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

NASA Astrophysics Data System (ADS)

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

2015-07-01

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

GeV Outbursts in Mrk 501

NASA Technical Reports Server (NTRS)

Sreekumar, P.; Bertsch, D. L.; Bloom, S. D.; Hartman, R. C.; Lin, Y. C.; Mukherjee, R.; Thompson, D. J.

1999-01-01

Mrk 501 is the third TeV blazar with a known GeV component. Previous multiwavelength campaigns on Mrk 501 showed well correlated outbursts at x-ray and TeV energies with no significant activity at GeV energies. We present here new evidence suggesting GeV outbursts in Mrk 501 when the spectrum appears to be extremely hard. However, this outburst appears uncorrelated with emission at x-ray energies. The resulting spectral energy distribution suggests a sharp cut off in the high-energy emission beyond a few hundred GeV.

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

PubMed

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

2018-05-12

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

A general equation to obtain multiple cut-off scores on a test from multinomial logistic regression.

PubMed

Bersabé, Rosa; Rivas, Teresa

2010-05-01

The authors derive a general equation to compute multiple cut-offs on a total test score in order to classify individuals into more than two ordinal categories. The equation is derived from the multinomial logistic regression (MLR) model, which is an extension of the binary logistic regression (BLR) model to accommodate polytomous outcome variables. From this analytical procedure, cut-off scores are established at the test score (the predictor variable) at which an individual is as likely to be in category j as in category j+1 of an ordinal outcome variable. The application of the complete procedure is illustrated by an example with data from an actual study on eating disorders. In this example, two cut-off scores on the Eating Attitudes Test (EAT-26) scores are obtained in order to classify individuals into three ordinal categories: asymptomatic, symptomatic and eating disorder. Diagnoses were made from the responses to a self-report (Q-EDD) that operationalises DSM-IV criteria for eating disorders. Alternatives to the MLR model to set multiple cut-off scores are discussed.

Force Modelling in Orthogonal Cutting Considering Flank Wear Effect

NASA Astrophysics Data System (ADS)

Rathod, Kanti Bhikhubhai; Lalwani, Devdas I.

2017-05-01

In the present work, an attempt has been made to provide a predictive cutting force model during orthogonal cutting by combining two different force models, that is, a force model for a perfectly sharp tool plus considering the effect of edge radius and a force model for a worn tool. The first force model is for a perfectly sharp tool that is based on Oxley's predictive machining theory for orthogonal cutting as the Oxley's model is for perfectly sharp tool, the effect of cutting edge radius (hone radius) is added and improve model is presented. The second force model is based on worn tool (flank wear) that was proposed by Waldorf. Further, the developed combined force model is also used to predict flank wear width using inverse approach. The performance of the developed combined total force model is compared with the previously published results for AISI 1045 and AISI 4142 materials and found reasonably good agreement.

Design of High Performance Microstrip LPF with Analytical Transfer Function

NASA Astrophysics Data System (ADS)

Mousavi, Seyed Mohammad Hadi; Raziani, Saeed; Falihi, Ali

2017-12-01

By exploiting butterfly and T-shaped resonators, a new design of microstrip lowpass filter (LPF) is proposed and analyzed. The LPF is investigated in four sections. Analyzing initial resonator and its equation in detail, providing a sharp skirt by using series configuration, suppressing in middle frequencies and suppressing in high frequencies are focused in each section, respectively. To present a theoretical design, LC equivalent circuit and transfer function are precisely calculated. The measured insertion loss of the LPF is less that 0.4 dB in frequency range from DC up to 1.25 GHz, and the return loss is better than 16 dB. A narrow transition band of 217 MHz and a roll-off rate of 170.5 dB /GHz are indicative of a sharp skirt. By utilizing T-shaped and modified T-shaped resonators in the third and fourth sections, respectively, a relative stopband bandwidth (RSB) of 166 % is obtained. Furthermore, the proposed LPF occupies a small circuit of 0.116{λ _g} × 0.141{λ _g}, where {λ _g} is the guided wavelength at cut-off frequency (1.495 GHz). Finally, the proposed LPF is fabricated and the measured results agree well with the simulated ones.

Aroma profile design of wine spirits: Multi-objective optimization using response surface methodology.

PubMed

Matias-Guiu, Pau; Rodríguez-Bencomo, Juan José; Pérez-Correa, José R; López, Francisco

2018-04-15

Developing new distillation strategies can help the spirits industry to improve quality, safety and process efficiency. Batch stills equipped with a packed column and an internal partial condenser are an innovative experimental system, allowing a fast and flexible management of the rectification. In this study, the impact of four factors (heart-cut volume, head-cut volume, pH and cooling flow rate of the internal partial condenser during the head-cut fraction) on 18 major volatile compounds of Muscat spirits was optimized using response surface methodology and desirability function approaches. Results have shown that high rectification at the beginning of the heart-cut enhances the overall positive aroma compounds of the product, reducing off-flavor compounds. In contrast, optimum levels of heart-cut volume, head-cut volume and pH factors varied depending on the process goal. Finally, three optimal operational conditions (head off-flavors reduction, flowery terpenic enhancement and fruity ester enhancement) were evaluated by chemical and sensory analysis. Copyright © 2017 Elsevier Ltd. All rights reserved.

Prospective, Multicenter Validation Study of Magnetic Resonance Volumetry for Response Assessment After Preoperative Chemoradiation in Rectal Cancer: Can the Results in the Literature be Reproduced?

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

Martens, Milou H., E-mail: mh.martens@hotmail.com; Department of Surgery, Maastricht University Medical Center, Maastricht; GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht

2015-12-01

Purpose: To review the available literature on tumor size/volume measurements on magnetic resonance imaging for response assessment after chemoradiotherapy, and validate these cut-offs in an independent multicenter patient cohort. Methods and Materials: The study included 2 parts. (1) Review of the literature: articles were included that assessed the accuracy of tumor size/volume measurements on magnetic resonance imaging for tumor response assessment. Size/volume cut-offs were extracted; (2) Multicenter validation: extracted cut-offs from the literature were tested in a multicenter cohort (n=146). Accuracies were calculated and compared with reported results from the literature. Results: The review included 14 articles, in which 3more » different measurement methods were assessed: (1) tumor length; (2) 3-dimensonial tumor size; and (3) whole volume. Study outcomes consisted of (1) complete response (ypT0) versus residual tumor; (2) tumor regression grade 1 to 2 versus 3 to 5; and (3) T-downstaging (ypT« less

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

PubMed Central

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

2016-01-01

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

The energy balance of wind waves and the remote sensing problem

NASA Technical Reports Server (NTRS)

Hasselmann, K.

1972-01-01

Measurements of wave growth indicate an energy balance of the wave spectrum governed primarily by input from the atmosphere, nonlinear transfer to shorter and longer waves, and advection. The pronounced spectral peak and sharp low frequency cut-off characteristic of fetch-limited spectra are explained as a self-stabilizing feature of the nonlinear wave-wave interactions. The momentum transferred from the atmosphere to the wind waves accounts for a large part of the wind drag. These findings are relevant for remote microwave sensing of the sea surface by backscatter and passive radiometry methods.

Retrospective analysis of insulin responses to standard dosed oral glucose tests (OGTs) via naso-gastric tubing towards definition of an objective cut-off value.

PubMed

Warnken, Tobias; Delarocque, Julien; Schumacher, Svenja; Huber, Korinna; Feige, Karsten

2018-01-19

Insulin dysregulation (ID) with basal or postprandial hyperinsulinemia is one of the key findings in horses and ponies suffering from the equine metabolic syndrome (EMS). Assessment of ID can easily be performed in clinical settings by the use of oral glucose challenge tests. Oral glucose test (OGT) performed with 1 g/kg bodyweight (BW) glucose administered via naso-gastric tube allows the exact administration of a defined glucose dosage in a short time. However, reliable cut-off values have not been available so far. Therefore, the aim of the study was to describe variations in insulin response to OGT via naso-gastric tubing and to provide a clinical useful cut-off value for ID when using the insulin quantification performed with an equine-optimized insulin enzyme-linked immunosorbent assay. Data visualization revealed no clear separation in the serum insulin concentration of insulin sensitive and insulin dysregulated horses during OGT. Therefore, a model based clustering method was used to circumvent the use of an arbitrary limit for categorization. This method considered all data-points for the classification, taking into account the individual insulin trajectory during the OGT. With this method two clusters were differentiated, one with low and one with high insulin responses during OGT. The cluster of individuals with low insulin response was consistently detected, independently of the initialization parameters of the algorithm. In this cluster the 97.5% quantile of insulin is 110 µLU/mL at 120 min. We suggest using this insulin concentration of 110 µLU/mL as a cut-off value for samples obtained at 120 min in OGT. OGT performed with 1 g/kg BW glucose and administration via naso-gastric tubing can easily be performed under clinical settings. Application of the cut-off value of 110 µLU/mL at 120 min allows assessment of ID in horses.

Numerical investigation of rarefaction effects in the vicinity of a sharp leading edge

NASA Astrophysics Data System (ADS)

Pan, Shaowu; Gao, Zhenxun; Lee, Chunhian

2014-12-01

This paper presents a study of rarefaction effect on hypersonic flow over a sharp leading edge. Both continuum approach and kinetic method: a widely spread commercial Computational Fluid Dynamics-Navior-Stokes-Fourier (CFD-NSF) software - Fluent together with a direct simulation Monte Carlo (DSMC) code developed by the authors are employed for simulation of transition regime with Knudsen number ranging from 0.005 to 0.2. It is found that Fluent can predict the wall fluxes in the case of hypersonic argon flow over the sharp leading edge for the lowest Kn case (Kn = 0.005) in current paper while for other cases it also has a good agreement with DSMC except at the location near the sharp leading edge. Among all of the wall fluxes, it is found that coefficient of pressure is the most sensitive to rarefaction while heat transfer is the least one. A parameter based on translational nonequilibrium and a cut-off value of 0.34 is proposed for continuum breakdown in this paper. The structure of entropy and velocity profile in boundary layer is analyzed. Also, it is found that the ratio of heat transfer coefficient to skin friction coefficient remains uniform along the surface for the four cases in this paper.

Coulomb Scattering in the Massless Nelson Model III: Ground State Wave Functions and Non-commutative Recurrence Relations

NASA Astrophysics Data System (ADS)

Dybalski, Wojciech; Pizzo, Alessandro

2018-02-01

Let $H_{P,\\sigma}$ be the single-electron fiber Hamiltonians of the massless Nelson model at total momentum $P$ and infrared cut-off $\\sigma>0$. We establish detailed regularity properties of the corresponding $n$-particle ground state wave functions $f^n_{P,\\sigma}$ as functions of $P$ and $\\sigma$. In particular, we show that \\[ |\\partial_{P^j}f^{n}_{P,\\sigma}(k_1,\\ldots, k_n)|, \\ \\ |\\partial_{P^j} \\partial_{P^{j'}} f^{n}_{P,\\sigma}(k_1,\\ldots, k_n)| \\leq \\frac{1}{\\sqrt{n!}} \\frac{(c\\lambda_0)^n}{\\sigma^{\\delta_{\\lambda_0}}} \\prod_{i=1}^n\\frac{ \\chi_{[\\sigma,\\kappa)}(k_i)}{|k_i|^{3/2}}, \\] where $c$ is a numerical constant, $\\lambda_0\\mapsto \\delta_{\\lambda_0}$ is a positive function of the maximal admissible coupling constant which satisfies $\\lim_{\\lambda_0\\to 0}\\delta_{\\lambda_0}=0$ and $\\chi_{[\\sigma,\\kappa)}$ is the (approximate) characteristic function of the energy region between the infrared cut-off $\\sigma$ and the ultraviolet cut-off $\\kappa$. While the analysis of the first derivative is relatively straightforward, the second derivative requires a new strategy. By solving a non-commutative recurrence relation we derive a novel formula for $f^n_{P,\\sigma}$ with improved infrared properties. In this representation $\\partial_{P^{j'}}\\partial_{P^{j}}f^n_{P,\\sigma}$ is amenable to sharp estimates obtained by iterative analytic perturbation theory in part II of this series of papers. The bounds stated above are instrumental for scattering theory of two electrons in the Nelson model, as explained in part I of this series.

Study of the use of a nonlinear, rate limited, filter on pilot control signals

NASA Technical Reports Server (NTRS)

Adams, J. J.

1977-01-01

The use of a filter on the pilot's control output could improve the performance of the pilot-aircraft system. What is needed is a filter with a sharp high frequency cut-off, no resonance peak, and a minimum of lag at low frequencies. The present investigation studies the usefulness of a nonlinear, rate limited, filter in performing the needed function. The nonlinear filter is compared with a linear, first order filter, and no filter. An analytical study using pilot models and a simulation study using experienced test pilots was performed. The results showed that the nonlinear filter does promote quick, steady maneuvering. It is shown that the nonlinear filter attenuates the high frequency remnant and adds less phase lag to the low frequency signal than does the linear filter. It is also shown that the rate limit in the nonlinear filter can be set to be too restrictive, causing an unstable pilot-aircraft system response.

Burst of reactive oxygen species in pedicel-mediated fruit abscission after carbohydrate supply was cut off in longan (Dimocarpus longan)

PubMed Central

Yang, Ziqin; Zhong, Xiumei; Fan, Yan; Wang, Huicong; Li, Jianguo; Huang, Xuming

2015-01-01

Cutting off carbohydrate supply to longan (Dimocarpus longan Lour.) fruit by girdling and defoliation or by detachment induced 100% abscission within a few days. We used these treatments to study the involvement of reactive oxygen species (ROS) in fruit abscission. Girdling plus defoliation decreased sugar concentrations in the fruit and pedicel and depleted starch grains in the chloroplasts in the cells of abscission zone. Prior to the occurrence of intensive fruit abscission, there was a burst in ROS in the pedicel, which peaked at 1 day after treatment (DAT), when H2O2 in the abscission zone was found to be chiefly located along the plasma membrane (PM). H2O2 was found exclusively in the cell walls 2 DAT, almost disappeared 3 DAT, and reappeared in the mitochondria and cell walls 4 DAT. Signs of cell death such as cytoplasm breakdown were apparent from 3 DAT. The burst of ROS coincided with a sharp increase in the activity of PM-bound NADPH oxidase in the pedicel. At the same time, activities of antioxidant enzymes including superoxide dismutase (SOD), catalase, and peroxidase (POD) were all increased by the treatment and maintained higher than those in the control. Accompanying the reduction in H2O2 abundance, there was a sharp decrease in PM-bound NADPH oxidase activity after 1 DAT in the treated fruit. H2O2 scavenger dimethylthiourea (DMTU, 1 g L–1) significantly inhibited fruit abscission in detached fruit clusters and suppressed the increase in cellulase activity in the abscission zone. These results suggest that fruit abscission induced by carbohydrate stress is mediated by ROS. Roles of ROS in regulating fruit abscission were discussed in relation to its subcellular distribution. PMID:26074931

How Can I Help a Friend Who Cuts?

MedlinePlus

... friend might injure himself or herself on purpose. Cutting — using a sharp object to cut your own ... upsetting to learn that a friend has been cutting. You might feel confused or scared. You may ...

On Spurious Numerics in Solving Reactive Equations

NASA Technical Reports Server (NTRS)

Kotov, D. V; Yee, H. C.; Wang, W.; Shu, C.-W.

2013-01-01

The objective of this study is to gain a deeper understanding of the behavior of high order shock-capturing schemes for problems with stiff source terms and discontinuities and on corresponding numerical prediction strategies. The studies by Yee et al. (2012) and Wang et al. (2012) focus only on solving the reactive system by the fractional step method using the Strang splitting (Strang 1968). It is a common practice by developers in computational physics and engineering simulations to include a cut off safeguard if densities are outside the permissible range. Here we compare the spurious behavior of the same schemes by solving the fully coupled reactive system without the Strang splitting vs. using the Strang splitting. Comparison between the two procedures and the effects of a cut off safeguard is the focus the present study. The comparison of the performance of these schemes is largely based on the degree to which each method captures the correct location of the reaction front for coarse grids. Here "coarse grids" means standard mesh density requirement for accurate simulation of typical non-reacting flows of similar problem setup. It is remarked that, in order to resolve the sharp reaction front, local refinement beyond standard mesh density is still needed.

Drastic increases in overweight and obesity from 1981 to 2010 and related risk factors: results from the Barbados Children's Health and Nutrition Study.

PubMed

Fernandez, Melissa Anne; Kubow, Stan; Gray-Donald, Katherine; Knight, JaDon; Gaskin, Pamela S

2015-12-01

To examine overweight and obesity (OWOB), changes in prevalence and potential risk factors in Barbadian children. A cross-section of students were weighed and measured. The WHO BMI-for-age growth references (BAZ), the International Obesity Task Force cut-offs and the US Centers for Disease Control and Prevention growth percentiles were used to determine OWOB prevalence. Harvard weight-for-height-for-age growth standards were used to estimate differences in OWOB prevalence from 1981 to 2010. Samples of parents and students were interviewed to describe correlates of OWOB. Barbados. Public-school students (n 580) in class 3. Based on WHO BAZ, the overall prevalence of OWOB was 34·8 % (95 % CI 30·9, 38·7 %). A trend of higher OWOB prevalence was seen for girls across cut-offs, with significant sex differences noted using the International Obesity Task Force cut-offs. According to Harvard growth standards, OWOB has increased dramatically, from 8·52 % to 32·5 %. Children were more likely to be OWOB when annual household income was below BBD 9000 (OR=2·69; 95 % CI 1·21, 5·99). Eating dinner with the family every night was associated with a lower prevalence of OWOB (OR=0·56; 95 % CI 0·36, 0·87). The sharp increase of OWOB rates in Barbados warrants attention. Sex disparities in OWOB prevalence may emerge at a young age. Promoting family meals may be a feasible option for OWOB prevention. Understanding familial and sociodemographic factors influencing OWOB will be useful in planning successful intervention or prevention programmes in Barbados.

Primary and secondary responses of the ovine lymph node to Toxoplasma gondii: cell output in efferent lymph and parasite detection.

PubMed

Buxton, D; Thomson, K M; Maley, S; Wastling, J M; Innes, E A; Panton, W R; Nicoll, S

1994-10-01

Efferent lymphatic cannulation was used to study the dissemination of strain S48 of Toxoplasma gondii and the cell output from the prefemoral lymph node, after infection of both "naive" and vaccinated sheep. In the former the mean cell output decreased for 3 days before reaching a peak at 11 and 12 days, but in vaccinated ewes a similar drop in cell output and subsequent peak occurred significantly earlier, at 24 h and 5 days, respectively. The cellular response in both types of sheep was largely due to a marked increase in blast cells. The detection of live toxoplasms and parasite DNA by mouse inoculation and the polymerase chain reaction, respectively, gave similar results; the parasite was demonstrated in lymph from days 3 to 12 during a primary infection but with a sharp cut-off after day 9 coinciding with the peak blast cell response. Very little evidence of T. gondii was found in lymph of vaccinated sheep after challenge. Immunity, which is thought to be largely T-cell mediated and is sustained without continuous antigenic stimulation, suppresses dissemination of the parasite in the lymph and therefore to other sites, which might include the gravid uterus.

Sticker Shock: State Funding Cuts Lead to Sharp Tuition Hikes at Florida Colleges

ERIC Educational Resources Information Center

Boulard, Garry

2011-01-01

The tuition increase at the University of Florida--one of 11 public universities in Florida to win the approval of the state's Board of Governors to tack a "tuition differential" of 7 percent onto an 8 percent increase already approved by the state legislature--comes in response to an unprecedented reduction of some $340 million in state…

Accidental cut-throat injuries from the broken windshield of an auto rickshaw: Two unusual cases.

PubMed

Swain, Rajanikanta; Dhaka, Shivani; Sharma, Munish; Bakshi, Mantaran Singh; Murty, O P; Sikary, Asit Kumar

2018-01-01

Accidental cut-throat injuries are extremely rare and usually involve a sharp-edged weapon. In this paper, two cases of a cut-throat wound to two auto-rickshaw drivers are presented where the broken windshield of the auto-rickshaws was responsible for the wounds. In both the cases, fatal incised wounds were present over the neck, cutting the soft tissue along with the major vessels. The death occurred due to exsanguination caused by neck-vessel injury in one case and trachea along with neck-vessel injury in the second case. Although the wounds on the neck initially suggested homicide, they were found to have occurred accidentally as a result of a road traffic accident involving a head-on collision of auto rickshaws. The injuries were inflicted by the shattered glass of the windshield.

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

PubMed Central

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

2015-01-01

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

Effects of Two Football Stud Types on Knee and Ankle Kinetics of Single-Leg Land-Cut and 180° Cut Movements on Infilled Synthetic Turf.

PubMed

Bennett, Hunter J; Brock, Elizabeth; Brosnan, James T; Sorochan, John C; Zhang, Songning

2015-10-01

Higher ACL injury rates have been recorded in cleats with higher torsional resistance in American football, which warrants better understanding of shoe/stud-dependent joint kinetics. The purpose of this study was to determine differences in knee and ankle kinetics during single-leg land cuts and 180° cuts on synthetic infilled turf while wearing 3 types of shoes. Fourteen recreational football players performed single-leg land cuts and 180° cuts in nonstudded running shoes (RS) and in football shoes with natural (NTS) and synthetic turf studs (STS). Knee and ankle kinetic variables were analyzed with a 3 × 2 (shoe × movement) repeated-measures ANOVA (P < .05). A significant shoe-by-movement interaction was found in loading response peak knee adduction moments, with NTS producing smaller moments compared with both STS and RS only in 180° cuts. Reduced peak negative plantar flexor powers were also found in NTS compared with STS. The single-leg land cut produced greater loading response and push-off peak knee extensor moments, as well as peak negative and positive extensor and plantar flexor powers, but smaller loading peak knee adduction moments and push-off peak ankle eversion moments than 180° cuts. Overall, the STS and 180° cuts resulted in greater frontal plane knee loading and should be monitored for possible increased ACL injury risks.

Cuts and puncture wounds

MedlinePlus

... pointed object such as a nail, knife, or sharp tooth. Symptoms Symptoms include: Bleeding Problems with function ... the last 10 years. Prevention Keep knives, scissors, sharp objects, firearms, and fragile items out of the ...

Frequency dispersion of nonlinear response of thin superconducting films in the Berezinskii-Kosterlitz-Thouless state

DOE PAGES

Dietrich, Scott; Mayer, William; Byrnes, Sean; ...

2015-02-20

The effects of microwave radiation on transport properties of atomically thin La 2-xSr xCuO₄ films were studied in the 0.1-20 GHz frequency range. Resistance changes induced by microwaves were investigated at different temperatures (8–15 K) near the superconducting transition. A strong decrease of the nonlinear response is observed within a few GHz of a cutoff frequency ν cut ≈ 2GHz. The expected frequency dependence vastly underestimates the sharpness of this drop. Numerical simulations that assume ac response to follow dc V-I characteristics of the films reproduce well the low frequency behavior, but fail above ν cut. Thus, high-frequency radiation ismore » much less effective in inducing vortex-antivortex dissociation in the oscillating superconducting condensate.« less

Apparatus for cutting elastomeric materials

NASA Technical Reports Server (NTRS)

Corbett, A. B.

1974-01-01

Sharp thin cutting edge is held in head of milling machine designed for metal working. Controls of machine are used to position cutting edge in same plane as vibrating specimen. Controls then are operated, making blade come into contact with specimen, to cut it into shapes and sizes desired. Cut surfaces appear mirror-smooth; vibrating mechanism causes no visible striations.

Observation of pick-up ions in the solar wind: Evidence for the source of the anomalous cosmic ray component?

NASA Technical Reports Server (NTRS)

Hovestadt, D.; Moebius, E.; Klecker, B.; Scholer, M.; Gloeckler, G.; Ipavich, F. M.

1985-01-01

Singly ionized energetic helium has been observed in the solar wind by using the time of flight spectrometer SULEICA on the AMPTE/IRM satellite between September and December, 1984. The energy density spectrum shows a sharp cut off which is strongly correlated with the four fold solar wind bulk energy. The absolute flux of the He(+)ions of about 10000 ion/sq cm.s is present independent of the IPL magnetic field orientation. The most likely source is the neutral helium of the interstellar wind which is ionized by solar UV radiation. It is suggested that these particles represent the source of the anomalous cosmic ray component.

Direct numerical simulation of a combusting droplet with convection

NASA Technical Reports Server (NTRS)

Liang, Pak-Yan

1992-01-01

The evaporation and combustion of a single droplet under forced and natural convection was studied numerically from first principles using a numerical scheme that solves the time-dependent multiphase and multispecies Navier-Stokes equations and tracks the sharp gas-liquid interface cutting across an arbitrary Eulerian grid. The flow fields both inside and outside of the droplet are resolved in a unified fashion. Additional governing equations model the interphase mass, energy, and momentum exchange. Test cases involving iso-octane, n-hexane, and n-propanol droplets show reasonable comparison rate, and flame stand-off distance. The partially validated code is, thus, readied to be applied to more demanding droplet combustion situations where substantial drop deformation render classical models inadequate.

Standardized Index of Shape (DCE-MRI) and Standardized Uptake Value (PET/CT): Two quantitative approaches to discriminate chemo-radiotherapy locally advanced rectal cancer responders under a functional profile

PubMed Central

Petrillo, Antonella; Fusco, Roberta; Petrillo, Mario; Granata, Vincenza; Delrio, Paolo; Bianco, Francesco; Pecori, Biagio; Botti, Gerardo; Tatangelo, Fabiana; Caracò, Corradina; Aloj, Luigi; Avallone, Antonio; Lastoria, Secondo

2017-01-01

Purpose To investigate dynamic contrast enhanced-MRI (DCE-MRI) in the preoperative chemo-radiotherapy (CRT) assessment for locally advanced rectal cancer (LARC) compared to18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). Methods 75 consecutive patients with LARC were enrolled in a prospective study. DCE-MRI analysis was performed measuring SIS: linear combination of percentage change (Δ) of maximum signal difference (MSD) and wash-out slope (WOS). 18F-FDG PET/CT analysis was performed using SUV maximum (SUVmax). Tumor regression grade (TRG) were estimated after surgery. Non-parametric tests, receiver operating characteristic were evaluated. Results 55 patients (TRG1-2) were classified as responders while 20 subjects as non responders. ΔSIS reached sensitivity of 93%, specificity of 80% and accuracy of 89% (cut-off 6%) to differentiate responders by non responders, sensitivity of 93%, specificity of 69% and accuracy of 79% (cut-off 30%) to identify pathological complete response (pCR). Therapy assessment via ΔSUVmax reached sensitivity of 67%, specificity of 75% and accuracy of 70% (cut-off 60%) to differentiate responders by non responders and sensitivity of 80%, specificity of 31% and accuracy of 51% (cut-off 44%) to identify pCR. Conclusions CRT response assessment by DCE-MRI analysis shows a higher predictive ability than 18F-FDG PET/CT in LARC patients allowing to better discriminate significant and pCR. PMID:28042958

Standardized Index of Shape (DCE-MRI) and Standardized Uptake Value (PET/CT): Two quantitative approaches to discriminate chemo-radiotherapy locally advanced rectal cancer responders under a functional profile.

PubMed

Petrillo, Antonella; Fusco, Roberta; Petrillo, Mario; Granata, Vincenza; Delrio, Paolo; Bianco, Francesco; Pecori, Biagio; Botti, Gerardo; Tatangelo, Fabiana; Caracò, Corradina; Aloj, Luigi; Avallone, Antonio; Lastoria, Secondo

2017-01-31

To investigate dynamic contrast enhanced-MRI (DCE-MRI) in the preoperative chemo-radiotherapy (CRT) assessment for locally advanced rectal cancer (LARC) compared to18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). 75 consecutive patients with LARC were enrolled in a prospective study. DCE-MRI analysis was performed measuring SIS: linear combination of percentage change (Δ) of maximum signal difference (MSD) and wash-out slope (WOS). 18F-FDG PET/CT analysis was performed using SUV maximum (SUVmax). Tumor regression grade (TRG) were estimated after surgery. Non-parametric tests, receiver operating characteristic were evaluated. 55 patients (TRG1-2) were classified as responders while 20 subjects as non responders. ΔSIS reached sensitivity of 93%, specificity of 80% and accuracy of 89% (cut-off 6%) to differentiate responders by non responders, sensitivity of 93%, specificity of 69% and accuracy of 79% (cut-off 30%) to identify pathological complete response (pCR). Therapy assessment via ΔSUVmax reached sensitivity of 67%, specificity of 75% and accuracy of 70% (cut-off 60%) to differentiate responders by non responders and sensitivity of 80%, specificity of 31% and accuracy of 51% (cut-off 44%) to identify pCR. CRT response assessment by DCE-MRI analysis shows a higher predictive ability than 18F-FDG PET/CT in LARC patients allowing to better discriminate significant and pCR.

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

PubMed Central

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

2016-01-01

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

Cut-off optimization for 13C-urea breath test in a community-based trial by mathematic, histology and serology approach.

PubMed

Li, Zhe-Xuan; Huang, Lei-Lei; Liu, Cong; Formichella, Luca; Zhang, Yang; Wang, Yu-Mei; Zhang, Lian; Ma, Jun-Ling; Liu, Wei-Dong; Ulm, Kurt; Wang, Jian-Xi; Zhang, Lei; Bajbouj, Monther; Li, Ming; Vieth, Michael; Quante, Michael; Zhou, Tong; Wang, Le-Hua; Suchanek, Stepan; Soutschek, Erwin; Schmid, Roland; Classen, Meinhard; You, Wei-Cheng; Gerhard, Markus; Pan, Kai-Feng

2017-05-18

The performance of diagnostic tests in intervention trials of Helicobacter pylori (H.pylori) eradication is crucial, since even minor inaccuracies can have major impact. To determine the cut-off point for 13 C-urea breath test ( 13 C-UBT) and to assess if it can be further optimized by serologic testing, mathematic modeling, histopathology and serologic validation were applied. A finite mixture model (FMM) was developed in 21,857 subjects, and an independent validation by modified Giemsa staining was conducted in 300 selected subjects. H.pylori status was determined using recomLine H.pylori assay in 2,113 subjects with a borderline 13 C-UBT results. The delta over baseline-value (DOB) of 3.8 was an optimal cut-off point by a FMM in modelling dataset, which was further validated as the most appropriate cut-off point by Giemsa staining (sensitivity = 94.53%, specificity = 92.93%). In the borderline population, 1,468 subjects were determined as H.pylori positive by recomLine (69.5%). A significant correlation between the number of positive H.pylori serum responses and DOB value was found (r s  = 0.217, P < 0.001). A mathematical approach such as FMM might be an alternative measure in optimizing the cut-off point for 13 C-UBT in community-based studies, and a second method to determine H.pylori status for subjects with borderline value of 13 C-UBT was necessary and recommended.

