS at baseline (NoWSB group), only PASS predicted PWS at 6 months with an explained variance of 0.49. For the Walking speed at baseline (WSB) group, cutoffs at baseline for walking faster than 0.8 m/s at 6 months were 30.5 points on the PASS, PWS 0.75 m/s, and age 73.5 years. For the NoWSB group, the cutoff for PASS was 20.5 points. PASS, PWS, and age the first week predicted PWS at 6 months post-stroke for participants with the best walking ability, and PASS alone predicted PWS at 6 months post-stroke for participants with the poorest walking ability.

Postpartum depression and its psychosocial correlates: A longitudinal study among a group of women in Turkey.

PubMed

Bolak Boratav, Hale; Toker, Özlem; Küey, Levent

2016-07-01

The postpartum period is a window of risk for psychological disturbances and particularly for depressive symptoms. This study explored the relationships between postpartum depression and prepartum depressive symptoms, marital adjustment, support from family, previous depressive symptomology, and pregnancy planning. A total of 128 women who were receiving prenatal care at a state hospital in Istanbul, Turkey, and who were in the last trimester of their pregnancy participated in the first phase of the study. Of these, eighty-seven women also participated in the second phase, during the 3-6 month postpartum period. The results indicated that depressed mood in the last trimester of pregnancy, family support, care and support from spouse, previous depression history, and unplanned pregnancy were significant risk factors for postpartum depressive symptoms; significant differences were found for study variables as a function of women's scores on the Edinburgh Postnatal Depression Scale in pregnancy and in the postpartum period. The recommendation is made to use screening tools, like the Edinburgh Postnatal Depression Scale, in the course of routine prenatal care, and to refer women with Edinburgh Postnatal Depression Scale scores above the cutoff score for further clinical examination.

Hubble Space Telescope Hx Imaging of Star-forming Galaxies at z approximately equal to 1-1.5: Evolution in the Size and Luminosity of Giant H II Regions

NASA Technical Reports Server (NTRS)

Livermore, R. C.; Jones, T.; Richard, J.; Bower, R. G.; Ellis, R. S.; Swinbank, A. M.; Rigby, J. R.; Smail, Ian; Arribas, S.; Rodriguez-Zaurin, J.;

Norwegian version of the rating anxiety in dementia scale (RAID-N): a validity and reliability study.

PubMed

Goyal, Alka R; Bergh, Sverre; Engedal, Knut; Kirkevold, Marit; Kirkevold, Øyvind

2017-12-01

Dementia-specific anxiety scales in the Norwegian language are lacking; the aim of this study was to investigate the validity and inter-rater reliability of a Norwegian version of the Rating Anxiety in Dementia (RAID-N) scale. The validity of the RAID-N was tested in a sample of 101 patients with dementia from seven Norwegian nursing homes. One psychogeriatrician (n = 50) or a physician with long experience with nursing home patients (n = 51) 'blind' to the RAID-N score diagnosed anxiety according to DSM-5 criteria of generalised anxiety disorder (GAD). A receiver operating characteristic (ROC) analysis assessed the best cut-off point for the RAID-N, and the area under the curve (AUC) was calculated. Inter-rater reliability was tested in a subgroup of 53 patients by intraclass correlation (ICC) and Cohen's kappa. Twenty-eight of 101 (27.7%) met the GAD criteria. The mean RAID-N score for patients with GAD was 16.1 (SD 6.3) and without GAD, 8.8 (SD 6.5) (p < 0.001). A cut-off score of ≥12 on the RAID-N gave a sensitivity of 82.1%, specificity of 70.0%, and 73.3% accuracy in identifying clinically significant GAD in patients with dementia. Inter-rater reliability on overall RAID-N items was good (ICC = 0.82), Cohen's kappa was 0.58 for total RAID-N score, with satisfactory internal consistency (Cronbach's alpha = 0.81). The RAID-N has fairly good validity and inter-rater reliability, and could be useful to assess GAD in patients with dementia. Further studies should investigate the optimal RAID-N cut-off score in different settings.

Spanish version of the Mattis Dementia Rating Scale-2 for early detection of Alzheimer's disease and mild cognitive impairment.

PubMed

Boycheva, Elina; Contador, Israel; Fernández-Calvo, Bernardino; Ramos-Campos, Francisco; Puertas-Martín, Verónica; Villarejo-Galende, Alberto; Bermejo-Pareja, Félix

2018-06-01

We aimed to analyse the clinical utility of the Mattis Dementia Rating Scale (MDRS-2) for early detection of Alzheimer's disease (AD) and amnestic mild cognitive impairment (MCI) in a sample of Spanish older adults. A total of 125 participants (age = 75.12 ± 6.83, years of education =7.08 ± 3.57) were classified in three diagnostic groups: 45 patients with mild AD, 37 with amnestic MCI-single and multiple domain and 43 cognitively healthy controls (HCs). Reliability, criterion validity and diagnostic accuracy of the MDRS-2 (total and subscales) were analysed. The MDRS-2 scores, adjusted by socio-demographic characteristics, were calculated through hierarchical multiple regression analysis. The global scale had adequate reliability (α = 0.736) and good criterion validity (r = 0.760, p < .001) with the Mini-Mental State Examination. The optimal cut-off point between AD patients and HCs was 124 (sensitivity [Se] = 97% and specificity [Sp] = 95%), whereas 131 (Se = 89%, Sp = 81%) was the optimal cut-off point between MCI and HCs. An optimal cut-off point of 123 had good Se (0.97), but poor Sp (0.56) to differentiate AD and MCI groups. The Memory and Initiation/Perseveration subscales had the highest discriminative capacity between the groups. The MDRS-2 is a reliable and valid instrument for the assessment of cognitive impairment in Spanish older adults. In particular, optimal capacity emerged for the detection of early AD and MCI. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Abrupt skin lesion border cutoff measurement for malignancy detection in dermoscopy images.

PubMed

Kaya, Sertan; Bayraktar, Mustafa; Kockara, Sinan; Mete, Mutlu; Halic, Tansel; Field, Halle E; Wong, Henry K

2016-10-06

Automated skin lesion border examination and analysis techniques have become an important field of research for distinguishing malignant pigmented lesions from benign lesions. An abrupt pigment pattern cutoff at the periphery of a skin lesion is one of the most important dermoscopic features for detection of neoplastic behavior. In current clinical setting, the lesion is divided into a virtual pie with eight sections. Each section is examined by a dermatologist for abrupt cutoff and scored accordingly, which can be tedious and subjective. This study introduces a novel approach to objectively quantify abruptness of pigment patterns along the lesion periphery. In the proposed approach, first, the skin lesion border is detected by the density based lesion border detection method. Second, the detected border is gradually scaled through vector operations. Then, along gradually scaled borders, pigment pattern homogeneities are calculated at different scales. Through this process, statistical texture features are extracted. Moreover, different color spaces are examined for the efficacy of texture analysis. The proposed method has been tested and validated on 100 (31 melanoma, 69 benign) dermoscopy images. Analyzed results indicate that proposed method is efficient on malignancy detection. More specifically, we obtained specificity of 0.96 and sensitivity of 0.86 for malignancy detection in a certain color space. The F-measure, harmonic mean of recall and precision, of the framework is reported as 0.87. The use of texture homogeneity along the periphery of the lesion border is an effective method to detect malignancy of the skin lesion in dermoscopy images. Among different color spaces tested, RGB color space's blue color channel is the most informative color channel to detect malignancy for skin lesions. That is followed by YCbCr color spaces Cr channel, and Cr is closely followed by the green color channel of RGB color space.

A Delphi study on environmental factors that impact work and social life participation of individuals with multiple sclerosis in Austria and Switzerland.

PubMed

Prodinger, Birgit; Weise, Andrea P; Shaw, Lynn; Stamm, Tanja A

2010-01-01

This study aimed to gain knowledge about environmental factors (EFs) that impact work and social life participation of people with multiple sclerosis (MS) in Austria and Switzerland to extend the knowledge of participation and to identify key areas for measuring participation. A three-round Delphi study was conducted defining patients as experts. In the 1st round, qualitative data was gathered through questionnaires, analyzed with content analysis, and factors were assigned to EFs as classified in the ICF. In the 2nd and 3rd round, experts judged EFs according to its relevance to obtain consensus (cut-off 75%). Categories were ranked on a scale from mostly important to important. One hundred and twelve Austrian and 109 Swiss experts were recruited. The content analysis revealed 768 EFs. The study resulted in a list of 176 consensus factors for Austria and 177 Switzerland. Five categories revealed to be highly important, 12 moderately important, 6 fairly important, and 10 important. This study indicates that participation in work or social life is influenced by physical, social, attitudinal, and policy factors. Consensus factors afford insights into areas for consideration in the development of participation outcome measurements and support a comprehensive and inclusive rehabilitation approach.

Changes in the incidence and etiology of congenital hypothyroidism detected during 30 years of a screening program in central Serbia.

PubMed

Mitrovic, Katarina; Vukovic, Rade; Milenkovic, Tatjana; Todorovic, Sladjana; Radivojcevic, Jovana; Zdravkovic, Dragan

2016-02-01

Congenital hypothyroidism (CH) is the most frequent congenital endocrine disorder. The purpose of the present study was to determine the incidence of CH in Central Serbia from 1983 to 2013. Newborn screening for CH was based on measuring neonatal thyroid-stimulating hormone (TSH) using a 30 mU/l cutoff (CO) until 12/1987 (P1), 15 mU/l until 12/1997 (P2), 10 mU/l until 12/2006 (P3), and 9 mU/l thereafter (P4). During the study period, there were 1,547,122 live births screened for CH. Primary CH was detected in 434 newborns, with incidence of 1:3728. With gradual lowering of the CO, the incidences of CH increased from 1:5943 in P1 to 1:1872 in P4 (p < 0.001). Incidence of CH with ectopic and enlarged gland doubled (p < 0.001), while prevalence of athyreosis remained relatively constant. The most prominent finding was the increase in the transient CH from none in P1 to 35 % of all CH patients in P4. The overall incidence of CH in Central Serbia during study period nearly tripled, with a significant increase in almost all etiological categories, and was associated with lowering TSH cutoffs as well as other yet unidentified factors. Further studies are needed to identify other factors associated with increasing incidence of CH. Congenital hypothyroidism (CH) is the main cause of preventable mental retardation. Recent reports have indicated a progressive increase in the incidence of primary CH throughout the world, partially explained by lowering of the TSH cutoff values. During the study period associated with lowering of the TSH cutoffs, the overall incidence of CH in Serbia tripled, including transient CH, ectopy, and dyshormonogenesis, while prevalence of athyreosis remained stable during 30 years. Significant increase in the incidence of both permanent and transient CH was observed, associated with lowering of TSH cutoffs as well as other yet unidentified factors.

Assessing cutoff values for increased exercise blood pressure to predict incident hypertension in a general population.

PubMed

Lorbeer, Roberto; Ittermann, Till; Völzke, Henry; Gläser, Sven; Ewert, Ralf; Felix, Stephan B; Dörr, Marcus

2015-07-01

Cutoff values for increased exercise blood pressure (BP) are not established in hypertension guidelines. The aim of the study was to assess optimal cutoff values for increased exercise BP to predict incident hypertension. Data of 661 normotensive participants (386 women) aged 25-77 years from the Study of Health in Pomerania (SHIP-1) with a 5-year follow-up were used. Exercise BP was measured at a submaximal level of 100 W and at maximum level of a symptom-limited cycle ergometry test. Cutoff values for increased exercise BP were defined at the maximum sum of sensitivity and specificity for the prediction of incident hypertension. The area under the receiver-operating characteristic curve (AUC) and net reclassification index (NRI) were calculated to investigate whether increased exercise BP adds predictive value for incident hypertension beyond established cardiovascular risk factors. In men, values of 160  mmHg (100  W level; AUC = 0.7837; NRI = 0.534, P < 0.001) and 210  mmHg (maximum level; AUC = 0.7677; NRI = 0.340, P = 0.003) were detected as optimal cutoff values for the definition of increased exercise SBP. A value of 190  mmHg (AUC = 0.8347; NRI = 0.519, P < 0.001) showed relevance for the definition of increased exercise SBP in women at the maximum level. According to our analyses, 190 and 210  mmHg are clinically relevant cutoff values for increased exercise SBP at the maximum exercise level of cycle ergometry test for women and men, respectively. In addition, for men, our analyses provided a cutoff value of 160  mmHg for increased exercise SBP at the 100  W level.

Waist-to-height: cutoff matters in predicting metabolic syndrome in Mexican children.

PubMed

Elizondo-Montemayor, Leticia; Serrano-González, Mónica; Ugalde-Casas, Patricia A; Bustamante-Careaga, Humberto; Cuello-García, Carlos

2011-06-01

Body-mass index (BMI), waist circumference (WC), and, recently, waist-to-height ratio (WHtR) have been proposed as clinical indexes to identify children at cardiometabolic risk. The aim was to identify the usefulness of WHtR cutoffs, WC, and BMI as predictors of metabolic syndrome in Mexican children, according to BMI z-scores, and the severity of obesity to cardiometabolic risk factors and metabolic syndrome. This was a cross-sectional study of 214 overweight/obese and 47 normal-weight Mexican children 6-12 years old. Children were divided in groups according to BMI z-scores. Anthropometric and biochemical measurements were determined. Receiver-operating characteristic (ROC) curves and areas under the curves were calculated to compare the abilities of the anthropometric measurements to predict metabolic syndrome. The overall prevalence of metabolic syndrome was 23.3%, ranging from 11.0% in the overweight group to 73.9% in the severely obese one. Children with metabolic syndrome had significantly higher WHtR, WC, BMI, percentage of body fat, triglycerides, total cholesterol, low-density lipoprotein cholesterol (LDL-C), systolic and diastolic blood pressure, and lower high-density lipoprotein cholesterol (HDL-C). A WHtR cutoff point of 0.59 from the ROC curve was identified as strong predictor of metabolic syndrome in our population, whereas a cutoff of 0.5 showed very poor specificity (22.7%). WC predicted metabolic syndrome as well. Cutoff values for WHtR make a difference in predicting metabolic syndrome. A cutoff of 0.59 for WHtR strongly predicted metabolic syndrome; it might be a simpler to use screening tools and counters for short people. Further studies are required to determine the cutoff points for an accurate prediction, because there are few in children and none in Mexico.

Predictive accuracy of risk scales following self-harm: multicentre, prospective cohort study†

PubMed Central

Quinlivan, Leah; Cooper, Jayne; Meehan, Declan; Longson, Damien; Potokar, John; Hulme, Tom; Marsden, Jennifer; Brand, Fiona; Lange, Kezia; Riseborough, Elena; Page, Lisa; Metcalfe, Chris; Davies, Linda; O'Connor, Rory; Hawton, Keith; Gunnell, David; Kapur, Nav

2017-01-01

Background Scales are widely used in psychiatric assessments following self-harm. Robust evidence for their diagnostic use is lacking. Aims To evaluate the performance of risk scales (Manchester Self-Harm Rule, ReACT Self-Harm Rule, SAD PERSONS scale, Modified SAD PERSONS scale, Barratt Impulsiveness Scale); and patient and clinician estimates of risk in identifying patients who repeat self-harm within 6 months. Method A multisite prospective cohort study was conducted of adults aged 18 years and over referred to liaison psychiatry services following self-harm. Scale a priori cut-offs were evaluated using diagnostic accuracy statistics. The area under the curve (AUC) was used to determine optimal cut-offs and compare global accuracy. Results In total, 483 episodes of self-harm were included in the study. The episode-based 6-month repetition rate was 30% (n = 145). Sensitivity ranged from 1% (95% CI 0–5) for the SAD PERSONS scale, to 97% (95% CI 93–99) for the Manchester Self-Harm Rule. Positive predictive values ranged from 13% (95% CI 2–47) for the Modified SAD PERSONS Scale to 47% (95% CI 41–53) for the clinician assessment of risk. The AUC ranged from 0.55 (95% CI 0.50–0.61) for the SAD PERSONS scale to 0.74 (95% CI 0.69–0.79) for the clinician global scale. The remaining scales performed significantly worse than clinician and patient estimates of risk (P<0.001). Conclusions Risk scales following self-harm have limited clinical utility and may waste valuable resources. Most scales performed no better than clinician or patient ratings of risk. Some performed considerably worse. Positive predictive values were modest. In line with national guidelines, risk scales should not be used to determine patient management or predict self-harm. PMID:28302702

Predictive accuracy of risk scales following self-harm: multicentre, prospective cohort study.

PubMed

Quinlivan, Leah; Cooper, Jayne; Meehan, Declan; Longson, Damien; Potokar, John; Hulme, Tom; Marsden, Jennifer; Brand, Fiona; Lange, Kezia; Riseborough, Elena; Page, Lisa; Metcalfe, Chris; Davies, Linda; O'Connor, Rory; Hawton, Keith; Gunnell, David; Kapur, Nav

2017-06-01

Background Scales are widely used in psychiatric assessments following self-harm. Robust evidence for their diagnostic use is lacking. Aims To evaluate the performance of risk scales (Manchester Self-Harm Rule, ReACT Self-Harm Rule, SAD PERSONS scale, Modified SAD PERSONS scale, Barratt Impulsiveness Scale); and patient and clinician estimates of risk in identifying patients who repeat self-harm within 6 months. Method A multisite prospective cohort study was conducted of adults aged 18 years and over referred to liaison psychiatry services following self-harm. Scale a priori cut-offs were evaluated using diagnostic accuracy statistics. The area under the curve (AUC) was used to determine optimal cut-offs and compare global accuracy. Results In total, 483 episodes of self-harm were included in the study. The episode-based 6-month repetition rate was 30% ( n = 145). Sensitivity ranged from 1% (95% CI 0-5) for the SAD PERSONS scale, to 97% (95% CI 93-99) for the Manchester Self-Harm Rule. Positive predictive values ranged from 13% (95% CI 2-47) for the Modified SAD PERSONS Scale to 47% (95% CI 41-53) for the clinician assessment of risk. The AUC ranged from 0.55 (95% CI 0.50-0.61) for the SAD PERSONS scale to 0.74 (95% CI 0.69-0.79) for the clinician global scale. The remaining scales performed significantly worse than clinician and patient estimates of risk ( P <0.001). Conclusions Risk scales following self-harm have limited clinical utility and may waste valuable resources. Most scales performed no better than clinician or patient ratings of risk. Some performed considerably worse. Positive predictive values were modest. In line with national guidelines, risk scales should not be used to determine patient management or predict self-harm. © The Royal College of Psychiatrists 2017.

A geomorphic explanation for a meander cutoff following channel relocation of a coarse-bedded river.

PubMed

Thompson, Douglas M

2003-03-01

The Veteran's Fishing section of the Blackledge River in central Connecticut was relocated in the late 1950s. The relocation resulted in an unstable channel despite extensive efforts to prevent erosion. Overbank erosion and meander cutoffs were investigated using detailed survey data, characterizations of sediment deposits, flow modeling, and a moment-stability analysis. Limited reworking of revetment boulders indicate that riprap bank material was immobile during a 1979 flood event responsible for the formation of the cutoff channel. A moment-stability analysis factor-of-safety value of 1.1 supports the conclusion that riprap was not directly eroded from the banks. Alluvial particles with d(95) values ranging up to 120 mm were deposited along a bar downstream from the cutoff channel at flows estimated to be below a 1.5-year recurrence interval flow. Development of the bar deposit resulted in locally elevated water surfaces at high flow. The resulting overbank flow across the meander neck to the adjacent downstream bend led to the creation of an upstream migrating knickpoint, the erosion of approximately 16,000-year-old sediments, and the subsequent meander cutoff. The results of the study indicate that traditional erosion-control measures cannot prevent extreme channel adjustments if the geomorphic processes that control sediment continuity also are not considered.

Optimal cutoff of the triglyceride to high-density lipoprotein cholesterol  ratio to detect cardiovascular risk factors among Han adults in Xinjiang.

PubMed

Li, Hua-Yin; Chen, Bang-Dang; Ma, Yi-Tong; Yang, Yi-Ning; Ma, Xiang; Liu, Fen; Fu, Zhen-Yan; Xie, Xiang; Li, Xiao-Mei; Pan, Shuo; He, Chun-Hui; Zheng, Ying-Ying; Wu, Yun; Tao, Jing; Dong, Chun-Lan; Wu, Ting-Ting

2016-09-01

To determine whether TG/HDL-C ratio, which has been shown to be an indicator of the metabolic syndrome (MetS) and insulin resistance (IR), can predict cardiovascular risk factors in the Chinese Han population in Xinjiang. The cardiovascular risk survey (CRS) was conducted from October 2007 to March 2010. A total of 14,618 representative participants were selected using a four-stage stratified sampling method. A total of 5757 Han participants were included in the study. The present statistical analysis was restricted to the 5595 Han subjects who had complete anthropometric data. The sensitivity, specificity, and distance on the receiver operating characteristic (ROC) curve in each TG/HDL level were calculated. The shortest distance in the ROC curves was used to determine the optimal cutoff of the TG/HDL-C ratio for detecting cardiovascular risk factors. The prevalence of hypertension, hypercholesterolemia, and hypertriglyceridemia was higher with higher TG/HDL-C ratio for both men and women. The TG/HDL-C ratio was positively associated with systolic blood pressure, diastolic blood pressure, and serum concentrations of total cholesterol. The optimal TG/HDL-C ratio cutoffs for predicting hypertension, dyslipidemia, diabetes, and ≥2 of these risk factors for Han adults in Xinjiang were 1.3, 1.3, 1.4, and 1.4 in men and 0.9, 1.0, 1.0, and 1.1 in women, respectively. The evaluation of TG/HDL-C ratio should be considered for one of cardiovascular risk factor predictors among Han adults in Xinjiang.

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

PubMed Central

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

2017-01-01

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

Initial mass function of planetesimals formed by the streaming instability

NASA Astrophysics Data System (ADS)

Schäfer, Urs; Yang, Chao-Chin; Johansen, Anders

2017-01-01

The streaming instability is a mechanism to concentrate solid particles into overdense filaments that undergo gravitational collapse and form planetesimals. However, it remains unclear how the initial mass function of these planetesimals depends on the box dimensions of numerical simulations. To resolve this, we perform simulations of planetesimal formation with the largest box dimensions to date, allowing planetesimals to form simultaneously in multiple filaments that can only emerge within such large simulation boxes. In our simulations, planetesimals with sizes between 80 km and several hundred kilometers form. We find that a power law with a rather shallow exponential cutoff at the high-mass end represents the cumulative birth mass function better than an integrated power law. The steepness of the exponential cutoff is largely independent of box dimensions and resolution, while the exponent of the power law is not constrained at the resolutions we employ. Moreover, we find that the characteristic mass scale of the exponential cutoff correlates with the mass budget in each filament. Together with previous studies of high-resolution simulations with small box domains, our results therefore imply that the cumulative birth mass function of planetesimals is consistent with an exponentially tapered power law with a power-law exponent of approximately -1.6 and a steepness of the exponential cutoff in the range of 0.3-0.4.

Adaptation of the Nomophobia Questionnaire (NMP-Q) to Spanish in a sample of adolescents.

PubMed

González-Cabrera, Joaquín; León-Mejía, Ana; Pérez-Sancho, Carlota; Calvete, Esther

2017-07-01

Nomophobia is the fear of being out of mobile phone contact. People suffering from this anxiety disorder have feelings of stress and nervousness when access to their mobiles or computers is not possible. This work is an adaptation and validation study of the Spanish version of the Nomophobia Questionnaire (NMP-Q). The study included 306 students (46.1% males and 53.9% females) with ages ranging 13 to 19 years (Md=15.41±1.22). Exploratory factor analysis revealed four dimensions that accounted for 64.4% of total variance. The ordinal α-value was 0.95, ranging from 0.75 to 0.92 across factors. Measure of stability was calculated by the testretest method (r=0.823). Indicators of convergence with the Spanish versions of the “Mobile Phone Problem Use Scale” (r=0.654) and the “Generalized Problematic Internet Use Scale” (r=0.531) were identified. Problematic mobile phone use patterns were examined taking the 15P, 80P and 95P percentiles as cut-off points. Scores of 39, 87 and 116 on NMP-Q corresponded to occasional, at-risk and problematic users, respectively. Psychometric analysis shows that the Spanish version of the NMP-Q is a valid and reliable tool for the study of nomophobia.

Fermi rules out the IC/CMB model for the Large-Scale Jet X-ray emission of 3C 273

NASA Astrophysics Data System (ADS)

Georganopoulos, Markos; Meyer, E. T.

2014-01-01

The process responsible for the Chandra-detected X-ray emission from the large-scale jets of powerful quasars is not clear yet. The two main models are inverse Compton scattering off the cosmic microwave background (IC/CMB) photons and synchrotron emission from a population of electrons separate from those producing the radio-IR emission. These two models imply radically different conditions in the large scale jet in terms of jet speed and maximum energy of the particle acceleration mechanism, with important implications for the impact of the jet on the larger-scale environment. Georganopoulos et al. (2006) proposed a diagnostic based on a fundamental difference between these two models: the production of synchrotron X-rays requires multi-TeV electrons, while the EC/CMB model requires a cutoff in the electron energy distribution below TeV energies. This has significant implications for the gamma-ray emission predicted by these two models. Here we present new Fermi observations that put an upper limit on the gamma-ray flux from the large-scale jet of 3C 273 that clearly violates the flux expected from the IC/CMB X-ray interpretation found by extrapolation of the UV to X-ray spectrum of knot A, thus ruling out the IC/CMB interpretation entirely for this source. Further, the Fermi upper limit constraints the Doppler beaming factor delta <5.

Assessing Bodily Preoccupations is sufficient: clinically effective screening for hypochondriasis.

PubMed

Höfling, Volkmar; Weck, Florian

2013-12-01

Hypochondriasis is a persistent psychiatric disorder and is associated with increased utilisation of health care services. However, effective psychiatric consultation interventions and CBT treatments are available. In the present study, we provide evidence of clinically effective screening for hypochondriasis. We describe the clinically effective identification of patients with a high probability of suffering from hypochondriasis. This identification is achieved by means of two brief standardised screening instruments, namely the Bodily Preoccupation (BP) Scale with 3 items and the Whiteley-7 (WI-7) with 7 items. Both the BP scale and the WI-7 were examined in a sample of 228 participants (72 with hypochondriasis, 80 with anxiety disorders and 76 healthy controls) in a large psychotherapy outpatients' unit, applying the DSM-IV criteria. Cut-off values for the BP scale and the WI-7 were computed to identify patients with a high probability of suffering from hypochondriasis. Additionally, other self-report symptom severity scales were completed in order to examine discriminant and convergent validity. Data was collected from June 2010 to March 2013. The BP scale and the WI-7 discriminated significantly between patients with hypochondriasis and those with an anxiety disorder (d=2.42 and d=2.34). Cut-off values for these two screening scales could be provided, thus identifying patients with a high probability of suffering from hypochondriasis. In order to reduce costs, the BP scale or the WI-7 should be applied in medical or primary care settings, to screen for patients with a high probability of hypochondriasis and to transfer them to further assessment and effective treatment. © 2013.

Physics implications of the diphoton excess from the perspective of renormalization group flow

DOE PAGES

Gu, Jiayin; Liu, Zhen

2016-04-06

A very plausible explanation for the recently observed diphoton excess at the 13 TeV LHC is a (pseudo)scalar with mass around 750 GeV, which couples to a gluon pair and to a photon pair through loops involving vector-like quarks (VLQs). To accommodate the observed rate, the required Yukawa couplings tend to be large. A large Yukawa coupling would rapidly run up with the scale and quickly reach the perturbativity bound, indicating that new physics, possibly with a strong dynamics origin, is near by. The case becomes stronger especially if the ATLAS observation of a large width persists. In this papermore » we study the implication on the scale of new physics from the 750 GeV diphoton excess using the method of renormalization group running with careful treatment of different contributions and perturbativity criterion. Our results suggest that the scale of new physics is generically not much larger than the TeV scale, in particular if the width of the hinted (pseudo)scalar is large. Introducing multiple copies of VLQs, lowing the VLQ masses and enlarging VLQ electric charges help reduce the required Yukawa couplings and can push the cutoff scale to higher values. Nevertheless, if the width of the 750 GeV resonance turns out to be larger than about 1 GeV, it is very hard to increase the cutoff scale beyond a few TeVs. This is a strong hint that new particles in addition to the 750 GeV resonance and the vector-like quarks should be around the TeV scale.« less

Comparison between European and Iranian cutoff points of triglyceride/high-density lipoprotein cholesterol concentrations in predicting cardiovascular disease outcomes.

PubMed

Gharipour, Mojgan; Sadeghi, Masoumeh; Dianatkhah, Minoo; Nezafati, Pouya; Talaie, Mohammad; Oveisgharan, Shahram; Golshahi, Jafar

2016-01-01

High triglyceride (TG) and low high-density lipoprotein cholesterol (HDL-C) are important cardiovascular risk factors. The exact prognostic value of the TG/HDL-C ratio, a marker for cardiovascular events, is currently unknown among Iranians so this study sought to determine the optimal cutoff point for the TG/HDL-C ratio in predicting cardiovascular disease events in the Iranian population. The Isfahan Cohort Study (ICS) is an ongoing, longitudinal, population-based study that was originally conducted on adults aged ≥ 35 years, living in urban and rural areas of three districts in central Iran. After 10 years of follow-up, 5431 participants were re-evaluated using a standard protocol similar to the one used for baseline. At both measurements, participants underwent medical interviews, physical examinations, and fasting blood measurements. "High-risk" subjects were defined by the discrimination power of indices, which were assessed using receiver operating characteristic (ROC) analysis; the optimal cutoff point value for each index was then derived. The mean age of the participants was 50.7 ± 11.6 years. The TG/HDL-C ratio, at a threshold of 3.68, was used to screen for cardiovascular events among the study population. Subjects were divided into two groups ("low" and "high" risk) according to the TG/HDL-C concentration ratio at baseline. A slightly higher number of high-risk individuals were identified using the European cutoff points of 63.7% in comparison with the ICS cutoff points of 49.5%. The unadjusted hazard ratio (HR) was greatest in high-risk individuals identified by the ICS cutoff points (HR = 1.54, 95% CI [1.33-1.79]) vs European cutoff points (HR = 1.38, 95% [1.17-1.63]). There were no remarkable changes after adjusting for differences in sex and age (HR = 1.58, 95% CI [1.36-1.84] vs HR = 1.44, 95% CI [1.22-1.71]) for the ICS and European cutoff points, respectively. The threshold of TG/HDL ≥ 3.68 is the optimal cutoff point for predicting cardiovascular events in Iranian individuals. Copyright © 2016 National Lipid Association. Published by Elsevier Inc. All rights reserved.

Model selection and constraints from holographic dark energy scenarios

NASA Astrophysics Data System (ADS)

Akhlaghi, I. A.; Malekjani, M.; Basilakos, S.; Haghi, H.

2018-07-01

In this study, we combine the expansion and the growth data in order to investigate the ability of the three most popular holographic dark energy models, namely event future horizon, Ricci scale, and Granda-Oliveros IR cutoffs, to fit the data. Using a standard χ2 minimization method, we place tight constraints on the free parameters of the models. Based on the values of the Akaike and Bayesian information criteria, we find that two out of three holographic dark energy models are disfavoured by the data, because they predict a non-negligible amount of fractional dark energy density at early enough times. Although the growth rate data are relatively consistent with the holographic dark energy models which are based on Ricci scale and Granda-Oliveros IR cutoffs, the combined analysis provides strong indications against these models. Finally, we find that the model for which the holographic dark energy is related with the future horizon is consistent with the combined observational data.

Early language screening in city and Hackney: the concurrent validity of a measure designed for use with 2 1/2-year-olds.

PubMed

Law, J

1994-01-01

This paper reports data relating to the development of a screening test for language impairment in 2 1/2-year-old children. The screening test itself has previously been described. The results of a pilot study and a larger community study are reported. In all, 34 children were included in the pilot study and 1015 in the community study. The reference test selected was the Reynell Developmental Language Scales and the cut-off adopted 1.5 standard deviations below the mean for either the expressive or the receptive scale of the test concerned. The pass mark on the screening test was ascertained using receiver operating characteristics (ROC). The validity is reported given the cut-off identified. The specificity, sensitivity and both positive and negative predictive abilities are reported for both the pilot and the subsequent study. The application of the test is discussed in the context of the current debate about early identification.

A Model-Free Diagnostic for Single-Peakedness of Item Responses Using Ordered Conditional Means.

PubMed

Polak, Marike; de Rooij, Mark; Heiser, Willem J

2012-09-01

In this article we propose a model-free diagnostic for single-peakedness (unimodality) of item responses. Presuming a unidimensional unfolding scale and a given item ordering, we approximate item response functions of all items based on ordered conditional means (OCM). The proposed OCM methodology is based on Thurstone & Chave's (1929) criterion of irrelevance, which is a graphical, exploratory method for evaluating the "relevance" of dichotomous attitude items. We generalized this criterion to graded response items and quantified the relevance by fitting a unimodal smoother. The resulting goodness-of-fit was used to determine item fit and aggregated scale fit. Based on a simulation procedure, cutoff values were proposed for the measures of item fit. These cutoff values showed high power rates and acceptable Type I error rates. We present 2 applications of the OCM method. First, we apply the OCM method to personality data from the Developmental Profile; second, we analyze attitude data collected by Roberts and Laughlin (1996) concerning opinions of capital punishment.

Utility of the T-SPOT®.TB test's borderline category to increase test resolution for results around the cut-off point.

PubMed

Rego, Karen; Pereira, Kristen; MacDougall, James; Cruikshank, William

2018-01-01

Accurate identification of individuals with TB infection, is required to achieve the WHO's End TB Strategy goals. While there is general acceptance that the T-SPOT.TB test borderline category provides an opportunity to increase test resolution of results around the test cut-off point, this has not been investigated. 645,947 tests were analyzed to determine frequency of borderline results, effect of age and time between tests and associations between subjects' clinical risk factors and retest results. 645,947 tests produced 93.5% negatives, 4% positives, 0.6% invalids, and 1.8% borderlines. Within the borderline results, 5044 were repeated, with 59.2%, 20.0% and 20.2% resolving to negative, positive and borderline, respectively. Age of subject did not affect retest results; however, time between tests indicated that retest resolution occurred with greatest frequency after 90 days. TB risk factors were provided for 2640 subjects and 17% of low risk subjects with a high initial borderline resolved to negative while 27.6% of subjects with high risk and an initial low borderline resolved to positive, suggesting that these subjects could have been inappropriately classified if using a single cut-off point test with no borderline category. This study demonstrates the utility of the T-SPOT.TB test's borderline category to increase test resolution around the test cut-off point. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

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

NASA Technical Reports Server (NTRS)

Beardsley, E G

1928-01-01

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

Benzocyclobutene (BCB) Polymer as Amphibious Buffer Layer for Graphene Field-Effect Transistor.

PubMed

Wu, Yun; Zou, Jianjun; Huo, Shuai; Lu, Haiyan; Kong, Yuecan; Chen, Tangshen; Wu, Wei; Xu, Jingxia

2015-08-01

Owing to the scattering and trapping effects, the interfaces of dielectric/graphene or substrate/graphene can tailor the performance of field-effect transistor (FET). In this letter, the polymer of benzocyclobutene (BCB) was used as an amphibious buffer layer and located at between the layers of substrate and graphene and between the layers of dielectric and graphene. Interestingly, with the help of nonpolar and hydrophobic BCB buffer layer, the large-scale top-gated, chemical vapor deposited (CVD) graphene transistors was prepared on Si/SiO2 substrate, its cutoff frequency (fT) and the maximum cutoff frequency (fmax) of the graphene field-effect transistor (GFET) can be reached at 12 GHz and 11 GHz, respectively.

[The optimal cutoff point of waist-to-hip ratio for screening Uyghur population aged 35 years and over at high-risk of cardiovascular diseases in Xinjiang].

PubMed

Abudukeremu, Nuremanguli; Pan, Shuo; Ma, Yitong; Yang, Yining; Ma, Xiang; Li, Xiaomei; Fu, Zhenyan; Huang, Ying; Xie, Xiang; Liu, Fen; Chen, Bangdang; Yu, Zixiang; Chen, You; He, Chunhui; Zheng, Yingying; Li, Shuangshuang; Jia, Lin; Wang, Yongtao

2015-02-01

To explore the appropriate waist-to-hip ratio (WHR) cutoffs to identify people at high risk of cardiovascular disease of Uygur population aged 35 years and over in Xinjiang. The cardiovascular risk survey (CRS) in Xinjiang was conducted from October 2007 to March 2010, using 4-stagestratified random sampling method and 14 618 representative participated this survey, and the questionnaire survey, anthropometric data, blood pressure, serum total cholesterol, triglyceride, low density lipoprotein (LDL-C), high density lipoprotein (HDL-C) and fasting glucose were measured. A total of 4 657 participants aged 35 years and over with complete anthropometric data were analyzed. The sensitivity, specificity and distance on the receiver operating characteristic (ROC) curve of different WHR levels predicting risk factors of cardiovascular disease were calculated. The analysis method of ROC curve was used to determine the optimum cut-off point of WHR predicting risk factors of cardiovascular disease. (1) There were significantly differences in prevalence of hypertension, diabetes mellitus, hypercholesterolemia, low HDL-C level, and hypertriglyceridemia between WHR < 0.75,0.75 ≤ WHR < 0.80,0.80 ≤ WHR < 0.85,0.85 ≤ WHR < 0.90,0.90 ≤ WHR < 0.95,0.95 ≤ WHR < 1.00, WHR ≥ 1.00 in male participants (P < 0.01 or 0.05), LDL-C level was similar among groups in males (P = 0.139). There were significantly differences in prevalence of hypertension, diabetes mellitus, hypercholesterolemia and hypertriglyceridemia between WHR < 0.75,0.75 ≤ WHR < 0.80,0.80 ≤ WHR < 0.85,0.85 ≤ WHR < 0.90,0.90 ≤ WHR < 0.95,0.95 ≤ WHR < 1.00, WHR ≥ 1.00 in female participants (all P < 0.01), and there were no significantly differences in prevalence of high LDL-C level and low HDL-C level among groups in females (both P > 0.05). (2) ROC analysis for hypertension, dyslipidemia, diabetes and ≥ 2 of these risk factors suggested a WHR cutoff of 0.92 for men and 0.90 for women as the optimal cutoff value for predicting high risk of cardiovascular disease of Uygur population aged 35 years and over in Xinjiang. Higher WHR cutoffs are needed for screening people at high risk of cardiovascular disease among Uygur population aged 35 years and over in Xinjiang.

The Ruinous Influence of Close Binary Companions on Planetary Systems

NASA Astrophysics Data System (ADS)

Kraus, Adam L.; Ireland, Michael; Mann, Andrew; Huber, Daniel; Dupuy, Trent J.

2017-01-01

The majority of solar-type stars are found in binary systems, and the dynamical influence of binary companions is expected to profoundly influence planetary systems. However, the difficulty of identifying planets in binary systems has left the magnitude of this effect uncertain; despite numerous theoretical hurdles to their formation and survival, at least some binary systems clearly host planets. We present high-resolution imaging of nearly 500 Kepler Objects of Interest (KOIs) obtained using adaptive-optics imaging and nonredundant aperture-mask interferometry on the Keck II telescope. We super-resolve some binary systems to projected separations of under 5 AU, showing that planets might form in these dynamically active environments. However, the full distribution of projected separations for our planet-host sample more broadly reveals a deep paucity of binary companions at solar-system scales. When the binary population is parametrized with a semimajor axis cutoff a cut and a suppression factor inside that cutoff S bin, we find with correlated uncertainties that inside acut = 47 +59/-23 AU, the planet occurrence rate in binary systems is only Sbin = 0.34 +0.14/-0.15 times that of wider binaries or single stars. Our results demonstrate that a fifth of all solar-type stars in the Milky Way are disallowed from hosting planetary systems due to the influence of a binary companion.

The Ruinous Influence of Close Binary Companions on Planetary Systems

NASA Astrophysics Data System (ADS)

Kraus, Adam L.; Ireland, Michael; Mann, Andrew; Huber, Daniel; Dupuy, Trent J.

2017-06-01

The majority of solar-type stars are found in binary systems, and the dynamical influence of binary companions is expected to profoundly influence planetary systems. However, the difficulty of identifying planets in binary systems has left the magnitude of this effect uncertain; despite numerous theoretical hurdles to their formation and survival, at least some binary systems clearly host planets. We present high-resolution imaging of nearly 500 Kepler Objects of Interest (KOIs) obtained using adaptive-optics imaging and nonredundant aperture-mask interferometry on the Keck II telescope. We super-resolve some binary systems to projected separations of under 5 AU, showing that planets might form in these dynamically active environments. However, the full distribution of projected separations for our planet-host sample more broadly reveals a deep paucity of binary companions at solar-system scales. When the binary population is parametrized with a semimajor axis cutoff a cut and a suppression factor inside that cutoff S bin, we find with correlated uncertainties that inside acut = 47 +59/-23 AU, the planet occurrence rate in binary systems is only Sbin = 0.34+0.14/-0.15 times that of wider binaries or single stars. Our results demonstrate that a fifth of all solar-type stars in the Milky Way are disallowed from hosting planetary systems due to the influence of a binary companion.

Improved cross-calibration of Thomson scattering and electron cyclotron emission with ECH on DIII-D

DOE PAGES

Brookman, M. W.; Austin, M. E.; McLean, A. G.; ...

2016-08-08

Thomson scattering (TS) produces n e profiles from measurement of scattered laser beam intensity. In the case of Rayleigh scattering, it provides a first calibration of the relation n e / ITS, which depends on many factors (e.g. laser alignment and power, optics, and measurement systems). On DIII-D, the n e calibration is adjusted for each laser and optic path against an absolute n e measurement from a density-driven cutoff on the 48 channel 2nd harmonic X-mode electron cyclotron emission (ECE) system. This method has been used to calibrate Thompson densities from the edge to near the core (r/a >more » 0.15). Application of core electron cyclotron heating improves the quality of cutoff and depth of its penetration into the core. ECH also changes underlying MHD activity. Furthermore, on the removal of ECH power, cutoff penetrates in from the edge to the core and channels fall successively and smoothly into cutoff. This improves the quality of the TS n e calibration while minimizing wall loading.« less

A Scale for Assessing the Severity of Arousal Disorders

PubMed Central

Arnulf, Isabelle; Zhang, Bin; Uguccioni, Ginevra; Flamand, Mathilde; Noël de Fontréaux, Alix; Leu-Semenescu, Smaranda; Brion, Agnès

2014-01-01

Background: Arousal disorders may have serious health consequences. Objective: To develop a scale assessing the severity of arousal disorders (Paris Arousal Disorders Severity Scale, PADSS). Setting: University hospital. Design: Controlled study. Participants: Consecutive patients (older than 15 y), with sleepwalking (SW) and/or sleep terrors (ST), subjects with previous SW/ST, normal controls and patients with rapid eye movement sleep behavior disorder. Intervention: The self-rated scale listed 17 parasomniac behaviors (PADSS-A), assessed their frequency from never to twice or more per night (PADSS-B) and evaluated the consequences (PADSS-C: disturbed sleep, injuries, fatigue, and psychological consequences). The clinimetric properties and face validity of the scale were tested. Results: Half of the 73 patients with SW/ST (more men than women) had injured themselves or others, whereas 15% had concomitant sexsomnia and 23% had amnestic eating behaviors. The total PADSS score (range: 0-50) was 19.4 ± 6.3 (range: 8-36) in this group, 11.7 ± 5.9 in 26 subjects with previous SW/ST, 8.8 ± 3.2 in 26 patients with RBD, and 2.0 ± 3.5 in 53 normal controls (P < 0.05). The PADSS demonstrated high sensitivity (83.6%), specificity (87.8%), internal consistency, and test-retest reliability (0.79). The best cutoff for the total score was at 13/14. Exploratory factor analysis revealed two components: wandering and violence/handling. The complexity of behaviors emerging from N3 sleep (scored on videopolysomnography) positively correlated with scores for the PADSS-total, PADSS-A, PADSS-C, and the “violence/handling” factor. Conclusion: This scale had reasonable psychometric properties and could be used for screening and stratifying patients and for evaluating the effects of treatments. Citation: Arnulf I; Zhang B; Uguccioni G; Flamand M; Noël de Fontréaux A; Leu-Semenescu S; Brion A. A scale for assessing the severity of arousal disorders. SLEEP 2014;37(1):127-136. PMID:24470702

Patient health questionnaire for school-based depression screening among Chinese adolescents.