A cautionary note about the cross-national and clinical validity of cut-off points for the Maslach Burnout Inventory.

PubMed

Schaufeli, W B; Van Dierendonck, D

1995-06-01

In the present study, burnout scores of three samples, as measured with the Maslach Burnout Inventory, were compared: (1) the normative American sample from the test-manual (N = 10,067), (2) the normative Dutch sample (N = 3,892), and (3) a Dutch outpatient sample (N = 142). Generally, the highest burnout scores were found for the outpatient sample, followed by the American and Dutch normative samples, respectively. Slightly different patterns were noted for each of the three components. Probably sampling bias, i.e., the healthy worker effect, or cultural value patterns, i.e., femininity versus masculinity, might be responsible for the results. It is concluded that extreme caution is required when cut-off points are used to classify individuals by burnout scores; only nation-specific and clinically derived cut-off points should be employed.

49 CFR 229.93 - Safety cut-off device.

Code of Federal Regulations, 2011 CFR

2011-10-01

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

49 CFR 229.93 - Safety cut-off device.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

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

Code of Federal Regulations, 2010 CFR

2010-07-01

..., measurement accuracy, and cut-off. 53.53 Section 53.53 Protection of Environment ENVIRONMENTAL PROTECTION..., measurement accuracy, and cut-off. (a) Overview. This test procedure is designed to evaluate a candidate... measurement accuracy, coefficient of variability measurement accuracy, and the flow rate cut-off function. The...

Commissioning a hobby cutting device for radiochromic film preparation.

PubMed

Zolfaghari, Somayeh; Francis, Kirby E; Kairn, Tanya; Crowe, Scott B

2017-06-01

In addition to a high spatial resolution and well characterised dose response, one of the major advantages of radiochromic film as a dosimeter is that sheets of film can be cut into pieces suitable for use as calibration films, and for in vivo and phantom measurements. The cutting of film is typically done using scissors or a guillotine, and this process can be time-consuming, limited in precision, requires extensive handling and does not allow holes to be cut from the film without cutting from an existing edge. This study investigated the use of a Brother ScanNCut hobby cutting system for EBT3 film preparation. The optimal operating parameters (blade size, pressure, speed) that resulted in precise cuts with minimal delamination at cut edges were identified using test cutting patterns. These parameters were then used to cut a large film insert for a stereotactic head phantom for comparison against an insert cut with scissors. While the hobby cutting system caused a wider region of delamination at the film edge (1.8 mm) compared to scissors (1 mm), the hobby cutting system was found to be able to produce reproducible cuts more efficiently and more accurately than scissors. The use of the hobby cutting system is recommended for complex phantom inserts (containing sharp corners or holes for alignment rods) or in situations where large numbers of film pieces need to be prepared.

Gigabit Digital Filter Bank: Digital Backend Subsystem in the VERA Data-Acquisition System

NASA Astrophysics Data System (ADS)

Iguchi, Satoru; Kkurayama, Tomoharu; Kawaguchi, Noriyuki; Kawakami, Kazuyuki

2005-02-01

The VERA terminal is a new data-acquisition system developed for the VERA project, which is a project to construct a new Japanese VLBI array dedicated to make a 3-D map of our Milky Way Galaxy in terms of high-precision astrometry. New technology, a gigabit digital filter, was introduced in the development. The importance and advantages of a digital filter for radio astronomy have been studied as follows: (1) the digital filter can realize a variety of observation modes and maintain compatibility with different data-acquisition systems (Kiuchi et al. 1997 and Iguchi et al. 2000a), (2) the folding noise occurring in the sampling process can be reduced by combination with a higher-order sampling technique (Iguchi, Kawaguchi 2002), (3) and an ideal sharp cut-off bandedge and a flat amplitude/phase responses are approached by using a large number of taps available to use LSI of a large number of logic cells (Iguchi et al. 2000a). We developed the custom Finite Impulse Response filter chips and manufactured the Gigabit Digital Filter Banks (GDFBs) as a digital backend subsystem in the VERA terminal. In this paper, the design and development of the GDFB are presented in detail, and the performances and demonstrations of the developed GDFB are shown.

A Non-Parametric Item Response Theory Evaluation of the CAGE Instrument Among Older Adults.

PubMed

Abdin, Edimansyah; Sagayadevan, Vathsala; Vaingankar, Janhavi Ajit; Picco, Louisa; Chong, Siow Ann; Subramaniam, Mythily

2018-02-23

The validity of the CAGE using item response theory (IRT) has not yet been examined in older adult population. This study aims to investigate the psychometric properties of the CAGE using both non-parametric and parametric IRT models, assess whether there is any differential item functioning (DIF) by age, gender and ethnicity and examine the measurement precision at the cut-off scores. We used data from the Well-being of the Singapore Elderly study to conduct Mokken scaling analysis (MSA), dichotomous Rasch and 2-parameter logistic IRT models. The measurement precision at the cut-off scores were evaluated using classification accuracy (CA) and classification consistency (CC). The MSA showed the overall scalability H index was 0.459, indicating a medium performing instrument. All items were found to be homogenous, measuring the same construct and able to discriminate well between respondents with high levels of the construct and the ones with lower levels. The item discrimination ranged from 1.07 to 6.73 while the item difficulty ranged from 0.33 to 2.80. Significant DIF was found for 2-item across ethnic group. More than 90% (CC and CA ranged from 92.5% to 94.3%) of the respondents were consistently and accurately classified by the CAGE cut-off scores of 2 and 3. The current study provides new evidence on the validity of the CAGE from the IRT perspective. This study provides valuable information of each item in the assessment of the overall severity of alcohol problem and the precision of the cut-off scores in older adult population.

A severe artifact in simulation of liquid water using a long cut-off length: Appearance of a strange layer structure

NASA Astrophysics Data System (ADS)

Yonetani, Yoshiteru

2005-04-01

We report that a severe artifact appeared in molecular dynamics simulation of bulk water using the long cut-off length 18 Å. Our result shows that increasing the cut-off length does not always improve the simulation result. Moreover, the use of the long cut-off length can lead to a spurious result. It is suggested that the simulation of solvated biomolecules using such a long cut-off length, which has been often performed, may contain an unexpected artifact.

On Computations of Duct Acoustics with Near Cut-Off Frequency

NASA Technical Reports Server (NTRS)

Dong, Thomas Z.; Povinelli, Louis A.

1997-01-01

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

Optimum wall impedance for spinning modes: A correlation with mode cut-off ratio

NASA Technical Reports Server (NTRS)

Rice, E. J.

1978-01-01

A correlating equation relating the optimum acoustic impedance for the wall lining of a circular duct to the acoustic mode cut-off ratio, is presented. The optimum impedance was correlated with cut-off ratio because the cut-off ratio appears to be the fundamental parameter governing the propagation of sound in the duct. Modes with similar cut-off ratios respond in a similar way to the acoustic liner. The correlation is a semi-empirical expression developed from an empirical modification of an equation originally derived from sound propagation theory in a thin boundary layer. This correlating equation represents a part of a simplified liner design method, based upon modal cut-off ratio, for multimodal noise propagation.

A look into the invisible: ultraviolet-B sensitivity in an insect (Caliothrips phaseoli) revealed through a behavioural action spectrum

PubMed Central

Mazza, Carlos A.; Izaguirre, Miriam M.; Curiale, Javier; Ballaré, Carlos L.

2010-01-01

Caliothrips phaseoli, a phytophagous insect, detects and responds to solar ultraviolet-B radiation (UV-B; λ ≤ 315 nm) under field conditions. A highly specific mechanism must be present in the thrips visual system in order to detect this narrow band of solar radiation, which is at least 30 times less abundant than the UV-A (315–400 nm), to which many insects are sensitive. We constructed an action spectrum of thrips responses to light by studying their behavioural reactions to monochromatic irradiation under confinement conditions. Thrips were maximally sensitive to wavelengths between 290 and 330 nm; human-visible wavelengths (λ ≥ 400 nm) failed to elicit any response. All but six ommatidia of the thrips compound eye were highly fluorescent when exposed to UV-A of wavelengths longer than 330 nm. We hypothesized that the fluorescent compound acts as an internal filter, preventing radiation with λ > 330 nm from reaching the photoreceptor cells. Calculations based on the putative filter transmittance and a visual pigment template of λmax = 360 nm produced a sensitivity spectrum that was strikingly similar to the action spectrum of UV-induced behavioural response. These results suggest that specific UV-B vision in thrips is achieved by a standard UV-A photoreceptor and a sharp cut-off internal filter that blocks longer UV wavelengths in the majority of the ommatidia. PMID:19846453

Serum AMH Level to Predict the Hyper Response in Women with PCOS and Non-PCOS Undergoing Controlled Ovarian Stimulation in ART.

PubMed

Vembu, Radha; Reddy, Nellepalli Sanjeeva

2017-01-01

It is essential to determine the cut-off value of serum anti-Mullerian hormone (AMH) to predict the hyper response in assisted reproductive technology (ART). There are few studies mentioning the cut-off value for the hyper response in infertile women but not specifically for polycystic ovary syndrome (PCOS) and non-PCOS groups. With this in background, this study was conducted. To determine the cut-off value of serum AMH to predict the hyper response in women with PCOS and non-PCOS undergoing a controlled ovarian stimulation (COS) in ART. To compare the outcome of stimulation in PCOS and non-PCOS groups. All 246 women enrolled for Intra Cytoplasmic Sperm Injection (ICSI) fulfilling the selection criteria were recruited. On the day 3 of the cycle, the serum AMH, Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), estradiol and antral follicle count (AFC) were measured. They underwent COS as per the unit protocol. They were divided into PCOS and non-PCOS groups as per the Rotterdam's criteria. The mean age, duration of infertility, Body Mass Index (BMI), Ovarian reserve markers and outcome of stimulation were compared. Using the Statistical Package for the Social Sciences version 16.0 software, the significant difference was measured by multivariate analysis, as well as a one-way analysis of variance with Tukey's post-hoc test was used. Among 246 women, 31.3% were in PCOS group, and 68.7% were in non-PCOS group. Comparison of PCOS and non-PCOS groups showed a significant difference in the age with the mean age being 29.2 and 31.5 years, respectively. The mean AMH and AFC were 2-fold higher in PCOS group. The mean number of follicles, oocytes retrieved, MII and oocytes fertilised were significantly higher in PCOS group. The pregnancy rate was 52.6% in PCOS and 30.9% in non-PCOS group. In the PCOS group, 22.1% had ovarian hyper stimulation syndrome (OHSS), and only 4.7% had OHSS in non-PCOS group ( P = 0.0005). Receiving Operator Curve (ROC) curve was plotted to predict the hyper response, which showed a cut-off value of 6.85 ng/ml with a sensitivity of 66.7% and a specificity of 68.7% for PCOS group and 4.85 ng/ml with a sensitivity of 85.7% and a specificity of 89.7% in non-PCOS group. The cut-off value of serum AMH to predict the hyper response in PCOS group is 6.85 ng/ml and in non-PCOS group is 4.85 ng/ml.

Liebowitz Social Anxiety Scale (LSAS): Optimal cut points for remission and response in a German sample.

PubMed

von Glischinski, M; Willutzki, U; Stangier, U; Hiller, W; Hoyer, J; Leibing, E; Leichsenring, F; Hirschfeld, G

2018-02-11

The Liebowitz Social Anxiety Scale (LSAS) is the most frequently used instrument to assess social anxiety disorder (SAD) in clinical research and practice. Both a self-reported (LSAS-SR) and a clinician-administered (LSAS-CA) version are available. The aim of the present study was to define optimal cut-off (OC) scores for remission and response to treatment for the LSAS in a German sample. Data of N = 311 patients with SAD were used who had completed psychotherapeutic treatment within a multicentre randomized controlled trial. Diagnosis of SAD and reduction in symptom severity according to the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition, served as gold standard. OCs yielding the best balance between sensitivity and specificity were determined using receiver operating characteristics. The variability of the resulting OCs was estimated by nonparametric bootstrapping. Using diagnosis of SAD (present vs. absent) as a criterion, results for remission indicated cut-off values of 35 for the LSAS-SR and 30 for the LSAS-CA, with acceptable sensitivity (LSAS-SR: .83, LSAS-CA: .88) and specificity (LSAS-SR: .82, LSAS-CA: .87). For detection of response to treatment, assessed by a 1-point reduction in the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition, rating, a reduction of 28% for the LSAS-SR and 29% for the LSAS-CA yielded the best balance between sensitivity (LSAS-SR: .75, LSAS-CA: .83) and specificity (LSAS-SR: .76, LSAS-CA: .80). To our knowledge, we are the first to define cut points for the LSAS in a German sample. Overall, the cut points for remission and response corroborate previously reported cut points, now building on a broader data basis. Copyright © 2018 John Wiley & Sons, Ltd.

Mitigation of EMU Cut Glove Hazard from Micrometeoroid and Orbital Debris Impacts on ISS Handrails

NASA Technical Reports Server (NTRS)

Ryan, Shannon; Christiansen, Eric L.; Davis, Bruce A.; Ordonez, Erick

2009-01-01

Recent cut damages sustained on crewmember gloves during extravehicular activity (ISS) onboard the International Space Station (ISS) have been caused by contact with sharp edges or a pinch point according to analysis of the damages. One potential source are protruding sharp edged crater lips from micrometeoroid and orbital debris (MMOD) impacts on metallic handrails along EVA translation paths. A number of hypervelocity impact tests were performed on ISS handrails, and found that mm-sized projectiles were capable of inducing crater lip heights two orders of magnitude above the minimum value for glove abrasion concerns. Two techniques were evaluated for mitigating the cut glove hazard of MMOD impacts on ISS handrails: flexible overwraps which act to limit contact between crewmember gloves and impact sites, and; alternate materials which form less hazardous impact crater profiles. In parallel with redesign efforts to increase the cut resilience of EMU gloves, the modifications to ISS handrails evaluated in this study provide the means to significantly reduce cut glove risk from MMOD impact craters

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

Code of Federal Regulations, 2011 CFR

2011-04-01

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

A System for Discovering Bioengineered Threats by Knowledge Base Driven Mining of Toxin Data

DTIC Science & Technology

2004-08-01

RMSD cut - off and select a residue substitution matrix. The user is also allowed...in the sense that after super-positioning, the RMSD between the substructures is no more than the cut - off RMSD . * Residue substitutions are allowed...during super-positioning. Default RMSD cut - off and residue substitution matrix are provided. Users can specify their own RMSD cut - offs as well as

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

PubMed

Roy, Mononita; Molnar, Frank

2013-01-01

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

Tilting at wave beams: a new perspective on the St Andrew's Cross

NASA Astrophysics Data System (ADS)

Akylas, T. R.; Kataoka, T.; Ghaemsaidi, S. J.; Holzenberger, N.; Peacock, T.

2017-11-01

The generation of internal gravity waves by a vertically oscillating cylinder that is tilted to the horizontal in a stratified fluid of constant buoyancy frequency, is investigated theoretically and experimentally. This forcing arrangement leads to a variant of the classical St Andrew's Cross that has certain unique features: (i) radiation of wave beams is limited due to a lower cut-off frequency set by the cylinder tilt angle to the horizontal; (ii) the response is essentially three-dimensional, as end effects eventually come into play when the cut-off frequency is approached, however long a cylinder might be. These results follow from kinematic considerations and are also confirmed by laboratory experiments. The kinematic analysis, moreover, suggests a resonance phenomenon near the cut-off frequency, where viscous and nonlinear effects are likely to play an important part. This scenario is examined by an asymptotic model as well as experimentally. Supported in part by NSF Grant DMS-1512925.

Role of sampling times and serum cortisol cut-off concentrations on the routine assessment of adrenal function using the standard cosyntropin test in an academic hospital from Spain: a retrospective chart review.

PubMed

Ortiz-Flores, Andrés E; Santacruz, Elisa; Jiménez-Mendiguchia, Lucía; García-Cano, Ana; Nattero-Chávez, Lia; Escobar-Morreale, Héctor F; Luque-Ramírez, Manuel

2018-05-05

Aiming to validate the use of a single poststimulus sampling protocol for cosyntropin test short standard high-dose test (SST) in our institution, our primary objectives were (1) to determine the concordance between 30 and 60 min serum cortisol (SC) measurements during SST; and (2) to evaluate the diagnostic agreement between both sampling times when using classic or assay-specific and sex-specific SC cut-off values. The secondary objectives included (1) estimating the specificity and positive predictive value of 30 and 60 min sampling times while considering the suspected origin of adrenal insufficiency (AI); and (2) obtaining assay-specific cut-off values for SC after SST in a group of subjects with normal hypothalamic-pituitary-adrenal (HPA) axis. This is a retrospective chart review study conducted at a Spanish academic hospital from 2011 to 2015. Two groups were evaluated: (1) a main study group including 370 patients in whom SC was measured at 30 and 60 min during SST; and (2) a confirmative group that included 150 women presenting with a normal HPA axis in whom SST was conducted to rule out late-onset congenital adrenal hyperplasia. Diagnostic agreement between both sampling times was assessed by considering both classic (500 nmol/L) and assay-specific SC cut-off concentrations. Diagnostic agreement between both sampling times was greater when applying sex-specific and assay-specific cut-off values instead of the classic cut-off values. For suspected primary AI, 30 min SC determination was enough to establish a diagnosis in over 95% of cases, without missing any necessary treatment. When central AI is suspected, 60 min SC measurement was more specific, establishing a diagnosis in over 97% of cases. Sex-specific and assay-specific SC cut-off values improve the diagnostic accuracy of SST. For primary disease, a subnormal SC response at 30 min is a reliable marker of adrenal dysfunction. On the contrary, when central AI is suspected, 60 min SC measurement improves the diagnostic accuracy of the test. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Azimuth cut-off model for significant wave height investigation along coastal water of Kuala Terengganu, Malaysia

NASA Astrophysics Data System (ADS)

Marghany, Maged; Ibrahim, Zelina; Van Genderen, Johan

2002-11-01

The present work is used to operationalize the azimuth cut-off concept in the study of significant wave height. Three ERS-1 images have been used along the coastal waters of Terengganu, Malaysia. The quasi-linear transform was applied to map the SAR wave spectra into real ocean wave spectra. The azimuth cut-off was then used to model the significant wave height. The results show that azimuth cut-off varied with the different period of the ERS-1 images. This is because of the fact that the azimuth cut-off is a function of wind speed and significant wave height. It is of interest to find that the significant wave height modeled from azimuth cut-off is in good relation with ground wave conditions. It can be concluded that ERS-1 can be used as a monitoring tool in detecting the significant wave height variation. The azimuth cut-off can be used to model the significant wave height. This means that the quasi-linear transform could be a good application to significant wave height variation during different seasons.

40 CFR 265.16 - Personnel training.

Code of Federal Regulations, 2013 CFR

2013-07-01

... automatic waste feed cut-off systems; (iii) Communications or alarm -systems; (iv) Response to fires or... bargaining unit, but must include the requisite skill, education, or other qualifications, and duties of...

40 CFR 265.16 - Personnel training.

Code of Federal Regulations, 2012 CFR

2012-07-01

... automatic waste feed cut-off systems; (iii) Communications or alarm -systems; (iv) Response to fires or... bargaining unit, but must include the requisite skill, education, or other qualifications, and duties of...

40 CFR 265.16 - Personnel training.

Code of Federal Regulations, 2014 CFR

2014-07-01

... automatic waste feed cut-off systems; (iii) Communications or alarm -systems; (iv) Response to fires or... bargaining unit, but must include the requisite skill, education, or other qualifications, and duties of...

Microcutting characteristics on the single crystal diamond tool with edge radius using molecular dynamics

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

Kim, Jeong-Du; Moon, Chan-Hong

1995-12-31

Ultraprecision metal cutting (UPMC) technology which makes possible submicrometer form accuracy and manometer roughness is developed to reach the 1nm nominal (undeformed) thickness of cut. At this thickness level, a few of atom`s layers should be considered. In this paper using the Molecuar Dynamics simulation, the phenomena of microcutting with a subnanometer chip thickness, the cutting mechanism for tool edge configuration to consider the sharp edge and round edge tool, the cut material and cutting speed are evaluated. Cutting mechanism of subnanometer depth of cut is evaluated.

PSA response to cabazitaxel is associated with improved progression-free survival in metastatic castration-resistant prostate cancer: the non-interventional QoLiTime study.

PubMed

Hammerer, Peter; Al-Batran, Salah-Eddin; Windemuth-Kieselbach, Christine; Keller, Martin; Hofheinz, Ralf-Dieter

2018-03-01

To evaluate the association between prostate-specific antigen (PSA) response and progression-free and overall survival in men with metastatic castration-resistant prostate cancer (mCRPC) treated with cabazitaxel. Men with mCRPC receiving cabazitaxel (25 mg/m 2 , every 3 weeks) plus oral prednis(ol)one (10 mg/day) were enrolled in the non-interventional, prospective QoLiTime study. Main outcome measures were progression-free survival and overall survival, in all patients and in those who showed a ≥ 50 or a ≥ 30% decrease in PSA relative to baseline after four cycles of cabazitaxel, as well as quality-of-life parameters. Of the 527 men (median age 72 years), 266 received ≥ 4 cycles of cabazitaxel and had PSA response data. After four cycles, 34.6% of men achieved a PSA decrease ≥ 50% and 49.6% a decrease ≥ 30%. Median progression-free survival was 7.7 (95% CI 6.2, 9.5) months, and overall survival was 19.5 (95% CI 16.0, 30.9) months, corresponding to 1-year event rates of 39.4 and 78.8%, respectively. Median progression-free survival was longer in PSA responders versus non-responders (15.7 vs 5.5 months at 50% cut-off; 15.7 vs 5.3 months for 30% cut-off; both P < 0.0001). Overall survival (50% cut-off) was 23.3 months in responders and 16.0 months in non-responders (P = 0.068); corresponding data at the 30% cut-off are 21.7 and 16.0 months (P = 0.057). Overall, 55.4% of men experienced ≥ 1 adverse event, 59.6% of whom had a serious adverse event. PSA response after four cycles of cabazitaxel is associated with improved progression-free survival in men with mCRPC treated with cabazitaxel plus prednis(ol)one.

Strait of Gibraltar

NASA Image and Video Library

1991-05-06

STS039-151-193 (28 April-6 May 1991) --- The Strait of Gibraltar, the only outlet for the Mediterranean Sea, was photographed with a large format handheld camera by the STS-39 crew members. Scientists site evidence in Shuttle photography that the Mediterranean Sea dried up a number of times between 5 million and 20 million years ago. Sea levels, they say, dropped slightly, cutting off the Mediterranean (top right) from the Atlantic Ocean (bottom). In southern Spain, the dark area near the coast is the delta of the Guadalquivir River with the city of Seville. The Sierra Nevada range still has some snow. A small field fire near the Spanish coast has generated a conspicuous smoke plume. The small spike of land on the north side of the Strait is the Rock of Gibraltar, an outpost of the British empire. The larger spike of land on the north coast of Africa marks the border between Morocco (center foreground) and Algeria (right). The sharp line cutting across them Mediterranean (top right) marks the edge of a dust cloud blowing from Africa into Europe. Photo credit: NASA

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

PubMed Central

Roy, Mononita; Molnar, Frank

2013-01-01

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

Concurrence of the strengths and difficulties questionnaire and developmental behaviour checklist among children with an intellectual disability.

PubMed

Rice, L J; Emerson, E; Gray, K M; Howlin, P; Tonge, B J; Warner, G L; Einfeld, S L

2018-02-01

The Strengths and Difficulties Questionnaire (SDQ) is widely used to measure emotional and behavioural problems in typically developing young people, although there is some evidence that it may also be suitable for children with intellectual disability (ID). The Developmental Behaviour Checklist - Parent version (DBC-P) is a measure of emotional and behavioural problems that was specifically designed for children and adolescents with an ID. The DBC-P cut-off has high agreement with clinical diagnosis. The aim of this study was to estimate the relationship between DBC-P and SDQ scores in a sample of children with ID. Parents of 83 young people with ID aged 4-17 years completed the parent versions of the SDQ and the DBC-P. We evaluated the concurrent validity of the SDQ and DBC-P total scores, and the agreement between the DBC-P cut-off and the SDQ cut-offs for 'borderline' and 'abnormal' behaviour. The SDQ total difficulties score correlated well with the DBC-P total behaviour problem score. Agreement between the SDQ borderline cut-off and the DBC-P cut-off for abnormality was high (83%), but was lower for the SDQ abnormal cut-off (75%). Positive agreement between the DBC-P and the SDQ borderline cut-off was also high, with the SDQ borderline cut-off identifying 86% of those who met the DBC-P criterion. Negative agreement was weaker, with the SDQ borderline cut-off identifying only 79% of the participants who did not meet the DBC-P cut-off. The SDQ borderline cut-off has some validity as a measure of overall levels of behavioural and emotional problems in young people with ID, and may be useful in epidemiological studies that include participants with and without ID. However, where it is important to focus on behavioural profiles in children with ID, a specialised ID instrument with established psychometric properties, such as the DBC-P, may provide more reliable and valid information. © 2017 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

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.

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

Critical analysis of forensic cut-offs and legal thresholds: A coherent approach to inference and decision.

PubMed

Biedermann, A; Taroni, F; Bozza, S; Augsburger, M; Aitken, C G G

2018-07-01

In this paper we critically discuss the definition and use of cut-off values by forensic scientists, for example in forensic toxicology, and point out when and why such values - and ensuing categorical conclusions - are inappropriate concepts for helping recipients of expert information with their questions of interest. Broadly speaking, a cut-off is a particular value of results of analyses of a target substance (e.g., a toxic substance or one of its metabolites in biological sample from a person of interest), defined in a way such as to enable scientists to suggest conclusions regarding the condition of the person of interest. The extent to which cut-offs can be reliably defined and used is not unanimously agreed within the forensic science community, though many practitioners - especially in operational laboratories - rely on cut-offs for reasons such as ease of use and simplicity. In our analysis, we challenge this practice by arguing that choices made for convenience should not be to the detriment of balance and coherence. To illustrate our discussion, we will choose the example of alcohol markers in hair, used widely by forensic toxicologists to reach conclusions regarding the drinking behaviour of individuals. Using real data from one of the co-authors' own work and recommendations of cut-offs published by relevant professional organisations, we will point out in what sense cut-offs are incompatible with current evaluative guidelines (e.g., [31]) and show how to proceed logically without cut-offs by using a standard measure for evidential value. Our conclusions run counter to much current practice, but are inevitable given the inherent definitional and conceptual shortcomings of scientific cut-offs. We will also point out the difference between scientific cut-offs and legal thresholds and argue that the latter - but not the former - are justifiable and can be dealt with in logical evaluative procedures. Copyright © 2018 Elsevier B.V. All rights reserved.

Optimal cut-off points for waist circumference in the definition of metabolic syndrome in Brazilian adults: baseline analyses of the Longitudinal Study of Adult Health (ELSA-Brasil).

PubMed

Cardinal, Thiane Ristow; Vigo, Alvaro; Duncan, Bruce Bartholow; Matos, Sheila Maria Alvim; da Fonseca, Maria de Jesus Mendes; Barreto, Sandhi Maria; Schmidt, Maria Inês

2018-01-01

Waist circumference (WC) has been incorporated in the definition of the metabolic syndrome (MetS) but the exact WC cut-off points across populations are not clear. The Joint Interim Statement (JIS) suggested possible cut-offs to different populations and ethnic groups. However, the adequacy of these cut-offs to Brazilian adults has been scarcely investigated. The objective of the study is to evaluate possible WC thresholds to be used in the definition of MetS using data from the Longitudinal Study of Adult Health (ELSA-Brasil), a multicenter cohort study of civil servants (35-74 years old) of six Brazilian cities. We analyzed baseline data from 14,893 participants (6772 men and 8121 women). A MetS was defined according to the JIS criteria, but excluding WC and thus requiring 2 of the 4 remaining elements. We used restricted cubic spline regression to graph the relationship between WC and MetS. We identified optimal cut-off points which maximized joint sensitivity and specificity (Youden's index) from Receiver Operator Characteristic Curves. We also estimated the C-statistics using logistic regression. We found no apparent threshold for WC in restricted cubic spline plots. Optimal cut-off for men was 92 cm (2 cm lower than that recommended by JIS for Caucasian/Europids or Sub-Saharan African men), but 2 cm higher than that recommended for ethnic Central and South American. For women, optimal cut-off was 86, 6 cm higher than that recommended for Caucasian/Europids and ethnic Central and South American. Optimal cut-offs did not very across age groups and most common race/color categories (except for Asian men, 87 cm). Sex-specific cut-offs for WC recommended by JIS differ from optimal cut-offs we found for adult men and women of Brazil´s most common ethnic groups.

Earth Observations taken by Expedition 38 crewmember

NASA Image and Video Library

2013-12-30

ISS038-E-023651 (26 Dec. 2013) --- Lake Sharpe near Lower Brule, South Dakota is featured in this image photographed by an Expedition 38 crew member on the International Space Station. The Missouri River rises in the Rocky Mountains of western Montana, and flows generally to the southeast for approximately 3,767 kilometers (2,341 miles) to its confluence with the Mississippi River north of St. Louis, Missouri -- making it the longest river in North America. The river does not follow a straight southeasterly course along this distance, but includes may meander bends such as illustrated in this photograph. This particular bend is occupied by Lake Sharpe, an approximately 130-kilometer (80 miles) long reservoir formed behind the Big Bend Dam on the Missouri River. The lake surface is frozen and covered with snow, presenting a uniform white appearance in the image. As meander bends develop, they tend to assume a distinctive U-shape when viewed from above. Over time, the river channel can continue to cut into the ends of the "U", eventually bringing them so close together that the river then cuts across the gap to achieve a shorter flow path, essentially short-circuiting or cutting off the meander bend. When this happens and the meander ceases to be part of the active river channel, it may become an oxbow lake. The distance across the narrow neck of land (lower right) associated with this meander near Lower Brule, South Dakota is approximately one kilometer (0.62 miles); however, as the river flow is controlled by the Big Bend Dam downstream, the natural process of meander cutoff has been significantly slowed. The snow cover also highlights circular agricultural fields on the small peninsula within the meander bend. This type of field indicates center-pivot irrigation, where water is distributed from a central point radially outwards using sprinklers to cover the field area. Crops grown here include corn and soybeans according to data from the US Department of Agriculture's CropScape database.

40 CFR 267.16 - What training must my employees have?

Code of Federal Regulations, 2011 CFR

2011-07-01

... feed cut-off systems. (iii) Communications or alarm systems. (iv) Response to fires or explosions. (v... section. This description must include the requisite skill, education, or other qualifications, and duties...

40 CFR 267.16 - What training must my employees have?

Code of Federal Regulations, 2014 CFR

2014-07-01

... feed cut-off systems. (iii) Communications or alarm systems. (iv) Response to fires or explosions. (v... section. This description must include the requisite skill, education, or other qualifications, and duties...

40 CFR 267.16 - What training must my employees have?

Code of Federal Regulations, 2013 CFR

2013-07-01

... feed cut-off systems. (iii) Communications or alarm systems. (iv) Response to fires or explosions. (v... section. This description must include the requisite skill, education, or other qualifications, and duties...

40 CFR 267.16 - What training must my employees have?

Code of Federal Regulations, 2012 CFR

2012-07-01

... feed cut-off systems. (iii) Communications or alarm systems. (iv) Response to fires or explosions. (v... section. This description must include the requisite skill, education, or other qualifications, and duties...

40 CFR 267.16 - What training must my employees have?

Code of Federal Regulations, 2010 CFR

2010-07-01

... feed cut-off systems. (iii) Communications or alarm systems. (iv) Response to fires or explosions. (v... section. This description must include the requisite skill, education, or other qualifications, and duties...

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

PubMed Central

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

2017-01-01

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

Airway hyperresponsiveness to methacholine in 7-year-old children: sensitivity and specificity for pediatric allergist-diagnosed asthma.

PubMed

Carlsten, Chris; Dimich-Ward, Helen; Ferguson, Alexander; Becker, Allan; Dybuncio, Anne; Chan-Yeung, Moira

2011-02-01

The operating characteristics of PC(20) values used as cut-offs to define airway hyperresponsiveness, as it informs the diagnosis of asthma in children, are poorly understood. We examine data from a unique cohort to inform this concern. Determine the sensitivity and specificity of incremental PC(20) cut-offs for allergist-diagnosed asthma. Airway reactivity at age 7 was assessed in children within a birth cohort at high risk for asthma; PC(20) for methacholine was determined by standard technique including interpolation. The diagnosis of asthma was considered by the pediatric allergist without knowledge of the methacholine challenge results. Sensitivity and specificity were calculated using a cross-tabulation of asthma diagnosis with incremental PC(20) cut-off values, from 1.0 to 8.0 mg/ml, and plotted as receiver operator characteristic (ROC) curves. The "optimal" cut-off was defined as that PC(20) conferring maximal value for sensitivity plus specificity while the "balanced" cut-off was defined as that PC(20) at which sensitivity and specificity were most equal. 70/348 children (20.1%) were diagnosed with asthma. The optimal and balanced PC(20) cut-offs, both for all children and for females alone, were respectively 3 mg/ml (sensitivity 80.0%, specificity 49.1%) and 2 mg/ml (sensitivity 63.1%, specificity 64.7%). For males alone, the "optimal" and "balanced" PC(20) cut-offs were both 2 mg/ml. For this cohort of 7-year olds at high risk for asthma, methacholine challenge testing using a cut-off value of PC(20) 3 mg/ml conferred the maximal sum of specificity plus sensitivity. For contexts in which higher sensitivity or specificity is desired, other cut-offs may be preferred. Copyright © 2011 Wiley-Liss, Inc.

Testing local-realism and macro-realism under generalized dichotomic measurements

NASA Astrophysics Data System (ADS)

Das, Debarshi; Mal, Shiladitya; Home, Dipankar

2018-04-01

Generalized quantum measurements with two outcomes are fully characterized by two real parameters, dubbed as sharpness parameter and biasedness parameter and they can be linked with different aspects of the experimental setup. It is known that sharpness parameter characterizes precision of the measurements and decreasing sharpness parameter of the measurements reduces the possibility of probing quantum features like quantum mechanical (QM) violation of local-realism (LR) or macro-realism (MR). Here we investigate the effect of biasedness together with that of sharpness of measurements and find a trade-off between those two parameters in the context of probing QM violations of LR and MR. Interestingly, we also find that the above mentioned trade-off is more robust in the latter case.

Calculating and Mitigating the Risk of a Cut Glove to a Space Walking Astronaut

NASA Technical Reports Server (NTRS)

Castillo, Theresa; Haught, Megan

2013-01-01

One of the high risk operations on the International Space Station (ISS) is conducting a space walk, or an Extra Vehicular Activity (EVA). Threats to the space walking crew include airlock failures, space suit failures, and strikes from micro ]meteoroids and orbital debris (MM/OD). There are risks of becoming untethered from the space station, being pinched between the robotic arm and a piece of equipment, tearing your suit on a sharp edge, and other human errors that can be catastrophic. For decades NASA identified and tried to control sharp edges on external structure and equipment by design; however a new and unexpected source of sharp edges has since become apparent. Until recently, one of the underappreciated environmental risks was damage to EVA gloves during a spacewalk. The ISS has some elements which have been flying in the environment of space for over 14 years. It has and continues to be bombarded with MM/OD strikes that have created small, sharp craters all over the structure, including the dedicated EVA handrails and surrounding structure. These craters are capable of cutting through several layers of the EVA gloves. Starting in 2006, five EVA crewmembers reported cuts in their gloves so large they rendered the gloves unusable and in some cases cut the spacewalk short for the safety of the crew. This new hazard took engineers and managers by surprise. NASA has set out to mitigate this risk to safety and operations by redesigning the spacesuit gloves to be more resilient and designing a clamp to isolate MM/OD strikes on handrails, and is considering the necessity of an additional tool to repair strikes on non ]handrail surfaces (such as a file). This paper will address how the ISS Risk Team quantified an estimate of the MM/OD damage to the ISS, and the resulting likelihood of sustaining a cut glove in order to measure the effectiveness of the solutions being investigated to mitigate this risk to the mission and crew.

Design and Analysis of Bionic Cutting Blades Using Finite Element Method.

PubMed

Li, Mo; Yang, Yuwang; Guo, Li; Chen, Donghui; Sun, Hongliang; Tong, Jin

2015-01-01

Praying mantis is one of the most efficient predators in insect world, which has a pair of powerful tools, two sharp and strong forelegs. Its femur and tibia are both armed with a double row of strong spines along their posterior edges which can firmly grasp the prey, when the femur and tibia fold on each other in capturing. These spines are so sharp that they can easily and quickly cut into the prey. The geometrical characteristic of the praying mantis's foreleg, especially its tibia, has important reference value for the design of agricultural soil-cutting tools. Learning from the profile and arrangement of these spines, cutting blades with tooth profile were designed in this work. Two different sizes of tooth structure and arrangement were utilized in the design on the cutting edge. A conventional smooth-edge blade was used to compare with the bionic serrate-edge blades. To compare the working efficiency of conventional blade and bionic blades, 3D finite element simulation analysis and experimental measurement were operated in present work. Both the simulation and experimental results indicated that the bionic serrate-edge blades showed better performance in cutting efficiency.

Design and Analysis of Bionic Cutting Blades Using Finite Element Method

PubMed Central

Li, Mo; Yang, Yuwang; Guo, Li; Chen, Donghui; Sun, Hongliang; Tong, Jin

2015-01-01

Praying mantis is one of the most efficient predators in insect world, which has a pair of powerful tools, two sharp and strong forelegs. Its femur and tibia are both armed with a double row of strong spines along their posterior edges which can firmly grasp the prey, when the femur and tibia fold on each other in capturing. These spines are so sharp that they can easily and quickly cut into the prey. The geometrical characteristic of the praying mantis's foreleg, especially its tibia, has important reference value for the design of agricultural soil-cutting tools. Learning from the profile and arrangement of these spines, cutting blades with tooth profile were designed in this work. Two different sizes of tooth structure and arrangement were utilized in the design on the cutting edge. A conventional smooth-edge blade was used to compare with the bionic serrate-edge blades. To compare the working efficiency of conventional blade and bionic blades, 3D finite element simulation analysis and experimental measurement were operated in present work. Both the simulation and experimental results indicated that the bionic serrate-edge blades showed better performance in cutting efficiency. PMID:27019583

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.

Clinical value of serum anti-mullerian hormone and inhibin B in prediction of ovarian response in patients with polycystic ovary syndrome.

PubMed

Zhang, Fan; Liu, Xiao-Ling; Rong, Nan; Huang, Xiao-Wen

2017-02-01

The present study aimed to investigate the clinical value of serum anti-mullerian hormone (AMH) and inhibin B (INHB) in predicting the ovarian response of patients with polycystic ovary syndrome (PCOS). A total of 120 PCOS patients were enrolled and divided into three groups in terms of the ovarian response: a low-response group (n=36), a normal-response group (n=44), and a high-response group (n=40). The serum AMH and INHB levels were measured by enzyme-linked immunosorbent assay (ELISA). The follicle stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) levels were determined by chemiluminescence microparticle immunoassay. The correlation of the serum AMH and INHB levels with other indicators was analyzed. A receiver operating characteristic (ROC) curve was established to analyze the prediction of ovarian response by AMH and INHB. The results showed that there were significant differences in age, body mass index (BMI), FSH, total gonadotropin-releasing hormone (GnRH), LH, E2, and antral follicle counts (AFCs) between the groups (P<0.05). The serum AMH and INHB levels were increased significantly with the ovarian response of PCOS patients increasing (P<0.05). The serum AMH and INHB levels were negatively correlated with the age, BMI, FSH level, Gn, and E2 levels (P<0.05). They were positively correlated with the LH levels and AFCs (P<0.05). ROC curve analysis of serum AMH and INHB in prediction of a low ovarian response showed that the area under the ROC curve (AUC) value of the serum AMH level was 0.817, with a cut-off value of 1.29 ng/mL. The sensitivity and specificity were 71.2% and 79.6%, respectively. The AUC value of serum INHB was 0.674, with a cut-off value of 38.65 ng/mL, and the sensitivity and specificity were 50.7% and 74.5%, respectively. ROC curve analysis showed when the serum AMH and INHB levels were used to predict a high ovarian response, the AUC value of the serum AMH level was 0.742, with a cut-off value of 2.84 ng/mL, and the sensitivity and specificity were 72.7% and 65.9%, respectively; the AUC value of the serum INHB level was 0.551 with a cut-off of 45.76 ng/mL, and the sensitivity and specificity were 76.3% and 40.2%, respectively. It was suggested the serum AMH and INHB levels have high clinical value in predicting the ovarian response of PCOS patients.

Microfabricated instrument for tissue biopsy and analysis

DOEpatents

Krulevitch, Peter A.; Lee, Abraham P.; Northrup, M. Allen; Benett, William J.

2001-01-01

A microfabricated biopsy/histology instrument which has several advantages over the conventional procedures, including minimal specimen handling, smooth cutting edges with atomic sharpness capable of slicing very thin specimens (approximately 2 .mu.m or greater), micro-liter volumes of chemicals for treating the specimens, low cost, disposable, fabrication process which renders sterile parts, and ease of use. The cutter is a "cheese-grater" style design comprising a block or substrate of silicon and which uses anisotropic etching of the silicon to form extremely sharp and precise cutting edges. As a specimen is cut, it passes through the silicon cutter and lies flat on a piece of glass which is bonded to the cutter. Microchannels are etched into the glass or silicon substrates for delivering small volumes of chemicals for treating the specimen. After treatment, the specimens can be examined through the glass substrate.

Latent class analysis of the diagnostic characteristics of PCR and conventional bacteriological culture in diagnosing intramammary infections caused by Staphylococcus aureus in dairy cows at dry off

PubMed Central

2012-01-01

Background Staphylococcus aureus is one of the most common causes of intramammary infections in dairy cows at dry off. Reliable identification is important for disease management on herd level and for antimicrobial treatment of infected animals. Our objective was to evaluate the test characteristics of PathoProof ™ Mastitis PCR Assay and bacteriological culture (BC) in diagnosing bovine intramammary infections caused by S. aureus at dry off at different PCR cycle threshold (Ct)-value cut-offs. Methods Sterile quarter samples and non-sterile composite samples from 140 animals in seven herds were collected in connection with the dairy herd improvement (DHI) milk recording. All quarter samples were analyzed using BC whereas all composite samples were analyzed with PathoProof ™ Mastitis PCR Assay. Latent class analysis was used to estimate test properties for PCR and BC in the absence of a perfect reference test. The population was divided into two geographically divided subpopulations and the Hui-Walter 2-test 2-populations model applied to estimate Se, Sp for the two tests, and prevalence for the two subpopulations. Results The Se for PCR increased with increasing Ct-value cut-off, accompanied by a small decrease in Sp. For BC the Se decreased and Sp increased with increasing Ct-value cut-off. Most optimal test estimates for the real-time PCR assay were at a Ct-value cut-off of 37; 0.93 [95% posterior probability interval (PPI) 0.60-0.99] for Se and 0.95 [95% PPI 0.95-0.99] for Sp. At the same Ct-value cut-off, Se and Sp for BC were 0.83 [95% PPI 0.66-0.99] and 0.97 [95% PPI 0.91-0.99] respectively. Depending on the chosen PCR Ct-value cut-off, the prevalence in the subpopulations varied; the prevalence increased with increasing PCR Ct-value cut-offs. Conclusion Neither BC nor real-time PCR is a perfect test in detecting IMI in dairy cows at dry off. The changes in sensitivity and prevalence at different Ct-value cut-offs for both PCR and BC may indicate a change in the underlying disease definition. At low PCR Ct-value cut-offs the underlying disease definition may be a truly/heavily infected cow, whereas at higher PCR Ct-value cut-offs the disease definition may be a S. aureus positive cow. PMID:23164432

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

PubMed

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

2016-11-03

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

Prospective Study of Optimal Obesity Index Cut-Off Values for Predicting Incidence of Hypertension in 18–65-Year-Old Chinese Adults

PubMed Central

Ren, Qian; Su, Chang; Wang, Huijun; Wang, Zhihong; Du, Wenwen; Zhang, Bing

2016-01-01

Background Overweight and obesity increase the risk of elevated blood pressure; most of the studies that serve as a background for the debates on the optimal obesity index cut-off values used cross-sectional samples. The aim of this study was to determine the cut-off values of anthropometric markers for detecting hypertension in Chinese adults with data from prospective cohort. Methods This study determines the best cut-off values for the obesity indices that represent elevated incidence of hypertension in 18–65-year-old Chinese adults using data from the China Health and Nutrition Survey (CHNS) 2006–2011 prospective cohort. Individual body mass index (BMI), waist circumference (WC), waist:hip ratio (WHR) and waist:stature ratio (WSR) were assessed. ROC curves for these obesity indices were plotted to estimate and compare the usefulness of these obesity indices and the corresponding values for the maximum of the Youden indices were considered the optimal cut-off values. Results Five-year cumulative incidences of hypertension were 21.5% (95% CI: 19.4–23.6) in men and 16.5% (95% CI: 14.7–18.2) in women, and there was a significant trend of increased incidence of hypertension with an increase in BMI, WC, WHR or WSR (P for trend < 0.001) in both men and women. The Youden index indicated that the optimal BMI, WC, WHR, WSR cut-off values were 23.53 kg/m2, 83.7 cm, 0.90, and 0.51 among men. The optimal BMI, WC, WHR, WSR cut-off values were 24.25 kg/m2, 79.9 cm, 0.85 and 0.52 among women. Conclusions Our study supported the hypothesis that the cut-off values for BMI and WC that were recently developed by the Working Group on Obesity in China (WGOC), the cut-off values for WHR that were developed by the World Health Organization (WHO), and a global WSR cut-off value of 0.50 may be the appropriate upper limits for Chinese adults. PMID:26934390

Digital Filtering of Three-Dimensional Lower Extremity Kinematics: an Assessment

PubMed Central

Sinclair, Jonathan; Taylor, Paul John; Hobbs, Sarah Jane

2013-01-01

Errors in kinematic data are referred to as noise and are an undesirable portion of any waveform. Noise is typically removed using a low-pass filter which removes the high frequency components of the signal. The selection of an optimal frequency cut-off is very important when processing kinematic information and a number of techniques exists for the determination of an optimal frequency cut-off. Despite the importance of cut-off frequency to the efficacy of kinematic analyses there is currently a paucity of research examining the influence of different cut-off frequencies on the resultant 3-D kinematic waveforms and discrete parameters. Twenty participants ran at 4.0 m•s−1 as lower extremity kinematics in the sagittal, coronal and transverse planes were measured using an eight camera motion analysis system. The data were filtered at a range of cut-off frequencies and the discrete kinematic parameters were examined using repeated measures ANOVA’s. The similarity between the raw and filtered waveforms were examined using intra-class correlations. The results show that the cut-off frequency has a significant influence on the discrete kinematic measure across displacement and derivative information in all three planes of rotation. Furthermore, it was also revealed that as the cut-off frequency decreased the attenuation of the kinematic waveforms became more pronounced, particularly in the coronal and transverse planes at the second derivative. In conclusion, this investigation provides new information regarding the influence of digital filtering on lower extremity kinematics and re-emphasizes the importance of selecting the correct cut-off frequency. PMID:24511338

Assessment of second (I2M) and third (I3M) molar indices for establishing 14 and 16 legal ages and validation of the Cameriere's I3M cut-off for 18 years old in Chilean population.

PubMed

Cameriere, Roberto; Velandia Palacio, Luz Andrea; Pinares, Jorge; Bestetti, Fiorella; Paba, Rossella; Coccia, Erminia; Ferrante, Luigi

2018-04-01

This retrospective cross-sectional study has two-fold aims: the first is to assess new cut-offs at the legal age thresholds (LATs) of 14 and 16 years old and the second is to validate the cut-off of third molar index I 3M =0.08 for 18 years of age in Chilean people. Orthopantomographs from 822 Chilean children aged from 11 to 22 (472 girls and 350 boys) were analysed. For LAT of 14 years, cut-offs were found using the ROC curves singly for boys and girls. The cut-offs for boys were I 2M =0.16 and I 3M =0.73 while for girls we obtained I 2M =0.10 and I 3M =0.77. For LAT of 16 years we obtained the same cut-offs regardless of gender, which were 0.06 and 0.36 for I 2M and I 3M respectively. Concerning the validity of I 3M cut-off for 18 years old in Chilean population, the proportion of correctly classified individuals was 83% and estimated post-test probability, PPV, was 93.2%, with a 95% confidence interval equals to 91.3%, 94.6%. Hence, the probability that a subject positive on the test was 18 years of age or older was 93.2%, confirming the validation of the I 3M cut-off for Chilean population. Copyright © 2018 Elsevier B.V. All rights reserved.

Radiomics-based differentiation of lung disease models generated by polluted air based on X-ray computed tomography data.

PubMed

Szigeti, Krisztián; Szabó, Tibor; Korom, Csaba; Czibak, Ilona; Horváth, Ildikó; Veres, Dániel S; Gyöngyi, Zoltán; Karlinger, Kinga; Bergmann, Ralf; Pócsik, Márta; Budán, Ferenc; Máthé, Domokos

2016-02-11

Lung diseases (resulting from air pollution) require a widely accessible method for risk estimation and early diagnosis to ensure proper and responsive treatment. Radiomics-based fractal dimension analysis of X-ray computed tomography attenuation patterns in chest voxels of mice exposed to different air polluting agents was performed to model early stages of disease and establish differential diagnosis. To model different types of air pollution, BALBc/ByJ mouse groups were exposed to cigarette smoke combined with ozone, sulphur dioxide gas and a control group was established. Two weeks after exposure, the frequency distributions of image voxel attenuation data were evaluated. Specific cut-off ranges were defined to group voxels by attenuation. Cut-off ranges were binarized and their spatial pattern was associated with calculated fractal dimension, then abstracted by the fractal dimension -- cut-off range mathematical function. Nonparametric Kruskal-Wallis (KW) and Mann-Whitney post hoc (MWph) tests were used. Each cut-off range versus fractal dimension function plot was found to contain two distinctive Gaussian curves. The ratios of the Gaussian curve parameters are considerably significant and are statistically distinguishable within the three exposure groups. A new radiomics evaluation method was established based on analysis of the fractal dimension of chest X-ray computed tomography data segments. The specific attenuation patterns calculated utilizing our method may diagnose and monitor certain lung diseases, such as chronic obstructive pulmonary disease (COPD), asthma, tuberculosis or lung carcinomas.

Statistical Considerations for Establishing CBTE Cut-Off Scores.

ERIC Educational Resources Information Center

Trzasko, Joseph A.

This report gives the basic definition and purpose of competency-based teacher education (CBTE) cut-off scores. It describes the basic characteristics of CBTE as a yes-no dichotomous decision regarding the presence of a specific ability or knowledge, which necesitates the establishment of a cut-off point to designate competency vs. incompetency on…

75 FR 13636 - Self-Regulatory Organizations; International Securities Exchange, LLC; Order Approving Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-22

... Rules Related to Cut-Off Time for Contrary Exercise Advice Submissions March 15, 2010. I. Introduction... to the cut-off time for submitting contrary exercise advices to the Exchange. The proposed rule... proposed to amend Rule 1100 to extend the cut-off time to submit contrary exercise advices (``CEAs'') \\4...

Open pit mining profit maximization considering selling stage and waste rehabilitation cost

NASA Astrophysics Data System (ADS)

Muttaqin, B. I. A.; Rosyidi, C. N.

2017-11-01

In open pit mining activities, determination of the cut-off grade becomes crucial for the company since the cut-off grade affects how much profit will be earned for the mining company. In this study, we developed a cut-off grade determination mode for the open pit mining industry considering the cost of mining, waste removal (rehabilitation) cost, processing cost, fixed cost, and selling stage cost. The main goal of this study is to develop a model of cut-off grade determination to get the maximum total profit. Secondly, this study is also developed to observe the model of sensitivity based on changes in the cost components. The optimization results show that the models can help mining company managers to determine the optimal cut-off grade and also estimate how much profit that can be earned by the mining company. To illustrate the application of the models, a numerical example and a set of sensitivity analysis are presented. From the results of sensitivity analysis, we conclude that the changes in the sales price greatly affects the optimal cut-off value and the total profit.

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

NASA Astrophysics Data System (ADS)

Romoli, Carlo; Taylor, Andrew M.; Aharonian, Felix

2017-01-01

The cut-off region of the gamma-ray spectrum of astrophysical sources encodes important information about the acceleration processes producing the parent particle population. For bright AGNs the cut-off happens in an energy range around a few tens of GeV, a region where satellites are limited by their effective area and current ground based telescopes by energy threshold. In the attempt to maximise the statistics, we have looked at two of the brightest AGNs seen by the Fermi-LAT (3C 454.3 and 3C 279) during extremely luminous flares. Our analysis showed the difficulty to obtain good constraints on the cut-off parameters when a power-law with modified exponential cut-off was assumed to fit the SEDs. We discuss the potential of future low-threshold Cherenkov telescope arrays, in particular CTA, showing the impact that a much bigger effective area can have on the determination of spectral parameters in the cut-off region. This preliminary study serves as an example, demonstrating the importance of having good wide-energy coverage around 10 GeV.

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

PubMed

Kang, Pingping; Xu, Shiguo

2017-03-01

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

Eating Disorder Symptomatology: Prevalence among Latino College Freshmen Students

PubMed Central

Reyes-Rodríguez, Mae Lynn; Franko, Debra L.; Matos-Lamourt, Anguelique; Bulik, Cynthia M.; Von Holle, Ann; Cámara-Fuentes, Luis R.; Rodríguez-Angleró, Dianisa; Cervantes-López, Sarah; Suárez-Torres, Alba

2010-01-01

Objective This study investigated the prevalence of eating disorder symptoms in first-year students at the University of Puerto Rico. Method Responses to the Bulimia Test Revised (BULIT-R), the Eating Attitudes Test (EAT-26), and the Beck Depression Inventory (BDI) were analyzed in a sample of 2,163 freshman students. Results The percentage of students at or above the clinical cut-off points was 3.24% for the BULIT-R, 9.59% for the EAT-26 and 1.88% met the cut-off point for both instruments. The 36.44% of the students who screen positive on eating disorders measures scored 18 or more on the BDI and 5.93% on this group presented high suicidal risk based on their responses to BDI items assessing suicidal thoughts. Discussion Eating disorder symptoms occur frequently in Puerto Rican college students, and prevention, detection, and treatment efforts are needed. PMID:20455253

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.

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.

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

NASA Astrophysics Data System (ADS)

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

2008-02-01

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

How the Hilbert integral theorem inspired flow lines

NASA Astrophysics Data System (ADS)

Winston, Roland; Jiang, Lun

2017-09-01

Nonimaging Optics has been shown to achieve the theoretical limits constrained only by thermodynamic principles. The designing principles of nonimaging optics allow a non-conventional way of thinking about and generating new optical devices. Compared to conventional imaging optics which rarely utilizes the framework of thermodynamic arguments, nonimaging optics chooses to map etendue instead of rays. This fundamental shift of design paradigm frees the optics design from ray based designs which heavily relies on error tolerance analysis. Instead, the underlying thermodynamic principles guide the nonimaging design to be naturally constructed for extended light source for illumination, non-tracking concentrators and sensors that require sharp cut-off angles. We argue in this article that such optical devices which has enabled a multitude of applications depends on probabilities, geometric flux field and radiative heat transfer while "optics" in the conventional sense recedes into the background.

Experimental study of high-temperature properties of zirconium carbide as a protective material for nuclear power and aerospace technologies (from 2000 to 5000 K)

NASA Astrophysics Data System (ADS)

Savvatimskiy, A. I.; Onufriev, S. V.; Muboyadzhyan, S. A.; Seredkin, N. N.

2017-11-01

The temperature dependences of the thermal and electro physical properties of the zirconium carbide ZrC + C and ZrCa0.95 were studied in the temperature range 2000-5000 K. The Zr+C specimens were in the form of thin layers sputtered on quarts substrate and ZrC0.95 specimens were in the form of plates cut off from the sintered block. The properties are measured: temperature and heat of fusion, enthalpy, specific heat and resistivity, referred to the initial dimensions. A steep increase in the specific heat of these substances before melting and a sharp decrease after melting were observed at a heating rate of ∼ 108 K/s, which is possibly due to the formation of Frenkel pair defects in the specimens.

Benchmark Dose for Urinary Cadmium based on a Marker of Renal Dysfunction: A Meta-Analysis

PubMed Central

Woo, Hae Dong; Chiu, Weihsueh A.; Jo, Seongil; Kim, Jeongseon

2015-01-01

Background Low doses of cadmium can cause adverse health effects. Benchmark dose (BMD) and the one-sided 95% lower confidence limit of BMD (BMDL) to derive points of departure for urinary cadmium exposure have been estimated in several previous studies, but the methods to derive BMD and the estimated BMDs differ. Objectives We aimed to find the associated factors that affect BMD calculation in the general population, and to estimate the summary BMD for urinary cadmium using reported BMDs. Methods A meta-regression was performed and the pooled BMD/BMDL was estimated using studies reporting a BMD and BMDL, weighted by sample size, that were calculated from individual data based on markers of renal dysfunction. Results BMDs were highly heterogeneous across studies. Meta-regression analysis showed that a significant predictor of BMD was the cut-off point which denotes an abnormal level. Using the 95th percentile as a cut off, BMD5/BMDL5 estimates for 5% benchmark responses (BMR) of β2-microglobulinuria (β2-MG) estimated was 6.18/4.88 μg/g creatinine in conventional quantal analysis and 3.56/3.13 μg/g creatinine in the hybrid approach, and BMD5/BMDL5 estimates for 5% BMR of N-acetyl-β-d-glucosaminidase (NAG) was 10.31/7.61 μg/g creatinine in quantal analysis and 3.21/2.24 g/g creatinine in the hybrid approach. However, the meta-regression showed that BMD and BMDL were significantly associated with the cut-off point, but BMD calculation method did not significantly affect the results. The urinary cadmium BMDL5 of β2-MG was 1.9 μg/g creatinine in the lowest cut-off point group. Conclusion The BMD was significantly associated with the cut-off point defining the abnormal level of renal dysfunction markers. PMID:25970611

Personality Factors Predicting Smartphone Addiction Predisposition: Behavioral Inhibition and Activation Systems, Impulsivity, and Self-Control

PubMed Central

Cho, Hyun; Jung, Dong-Jin; Kwak, Minjung; Rho, Mi Jung; Yu, Hwanjo; Kim, Dai-Jin; Choi, In Young

2016-01-01

The purpose of this study was to identify personality factor-associated predictors of smartphone addiction predisposition (SAP). Participants were 2,573 men and 2,281 women (n = 4,854) aged 20–49 years (Mean ± SD: 33.47 ± 7.52); participants completed the following questionnaires: the Korean Smartphone Addiction Proneness Scale (K-SAPS) for adults, the Behavioral Inhibition System/Behavioral Activation System questionnaire (BIS/BAS), the Dickman Dysfunctional Impulsivity Instrument (DDII), and the Brief Self-Control Scale (BSCS). In addition, participants reported their demographic information and smartphone usage pattern (weekday or weekend average usage hours and main use). We analyzed the data in three steps: (1) identifying predictors with logistic regression, (2) deriving causal relationships between SAP and its predictors using a Bayesian belief network (BN), and (3) computing optimal cut-off points for the identified predictors using the Youden index. Identified predictors of SAP were as follows: gender (female), weekend average usage hours, and scores on BAS-Drive, BAS-Reward Responsiveness, DDII, and BSCS. Female gender and scores on BAS-Drive and BSCS directly increased SAP. BAS-Reward Responsiveness and DDII indirectly increased SAP. We found that SAP was defined with maximal sensitivity as follows: weekend average usage hours > 4.45, BAS-Drive > 10.0, BAS-Reward Responsiveness > 13.8, DDII > 4.5, and BSCS > 37.4. This study raises the possibility that personality factors contribute to SAP. And, we calculated cut-off points for key predictors. These findings may assist clinicians screening for SAP using cut-off points, and further the understanding of SA risk factors. PMID:27533112

Personality Factors Predicting Smartphone Addiction Predisposition: Behavioral Inhibition and Activation Systems, Impulsivity, and Self-Control.

PubMed

Kim, Yejin; Jeong, Jo-Eun; Cho, Hyun; Jung, Dong-Jin; Kwak, Minjung; Rho, Mi Jung; Yu, Hwanjo; Kim, Dai-Jin; Choi, In Young

2016-01-01

The purpose of this study was to identify personality factor-associated predictors of smartphone addiction predisposition (SAP). Participants were 2,573 men and 2,281 women (n = 4,854) aged 20-49 years (Mean ± SD: 33.47 ± 7.52); participants completed the following questionnaires: the Korean Smartphone Addiction Proneness Scale (K-SAPS) for adults, the Behavioral Inhibition System/Behavioral Activation System questionnaire (BIS/BAS), the Dickman Dysfunctional Impulsivity Instrument (DDII), and the Brief Self-Control Scale (BSCS). In addition, participants reported their demographic information and smartphone usage pattern (weekday or weekend average usage hours and main use). We analyzed the data in three steps: (1) identifying predictors with logistic regression, (2) deriving causal relationships between SAP and its predictors using a Bayesian belief network (BN), and (3) computing optimal cut-off points for the identified predictors using the Youden index. Identified predictors of SAP were as follows: gender (female), weekend average usage hours, and scores on BAS-Drive, BAS-Reward Responsiveness, DDII, and BSCS. Female gender and scores on BAS-Drive and BSCS directly increased SAP. BAS-Reward Responsiveness and DDII indirectly increased SAP. We found that SAP was defined with maximal sensitivity as follows: weekend average usage hours > 4.45, BAS-Drive > 10.0, BAS-Reward Responsiveness > 13.8, DDII > 4.5, and BSCS > 37.4. This study raises the possibility that personality factors contribute to SAP. And, we calculated cut-off points for key predictors. These findings may assist clinicians screening for SAP using cut-off points, and further the understanding of SA risk factors.