PubMed

Tsai, Fang-Ju; Huang, Yu-Hsin; Liu, Hui-Ching; Huang, Kuo-Yang; Huang, Yen-Hsun; Liu, Shen-Ing

2014-02-01

The aim of this study was to determine the reliability and validity of a Chinese version of the Patient Health Questionnaire-9 item (PHQ-9) and its 2 subscales (1 item and 2 items) for the screening of major depressive disorder (MDD) among adolescents in Taiwan. A total of 2257 adolescents were recruited from high schools in Taipei. The participants completed assessments including demographic information, the Chinese version of the PHQ-9, and the Rosenberg Self-Esteem Scale, and data on the number of physical illnesses and mental health service utilizations were recorded. Among them, 430 were retested using the PHQ-9 within 2 weeks. Child psychiatrists interviewed a subsample of the adolescents (n = 165) using the Kiddie-Schedule for Affective Disorder and Schizophrenia Epidemiological Version as the criterion standard. The PHQ-9 had good internal consistency (α = 0.84) and acceptable test-retest reliability (0.80). The participants with higher PHQ-9 scores were more likely to have MDD. Principal component factor analysis of the PHQ-9 yielded a 1-factor structure, which accounted for 45.3% of the variance. A PHQ-9 score ≥15 had a sensitivity of 0.72 and a specificity of 0.95 for recognizing MDD. The area under the receiver operating characteristic curve was 0.90. The screening accuracy of the 2 subscales was also satisfactory, with a Patient Health Questionnaire-2 item cutoff of ≥3 being 94.4% sensitive and 82.5% specific and a Patient Health Questionnaire-1 item cutoff of ≥2 being 61.1% sensitive and 87.7% specific. The PHQ-9 and its 2 subscales appear to be reliable and valid for detecting MDD among ethnic Chinese adolescents in Taiwan.

Psychometric Properties of the Problematic Internet Use Questionnaire Short-Form (PIUQ-SF-6) in a Nationally Representative Sample of Adolescents.

PubMed

Demetrovics, Zsolt; Király, Orsolya; Koronczai, Beatrix; Griffiths, Mark D; Nagygyörgy, Katalin; Elekes, Zsuzsanna; Tamás, Domokos; Kun, Bernadette; Kökönyei, Gyöngyi; Urbán, Róbert

2016-01-01

Despite the large number of measurement tools developed to assess problematic Internet use, numerous studies use measures with only modest investigation into their psychometric properties. The goal of the present study was to validate the short (6-item) version of the Problematic Internet Use Questionnaire (PIUQ) on a nationally representative adolescent sample (n = 5,005; mean age 16.4 years, SD = 0.87) and to determine a statistically established cut-off value. Data were collected within the framework of the European School Survey Project on Alcohol and Other Drugs project. Results showed an acceptable fit of the original three-factor structure to the data. In addition, a MIMIC model was carried out to justify the need for three distinct factors. The sample was divided into users at-risk of problematic Internet use and those with no-risk using a latent profile analysis. Two latent classes were obtained with 14.4% of adolescents belonging to the at-risk group. Concurrent and convergent validity were tested by comparing the two groups across a number of variables (i.e., time spent online, academic achievement, self-esteem, depressive symptoms, and preferred online activities). Using the at-risk latent profile analysis class as the gold standard, a cut-off value of 15 (out of 30) was suggested based on sensitivity and specificity analyses. In conclusion, the brief version of the (6-item) PIUQ also appears to be an appropriate measure to differentiate between Internet users at risk of developing problematic Internet use and those not at risk. Furthermore, due to its brevity, the shortened PIUQ is advantageous to utilize within large-scale surveys assessing many different behaviors and/or constructs by reducing the overall number of survey questions, and as a consequence, likely increasing completion rates.

The Glittre-ADL Test Cut-Off Point to Discriminate Abnormal Functional Capacity in Patients with COPD.

PubMed

Gulart, Aline Almeida; Munari, Anelise Bauer; Klein, Suelen Roberta; Santos da Silveira, Lucas; Mayer, Anamaria Fleig

2018-02-01

The study objective was to determine a cut-off point for the Glittre activities of daily living (ADL)test (TGlittre) to discriminate patients with normal and abnormal functional capacity. Fifty-nine patients with moderate to very severe COPD (45 males; 65 ± 8.84 years; BMI: 26 ± 4.78 kg/m 2 ; FEV 1 : 35.3 ± 13.4% pred) were evaluated for spirometry, TGlittre, 6-minute walk test (6 MWT), physical ADL, modified Medical Research Council scale (mMRC), BODE index, Saint George's Respiratory Questionnaire (SGRQ), and COPD Assessment Test (CAT). The receiver operating characteristic (ROC) curve was used to determine the cut-off point for TGlittre in order to discriminate patients with 6 MWT < 82% pred. The ROC curve indicated a cut-off point of 3.5 minutes for the TGlittre (sensitivity = 92%, specificity = 83%, and area under the ROC curve = 0.95 [95% CI: 0.89-0.99]). Patients with abnormal functional capacity had higher mMRC (median difference 1 point), CAT (mean difference: 4.5 points), SGRQ (mean difference: 12.1 points), and BODE (1.37 points) scores, longer time of physical activity <1.5 metabolic equivalent of task (mean difference: 47.9 minutes) and in sitting position (mean difference: 59.4 minutes) and smaller number of steps (mean difference: 1,549 minutes); p < 0.05 for all. In conclusion, the cut-off point of 3.5 minutes in the TGlittre is sensitive and specific to distinguish COPD patients with abnormal and normal functional capacity.

The effect of decentralized behavioral decision making on system-level risk.

PubMed

Kaivanto, Kim

2014-12-01

Certain classes of system-level risk depend partly on decentralized lay decision making. For instance, an organization's network security risk depends partly on its employees' responses to phishing attacks. On a larger scale, the risk within a financial system depends partly on households' responses to mortgage sales pitches. Behavioral economics shows that lay decisionmakers typically depart in systematic ways from the normative rationality of expected utility (EU), and instead display heuristics and biases as captured in the more descriptively accurate prospect theory (PT). In turn, psychological studies show that successful deception ploys eschew direct logical argumentation and instead employ peripheral-route persuasion, manipulation of visceral emotions, urgency, and familiar contextual cues. The detection of phishing emails and inappropriate mortgage contracts may be framed as a binary classification task. Signal detection theory (SDT) offers the standard normative solution, formulated as an optimal cutoff threshold, for distinguishing between good/bad emails or mortgages. In this article, we extend SDT behaviorally by rederiving the optimal cutoff threshold under PT. Furthermore, we incorporate the psychology of deception into determination of SDT's discriminability parameter. With the neo-additive probability weighting function, the optimal cutoff threshold under PT is rendered unique under well-behaved sampling distributions, tractable in computation, and transparent in interpretation. The PT-based cutoff threshold is (i) independent of loss aversion and (ii) more conservative than the classical SDT cutoff threshold. Independently of any possible misalignment between individual-level and system-level misclassification costs, decentralized behavioral decisionmakers are biased toward underdetection, and system-level risk is consequently greater than in analyses predicated upon normative rationality. © 2014 Society for Risk Analysis.

Filtering Drifter Trajectories Sampled at Submesoscale Resolution

DTIC Science & Technology

2015-05-11

bution. The modification allows PE variances to change in time through parameterization (10) with the cutoff scale 1.56 10 ms , corresponding to the...more sophisticated real-time ionosphere correction algo- rithms. We consider this study to be an attempt at improving the quality of the drifter data

Comparative analysis of anthropometric indices of obesity as correlates and potential predictors of risk for hypertension and prehypertension in a population in Nigeria.

PubMed

Ononamadu, Chimaobi James; Ezekwesili, Chinwe Nonyelum; Onyeukwu, Onyemaechi Faith; Umeoguaju, Uchenna Francis; Ezeigwe, Obiajulu Christian; Ihegboro, Godwin Okwudiri

Obesity is a well-established independent risk factor for hypertension and other cardiometabolic disorders. However, the best anthropometric index of obesity that predicts or associates strongly with hypertension and related conditions remains controversial and inconclusive. This study compared the performance of eight anthropometric indices of obesity: body mass index (BMI), ponderal index (PI), waist circumference (WC), hip circumference (HC), waist-hip ratio (WHR), waist-height ratio (WHtR), body adiposity index (BAI) and conicity index (CI) as correlates and potential predictors of risk of hypertension and prehypertension in a Nigerian population, and also the possible effect of combining two or more indices in that regard. This church-based, cross-sectional study was conducted in Anambra state, south-eastern Nigeria from 2012 to 2013. A total of 912 persons (436 male and 476 female) drawn randomly from three major cities (Awka, Onitsha and Nnewi) in the state participated in the study. Information on demography, medical history and lifestyle were obtained using a well-structured and validated questionnaire. The systolic/diastolic blood pressure and anthropometric measurements were taken by well-trained personnel. The resulting data were analysed using descriptive statistics, logistic regression, Poisson regression and receiver operating characteristic curve analysis. The mean values of all the anthropometric indices studied increased from normotension, through prehypertension to hypertension in both genders. BMI, WC, HC and CI were significantly higher (p < 0.05) in females than males. All the anthropometric indices studied were significantly (p < 0.001 except for CI) correlated with systolic and diastolic blood pressure. BMI, WHtR, WC and PI (with higher correlation coefficients for blood pressure) showed the best potential to predict hypertension and prehypertension in the study: BMI (cut-off = 24.49, AUC = 0.698; cut-off = 23.62, AUC = 0.659), WHtR (cut-off = 0.55, AUC = 0.682; cut-off = 0.5, AUC = 0.636), WC (cut-off = 91.44, AUC = 0.692; cut-off = 82.55, AUC = 0.645), PI (cut-off = 14.45, AUC = 0.670; cut-off = 13.69, AUC = 0.639), in males; and BMI (cut-off = 24.44, AUC = 0.622; cut-off = 28.01, AUC = 0.609), WHtR (cut-off = 0.51, AUC = 0.624; cut-off = 0.6, AUC = 0.572), WC ( cut-off = 96.62, AUC = 0.616; cut-off = 96.52, AUC = 0.584), PI ( cut-off = 16.38, AUC = 0.619; cut-off = 17.65, AUC = 0.599), in females for hypertension and prehypertension, respectively. In predicting hypertension risk, WC and WHtR did not significantly improve the performance of BMI in the models when included using our decision rule. Overall, CI had a very poor discriminatory power for both conditions in this study. BMI, WHtR, WC and PI emerged the best predictors of hypertension risk, and BMI, WC and PI of prehypertension risk in this study. The combination of high-performing anthropometric indices in a model did not improve their performance. Therefore we recommend the simultaneous but independent use of BMI and either WC or WHtR for predicting hypertension, and BMI and WC for prehypertension risk, bearing in mind that both types of index (abdominal and general obesity) account for different forms of obesity.

Comparative analysis of anthropometric indices of obesity as correlates and potential predictors of risk for hypertension and prehypertension in a population in Nigeria

PubMed Central

Ononamadu, Chimaobi James; Ihegboro, Godwin Okwudiri; Ezekwesili, Chinwe Nonyelum; Onyeukwu, Onyemaechi Faith; Umeoguaju,, Uchenna Francis; Ezeigwe, Obiajulu Christian

2017-01-01

Summary Background: Obesity is a well-established independent risk factor for hypertension and other cardiometabolic disorders. However, the best anthropometric index of obesity that predicts or associates strongly with hypertension and related conditions remains controversial and inconclusive. Objective: This study compared the performance of eight anthropometric indices of obesity: body mass index (BMI), ponderal index (PI), waist circumference (WC), hip circumference (HC), waist–hip ratio (WHR), waist–height ratio (WHtR), body adiposity index (BAI) and conicity index (CI) as correlates and potential predictors of risk of hypertension and prehypertension in a Nigerian population, and also the possible effect of combining two or more indices in that regard. Methods: This church-based, cross-sectional study was conducted in Anambra state, south-eastern Nigeria from 2012 to 2013. A total of 912 persons (436 male and 476 female) drawn randomly from three major cities (Awka, Onitsha and Nnewi) in the state participated in the study. Information on demography, medical history and lifestyle were obtained using a well-structured and validated questionnaire. The systolic/diastolic blood pressure and anthropometric measurements were taken by well-trained personnel. The resulting data were analysed using descriptive statistics, logistic regression, Poisson regression and receiver operating characteristic curve analysis. Results: The mean values of all the anthropometric indices studied increased from normotension, through prehypertension to hypertension in both genders. BMI, WC, HC and CI were significantly higher (p < 0.05) in females than males. All the anthropometric indices studied were significantly (p < 0.001 except for CI) correlated with systolic and diastolic blood pressure. BMI, WHtR, WC and PI (with higher correlation coefficients for blood pressure) showed the best potential potential to predict hypertension and prehypertension in the study: BMI (cut-off = 24.49, AUC = 0.698; cut-off = 23.62, AUC = 0.659), WHtR (cut-off = 0.55, AUC = 0.682; cut-off = 0.5, AUC = 0.636), WC (cut-off = 91.44, AUC = 0.692; cut-off = 82.55, AUC = 0.645), PI (cut-off = 14.45, AUC = 0.670; cut-off = 13.69, AUC = 0.639), in males; and BMI (cut-off = 24.44, AUC = 0.622; cut-off = 28.01, AUC = 0.609), WHtR (cut-off = 0.51, AUC = 0.624; cut-off = 0.6, AUC = 0.572), WC (cut-off = 96.62, AUC = 0.616; cut-off = 96.52, AUC = 0.584), PI (cut-off = 16.38, AUC = 0.619; cut-off = 17.65, AUC = 0.599), in females for hypertension and prehypertension, respectively. In predicting hypertension risk, WC and WHtR did not significantly improve the performance of BMI in the models when included using our decision rule. Overall, CI had a very poor discriminatory power for both conditions in this study. Conclusion: BMI, WHtR, WC and PI emerged the best predictors of hypertension risk, and BMI, WC and PI of prehypertension risk in this study. The combination of high-performing anthropometric indices in a model did not improve their performance. Therefore we recommend the simultaneous but independent use of BMI and either WC or WHtR for predicting hypertension, and BMI and WC for prehypertension risk, bearing in mind that both types of index (abdominal and general obesity) account for different forms of obesity. PMID:27701484

Predicting survival time in noncurative patients with advanced cancer: a prospective study in China.

PubMed

Cui, Jing; Zhou, Lingjun; Wee, B; Shen, Fengping; Ma, Xiuqiang; Zhao, Jijun

2014-05-01

Accurate prediction of prognosis for cancer patients is important for good clinical decision making in therapeutic and care strategies. The application of prognostic tools and indicators could improve prediction accuracy. This study aimed to develop a new prognostic scale to predict survival time of advanced cancer patients in China. We prospectively collected items that we anticipated might influence survival time of advanced cancer patients. Participants were recruited from 12 hospitals in Shanghai, China. We collected data including demographic information, clinical symptoms and signs, and biochemical test results. Log-rank tests, Cox regression, and linear regression were performed to develop a prognostic scale. Three hundred twenty patients with advanced cancer were recruited. Fourteen prognostic factors were included in the prognostic scale: Karnofsky Performance Scale (KPS) score, pain, ascites, hydrothorax, edema, delirium, cachexia, white blood cell (WBC) count, hemoglobin, sodium, total bilirubin, direct bilirubin, aspartate aminotransferase (AST), and alkaline phosphatase (ALP) values. The score was calculated by summing the partial scores, ranging from 0 to 30. When using the cutoff points of 7-day, 30-day, 90-day, and 180-day survival time, the scores were calculated as 12, 10, 8, and 6, respectively. We propose a new prognostic scale including KPS, pain, ascites, hydrothorax, edema, delirium, cachexia, WBC count, hemoglobin, sodium, total bilirubin, direct bilirubin, AST, and ALP values, which may help guide physicians in predicting the likely survival time of cancer patients more accurately. More studies are needed to validate this scale in the future.

High EDSS can predict risk for upper urinary tract damage in patients with multiple sclerosis.

PubMed

Ineichen, Benjamin V; Schneider, Marc P; Hlavica, Martin; Hagenbuch, Niels; Linnebank, Michael; Kessler, Thomas M

2018-04-01

Neurogenic lower urinary tract dysfunction (NLUTD) is very common in patients with multiple sclerosis (MS), and it might jeopardize renal function and thereby increase mortality. Although there are well-known urodynamic risk factors for upper urinary tract damage, no clinical prediction parameters are available. We aimed to assess clinical parameters potentially predicting urodynamic risk factors for upper urinary tract damage. A consecutive series of 141 patients with MS referred from neurologists for primary neuro-urological work-up including urodynamics were prospectively evaluated. Clinical parameters taken into account were age, sex, duration, and clinical course of MS and Expanded Disability Status Scale (EDSS). Multivariate modeling revealed EDSS as a clinical parameter significantly associated with urodynamic risk factors for upper urinary tract damage (odds ratio = 1.34, 95% confidence interval (CI) = 1.06-1.71, p = 0.02). Using receiver operator characteristic (ROC) curves, an EDSS of 5.0 as cutoff showed a sensitivity of 86%-87% and a specificity of 52% for at least one urodynamic risk factor for upper urinary tract damage. High EDSS is significantly associated with urodynamic risk factors for upper urinary tract damage and allows a risk-dependent stratification in daily neurological clinical practice to identify MS patients requiring further neuro-urological assessment and treatment.

Minority Carrier Lifetime in Beryllium-Doped InAs/InAsSb Strained Layer Superlattices

DTIC Science & Technology

2014-06-03

FTIR) spectrometer, operating in either continuous-scan or step-scan mode with a 14-lm cut-off wavelength external HgCdTe photo- detector . The PL...was collected by reflective optics and detected with a Vigo 10-lm cut-off, HgCdTe detector with a 3-ns time constant. The laser emission scattered from...45 ns and 8 ns were measured. The 6 × 10^16 cm?3 doping level is a factor of 6 greater than the typical background doping level in long-wave infrared

Optimal Cutoff Values of WHO-HPQ Presenteeism Scores by ROC Analysis for Preventing Mental Sickness Absence in Japanese Prospective Cohort

PubMed Central

Suzuki, Tomoko; Miyaki, Koichi; Sasaki, Yasuharu; Song, Yixuan; Tsutsumi, Akizumi; Kawakami, Norito; Shimazu, Akihito; Takahashi, Masaya; Inoue, Akiomi; Kurioka, Sumiko; Shimbo, Takuro

2014-01-01

Objectives Sickness absence due to mental disease in the workplace has become a global public health problem. Previous studies report that sickness presenteeism is associated with sickness absence. We aimed to determine optimal cutoff scores for presenteeism in the screening of the future absences due to mental disease. Methods A prospective study of 2195 Japanese employees from all areas of Japan was conducted. Presenteeism and depression were measured by the validated Japanese version of the World Health Organization Health and Work Performance Questionnaire (WHO-HPQ) and K6 scale, respectively. Absence due to mental disease across a 2-year follow-up was surveyed using medical certificates obtained for work absence. Socioeconomic status was measured via a self-administered questionnaire. Receiver operating curve (ROC) analysis was used to determine optimal cutoff scores for absolute and relative presenteeism in relation to the area under the curve (AUC), sensitivity, and specificity. Results The AUC values for absolute and relative presenteeism were 0.708 (95% CI, 0.618–0.797) and 0.646 (95% CI, 0.546–0.746), respectively. Optimal cutoff scores of absolute and relative presenteeism were 40 and 0.8, respectively. With multivariate adjustment, cohort participants with our proposal cutoff scores for absolute and relative presenteeism were significantly more likely to be absent due to mental disease (OR = 4.85, 95% CI: 2.20–10.73 and OR = 5.37, 95% CI: 2.42–11.93, respectively). The inclusion or exclusion of depressive symptoms (K6≥13) at baseline in the multivariate adjustment did not influence the results. Conclusions Our proposed optimal cutoff scores of absolute and relative presenteeism are 40 and 0.8, respectively. Participants who scored worse than the cutoff scores for presenteeism were significantly more likely to be absent in future because of mental disease. Our findings suggest that the utility of presenteeism in the screening of sickness absence due to mental disease would help prevent such an absence. PMID:25340520

The Center for Epidemiologic Studies Depression Scale is an adequate screening instrument for depression and anxiety disorder in adults with congential heart disease.