Should short children born small for gestational age with a distance to target height <1 standard deviation score be excluded from growth hormone treatment?

PubMed

Lem, Annemieke J; de Kort, Sandra W K; de Ridder, Maria A J; Hokken-Koelega, Anita C S

2010-09-01

The criteria for starting growth hormone (GH), an approved treatment for short children born small for gestational age (SGA), differ between Europe and the USA. One European requirement for starting GH, a distance to target height (DTH) of > or =1 standard deviation score (SDS), is controversial. To investigate the influence of DTH on growth during GH treatment in short SGA children and to ascertain whether it is correct to exclude children with a DTH <1 SDS from GH. A large group of short prepubertal SGA children (baseline n = 446; 4 years GH n = 215). We analysed the prepubertal growth response during 4 years of GH. We investigated the influence of the continuous variable DTH SDS on growth response and a possible DTH SDS cut-off level below which point the growth response is insufficient. Height gain SDS during 4 years of GH showed a wide variation at every DTH SDS level. Multiple regression analyses demonstrated that, after correction for other significant variables, an additional DTH of 1 SDS resulted in 0.13 SDS more height gain during 4 years of GH. We found no significant differences in height gain below and above certain DTH SDS cut-off levels. DTH SDS had a weak positive effect on height gain during 4 years of GH, while several other determinants had much larger effects. We found no support for using any DTH cut-off level. Based on our data, excluding children with a DTH <1 SDS from GH treatment is not justified.

A comparison of South Asian specific and established BMI thresholds for determining obesity prevalence in pregnancy and predicting pregnancy complications: findings from the Born in Bradford cohort.

PubMed

Bryant, M; Santorelli, G; Lawlor, D A; Farrar, D; Tuffnell, D; Bhopal, R; Wright, J

2014-03-01

To describe how maternal obesity prevalence varies by established international and South Asian specific body mass index (BMI) cut-offs in women of Pakistani origin and investigate whether different BMI thresholds can help to identify women at risk of adverse pregnancy and birth outcomes. Prospective bi-ethnic birth cohort study (the Born in Bradford (BiB) cohort). Bradford, a deprived city in the North of the UK. A total of 8478 South Asian and White British pregnant women participated in the BiB cohort study. Maternal obesity prevalence; prevalence of known obesity-related adverse pregnancy outcomes: mode of birth, hypertensive disorders of pregnancy (HDP), gestational diabetes, macrosomia and pre-term births. Application of South Asian BMI cut-offs increased prevalence of obesity in Pakistani women from 18.8 (95% confidence interval (CI) 17.6-19.9) to 30.9% (95% CI 29.5-32.2). With the exception of pre-term births, there was a positive linear relationship between BMI and prevalence of adverse pregnancy and birth outcomes, across almost the whole BMI distribution. Risk of gestational diabetes and HDP increased more sharply in Pakistani women after a BMI threshold of at least 30 kg m(-2), but there was no evidence of a sharp increase in any risk factors at the new, lower thresholds suggested for use in South Asian women. BMI was a good single predictor of outcomes (area under the receiver operating curve: 0.596-0.685 for different outcomes); prediction was more discriminatory and accurate with BMI as a continuous variable than as a binary variable for any possible cut-off point. Applying the new South Asian threshold to pregnant women would markedly increase those who were referred for monitoring and lifestyle advice. However, our results suggest that lowering the BMI threshold in South Asian women would not improve the predictive ability for identifying those who were at risk of adverse pregnancy outcomes.

ALK-FISH borderline cases in non-small cell lung cancer: Implications for diagnostics and clinical decision making.

PubMed

von Laffert, Maximilian; Stenzinger, Albrecht; Hummel, Michael; Weichert, Wilko; Lenze, Dido; Warth, Arne; Penzel, Roland; Herbst, Hermann; Kellner, Udo; Jurmeister, Philipp; Schirmacher, Peter; Dietel, Manfred; Klauschen, Frederick

2015-12-01

Fluorescence in-situ hybridization (FISH) for the detection of ALK-rearrangements in non-small cell lung cancer (NSCLC) is based on at first sight clear cut-off criteria (≥15% of tumor cells) for split signals (SS) and single red signals (SRS). However, NSCLC with SS-counts around the cut-off may cause interpretation problems. Tissue microarrays containing 753 surgically resected NSCLCs were independently tested for ALK-alterations by FISH and immunohistochemistry (IHC). Our analysis focused on samples with SS/SRS in the range between 10% and 20% (ALK-FISH borderline group). To better understand the role of these samples in routine diagnostics, we performed statistical analyses to systematically estimate the probability of ALK-FISH-misclassification (false negative or positive) for different numbers of evaluated tumor cell nuclei (30, 50, 100, and 200). 94.3% (710/753) of the cases were classified as unequivocally (<10% or ≥20%) ALK-FISH-negative (93%; 700/753) or positive (1.3%; 10/753) and showed concordant IHC results. 5.7% (43/753) of the samples showed SS/SRS between 10% and 20% of the tumor cells. Out of these, 7% (3/43; ALK-FISH: 14%, 18% and 20%) were positive by ALK-IHC, while 93% (40/43) had no detectable expression of the ALK-protein. Statistical analysis showed that ALK-FISH misclassifications occur frequently for samples with rearrangements between 10% and 20% if ALK-characterization is based on a sharp cut-off point (15%). If results in this interval are defined as equivocal (borderline), statistical sampling-related ALK-FISH misclassifications will occur in less than 1% of the cases if 100 tumor cells are evaluated. While ALK status can be determined robustly for the majority of NSCLC by FISH our analysis showed that ∼6% of the cases belong to a borderline group for which ALK-FISH evaluation has only limited reliability due to statistical sampling effects. These cases should be considered equivocal and therapy decisions should include additional tests and clinical considerations. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Revisiting the Phadia/EliA cut-off values for anticardiolipin and anti-β2-glycoprotein I antibodies: a systematic evaluation according to the guidelines.

PubMed

Bor, M V; Jacobsen, I-L Søtang; Gram, J B; Sidelmann, J J

2018-01-01

Background Phadia/EliA fluorescence enzyme immunoassays are widely used automated assays for anticardiolipin (aCL) and anti-β2-glycoprotein I (aβ2GPI) antibodies. To date, cut-off values for these assays have not been evaluated systematically and the evidence behind manufacturer's recommended cut-off values is not clear. Objective To determine Phadia/EliA cut-off values for antiphospholipid antibodies (aPL) according to the procedures suggested by guidelines. Methods A total of 266 blood donors (135 females and 131 males) were included. The pre-handling and analysis of the samples were performed according to the International Society on Thrombosis and Hemostasis (ISTH) guideline for solid phase aPL assays. Cut-off values and corresponding 90% confidence intervals (CI) for each antibody were established and outliers were handled according to the Clinical and Laboratory Standards Institute (CLSI) guideline for reference intervals. Samples from 377 consecutive patients, referred to our thrombophilia center with evidence of thrombosis or pregnancy morbidity were included for aPL testing. Results The in-house 99th (97.5th) percentile cut-off values were 11 (8.7), 12 (6.9) 8.5 (5.0) AU/mL for aβ2GPI IgG, IgM and IgA, and 21 (13) GPL-U/mL and 41 (25) MPL-U/mL for aCL IgG and IgM, respectively. The prevalence of positive results (%) defined by these cut-off values in patients with evidence of thrombosis or pregnancy morbidity was 9.5 (12.2), 1.6 (2.9), and 7.0 (9.9), and 0.8 (3.8) for aβ2GPI IgG, IgM, and aCL IgG and IgM respectively. The use of in-house 99th percentile cut-off values compared to the manufacturer suggested cut-off values resulted in 1 and 39 fewer samples for aβ2GPI and aCL to be classified as positive for aPL, respectively. Conclusions We present Phadia/EliA cut-off values with 90% CI for aPL determined systematically according to the ISTH and CLSI guidelines. These values are different from values previously determined, suggesting variation of aPLs in different populations. Our findings indicate the need for each laboratory to determine/validate assay specific cut-off values for aPL.

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.

Extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity.

PubMed

Cole, T J; Lobstein, T

2012-08-01

The international (International Obesity Task Force; IOTF) body mass index (BMI) cut-offs are widely used to assess the prevalence of child overweight, obesity and thinness. Based on data from six countries fitted by the LMS method, they link BMI values at 18 years (16, 17, 18.5, 25 and 30 kg m(-2)) to child centiles, which are averaged across the countries. Unlike other BMI references, e.g. the World Health Organization (WHO) standard, these cut-offs cannot be expressed as centiles (e.g. 85th). To address this, we averaged the previously unpublished L, M and S curves for the six countries, and used them to derive new cut-offs defined in terms of the centiles at 18 years corresponding to each BMI value. These new cut-offs were compared with the originals, and with the WHO standard and reference, by measuring their prevalence rates based on US and Chinese data. The new cut-offs were virtually identical to the originals, giving prevalence rates differing by < 0.2% on average. The discrepancies were smaller for overweight and obesity than for thinness. The international and WHO prevalences were systematically different before/after age 5. Defining the international cut-offs in terms of the underlying LMS curves has several benefits. New cut-offs are easy to derive (e.g. BMI 35 for morbid obesity), and they can be expressed as BMI centiles (e.g. boys obesity = 98.9th centile), allowing them to be compared with other BMI references. For WHO, median BMI is relatively low in early life and high at older ages, probably due to its method of construction. © 2012 The Authors. Pediatric Obesity © 2012 International Association for the Study of Obesity.

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.

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.

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.

Prediction of esophageal varices and variceal hemorrhage in patients with acute upper gastrointestinal bleeding.

PubMed

Rockey, Don C; Elliott, Alan; Lyles, Thomas

2016-03-01

In patients with upper gastrointestinal bleeding (UGIB), identifying those with esophageal variceal hemorrhage prior to endoscopy would be clinically useful. This retrospective study of a large cohort of patients with UGIB used logistic regression analyses to evaluate the platelet count, aspartate aminotransferase (AST) to platelet ratio index (APRI), AST to alanine aminotransferase (ALT) ratio (AAR) and Lok index (all non-invasive blood markers) as predictors of variceal bleeding in (1) all patients with UGIB and (2) patients with cirrhosis and UGIB. 2233 patients admitted for UGIB were identified; 1034 patients had cirrhosis (46%) and of these, 555 patients (54%) had acute UGIB due to esophageal varices. In all patients with UGIB, the platelet count (cut-off 122,000/mm(3)), APRI (cut-off 5.1), AAR (cut-off 2.8) and Lok index (cut-off 0.9) had area under the curve (AUC)s of 0.80 0.82, 0.64, and 0.80, respectively, for predicting the presence of varices prior to endoscopy. To predict varices as the culprit of bleeding, the platelet count (cut-off 69,000), APRI (cut-off 2.6), AAR (cut-off 2.5) and Lok Index (0.90) had AUCs of 0.76, 0.77, 0.57 and 0.73, respectively. Finally, in patients with cirrhosis and UGIB, logistic regression was unable to identify optimal cut-off values useful for predicting varices as the culprit bleeding lesion for any of the non-invasive markers studied. For all patients with UGIB, non-invasive markers appear to differentiate patients with varices from those without varices and to identify those with a variceal culprit lesion. However, these markers could not distinguish between a variceal culprit and other lesions in patients with cirrhosis. Copyright © 2016 American Federation for Medical Research.

Cut marks on bone surfaces: influences on variation in the form of traces of ancient behaviour

PubMed Central

Braun, David R.; Pante, Michael; Archer, William

2016-01-01

Although we know that our lineage has been producing sharp-edged tools for over 2.6 Myr, our knowledge of what they were doing with these tools is far less complete. Studies of these sharp-edged stone tools show that they were most probably used as cutting implements. However, the only substantial evidence of this is the presence of cut marks on the bones of animals found in association with stone tools in ancient deposits. Numerous studies have aimed to quantify the frequency and placement of these marks. At present there is little consensus on the meaning of these marks and how the frequency relates to specific behaviours in the past. Here we investigate the possibility that mechanical properties associated with edges of stone tools as well as the properties of bones themselves may contribute to the overall morphology of these marks and ultimately their placement in the archaeological record. Standardized tests of rock mechanics (Young's modulus and Vickers hardness) indicate that the hardness of tool edges significantly affects cut-mark morphology. In addition, we show that indentation hardness of bones also impacts the overall morphology of cut marks. Our results show that rock type and bone portions influence the shape and prevalence of cut marks on animal bones. PMID:27274806

Analysis of Cutmarks on Bone: Can Light Microscopy Be of Any Help?

PubMed

Cerutti, Elisa; Spagnoli, Laura; Araujo, Nadezhda; Gibelli, Daniele; Mazzarelli, Debora; Cattaneo, Cristina

2016-12-01

One of the main issues in forensic anthropology consists of the identification of signs of trauma in skeletal remains, including sharp-force injuries. So far, several studies have been performed to assess differences between injuries caused by different instruments, not, however, through light microscopy.In this study, 152 sharp-force injuries were performed by 5 different tools through 2 different orientations on 2 humeral diaphyses and were analyzed by stereo and light microscopy to assess possible morphological differences.This study showed that although W-shaped injuries are frequently reported in cases of wood-cutting saws, other shapes are often observed; lesions due to metal-cutting saws are almost always U shaped, whereas injuries caused by knives are V shaped. Although cut marks may represent a variable range of features, the present study was able to highlight typical profiles that may be of some help for the diagnosis of weapon and the intentionality of the action.

Modelling tooth–prey interactions in sharks: the importance of dynamic testing

PubMed Central

Farina, Stacy C.; Brash, Jeffrey; Summers, Adam P.

2016-01-01

The shape of shark teeth varies among species, but traditional testing protocols have revealed no predictive relationship between shark tooth morphology and performance. We developed a dynamic testing device to quantify cutting performance of teeth. We mimicked head-shaking behaviour in feeding large sharks by attaching teeth to the blade of a reciprocating power saw fixed in a custom-built frame. We tested three tooth types at biologically relevant speeds and found differences in tooth cutting ability and wear. Teeth from the bluntnose sixgill (Hexanchus griseus) showed poor cutting ability compared with tiger (Galeocerdo cuvier), sandbar (Carcharhinus plumbeus) and silky (C. falciformis) sharks, but they also showed no wear with repeated use. Some shark teeth are very sharp at the expense of quickly dulling, while others are less sharp but dull more slowly. This demonstrates that dynamic testing is vital to understanding the performance of shark teeth. PMID:27853592

Open Cascades as Simple Solutions to Providing Ultrasensitivity and Adaptation in Cellular Signaling

PubMed Central

Srividhya, Jeyaraman; Li, Yongfeng; Pomerening, Joseph R.

2011-01-01

Cell signaling is achieved predominantly by reversible phosphorylation-dephosphorylation reaction cascades. Up until now, circuits conferring adaptation have all required the presence of a cascade with some type of closed topology: negative–feedback loop with a buffering node, or incoherent feedforward loop with a proportioner node. In this paper—using Goldbeter and Koshland-type expressions—we propose a differential equation model to describe a generic, open signaling cascade that elicits an adaptation response. This is accomplished by coupling N phosphorylation–dephosphorylation cycles unidirectionally, without any explicit feedback loops. Using this model, we show that as the length of the cascade grows, the steady states of the downstream cycles reach a limiting value. In other words, our model indicates that there are a minimum number of cycles required to achieve a maximum in sensitivity and amplitude in the response of a signaling cascade. We also describe for the first time that the phenomenon of ultrasensitivity can be further subdivided into three sub–regimes, separated by sharp stimulus threshold values: OFF, OFF-ON-OFF, and ON. In the OFF-ON-OFF regime, an interesting property emerges. In the presence of a basal amount of activity, the temporal evolution of early cycles yields damped peak responses. On the other hand, the downstream cycles switch rapidly to a higher activity state for an extended period of time, prior to settling to an OFF state (OFF-ON-OFF). This response arises from the changing dynamics between a feed–forward activation module and dephosphorylation reactions. In conclusion, our model gives the new perspective that open signaling cascades embedded in complex biochemical circuits may possess the ability to show a switch–like adaptation response, without the need for any explicit feedback circuitry. PMID:21566270

75 FR 51140 - Self-Regulatory Organizations; Notice of Filing and Immediate Effectiveness of a Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-18

... NASDAQ Stock Market LLC To Amend Exchange Rules Related to the Cut-off Time for Contrary Exercise Advice... Options Contracts) to make changes to extend the cut-off time to submit contrary exercise advices... Chapter VIII, Section 1 to extend the cut-off time to submit Contrary Exercise Advices to the Exchange; to...

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

Treesearch

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

2000-01-01

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

Modal density function and number of propagating modes in ducts

NASA Technical Reports Server (NTRS)

Rice, E. J.

1976-01-01

The question of the number of propagating modes within a small range of mode cut off ratio was raised. The population density of modes were shown to be greatest near cut off and least for the well propagating modes. It was shown that modes of nearly the same cut off ratio behave nearly the same in a sound absorbing duct as well as in the way they propagate to the far. Handling all of the propagating modes individually, they can be grouped into several cut off ratio ranges. It is important to know the modal density function to estimate acoustic power distribution.

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

NASA Astrophysics Data System (ADS)

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

2017-02-01

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

Parametric response mapping cut-off values that predict survival of hepatocellular carcinoma patients after TACE.

PubMed

Nörthen, Aventinus; Asendorf, Thomas; Shin, Hoen-Oh; Hinrichs, Jan B; Werncke, Thomas; Vogel, Arndt; Kirstein, Martha M; Wacker, Frank K; Rodt, Thomas

2018-04-21

Parametric response mapping (PRM) is a novel image-analysis technique applicable to assess tumor viability and predict intrahepatic recurrence of hepatocellular carcinoma (HCC) patients treated with transarterial chemoembolization (TACE). However, to date, the prognostic value of PRM for prediction of overall survival in HCC patients undergoing TACE is unclear. The objective of this explorative, single-center study was to identify cut-off values for voxel-specific PRM parameters that predict the post TACE overall survival in HCC patients. PRM was applied to biphasic CT data obtained at baseline and following 3 TACE treatments of 20 patients with HCC tumors ≥ 2 cm. The individual portal venous phases were registered to the arterial phases followed by segmentation of the largest lesion, i.e., the region of interest (ROI). Segmented voxels with their respective arterial and portal venous phase density values were displayed as a scatter plot. Voxel-specific PRM parameters were calculated and compared to patients' survival at 1, 2, and 3 years post treatment to identify the maximal predictive parameters. The hypervascularized tissue portion of the ROI was found to represent an independent predictor of the post TACE overall survival. For this parameter, cut-off values of 3650, 2057, and 2057 voxels, respectively, were determined to be optimal to predict overall survival at 1, 2, and 3 years after TACE. Using these cut points, patients were correctly classified as having died with a sensitivity of 80, 92, and 86% and as still being alive with a specificity of 60, 75, and 83%, respectively. The prognostic accuracy measured by area under the curve (AUC) values ranged from 0.73 to 0.87. PRM may have prognostic value to predict post TACE overall survival in HCC patients.

Identifying self-interstitials of bcc and fcc crystals in molecular dynamics

NASA Astrophysics Data System (ADS)

Bukkuru, S.; Bhardwaj, U.; Warrier, M.; Rao, A. D. P.; Valsakumar, M. C.

2017-02-01

Identification of self-interstitials in molecular dynamics (MD) simulations is of critical importance. There exist several criteria for identifying the self-interstitial. Most of the existing methods use an assumed cut-off value for the displacement of an atom from its lattice position to identify the self-interstitial. The results obtained are affected by the chosen cut-off value. Moreover, these chosen cut-off values are independent of temperature. We have developed a novel unsupervised learning algorithm called Max-Space Clustering (MSC) to identify an appropriate cut-off value and its dependence on temperature. This method is compared with some widely used methods such as effective sphere (ES) method and nearest neighbor sphere (NNS) method. The cut-off radius obtained using our method shows a linear variation with temperature. The value of cut-off radius and its temperature dependence is derived for five bcc (Cr, Fe, Mo, Nb, W) and six fcc (Ag, Au, Cu, Ni, Pd, Pt) crystals. It is seen that the ratio of the cut-off values "r" to the lattice constant "a" lies between 0.23 and 0.3 at 300 K and this ratio is on an average smaller for the fcc crystals. Collision cascade simulations are carried out for Primary knock-on Atom (PKA) energies of 5 keV in Fe (at 300 K and 1000 K) and W (at 300 K and 2500 K) and the results are compared using the various methods.

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.

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.

MO-FG-204-09: High Spatial Resolution and Artifact-Free CT Bone Imaging at Off-Centered Positions: An Application of Model-Based Iterative Reconstruction

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

Chen, G; Li, K; Gomez-Cardona, D

Purpose: Although the anatomy of interest should be positioned as close as possible to the isocenter of CT scanners, off-centering may be inevitable during certain exams in clinical practice such as lumbar spine and elbow imaging. Off-centering degrades image sharpness, generates streak artifacts, and sometimes creates blooming artifacts due to truncation. The purpose of this work was to investigate whether the use of model-based image reconstruction (MBIR) can alleviate the negative impacts of off-centering to achieve high quality CT bone imaging. Methods: Both an anthropomorphic phantom and an ex vivo swine elbow sample were scanned at centered and off-centered positionsmore » using clinical CT bone scan protocols. The magnitude of off-centering was determined from localizer radiographs. Both FBP and MBIR reconstructions were performed. For FBP, both standard and Bone Plus kernels commonly used in bone imaging were used. Objective assessment of image sharpness, noise standard deviation, and noise nonuniformity were performed. Additionally, we retrospectively analyzed human subject data acquired under off-centered conditions as a validation study. Results: In FBP images of the phantom, off-centering by 10 cm led to a 14% increase in noise (p<1e-3) and a 68% increase in noise nonuniformity (p<0.02). A visible drop in bone sharpness was observed. In contrast, no significant difference in the noise magnitude or the noise nonuniformity between the centered and off-centered MBIR images was found. The image sharpness of off-centered MBIR images outperformed that of FBP images reconstructed with the Bone Plus kernel. In images of the swine elbow off-centered by 20 cm, not only was the noise and spatial resolution performance improved by MBIR, truncation artifacts were also elliminated. The human subject study generated similar results, in which the visibility of the off-centered lumbar spine was significantly improved. Conclusion: High quality CT bone imaging at off-centered positions can be achieved using MBIR. This work was partially supported by an NIH grant R01CA169331 and GE Healthcare. K. Li, D. Gomez-Cardona: Nothing to disclose. G.-H. Chen: Research funded, GE Healthcare; Research funded, Siemens AX. A. Budde, J. Hsieh: Employee, GE Healthcare.« less

Microfabricated instrument for tissue biopsy and analysis

DOEpatents

Krulevitch, Peter A.; Lee, Abraham P.; Northrup, M. Allen; Benett, William J.

1999-01-01

A microfabricated biopsy/histology instrument which has several advantages over the conventional procedures, including minimal specimen handling, smooth cutting edges with atomic sharpness capable of slicing very thin specimens (approximately 2 .mu.m or greater), micro-liter volumes of chemicals for treating the specimens, low cost, disposable, fabrication process which renders sterile parts, and ease of use. The cutter is a "cheese-grater" style design comprising a block or substrate of silicon and which uses anisotropic etching of the silicon to form extremely sharp and precise cutting edges. As a specimen is cut, it passes through the silicon cutter and lies flat on a piece of glass which is bonded to the cutter. Microchannels are etched into the glass or silicon substrates for delivering small volumes of chemicals for treating the specimen. After treatment, the specimens can be examined through the glass substrate. For automation purposes, microvalves and micropumps may be incorporated. Also, specimens in parallel may be cut and treated with identical or varied chemicals. The instrument is disposable due to its low cost and thus could replace current expensive microtome and histology equipment.

75 FR 51308 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-19

... Effectiveness of Proposal To Extend the Cut-Off Time To Submit Contrary Exercise Advices August 12, 2010... to amend Rule 11.1 to extend the cut-off time to submit contrary exercise advices. The text of the.... Purpose The purpose of the proposed rule change is to amend Rule 11.1 to extend the cut-off time to submit...

Reduction of centrifugal fan noise by use of resonators

NASA Astrophysics Data System (ADS)

Neise, W.; Koopmann, G. H.

1980-11-01

A method by which an acoustic resonator can be used to reduce at source the aerodynamic noise generated by turbomachinery has been investigated experimentally. The casing of a small, centrifugal blower was modified by replacing the cut-off of the scroll with the mouth of a quarter-wavelength resonator. The mouth of the resonator was constructed from a series of perforated plates with the same curvature as the cut-off to preserve the original geometry of the casing. Tuning of the resonator was achieved by changing the length via a movable end plug. The noise measurements were made in an anechoically terminated outlet duct at nearly a free delivery operating condition of the blower. With appropriate tuning of the resonator, reductions in the blade passing frequency tones of up to 29 dB were observed with corresponding overall sound pressure levels reductions of up to 7 dB(A). Parameters which influenced the band width of the resonator response were the porosity and the size of the resonator mouth and the flow velocity near the cut-off region. Throughout the tests, the aerodynamic performance of the blower was unaffected by the addition of the resonator to the casing.

Prediction of Short- and Medium-term Efficacy of Biosimilar Infliximab Therapy. Do Trough Levels and Antidrug Antibody Levels or Clinical And Biochemical Markers Play the More Important Role?

PubMed

Gonczi, Lorant; Vegh, Zsuzsanna; Golovics, Petra Anna; Rutka, Mariann; Gecse, Krisztina Barbara; Bor, Renata; Farkas, Klaudia; Szamosi, Tamás; Bene, László; Gasztonyi, Beáta; Kristóf, Tünde; Lakatos, László; Miheller, Pál; Palatka, Károly; Papp, Mária; Patai, Árpád; Salamon, Ágnes; Tóth, Gábor Tamás; Vincze, Áron; Biro, Edina; Lovasz, Barbara Dorottya; Kurti, Zsuzsanna; Szepes, Zoltan; Molnár, Tamás; Lakatos, Péter L

2017-06-01

Biosimilar infliximab CT-P13 received European Medicines Agency [EMA] approval in June 2013 for all indications of the originator product. In the present study, we aimed to evaluate the predictors of short- and medium-term clinical outcome in patients treated with the biosimilar infliximab at the participating inflammatory bowel disease [IBD] centres in Hungary. Demographic data were collected and a harmonised monitoring strategy was applied. Clinical and biochemical activities were evaluated at Weeks 14, 30, and 54. Trough level [TL] and anti-drug antibody [ADA] concentrations were measured by enzyme-linked immunosorbent assay [ELISA] [LT-005, Theradiag, France] at baseline at 14, 30 and 54 weeks and in two centres at Weeks 2 and 6. A total of 291 consecutive IBD patients (184 Crohn's disease [CD] and 107 ulcerative colitis [UC]) were included. In UC, TLs at Week 2 predicted both clinical response and remission at Weeks 14 and 30 (clinical response/remission at Week 14: area under the curve [AUC] = 0.81, p < 0.001, cut-off: 11.5 μg/ml/AUC = 0.79, p < 0.001, cut-off: 15.3μg/ml; clinical response/remission at Week 30: AUC = 0.79, p = 0.002, cut-off: 11.5 μg/ml/AUC = 0.74, p = 0.006, cut-off: 14.5 μg/ml), whereas ADA positivity at Week 14 was inversely associated with clinical response at Week 30 [58.3% vs 84.8% ,p = 0.04]. Previous anti-tumour necrosis factor [TNF] exposure was inversely associated with short-term clinical remission [Week 2: 18.8% vs 47.8%, p = 0.03, at Week 6: 38.9% vs 69.7%, p = 0.013, at Week 14: 37.5% vs 2.5%, p = 0.06]. In CD, TLs at Week 2 predicted short-term [Week 14 response/remission, AUCTLweek2 = 0.715-0.721, p = 0.05/0.005] but not medium-term clinical efficacy. In addition, early ADA status by Week 14 [p = 0.04-0.05 for Weeks 14 and 30], early clinical response [p < 0.001 for Weeks 30/54] and normal C-reactive protein [CRP] at Week 14 [p = 0.005-0.0001] and previous anti-TNF exposure [p = 0.03-0.0001 for Weeks 14, 30, and 54] were associated with short-and medium-term clinical response and remission. In UC, early TLs were predictive for short- and medium-term clinical efficacy, whereas in CD, Week 2 TLs were associated only with short-term clinical outcomes. Copyright © 2016 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com

Athermal brittle-to-ductile transition in amorphous solids.

PubMed

Dauchot, Olivier; Karmakar, Smarajit; Procaccia, Itamar; Zylberg, Jacques

2011-10-01

Brittle materials exhibit sharp dynamical fractures when meeting Griffith's criterion, whereas ductile materials blunt a sharp crack by plastic responses. Upon continuous pulling, ductile materials exhibit a necking instability that is dominated by a plastic flow. Usually one discusses the brittle to ductile transition as a function of increasing temperature. We introduce an athermal brittle to ductile transition as a function of the cutoff length of the interparticle potential. On the basis of extensive numerical simulations of the response to pulling the material boundaries at a constant speed we offer an explanation of the onset of ductility via the increase in the density of plastic modes as a function of the potential cutoff length. Finally we can resolve an old riddle: In experiments brittle materials can be strained under grip boundary conditions and exhibit a dynamic crack when cut with a sufficiently long initial slot. Mysteriously, in molecular dynamics simulations it appeared that cracks refused to propagate dynamically under grip boundary conditions, and continuous pulling was necessary to achieve fracture. We argue that this mystery is removed when one understands the distinction between brittle and ductile athermal amorphous materials.

Enhanced 40 and 80 Gb/s wavelength conversion using a rectangular shaped optical filter for both red and blue spectral slicing.

PubMed

Raz, O; Herrera, J; Dorren, H J S

2009-02-02

By using a tunable filter with tunability of both bandwidth and wavelength and a very sharp filter roll-off, considerable improvement of all optical Wavelength Conversion, based on Cross Gain and Phase Modulation effects in a Semiconductor Optical Amplifier and spectral slicing, is shown. At 40 Gb/s slicing of blue spectral components is shown to result in a small penalty of 0.7 dB, with a minimal eye broadening, and at 80 Gb/s the low demonstrated 0.5 dB penalty is a dramatic improvement over previously reported wavelength converters using the same principal. Additionally, we give for the first time quantitative results for the case of red spectral slicing at 40 Gb/s which we found to have only 0.5 dB penalty and a narrower time response, as anticipated by previously published theoretical papers. Numerical simulations for the dependence of the eye opening on the filter characteristics highlight the importance of the combination of a sharp filter roll-off and a broad passband.

Ice Atlas 1985 - 1986. Monongahela River, Allegheny River, Ohio River, Illinois River and Kankakee River.

DTIC Science & Technology

1987-11-01

Des P/o,,nes River Grant Cut -off V 1Kankrokee Cut- off Drsdn slndCountyI Line Bordwell Isi. V _ KankakeKRiver 2 */0 7r Prairle Cr 6 0 1 M1 Survey date...2 x 10 6t 81 279 River 279 13 February 1986 275 Kankak Des P/amnes RIver Gran7 Cree Cut-off DrsenIladCount y Line Bordwell Isr. 0 1 M1 ’kornkokee A...Gat Cut - off KankakeeFiver ’e Drsdn slndCounty Line Bordwell s 1 mi 2urve date FerarM1,i Kankakee River :2.4 oCr. 󈧢 X9Kankakcee River :14 ML 0- 5𔃿

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.

75 FR 51324 - Self-Regulatory Organizations; NASDAQ OMX BX, Inc.; Notice of Filing of Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-19

... Organizations; NASDAQ OMX BX, Inc.; Notice of Filing of Proposed Rule Change Relating To Extend the Cut-Off Time... Deliveries) of the Rules of the Boston Options Exchange Group, LLC (``BOX'') to extend the cut-off time to... proposed rule change is to amend Chapter VII, Section 1 of the BOX Trading Rules to extend the cut-off time...

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

NASA Astrophysics Data System (ADS)

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

2007-04-01

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

Lactate clearance cut off for early mortality prediction in adult sepsis and septic shock patients

NASA Astrophysics Data System (ADS)

Sinto, R.; Widodo, D.; Pohan, H. T.

2018-03-01

Previous lactate clearance cut off for early mortality prediction in sepsis and septic shock patient was determined by consensus from small sample size-study. We investigated the best lactate clearance cut off and its ability to predict early mortality in sepsis and septic shock patients. This cohort study was conducted in Intensive Care Unit of CiptoMangunkusumo Hospital in 2013. Patients’ lactate clearance and eight other resuscitationendpoints were recorded, and theoutcome was observed during the first 120 hours. The clearance cut off was determined using receiver operating characteristic (ROC) analysis, and its ability was investigated with Cox’s proportional hazard regression analysis using other resuscitation endpoints as confounders. Total of 268 subjects was included, of whom 70 (26.11%) subjects died within the first 120 hours. The area under ROC of lactate clearance to predict early mortality was 0.78 (95% % confidence interval [CI] 0.71-0.84) with best cut off was <7.5% (sensitivity and specificity 88.99% and 81.4% respectively). Compared with group achieving lactate clearance target, group not achieving lactate clearance target had to increase early mortality risk (adjusted hazard ratio 13.42; 95%CI 7.19-25.07). In conclusion, the best lactate clearance cut off as anearly mortality predictor in sepsis and septic shock patients is 7.5%.

Derivation of the cut-off length from the quantum quadratic enhancement of a mass in vacuum energy constant Lambda

NASA Astrophysics Data System (ADS)

Fukushima, Kimichika; Sato, Hikaru

2018-04-01

Ultraviolet self-interaction energies in field theory sometimes contain meaningful physical quantities. The self-energies in such as classical electrodynamics are usually subtracted from the rest mass. For the consistent treatment of energies as sources of curvature in the Einstein field equations, this study includes these subtracted self-energies into vacuum energy expressed by the constant Lambda (used in such as Lambda-CDM). In this study, the self-energies in electrodynamics and macroscopic classical Einstein field equations are examined, using the formalisms with the ultraviolet cut-off scheme. One of the cut-off formalisms is the field theory in terms of the step-function-type basis functions, developed by the present authors. The other is a continuum theory of a fundamental particle with the same cut-off length. Based on the effectiveness of the continuum theory with the cut-off length shown in the examination, the dominant self-energy is the quadratic term of the Higgs field at a quantum level (classical self-energies are reduced to logarithmic forms by quantum corrections). The cut-off length is then determined to reproduce today's tiny value of Lambda for vacuum energy. Additionally, a field with nonperiodic vanishing boundary conditions is treated, showing that the field has no zero-point energy.

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

PubMed Central

2017-01-01

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

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

PubMed

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

2017-03-01

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

Predictive Value of IL-8 for Sepsis and Severe Infections after Burn Injury - A Clinical Study

PubMed Central

Kraft, Robert; Herndon, David N; Finnerty, Celeste C; Cox, Robert A; Song, Juquan; Jeschke, Marc G

2014-01-01

The inflammatory response induced by burn injury contributes to increased incidence of infections, sepsis, organ failure, and mortality. Thus, monitoring post-burn inflammation is of paramount importance but so far there are no reliable biomarkers available to monitor and/or predict infectious complications after burn. As IL-8 is a major mediator for inflammatory responses, the aim of our study was to determine whether IL-8 expression can be used to predict post-burn sepsis, infections, and mortality other outcomes post-burn. Plasma cytokines, acute phase proteins, constitutive proteins, and hormones were analyzed during the first 60 days post injury from 468 pediatric burn patients. Demographics and clinical outcome variables (length of stay, infection, sepsis, multiorgan failure (MOF), and mortality were recorded. A cut-off level for IL-8 was determined using receiver operating characteristic (ROC) analysis. Statistical significance is set at (p<0.05). ROC analysis identified a cut-off level of 234 pg/ml for IL-8 for survival. Patients were grouped according to their average IL-8 levels relative to this cut off and stratified into high (H) (n=133) and low (L) (n=335) groups. In the L group, regression analysis revealed a significant predictive value of IL-8 to percent of total body surface area (TBSA) burned and incidence of MOF (p<0.001). In the H group IL-8 levels were able to predict sepsis (p<0.002). In the H group, elevated IL-8 was associated with increased inflammatory and acute phase responses compared to the L group (p<0.05). High levels of IL-8 correlated with increased MOF, sepsis, and mortality. These data suggest that serum levels of IL-8 may be a valid biomarker for monitoring sepsis, infections, and mortality in burn patients. PMID:25514427

A cut-off of daily sedentary time and all-cause mortality in adults: a meta-regression analysis involving more than 1 million participants.

PubMed

Ku, Po-Wen; Steptoe, Andrew; Liao, Yung; Hsueh, Ming-Chun; Chen, Li-Jung

2018-05-25

The appropriate limit to the amount of daily sedentary time (ST) required to minimize mortality is uncertain. This meta-analysis aimed to quantify the dose-response association between daily ST and all-cause mortality and to explore the cut-off point above which health is impaired in adults aged 18-64 years old. We also examined whether there are differences between studies using self-report ST and those with device-based ST. Prospective cohort studies providing effect estimates of daily ST (exposure) on all-cause mortality (outcome) were identified via MEDLINE, PubMed, Scopus, Web of Science, and Google Scholar databases until January 2018. Dose-response relationships between daily ST and all-cause mortality were examined using random-effects meta-regression models. Based on the pooled data for more than 1 million participants from 19 studies, the results showed a log-linear dose-response association between daily ST and all-cause mortality. Overall, more time spent in sedentary behaviors is associated with increased mortality risks. However, the method of measuring ST moderated the association between daily ST and mortality risk (p < 0.05). The cut-off of daily ST in studies with self-report ST was 7 h/day in comparison with 9 h/day for those with device-based ST. Higher amounts of daily ST are log-linearly associated with increased risk of all-cause mortality in adults. On the basis of a limited number of studies using device-based measures, the findings suggest that it may be appropriate to encourage adults to engage in less sedentary behaviors, with fewer than 9 h a day being relevant for all-cause mortality.

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

PubMed

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

2017-04-01

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

Cut-off levels for breath carbon monoxide as a marker for cigarette smoking.

PubMed

Javors, Martin A; Hatch, John P; Lamb, Richard J

2005-02-01

Current clinical studies often use a breath carbon monoxide (BCO) cut-off level of 8 parts per million (p.p.m.) or higher to identify smoking. In this study, the cut-off level of BCO as an indicator of smoking over the past 24 hours was re-examined. BCO and self-reported smoking were obtained each weekday for up to 14 weeks in 213 subjects paid to deliver reduced BCO values. Analysis of 12 386 paired values for reported smoking and BCO were analyzed. The 25% quartile, median and 75% quartile values for BCO were 1, 1 and 2 p.p.m. on non-smoking days and 2, 5 and 12 p.p.m. on smoking days, respectively. Receiver-operating characteristic (ROC) analysis indicated that BCO provided high diagnostic accuracy to distinguish between smoking and non-smoking days [area under the curve (AUC) = 0.853, P < 0.0001]. The highest combined sensitivity and specificity was observed at a BCO cut-off level of 3 p.p.m. (sensitivity = 71.5%; specificity = 84.8%). At a BCO cut-off of 8 p.p.m. sensitivity and specificity were 40.6% and 98.2%, respectively, indicating that many smokers would be falsely classified as abstinent. Finally, the percentage of true tests (positive and negative) was highest at a BCO cut-off of 2 p.p.m. (80.2%). BCO cut-off levels well below 8 p.p.m and as low as 2-3 p.p.m. may be more useful when it is important to maximize identification of smoking abstinence with a high degree of certainty.

Serum anti-PLA2R antibody as a diagnostic biomarker of idiopathic membranous nephropathy: The optimal cut-off value for Chinese patients.

PubMed

Liu, Yipeng; Li, Xuan; Ma, Chaoqun; Wang, Ping; Liu, Ju; Su, Hong; Zhuo, Hao; Kong, Xianglei; Xu, Dayu; Xu, Dongmei

2018-01-01

The M-type phospholipase A2 receptor (PLA2R) is a specific target autoantigen identified in idiopathic membranous nephropathy (IMN). The autoantibody against PLA2R (anti-PLA2R) may be used to diagnose IMN. However, the appropriate diagnosis cut-off value for Chinese patients with IMN has not been established. In total, 119 patients who underwent renal biopsy (57 patients with IMN and 62 patients with non-IMN glomerulonephritis) and 22 healthy individuals were recruited for our observation study from Qianfoshan Hospital between September 2011 and March 2016. The serum concentration of anti-PLA2R was measured using a quantitative enzyme-linked immunosorbent assay (ELISA). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and receiver operating characteristic (ROC) curve of anti-PLA2R in diagnosing IMN were analysed based on the ELISA detection. The sensitivity, specificity, PPV, and NPV of anti-PLA2R in the diagnosis of IMN in the Chinese patients were 82.5, 75, 69.1, and 86.3% for the 2RU/ml cut-off value; 78.9, 91.7, 86.5, and 86.5% for the 2.6RU/ml cut-off value; 59.6, 95.2, 89.5, and 77.7% for the 14RU/ml cut-off value; 50.9, 96.4, 90.6, and 74.3% for the 20RU/ml cut-off value; and 47.4, 97.6, 93.1, and 73.2% for the 40RU/ml cut-off value, respectively. The area under the ROC curve was 0.879. The cut-off value of 2.6RU/ml is recommended for the use of anti-PLA2R for the diagnosis of IMN in Chinese patients based on the ELISA. Copyright © 2017. Published by Elsevier B.V.

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

Insulin Resistance Distribution and Cut-Off Value in Koreans from the 2008-2010 Korean National Health and Nutrition Examination Survey

PubMed Central

Yun, Kyung-Jin; Han, Kyungdo; Kim, Mee Kyoung; Park, Yong-Moon; Baek, Ki-Hyun; Song, Ki-Ho; Kwon, Hyuk-Sang

2016-01-01

Background We sought to identify the distribution and cut-off value of the ‘homeostasis model assessment of insulin resistance’ (HOMA-IR) according to gender and menopausal status for metabolic syndrome in Koreans. Methods Data were from the Korean National Health and Nutrition Examination Survey in 2008–2010. The subjects included adults aged 20 years or older. We excluded participants who had diabetes or fasting serum glucose ≥ 7 mmol/L. Finally, 11,121 subjects (4,911 men, 3,597 premenopausal women, 2,613 postmenopausal women) were enrolled. The modified Adult Treatment Panel III criteria were used to define metabolic syndrome. Results The mean HOMA-IR was 2.11 (2.07–2.15) for men, 2.0 (1.97–2.04) for premenopausal women, and 2.14 (2.2–2.19) for postmenopausal women. The first cut-off values in men, premenopausal women, and postmenopausal women were 2.23 (sensitivity 70.6%, specificity 66.9%), 2.39 (sensitivity 72.3%, specificity 76.4%), and 2.48 (sensitivity 51.9%, specificity 80.2%), respectively. Based on the first HOMA-IR cut-off value, the prevalence of metabolic syndrome was 22.9% in men, 13.7% in premenopausal women, and 51.6% in postmenopausal women. The second cut-off value was around 3.2 in all three groups. Based on the second HOMA-IR cut-off value, the prevalence of metabolic syndrome was 50.8% in men, 42.5% in premenopausal women, and 71.6% in postmenopausal women. Conclusion In conclusion, the first cut-off values for HOMA-IR were 2.2–2.5 and the second cut-off value was 3.2 in Korea. The distribution of HOMA-IR showed differences according to gender and menopausal status. When we apply HOMA-IR, we should consider gender, menopausal status, and the prevalence of metabolic syndrome. PMID:27128847

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.

Cosmic Rays In The Magnetosphere, 2. Apparent Cut-off Rigidities and Coupling Functions

NASA Astrophysics Data System (ADS)

Dorman, L. I.; Danilova, O. A.; Iucci, N.; Parisi, M.; Ptitsyna, N. G.; Tyasto, M. I.; Villoresi, G.

We calculate the apparent cut-off rigidities along the survey Italy-Antarctica-Italy** on the basis of results of Danilova et al. (2001) on trajectory calculations for inclined cut- off rigidities at eight azimuths (through 45?) and five zeniths angles (through 15?) along the survey. For calculations of apparent cut-off rigidities we use also the infor- mation on integral multiplicities of secondary neutrons in dependence of zenith angle of incident primary cosmic ray particles, as theoretically computed. This information is based on the theoretical calculations of meson-nuclear cascades for primary protons with different rigidities arriving to the EarthSs atmosphere at different zenith angles (Dorman and Pakhomov, 1979). These results have been checked and normalized by using coupling functions obtained in the same survey [Dorman et al. (2000)]. The determined apparent cut-off rigidities have been compared with results obtained by Clem et al. (1997) and with those used by Dorman et al. (2000) computed by using vertical cut-off rigidities, for trajectories especially calculated for the survey. On the basis of the apparent cut-off rigidities along the latitude survey, the coupling functions for neutron monitor and bare neutron counters found by Dorman et al. (2000) are now determined more accurately. **Survey realized with logistic and financial support of the Italian Antarctic Program (PNRA) and with the co-operation of IFSI-CNR. REFERENCES: Clem, J.M., et al. J. Geophys. Res., 102, 26,919 (1997). Danilova, O.A., et al., Latitude survey in December 1996-March 1997, 1. Cut-off rigidities for different azimuth and zenith angles, Paper ST13, This issue (2001) Dorman L.I. and Pakhomov N.I., "The dependence of the integral generation multiplicity of neutron component at various depths in the atmosphere on zenith angle on primary particle in- cidence". Proc. 16-th ICRC, Kyoto, 4, 416-420 (1979) Dorman, L.I., et al., J. Geophys. Res. 105 , 21,047 (2000).

Effect of cutting edge radius on surface roughness in diamond tool turning of transparent MgAl2O4 spinel ceramic

NASA Astrophysics Data System (ADS)

Yue, Xiaobin; Xu, Min; Du, Wenhao; Chu, Chong

2017-09-01

Transparent magnesium aluminate spinel (MgAl2O4) ceramic is one of an important optical materials. However, due to its pronounced hardness and brittleness, the optical machining of this material is very difficult. Diamond turning has advantages over the grinding process in flexibility and material removal rate. However, there is a lack of research that could support the use of diamond turning technology in the machining of MgAl2O4 spinel ceramic. Using brittle-ductile transition theory of brittle material machining, this work provides critical information that may help to realize ductile-regime turning of MgAl2O4 spinel ceramic. A characterization method of determination the cutting edge radius is introduced here. Suitable diamond tools were measured for sharpness and then chosen from a large number of candidate tools. The influence of rounded cutting edges on surface roughness of the MgAl2O4 spinel ceramic is also investigated. These results indicate that surface quality of MgAl2O4 spinel is relate to the radius of diamond tool's cutting edge, cutting speed, and feed rate. Sharp diamond tools (small radius of cutting edge) facilitated ductile-regime turning of MgAl2O4 spinel and shows great potential to reduce surface roughness and produce smoother final surface.

Binary model of Circinus X-1. I - Eccentricity from combined X-ray and radio observations

NASA Technical Reports Server (NTRS)

Murdin, P.; Jauncey, D. L.; Lerche, I.; Nicolson, G. D.; Kaluzienski, L. J.; Holt, S. S.; Haynes, R. F.

1980-01-01

A binary star model is used to account for the 16.59-d flaring behavior of the X-ray emission from Circinus X-1. The orbital eccentricity of 0.8 + or - 0.1 is derived from the X-ray light curve by assuming that the sharp X-ray cut-off every 16.59-d is a result of bound-free absorption in the primary star's stellar wind. The shape of the light curve has changed over the last eight years, and this is interpreted as due to orbital precession of the binary system. Simultaneous radio and X-ray observations of the flare from Circinus X-1 on February 1-5, 1978 are reported. These are accounted for within the framework of the model. The radio observations at 5 GHz are used independently to derive a high value of the orbital eccentricity (e = 0.7).

Oblique H.F. radiowave propagation in the main trough region of the ionosphere

NASA Astrophysics Data System (ADS)

Lockwood, M.; Mitchell, V. B.

1980-12-01

The propagation of 7.335 MHz, CW signals over a 5212 km subauroral, west-east path is studied. Measurements and semiempirical predictions are made of the amplitude distributions and Doppler shifts of the received signals. The observed amplitude distribution is fitted with a numerical fading model, yielding the power losses suffered by the signals during propagation via the predominating modes. The mid-latitude trough in the F2 peak ionization density is predicted by a statistical model to be at the latitudes of this path at these times and at low K sub p values; a sharp cut-off in low-power losses at a mean K sub p of 2.75 strongly implicates the trough in the propagation of these signals. It is shown that a simple extension of this model to allow for the trough can reproduce the form of the observed diurnal variation.

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…

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Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-28

... Acceptance Cut-Off Time Cannot Be Past 4:30 p.m. November 21, 2012. Pursuant to Section 19(b)(1) of the... that the order acceptance cut-off time cannot be past 4:30 p.m. The text of the proposed rule change is... order acceptance cut-off time cannot be past 4:30 p.m. (or 30 minutes after the scheduled close in the...

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Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-07

... Amending Rule 123C(9)(a)(1)(ii)--Equities To Delete the Requirement That the Order Acceptance Cut-Off Time... order acceptance cut-off time cannot be past 4:30 p.m. The text of the proposed rule change is available... acceptance cut-off time cannot be past 4:30 p.m. (or 30 minutes after the scheduled close in the case of an...

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

ERIC Educational Resources Information Center

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

2013-01-01

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

Resonant tunneling of surface plasmon polariton in the plasmonic nano-cavity.

PubMed

Park, Junghyun; Kim, Hwi; Lee, Il-Min; Kim, Seyoon; Jung, Jaehoon; Lee, Byoungho

2008-10-13

We investigate the reflection and transmission characteristics of the low-dielectric constant cut off barrier in the metal-insulator-metal (MIM) waveguide and propose a novel plasmonic nano-cavity made of two cut off barriers and the waveguide between them. It is shown that the anti-symmetric mode in the MIM waveguide with the core of the low dielectric constant below the specific value cannot be supported and this region can be regarded as a cut off barrier with high stability. The phase shift due to the reflection at the finite-length cut off barrier is calculated and the design scheme of the cavity length for the resonant tunneling is presented. The transmission spectra through the proposed nano-cavity are also discussed.

The role of quantitative estrogen receptor status in predicting tumor response at surgery in breast cancer patients treated with neoadjuvant chemotherapy.

PubMed

Raphael, Jacques; Gandhi, Sonal; Li, Nim; Lu, Fang-I; Trudeau, Maureen

2017-07-01

Estrogen receptor (ER) negative (-) breast cancer (BC) patients have better tumor response rates than ER-positive (+) patients after neoadjuvant chemotherapy (NCT). We conducted a retrospective review using the institutional database "Biomatrix" to assess the value of quantitative ER status in predicting tumor response at surgery and to identify potential predictors of survival outcomes. Univariate followed by multivariable regression analyses were conducted to assess the association between quantitative ER and tumor response assessed as tumor size reduction and pathologic complete response (pCR). Predictors of recurrence-free survival (RFS) were identified using a cox proportional hazards model (CPH). A log-rank test was used to compare RFS between groups if a significant predictor was identified. 304 patients were included with a median follow-up of 43.3 months (Q1-Q3 28.7-61.1) and a mean age of 49.7 years (SD 10.9). Quantitative ER was inversely associated with tumor size reduction and pCR (OR 0.99, 95% CI 0.99-1.00, p = 0.027 and 0.98 95% CI 0.97-0.99, p < 0.0001, respectively). A cut-off of 60 and 80% predicted best the association with tumor size reduction and pCR, respectively. pCR was shown to be an independent predictor of RFS (HR 0.17, 95% CI 0.07-0.43, p = 0.0002) in all patients. At 5 years, 93% of patients with pCR and 72% of patients with residual tumor were recurrence-free, respectively (p = 0.0012). Quantitative ER status is inversely associated with tumor response in BC patients treated with NCT. A cut-off of 60 and 80% predicts best the association with tumor size reduction and pCR, respectively. Therefore, patients with an ER status higher than the cut-off might benefit from a neoadjuvant endocrine therapy approach. Patients with pCR had better survival outcomes independently of their tumor phenotype. Further prospective studies are needed to validate the clinical utility of quantitative ER as a predictive marker of tumor response.

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

Determination and Validation of a Lower Cut Off Value of Cerebrospinal Fluid Adenosine Deaminase (CSF-ADA) Activity in Diagnosis of Tuberculous Meningitis.

PubMed

Raviraj; Henry, Renoy A; Rao, G Ganapathi

2017-04-01

Tuberculous meningitis is an infection of the meninges caused by Mycobacterium tuberculosis . It is one of the most common infectious diseases of the Central Nervous System (CNS) and a major health problem in developing countries like India. If there is delay in diagnosis and initiation of specific treatment, it causes significant morbidity and mortality. CSF-ADA 10 U/l is the standard cut off value that is used for differentiation between Tuberculous (TBM) and Non-Tuberculous Meningitis (non-TBM). To determine and validate a lower cut off value for CSF-ADA for diagnosing TBM in an Indian setting. This was a prospective study involving 85 cases of meningitis whose CSF were analysed and ADA estimated using an enzymatic deamination assay kit. Diagnosis of various types of meningitis was made based on specified diagnostic criteria. The comparison of mean value of CSF- ADA activity of the two types of meningitis was done using two Sample t-test. A p-value of <0.05 was considered as significant. Cut off value to differentiate between TBM and non-TBM meningitis was determined using ROC curve analysis. The CSF-ADA activity of TBM and non-TBM cases was compared. The mean CSF-ADA activity was found to be significantly higher in TBM patients (10.97±4.43; Mean±SD) than in non-TBM patients (5.09±1.53) which was statistically significant with a p-value of <0.001. A cut off value of 6.65 was calculated using ROC curve for the diagnosis of TBM which gave a sensitivity of 85.3% and a specificity of 84.3% for differentiating TBM from non-TBM. The positive predictive value was 78.3% and negative predictive value of 89.5% using the above cut off. The positive likelihood ratio was 5.44 and negative likelihood ratio of 0.17 when this lower cut off value was applied. This study has demonstrated that CSF-ADA can be used as an important diagnostic tool in early diagnosis of TBM using a cut off value of 6.65. This cut off value gave a good sensitivity and specificity in differentiating it from non-TBM.

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.

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.

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.

Reference intervals for plasma free metanephrines with an age adjustment for normetanephrine for optimized laboratory testing of phaeochromocytoma.

PubMed

Eisenhofer, Graeme; Lattke, Peter; Herberg, Maria; Siegert, Gabriele; Qin, Nan; Därr, Roland; Hoyer, Jana; Villringer, Arno; Prejbisz, Aleksander; Januszewicz, Andrzej; Remaley, Alan; Martucci, Victoria; Pacak, Karel; Ross, H Alec; Sweep, Fred C G J; Lenders, Jacques W M

2013-01-01

Measurements of plasma normetanephrine and metanephrine provide a useful diagnostic test for phaeochromocytoma, but this depends on appropriate reference intervals. Upper cut-offs set too high compromise diagnostic sensitivity, whereas set too low, false-positives are a problem. This study aimed to establish optimal reference intervals for plasma normetanephrine and metanephrine. Blood samples were collected in the supine position from 1226 subjects, aged 5-84 y, including 116 children, 575 normotensive and hypertensive adults and 535 patients in whom phaeochromocytoma was ruled out. Reference intervals were examined according to age and gender. Various models were examined to optimize upper cut-offs according to estimates of diagnostic sensitivity and specificity in a separate validation group of 3888 patients tested for phaeochromocytoma, including 558 with confirmed disease. Plasma metanephrine, but not normetanephrine, was higher (P < 0.001) in men than in women, but reference intervals did not differ. Age showed a positive relationship (P < 0.0001) with plasma normetanephrine and a weaker relationship (P = 0.021) with metanephrine. Upper cut-offs of reference intervals for normetanephrine increased from 0.47 nmol/L in children to 1.05 nmol/L in subjects over 60 y. A curvilinear model for age-adjusted compared with fixed upper cut-offs for normetanephrine, together with a higher cut-off for metanephrine (0.45 versus 0.32 nmol/L), resulted in a substantial gain in diagnostic specificity from 88.3% to 96.0% with minimal loss in diagnostic sensitivity from 93.9% to 93.6%. These data establish age-adjusted cut-offs of reference intervals for plasma normetanephrine and optimized cut-offs for metanephrine useful for minimizing false-positive results.

Reference intervals for plasma free metanephrines with an age adjustment for normetanephrine for optimized laboratory testing of phaeochromocytoma

PubMed Central

Eisenhofer, Graeme; Lattke, Peter; Herberg, Maria; Siegert, Gabriele; Qin, Nan; Därr, Roland; Hoyer, Jana; Villringer, Arno; Prejbisz, Aleksander; Januszewicz, Andrzej; Remaley, Alan; Martucci, Victoria; Pacak, Karel; Ross, H Alec; Sweep, Fred C G J; Lenders, Jacques W M

2016-01-01

Background Measurements of plasma normetanephrine and metanephrine provide a useful diagnostic test for phaeochromocytoma, but this depends on appropriate reference intervals. Upper cut-offs set too high compromise diagnostic sensitivity, whereas set too low, false-positives are a problem. This study aimed to establish optimal reference intervals for plasma normetanephrine and metanephrine. Methods Blood samples were collected in the supine position from 1226 subjects, aged 5–84 y, including 116 children, 575 normotensive and hypertensive adults and 535 patients in whom phaeochromocytoma was ruled out. Reference intervals were examined according to age and gender. Various models were examined to optimize upper cut-offs according to estimates of diagnostic sensitivity and specificity in a separate validation group of 3888 patients tested for phaeochromocytoma, including 558 with confirmed disease. Results Plasma metanephrine, but not normetanephrine, was higher (P < 0.001) in men than in women, but reference intervals did not differ. Age showed a positive relationship (P < 0.0001) with plasma normetanephrine and a weaker relationship (P = 0.021) with metanephrine. Upper cut-offs of reference intervals for normetanephrine increased from 0.47 nmol/L in children to 1.05 nmol/L in subjects over 60 y. A curvilinear model for age-adjusted compared with fixed upper cut-offs for normetanephrine, together with a higher cut-off for metanephrine (0.45 versus 0.32 nmol/L), resulted in a substantial gain in diagnostic specificity from 88.3% to 96.0% with minimal loss in diagnostic sensitivity from 93.9% to 93.6%. Conclusions These data establish age-adjusted cut-offs of reference intervals for plasma normetanephrine and optimized cut-offs for metanephrine useful for minimizing false-positive results. PMID:23065528

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

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.

Assessment of under nutrition of Bangladeshi adults using anthropometry: can body mass index be replaced by mid-upper-arm-circumference?

PubMed

Sultana, Tania; Karim, Md Nazmul; Ahmed, Tahmeed; Hossain, Md Iqbal

2015-01-01

Body-mass-index (BMI) is widely accepted as an indicator of nutritional status in adults. Mid-upper-arm-circumference (MUAC) is another anthropometric-measure used primarily among children. The present study attempted to evaluate the use of MUAC as a simpler alternative to BMI cut-off <18.5 to detect adult undernutrition, and thus to suggest a suitable cut-off value. A cross-sectional study in 650 adult attendants of the patients of Dhaka-Hospital, of the International Centre for Diarrheal Disease Research, Bangladesh (icddr,b) was conducted during 2012. Height, weight and MUAC of 260 male and 390 female aged 19-60 years were measured. Curve estimation was done to assess the linearity and correlation of BMI and MUAC. Sensitivity and specificity of MUAC against BMI<18.5 was determined. Separate Receiver-operating-characteristic (ROC) analyses were performed for male and female. Area under ROC curve and Youden's index were generated to aid selection of the most suitable cut-off value of MUAC for undernutrition. A value with highest Youden's index was chosen for cut-off. Our data shows strong significant positive correlation (linear) between MUAC and BMI, for males r = 0.81, (p<0.001) and for females r = 0.828, (p<0.001). MUAC cut-off <25.1 cm in males (AUC 0.930) and <23.9 cm in females (AUC 0.930) were chosen separately based on highest corresponding Youden's index. These values best correspond with BMI cut-off for under nutrition (BMI <18.5) in either gender. MUAC correlates closely with BMI. For the simplicity and easy to remember MUAC <25 cm for male and <24 cm for female may be considered as a simpler alternative to BMI cut-off <18.5 to detect adult undernutrition.

Determination of glucose-6-phosphate dehydrogenase cut-off values in a Tunisian population.