PubMed

Moon, Ju Ryoung; Huh, June; Song, Jinyoung; Kang, I-Seok; Park, Seung Woo; Chang, Sung-A; Yang, Ji-Hyuk; Jun, Tae-Gook

2017-09-05

The Center for Epidemiological Studies Depression Scale (CES-D) is an instrument that is commonly used to screen for depression in patients with chronic disease, but the characteristics of the CES-D in adults with congenital heart disease (CHD) have not yet been studied. The aim of this study was to investigate the criterion validities and the predictive powers of the CES-D for depression and anxiety disorders in adults with CHD. Two hundred patients were screened with the CES-D and secondarily interviewed with a diagnostic instrument, i.e., the Mini International Neuropsychiatric Instrument. The sensitivity and specificity values of the CES-D were calculated by cross-tabulation at different cutoff scores. Receiver operating characteristic (ROC) curves were used to assess the optimal cutoff point for each disorder and to assess the predictive power of the instrument. The CES-D exhibited satisfactory criterion validities for depression and for all combinations of depression and/or anxiety. With a desired sensitivity of at least 80%, the optimal cutoff scores were 18. The predictive power of the CES-D in the patients was best for major depression and dysthymia (area under the ROC curve: 0.92) followed by the score for any combination of depression and/or anxiety (0.88). The use of CES-D to simultaneously screen for both depression and anxiety disorders may be useful in adults with CHD. CESDEP 212. Registered 2 March 2014 (retrospectively registered).

Criterion validity of a Wechsler-III Scale Short Form in a sample of brazilian elderly.

PubMed

Banhato, Eliane Ferreira Carvalho; Leite, Isabel Cristina Gonçalves; Guedes, Danielle Viveiros; Chaoubah, Alfredo

2010-01-01

Although a normative process, changes in cognitive functioning vary among older adults. The differential diagnosis between normal and pathological aging must be made early using psychometrically adequate measures. To assess the evidence of criterion validity of a Short Form (SF) of the Wechsler-III Scale containing eight subtests (SF8) by determining its sensitivity, specificity, positive and negative predictive values and cut-off points for Brazilian elderly from different age groups. 168 individuals, aged 60 years or above, living in the community or in an institution, were assigned to case and control groups, and investigated according to age range. Measures included a sociodemographic questionnaire, the Mini-Mental State Examination (MMSE), Verbal Fluency Test, Clock-Drawing Test and the SF8. More than two thirds of the sample was women (73.8%), mean age was 74.5 years (SD=8.9), mean education was 6.2 years (SD=4.8) and 40.5% were widows/widowers. In the total sample, the best cut-off point for the SF8 was 142 while cut offs among individuals aged 60 to 69 years, 70 to 79 years, and more than 80 years were 160, 129 and 129, respectively. The results demonstrated the importance of different cut-off points for different age ranges. Sensitivity and specificity values of the SF8 were sufficiently high to warrant the use of the SF8 as an instrument to identify cognitive impairment in the elderly.

Criterion validity of a Wechsler-III Scale Short Form in a sample of brazilian elderly

PubMed Central

Banhato, Eliane Ferreira Carvalho; Leite, Isabel Cristina Gonçalves; Guedes, Danielle Viveiros; Chaoubah, Alfredo

2010-01-01

Although a normative process, changes in cognitive functioning vary among older adults. The differential diagnosis between normal and pathological aging must be made early using psychometrically adequate measures. Objectives To assess the evidence of criterion validity of a Short Form (SF) of the Wechsler-III Scale containing eight subtests (SF8) by determining its sensitivity, specificity, positive and negative predictive values and cut-off points for Brazilian elderly from different age groups. Methods 168 individuals, aged 60 years or above, living in the community or in an institution, were assigned to case and control groups, and investigated according to age range. Measures included a sociodemographic questionnaire, the Mini-Mental State Examination (MMSE), Verbal Fluency Test, Clock-Drawing Test and the SF8. Results More than two thirds of the sample was women (73.8%), mean age was 74.5 years (SD=8.9), mean education was 6.2 years (SD=4.8) and 40.5% were widows/widowers. In the total sample, the best cut-off point for the SF8 was 142 while cut offs among individuals aged 60 to 69 years, 70 to 79 years, and more than 80 years were 160, 129 and 129, respectively. Conclusions The results demonstrated the importance of different cut-off points for different age ranges. Sensitivity and specificity values of the SF8 were sufficiently high to warrant the use of the SF8 as an instrument to identify cognitive impairment in the elderly. PMID:29213688

The prevalence rate of internet addiction among Japanese college students: two cross-sectional studies and reconsideration of cut-off points of Young's internet addiction test in Japan.

PubMed

Tateno, Masaru; Teo, Alan R; Shiraishi, Masaki; Tayama, Masaya; Kawanishi, Chiaki; Kato, Takahiro A

2018-05-30

Due to variation in estimates of the prevalence of internet addiction (IA) in prior research, we conducted two cross-sectional studies over two years and investigated the prevalence rate of IA in college students in Japan, and reconsidered appropriate cut-off points of self-rating scale to screen possible IA. This study is composed of two parts: survey I in 2014 and survey II in 2016, which were conducted in the same schools with an interval of two years. The study questionnaire included questions about demographics and internet use, and the Young's Internet Addiction Test (IAT). Additionally, the subjects in survey II were asked about self-reported IA. There were 1,005 respondents in total with a mean age of 18.9±1.3. The mean IAT scores remained stable between 2014 and 2016: 45.2±12.6 in survey I and 45.5±13.1 in survey II (overall mean IAT score of 45.4±13.0). With respect to self-reported IA in survey II, a total of 21.6% agreed (score of 5 or 6 on a 6-point Likert scale). We categorized these subjects as IA, and the remainder as non-IA. The mean IAT score showed significant difference between these two groups (57.8±14.3 vs 42.1±10.7, p<0.001). The severity of symptoms of IA among Japanese college students appears stable in recent years, with a mean IAT scores of over 40. Our results suggest that a screening score cut-off of 40 on the IAT could be reconsidered and that of 50 might be proposed for the cut-off. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Validation of the Edinburgh postnatal depression scale (EPDS) in a sample of women with high-risk pregnancies in France.

PubMed

Adouard, F; Glangeaud-Freudenthal, N M C; Golse, B

2005-06-01

This research is intended to validate the Edinburgh Postnatal Depression Scale (EPDS) in a high-risk pregnant population. Sixty women attending antenatal consultations for pregnancy complication in a major Parisian maternity facility were included. They completed the EPDS and were then interviewed according to a standardised psychiatric interview. The study of its sensitivity, specificity and predictive values, with a DSM-IV diagnosis of major depression as the reference, found that 11.5 was the optimal cut-off score (Se 0.80; Sp 0.80). Its validity as an index of severity of depression was also good as well as internal consistency and reliability. Factor analysis showed that its internal structure is composed of two subscales (F2 "depression" and F1 with items reflecting depression and other disorders, including anxiety). The French version of the EPDS would be a valid instrument to identify pregnant women who are likely to have clinical major depression. The results may have to be confirmed on a community sample before clinical use.

Analog and RF performance of a multigate FinFET at nano scale

NASA Astrophysics Data System (ADS)

Kumar, Abhishek

2016-12-01

In this paper, analog and RF performance of the Fin field effect transistor (FET) at Nano scale is observed through 3D simulation. FinFET devices like rectangular gate all around (RE-GAA) FinFET, cylindrical gate all around (CY-GAA) FinFET and triple gate (TG) FinFET are observed. The figure of merit (FOMs) such as input-output characteristics, trans-conductance (gm), output-conductance (gd), intrinsic gain (gm/gd), gate capacitance (gate to source and total gate capacitance), unity gain cut-off frequency (ft), trans-conductance generation factor (TGF), gain frequency product (GFP), gain bandwidth product (GBP) and gain transconductance frequency product (GTFP) are observed. The analog performance of a FinFETs are observed by realising source follower circuit with NMOS transistor as a current source. The source follower circuit gain is observed. It has been observed that maximum capacitance is observed in case gate all around condition. Rectangular gate all around has the highest transconductance. In the source follower circuit, the gain curve (Vout/Vin) is sharper for TG-FinFET.

Motivation of health workers and associated factors in public hospitals of West Amhara, Northwest Ethiopia.

PubMed

Weldegebriel, Zemichael; Ejigu, Yohannes; Weldegebreal, Fitsum; Woldie, Mirkuzie

2016-01-01

Health professionals' motivation reflects the interaction between health professionals and their work environment. It can potentially affect the provision of health services; however, this important attribute of the workplace climate in public hospitals is not usually given serious attention to the desired level. For this reason, the authors of this study have assessed the level of motivation of health professionals and associated factors in public hospitals of West Amhara, Northwest Ethiopia. A facility based cross-sectional study was conducted in eight public hospitals of West Amhara from June 1 to July 30, 2013. A total of 304 health professionals were included in this study. The collected data were analyzed using SPSS software version 20. The reliability of the instrument was assessed through Cronbach's α. Factor scores were generated for the items found to represent the scales (eigenvalue greater than one in varimax rotation) used in the measurement of the variables. The scores were further analyzed using one-way analysis of variance, t-tests, Pearson's correlation, and hierarchical multiple linear regression analyses. The cut-off point for the regression analysis to determine significance was set at β (95% confidence interval, P<0.05). Mean motivation scores (as the percentage of maximum scale scores) were 58.6% for the overall motivation score, 71.0% for the conscientiousness scale, 52.8% for the organizational commitment scale, 58.3% for the intrinsic motivation scale, and 64.0% for organizational burnout scale. Professional category, age, type of the hospital, nonfinancial motivators like performance evaluation and management, staffing and work schedule, staff development and promotion, availability of necessary resources, and ease of communication were found to be strong predictors of health worker motivation. Across the hospitals and professional categories, health workers' overall level of motivation with absolute level of compensation was not significantly associated with their overall level of motivation. The strongest drivers of all motivation dimensions were found to be nonfinancial human resource management tools, so policy makers and health workforce stake holders should focus on these tools to alleviate motivation problems.

Motivation of health workers and associated factors in public hospitals of West Amhara, Northwest Ethiopia

PubMed Central

Weldegebriel, Zemichael; Ejigu, Yohannes; Weldegebreal, Fitsum; Woldie, Mirkuzie

2016-01-01

Background Health professionals’ motivation reflects the interaction between health professionals and their work environment. It can potentially affect the provision of health services; however, this important attribute of the workplace climate in public hospitals is not usually given serious attention to the desired level. For this reason, the authors of this study have assessed the level of motivation of health professionals and associated factors in public hospitals of West Amhara, Northwest Ethiopia. Methods A facility based cross-sectional study was conducted in eight public hospitals of West Amhara from June 1 to July 30, 2013. A total of 304 health professionals were included in this study. The collected data were analyzed using SPSS software version 20. The reliability of the instrument was assessed through Cronbach’s α. Factor scores were generated for the items found to represent the scales (eigenvalue greater than one in varimax rotation) used in the measurement of the variables. The scores were further analyzed using one-way analysis of variance, t-tests, Pearson’s correlation, and hierarchical multiple linear regression analyses. The cut-off point for the regression analysis to determine significance was set at β (95% confidence interval, P<0.05). Results Mean motivation scores (as the percentage of maximum scale scores) were 58.6% for the overall motivation score, 71.0% for the conscientiousness scale, 52.8% for the organizational commitment scale, 58.3% for the intrinsic motivation scale, and 64.0% for organizational burnout scale. Professional category, age, type of the hospital, nonfinancial motivators like performance evaluation and management, staffing and work schedule, staff development and promotion, availability of necessary resources, and ease of communication were found to be strong predictors of health worker motivation. Across the hospitals and professional categories, health workers’ overall level of motivation with absolute level of compensation was not significantly associated with their overall level of motivation. Conclusion The strongest drivers of all motivation dimensions were found to be nonfinancial human resource management tools, so policy makers and health workforce stake holders should focus on these tools to alleviate motivation problems. PMID:26929608

Optimal optic nerve sheath diameter threshold for the identification of elevated opening pressure on lumbar puncture in a Chinese population.

PubMed

Wang, Lijuan; Feng, Liangshu; Yao, Yan; Wang, Yuzhi; Chen, Ying; Feng, Jiachun; Xing, Yingqi

2015-01-01

Ultrasonography of the optic nerve sheath diameter (ONSD) is a non-invasive and rapid method that might be helpful in the identification of increased intracranial pressure (ICP). The use of an ONSD greater than 5 mm on ultrasound as an indicator of increased ICP in a Caucasian population has been studied. However, the cut-off point of this predictor in Chinese patients has not been established. Thus, we conducted this study to identify the ONSD criterion for the detection of elevated opening pressure on lumbar puncture (LP) in a Chinese population and to investigate the influencing factors. This study was a blind cross-sectional study. Patients who presented with suspected increased ICP were included. The opening pressure on LP of each participant was confirmed. We analyzed the clinical differences between the groups of patients with abnormal and normal opening pressures on LP. A receiver operating characteristic curve was constructed to determine the ONSD cut-off point for the identification of abnormal opening pressure on LP. In total, 279 patients were recruited, and 101 patients presented with elevated opening pressure on LP. ONSD was a significant independent predictor of elevated opening pressure on LP (p<0.001). However, no statistical significance was observed regarding the factors that might have affected this relationship including gender, age, body mass index, waistline, head circumference, hypertension and pathological subtype. The ONSD cut-off point for the identification of elevated opening pressure on LP was 4.1 mm; this cut-off yielded a sensitivity of 95% and a specificity of 92%. ONSD is a strong and accurate predictor of elevated opening pressure on LP. The cut-off point of this predictor in a Chinese population was remarkably lower than that found in a Caucasian population. Thus, ethnic differences should be noted when using the ONSD as an indicator of increased ICP.

The Bergen Shopping Addiction Scale: reliability and validity of a brief screening test.

PubMed

Andreassen, Cecilie S; Griffiths, Mark D; Pallesen, Ståle; Bilder, Robert M; Torsheim, Torbjørn; Aboujaoude, Elias

2015-01-01

Although excessive and compulsive shopping has been increasingly placed within the behavioral addiction paradigm in recent years, items in existing screens arguably do not assess the core criteria and components of addiction. To date, assessment screens for shopping disorders have primarily been rooted within the impulse-control or obsessive-compulsive disorder paradigms. Furthermore, existing screens use the terms 'shopping,' 'buying,' and 'spending' interchangeably, and do not necessarily reflect contemporary shopping habits. Consequently, a new screening tool for assessing shopping addiction was developed. Initially, 28 items, four for each of seven addiction criteria (salience, mood modification, conflict, tolerance, withdrawal, relapse, and problems), were constructed. These items and validated scales (i.e., Compulsive Buying Measurement Scale, Mini-International Personality Item Pool, Hospital Anxiety and Depression Scale, Rosenberg Self-Esteem Scale) were then administered to 23,537 participants (M age = 35.8 years, SD age = 13.3). The highest loading item from each set of four pooled items reflecting the seven addiction criteria were retained in the final scale, The Bergen Shopping Addiction Scale (BSAS). The factor structure of the BSAS was good (RMSEA = 0.064, CFI = 0.983, TLI = 0.973) and coefficient alpha was 0.87. The scores on the BSAS converged with scores on the Compulsive Buying Measurement Scale (CBMS; 0.80), and were positively correlated with extroversion and neuroticism, and negatively with conscientiousness, agreeableness, and intellect/imagination. The scores of the BSAS were positively associated with anxiety, depression, and low self-esteem and inversely related to age. Females scored higher than males on the BSAS. The BSAS is the first scale to fully embed shopping addiction within an addiction paradigm. A recommended cutoff score for the new scale and future research directions are discussed.

The Bergen Shopping Addiction Scale: reliability and validity of a brief screening test

PubMed Central

Andreassen, Cecilie S.; Griffiths, Mark D.; Pallesen, Ståle; Bilder, Robert M.; Torsheim, Torbjørn; Aboujaoude, Elias

2015-01-01

Although excessive and compulsive shopping has been increasingly placed within the behavioral addiction paradigm in recent years, items in existing screens arguably do not assess the core criteria and components of addiction. To date, assessment screens for shopping disorders have primarily been rooted within the impulse-control or obsessive-compulsive disorder paradigms. Furthermore, existing screens use the terms ‘shopping,’ ‘buying,’ and ‘spending’ interchangeably, and do not necessarily reflect contemporary shopping habits. Consequently, a new screening tool for assessing shopping addiction was developed. Initially, 28 items, four for each of seven addiction criteria (salience, mood modification, conflict, tolerance, withdrawal, relapse, and problems), were constructed. These items and validated scales (i.e., Compulsive Buying Measurement Scale, Mini-International Personality Item Pool, Hospital Anxiety and Depression Scale, Rosenberg Self-Esteem Scale) were then administered to 23,537 participants (Mage = 35.8 years, SDage = 13.3). The highest loading item from each set of four pooled items reflecting the seven addiction criteria were retained in the final scale, The Bergen Shopping Addiction Scale (BSAS). The factor structure of the BSAS was good (RMSEA = 0.064, CFI = 0.983, TLI = 0.973) and coefficient alpha was 0.87. The scores on the BSAS converged with scores on the Compulsive Buying Measurement Scale (CBMS; 0.80), and were positively correlated with extroversion and neuroticism, and negatively with conscientiousness, agreeableness, and intellect/imagination. The scores of the BSAS were positively associated with anxiety, depression, and low self-esteem and inversely related to age. Females scored higher than males on the BSAS. The BSAS is the first scale to fully embed shopping addiction within an addiction paradigm. A recommended cutoff score for the new scale and future research directions are discussed. PMID:26441749

Subjective Assessment of Sleep in Huntington Disease: Reliability of Sleep Questionnaires Compared to Polysomnography.

PubMed

Piano, Carla; Della Marca, Giacomo; Losurdo, Anna; Imperatori, Claudio; Solito, Marcella; Calandra-Buonaura, Giovanna; Provini, Federica; Cortelli, Pietro; Bentivoglio, Anna Rita

2017-01-01

The aim of the study was to evaluate the clinical reliability of subjective sleep evaluation, based on sleep and psychometric questionnaires, by comparing the results with those obtained with laboratory-based video-polysomnography (V-PSG). Thirty consecutive Huntington disease (HD) patients were enrolled. Subjective evaluation of sleep included the Pittsburgh Sleep Quality Index (PSQI), the sleep questionnaire for HD (HDQ), the Epworth Sleepiness Scale, the Bologna questionnaire for sleepiness (BQ), the Berlin questionnaire, and the RBD questionnaire; the International Restless Legs Syndrome Study Group scale was administered to patients with positive screening. The psychometric evaluation included the Zung Anxiety Scale, the short form of the Beck Depression Inventory, and the Maudsley Obsessive-Compulsive Inventory. All patients underwent V-PSG. In sleepiness evaluation, the Epworth score was above the cutoff in 6 subjects, and the BQ detected a "high risk" of sleepiness in 7 cases. The results were concordant in 24 and discordant in 5 cases. In the evaluation of sleep quality, the PSQI score was above the cutoff in 18 subjects. According to the HDQ, 10 subjects were poor sleepers. The results were concordant with the PSQI in 20 subjects. All comparisons between scale scores and PSG results showed poor or totally absent concordance between subjective and objective measures. The subjective evaluation of sleep in HD patients shows a poor correlation with PSG results. © 2017 S. Karger AG, Basel.

No Effect of Generalized Joint Hypermobility on Injury Risk in Elite Female Soccer Players: A Prospective Cohort Study.

PubMed

Blokland, Donna; Thijs, Karin M; Backx, Frank J G; Goedhart, Edwin A; Huisstede, Bionka M A

2017-02-01

Although it has been suggested that generalized joint hypermobility (GJH) is a risk factor for injury in soccer players, it remains unclear whether this applies to elite female soccer players. To investigate whether GJH is a risk factor for injury in elite female soccer players. Cohort study; Level of evidence, 2. Elite female soccer players in the Netherlands were screened at the start of the 2014-2015 competitive season. GJH was assessed using the Beighton score. Soccer injuries and soccer exposure were registered throughout the entire season. Poisson regression was performed to calculate incidence risk ratios (IRRs) using different cutoff points of the Beighton score (≥3, ≥4, and ≥5) to indicate GJH. Of the 114 players included in the study, 20 were classified as hypermobile (Beighton score ≥4). The mean (±SD) injury incidence per player was 8.40 ± 9.17 injuries/1000 hours of soccer, with no significant difference between hypermobile and nonhypermobile players. GJH was not a risk factor for injuries when using Beighton score cutoff points of ≥3 (IRR = 1.06 [95% CI, 0.74-1.50]; P = .762), ≥4 (IRR = 1.10 [95% CI, 0.72-1.68]; P = .662), or ≥5 (IRR = 1.15 [95% CI, 0.68-1.95]; P = .602). Similarly, GJH was not a significant risk factor for thigh, knee, or ankle injuries evaluated separately. This study indicates that GJH is not a risk factor for injuries in elite female soccer players, irrespective of Beighton score cutoff point. Hypermobile players at this elite level might have improved their active stability and/or used braces to compensate for joint laxity.

Validity of the MCMI Drug Abuse Scale varies as a function of drug choice, race, and axis II subtypes.