PubMed

Laouini, Naouel; Sahli, Chaima Abdelhafidh; Jouini, Latifa; Haloui, Sabrine; Fredj, Sondes Hadj; Daboubi, Rym; Siala, Hajer; Ouali, Faida; Becher, Meriam; Toumi, Nourelhouda; Bibi, Amina; Messsaoud, Taieb

2017-07-26

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the commonest enzymopathy worldwide. The incidence depends essentially on the methods used for the assessment. In this respect, we attempted in this study to set cut-off values of G6PD activity to discriminate among normal, heterozygous, and deficient individuals using the World Health Organization (WHO) classification and the receiver operating characteristics (ROC) curve analysis. Blood samples from 250 female and 302 male subjects were enrolled in this study. The G6PD activity was determined using a quantitative assay. The common G6PD mutations in Tunisia were determined using the amplification refractory mutation system (ARMS-PCR) method. The ROC curve was used to choice the best cut-off. Normal G6PD values were 7.69±2.37, 7.86±2.39, and 7.51±2.35 U/g Hb for the entire, male, and female groups, respectively. Cut-off values for the total, male, and female were determined using the WHO classification and ROC curves analysis. In the male population, both cut-offs established using ROC curve analysis (4.00 U/g Hb) and the 60% level (3.82 U/g Hb), respectively are sensitive and specific resulting in a good efficiency of discrimination between deficient and normal males. For the female group the ROC cut-off (5.84 U/g Hb) seems better than the 60% level cut-off (3.88 U/g Hb) to discriminate between normal and heterozygote or homozygote women with higher Youden Index. The establishment of the normal values for a population is important for a better evaluation of the assay result. The ROC curve analysis is an alternative method to determine the status of patients since it correlates DNA analysis and G6PD activity.

Validation of an Argentine version of Lupus Quality of Life questionnaire.

PubMed

Machado Escobar, M A; Yacuzzi, M S; Martinez, R N; González Lucero, L; Bellomio, V I; Santana, M; Galindo, L; Mayer, M M; Barreira, J C; Sarano, J; Gomez, G; Collado, M V; Martinez, A; Orozco, M C; Betancur, G; Dal Pra, F; Sanchez, A; Juarez, V; Lucero, E V

2016-12-01

To determine reproducibility and validity of an Argentine version of the Lupus Quality of Life questionnaire (LupusQoL) and to determine cut-off values in the questionnaire. One hundred and forty-seven systemic lupus erythematosus patients (American College of Rheumatology 1982/1997) were assessed from April 2014 to July 2014. Demographic and socioeconomic variables were collected, as well as SELENA/SLEDAI, Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index Score, comorbidities and treatment data. Patients completed LupusQoL-Argentine version and European Quality of Life Questionnaire (EuroQoL-5D). Internal consistency and reliability were examined. Convergent validity with EuroQoL-5D was assessed through analysis of latent classes, which established homogeneous categories from the responses of each domain of LupusQoL and for the total. Out of 147 patients, 93.2% were female, mean age 36.4 ± 11.1 years, mean disease duration 2.7 ± 9 years, mean SELENA/SLEDAI 2.7 ± 3 points. The cut-off point that defined good or bad quality of life was 0.739 for EuroQoL 5D and 63 for LupusQoL. Cut-off values for each LupusQoL domain were also defined, creating two classes in each of them. There was moderate to high concordance to classify quality of life (Kappa = 0.74, 95% confidence interval = 0.54, 0.95). The Argentine version of LupusQoL is a valid, reliable and reproducible instrument to assess quality of life. In this study, cut-off points that allow the classification of patients regarding whether they have good or bad quality of life are established for the first time. © The Author(s) 2016.

Computational issues in the simulation of two-dimensional discrete dislocation mechanics

NASA Astrophysics Data System (ADS)

Segurado, J.; LLorca, J.; Romero, I.

2007-06-01

The effect of the integration time step and the introduction of a cut-off velocity for the dislocation motion was analysed in discrete dislocation dynamics (DD) simulations of a single crystal microbeam. Two loading modes, bending and uniaxial tension, were examined. It was found that a longer integration time step led to a progressive increment of the oscillations in the numerical solution, which would eventually diverge. This problem could be corrected in the simulations carried out in bending by introducing a cut-off velocity for the dislocation motion. This strategy (long integration times and a cut-off velocity for the dislocation motion) did not recover, however, the solution computed with very short time steps in uniaxial tension: the dislocation density was overestimated and the dislocation patterns modified. The different response to the same numerical algorithm was explained in terms of the nature of the dislocations generated in each case: geometrically necessary in bending and statistically stored in tension. The evolution of the dislocation density in the former was controlled by the plastic curvature of the beam and was independent of the details of the simulations. On the contrary, the steady-state dislocation density in tension was determined by the balance between nucleation of dislocations and those which are annihilated or which exit the beam. Changes in the DD imposed by the cut-off velocity altered this equilibrium and the solution. These results point to the need for detailed analyses of the accuracy and stability of the dislocation dynamic simulations to ensure that the results obtained are not fundamentally affected by the numerical strategies used to solve this complex problem.

ROC-king onwards: intraepithelial lymphocyte counts, distribution & role in coeliac disease mucosal interpretation

PubMed Central

Rostami, Kamran; Marsh, Michael N; Johnson, Matt W; Mohaghegh, Hamid; Heal, Calvin; Holmes, Geoffrey; Ensari, Arzu; Aldulaimi, David; Bancel, Brigitte; Bassotti, Gabrio; Bateman, Adrian; Becheanu, Gabriel; Bozzola, Anna; Carroccio, Antonio; Catassi, Carlo; Ciacci, Carolina; Ciobanu, Alexandra; Danciu, Mihai; Derakhshan, Mohammad H; Elli, Luca; Ferrero, Stefano; Fiorentino, Michelangelo; Fiorino, Marilena; Ganji, Azita; Ghaffarzadehgan, Kamran; Going, James J; Ishaq, Sauid; Mandolesi, Alessandra; Mathews, Sherly; Maxim, Roxana; Mulder, Chris J; Neefjes-Borst, Andra; Robert, Marie; Russo, Ilaria; Rostami-Nejad, Mohammad; Sidoni, Angelo; Sotoudeh, Masoud; Villanacci, Vincenzo; Volta, Umberto; Zali, Mohammad R; Srivastava, Amitabh

2017-01-01

Objectives Counting intraepithelial lymphocytes (IEL) is central to the histological diagnosis of coeliac disease (CD), but no definitive ‘normal’ IEL range has ever been published. In this multicentre study, receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut-off between normal and CD (Marsh III lesion) duodenal mucosa, based on IEL counts on >400 mucosal biopsy specimens. Design The study was designed at the International Meeting on Digestive Pathology, Bucharest 2015. Investigators from 19 centres, eight countries of three continents, recruited 198 patients with Marsh III histology and 203 controls and used one agreed protocol to count IEL/100 enterocytes in well-oriented duodenal biopsies. Demographic and serological data were also collected. Results The mean ages of CD and control groups were 45.5 (neonate to 82) and 38.3 (2–88) years. Mean IEL count was 54±18/100 enterocytes in CD and 13±8 in normal controls (p=0.0001). ROC analysis indicated an optimal cut-off point of 25 IEL/100 enterocytes, with 99% sensitivity, 92% specificity and 99.5% area under the curve. Other cut-offs between 20 and 40 IEL were less discriminatory. Additionally, there was a sufficiently high number of biopsies to explore IEL counts across the subclassification of the Marsh III lesion. Conclusion Our ROC curve analyses demonstrate that for Marsh III lesions, a cut-off of 25 IEL/100 enterocytes optimises discrimination between normal control and CD biopsies. No differences in IEL counts were found between Marsh III a, b and c lesions. There was an indication of a continuously graded dose–response by IEL to environmental (gluten) antigenic influence. PMID:28893865

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.

Predictive Accuracy of Calf Circumference Measurements to Detect Decreased Skeletal Muscle Mass and European Society for Clinical Nutrition and Metabolism-Defined Malnutrition in Hospitalized Older Patients.

PubMed

Maeda, Keisuke; Koga, Takayuki; Nasu, Tomomi; Takaki, Miki; Akagi, Junji

2017-01-01

The ability to readily diagnose sarcopenia and malnutrition in a clinical setting is essential. This study is aimed at clarifying the calf circumference (CC) cut-off values for decreased skeletal muscle mass (SMM), according to the Asian Work Group for Sarcopenia's criteria definition of sarcopenia, and those for European Society for Clinical Nutrition and Metabolism-defined malnutrition, in hospitalized Japanese patients. The study involved 1,164 patients aged ≥65 years. Predictive CC cut-off values were determined using receiver operating curve (ROC) analyses. The predictive validity of the cut-off values was confirmed against in-hospital mortality. There were 654 females and 510 males (mean age, 83.5 ± 8.2 years). Decreased SMM and malnutrition were observed in 80.4 and 32.8% of all patients, respectively. ROC analyses identified CCs of ≤29 cm (female, area under the curve [AUC] 0.791) and ≤30 cm (male, AUC 0.832) as cut-off values for decreased SMM, and CCs of ≤26 cm (female, AUC 0.798) and ≤28 cm (male, AUC 0.837) for malnutrition. CC cut-off values for SMM and malnutrition were independently correlated with in-hospital mortality. The study determined appropriate cut-off values for CC to identify decreased SMM and malnutrition according to the relevant guidelines. © 2017 S. Karger AG, Basel.

The Objective Borderline method (OBM): a probability-based model for setting up an objective pass/fail cut-off score in medical programme assessments.

PubMed

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

2013-05-01

The decision to pass or fail a medical student is a 'high stakes' one. The aim of this study is to introduce and demonstrate the feasibility and practicality of a new objective standard-setting method for determining the pass/fail cut-off score from borderline grades. Three methods for setting up pass/fail cut-off scores were compared: the Regression Method, the Borderline Group Method, and the new Objective Borderline Method (OBM). Using Year 5 students' OSCE results from one medical school we established the pass/fail cut-off scores by the abovementioned three methods. The comparison indicated that the pass/fail cut-off scores generated by the OBM were similar to those generated by the more established methods (0.840 ≤ r ≤ 0.998; p < .0001). Based on theoretical and empirical analysis, we suggest that the OBM has advantages over existing methods in that it combines objectivity, realism, robust empirical basis and, no less importantly, is simple to use.

Calculation of the ELISA's cut-off based on the change-point analysis method for detection of Trypanosoma cruzi infection in Bolivian dogs in the absence of controls.

PubMed

Lardeux, Frédéric; Torrico, Gino; Aliaga, Claudia

2016-07-04

In ELISAs, sera of individuals infected by Trypanosoma cruzi show absorbance values above a cut-off value. The cut-off is generally computed by means of formulas that need absorbance readings of negative (and sometimes positive) controls, which are included in the titer plates amongst the unknown samples. When no controls are available, other techniques should be employed such as change-point analysis. The method was applied to Bolivian dog sera processed by ELISA to diagnose T. cruzi infection. In each titer plate, the change-point analysis estimated a step point which correctly discriminated among known positive and known negative sera, unlike some of the six usual cut-off formulas tested. To analyse the ELISAs results, the change-point method was as good as the usual cut-off formula of the form "mean + 3 standard deviation of negative controls". Change-point analysis is therefore an efficient alternative method to analyse ELISA absorbance values when no controls are available.

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.

Categorization of low cardiorespiratory fitness using obesity indices in non-smoking Singaporean women.

PubMed

Pua, Yong-Hao; Lim, Cheng-Kuan; Ang, Adele

2006-11-01

To revisit cut-off values of BMI, waist circumference (WC), and waist-to-stature ratio (WSR) based on their association with cardiorespiratory fitness (CRF). The derived cut-off points were compared with current values (BMI, 25.0 kg/m(2); WC, 80 cm) as recommended by the World Health Organization. Anthropometric indices were measured in a cross sectional study of 358 Singaporean female employees of a large tertiary hospital (63% Singaporean Chinese, 28% Malays, and 9% Indians). CRF was determined by the 1-mile walk test. Receiver operating characteristic curves were constructed to determine cut-off points. The cut-off points for BMI, WC, and WSR were 23.6 kg/m(2), 75.3 cm, and 0.48, respectively. The areas under the curve of BMI, WC, and WSR were 0.68, 0.74, and 0.74, respectively. For a given BMI, women with low CRF had higher WSR compared with women with high CRF. These findings provide convergent evidence that the cut-off points for Singaporean women were lower than the World Health Organization's criteria but were in good agreement with those reported for Asians.

Detecting liver fibrosis with Gd-EOB-DTPA-enhanced MRI: A confirmatory study.

PubMed

Verloh, Niklas; Utpatel, Kirsten; Haimerl, Michael; Zeman, Florian; Beyer, Lukas; Fellner, Claudia; Brennfleck, Frank; Dahlke, Marc H; Stroszczynski, Christian; Evert, Matthias; Wiggermann, Philipp

2018-04-18

Strong correlations between the grade of fibrosis and cirrhosis, classified using the Ishak scoring system, and the uptake characteristics of Gd-EOB-DTPA with the relative enhancement (RE) of the liver parenchyma have been reported. To confirm the results of a retrospective analysis, patients undergoing liver surgery were prospectively examined with Gd-EOB-DTPA-enhanced liver 3 Tesla MRI to determine the degree of liver fibrosis. Correlations between the grade of fibrosis and cirrhosis, classified using the Ishak scoring system, and RE were investigated and compared with those derived from an initial retrospective study. After validating the cut-off values in the retrospective study (Ishak ≥ 1, RE-cut-off 0.90; Ishak ≥ 2, RE-cut-off 0.79; Ishak ≥ 4, RE-cut-off 0.60; and Ishak = 6, RE-cut-off 0.47), we showed that Gd-EOB-DTPA has a high sensitivity (≥86%) and a high positive predictive value (≥86%). These results support the use of Gd-EOB-DTPA-enhanced liver MRI as a non-invasive method for determining the degree of liver fibrosis and cirrhosis.

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.

SEMICONDUCTOR INTEGRATED CIRCUITS: A reconfigurable analog baseband circuit for WLAN, WCDMA, and Bluetooth

NASA Astrophysics Data System (ADS)

Tao, Tong; Baoyong, Chi; Ziqiang, Wang; Ying, Zhang; Hanjun, Jiang; Zhihua, Wang

2010-05-01

A reconfigurable analog baseband circuit for WLAN, WCDMA, and Bluetooth in 0.35 μm CMOS is presented. The circuit consists of two variable gain amplifiers (VGA) in cascade and a Gm-C elliptic low-pass filter (LPF). The filter-order and the cut-off frequency of the LPF can be reconfigured to satisfy the requirements of various applications. In order to achieve the optimum power consumption, the bandwidth of the VGAs can also be dynamically reconfigured and some Gm cells can be cut off in the given application. Simulation results show that the analog baseband circuit consumes 16.8 mW for WLAN, 8.9 mW for WCDMA and only 6.5 mW for Bluetooth, all with a 3 V power supply. The analog baseband circuit could provide -10 to +40 dB variable gain, third-order low pass filtering with 1 MHz cut-off frequency for Bluetooth, fourth-order low pass filtering with 2.2 MHz cut-off frequency for WCDMA, and fifth-order low pass filtering with 11 MHz cut-off frequency for WLAN, respectively.

1955 Pulpwood production in the south

Treesearch

James W. Cruikshank; J.F. McCormack

1956-01-01

Another record high was established in pulpwood production by southern states during 1955. The total harvest amounted to 18,014,600 cords, an increase of 1,745,000 cords, or 10.7 percent, over production in 1954. The sharp upward trend of production in the South is especially apparent when compared with earlier years. The 1955 cut was about double the amount cut in...

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

Estimation of test characteristics of real-time PCR and bacterial culture for diagnosis of subclinical intramammary infections with Streptococcus agalactiae in Danish dairy cattle in 2012 using latent class analysis.

PubMed

Mahmmod, Yasser S; Toft, Nils; Katholm, Jørgen; Grønbæk, Carsten; Klaas, Ilka C

2013-05-01

The misdiagnosis of intramammary infections (IMI) with Streptococcus agalactiae (S. agalactiae) could lead farmers to treat or cull animals unnecessarily. The objective of this field study was to estimate the sensitivity (Se) and specificity (Sp) of real-time PCR at different cut-offs for cycle threshold (Ct) values against bacterial culture (BC) for diagnosis of S. agalactiae IMI using latent class analysis to avoid the assumption of a perfect reference test. A total of 614 dairy cows were randomly selected from 6 herds with bulk tank PCR Ct value ≤ 39 for S. agalactiae and S. aureus. At milk recording, 2456 quarter milk samples were taken aseptically for BC and the routinely taken cow level milk samples were analyzed by PCR. Results showed that 53 cows (8.6%) were positive for S. agalactiae IMI by BC. Sensitivity of PCR at cut-offs; ≤ 39, ≤ 37, ≤ 34, and ≤ 32, was 96.2%, 91.9%, 87.2% and 73.9%, while Se of BC was 25.7%, 29.9%, 59.9% and 72.1%. Specificity of PCR at cut-offs; ≤ 39, ≤ 37, ≤ 34, and ≤ 32, was 96.8%, 96.9%, 96.7%, and 97.22%, while Sp of BC was 99.7%, 99.5%, 99.2%, and 98.9%. The estimated prevalence of S. agalactiae IMI by PCR was higher than the apparent prevalence at the tested cut-offs, indicating under estimation of S. agalactiae IMI in the examined dairy cows. In conclusion, Se of PCR is always higher than Se of BC at all tested cut-offs. The lower cut-off, the more comparable becomes Se of PCR and Se of BC. The changes in Se in both PCR and BC at different Ct-value cut-offs may indicate a change in the definition of the latent infection. The similar Se of both tests at cut-off ≤ 32 may indicate high concentrations of S. agalactiae viable cells, representing a cow truly/heavily infected with S. agalactiae and thus easier to detect with BC. At cut-off ≤ 39 the latent definition of infection may reflect a more general condition of cows being positive for S. agalactiae. Our findings indicate that PCR Ct-value cut-offs should be chosen according to the underlying latent infection definition of interest. Latent class analysis proposes a useful alternative to classic test evaluation of diagnostic tests used for detection of S. agalactiae IMI in milk. Copyright © 2012 Elsevier B.V. All rights reserved.

Serological Tests Do Not Predict Residual Fibrosis in Hepatitis C Cirrhotics with a Sustained Virological Response to Interferon.

PubMed

D'Ambrosio, Roberta; Degasperi, Elisabetta; Aghemo, Alessio; Fraquelli, Mirella; Lampertico, Pietro; Rumi, Maria Grazia; Facchetti, Floriana; Grassi, Eleonora; Casazza, Giovanni; Rosenberg, William; Bedossa, Pierre; Colombo, Massimo

2016-01-01

Liver biopsy (LB) has lost popularity to stage liver fibrosis in the era of highly effective anti-hepatitis C virus (HCV) therapy, yet diagnosis of persistent cirrhosis may have important implications following HCV eradication. As performance of serological non-invasive tests (NITs) to predict residual fibrosis in non-viremic HCV patients is unknown, we investigated accuracy of NITs to predict residual fibrosis in cirrhotics after a sustained virological response (SVR) to interferon (IFN). Thirty-eight patients with a pre-treatment histological diagnosis of cirrhosis and a 48-104 months post-SVR LB were tested with APRI, CDS, FIB-4, FibroQ, Forns Score, GUCI Index, King Score, Lok Index, PLF, ELF. In 23 (61%) patients, cirrhosis had histologically regressed. All NITs values declined after SVR without any significant difference between regressors and non-regressors (AUROC 0.52-0.75). Using viremic cut-offs, PPV ranged from 34% to 100%, with lower NPV (63% - 68%). NITs performance did not improve using derived cut-offs (PPV: 40% - 80%; NPV: 66% - 100%). PLF, which combines several NITs with transient elastography, had the best diagnostic performance (AUROC 0.75, Sn 61%, Sp 90%, PPV 80%, NPV 78%). After treatment, none of the NITs resulted significantly associated with any of the histological features (activity grade, fibrosis stage, area of fibrosis). The diagnostic estimates obtained using both viremic and derived cut-off values of NITs were suboptimal, indicating that none of these tests helps predicting residual fibrosis and that LB remains the gold standard for this purpose.

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

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

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

Sherman, S.J.

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

Economic Outlook for Radiometric Selection of Ores; POSSIBILITES OUVERTES EN MATIERE ECONOMIQUE PAR SELECTION RADIOMETRIQUE DES MINERAIS

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

Formery, P.; Ziegler, V.

1959-10-31

The radiometric grading of uranium ores is analyzed. The cut-off is defined, and its parameters are derived. Cut-off above ground and underground are statistically interpreted. An evaluation is made of the combined effects of both kinds of cut-off made in succession. The corrections to be made to the radiometric apparatus used are determined. Application of the theory of cutoff to the evaluation of reserves is discussed. (J.S.R.)

15 CFR Supplement No. 3 to Part 732 - BIS's “Know Your Customer” Guidance and Red Flags

Code of Federal Regulations, 2010 CFR

2010-01-01

... verification steps. (3) Do not self-blind. Do not cut off the flow of information that comes to your firm in... be evaluated by responsible senior officials. Failure to do so could be regarded as a form of self...

Mathematics Placement at Cottey College.

ERIC Educational Resources Information Center

Callahan, Susan

In response to the large numbers of students who were failing or dropping out of basic algebra and calculus classes, Cottey College, in Missouri, developed a math placement program in 1982 using Basic Algebra (BA) and Calculus Readiness (CR) tests from the Mathematical Association of America's Placement Testing Program. Cut off scores for the…

Hygiene Basics

MedlinePlus

... you use a regular razor, make sure the blade is new and sharp to prevent cuts and ... newer razors contain shaving gel right in the blade area, making even beginners feel comfortable shaving. Whether ...

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

Performance of new thresholds of the Glasgow Blatchford score in managing patients with upper gastrointestinal bleeding.

PubMed

Laursen, Stig B; Dalton, Harry R; Murray, Iain A; Michell, Nick; Johnston, Matt R; Schultz, Michael; Hansen, Jane M; Schaffalitzky de Muckadell, Ove B; Blatchford, Oliver; Stanley, Adrian J

2015-01-01

Upper gastrointestinal hemorrhage (UGIH) is a common cause of hospital admission. The Glasgow Blatchford score (GBS) is an accurate determinant of patients' risk for hospital-based intervention or death. Patients with a GBS of 0 are at low risk for poor outcome and could be managed as outpatients. Some investigators therefore have proposed extending the definition of low-risk patients by using a higher GBS cut-off value, possibly with an age adjustment. We compared 3 thresholds of the GBS and 2 age-adjusted modifications to identify the optimal cut-off value or modification. We performed an observational study of 2305 consecutive patients presenting with UGIH at 4 centers (Scotland, England, Denmark, and New Zealand). The performance of each threshold and modification was evaluated based on sensitivity and specificity analyses, the proportion of low-risk patients identified, and outcomes of patients classified as low risk. There were differences in age (P = .0001), need for intervention (P < .0001), mortality (P < .015), and GBS (P = .0001) among sites. All systems identified low-risk patients with high levels of sensitivity (>97%). The GBS at cut-off values of ≤1 and ≤2, and both modifications, identified low-risk patients with higher levels of specificity (40%-49%) than the GBS with a cut-off value of 0 (22% specificity; P < .001). The GBS at a cut-off value of ≤2 had the highest specificity, but 3% of patients classified as low-risk patients had adverse outcomes. All GBS cut-off values, and score modifications, had low levels of specificity when tested in New Zealand (2.5%-11%). A GBS cut-off value of ≤1 and both GBS modifications identify almost twice as many low-risk patients with UGIH as a GBS at a cut-off value of 0. Implementing a protocol for outpatient management, based on one of these scores, could reduce hospital admissions by 15% to 20%. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

Electron path control of high-order harmonic generation by a spatially inhomogeneous field

NASA Astrophysics Data System (ADS)

Mohebbi, Masoud; Nazarpoor Malaei, Sakineh

2016-04-01

We theoretically investigate the control of high-order harmonics cut-off and as-pulse generation by a chirped laser field using a metallic bow tie-shaped nanostructure. The numerical results show that the trajectories of the electron wave packet are strongly modified, the short quantum path is enhanced, the long quantum path is suppressed and the low modulated spectrum of the harmonics can be remarkably extended. Our calculated results also show that, by confining electron motion, a broadband supercontinuum with the width of 1670 eV can be produced which directly generates an isolated 34 as-pulse without phase compensation. To explore the underlying mechanism responsible for the cut-off extension and the quantum path selection, we perform time-frequency analysis and a classical simulation based on the three-step model.

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

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

PubMed

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

2013-01-01

Obesity is associated with increased morbidity and premature death. Obesity rates have increased worldwide and the WHO recommends monitoring. A steep rise in body mass index (BMI), a measure of adiposity, was detected in Greenland from 1963 to 1998. Interestingly, the BMI starting point was in the overweight range. This is not conceivable in a disease-free, physically active, pre-western hunter population. This led us to reconsider the cut-off point for overweight among Inuit in Greenland. We found 3 different approaches to defining the cut-off point of high BMI in Inuit. First, the contribution to the height by the torso compared to the legs is relatively high. This causes relatively more kilograms per centimetre of height that increases the BMI by approximately 10% compared to Caucasian whites. Second, defining the cut-off by the upper 90-percentile of BMI from height and weight in healthy young Inuit surveyed in 1963 estimated the cut-off point to be around 10% higher compared to Caucasians. Third, if similar LDL-cholesterol and triglycerides are assumed for a certain BMI in Caucasians, the corresponding BMI in Inuit in both Greenland and Canada is around 10% higher. However, genetic admixture of Greenland Inuit and Caucasian Danes will influence this difference and hamper a clear distinction with time. Defining overweight according to the WHO cut-off of a BMI above 25 kg/m(2) in Greenland Inuit may overestimate the number of individuals with elevated BMI.

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

PubMed Central

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

2013-01-01

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

The need for re-defining cut-off values in heart failure: From obesity to iron deficiency.

PubMed

Konishi, Masaaki; von Haehling, Stephan

2017-01-01

The health status of older people is frequently complicated by one or more chronic diseases. Some conditions might have a different meaning in certain groups of elderly subjects, like in frail people or older patients with heart failure. Cut-off values defining these conditions may require adjustment in such groups. Indeed, several such conditions (e.g. obesity and hypercholesterolemia) have been discussed recently in light of so-called paradoxical situations, which are - counter-intuitively - associated with better outcome instead of a negative impact on survival in the general population. Therefore, different cut-off values may be needed in some groups of older subjects. The pathophysiological mechanisms for these paradoxical situations need to be understood in at least two different ways, causal and non-causal. The aim of this review is to provide an overview of a variety of conditions (obesity, dyslipidaemia, hypertension, and diabetes) in which new cut-offs may have diagnostic, clinical, or prognostic value, focusing on heart failure as a chronic disease, which is frequently observed in older patients. Haemoglobin concentration may need a different cut-off in heart failure for a reason other than paradox. Namely, underlying iron deficiency itself, both in those with or without anaemia, can have effects on symptoms and quality of life. Further studies will be needed for re-defining cut-off values in heart failure and maybe in the other chronic illnesses. Copyright © 2016 Elsevier Inc. All rights reserved.

Fractional Flow Reserve: Does a Cut-off Value add Value?

PubMed Central

Mohdnazri, Shah R; Keeble, Thomas R

2016-01-01

Fractional flow reserve (FFR) has been shown to improve outcomes when used to guide percutaneous coronary intervention (PCI). There have been two proposed cut-off points for FFR. The first was derived by comparing FFR against a series of non-invasive tests, with a value of ≤0.75 shown to predict a positive ischaemia test. It was then shown in the DEFER study that a vessel FFR value of ≥0.75 was associated with safe deferral of PCI. During the validation phase, a ‘grey zone’ for FFR values of between 0.76 and 0.80 was demonstrated, where a positive non-invasive test may still occur, but sensitivity and specificity were sub-optimal. Clinical judgement was therefore advised for values in this range. The FAME studies then moved the FFR cut-off point to ≤0.80, with a view to predicting outcomes. The ≤0.80 cut-off point has been adopted into clinical practice guidelines, whereas the lower value of ≤0.75 is no longer widely used. Here, the authors discuss the data underpinning these cut-off values and the practical implications for their use when using FFR guidance in PCI. PMID:29588700

Utility of inline milk fat and protein ratio to diagnose subclinical ketosis and to assign propylene glycol treatment in lactating dairy cows.

PubMed

Jenkins, Nicholas T; Peña, Gustavo; Risco, Carlos; Barbosa, Carolina C; Vieira-Neto, Achilles; Galvão, Klibs N

2015-08-01

The objective was to identify a fat-to-protein ratio (FPR) cut-off to diagnose subclinical ketosis (SCK) and to evaluate the effect of propylene glycol (PPG) treatment of cows with high FPR. The optimized cut-off was > 1.42; sensitivity (Se) = 92%; specificity (Sp) = 65%. A cut-off > 1.5 was selected for the PPG trial for balanced Se-Sp. Fat-to-protein ratio cut-offs > 1.25, 1.35, 1.50, 1.60, and 1.70 resulted in Se-Sp of 100% to 49%, 96% to 59%, 75% to 78%, 33% to 90%, and 8% to 96%, respectively. The proportions of cows with FPR > 1.25, 1.35, 1.42, 1.50, 1.60, and 1.70 were 60%, 50%, 44%, 30%, 14%, and 6%, respectively. Incidences of clinical ketosis and milk yield were similar between cows that received 400 mL of PPG (n = 34) and control cows (n = 38). Prevalence of SCK at enrollment was 29.2%; therefore, FPR > 1.5 is not indicated for treatment. Lower cut-offs should be used for screening.

Utility of inline milk fat and protein ratio to diagnose subclinical ketosis and to assign propylene glycol treatment in lactating dairy cows

PubMed Central

Jenkins, Nicholas T.; Peña, Gustavo; Risco, Carlos; Barbosa, Carolina C.; Vieira-Neto, Achilles; Galvão, Klibs N.

2015-01-01

The objective was to identify a fat-to-protein ratio (FPR) cut-off to diagnose subclinical ketosis (SCK) and to evaluate the effect of propylene glycol (PPG) treatment of cows with high FPR. The optimized cut-off was > 1.42; sensitivity (Se) = 92%; specificity (Sp) = 65%. A cut-off > 1.5 was selected for the PPG trial for balanced Se-Sp. Fat-to-protein ratio cut-offs > 1.25, 1.35, 1.50, 1.60, and 1.70 resulted in Se-Sp of 100% to 49%, 96% to 59%, 75% to 78%, 33% to 90%, and 8% to 96%, respectively. The proportions of cows with FPR > 1.25, 1.35, 1.42, 1.50, 1.60, and 1.70 were 60%, 50%, 44%, 30%, 14%, and 6%, respectively. Incidences of clinical ketosis and milk yield were similar between cows that received 400 mL of PPG (n = 34) and control cows (n = 38). Prevalence of SCK at enrollment was 29.2%; therefore, FPR > 1.5 is not indicated for treatment. Lower cut-offs should be used for screening. PMID:26246632

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

PubMed Central

Habibzadeh, Parham; Yadollahie, Mahboobeh

2016-01-01

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

Sensitivity and specificity of the body mass index for the diagnosis of overweight/obesity in elderly.