PubMed

Calsyn, D A; Saxon, A J; Daisy, F

1991-06-01

The validity of the Drug Abuse Scale (T) from the Million Clinical Multiaxial Inventory (MCMI) was studied by administering the MCMI to 110 male veterans seeking treatment for opioid or cocaine dependence. Only 26 and 23% of the sample obtained base rate (BR) scores above the clinical relevant cutoffs of 84 and 74, respectively. Covariables associated with elevated scores on the T Scale were Black race, presence of narcissistic/antisocial personality features, and more severe psychopathology in general. The authors urge caution in using the Drug Abuse Scale for the purpose of identifying drug abusers.

Socioeconomic Factors Influence Physical Activity and Sport in Quebec Schools

ERIC Educational Resources Information Center

Morin, Pascale; Lebel, Alexandre; Robitaille, Éric; Bisset, Sherri

2016-01-01

Background: School environments providing a wide selection of physical activities and sufficient facilities are both essential and formative to ensure young people adopt active lifestyles. We describe the association between school opportunities for physical activity and socioeconomic factors measured by low-income cutoff index, school size…

Dynamic interaction between fetal adversity and a genetic score reflecting dopamine function on developmental outcomes at 36 months

PubMed Central

Pokhvisneva, Irina; Léger, Étienne; Gaudreau, Hélène; Steiner, Meir; Kennedy, James L.; O’Donnell, Kieran J.; Diorio, Josie; Meaney, Michael J.; Silveira, Patrícia P.

2017-01-01

Background Fetal adversity, evidenced by poor fetal growth for instance, is associated with increased risk for several diseases later in life. Classical cut-offs to characterize small (SGA) and large for gestational age (LGA) newborns are used to define long term vulnerability. We aimed at exploring the possible dynamism of different birth weight cut-offs in defining vulnerability in developmental outcomes (through the Bayley Scales of Infant and Toddler Development), using the example of a gene vs. fetal adversity interaction considering gene choices based on functional relevance to the studied outcome. Methods 36-month-old children from an established prospective birth cohort (Maternal Adversity, Vulnerability, and Neurodevelopment) were classified according to birth weight ratio (BWR) (SGA ≤0.85, LGA >1.15, exploring a wide range of other cut-offs) and genotyped for polymorphisms associated with dopamine signaling (TaqIA-A1 allele, DRD2-141C Ins/Ins, DRD4 7-repeat, DAT1-10- repeat, Met/Met-COMT), composing a score based on the described function, in which hypofunctional variants received lower scores. Results There were 251 children (123 girls and 128 boys). Using the classic cut-offs (0.85 and 1.15), there were no statistically significant interactions between the neonatal groups and the dopamine genetic score. However, when changing the cut-offs, it is possible to see ranges of BWR that could be associated with vulnerability to poorer development according to the variation in the dopamine function. Conclusion The classic birth weight cut-offs to define SGA and LGA newborns should be seen with caution, as depending on the outcome in question, the protocols for long-term follow up could be either too inclusive—therefore most costly, or unable to screen true vulnerabilities—and therefore ineffective to establish early interventions and primary prevention. PMID:28505190

Depression and anxiety levels in early stage Turkish breast cancer patients and related factors.

PubMed

Dastan, Nihal Bostanci; Buzlu, Sevim

2011-01-01

Psychiatric disorders such as depression and anxiety are common among cancer patients. If left untreated, these disorders can lead to poor treatment compliance, prolonged hospital stay and reduced life quality. In this prospective study, we aimed determine anxiety and depression levels and related factors among female breast cancer patients presenting to a breast surgery clinic in Istanbul and who met the inclusion criteria. Data were collected using a questionnaire and the Hospital Anxiety and Depression Scale (HAD). The mean age was 48.2 years and the mean post-operative period was 17.9 months. It was found that 46.3 % of the patients had stage I, and 53.7 % stage II, 59.3 % of them undergoing breast conserving surgery and 40.7 % mastectomy. When evaluated according to the HAD Scale, it was found that anxiety scores of 35.1 % of the patients and depression scores of 17.1 % of the patients were higher than their cut-off points. With regard to the affecting factors, depression scores of those with no family history of breast cancer were significantly higher than those with no family history of breast cancer (t= 1.53; p= 0.03); that the depression scores of the patients who underwent mastectomy were significantly higher than those who underwent breast conserving surgery (t= 1.75; p= 0.04). Additionally, it was found that low income was an important risk factor for anxiety; whereas a history of breast cancer in the family and mastectomy was an important risk factor for depression.These results indicate the importance of determining psychiatric problems and appropriate approaches in addition to medical treatment in breast cancer patients.

Validation of the Caregiver Guilt Questionnaire (CGQ) in a sample of British dementia caregivers.

PubMed

Roach, Louise; Laidlaw, Ken; Gillanders, David; Quinn, Kathryn

2013-12-01

Depression is well documented as a key outcome variable for dementia caregivers; however, guilt has been under-researched, which may be in part due to the lack of an appropriate measure. The Caregiver Guilt Questionnaire (CGQ) was originally developed and piloted with a Spanish population but has not yet been tested in an English-speaking population. A cross-sectional postal survey was undertaken with a sample of 221 dementia caregivers in the UK, as part of a larger study of dementia caregiver outcome measures. The five-factor structure identified for the CGQ in the Spanish sample was replicated in this study. The five factors, "guilt about doing wrong by the care recipient," "guilt about failing to meet the challenges of caregiving," 'guilt over experience of negative emotions in relation to caregiving," "guilt about self-care," and "guilt about neglecting other relatives" accounted for 60% of the variance. Internal consistencies for the whole scale and factors were acceptable, and convergent validity was established with the Zarit Burden Interview guilt factor. A higher score on the CGQ was associated with a higher score on the Center for Epidemiological Studies Depression scale (CES-D) and a new cut-off score of 22 was established, which predicted a clinical score on the CES-D with 80.0% sensitivity and 61.5% specificity. The replication of the five-factor structure suggests that these are relevant themes within the feelings of guilt to both Hispanic and British dementia caregivers. The CGQ has been demonstrated to be a valid measure for use with British dementia caregivers and is likely to be of use in clinical and research settings.

Clinical Applicability and Cutoff Values for an Unstructured Neuropsychological Assessment Protocol for Older Adults with Low Formal Education

PubMed Central

de Paula, Jonas Jardim; Bertola, Laiss; Ávila, Rafaela Teixeira; Moreira, Lafaiete; Coutinho, Gabriel; de Moraes, Edgar Nunes; Bicalho, Maria Aparecida Camargos; Nicolato, Rodrigo; Diniz, Breno Satler; Malloy-Diniz, Leandro Fernandes

2013-01-01

Background and Objectives The neuropsychological exam plays a central role in the assessment of elderly patients with cognitive complaints. It is particularly relevant to differentiate patients with mild dementia from those subjects with mild cognitive impairment. Formal education is a critical factor in neuropsychological performance; however, there are few studies that evaluated the psychometric properties, especially criterion related validity, neuropsychological tests for patients with low formal education. The present study aims to investigate the validity of an unstructured neuropsychological assessment protocol for this population and develop cutoff values for clinical use. Methods and Results A protocol composed by the Rey-Auditory Verbal Learning Test, Frontal Assessment Battery, Category and Letter Fluency, Stick Design Test, Clock Drawing Test, Digit Span, Token Test and TN-LIN was administered to 274 older adults (96 normal aging, 85 mild cognitive impairment and 93 mild Alzheimer`s disease) with predominantly low formal education. Factor analysis showed a four factor structure related to Executive Functions, Language/Semantic Memory, Episodic Memory and Visuospatial Abilities, accounting for 65% of explained variance. Most of the tests showed a good sensitivity and specificity to differentiate the diagnostic groups. The neuropsychological protocol showed a significant ecological validity as 3 of the cognitive factors explained 31% of the variance on Instrumental Activities of Daily Living. Conclusion The study presents evidence of the construct, criteria and ecological validity for this protocol. The neuropsychological tests and the proposed cutoff values might be used for the clinical assessment of older adults with low formal education. PMID:24066031

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

PubMed

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

2015-01-01

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

Familial clustering of epilepsy and behavioral disorders: Evidence for a shared genetic basis

PubMed Central

Hesdorffer, Dale C.; Caplan, Rochelle; Berg, Anne T.

2011-01-01

Purpose To examine whether family history of unprovoked seizures is associated with behavioral disorders in epilepsy probands, thereby supporting the hypothesis of shared underlying genetic susceptibility to these disorders. Methods We conducted an analysis of the 308 probands with childhood onset epilepsy from the Connecticut Study of Epilepsy with information on first degree family history of unprovoked seizures and of febrile seizures whose parents completed the Child Behavior Checklist (CBCL) at the 9-year follow-up. Clinical cut-offs for CBCL problem and DSM-Oriented scales were examined. The association between first degree family history of unprovoked seizure and behavioral disorders was assessed separately in uncomplicated and complicated epilepsy and separately for first degree family history of febrile seizures. A subanalysis, accounting for the tendency for behavioral disorders to run in families, adjusted for siblings with the same disorder as the proband. Prevalence ratios were used to describe the associations. Key findings In probands with uncomplicated epilepsy, first degree family history of unprovoked seizure was significantly associated with clinical cut-offs for Total Problems and Internalizing Disorders. Among Internalizing Disorders, clinical cut-offs for Withdrawn/Depressed, and DSM-Oriented scales for Affective Disorder and Anxiety Disorder were significantly associated with family history of unprovoked seizures. Clinical cut-offs for Aggressive Behavior and Delinquent Behavior, and DSM-Oriented scales for Conduct Disorder and Oppositional Defiant Disorder were significantly associated with family history of unprovoked seizure. Adjustment for siblings with the same disorder revealed significant associations for the relationship between first degree family history of unprovoked seizure and Total Problems and Agressive Behavior in probands with uncomplicated epilepsy; marginally significant results were seen for Internalizing Disorder, Withdrawn/Depressed and Anxiety Disorder. There was no association between family history of unprovoked seizure and behavioral problems in probands with complicated epilepsy. First degree family history of febrile seizure was not associated with behavioral problems in probands with uncomplicated or in those with complicated epilepsy. Significance Increased occurrence of behavioral disorders in probands with uncomplicated epilepsy and first degree family history of unprovoked seizure suggests familial clustering of these disorders. This supports the idea that behavioral disorders may be another manifestation of the underlying pathophysiology involved in epilepsy or closely related to it. PMID:22191626

Familial clustering of epilepsy and behavioral disorders: evidence for a shared genetic basis.

PubMed

Hesdorffer, Dale C; Caplan, Rochelle; Berg, Anne T

2012-02-01

To examine whether family history of unprovoked seizures is associated with behavioral disorders in epilepsy probands, thereby supporting the hypothesis of shared underlying genetic susceptibility to these disorders. We conducted an analysis of the 308 probands with childhood onset epilepsy from the Connecticut Study of Epilepsy with information on first-degree family history of unprovoked seizures and of febrile seizures whose parents completed the Child Behavior Checklist (CBCL) at the 9-year follow-up. Clinical cutoffs for CBCL problem and Diagnostic and Statistical Manual of Mental Disorders (DSM)-Oriented scales were examined. The association between first-degree family history of unprovoked seizure and behavioral disorders was assessed separately in uncomplicated and complicated epilepsy and separately for first-degree family history of febrile seizures. A subanalysis, accounting for the tendency for behavioral disorders to run in families, was adjusted for siblings with the same disorder as the proband. Prevalence ratios were used to describe the associations. In probands with uncomplicated epilepsy, first-degree family history of unprovoked seizure was significantly associated with clinical cutoffs for Total Problems and Internalizing Disorders. Among Internalizing Disorders, clinical cutoffs for Withdrawn/Depressed, and DSM-Oriented scales for Affective Disorder and Anxiety Disorder were significantly associated with family history of unprovoked seizures. Clinical cutoffs for Aggressive Behavior and Delinquent Behavior, and DSM-Oriented scales for Conduct Disorder and Oppositional Defiant Disorder were significantly associated with family history of unprovoked seizure. Adjustment for siblings with the same disorder revealed significant associations for the relationship between first-degree family history of unprovoked seizure and Total Problems and Aggressive Behavior in probands with uncomplicated epilepsy; marginally significant results were seen for Internalizing Disorder, Withdrawn/Depressed, and Anxiety Disorder. There was no association between family history of unprovoked seizure and behavioral problems in probands with complicated epilepsy. First-degree family history of febrile seizure was not associated with behavioral problems in probands with uncomplicated or in those with complicated epilepsy. Increased occurrence of behavioral disorders in probands with uncomplicated epilepsy and first degree family history of unprovoked seizure suggests familial clustering of these disorders. This supports the idea that behavioral disorders may be another manifestation of the underlying pathophysiology involved in epilepsy or closely related to it. Wiley Periodicals, Inc. © 2011 International League Against Epilepsy.

Predicting posttraumatic stress disorder in children and parents following accidental child injury: evaluation of the Screening Tool for Early Predictors of Posttraumatic Stress Disorder (STEPP).

PubMed

van Meijel, Els P M; Gigengack, Maj R; Verlinden, Eva; Opmeer, Brent C; Heij, Hugo A; Goslings, J Carel; Bloemers, Frank W; Luitse, Jan S K; Boer, Frits; Grootenhuis, Martha A; Lindauer, Ramón J L

2015-05-12

Children and their parents are at risk of posttraumatic stress disorder (PTSD) following injury due to pediatric accidental trauma. Screening could help predict those at greatest risk and provide an opportunity for monitoring so that early intervention may be provided. The purpose of this study was to evaluate the Screening Tool for Early Predictors of Posttraumatic Stress Disorder (STEPP) in a mixed-trauma sample in a non-English speaking country (the Netherlands). Children aged 8-18 and one of their parents were recruited in two academic level I trauma centers. The STEPP was assessed in 161 children (mean age 13.9 years) and 156 parents within one week of the accident. Three months later, clinical diagnoses and symptoms of PTSD were assessed in 147 children and 135 parents. We used the Anxiety Disorders Interview Schedule for DSM-IV - Child and Parent version, the Children's Revised Impact of Event Scale and the Impact of Event Scale-Revised. Receiver Operating Characteristic analyses were performed to estimate the Areas Under the Curve as a measure of performance and to determine the optimal cut-off score in our sample. Sensitivity, specificity, positive and negative predictive values were calculated. The aim was to maximize both sensitivity and negative predictive values. PTSD was diagnosed in 12% of the children; 10% of their parents scored above the cut-off point for PTSD. At the originally recommended cut-off scores (4 for children, 3 for parents), the sensitivity in our sample was 41% for children and 54% for parents. Negative predictive values were 92% for both groups. Adjusting the cut-off scores to 2 improved sensitivity to 82% for children and 92% for parents, with negative predictive values of 92% and 96%, respectively. With adjusted cut-off scores, the STEPP performed well: 82% of the children and 92% of the parents with a subsequent positive diagnosis were identified correctly. Special attention in the screening procedure is required because of a high rate of false positives. The STEPP appears to be a valid and useful instrument that can be used in the Netherlands as a first screening method in stepped psychotrauma care following accidents.

Evaluation of predictive capacities of biomarkers based on research synthesis.

PubMed

Hattori, Satoshi; Zhou, Xiao-Hua

2016-11-10

The objective of diagnostic studies or prognostic studies is to evaluate and compare predictive capacities of biomarkers. Suppose we are interested in evaluation and comparison of predictive capacities of continuous biomarkers for a binary outcome based on research synthesis. In analysis of each study, subjects are often classified into two groups of the high-expression and low-expression groups according to a cut-off value, and statistical analysis is based on a 2 × 2 table defined by the response and the high expression or low expression of the biomarker. Because the cut-off is study specific, it is difficult to interpret a combined summary measure such as an odds ratio based on the standard meta-analysis techniques. The summary receiver operating characteristic curve is a useful method for meta-analysis of diagnostic studies in the presence of heterogeneity of cut-off values to examine discriminative capacities of biomarkers. We develop a method to estimate positive or negative predictive curves, which are alternative to the receiver operating characteristic curve based on information reported in published papers of each study. These predictive curves provide a useful graphical presentation of pairs of positive and negative predictive values and allow us to compare predictive capacities of biomarkers of different scales in the presence of heterogeneity in cut-off values among studies. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Diagnostic Utility of the Posttraumatic Stress Disorder (PTSD) Checklist for Identifying Full and Partial PTSD in Active-Duty Military.

PubMed

Dickstein, Benjamin D; Weathers, Frank W; Angkaw, Abigail C; Nievergelt, Caroline M; Yurgil, Kate; Nash, William P; Baker, Dewleen G; Litz, Brett T

2015-06-01

The aim of this study was to determine optimally efficient cutoff scores on the Posttraumatic Stress Disorder Checklist (PCL) for identifying full posttraumatic stress disorder (PTSD) and partial PTSD (P-PTSD) in active-duty Marines and Sailors. Participants were 1,016 Marines and Sailors who were administered the PCL and Clinician-Administered PTSD Scale (CAPS) 3 months after returning from Operations Iraqi and Enduring Freedom. PCL cutoffs were tested against three CAPS-based classifications: full PTSD, stringent P-PTSD, and lenient P-PTSD. A PCL score of 39 was found to be optimally efficient for identifying full PTSD. Scores of 38 and 33 were found to be optimally efficient for identifying stringent and lenient P-PTSD, respectively. Findings suggest that the PCL cutoff that is optimally efficient for detecting PTSD in active-duty Marines and Sailors is substantially lower than the score of 50 commonly used by researchers. In addition, findings provide scores useful for identifying P-PTSD in returning service members. © The Author(s) 2014.

The effect of pair cascades on the high-energy spectral cut-off in gamma-ray bursts

NASA Astrophysics Data System (ADS)

Gill, Ramandeep; Granot, Jonathan

2018-03-01

The highly luminous and variable prompt emission in gamma-ray bursts (GRBs) arises in an ultra-relativistic outflow. The exact underlying radiative mechanism shaping its non-thermal spectrum is still uncertain, making it hard to determine the outflow's bulk Lorentz factor Γ. GRBs with spectral cut-off due to pair production (γγ → e+e-) at energies Ec ≳ 10 MeV are extremely useful for inferring Γ. We find that when the emission region has a high enough compactness, then as it becomes optically thick to scattering, Compton downscattering by non-relativistic e±-pairs can shift the spectral cut-off energy well below the self-annihilation threshold, Esa = Γmec2/(1 + z). We treat this effect numerically and show that Γ obtained assuming Ec = Esa can underpredict its true value by as much as an order of magnitude.

Expanding (3+1)-dimensional universe from a lorentzian matrix model for superstring theory in (9+1) dimensions.

PubMed

Kim, Sang-Woo; Nishimura, Jun; Tsuchiya, Asato

2012-01-06

We reconsider the matrix model formulation of type IIB superstring theory in (9+1)-dimensional space-time. Unlike the previous works in which the Wick rotation was used to make the model well defined, we regularize the Lorentzian model by introducing infrared cutoffs in both the spatial and temporal directions. Monte Carlo studies reveal that the two cutoffs can be removed in the large-N limit and that the theory thus obtained has no parameters other than one scale parameter. Moreover, we find that three out of nine spatial directions start to expand at some "critical time," after which the space has SO(3) symmetry instead of SO(9).

Sarcopenia is an Independent Predictor of Severe Postoperative Complications and Long-Term Survival After Radical Gastrectomy for Gastric Cancer

PubMed Central

Zhuang, Cheng-Le; Huang, Dong-Dong; Pang, Wen-Yang; Zhou, Chong-Jun; Wang, Su-Lin; Lou, Neng; Ma, Liang-Liang; Yu, Zhen; Shen, Xian

2016-01-01

Abstract Currently, the association between sarcopenia and long-term prognosis after gastric cancer surgery has not been investigated. Moreover, the association between sarcopenia and postoperative complications remains controversial. This large-scale retrospective study aims to ascertain the prevalence of sarcopenia and assess its impact on postoperative complications and long-term survival in patients undergoing radical gastrectomy for gastric cancer. From December 2008 to April 2013, the clinical data of all patients who underwent elective radical gastrectomy for gastric cancer were collected prospectively. Only patients with available preoperative abdominal CT scan within 30 days of surgery were considered for analysis. Skeletal muscle mass was determined by abdominal (computed tomography) CT scan, and sarcopenia was diagnosed by the cut-off values obtained by means of optimum stratification. Univariate and multivariate analyses evaluating risk factors of postoperative complications and long-term survival were performed. A total of 937 patients were included in this study, and 389 (41.5%) patients were sarcopenic based on the diagnostic cut-off values (34.9 cm2/m2 for women and 40.8 cm2/m2 for men). Sarcopenia was an independent risk factor for severe postoperative complications (OR = 3.010, P < 0.001), but not for total complications. However, sarcopenia did not show significant association with operative mortality. Moreover, sarcopenia was an independent predictor for poorer overall survival (HR = 1.653, P < 0.001) and disease-free survival (HR = 1.620, P < 0.001). Under the adjusted tumor-node-metastasis (TNM) stage, sarcopenia remained an independent risk factor for overall survival and disease-free survival in patients with TNM stage II and III, but not in patients with TNM stage I. Sarcopenia is an independent predictive factor of severe postoperative complications after radical gastrectomy for gastric cancer. Moreover, sarcopenia is independently associated with overall and disease-free survival in patients with TNM stage II and III, but not in patients with TNM stage I. PMID:27043677

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

PubMed Central

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

2013-01-01

Objectives To estimate the prevalence and factors associated with smoking and misclassification in pregnant women from INMA (INfancia y Medio Ambiente, Environment and Childhood) project, Spain, and to assess the optimal cut-offs for urinary cotinine (UC) that best distinguish daily and occasional smokers with varying levels of second-hand smoke (SHS) exposure. Design We used logistic regression models to study the relationship between sociodemographic variables and self-reported smoking and misclassification (self-reported non-smokers with UC >50 ng/ml). Receiver operating characteristic (ROC) curves were used to calculate the optimal cut-off point for discriminating smokers. The cut-offs were also calculated after stratification among non-smokers by the number of sources of SHS exposure. The cut-off points used to discriminate smoking status were the level of UC given by Youden's index and for 50 and 100 ng/ml for daily smokers, or 25 and 50 ng/ml for occasional smokers. Participants At the third trimester of pregnancy, 2263 pregnant women of the INMA Project were interviewed between 2004 and 2008 and a urine sample was collected. Results Prevalence of self-reported smokers at the third trimester of pregnancy was 18.5%, and another 3.9% misreported their smoking status. Variables associated with self-reported smoking and misreporting were similar, including born in Europe, educational level and exposure to SHS. The optimal cut-off was 82 ng/ml (95% CI 42 to 133), sensitivity 95.2% and specificity 96.6%. The area under the ROC curve was 0.986 (95% CI 0.982 to 0.990). The cut-offs varied according to the SHS exposure level being 42 (95% CI 27 to 57), 82 (95% CI 46 to 136) and 106 ng/ml (95% CI 58 to 227) for not being SHS exposed, exposed to one, and to two or more sources of SHS, respectively. The optimal cut-off for discriminating occasional smokers from non-smokers was 27 ng/ml (95% CI 11 to 43). Conclusions Prevalence of smoking during pregnancy in Spain remains high. UC is a reliable biomarker for classifying pregnant women according to their smoking status. However, cut-offs would differ based on baseline exposure to SHS. PMID:23355667

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

PubMed

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

2013-01-24

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

Cut-off Points for Muscle Mass - Not Grip Strength or Gait Speed - Determine Variations in Sarcopenia Prevalence.

PubMed

Masanés, F; Rojano I Luque, X; Salvà, A; Serra-Rexach, J A; Artaza, I; Formiga, F; Cuesta, F; López Soto, A; Ruiz, D; Cruz-Jentoft, A J

2017-01-01

The European Working Group on Sarcopenia in Older People (EWGSOP) has proposed different methods and cut-off points for the three parameters that define sarcopenia: muscle mass, muscle strength and physical performance. Although this facilitates clinical practice, it limits comparability between studies and leads to wide differences in published prevalence rates. The aim of this study was to assess how changes in cut-off points for muscle mass, gait speed and grip strength affected sarcopenia prevalence according to EWGSOP criteria. Cross-sectional analysis of elderly individuals recruited from outpatient clinics (n=298) and nursing homes (n=276). We measured muscle mass, grip strength and gait speed and assessed how changes in cut-off points changed sarcopenia prevalence in both populations. An increase from 5.45 kg/m2 to 6.68 kg/m2 in the muscle mass index for female outpatients and nursing-home residents increased sarcopenia prevalence from 4% to 23% and from 9% to 47%, respectively; for men, for an increase from 7.25 kg/m2 to 8.87 kg/m2, the corresponding increases were from 1% to 22% and from 6% to 41%, respectively. Changes in gait speed and grip strength had a limited impact on sarcopenia prevalence. The cut-off points used for muscle mass affect the reported prevalence rates for sarcopenia and, in turn, affect comparability between studies. The main factors influencing the magnitude of the change are muscle mass index distribution in the population and the absolute value of the cut-off points: the same difference between two references (e.g., 7.5 kg/m2 to 7.75 kg/m2 or 7.75 kg/m2 to 8 kg/m2) may produce different changes in prevalence. Changes in cut-off points for gait speed and grip strength had a limited impact on sarcopenia prevalence and on study comparability.

Activities-specific balance confidence scale for predicting future falls in Indian older adults.

PubMed

Moiz, Jamal Ali; Bansal, Vishal; Noohu, Majumi M; Gaur, Shailendra Nath; Hussain, Mohammad Ejaz; Anwer, Shahnawaz; Alghadir, Ahmad

2017-01-01

Activities-specific balance confidence (ABC) scale is a subjective measure of confidence in performing various ambulatory activities without falling or experiencing a sense of unsteadiness. This study aimed to examine the ability of the Hindi version of the ABC scale (ABC-H scale) to discriminate between fallers and non-fallers and to examine its predictive validity for prospective falls. This was a prospective cohort study. A total of 125 community-dwelling older adults (88 were men) completed the ABC-H scale. The occurrence of falls over the follow-up period of 12 months was recorded. Discriminative validity was analyzed by comparing the total ABC-H scale scores between the faller and non-faller groups. A receiver operating characteristic curve analysis and a logistic regression analysis were used to examine the predictive accuracy of the ABC-H scale. The mean ABC-H scale score of the faller group was significantly lower than that of the non-faller group (52.6±8.1 vs 73.1±12.2; P <0.001). The optimal cutoff value for distinguishing faller and non-faller adults was ≤58.13. The sensitivity, specificity, area under the curve, and positive and negative likelihood ratios of the cutoff score were 86.3%, 87.3%, 0.91 ( P <0.001), 6.84, and 0.16, respectively. The percentage test accuracy and false-positive and false-negative rates were 86.87%, 12.2%, and 13.6%, respectively. A dichotomized total ABC-H scale score of ≤58.13% (adjusted odds ratio =0.032, 95% confidence interval =0.004-0.25, P =0.001) was significantly related with future falls. The ABC-H scores were significantly and independently related with future falls in the community-dwelling Indian older adults. The ability of the ABC-H scale to predict future falls was adequate with high sensitivity and specificity values.

The German version of the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): psychometric properties and diagnostic utility.

PubMed

Krüger-Gottschalk, Antje; Knaevelsrud, Christine; Rau, Heinrich; Dyer, Anne; Schäfer, Ingo; Schellong, Julia; Ehring, Thomas

2017-11-28

The Posttraumatic Stress Disorder (PTSD) Checklist (PCL, now PCL-5) has recently been revised to reflect the new diagnostic criteria of the disorder. A clinical sample of trauma-exposed individuals (N = 352) was assessed with the Clinician Administered PTSD Scale for DSM-5 (CAPS-5) and the PCL-5. Internal consistencies and test-retest reliability were computed. To investigate diagnostic accuracy, we calculated receiver operating curves. Confirmatory factor analyses (CFA) were performed to analyze the structural validity. Results showed high internal consistency (α = .95), high test-retest reliability (r = .91) and a high correlation with the total severity score of the CAPS-5, r = .77. In addition, the recommended cutoff of 33 on the PCL-5 showed high diagnostic accuracy when compared to the diagnosis established by the CAPS-5. CFAs comparing the DSM-5 model with alternative models (the three-factor solution, the dysphoria, anhedonia, externalizing behavior and hybrid model) to account for the structural validity of the PCL-5 remained inconclusive. Overall, the findings show that the German PCL-5 is a reliable instrument with good diagnostic accuracy. However, more research evaluating the underlying factor structure is needed.

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

NASA Astrophysics Data System (ADS)

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

2017-04-01

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

Determining an anthropometric surrogate measure for identifying low birth weight babies in Uganda: a hospital-based cross sectional study

PubMed Central

2013-01-01

Background Achieving Millennium Development Goal 4 is dependent on significantly reducing neonatal mortality. Low birth weight is an underlying factor in most neonatal deaths. In developing countries the missed opportunity for providing life saving care is mainly a result of failure to identify low birth weight newborns. This study aimed at identifying a reliable anthropometric measurement for screening low birth weight and determining an operational cut-off point in the Uganda setting. This simple measurement is required because of lack of weighing scales in the community, and sometimes in the health facilities. Methods This was a hospital-based cross-sectional study. Two midwives weighed 706 newborns and measured their foot length, head, chest, thigh and mid-upper arm circumferences within 24 hours after birth. Data was analysed using STATA version 10.0. Correlation with birth weight using Pearson’s correlation coefficient and Receiver Operating Characteristics curve analysis were done to determine the measure that best predicts birth weight. Sensitivity and specificity were calculated for a range of measures to obtain operational cut-off points; and Likelihood Ratios and Diagnostic Odds Ratio were determined for each cut-off point. Results Birth weights ranged from 1370–5350 grams with a mean of 3050 grams (SD 0.53) and 85 (12%) babies weighed less than 2500 grams. All anthropometric measurements had a positive correlation with birth weight, with foot length showing the strongest (r = 0.76) and thigh circumference the weakest (r = 0.62) correlations. Foot length had the highest predictive value for low birth weight (AUC = 0.97) followed by mid-upper arm circumference (AUC = 0.94). Foot length and chest circumference had the highest sensitivity (94%) and specificity (90%) respectively for screening low birth weight babies at the selected cut-off points. Chest circumference had a significantly higher positive likelihood ratio (8.7) than any other measure, and foot length had the lowest negative likelihood ratio. Chest circumference and foot length had diagnostic odds ratios of 97% and 77% respectively. Foot length was easier to measure and it involved minimal exposure of the baby to cold. A cut-off of foot length 7.9 cm had sensitivity of 94% and specificity of 83% for predicting low birth weight. Conclusions This study suggests foot length as the most appropriate predictor for low birth weight in comparison to chest, head, mid-upper arm and thigh circumference in the Uganda setting. Use of low cost and easy to use tools to identify low birth weight babies by village health teams could support community efforts to save newborns. PMID:23587297

Clinical tests performed in acute stroke identify the risk of falling during the first year: postural stroke study in Gothenburg (POSTGOT).

PubMed

Persson, Carina U; Hansson, Per-Olof; Sunnerhagen, Katharina S

2011-03-01

To assess the likelihood of clinical tests for postural balance, walking and motor skills, performed during the first week after stroke, identifying the risk of falling. Prospective study. Patients with first stroke. Assessments were carried out during the first week, and the occurrence of falls was recorded 3, 6 and 12 months after stroke onset. The tests used were: 10-Metre Walking Test (10MWT), Timed Up & Go, Swedish Postural Assessment Scale for Stroke Patients, Berg Balance Scale and Modified Motor Assessment Scale. Cut-off levels were obtained by receiver operation characteristic curves, and odds ratios were used to assess cut-off levels for falling. The analyses were based on 96 patients. Forty-eight percent had at least one fall during the first year. All tests were associated with the risk of falling. The highest predictive values were found for the 10MWT (positive predictive value 64%, negative predictive value 76%). Those subjects who were unable to perform the 10MWT had the highest odds ratio, 6.06 (95% confidence interval 2.66-13.84, p<0.001) of falling. Clinical tests used during the first week after stroke onset can, to some extent, identify those patients at risk of falling during the first year after stroke.

Appropriate Body Mass Index and Waist Circumference Cutoffs for Categorization of Overweight and Central Adiposity among Uighur Adults in Xinjiang

PubMed Central

Ma, Yi-Tong; Liu, Fen; Yang, Yi-Ning; Ma, Xiang; Fu, Zhen-Yan; Li, Xiao-Mei; Xie, Xiang; Chen, You; Chen, Bangdang; He, Chun-Hui

2013-01-01

Objective The current overweight and central adiposity guidelines based on Western populations were not consistent with many studied based on the Asian populations. Uighur people live in Xinjiang Uighur Autonomous Region which is located in the center of Asia. Their overweight and central cutoffs were largely unknown. We aimed to identify cutoffs for body mass index (BMI; in kg/m2) and waist circumference (WC; in cm) for categorization of overweight and central adiposity among Uighur adults in Xinjiang. Methods 4767 Uighur participants were selected from the Cardiovascular Risk Survey (CRS) which was carried out from October 2007 to March 2010. The age of the participants were from 35 to 101 years old with the mean age of 50.09 years. Anthropometric data, blood pressure, serum concentration of serum total cholesterol, triglyceride, low density lipoprotein (LDL), high density lipoprotein (HDL) and fasting glucose were documented. The prevalence, sensitivity, specificity and distance on the receiver operating characteristic (ROC) curve of each BMI and waist circumference values were calculated. Results The prevalence of hypertension, hypercholesterolemia and hypertriglyceridemia were higher with higher BMI for both men and women. The prevalence of hypertension and hypercholesterolemia were higher with higher waist circumference for both men and women. In women, the prevalence of hypertriglyceridemia was noticed to increase as the waist circumference increased. The shortest distance in the receiver operating characteristic curves for hypertension, dyslipidemia, diabetes, or ≥ 2 of these risk factors suggested a BMI cutoff of 26 and a waist circumference cutoff of 90 cm for both men and women. Conclusions Higher cutoffs for BMI and waist circumference are needed in the identification of Uighur patients at high risk of cardiovascular disease. PMID:24244645

Appropriate body mass index and waist circumference cutoffs for categorization of overweight and central adiposity among Uighur adults in Xinjiang.

PubMed

Pan, Shuo; Yu, Zi-Xiang; Ma, Yi-Tong; Liu, Fen; Yang, Yi-Ning; Ma, Xiang; Fu, Zhen-Yan; Li, Xiao-Mei; Xie, Xiang; Chen, You; Chen, Bangdang; He, Chun-Hui

2013-01-01

The current overweight and central adiposity guidelines based on Western populations were not consistent with many studied based on the Asian populations. Uighur people live in Xinjiang Uighur Autonomous Region which is located in the center of Asia. Their overweight and central cutoffs were largely unknown. We aimed to identify cutoffs for body mass index (BMI; in kg/m(2)) and waist circumference (WC; in cm) for categorization of overweight and central adiposity among Uighur adults in Xinjiang. 4767 Uighur participants were selected from the Cardiovascular Risk Survey (CRS) which was carried out from October 2007 to March 2010. The age of the participants were from 35 to 101 years old with the mean age of 50.09 years. Anthropometric data, blood pressure, serum concentration of serum total cholesterol, triglyceride, low density lipoprotein (LDL), high density lipoprotein (HDL) and fasting glucose were documented. The prevalence, sensitivity, specificity and distance on the receiver operating characteristic (ROC) curve of each BMI and waist circumference values were calculated. The prevalence of hypertension, hypercholesterolemia and hypertriglyceridemia were higher with higher BMI for both men and women. The prevalence of hypertension and hypercholesterolemia were higher with higher waist circumference for both men and women. In women, the prevalence of hypertriglyceridemia was noticed to increase as the waist circumference increased. The shortest distance in the receiver operating characteristic curves for hypertension, dyslipidemia, diabetes, or ≥ 2 of these risk factors suggested a BMI cutoff of 26 and a waist circumference cutoff of 90 cm for both men and women. Higher cutoffs for BMI and waist circumference are needed in the identification of Uighur patients at high risk of cardiovascular disease.

Hypopituitarism following traumatic brain injury: prevalence is affected by the use of different dynamic tests and different normal values.

PubMed

Kokshoorn, Nieke E; Wassenaar, Moniek J E; Biermasz, Nienke R; Roelfsema, Ferdinand; Smit, Johannes W A; Romijn, Johannes A; Pereira, Alberto M

2010-01-01

Traumatic brain injury (TBI) has emerged as an important cause of hypopituitarism. However, considerable variations in the prevalence of hypopituitarism are reported. These can partly be explained by severity of trauma and timing of hormonal evaluation, but may also be dependent on endocrine tests and criteria used for diagnosis of hypopituitarism. Systematic review of studies reporting prevalence of hypopituitarism in adults >or=1 year after TBI focusing on used (dynamic) tests and biochemical criteria. We included data from 14 studies with a total of 931 patients. There was considerable variation in definition of hypopituitarism. Overall, reported prevalences of severe GH deficiency varied between 2 and 39%. Prevalences were 8-20% using the GHRH-arginine test (cutoff <9 microg/l), 11-39% using the glucagon test (cutoff 1-5 microg/l), 2% using the GHRH test (no cutoff), and 15-18% using the insulin tolerance test (ITT; cutoff <3 microg/l). Overall, the reported prevalence of secondary adrenal insufficiency had a broad range from 0 to 60%. This prevalence was 0-60% with basal cortisol (cutoff <220 or <440 nmol/l), 7-19% using the ACTH test, and 5% with the ITT as first test (cutoff <500 or <550 nmol/l). Secondary hypothyroidism was present in 0-19% (free thyroxine) or 5-15% (thyroid-releasing hormone stimulation). Secondary hypogonadism was present in 0-29%. The reported variations in the prevalence rates of hypopituitarism after TBI are in part caused by differences in definitions, endocrine assessments of hypopituitarism, and confounding factors. These methodological issues prohibit simple generalizations of results of original studies on TBI-associated hypopituitarism in the perspective of meta-analyses or reviews.

Validation of the Alcohol Use Disorders Identification Test in university students: AUDIT and AUDIT-C.

PubMed

García Carretero, Miguel Ángel; Novalbos Ruiz, José Pedro; Martínez Delgado, José Manuel; O'Ferrall González, Cristina

2016-03-02

The aim of this study was to determine the psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT and AUDIT-C) in order to detect problems related to the consumption of alcohol in the university population. The sample consisted of 1309 students.A Weekly Alcohol Consumption Diary was used as a gold standard; Cronbach's Alpha, the Kappa index, Spearman's correlation coefficient and exploratory factor analysis were applied for diagnostic reliability and validity, with ROC curves used to establish the different cut-off points. Binge Drinking (BD) episodes were found in 3.9% of men and 4.0% of women with otherwise low-risk drinking patterns. AUDIT identified 20.1% as high-risk drinkers and 6.4% as drinkers with physical-psychological problems and probable alcohol dependence.Cronbach's alpha of 0.75 demonstrates good internal consistency. The best cut-off points for high-risk drinking students were 8 for males and 6 for females. As for problem drinkers and probable ADS, 13 was the best cut-off point for both sexes. In relation to AUDIT-C, 5 and 4 were the best cut-off points for males and females with high-risk patterns, respectively. The criterion validity of AUDIT and AUDIT-C to detect binge drinking episodes was found to have a moderate K value. The results obtained show that AUDIT has good psychometric properties to detect early alcohol abuse disorders in university students; however, it is recommended that the cut-off point be reduced to 8 in men. AUDIT-C improves its predictive value by raising the cut-off point by one unit. Items 2 and 3 should be reviewed to increase its predictive value for BD.

Measuring compulsive buying behaviour: psychometric validity of three different scales and prevalence in the general population and in shopping centres.

PubMed

Maraz, Aniko; Eisinger, Andrea; Hende, Borbála; Urbán, Róbert; Paksi, Borbála; Kun, Bernadette; Kökönyei, Gyöngyi; Griffiths, Mark D; Demetrovics, Zsolt

2015-02-28

Due to the problems of measurement and the lack of nationally representative data, the extent of compulsive buying behaviour (CBB) is relatively unknown. The validity of three different instruments was tested: Edwards Compulsive Buying Scale (ECBS; Edwards, E.A., 1993. Development of a new scale for measuring compulsive buying behaviour. Financial Counseling and Planning. 4, 67-85), Questionnaire About Buying Behavior (QABB; Lejoyeux, M., Ades, J., 1994. Les achats pathologiques: une addiction comportementale. Neuro-Psy. 9, 25-32.) and Richmond Compulsive Buying Scale (RCBS; Ridgway, N.M., Kukar-Kinney, M., Monroe, K.B., 2008. An expanded conceptualization and a new measure of compulsive buying. Journal of Consumer Research. 35, 622-639.) using two independent samples. One was nationally representative of the Hungarian population (N=2710) while the other comprised shopping mall customers (N=1447). As a result, a new, four-factor solution for the ECBS was developed (Edwards Compulsive Buying Scale Revised (ECBS-R)), and confirmed the other two measures. Additionally, cut-off scores were defined for all measures. Results showed that the prevalence of CBB is 1.85% (with QABB) in the general population but significantly higher in shopping mall customers (8.7% with ECBS-R, 13.3% with QABB and 2.5% with RCBS-R). Conclusively, due to the diversity of content, each measure identifies a somewhat different CBB group. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Assessing Attitudes towards Statistics among Medical Students: Psychometric Properties of the Serbian Version of the Survey of Attitudes Towards Statistics (SATS)

PubMed Central

Stanisavljevic, Dejana; Trajkovic, Goran; Marinkovic, Jelena; Bukumiric, Zoran; Cirkovic, Andja; Milic, Natasa

2014-01-01

Background Medical statistics has become important and relevant for future doctors, enabling them to practice evidence based medicine. Recent studies report that students’ attitudes towards statistics play an important role in their statistics achievements. The aim of the study was to test the psychometric properties of the Serbian version of the Survey of Attitudes Towards Statistics (SATS) in order to acquire a valid instrument to measure attitudes inside the Serbian educational context. Methods The validation study was performed on a cohort of 417 medical students who were enrolled in an obligatory introductory statistics course. The SATS adaptation was based on an internationally accepted methodology for translation and cultural adaptation. Psychometric properties of the Serbian version of the SATS were analyzed through the examination of factorial structure and internal consistency. Results Most medical students held positive attitudes towards statistics. The average total SATS score was above neutral (4.3±0.8), and varied from 1.9 to 6.2. Confirmatory factor analysis validated the six-factor structure of the questionnaire (Affect, Cognitive Competence, Value, Difficulty, Interest and Effort). Values for fit indices TLI (0.940) and CFI (0.961) were above the cut-off of ≥0.90. The RMSEA value of 0.064 (0.051–0.078) was below the suggested value of ≤0.08. Cronbach’s alpha of the entire scale was 0.90, indicating scale reliability. In a multivariate regression model, self-rating of ability in mathematics and current grade point average were significantly associated with the total SATS score after adjusting for age and gender. Conclusion Present study provided the evidence for the appropriate metric properties of the Serbian version of SATS. Confirmatory factor analysis validated the six-factor structure of the scale. The SATS might be reliable and a valid instrument for identifying medical students’ attitudes towards statistics in the Serbian educational context. PMID:25405489

Assessing attitudes towards statistics among medical students: psychometric properties of the Serbian version of the Survey of Attitudes Towards Statistics (SATS).