PubMed

Vasconcelos, Francisco de Assis Guedes de; Cordeiro, Braian Alves; Rech, Cassiano Ricardo; Petroski, Edio Luiz

2010-08-01

The aim of this article was to verify the sensitivity and specificity of the body mass index (BMI) cut-off points proposed by the World Health Organization (WHO) and the Nutrition Screening Initiative (NSI) for the diagnosis of obesity in the elderly. A cross-sectional study was made with 180 healthy elderly subjects from Florianópolis, Santa Catarina State, Brazil. Body fat percentage (%BF) was determined using DEXA (dual energy X-ray absorptiometry). The BMI cut-off point of the NSI offers better sensitivity and specificity for men (73.7% and 72.5% respectively). For women, the lower the cut-off point the better the sensitivity, with a BMI of 25kg/m² (sensitivity of 76.3% and specificity of 100%) being the most accurate for diagnosing obesity in elderly women. The WHO cut-off point offered very low sensitivity (28.9%). The results of this investigation lead to the conclusion that the cut-off points proposed by the WHO and the ones adopted by the NSI and by Lipschitz are not good indicators of obesity for the elderly of either sex, since they offer low sensitivity.

Influence of Pericarp, Cotyledon and Inhibitory Substances on Sharp Tooth Oak (Quercus aliena var. acuteserrata) Germination

PubMed Central

Liu, Yan; Liu, Guangquan; Li, Qingmei; Liu, Yong; Hou, Longyu; Li, GuoLei

2012-01-01

In order to explore the mechanism of delayed and uneven germination in sharp tooth oak (Quercus aliena var. acuteserrata) (STO), mechanical scarification techniques were used to study STO root and shoot germination and growth. The techniques used were: removing cup scar (RS), removing the pericarp (RP), and cutting off 1/2 (HC) and 2/3 (TC) cotyledons. Germination percentage and root and shoot length for Chinese cabbage (Beassica pekinensis) seeds (CCS) were also investigated for CCS cultivated in a Sanyo growth cabinet watered by distilled water and 80% methanol extracts from the acorn embryo, cotyledon and pericarp with concentrations of 1.0 g, 0.8 g, 0.6 g and 0.4 g dry acorn weight per ml methanol. The results showed that the majority of roots and shoots from acorns with RP and HC treatment emerged two weeks earlier, more simultaneously, and their total emergences were more than 46% and 28% higher, respectively. TC accelerated root and shoot emergence time and root length, but root and shoot germination rate and shoot height had no significant difference from the control. Positive consequences were not observed on all indices of RS treatment. The germination rates of CCS watered by 1.0 g·ml−1 methanol extracts from the embryo and cotyledon were significantly lower than those from the pericarp, and all concentrations resulted in decreased growth of root and shoot. Methanol extracts from pericarp significantly reduced root length of CCS, but presented little response in germination percentage and shoot length. The inhibitory effect was gradually increased with the increasing concentration of the methanol extract. We conclude that both the mechanical restriction of the pericarp and the presence of germination inhibitors in the embryo, cotyledon and pericarp are the causes for delayed and asynchronous germination of STO acorns. PMID:23133517

[Research progress on the clinical value of Ki-67 in breast cancer and its cut-off definition].

PubMed

Chen, Qing; Wu, Kejin

2015-08-01

Ki-67 has an important application value in clinical practice. However, it is still a little tough in clinical application because of the debate on the cut-off definition of Ki-67 index. This review summarizes most studies on the prognostic and predictive value of Ki-67, analyzes the reasons for the discrepancies among the studies cited, and presents the necessity and clinical significance of scientifically defining the cut-off of Ki-67 index, providing a theoretical basis for Ki-67 in clinical application.

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

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

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.

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.

Effectiveness of the CANRISK tool in the identification of dysglycemia in First Nations and Métis in Canada

PubMed Central

Gina, Agarwal; Ying, Jiang; Susan, Rogers Van Katwyk; Chantal, Lemieux; Heather, Orpana; Yang, Mao; Brandan, Hanley; Karen, Davis; Laurel, Leuschen; Howard, Morrison

2018-01-01

Abstract Introduction: First Nations/Métis populations develop diabetes earlier and at higher rates than other Canadians. The Canadian diabetes risk questionnaire (CANRISK) was developed as a diabetes screening tool for Canadians aged 40 years or over. The primary aim of this paper is to assess the effectiveness of the existing CANRISK tool and risk scores in detecting dysglycemia in First Nations/Métis participants, including among those under the age of 40. A secondary aim was to determine whether alternative waist circumference (WC) and body mass index (BMI) cut-off points improved the predictive ability of logistic regression models using CANRISK variables to predict dysglycemia. Methods: Information from a self-administered CANRISK questionnaire, anthropometric measurements, and results of a standard oral glucose tolerance test (OGTT) were collected from First Nations and Métis participants (n = 1479). Sensitivity and specificity of CANRISK scores using published risk score cut-off points were calculated. Logistic regression was conducted with alternative ethnicity-specific BMI and WC cut-off points to predict dysglycemia using CANRISK variables. Results: Compared with OGTT results, using a CANRISK score cut-off point of 33, the sensitivity and specificity of CANRISK was 68% and 63% among individuals aged 40 or over; it was 27% and 87%, respectively among those under 40. Using a lower cut-off point of 21, the sensitivity for individuals under 40 improved to 77% with a specificity of 44%. Though specificity at this threshold was low, the higher level of sensitivity reflects the importance of the identification of high risk individuals in this population. Despite altered cut-off points of BMI and WC, logistic regression models demonstrated similar predictive ability. Conclusion: CANRISK functioned well as a preliminary step for diabetes screening in a broad age range of First Nations and Métis in Canada, with an adjusted CANRISK cutoff point for individuals under 40, and with no incremental improvement from using alternative BMI/WC cut-off points. PMID:29443485

Assessment of Under Nutrition of Bangladeshi Adults Using Anthropometry: Can Body Mass Index Be Replaced by Mid-Upper-Arm-Circumference?

PubMed Central

Sultana, Tania; Karim, Md. Nazmul; Ahmed, Tahmeed; Hossain, Md. Iqbal

2015-01-01

Background and Objective Body-mass-index (BMI) is widely accepted as an indicator of nutritional status in adults. Mid-upper-arm-circumference (MUAC) is another anthropometric-measure used primarily among children. The present study attempted to evaluate the use of MUAC as a simpler alternative to BMI cut-off <18.5 to detect adult undernutrition, and thus to suggest a suitable cut-off value. Methods A cross-sectional study in 650 adult attendants of the patients of Dhaka-Hospital, of the International Centre for Diarrheal Disease Research, Bangladesh (icddr,b) was conducted during 2012. Height, weight and MUAC of 260 male and 390 female aged 19–60 years were measured. Curve estimation was done to assess the linearity and correlation of BMI and MUAC. Sensitivity and specificity of MUAC against BMI<18.5 was determined. Separate Receiver-operating-characteristic (ROC) analyses were performed for male and female. Area under ROC curve and Youden's index were generated to aid selection of the most suitable cut-off value of MUAC for undernutrition. A value with highest Youden's index was chosen for cut-off. Results Our data shows strong significant positive correlation (linear) between MUAC and BMI, for males r = 0.81, (p<0.001) and for females r = 0.828, (p<0.001). MUAC cut-off <25.1 cm in males (AUC 0.930) and <23.9 cm in females (AUC 0.930) were chosen separately based on highest corresponding Youden's index. These values best correspond with BMI cut-off for under nutrition (BMI <18.5) in either gender. Conclusion MUAC correlates closely with BMI. For the simplicity and easy to remember MUAC <25 cm for male and <24 cm for female may be considered as a simpler alternative to BMI cut-off <18.5 to detect adult undernutrition. PMID:25875397

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.

The Autism Diagnostic Observation Schedule, Module 4: Application of the Revised Algorithms in an Independent, Well-Defined, Dutch Sample (n = 93).

PubMed

de Bildt, Annelies; Sytema, Sjoerd; Meffert, Harma; Bastiaansen, Jojanneke A C J

2016-01-01

This study examined the discriminative ability of the revised Autism Diagnostic Observation Schedule module 4 algorithm (Hus and Lord in J Autism Dev Disord 44(8):1996-2012, 2014) in 93 Dutch males with Autism Spectrum Disorder (ASD), schizophrenia, psychopathy or controls. Discriminative ability of the revised algorithm ASD cut-off resembled the original algorithm ASD cut-off: highly specific for psychopathy and controls, lower sensitivity than Hus and Lord (2014; i.e. ASD .61, AD .53). The revised algorithm AD cut-off improved sensitivity over the original algorithm. Discriminating ASD from schizophrenia was still challenging, but the better-balanced sensitivity (.53) and specificity (.78) of the revised algorithm AD cut-off may aide clinicians' differential diagnosis. Findings support using the revised algorithm, being conceptually conform the other modules, thus improving comparability across the lifespan.

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.

Method and system for assigning a confidence metric for automated determination of optic disc location

DOEpatents

Karnowski, Thomas P [Knoxville, TN; Tobin, Jr., Kenneth W.; Muthusamy Govindasamy, Vijaya Priya [Knoxville, TN; Chaum, Edward [Memphis, TN

2012-07-10

A method for assigning a confidence metric for automated determination of optic disc location that includes analyzing a retinal image and determining at least two sets of coordinates locating an optic disc in the retinal image. The sets of coordinates can be determined using first and second image analysis techniques that are different from one another. An accuracy parameter can be calculated and compared to a primary risk cut-off value. A high confidence level can be assigned to the retinal image if the accuracy parameter is less than the primary risk cut-off value and a low confidence level can be assigned to the retinal image if the accuracy parameter is greater than the primary risk cut-off value. The primary risk cut-off value being selected to represent an acceptable risk of misdiagnosis of a disease having retinal manifestations by the automated technique.

Encouraging Creativity in Children

ERIC Educational Resources Information Center

Starke, Kathryn

2012-01-01

Creativity isn't formally assessed or evaluated on tests or report cards, so teachers rarely plan lessons that encourage it. In fact, many teachers unintentionally stifle children's creativity when they cut off student's oral responses or stop them from adding more to their work so that they can bring the class back to the task at hand. Instead,…

Response to Intervention and Reading Difficulties: A Conceptual Model that Includes Reading Recovery

ERIC Educational Resources Information Center

Dunn, Michael

2010-01-01

Reading Recovery (RR) is a widely used first grade intervention program for students who are struggling with literacy skills. With its component strategies, teacher training, high degree of fidelity of treatment, specified timeline, and cut-off score defining which students have succeeded, RR fits the problem-solving approach of the…

47 CFR 25.157 - Consideration of NGSO-like satellite applications.

Code of Federal Regulations, 2012 CFR

2012-10-01

... satellite systems, in which the satellites are designed to communicate with earth stations with omni... response to a public notice initiating a processing round, or a “lead application,” i.e., all other NGSO... public notice. This public notice will initiate a processing round, establish a cut-off date for...

47 CFR 25.157 - Consideration of NGSO-like satellite applications.

Code of Federal Regulations, 2013 CFR

2013-10-01

... satellite systems, in which the satellites are designed to communicate with earth stations with omni... response to a public notice initiating a processing round, or a “lead application,” i.e., all other NGSO... public notice. This public notice will initiate a processing round, establish a cut-off date for...

47 CFR 25.157 - Consideration of NGSO-like satellite applications.

Code of Federal Regulations, 2011 CFR

2011-10-01

... satellite systems, in which the satellites are designed to communicate with earth stations with omni... response to a public notice initiating a processing round, or a “lead application,” i.e., all other NGSO... public notice. This public notice will initiate a processing round, establish a cut-off date for...

47 CFR 25.157 - Consideration of NGSO-like satellite applications.

Code of Federal Regulations, 2014 CFR

2014-10-01

... satellite systems, in which the satellites are designed to communicate with earth stations with omni... response to a public notice initiating a processing round, or a “lead application,” i.e., all other NGSO... public notice. This public notice will initiate a processing round, establish a cut-off date for...

Concentrating phenolic acids from Lonicera japonica by nanofiltration technology

NASA Astrophysics Data System (ADS)

Li, Cunyu; Ma, Yun; Li, Hongyang; Peng, Guoping

2017-03-01

Response surface analysis methodology was used to optimize the concentrate process of phenolic acids from Lonicera japonica by nanofiltration technique. On the basis of the influences of pressure, temperature and circulating volume, the retention rate of neochlorogenic acid, chlorogenic acid and 4-dicaffeoylquinic acid were selected as index, molecular weight cut-off of nanofiltration membrane, concentration and pH were selected as influencing factors during concentrate process. The experiment mathematical model was arranged according to Box-Behnken central composite experiment design. The optimal concentrate conditions were as following: nanofiltration molecular weight cut-off, 150 Da; solutes concentration, 18.34 µg/mL; pH, 4.26. The predicted value of retention rate was 97.99% under the optimum conditions, and the experimental value was 98.03±0.24%, which was in accordance with the predicted value. These results demonstrate that the combination of Box-Behnken design and response surface analysis can well optimize the concentrate process of Lonicera japonica water-extraction by nanofiltration, and the results provide the basis for nanofiltration concentrate for heat-sensitive traditional Chinese medicine.

Psychometric evaluation of a daily gastro-oesophageal reflux disease symptom measure.

PubMed

Bytzer, Peter; Reimer, Christina; Smith, Gary; Anatchkova, Milena D; Hsieh, Ray; Wilkinson, Joanne; Thomas, S Jane; Lenderking, William R

2017-03-01

The objective of this study was to evaluate the validity of the Heartburn Reflux Dyspepsia Questionnaire (HRDQ), a newly developed measure of gastro-oesophageal reflux disease (GORD) symptoms. Specifically, the HRDQ was developed for patients, who still experience symptoms with proton pump inhibitor (PPI) treatment. The psychometric properties of HRDQ were evaluated based on data from two clinical trials of patients with GORD with a partial response to PPIs, one from the UK and one from Denmark and Germany. The HRDQ had good internal consistency (Cronbach's alpha range .83-.88) and test-retest reliability (intraclass correlation coefficient range .71-.90). Convergent and discriminant validity were supported by high correlations with ReQuest™ and ability to differentiate between groups based on ReQuest™ cut-off values. Responsiveness of HRDQ was demonstrated by moderate to high correlations with ReQuest™ change scores and time with symptoms. An HRDQ cut-off value of 0.70 for definition of 'bad day' was also evaluated. Based on existing evidence, the HRDQ is a valid and reliable measure of GORD symptoms that can be used as a study outcome in clinical trials.

Quasi-Brittle Fracture of Compact Specimens with Sharp Notches and U-Shaped Cuts

NASA Astrophysics Data System (ADS)

Kornev, V. M.; Demeshkin, A. G.

2018-01-01

A two-parameter (coupled) discrete-integral criterion of fracture is proposed. It can be used to construct fracture diagrams for compact specimens with sharp cracks. Curves separating the stress-crack length plane into three domains are plotted. These domains correspond to the absence of fracture, damage accumulation in the pre-fracture region under repeated loading, and specimen fragmentation under monotonic loading. Constants used for the analytical description of fracture diagrams for quasi-brittle materials with cracks are selected with the use of approximation of the classical stress-strain diagrams for the initial material and the critical stress intensity factor. Predictions of the proposed theory are compared with experimental results on fracture of compact specimens with different radii made of polymethylmethacrylate (PMMA) and solid rubber with crack-type effects in the form of U-shaped cuts.

Psychometric goodness of the Mini Sleep Questionnaire.

PubMed

Natale, Vincenzo; Fabbri, Marco; Tonetti, Lorenzo; Martoni, Monica

2014-07-01

The current study was conducted to evaluate the psychometric properties and analyze the convergent validity of the Italian version of the Mini Sleep Questionnaire (MSQ). In addition, it was aimed to put forward cut-off values to be used in screening protocols. The MSQ was administered to 1830 participants (age range 18-87 years), of whom 1208 also completed the Sleep Disorder Questionnaire (age range 18-87 years). A subgroup of 187 (age range 18-71 years) participants was randomly chosen to test the test-retest reliability. A complete psychometric evaluation was performed on the MSQ. To study the validity of the tool, the Sleep Disorder Questionnaire was used as an external criterion to validate the MSQ. Using the Youden index, we calculated the cut-off values that performed best. Finally, we created receiver-operator curves to test the accuracy of each cut-off value identified. For the MSQ, Cronbach's alpha score was 0.77 while homogeneity was 0.26. Factorial analyses confirmed the presence of two dimensions: sleep (Cronbach's alpha 0.75; homogeneity 0.37) and wake (Cronbach's alpha 0.75; homogeneity 0.44). For each dimension, a cut-off value was identified (>16 and >14, respectively). Both cut-off values obtained an area under the curve higher than 0.80. Psychometric evaluation of the MSQ was satisfactory. The cut-off values analyzed in the present study showed good performance. On the whole, the results of this study suggest that the MSQ can be a useful screening tool. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

HMMER Cut-off Threshold Tool (HMMERCTTER): Supervised classification of superfamily protein sequences with a reliable cut-off threshold.

PubMed

Pagnuco, Inti Anabela; Revuelta, María Victoria; Bondino, Hernán Gabriel; Brun, Marcel; Ten Have, Arjen

2018-01-01

Protein superfamilies can be divided into subfamilies of proteins with different functional characteristics. Their sequences can be classified hierarchically, which is part of sequence function assignation. Typically, there are no clear subfamily hallmarks that would allow pattern-based function assignation by which this task is mostly achieved based on the similarity principle. This is hampered by the lack of a score cut-off that is both sensitive and specific. HMMER Cut-off Threshold Tool (HMMERCTTER) adds a reliable cut-off threshold to the popular HMMER. Using a high quality superfamily phylogeny, it clusters a set of training sequences such that the cluster-specific HMMER profiles show cluster or subfamily member detection with 100% precision and recall (P&R), thereby generating a specific threshold as inclusion cut-off. Profiles and thresholds are then used as classifiers to screen a target dataset. Iterative inclusion of novel sequences to groups and the corresponding HMMER profiles results in high sensitivity while specificity is maintained by imposing 100% P&R self detection. In three presented case studies of protein superfamilies, classification of large datasets with 100% precision was achieved with over 95% recall. Limits and caveats are presented and explained. HMMERCTTER is a promising protein superfamily sequence classifier provided high quality training datasets are used. It provides a decision support system that aids in the difficult task of sequence function assignation in the twilight zone of sequence similarity. All relevant data and source codes are available from the Github repository at the following URL: https://github.com/BBCMdP/HMMERCTTER.

HMMER Cut-off Threshold Tool (HMMERCTTER): Supervised classification of superfamily protein sequences with a reliable cut-off threshold

PubMed Central

Pagnuco, Inti Anabela; Revuelta, María Victoria; Bondino, Hernán Gabriel; Brun, Marcel

2018-01-01

Background Protein superfamilies can be divided into subfamilies of proteins with different functional characteristics. Their sequences can be classified hierarchically, which is part of sequence function assignation. Typically, there are no clear subfamily hallmarks that would allow pattern-based function assignation by which this task is mostly achieved based on the similarity principle. This is hampered by the lack of a score cut-off that is both sensitive and specific. Results HMMER Cut-off Threshold Tool (HMMERCTTER) adds a reliable cut-off threshold to the popular HMMER. Using a high quality superfamily phylogeny, it clusters a set of training sequences such that the cluster-specific HMMER profiles show cluster or subfamily member detection with 100% precision and recall (P&R), thereby generating a specific threshold as inclusion cut-off. Profiles and thresholds are then used as classifiers to screen a target dataset. Iterative inclusion of novel sequences to groups and the corresponding HMMER profiles results in high sensitivity while specificity is maintained by imposing 100% P&R self detection. In three presented case studies of protein superfamilies, classification of large datasets with 100% precision was achieved with over 95% recall. Limits and caveats are presented and explained. Conclusions HMMERCTTER is a promising protein superfamily sequence classifier provided high quality training datasets are used. It provides a decision support system that aids in the difficult task of sequence function assignation in the twilight zone of sequence similarity. All relevant data and source codes are available from the Github repository at the following URL: https://github.com/BBCMdP/HMMERCTTER. PMID:29579071

Accuracy and adequacy of waist circumference cut-off points currently recommended in Brazilian adults.

PubMed

Vianna, Carolina Avila; da Silva Linhares, Rogério; Bielemann, Renata Moraes; Machado, Eduardo Coelho; González-Chica, David Alejandro; Matijasevich, Alicia Manitto; Gigante, Denise Petrucci; da Silva Dos Santos, Iná

2014-04-01

To evaluate the adequacy and accuracy of cut-off values currently recommended by the WHO for assessment of cardiovascular risk in southern Brazil. Population-based study aimed at determining the predictive ability of waist circumference for cardiovascular risk based on the use of previous medical diagnosis for hypertension, diabetes mellitus and/or dyslipidaemia. Descriptive analysis was used for the adequacy of current cut-off values of waist circumference, receiver operating characteristic curves were constructed and the most accurate criteria according to the Youden index and points of optimal sensitivity and specificity were identified. Pelotas, southern Brazil. Individuals (n 2112) aged ≥20 years living in the city were selected by multistage sampling, since these individuals did not report the presence of previous myocardial infarction, angina pectoris or stroke. The cut-off values currently recommended by WHO were more appropriate in men than women, with overestimation of cardiovascular risk in women. The area under the receiver operating characteristic curve showed moderate predictive ability of waist circumference in men (0.74, 95% CI 0.71, 0.76) and women (0.75, 95% CI 0.73, 0.77). The method of optimal sensitivity and specificity showed better performance in assessing the accuracy, identifying the values of 95 cm in men and 87 cm in women as the best cut-off values of waist circumference to assess cardiovascular risk. The cut-off values currently recommended for waist circumference are not suitable for women. Longitudinal studies should be conducted to evaluate the consistency of the findings.

Optimal Waist-to-Height Ratio Values for Cardiometabolic Risk Screening in an Ethnically Diverse Sample of South African Urban and Rural School Boys and Girls

PubMed Central

Matsha, Tandi E.; Kengne, Andre-Pascal; Yako, Yandiswa Y.; Hon, Gloudina M.; Hassan, Mogamat S.; Erasmus, Rajiv T.

2013-01-01

Background The proposed waist-to-height ratio (WHtR) cut-off of 0.5 is less optimal for cardiometabolic risk screening in children in many settings. The purpose of this study was to determine the optimal WHtR for children from South Africa, and investigate variations by gender, ethnicity and residence in the achieved value. Methods Metabolic syndrome (MetS) components were measured in 1272 randomly selected learners, aged 10–16 years, comprising of 446 black Africans, 696 mixed-ancestry and 130 Caucasians. The Youden’s index and the closest-top-left (CTL) point approaches were used to derive WHtR cut-offs for diagnosing any two MetS components, excluding the waist circumference. Results The two approaches yielded similar cut-off in girls, 0.465 (sensitivity 50.0, specificity 69.5), but two different values in boys, 0.455 (42.9, 88.4) and 0.425 (60.3, 67.7) based on the Youden’s index and the CTL point, respectively. Furthermore, WHtR cut-off values derived differed substantially amongst the regions and ethnic groups investigated, whereby the highest cut-off was observed in semi-rural and white children, respectively, Youden’s index0.505 (31.6, 87.1) and CTL point 0.475 (44.4, 75.9). Conclusion The WHtR cut-off of 0.5 is less accurate for screening cardiovascular risk in South African children. The optimal value in this setting is likely gender and ethnicity-specific and sensitive to urbanization. PMID:23967160

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.

Sensitivity and specificity of waist circumference as a single screening tool for identification of overweight and obesity among Malaysian adults.

PubMed

Kee, C C; Jamaiyah, H; Geeta, A; Ali, Z Ahmad; Safiza, M N Noor; Suzana, S; Khor, G L; Rahmah, R; Jamalludin, A R; Sumarni, M G; Lim, K H; Faudzi, Y Ahmad; Amal, N M

2011-12-01

Generalised obesity and central obesity are risk factors for Type II diabetes mellitus and cardiovascular diseases. Waist circumference (WC) has been suggested as a single screening tool for identification of overweight or obese subjects in lieu of the body mass index (BMI) for weight management in public health program. Currently, the recommended waist circumference cut-off points of > or = 94cm for men and > or =80cm for women (waist action level 1) and > or = 102cm for men and > or = 88cm for women (waist action level 2) used for identification of overweight and obesity are based on studies in Caucasian populations. The objective of this study was to assess the sensitivity and specificity of the recommended waist action levels, and to determine optimal WC cut-off points for identification of overweight or obesity with central fat distribution based on BMI for Malaysian adults. Data from 32,773 subjects (14,982 men and 17,791 women) aged 18 and above who participated in the Third National Health Morbidity Survey in 2006 were analysed. Sensitivity and specificity of WC at waist action level 1 were 48.3% and 97.5% for men; and 84.2% and 80.6% for women when compared to the cut-off points based on BMI > or = 25kg/m2. At waist action level 2, sensitivity and specificity were 52.4% and 98.0% for men, and 79.2% and 85.4% for women when compared with the cut-off points based on BMI (> or = 30 kg/m2). Receiver operating characteristic analyses showed that the appropriatescreening cut-off points for WC to identify subjects with overweight (> or = 25kg/m2) was 86.0cm (sensitivity=83.6%, specificity=82.5%) for men, and 79.1cm (sensitivity=85.0%, specificity=79.5%) for women. Waist circumference cut-off points to identify obese subjects (BMI > or = 30 kg/m2) was 93.2cm (sensitivity=86.5%, specificity=85.7%) for men and 85.2cm (sensitivity=77.9%, specificity=78.0%) for women. Our findings demonstrated that the current recommended waist circumference cut-off points have low sensitivity for identification of overweight and obesity in men. We suggest that these newly identified cut-off points be considered.

Yield and Water Productivity Responses to Irrigation Cut-off Strategies after Fruit Set Using Stem Water Potential Thresholds in a Super-High Density Olive Orchard

PubMed Central

Ahumada-Orellana, Luis E.; Ortega-Farías, Samuel; Searles, Peter S.; Retamales, Jorge B.

2017-01-01

An increase in the land area dedicated to super-high density olive orchards has occurred in Chile in recent years. Such modern orchards have high irrigation requirements, and optimizing water use is a priority. Moreover, this region presents low water availability, which makes necessary to establish irrigation strategies to improve water productivity. An experiment was conducted during four consecutive growing seasons (2010–2011 to 2013–2014) to evaluate the responses of yield and water productivity to irrigation cut-off strategies. These strategies were applied after fruit set using midday stem water potential (Ψstem) thresholds in a super-high density olive orchard (cv. Arbequina), located in the Pencahue Valley, Maule Region, Chile. The experimental design was completely randomized with four irrigation cut-off treatments based on the Ψstem thresholds and four replicate plots per treatment (five trees per plot). Similar to commercial growing conditions in our region, the Ψstem in the T1 treatment was maintained between -1.4 and -2.2 MPa (100% of actual evapotranspiration), while T2, T3 and T4 treatments did not receive irrigation from fruit set until they reached a Ψstem threshold of approximately -3.5, -5.0, and -6.0 MPa, respectively. Once the specific thresholds were reached, irrigation was restored and maintained as T1 in all treatments until fruits were harvested. Yield and its components were not significantly different between T1 and T2, but fruit yield and total oil yield, fruit weight, and fruit diameter were decreased by the T3 and T4 treatments. Moreover, yield showed a linear response with water stress integral (SΨ), which was strongly influenced by fruit load. Total oil content (%) and pulp/stone ratio were not affected by the different irrigation strategies. Also, fruit and oil water productivities were significantly greater in T1 and T2 than in the T3 and T4. Moreover, the T2, T3, and T4 treatments averaged 37, 51, and 72 days without irrigation which represented 75–83, 62–76, and 56–70% of applied water compared with T1, respectively. These results suggest that using the T2 irrigation cut-off strategy could be applied in a super-high density olive orchard (cv. Arbequina) because it maintained yields, saving 20% of the applied water. PMID:28785274

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

NASA Technical Reports Server (NTRS)

Ransom, Khadijah S.; Johnson, Grace K.

2013-01-01

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

The cutting edge - Micro-CT for quantitative toolmark analysis of sharp force trauma to bone.

PubMed

Norman, D G; Watson, D G; Burnett, B; Fenne, P M; Williams, M A

2018-02-01

Toolmark analysis involves examining marks created on an object to identify the likely tool responsible for creating those marks (e.g., a knife). Although a potentially powerful forensic tool, knife mark analysis is still in its infancy and the validation of imaging techniques as well as quantitative approaches is ongoing. This study builds on previous work by simulating real-world stabbings experimentally and statistically exploring quantitative toolmark properties, such as cut mark angle captured by micro-CT imaging, to predict the knife responsible. In Experiment 1 a mechanical stab rig and two knives were used to create 14 knife cut marks on dry pig ribs. The toolmarks were laser and micro-CT scanned to allow for quantitative measurements of numerous toolmark properties. The findings from Experiment 1 demonstrated that both knives produced statistically different cut mark widths, wall angle and shapes. Experiment 2 examined knife marks created on fleshed pig torsos with conditions designed to better simulate real-world stabbings. Eight knives were used to generate 64 incision cut marks that were also micro-CT scanned. Statistical exploration of these cut marks suggested that knife type, serrated or plain, can be predicted from cut mark width and wall angle. Preliminary results suggest that knives type can be predicted from cut mark width, and that knife edge thickness correlates with cut mark width. An additional 16 cut marks walls were imaged for striation marks using scanning electron microscopy with results suggesting that this approach might not be useful for knife mark analysis. Results also indicated that observer judgements of cut mark shape were more consistent when rated from micro-CT images than light microscopy images. The potential to combine micro-CT data, medical grade CT data and photographs to develop highly realistic virtual models for visualisation and 3D printing is also demonstrated. This is the first study to statistically explore simulated real-world knife marks imaged by micro-CT to demonstrate the potential of quantitative approaches in knife mark analysis. Findings and methods presented in this study are relevant to both forensic toolmark researchers as well as practitioners. Limitations of the experimental methodologies and imaging techniques are discussed, and further work is recommended. Copyright © 2017 Elsevier B.V. All rights reserved.

Study of guided modes in three-dimensional composites

NASA Astrophysics Data System (ADS)

Baste, S.; Gerard, A.

The propagation of elastic waves in a three-dimensional carbon-carbon composite is modeled with a mixed variational method, using the Bloch or Floquet theories and the Hellinger-Reissner function for two independent fields. The model of the equivalent homogeneous material only exists below a cut-off frequency of about 600 kHz. The existence below the cut-off frequency of two guided waves can account for the presence of a slow guided wave on either side of the cut-off frequency. Optical modes are generated at low frequencies, and can attain high velocites (rapid guided modes of 15,000 m/sec).