PubMed

Stanisavljevic, Dejana; Trajkovic, Goran; Marinkovic, Jelena; Bukumiric, Zoran; Cirkovic, Andja; Milic, Natasa

2014-01-01

Medical statistics has become important and relevant for future doctors, enabling them to practice evidence based medicine. Recent studies report that students' attitudes towards statistics play an important role in their statistics achievements. The aim of the study was to test the psychometric properties of the Serbian version of the Survey of Attitudes Towards Statistics (SATS) in order to acquire a valid instrument to measure attitudes inside the Serbian educational context. The validation study was performed on a cohort of 417 medical students who were enrolled in an obligatory introductory statistics course. The SATS adaptation was based on an internationally accepted methodology for translation and cultural adaptation. Psychometric properties of the Serbian version of the SATS were analyzed through the examination of factorial structure and internal consistency. Most medical students held positive attitudes towards statistics. The average total SATS score was above neutral (4.3±0.8), and varied from 1.9 to 6.2. Confirmatory factor analysis validated the six-factor structure of the questionnaire (Affect, Cognitive Competence, Value, Difficulty, Interest and Effort). Values for fit indices TLI (0.940) and CFI (0.961) were above the cut-off of ≥0.90. The RMSEA value of 0.064 (0.051-0.078) was below the suggested value of ≤0.08. Cronbach's alpha of the entire scale was 0.90, indicating scale reliability. In a multivariate regression model, self-rating of ability in mathematics and current grade point average were significantly associated with the total SATS score after adjusting for age and gender. Present study provided the evidence for the appropriate metric properties of the Serbian version of SATS. Confirmatory factor analysis validated the six-factor structure of the scale. The SATS might be reliable and a valid instrument for identifying medical students' attitudes towards statistics in the Serbian educational context.

Early Recurrence After Hepatectomy for Colorectal Liver Metastases: What Optimal Definition and What Predictive Factors?

PubMed Central

Imai, Katsunori; Allard, Marc-Antoine; Benitez, Carlos Castro; Vibert, Eric; Sa Cunha, Antonio; Cherqui, Daniel; Castaing, Denis; Bismuth, Henri; Baba, Hideo

2016-01-01

Background. The purpose of this study was to determine the optimal definition and elucidate the predictive factors of early recurrence after surgery for colorectal liver metastases (CRLM). Methods. Among 987 patients who underwent curative surgery for CRLM from 1990 to 2012, 846 with a minimum follow-up period of 24 months were eligible for this study. The minimum p value approach of survival after initial recurrence was used to determine the optimal cutoff for the definition of early recurrence. The predictive factors of early recurrence and prognostic factors of survival were analyzed. Results. For 667 patients (79%) who developed recurrence, the optimal cutoff point of early recurrence was determined to be 8 months after surgery. The impact of early recurrence on survival was demonstrated mainly in patients who received preoperative chemotherapy. Among the 691 patients who received preoperative chemotherapy, recurrence was observed in 562 (81%), and survival in patients with early recurrence was significantly worse than in those with late recurrence (5-year survival 18.5% vs. 53.4%, p < .0001). Multivariate logistic analysis identified age ≤57 years (p = .0022), >1 chemotherapy line (p = .03), disease progression during last-line chemotherapy (p = .024), >3 tumors (p = .0014), and carbohydrate antigen 19-9 >60 U/mL (p = .0003) as independent predictors of early recurrence. Salvage surgery for recurrence significantly improved survival, even in patients with early recurrence. Conclusion. The optimal cutoff point of early recurrence was determined to be 8 months. The preoperative prediction of early recurrence is possible and crucial for designing effective perioperative chemotherapy regimens. Implications for Practice: In this study, the optimal cutoff point of early recurrence was determined to be 8 months after surgery based on the minimum p value approach, and its prognostic impact was demonstrated mainly in patients who received preoperative chemotherapy. Five factors, including age, number of preoperative chemotherapy lines, response to last-line chemotherapy, number of tumors, and carbohydrate antigen 19-9 concentrations, were identified as predictors of early recurrence. Salvage surgery for recurrence significantly improved survival, even in patients with early recurrence. For better selection of patients who could truly benefit from surgery and should also receive strong postoperative chemotherapy, the accurate preoperative prediction of early recurrence is crucial. PMID:27125753

Dark Energy and Key Physical Parameters of Clusters of Galaxies

NASA Astrophysics Data System (ADS)

Chernin, A. D.; Bisnovatyi-Kogan, G. S.

We discuss the physics of clusters of galaxies embedded in the cosmic dark energy background and show that 1) the halo cut-off radius of a cluster like the Virgo cluster is practically, if not exactly, equal to the zero-gravity radius at which the dark matter gravity is balanced by the dark energy antigravity; 2) the halo averaged density is equal to two densities of dark energy; 3) the halo edge (cut-off) density is the dark energy density with a numerical factor of the unity order slightly depending on the halo profile.

Evolution of the phase-space density and the Jeans scale for dark matter derived from the Vlasov-Einstein equation

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

Piattella, O.F.; Rodrigues, D.C.; Fabris, J.C.

2013-11-01

We discuss solutions of Vlasov-Einstein equation for collisionless dark matter particles in the context of a flat Friedmann universe. We show that, after decoupling from the primordial plasma, the dark matter phase-space density indicator Q = ρ/(σ{sub 1D}{sup 2}){sup 3/2} remains constant during the expansion of the universe, prior to structure formation. This well known result is valid for non-relativistic particles and is not ''observer dependent'' as in solutions derived from the Vlasov-Poisson system. In the linear regime, the inclusion of velocity dispersion effects permits to define a physical Jeans length for collisionless matter as function of the primordial phase-spacemore » density indicator: λ{sub J} = (5π/G){sup 1/2}Q{sup −1/3}ρ{sub dm}{sup −1/6}. The comoving Jeans wavenumber at matter-radiation equality is smaller by a factor of 2-3 than the comoving wavenumber due to free-streaming, contributing to the cut-off of the density fluctuation power spectrum at the lowest scales. We discuss the physical differences between these two scales. For dark matter particles of mass equal to 200 GeV, the derived Jeans mass is 4.3 × 10{sup −6}M{sub ⊙}.« less

Characteristics of Adolescents at Risk for Compulsive Overeating on a Brief Screening Test.

ERIC Educational Resources Information Center

Marston, Albert R.; And Others

1988-01-01

Surveyed addictive behavior, finding 26% of male and 57% of female high school students scored above cutoff point on the Overeaters Anonymous scale for assessing compulsive overeating. At-risk students perceived their life quality and relationship with person closest to them as significantly less positive, indicated overeating's defensive…

Comparison of the GHQ-36, the GHQ-12 and the SCL-90 as psychiatric screening instruments in the Finnish population.

PubMed

Holi, Matti M; Marttunen, Mauri; Aalberg, Veikko

2003-01-01

The aim of the study was to compare the screening properties of two General Health Questionnaire (GHQ) versions and the Symptom Checklist (SCL-90), and to evaluate them as psychiatric screening instruments in Finland. We administered the GHQ-36 and the SCL-90 to psychiatric outpatients (n=207) and to a community sample (n=315). Receiver operating characteristic (ROC) analysis was used to estimate the screening performance of the two instruments and of the GHQ-12 extracted from the GHQ-36. The screening properties of the scales were found to be good and similar. Suggested optimal cut-off points were 3/4 for the GHQ-12, 8/9 for the GHQ-36 and 0.90/0.91 for the SCL-90. In conclusion, the scales functioned equally well in screening. This favors the GHQ-12 for pure screening. When information on the symptom level is also needed, the GHQ-36 and the SCL-90 become better choices. The cut-off points presented here should be considered in the future Finnish psychiatric screening studies.

The Total Urine Protein-to-Creatinine Ratio Can Predict the Presence of Microalbuminuria

PubMed Central

Yamamoto, Kyoko; Yamamoto, Hiroyuki; Yoshida, Katsumi; Niwa, Koichiro; Nishi, Yutaro; Mizuno, Atsushi; Kuwabara, Masanari; Asano, Taku; Sakoda, Kunihiro; Niinuma, Hiroyuki; Nakahara, Fumiko; Takeda, Kyoko; Shindoh, Chiyohiko; Komatsu, Yasuhiro

2014-01-01

Background The Kidney Disease: Improving Global Outcomes chronic kidney disease (CKD) guidelines recommend that CKD be classified based on the etiology, glomerular filtration rate (GFR) and degree of albuminuria. The present study aimed to establish a method that predicts the presence of microalbuminuria by measuring the total urine protein-to-creatinine ratio (TPCR) in patients with cardiovascular disease (CVD) risk factors. Methods and Results We obtained urine samples from 1,033 patients who visited the cardiovascular clinic at St. Luke's International Hospital from February 2012 to August 2012. We measured the TPCR and the urine albumin-to-creatinine ratio (ACR) from random spot urine samples. We performed correlation, receiver operating characteristic (ROC) curve, sensitivity, and subgroup analyses. There was a strong positive correlation between the TPCR and ACR (R2 = 0.861, p<0.001). A ROC curve analysis for the TPCR revealed a sensitivity of 94.4%, a specificity of 86.1%, and an area under the curve of 0.903 for detecting microalbuminuria for a TPCR cut-off value of 84 mg/g of creatinine. The subgroup analysis indicated that the cut-off value could be used for patients with CVD risk factors. Conclusions These results suggest that the TPCR with an appropriate cut-off value could be used to screen for the presence of microalbuminuria in patients with CVD risk factors. This simple, inexpensive measurement has broader applications, leading to earlier intervention and public benefit. PMID:24614247

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

PubMed

Schreiber, H; Steinhauser, O

1992-12-05

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

The power metric: a new statistically robust enrichment-type metric for virtual screening applications with early recovery capability.

PubMed

Lopes, Julio Cesar Dias; Dos Santos, Fábio Mendes; Martins-José, Andrelly; Augustyns, Koen; De Winter, Hans

2017-01-01

A new metric for the evaluation of model performance in the field of virtual screening and quantitative structure-activity relationship applications is described. This metric has been termed the power metric and is defined as the fraction of the true positive rate divided by the sum of the true positive and false positive rates, for a given cutoff threshold. The performance of this metric is compared with alternative metrics such as the enrichment factor, the relative enrichment factor, the receiver operating curve enrichment factor, the correct classification rate, Matthews correlation coefficient and Cohen's kappa coefficient. The performance of this new metric is found to be quite robust with respect to variations in the applied cutoff threshold and ratio of the number of active compounds to the total number of compounds, and at the same time being sensitive to variations in model quality. It possesses the correct characteristics for its application in early-recognition virtual screening problems.

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

PubMed

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

2013-09-25

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

The development of a new tool for the evaluation of handicap in elderly: the Geriatric Handicap Scale (GHS).

PubMed

Verrusio, Walter; Renzi, Alessia; Spallacci, Giulia; Pecci, Maria Tecla; Pappadà, Maria Antonella; Cacciafesta, Mauro

2018-02-10

To date, the comprehensive geriatric assessment (CGA) does not include an evaluation tool for handicap. To develop a new instrument for assessing handicap in the elderly: the Geriatric Handicap Scale (GHS). 656 community-dwelling elderly were enrolled in this study. We identified the thematic areas investigated by the CGA which showed a significant correlation with the handicap condition (handicap yes/not) to be included in our scale (Phase 1). Afterwards, we evaluated the possible correlations between: (1) the score obtained in each area of GHS and those obtained in CGA tests investigating similar dimensions, (2) GHS total score and the Multidimensional Prognostic Index (MPI) total score (Phase 2). In Phase 1, data analysis showed several significant correlations between the handicap condition and the scores obtained to the CGA tests exploring cognition, mood, functional impairment, comorbidity, social and environmental variables. Thus, we developed a tool considering five variables: (1) cognition and mood; (2) functional impairment; (3) hearing/visual impairment; (4) any additional comorbidity factors; (5) environmental/social risk factors. In Phase 2, data analysis showed significant correlations between the score obtained in each area of GHS and those obtained in the CGA tests investigating similar dimensions. A positive correlation between GHS total score and MPI total score (r = 68; p = 0.001) was also reported. Cut-off score for the GHS was established. Psychometric properties of GHS were also investigated and adequate estimates of internal reliability were demonstrated. Our tool could prove useful to correctly categorize the disadvantageous condition related to patient's disability.

Measuring the impostor phenomenon: a comparison of Clance's IP Scale and Harvey's I-P Scale.

PubMed

Holmes, S W; Kertay, L; Adamson, L B; Holland, C L; Clance, P R

1993-02-01

Many of the discrepancies reported to date in empirical investigations of the impostor phenomenon (IP) may be due in part to (a) the use of different methods for identifying individuals suffering from this syndrome (impostors), (b) the common use of a median split procedure to classify subjects and (c) the fact that subjects in many studies were drawn from impostor-prone samples. In this study, we compared the scores of independently identified impostors and nonimpostors on two instruments designed to measure the IP: Harvey's I-P Scale and Clance's IP Scale. The results suggest that Clance's scale may be the more sensitive and reliable instrument. Cutoff score suggestions for both instruments are offered.

Clinical utility of the Neurobehavioral Symptom Inventory validity scales to screen for symptom exaggeration following traumatic brain injury.

PubMed

Lange, Rael T; Brickell, Tracey A; Lippa, Sara M; French, Louis M

2015-01-01

The purpose of this study was to examine the clinical utility of three recently developed validity scales (Validity-10, NIM5, and LOW6) designed to screen for symptom exaggeration using the Neurobehavioral Symptom Inventory (NSI). Participants were 272 U.S. military service members who sustained a mild, moderate, severe, or penetrating traumatic brain injury (TBI) and who were evaluated by the neuropsychology service at Walter Reed Army Medical Center within 199 weeks post injury. Participants were divided into two groups based on the Negative Impression Management scale of the Personality Assessment Inventory: (a) those who failed symptom validity testing (SVT-fail; n = 27) and (b) those who passed symptom validity testing (SVT-pass; n = 245). Participants in the SVT-fail group had significantly higher scores (p<.001) on the Validity-10, NIM5, LOW6, NSI total, and Personality Assessment Inventory (PAI) clinical scales (range: d = 0.76 to 2.34). Similarly high sensitivity, specificity, positive predictive power (PPP), and negative predictive (NPP) values were found when using all three validity scales to differentiate SVT-fail versus SVT-pass groups. However, the Validity-10 scale consistently had the highest overall values. The optimal cutoff score for the Validity-10 scale to identify possible symptom exaggeration was ≥19 (sensitivity = .59, specificity = .89, PPP = .74, NPP = .80). For the majority of people, these findings provide support for the use of the Validity-10 scale as a screening tool for possible symptom exaggeration. When scores on the Validity-10 exceed the cutoff score, it is recommended that (a) researchers and clinicians do not interpret responses on the NSI, and (b) clinicians follow up with a more detailed evaluation, using well-validated symptom validity measures (e.g., Minnesota Multiphasic Personality Inventory-2 Restructured Form, MMPI-2-RF, validity scales), to seek confirmatory evidence to support an hypothesis of symptom exaggeration.

The accuracy of serum galactomannan assay in diagnosing invasive pulmonary aspergillosis.

PubMed

Sarrafzadeh, Shokooh Azam; Hoseinpoor Rafati, Ali; Ardalan, Maryam; Mansouri, Davood; Tabarsi, Payam; Pourpak, Zahra

2010-09-01

Galactomannan (GM) antigen is an aspergillus specific antigen that is released during the growth phase of invasive aspergillosis. We aimed to find the optimum cutoff and accuracy of serum Galactomannan assay in immunocompromised patients. Immunocompromised patients diagnosed with invasive pulmonary aspergillosis (IPA) based on the European Organization for Research and Treatment of Cancer/Invasive Mycosis Study Group (EORTC/MSG) with three levels of certainty proven, probable and possible, referred for GM antigen measurement at Immunology, Asthma and Allergy Research Institute (IAARI) from 2006 to 2009 and if they met the criteria were enrolled in this study. Totally 49 patients with IPA were enrolled in our study. According to EORTC/MSG, patients categorized into three levels of certainty: They were diagnosed as 'proven' invasive pulmonary aspergillosis 16(32.7%), 'probable' 18(36.7%) and 'possible' 15(30.6%). The most common host risk factor was solid tumors 17(34.7%). The accuracy of Galactomannan assay increased from 0.5 to 2 cutoffs. The optimum sensitivity and specificity obtained at the index cutoff of ≥1.5 for diagnosis of "proven" IPA; which were respectively, 69.2% and 72.2%. Other cutoffs had high variance between sensitivity and specificity for diagnosis of IPA. The calculated cutoff gained by receiver operating characteristic (ROC) analysis for detecting proven IPA was 1.5. Intermediate accuracy of serum GM test in conjunct with clinical findings would help early IPA detection among immunocompromised patients.

Metabolic markers and ALT cutoff level for diagnosing nonalcoholic fatty liver disease: a community-based cross-sectional study.

PubMed

Miyake, Teruki; Kumagi, Teru; Hirooka, Masashi; Koizumi, Mitsuhito; Furukawa, Shinya; Ueda, Teruhisa; Tokumoto, Yoshio; Ikeda, Yoshio; Abe, Masanori; Kitai, Kohichiro; Hiasa, Yoichi; Matsuura, Bunzo; Onji, Morikazu

2012-06-01

Untreated nonalcoholic fatty liver disease (NAFLD) may progress to liver cirrhosis or failure and is associated with the development of hepatocellular carcinoma, diabetes, and cardiovascular disease. It is therefore essential to diagnose and treat NAFLD at an early stage. To assist in this effort, this retrospective study explored the risk factors for NAFLD, and derived new surrogates, a revised alanine aminotransferase (ALT) cutoff level and a novel NAFLD index, to identify previously undiagnosed cases of NAFLD. Using a community-based, cross-sectional design, the records of 6,370 Japanese subjects who had undergone at least 1 annual health check-up were reviewed for the identification of subjects meeting the diagnostic criteria for NAFLD and the variables associated with NAFLD for the estimation of ideal ALT cutoff levels. The results of multivariate analysis of the 1,346 subjects who met the diagnostic criteria for NAFLD confirmed that metabolic disease markers and a novel NAFLD index, using the variables derived from multivariate analysis, were also markers of NAFLD. The ALT cutoff levels for NAFLD diagnosis were estimated at 25 U/L for males and 17 U/L for females. ALT level and the novel NAFLD index were confirmed to be surrogate markers for NAFLD in addition to metabolic disease markers. The ALT cutoff level used in NAFLD diagnosis should be revised downward to identify subjects at risk of NAFLD to prevent NAFLD progression and the development of associated diseases.

Validation of the Arabic Rowland Universal Dementia Assessment Scale (A-RUDAS) in elderly with mild and moderate dementia.

PubMed

Chaaya, M; Phung, T K T; El Asmar, K; Atweh, S; Ghusn, H; Khoury, R M; Prince, M; Nielsen, T R; Waldemar, G

2016-08-01

Validated screening tests for dementia in Arabic are lacking. Given the low levels of education among elderly in the Middle East and North Africa region, the commonly used screening instrument, the Mini Mental State Examination, is not best suited. Alternatively, the Rowland Universal Dementia Assessment Scale (RUDAS) was especially designed to minimize the effects of cultural learning and education. The aim of this study was to validate the RUDAS in the Arabic language (A-RUDAS), evaluate its ability to screen for mild and moderate dementia, and assess the effect of education, sex, age, depression, and recruitment site on its performance. A-RUDAS was administered to 232 elderly aged ≥65 years recruited from the communities, community-based primary care clinics, and hospital-based specialist clinics. Of these, 136 had normal cognition, and 96 had dementia. Clinicians diagnosed dementia according to the Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) criteria. Interviewers, blind to the cognitive status of participants, administered A-RUDAS. The psychometric properties of A-RUDAS were examined for three cutoffs. At the cutoff of ≤22, A-RUDAS exhibited good sensitivity (83%) and specificity (85%) with an area under the receiver operating characteristic curve of 83.95%. Adjusting for age, sex, education, depression, and recruitment site, A-RUDAS score demonstrated a high level of accuracy in screening for mild and moderate dementia against DSM-IV diagnosis. The A-RUDAS is proposed for dementia screening in clinical practice and in research in Arabic-speaking populations with an optimal cutoff of ≤22.

Major depressive disorder with psychotic features may lead to misdiagnosis of dementia: a case report and review of the literature.

PubMed

Wagner, Gerhardt S; McClintock, Shawn M; Rosenquist, Peter B; McCall, W Vaughn; Kahn, David A

2011-11-01

Major depressive disorder (MDD) with psychotic features is relatively frequent in patients with greater depressive symptom severity and is associated with a poorer course of illness and greater functional impairment than MDD without psychotic features. Multiple studies have found that patients with psychotic mood disorders demonstrate significantly poorer cognitive performance in a variety of areas than those with nonpsychotic mood disorders. The Mini Mental State Examination (MMSE) and the Dementia Rating Scale, Second Edition (DRS-2) are widely used to measure cognitive functions in research on MDD with psychotic features. Established total raw score cut-offs of 24 on the MMSE and 137 on the DRS-2 in published manuals suggest possible global cognitive impairment and dementia, respectively. Limited research is available on these suggested cut-offs for patients with MDD with psychotic features. We document the therapeutic benefit of electroconvulsive therapy (ECT), which is usually associated with short-term cognitive impairment, in a 68-year-old woman with psychotic depression whose MMSE and DRS-2 scores initially suggested possible global cognitive impairment and dementia. Over the course of four ECT treatments, the patient's MMSE scores progressively increased. After the second ECT treatment, the patient no longer met criteria for global cognitive impairment. With each treatment, depression severity, measured by the 24-item Hamilton Rating Scale for Depression, improved sequentially. Thus, the suggested cut-off scores for the MMSE and the DRS-2 in patients with MDD with psychotic features may in some cases produce false-positive indications of dementia.

Validation of the Hospital Anxiety and Depression Scale in patients with epilepsy.

PubMed

Wiglusz, Mariusz S; Landowski, Jerzy; Michalak, Lidia; Cubała, Wiesław J

2016-05-01

Despite the fact that depressive disorders are the most common comorbidities among patients with epilepsy (PWEs), they often go unrecognized and untreated. The availability of validated screening instruments to detect depression in PWEs is limited. The aim of the present study was to validate the Hospital Anxiety and Depression Scale (HADS) in adult PWEs. A consecutive group of 118 outpatient PWEs was invited to participate in the study. Ninety-six patients met inclusion criteria, completed HADS, and were examined by a trained psychiatrist using Structured Clinical Interview (SCID-I) for DSM-IV-TR. Receiver operating characteristic (ROC) curves were used to determine the optimal threshold scores for the HADS depression subscale (HADS-D). Receiver operating characteristic analyses showed areas under the curve at approximately 84%. For diagnoses of MDD, the HADS-D demonstrated the best psychometric properties for a cutoff score ≥7 with sensitivity of 90.5%, specificity of 70.7%, positive predictive value of 46.3%, and negative predictive value of 96.4%. In the case of the group with 'any depressive disorder', the HADS-D optimum cutoff score was ≥6 with sensitivity of 82.5%, specificity of 73.2%, positive predictive value of 68.8%, and negative predictive value of 85.4%. The HADS-D proved to be a valid and reliable psychometric instrument in terms of screening for depressive disorders in PWEs. In the epilepsy setting, HADS-D maintains adequate sensitivity, acceptable specificity, and high NPV but low PPV for diagnosing MDD with an optimum cutoff score ≥7. Copyright © 2016 Elsevier Inc. All rights reserved.

Sensitivity and specificity of the Distress Impact Thermometer for the detection of psychological distress among CRC survivors.

PubMed

Craike, Melinda J; Livingston, Patricia M; Warne, Charles

2011-01-01

This study assessed the relative screening performance of the Distress Impact Thermometer (DIT) and cutoff levels with the established clinical case threshold of the Hospital Anxiety and Depression Scale (HADS) among a sample of colorectal cancer (CRC) survivors. Fifty-nine CRC survivors completed the DIT, HADS, and provided demographic information at baseline, and 45 of these patients completed the same measures at follow-up, giving a total of 104 participant data. Receiver operating characteristic (ROC) analysis was performed to determine the accuracy of the DIT compared to the HADS, with a cutoff score ≥8 on each HADS subscale (depression and anxiety) and ≥15 on the HADS total scale used to identify patients with psychological distress. The sample comprised slightly more males (63%) than females, with an average age of 59 years (SD = 9.53) and ranging from 33 to 77 years. The optimum DT cutoff score of ≥5 yielded a sensitivity of 60% and specificity of 86.1%; the area under the curve was 0.771 (95% confidence interval [CI] [0.646, 0.896]). For the depression subscale, the DT performed better on specificity than sensitivity, however the opposite was true for the anxiety subscale. The addition of an impact thermometer did not enhance screening performance. The results of this study provide support for a DT score of ≥5 for detecting psychological distress among CRC survivors and do not support the addition of an impact thermometer. The use of the DT might underestimate depression but overestimate anxiety.

ICU versus Non-ICU Hospital Death: Family Member Complicated Grief, Posttraumatic Stress, and Depressive Symptoms.

PubMed

Probst, Danielle R; Gustin, Jillian L; Goodman, Lauren F; Lorenz, Amanda; Wells-Di Gregorio, Sharla M

2016-04-01

Family members of patients who die in an ICU are at increased risk of psychological sequelae compared to those who experience a death in hospice. This study explored differences in rates and levels of complicated grief (CG), posttraumatic stress disorder (PTSD), and depression between family members of patients who died in an ICU versus a non-ICU hospital setting. Differences in family members' most distressing experiences at the patient's end of life were also explored. The study was an observational cohort. Subjects were next of kin of 121 patients who died at a large, Midwestern academic hospital; 77 died in the ICU. Family members completed measures of CG, PTSD, depression, and end-of-life experiences. Participants were primarily Caucasian (93%, N = 111), female (81%, N = 98), spouses (60%, N = 73) of the decedent, and were an average of nine months post-bereavement. Forty percent of family members met the Inventory of Complicated Grief CG cut-off, 31% met the Impact of Events Scale-Revised PTSD cut-off, and 51% met the Center for Epidemiologic Studies Depression Scale depression cut-off. There were no significant differences in rates or levels of CG, PTSD, or depressive symptoms reported by family members between hospital settings. Several distressing experiences were ranked highly by both groups, but each setting presented unique distressing experiences for family members. Psychological distress of family members did not differ by hospital setting, but the most distressing experiences encountered at end of life in each setting highlight potentially unique interventions to reduce distress post-bereavement for family members.

Morphological adjustments in a meandering reach of the middle Yangtze River caused by severe human activities

NASA Astrophysics Data System (ADS)

Zhou, Meirong; Xia, Junqiang; Lu, Jinyou; Deng, Shanshan; Lin, Fenfen

2017-05-01

In the past 50 years, the Shishou reach in the middle Yangtze River underwent significant channel evolution owing to the implementation of an artificial cutoff, the construction of bank revetment works and the operation of the Three Gorges Project (TGP). Based on the measured hydrological data and topographic data, the processes of channel evolution in this reach were investigated mainly from the adjustments in planform and cross-sectional geometries. The variation in planform geometry obtained in this study indicates that (i) the artificial cutoff at Zhongzhouzi caused the river regime to adjust drastically, with the mean rate of thalweg migration at reach scale of 42.0 m/a over the period 1966-1975; (ii) then the effect of this artificial cutoff reduced gradually, with the mean migration rate decreasing to < 30 m/a in 1975-1993, while it increased to > 40 m/a owing to the occurrence of high water levels in 1993-1998; and (iii) the average annual rate of thalweg migration decreased to 29.3 m/a because of the impacts of various bank protection engineering and the TGP operation during the period 2002-2015. However, remarkable thalweg migration processes still occurred in local regions after the TGP operation, which resulted in significant bankline migration in local reaches of Beimenkou, Shijiatai, and Tiaoxiankou. In addition, the adjustments of bankfull channel geometry were investigated at section and reach scales after the TGP operation. Calculated results show that lateral channel migration in this reach was restricted by various river regulation works and that channel evolution was mainly characterized by an increase in bankfull depth and cross-sectional area. Empirical relationships were developed between the reach-scale bankfull dimensions (depth and area), the bankfull widths at specified sections, and the previous 5-year average fluvial erosion intensity during flood seasons, with high correlation degrees between them being obtained.

Detecting insomnia in patients with low back pain: accuracy of four self-report sleep measures

PubMed Central

2013-01-01

Background Although insomnia is common in patients with low back pain (LBP), it is unknown whether commonly used self-report sleep measures are sufficiently accurate to screen for insomnia in the LBP population. This study investigated the discriminatory properties of the Pittsburgh Sleep Quality Index (Pittsburgh questionnaire), Insomnia Severity Index (Insomnia index), Epworth Sleepiness Scale (Epworth scale) and the sleep item of the Roland and Morris Disability Questionnaire (Roland item) to detect insomnia in patients with LBP by comparing their accuracy to detect insomnia to a sleep diary. The study also aimed to determine the clinical optimal cut-off scores of the questionnaires to detect insomnia in the LBP population. Methods Seventy nine patients with LBP completed the four self-reported questionnaires and a sleep diary for 7 consecutive nights. The accuracy of the questionnaires was evaluated using Receiver Operator Characteristic (ROC) curves with the Area Under the Curve (AUC) used to examine each test’s accuracy to discriminate participants with insomnia from those without insomnia. Results The Pittsburgh questionnaire and Insomnia index had moderate accuracy to detect insomnia (AUC = 0.79, 95% CI = 0.68 to 0.87 and AUC = 0.78, 95% CI = 0.67 to 0.86 respectively), whereas the Epworth scale and the Roland item were not found to be accurate discriminators (AUC = 0.53, 95% CI = 0. 41 to 0.64 and AUC = 0.64, 95% CI = 0.53 to 0.75 respectively). The cut-off score of > 6 for the Pittsburgh questionnaire and the cut-off point of > 14 for the Insomnia index provided optimal sensitivity and specificity for the detection of insomnia. Conclusions The Pittsburgh questionnaire and Insomnia index had similar ability to screen for insomnia in patients with low back pain. PMID:23805978

Prevalence of normal weight central obesity among Thai healthcare providers and their association with CVD risk: a cross-sectional study.

PubMed

Thaikruea, Lakkana; Thammasarot, Jiraporn

2016-11-16

This study aims to determine the prevalence of health personnel with normal weight central obesity and to investigate whether this group had higher cardiovascular disease (CVD) risk factors than those of the people with normal weight and without central obesity. A waist-to-height ratio was calculated as waist circumference (at umbilical level) in cm divided by height in cm. The central obesity cut-off level was 0.5. The body mass index was calculated as weight in kg divided by height in meters squared. The obesity cut-off level was 25 kg/m 2 . The prevalence of health personnel with normal weight central obesity was 15.4% (499 out of 3235). When compare this group to 1787 health personnel who had normal weight and without central obesity, they were 2.03 times (95% CI of adjusted OR; 1.62 to 2.54) more likely to have at least one CVD factor. The waist-to-height ratio cut-off value of 0.5 can be used as a self-assessment tool for central obesity without the need for a standard measuring tape. It is feasible to be implemented in screening or self-monitoring for the general population.

Construction and evaluation of a self rating scale for stress-induced Exhaustion Disorder, the Karolinska Exhaustion Disorder Scale

PubMed Central

Besèr, Aniella; Sorjonen, Kimmo; Wahlberg, Kristina; Peterson, Ulla; Nygren, Åke; Åsberg, Marie

2014-01-01

Prolonged stress (≥ six months) may cause a condition which has been named exhaustion disorder (ED) with ICD-10 code F43.8. ED is characterised by exhaustion, cognitive problems, poor sleep and reduced tolerance to further stress. ED can cause long term disability and depressive symptoms may develop. The aim was to construct and evaluate a self-rating scale, the Karolinska Exhaustion Disorder Scale (KEDS), for the assessment of ED symptoms. A second aim was to examine the relationship between self-rated symptoms of ED, depression, and anxiety using KEDS and the Hospital Anxiety and Depression Scale (HAD). Items were selected based on their correspondence to criteria for ED as formulated by the Swedish National Board of Health and Welfare (NBHW), with seven response alternatives in a Likert-format. Self-ratings performed by 317 clinically assessed participants were used to analyse the scale’s psychometric properties. KEDS consists of nine items with a scale range of 0–54. Receiver operating characteristics analysis demonstrated that a cut-off score of 19 was accompanied by high sensitivity and specificity (each above 95%) in the discrimination between healthy subjects and patients with ED. Reliability was satisfactory and confirmatory factor analysis revealed that ED, depression and anxiety are best regarded as different phenomena. KEDS may be a useful tool in the assessment of symptoms of Exhaustion Disorder in clinical as well as research settings. There is evidence that the symptom clusters of ED, anxiety and depression, respectively, reflect three different underlying dimensions. PMID:24236500

Development of a work addiction scale.

PubMed

Andreassen, Cecilie Schou; Griffiths, Mark D; Hetland, Jørn; Pallesen, Ståle

2012-06-01

Research into excessive work has gained increasing attention over the last 20 years. Terms such as "workaholism,"work addiction" and "excessive work" have been used interchangeably. Given the increase in empirical research, this study presents the development of the Bergen Work Addiction Scale (BWAS), a new psychometrically validated scale for the assessment of work addiction. A pool of 14 items, with two reflecting each of seven core elements of addiction (i.e., salience, mood modification, tolerance, withdrawal, conflict, relapse, and problems) was initially constructed. The items were then administered to two samples, one recruited by a web survey following a television broadcast about workaholism (n = 11,769) and one comprising participants in the second wave of a longitudinal internet-based survey about working life (n = 368). The items with the highest corrected item-total correlation from within each of the seven addiction elements were retained in the final scale. The assumed one-factor solution of the refined seven-item scale was acceptable (root mean square error of approximation = 0.077, Comparative Fit Index = 0.96, Tucker-Lewis Index = 0.95) and the internal reliability of the two samples were 0.84 and 0.80, respectively. The scores of the BWAS converged with scores on other workaholism scales, except for a Work Enjoyment subscale. A suggested cut-off for categorization of workaholics showed good discriminative ability in terms of working hours, leadership position, and subjective health complaints. It is concluded that the BWAS has good psychometric properties. © 2012 The Authors. Scandinavian Journal of Psychology © 2012 The Scandinavian Psychological Associations.

Resummation of high order corrections in Higgs boson plus jet production at the LHC

DOE PAGES

Sun, Peng; Isaacson, Joshua; Yuan, C. -P.; ...

2017-02-22

We study the effect of multiple parton radiation to Higgs boson plus jet production at the LHC. The large logarithms arising from the small imbalance in the transverse momentum of the Higgs boson plus jet final state system are resummed to all orders in the expansion of the strong interaction coupling at the accuracy of Next-to-Leading Logarithm (NLL), by applying the transverse momentum dependent (TMD) factorization formalism. We show that the appropriate resummation scale should be the jet transverse momentum, rather than the partonic center of mass energy which has been normally used in the TMD resummation formalism. Furthermore, themore » transverse momentum distribution of the Higgs boson, particularly near the lower cut-off applied on the jet transverse momentum, can only be reliably predicted by the resummation calculation which is free of the so-called Sudakov-shoulder singularity problem, present in fixed-order calculations.« less

Community Assembly Processes of the Microbial Rare Biosphere.

PubMed

Jia, Xiu; Dini-Andreote, Francisco; Falcão Salles, Joana

2018-03-14

Our planet teems with microorganisms that often present a skewed abundance distribution in a local community, with relatively few dominant species coexisting alongside a high number of rare species. Recent studies have demonstrated that these rare taxa serve as limitless reservoirs of genetic diversity, and perform disproportionate types of functions despite their low abundances. However, relatively little is known about the mechanisms controlling rarity and the processes promoting the development of the rare biosphere. Here, we propose the use of multivariate cut-offs to estimate rare species and phylogenetic null models applied to predefined rare taxa to disentangle the relative influences of ecoevolutionary processes mediating the assembly of the rare biosphere. Importantly, the identification of the factors controlling rare species assemblages is critical for understanding the types of rarity, how the rare biosphere is established, and how rare microorganisms fluctuate over spatiotemporal scales, thus enabling prospective predictions of ecosystem responses. Copyright © 2018 Elsevier Ltd. All rights reserved.

Resummation of high order corrections in Higgs boson plus jet production at the LHC

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

Sun, Peng; Isaacson, Joshua; Yuan, C. -P.

We study the effect of multiple parton radiation to Higgs boson plus jet production at the LHC. The large logarithms arising from the small imbalance in the transverse momentum of the Higgs boson plus jet final state system are resummed to all orders in the expansion of the strong interaction coupling at the accuracy of Next-to-Leading Logarithm (NLL), by applying the transverse momentum dependent (TMD) factorization formalism. We show that the appropriate resummation scale should be the jet transverse momentum, rather than the partonic center of mass energy which has been normally used in the TMD resummation formalism. Furthermore, themore » transverse momentum distribution of the Higgs boson, particularly near the lower cut-off applied on the jet transverse momentum, can only be reliably predicted by the resummation calculation which is free of the so-called Sudakov-shoulder singularity problem, present in fixed-order calculations.« less

Infused autograft lymphocyte-to-monocyte ratio and survival in T-cell lymphoma post-autologous peripheral blood hematopoietic stem cell transplantation.

PubMed

Porrata, Luis F; Inwards, David J; Ansell, Stephen M; Micallef, Ivana N; Johnston, Patrick B; Hogan, William J; Markovic, Svetomir N

2015-07-03

The infused autograft lymphocyte-to-monocyte ratio (A-LMR) is a prognostic factor for survival in B-cell lymphomas post-autologous peripheral hematopoietic stem cell transplantation (APHSCT). Thus, we set out to investigate if the A-LMR is also a prognostic factor for survival post-APHSCT in T-cell lymphomas. From 1998 to 2014, 109 T-cell lymphoma patients that underwent APHSCT were studied. Receiver operating characteristic (ROC) and area under the curve (AUC) were used to identify the optimal cut-off value of A-LMR for survival analysis and k-fold cross-validation model to validate the A-LMR cut-off value. Univariate and multivariate Cox proportional hazard models were used to assess the prognostic discriminator power of A-LMR. ROC and AUC identified an A-LMR ≥ 1 as the best cut-off value and was validated by k-fold cross-validation. Multivariate analysis showed A-LMR to be an independent prognostic factor for overall survival (OS) and progression-free survival (PFS). Patients with an A-LMR ≥ 1.0 experienced a superior OS and PFS versus patients with an A-LMR < 1.0 [median OS was not reached vs 17.9 months, 5-year OS rates of 87% (95% confidence interval (CI), 75-94%) vs 26% (95% CI, 13-42%), p < 0.0001; median PFS was not reached vs 11.9 months, 5-year PFS rates of 72% (95% CI, 58-83%) vs 16% (95% CI, 6-32%), p < 0.0001]. A-LMR is also a prognostic factor for clinical outcomes in patients with T-cell lymphomas undergoing APHSCT.

Low skeletal muscle mass is a predictive factor for chemotherapy dose-limiting toxicity in patients with locally advanced head and neck cancer.

PubMed

Wendrich, Anne W; Swartz, Justin E; Bril, Sandra I; Wegner, Inge; de Graeff, Alexander; Smid, Ernst J; de Bree, Remco; Pothen, Ajit J

2017-08-01

Low skeletal muscle mass (SMM) or sarcopenia is emerging as an adverse prognostic factor for chemotherapy dose-limiting toxicity (CLDT) and survival in cancer patients. Our aim was to determine the impact of low SMM on CDLT in patients with locally advanced head and neck squamous cell carcinoma (LA-HNSCC) treated with primary radiochemotherapy (RCT). Consecutive patients diagnosed with LA-HNSCC and treated with primary RCT between 2007 and 2011 in our center were included. Clinical variables were retrospectively retrieved and SMM was measured at the level of the third cervical vertebra using pre-treatment head and neck CT-scans. After determining a cut-off value for low SMM, multivariate analysis was performed to identify prognostic factors for CDLT. Of 112 patients included, 30.4% experienced CDLT. The optimal cut-off value for low SMM as a predictor of CDLT was ≤43.2cm 2 /m 2 . Using this cut-off, 54.5% patients had low SMM. Patients with low SMM experienced CDLT more frequently than patients with normal SMM (44.3% vs. 13.7%, p<0.001) and received a higher dose of chemotherapy/kg lean body mass (estimated from SMM, p=0.044). At multivariate analysis, low SMM was independently inversely associated with CDLT (OR 0.93, 95%CI: 0.88-0.98). Patients experiencing CDLT had a lower overall survival than patients who did not (mean 36.6vs. 54.2months, p=0.038). Low SMM is an independent risk factor for CDLT in LA-HNSCC patients treated with primary RCT. Pre-therapeutic estimation of SMM using routine CT-scans of the head and neck region may identify patients at risk of CDLT. Copyright © 2017 Elsevier Ltd. All rights reserved.

Prediction of Response to Sorafenib in Hepatocellular Carcinoma: A Putative Marker Panel by Multiple Reaction Monitoring-Mass Spectrometry (MRM-MS).

PubMed

Kim, Hyunsoo; Yu, Su Jong; Yeo, Injun; Cho, Young Youn; Lee, Dong Hyeon; Cho, Yuri; Cho, Eun Ju; Lee, Jeong-Hoon; Kim, Yoon Jun; Lee, Sungyoung; Jun, Jongsoo; Park, Taesung; Yoon, Jung-Hwan; Kim, Youngsoo

2017-07-01

Sorafenib is the only standard treatment for unresectable hepatocellular carcinoma (HCC), but it provides modest survival benefits over placebo, necessitating predictive biomarkers of the response to sorafenib. Serum samples were obtained from 115 consecutive patients with HCC before sorafenib treatment and analyzed by multiple reaction monitoring-mass spectrometry (MRM-MS) and ELISA to quantify candidate biomarkers. We verified a triple-marker panel to be predictive of the response to sorafenib by MRM-MS, comprising CD5 antigen-like (CD5L), immunoglobulin J (IGJ), and galectin-3-binding protein (LGALS3BP), in HCC patients. This panel was a significant predictor (AUROC > 0.950) of the response to sorafenib treatment, having the best cut-off value (0.4) by multivariate analysis. In the training set, patients who exceeded this cut-off value had significantly better overall survival (median, 21.4 months) than those with lower values (median, 8.6 months; p = 0.001). Further, a value that was lower than this cutoff was an independent predictor of poor overall survival [hazard ratio (HR), 2.728; 95% confidence interval (CI), 1.312-5.672; p = 0.007] and remained an independent predictive factor of rapid progression (HR, 2.631; 95% CI, 1.448-4.780; p = 0.002). When applied to the independent validation set, levels of the cut-off value for triple-marker panel maintained their prognostic value for poor clinical outcomes. On the contrast, the triple-marker panel was not a prognostic factor for patients who were treated with transarterial chemoembolization (TACE). The discriminatory signature of a triple-marker panel provides new insights into targeted proteomic biomarkers for individualized sorafenib therapy. © 2017 by The American Society for Biochemistry and Molecular Biology, Inc.