Removal of methadone by extended dialysis using a high cut-off dialyzer: implications for the treatment of overdose and for pain management in patients undergoing light chain removal.

PubMed

Arelin, Viktor; Schmidt, Julius J; Kayser, Nathalie; Kühn-Velten, W Nikolaus; Suhling, Hendrik; Eden, Gabriele; Kielstein, Jan T

2016-06-01

The synthetic opioid methadone hydrochloride has a low molecular weight of 346 D, a high volume of distribution (4 - 7 L/kg), and is lipophilic. It is used as an analgesic and for the maintenance treatment of opiate dependence. In drug addicts, methadone is frequently involved in mixed intoxications that can lead to death. Here we present the case of a drug addict in whom a high cut-off dialysis membrane together with extended dialysis was used in the setting of suspected overdose and acute kidney injury. Although the observed dialyzer plasma clearance (31.5 mL/min) and reduction ratio (38%) were higher than previously reported for standard hemodialysis, the total amount of methadone in the spent dialysate after 1 extended dialysis session was quite low. Hence, even extended dialysis with a high cut-off membrane does not seem to offer a clinically relevant benefit in the setting of overdose for enhanced methadone removal. On the other hand, in patients undergoing high cut-off dialysis for the removal of light chains, methadone could still be used as an analgesic without an additional dose after high cut-off hemodialysis.

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.

[Influence of different surgeries on growth and development of alar cartilage in young-rabbit].

PubMed

Jiang, Lian; Dong, Xiqian; Song, Qinggao; Chen, Shang; Zou, Sihai

2011-01-01

The purpose of this study is to observe the affection of different clinical surgeries on alar nasal cartilages' growth and development. The experimental results can provide some theory basis for clinical surgeries. Twenty-eight New Zealand immature rabbits were used in this study, and divided into normal control group, hidden dissection group and cutting off alar nasal cartilages group randomly, which included 4,12 and 12 rabbits, separately. Arc incision were made on the mucous membrane of nasal cavity,and then dissect the alar nasal cartilages hidden or cut off the alar nasal cartilages, separately. The growth and development of the alar cartilage were observed at different stages after the surgery using histological and immuno-histochemical methods. Four weeks, eight weeks, twelve weeks and sixteen weeks after surgery, there were no significant differences in the indexes of chondrocytes between hidden dissection group and control group. In cutting off alar nasal cartilages group, fiber tissue were observed in the vacancy left after being cut off cartilages, and even mucous membrane tissue could be seen in some slices. There is no adverse influence on the growth and development of the alar cartilage after being hidden dissected. Contrarily, the restoring capability of transparent cartilage cannot counteract the injury resulted form the surgery after the alar nasal cartilages being cut off.

Performance of a semi-quantitative whole blood test for human heart-type fatty acid-binding protein (H-FABP).

PubMed

Hiura, Masahito; Nakajima, Osamu; Mori, Toshizumi; Kitano, Katsuya

2005-10-01

We evaluated the accuracy of visually reading the whole blood Rapicheck H-FABP panel test using the quantitative plasma H-FABP concentration as the reference. Consecutive patients with chest pain (n = 237) who were suspected of having acute myocardial infarction were recruited. The appearance of an evident test line within 5 min was given a grade of +3 (strongly positive), appearance within 15 min +2 (moderately positive) and the appearance of a weak test line within 15 min +1 (weakly positive). The concordance rates were 91.8% for positive, 70.1% for negative and 80.2% for overall. Plasma H-FABP concentrations were above the cut-off value for 9.2% of negative (0) results. Fifty percent of weakly positive (+1) and 25.0% of moderately positive (+2) results had H-FABP concentrations lower than the cut-off value. All of the strongly positive (+3) were above the cut-off value. These results suggested that the false-positive and false-negative results of Rapicheck H-FABP were caused by over or underestimation in visual reading when the plasma H-FABP concentration was near the cut-off concentration. Low accuracy of visual reading of Rapicheck H-FABP was due to poor estimation by manual reading around the cut-off value.

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.

The "Iconoclast," a superb instrument for undermining.

PubMed

Luikart, R

1980-04-01

The "Iconoclast" was designed to separate with ease the dermis from underlying fascia or periosteum. It dissects bluntly and thus reduces need for sharp cutting and snipping, and minimizes damage to blood vessels and nerves.

The Sharpness of Blades Used in Dermatologic Surgery.

PubMed

Awadalla, Farah; Hexsel, Camile; Goldberg, Leonard H

2016-01-01

There are numerous blades available for use in dermatologic procedures. There are different advantages that are inhere.nt to different blades due to their shape and size. One aspect of the blade that is instrumental to its performance, but is not objectively defined, is sharpness. This information could be useful when choosing a blade for a particular procedure. This study aims to objectively define the sharpness of blades used in dermatologic surgery. The Sharpness Tester (Cutlery and Allied Trades Research Association, Sheffield, UK) was used to test the force in Newtons a blade requires to cut through a silicone cylinder. New blades were used to determine a standard for the sharpness of new blades. Blades used for surgery were tested to determine the sharpness after use. The sharpest blade is the double-edged razor blade (0.395 N) followed by the dermablade (0.46 N), plastic handled #15 (0.541 N), #15c (0.575 N), #10 (0.647 N), and the #15 blade (0.664 N). The sharpness of a blade is an important factor in its ability to perform a task and should be taken into account when choosing a particular blade for a particular procedure.

An optical spectrum of the afterglow of a gamma-ray burst at a redshift of z = 6.295.

PubMed

Kawai, N; Kosugi, G; Aoki, K; Yamada, T; Totani, T; Ohta, K; Iye, M; Hattori, T; Aoki, W; Furusawa, H; Hurley, K; Kawabata, K S; Kobayashi, N; Komiyama, Y; Mizumoto, Y; Nomoto, K; Noumaru, J; Ogasawara, R; Sato, R; Sekiguchi, K; Shirasaki, Y; Suzuki, M; Takata, T; Tamagawa, T; Terada, H; Watanabe, J; Yatsu, Y; Yoshida, A

2006-03-09

The prompt gamma-ray emission from gamma-ray bursts (GRBs) should be detectable out to distances of z > 10 (ref. 1), and should therefore provide an excellent probe of the evolution of cosmic star formation, reionization of the intergalactic medium, and the metal enrichment history of the Universe. Hitherto, the highest measured redshift for a GRB has been z = 4.50 (ref. 5). Here we report the optical spectrum of the afterglow of GRB 050904 obtained 3.4 days after the burst; the spectrum shows a clear continuum at the long-wavelength end of the spectrum with a sharp cut-off at around 9,000 A due to Lyman alpha absorption at z approximately 6.3 (with a damping wing). A system of absorption lines of heavy elements at z = 6.295 +/- 0.002 was also detected, yielding the precise measurement of the redshift. The Si ii fine-structure lines suggest a dense, metal-enriched environment around the progenitor of the GRB.

Advanced optical systems for ultra high energy cosmic rays detection

NASA Astrophysics Data System (ADS)

Gambicorti, L.; Pace, E.; Mazzinghi, P.

2017-11-01

A new advanced optical system is proposed and analysed in this work with the purpose to improve the photons collection efficiency of Multi-AnodePhotoMultipliers (MAPMT) detectors, which will be used to cover large focal surface of instruments dedicated to the Ultra High Energy Cosmic Rays (UHECRs, above 1019eV) and Ultra High Energy Neutrino (UHEN) detection. The employment of the advanced optical system allows to focus all photons inside the sensitive area of detectors and to improve the signal-to-noise ratios in the wavelength range of interest (300-400nm), thus coupling imaging and filtering capability. Filter is realised with a multilayer coating to reach high transparency in UV range and with a sharp cut-off outside. In this work the applications on different series of PMTs have been studied and results of simulations are shown. First prototypes have been realised. Finally, this paper proposes another class of adapters to be optically coupled on each pixel of MAPMT detector selected, consisting of non-imaging concentrators as Winston cones.

Work ability index and perceived work ability as predictors of disability pension: a prospective study among Finnish municipal employees.

PubMed

Jääskeläinen, Anne; Kausto, Johanna; Seitsamo, Jorma; Ojajärvi, Anneli; Nygård, Clas-Håkan; Arjas, Elja; Leino-Arjas, Päivi

2016-06-01

We analyzed the work ability index (WAI) and its first item (work ability score, WAS) - and subsequent four-year changes thereof - as predictors of disability pension (DP). We linked survey responses of 5251 Finnish municipal employees, aged 44-58 years, to pension and death register data until 2009. Job content (physical, mental, or mixed) was based on observation. Baseline (1981) WAI was divided into poor (<27), moderate (28-36), and good/excellent (>37) and WAS into poor (0-5), moderate (6-7), and good/excellent (8-10). Four-year changes in these scores were classified as strong decline (

Bipolar diagnosis in China: Evaluating diagnostic confidence using the Bipolarity Index.

PubMed

Ma, Yantao; Gao, Huimin; Yu, Xin; Si, Tianmei; Wang, Gang; Fang, Yiru; Liu, Zhening; Sun, Jing; Yang, Haichen; Wang, Xueyi; Li, Jing; Zhang, Yonghua; Sachs, Gary

2016-09-15

Diagnosis of bipolar disorder is inherently difficult. The goal of this study was to examine the utility and psychometric properties of the Bipolarity Index (BPx) in a population of patients treated in China. At nine Chinese health facilities participating in CAFÉ-BD, clinicians completed a standardized affective disorder evaluation for consecutive patients (N=615) with a clinical diagnosis of MDD and BPD and scored the Bipolarity Index. The investigators constructed ROC curves to determine the optimal cut off points to discriminate subjects in three clinical diagnostic groups: bipolar disorder (BPD), major depressive disorder (MDD) and healthy (no psychiatric diagnosis) controls (HC). This study is registered with ClinicalTrials.gov, number NCT02015143. 1) The cut-off score between the MDD and BPD groups was 42.0, with a sensitivity of 0.957 and specificity of 0.881 (Z=63.064, P<0.001); the cut-off score between the MDD and BPD II groups was 34.0, with a sensitivity of 0.810 and specificity of 0.855 (Z=20.174, P<0.001); and the cut-off score between the BPD II and BPD I groups was 57.0, with a sensitivity of 0.680 and specificity of 0.772 (Z=9.636, P<0.001). 2) Five domains contributed to the discrimination results. State-related domains (episode characteristics and course of illness) made greater contributions than trait-related domains (age of onset, family history, and treatment response). The data are purely descriptive. The BPD II sample and the family history dataset were small. Our finding indicates good reliability and validity for the Chinese version of the BPx, which encourages its use as a measure of diagnostic confidence for bipolar spectrum disorders. Further prospective study is necessary to determine if the BPx is useful in identifying subgroups among MDD subjects at high risk for conversion to BPD. Copyright © 2016 Elsevier B.V. All rights reserved.

ROC-king onwards: intraepithelial lymphocyte counts, distribution & role in coeliac disease mucosal interpretation.

PubMed

Rostami, Kamran; Marsh, Michael N; Johnson, Matt W; Mohaghegh, Hamid; Heal, Calvin; Holmes, Geoffrey; Ensari, Arzu; Aldulaimi, David; Bancel, Brigitte; Bassotti, Gabrio; Bateman, Adrian; Becheanu, Gabriel; Bozzola, Anna; Carroccio, Antonio; Catassi, Carlo; Ciacci, Carolina; Ciobanu, Alexandra; Danciu, Mihai; Derakhshan, Mohammad H; Elli, Luca; Ferrero, Stefano; Fiorentino, Michelangelo; Fiorino, Marilena; Ganji, Azita; Ghaffarzadehgan, Kamran; Going, James J; Ishaq, Sauid; Mandolesi, Alessandra; Mathews, Sherly; Maxim, Roxana; Mulder, Chris J; Neefjes-Borst, Andra; Robert, Marie; Russo, Ilaria; Rostami-Nejad, Mohammad; Sidoni, Angelo; Sotoudeh, Masoud; Villanacci, Vincenzo; Volta, Umberto; Zali, Mohammad R; Srivastava, Amitabh

2017-12-01

Counting intraepithelial lymphocytes (IEL) is central to the histological diagnosis of coeliac disease (CD), but no definitive 'normal' IEL range has ever been published. In this multicentre study, receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut-off between normal and CD (Marsh III lesion) duodenal mucosa, based on IEL counts on >400 mucosal biopsy specimens. The study was designed at the International Meeting on Digestive Pathology, Bucharest 2015. Investigators from 19 centres, eight countries of three continents, recruited 198 patients with Marsh III histology and 203 controls and used one agreed protocol to count IEL/100 enterocytes in well-oriented duodenal biopsies. Demographic and serological data were also collected. The mean ages of CD and control groups were 45.5 (neonate to 82) and 38.3 (2-88) years. Mean IEL count was 54±18/100 enterocytes in CD and 13±8 in normal controls (p=0.0001). ROC analysis indicated an optimal cut-off point of 25 IEL/100 enterocytes, with 99% sensitivity, 92% specificity and 99.5% area under the curve. Other cut-offs between 20 and 40 IEL were less discriminatory. Additionally, there was a sufficiently high number of biopsies to explore IEL counts across the subclassification of the Marsh III lesion. Our ROC curve analyses demonstrate that for Marsh III lesions, a cut-off of 25 IEL/100 enterocytes optimises discrimination between normal control and CD biopsies. No differences in IEL counts were found between Marsh III a, b and c lesions. There was an indication of a continuously graded dose-response by IEL to environmental (gluten) antigenic influence. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Evaluation of a multiplex immunoassay for bovine respiratory syncytial virus and bovine coronavirus antibodies in bulk tank milk against two indirect ELISAs using latent class analysis.

PubMed

Toftaker, Ingrid; Toft, Nils; Stokstad, Maria; Sølverød, Liv; Harkiss, Gordon; Watt, Neil; O' Brien, Amanda; Nødtvedt, Ane

2018-06-01

Bovine respiratory syncytial virus (BRSV) and bovine coronavirus (BCV) are responsible for respiratory disease and diarrhea in cattle worldwide. The Norwegian control program against these infections is based on herd-level diagnosis using a new multiplex immunoassay. The objective of this study was to estimate sensitivity and specificity across different cut-off values for the MVD-Enferplex BCV/BRSV multiplex, by comparing them to a commercially available ELISA, the SVANOVIR ® BCV-Ab and SVANOVIR ® BRSV-Ab, respectively. We analyzed bulk tank milk samples from 360 herds in a low- and 360 herds in a high-prevalence area. As none of the tests were considered perfect, estimation of test characteristics was performed using Bayesian latent class models. At the manufacturers' recommended cut-off values, the median sensitivity for the BRSV multiplex and the BRSV ELISA was 94.4 [89.8-98.7 95% Posterior Credibility Interval (PCI)] and 99.8 [98.7-100 95% PCI], respectively. The median specificity for the BRSV multiplex was 90.6 [85.5-94.4 95% PCI], but only 57.4 [50.5-64.4 95% PCI] for the BRSV ELISA. However, increasing the cut-off of the BRSV ELISA increased specificity without compromising sensitivity. For the BCV multiplex we found that by using only one of the three antigens included in the test, the specificity increased, without concurrent loss in sensitivity. At the recommended cut-off this resulted in a sensitivity of 99.9 [99.3-100 95% PCI] and specificity of 93.7 [88.8-97.8 95% PCI] for the multiplex and a sensitivity of 99.5 [98.1-100 95% PCI] and a specificity of 99.6 [97.6-100 95% PCI] for the BCV ELISA. Copyright © 2018 Elsevier B.V. All rights reserved.

Definition of improvement in juvenile idiopathic arthritis using the juvenile arthritis disease activity score.

PubMed

Horneff, Gerd; Becker, Ingrid

2014-07-01

The aim of this study was to define improvement thresholds for the Juvenile Arthritis Disease Activity Score (JADAS). Physicians' and parents' judgements on treatment efficacy, the ACR paediatric response measure (PedACR) and JADAS were extracted from BIKER. Patients were categorized by baseline classes in the 10-joint JADAS (JADAS10) as low (5 to <15), moderate (15 to <25) and high (25 to ≤40). Cut-offs for defining improvement following treatment with biologics or MTX were chosen by calculating the interquartile ranges (IQRs) of the judgement groups and considering the accuracy, sensitivity and specificity of the resulting model. Differences in the change of JADAS10 by JIA category were also analysed by analysis of variance (ANOVA). Sensitivity, specificity and accuracy were calculated. A total of 1315 treatment courses were analysed. The ANOVA of the JIA categories showed no significant differences of the mean JADAS10 in all baseline classes and IQRs also showed good overall limits. Therefore all JIA categories were combined for a collective cut-off. Analysis by baseline class revealed clear cut-off points. Improvement could be defined by the minimal decrease in the JADAS10 in baseline class low by 4 (41%), moderate by 10 (53%) and high by 17 (57%). The model shows values for accuracy from 75.6 to 85.5% and comparable values for sensitivity and specificity. Improvement after 3 months can be defined efficiently by the decrease of the JADAS10, depending on the baseline JADAS10 score, which specifies low, moderate or high disease activity. Our model demonstrates clear cut-off values. The JADAS10 may be used in addition to ACR criteria in clinical trials. Also, since the JADAS10 can easily be calculated at each patient visit, it also can be used for clinical decisions. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Investigating bone chip formation in craniotomy.

PubMed

Huiyu, He; Chengyong, Wang; Yue, Zhang; Yanbin, Zheng; Linlin, Xu; Guoneng, Xie; Danna, Zhao; Bin, Chen; Haoan, Chen

2017-10-01

In a craniotomy, the milling cutter is one of the most important cutting tools. The operating performance, tool durability and cutting damage to patients are influenced by the tool's sharpness, intensity and structure, whereas the cutting characteristics rely on interactions between the tool and the skull. In this study, an orthogonal cutting experiment during a craniotomy of fresh pig skulls was performed to investigate chip formation on the side cutting and face cutting of the skull using a high-speed camera. The cutting forces with different combinations of cutting parameters, such as the rake angle, clearance angle, depth of cut and cutting speed, were measured. The skull bone microstructure and cutting damage were observed by scanning electron microscope. Cutting models for different cutting approaches and various depths of cut were constructed and analyzed. The study demonstrated that the effects of shearing, tension and extrusion occur during chip formation. Various chip types, such as unit chips, splintering chips and continuous chips, were generated. Continuous pieces of chips, which are advisable for easy removal from the field of operation, were formed at greater depths of cut and tool rake angles greater than 10°. Cutting damage could be relieved with a faster recovery with clearance angles greater than 20°.

Measurement of asthma control according to global initiative for asthma guidelines: a comparison with the asthma control questionnaire

PubMed Central

2012-01-01

Introduction Asthma Control Questionnaire (ACQ) is a validated tool to measure asthma control. Cut-off points that best discriminate “well-controlled” or “not well-controlled” asthma have been suggested from the analysis of a large randomized clinical trial but they may not be adequate for daily clinical practice. Aims To establish cut-off points of the ACQ that best discriminate the level of control according to Global Initiative for Asthma (GINA) 2006 guidelines in patients with asthma managed at Allergology and Pulmonology Departments as well as Primary Care Centers in Spain. Patients and methods An epidemiological descriptive study, with prospective data collection. Asthma control following GINA-2006 classification and 7-item ACQ was assessed. The study population was split in two parts: 2/3 for finding the cut-off points (development population) and 1/3 for validating the results (validation population). Results A total of 1,363 stable asthmatic patients were included (mean age 38 ± 14 years, 60.3% women; 69.1% non-smokers). Patient classification according to GINA-defined asthma control was: controlled 13.6%, partially controlled 34.2%, and uncontrolled 52.3%. The ACQ cut-off points that better agreed with GINA-defined asthma control categories were calculated using receiver operating curves (ROC). The analysis showed that ACQ < 0.5 was the optimal cut-off point for “controlled asthma” (sensitivity 74.1%, specificity 77.5%) and 1.00 for “uncontrolled asthma” (sensitivity 73%, specificity 88.2%). Kappa index between GINA categories and ACQ was 0.62 (p < 0.001). Conclusion The ACQ cut-off points associated with GINA-defined asthma control in a real-life setting were <0.5 for controlled asthma and ≥1 for uncontrolled asthma. PMID:22726416

Exploring the screening capacity of the Fear of Cancer Recurrence Inventory-Short Form for clinical levels of fear of cancer recurrence.

PubMed

Fardell, Joanna E; Jones, Georden; Smith, Allan Ben; Lebel, Sophie; Thewes, Belinda; Costa, Daniel; Tiller, Kerry; Simard, Sébastien; Feldstain, Andrea; Beattie, Sara; McCallum, Megan; Butow, Phyllis

2018-02-01

Fear of cancer recurrence (FCR) is a common concern among cancer survivors. Identifying survivors with clinically significant FCR requires validated screening measures and clinical cut-offs. We evaluated the Fear of Cancer Recurrence Inventory-Short Form (FCRI-SF) clinical cut-off in 2 samples. Level of FCR in study 1 participants (from an Australian randomized controlled trial: ConquerFear) was compared with FCRI-SF scores. Based on a biopsychosocial interview, clinicians rated participants as having nonclinical, subclinical, or clinical FCR. Study 2 participants (from a Canadian FCRI-English validation study) were classified as having clinical or nonclinical FCR by using the semistructured clinical interview for FCR (SIFCR). Receiver operating characteristic analyses evaluated the screening ability of the FCRI-SF against clinician ratings (study 1) and the SIFCR (study 2). In study 1, 167 cancer survivors (mean age: 53 years, SD = 10.1) participated. Clinicians rated 43% as having clinical FCR. In study 2, 40 cancer survivors (mean age: 68 years, SD = 7.0) participated; 25% met criteria for clinical FCR according to the SIFCR. For both studies 1 and 2, receiver operating characteristic analyses suggested a cut-off ≥22 on the FCRI-SF identified cancer survivors with clinical levels of FCR with adequate sensitivity and specificity. Establishing clinical cut-offs on FCR screening measures is crucial to tailoring individual care and conducting rigorous research. Our results suggest using a higher cut-off on the FCRI-SF than previously reported to identify clinically significant FCR. Continued evaluation and validation of the FCRI-SF cut-off is required across diverse cancer populations. Copyright © 2017 John Wiley & Sons, Ltd.

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

PubMed

Black, A E

2000-09-01

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

Break-apart interphase fluorescence in situ hybridization assay in papillary thyroid carcinoma: on the road to optimizing the cut-off level for RET/PTC rearrangements.

PubMed

Colato, Chiara; Vicentini, Caterina; Cantara, Silvia; Pedron, Serena; Brazzarola, Paolo; Marchetti, Ivo; Di Coscio, Giancarlo; Chilosi, Marco; Brunelli, Matteo; Pacini, Furio; Ferdeghini, Marco

2015-05-01

Chromosomal rearrangements of the RET proto-oncogene is one of the most common molecular events in papillary thyroid carcinoma (PTC). However, their pathogenic role and clinical significance are still debated. This study aimed to investigate the prevalence of RET/PTC rearrangement in a cohort of BRAF WT PTCs by fluorescence in situ hybridization (FISH) and to search a reliable cut-off level in order to distinguish clonal or non-clonal RET changes. Forty BRAF WT PTCs were analyzed by FISH for RET rearrangements. As controls, six BRAFV600E mutated PTCs, 13 follicular adenomas (FA), and ten normal thyroid parenchyma were also analyzed. We performed FISH analysis on formalin-fixed, paraffin-embedded tissue using a commercially available RET break-apart probe. A cut-off level equivalent to 10.2% of aberrant cells was accepted as significant. To validate FISH results, we analyzed the study cohort by qRT-PCR. Split RET signals above the cut-off level were observed in 25% (10/40) of PTCs, harboring a percentage of positive cells ranging from 12 to 50%, and in one spontaneous FA (1/13, 7.7%). Overall, the data obtained by FISH matched well with qRT-PCR results. Challenging findings were observed in five cases showing a frequency of rearrangement very close to the cut-off. FISH approach represents a powerful tool to estimate the ratio between broken and non-broken RET tumor cells. Establishing a precise FISH cut-off may be useful in the interpretation of the presence of RET rearrangement, primarily when this strategy is used for cytological evaluation or for targeted therapy. © 2015 European Society of Endocrinology.

The role of urinary fractionated metanephrines in the diagnosis of phaeochromocytoma

PubMed Central

Jeyaraman, Kanakamani; Natarajan, Vasanthi; Thomas, Nihal; Jacob, Paul Mazhuvanchary; Nair, Aravindan; Shanthly, Nylla; Oommen, Regi; Varghese, Gracy; Joseph, Fleming Jude; Seshadri, Mandalam Subramaniam; Rajaratnam, Simon

2013-01-01

Background & objectives: Plasma and urinary metanephrines are used as screening tests for the diagnosis of phaeochromocytoma. The recommended cut-off levels are not standardized. This study was conducted to identify a cut-off level for 24 h urinary fractionated metanephrines viz. metanephrine (uMN) and normetanephrine (uNMN) using enzyme immunoassay for the diagnosis of phaeochromocytoma. Methods: Consecutive patients suspected to have phaeochromocytoma were included in the study. uMN and uNMN in 24 h urinary sample were measured using a commercial ELISA kit. Results: Overall, 72 patients were included over a period of 18 months. Twenty patients had histopathologically confirmed phaeochromocytoma and in 52 patients phaeochromocytoma was ruled out. Using the upper limit of normal stated by the assay manufacturer as the cut-off, uMN >350 μg/day had a low sensitivity and uNMN >600 μg/day had a poor specificity. By increasing the cut-off value of uNMN to twice the upper limit, specificity increased significantly without much loss in sensitivity. Combining uMN and uNMN using a cut-off twice the upper limit improved the diagnostic performance - sensitivity (95%); specificity (92.3%); positive predictive value (PPV - 82.6%); negative predictive value (NPV - 98%). In subsets of patients with a variable pretest probability for phaeochromocytoma, the PPV correlates well with the occurred of these tumors decreased, while the NPV remained at 100 per cent. Interpretation & conclusions: ELISA is a simple and reliable method for measuring uMN and uNMN. The test has a good NPV and can be used as an initial screening test for ruling out phaeochromocytoma. Each hospital will have to define the cut-off value for the assay being used, choosing a proper control population. PMID:23563375

The role of urinary fractionated metanephrines in the diagnosis of phaeochromocytoma.

PubMed

Jeyaraman, Kanakamani; Natarajan, Vasanthi; Thomas, Nihal; Jacob, Paul Mazhuvanchary; Nair, Aravindan; Shanthly, Nylla; Oommen, Regi; Varghese, Gracy; Joseph, Fleming Jude; Seshadri, Mandalam Subramaniam; Rajaratnam, Simon

2013-02-01

Plasma and urinary metanephrines are used as screening tests for the diagnosis of phaeochromocytoma. The recommended cut-off levels are not standardized. This study was conducted to identify a cut-off level for 24 h urinary fractionated metanephrines viz. metanephrine (uMN) and normetanephrine (uNMN) using enzyme immunoassay for the diagnosis of phaeochromocytoma. Consecutive patients suspected to have phaeochromocytoma were included in the study. uMN and uNMN in 24 h urinary sample were measured using a commercial ELISA kit. Overall, 72 patients were included over a period of 18 months. Twenty patients had histopathologically confirmed phaeochromocytoma and in 52 patients phaeochromocytoma was ruled out. Using the upper limit of normal stated by the assay manufacturer as the cut-off, uMN >350 μg/day had a low sensitivity and uNMN >600 μg/day had a poor specificity. By increasing the cut-off value of uNMN to twice the upper limit, specificity increased significantly without much loss in sensitivity. Combining uMN and uNMN using a cut-off twice the upper limit improved the diagnostic performance - sensitivity (95%); specificity (92.3%); positive predictive value (PPV - 82.6%); negative predictive value (NPV - 98%). In subsets of patients with a variable pretest probability for phaeochromocytoma, the PPV correlates well with the occurred of these tumors decreased, while the NPV remained at 100 per cent. ELISA is a simple and reliable method for measuring uMN and uNMN. The test has a good NPV and can be used as an initial screening test for ruling out phaeochromocytoma. Each hospital will have to define the cut-off value for the assay being used, choosing a proper control population.

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.

Diagnostic performance of matrix-assisted laser desorption ionisation time-of-flight mass spectrometry in blood bacterial infections: a systematic review and meta-analysis.

PubMed

Scott, Jamie S; Sterling, Sarah A; To, Harrison; Seals, Samantha R; Jones, Alan E

2016-07-01

Matrix-assisted laser desorption ionisation time-of-flight mass spectrometry (MALDI-TOF MS) has shown promise in decreasing time to identification of causative organisms compared to traditional methods; however, the utility of MALDI-TOF MS in a heterogeneous clinical setting is uncertain. To perform a systematic review on the operational performance of the Bruker MALDI-TOF MS system and evaluate published cut-off values compared to traditional blood cultures. A comprehensive literature search was performed. Studies were included if they performed direct MALDI-TOF MS analysis of blood culture specimens in human patients with suspected bacterial infections using the Bruker Biotyper software. Sensitivities and specificities of the combined studies were estimated using a hierarchical random effects linear model (REML) incorporating cut-off scores of ≥1.7 and ≥2.0. Fifty publications were identified, with 11 studies included after final review. The estimated sensitivity utilising a cut-off of ≥2.0 from the combined studies was 74.6% (95% CI = 67.9-89.3%), with an estimated specificity of 88.0% (95% CI = 74.8-94.7%). When assessing a cut-off of ≥1.7, the combined sensitivity increases to 92.8% (95% CI = 87.4-96.0%), but the estimated specificity decreased to 81.2% (95% CI = 61.9-96.6%). In this analysis, MALDI-TOF MS showed acceptable sensitivity and specificity in bacterial speciation with the current recommended cut-off point compared to blood cultures; however, lowering the cut-off point from ≥2.0 to ≥1.7 would increase the sensitivity of the test without significant detrimental effect on the specificity, which could improve clinician confidence in their results.

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.

Effectiveness of teaching International Caries Detection and Assessment System II and its e-learning program to freshman dental students on occlusal caries detection

PubMed Central

El-Damanhoury, Hatem M.; Fakhruddin, Kausar Sadia; Awad, Manal A.

2014-01-01

Objective: To assess the feasibility of teaching International Caries Detection and Assessment System (ICDAS) II and its e-learning program as tools for occlusal caries detection to freshmen dental students in comparison to dental graduates with 2 years of experience. Materials and Methods: Eighty-four freshmen and 32 dental graduates examined occlusal surfaces of molars/premolars (n = 72) after a lecture and a hands-on workshop. The same procedure was repeated after 1 month following the training with ICDAS II e-learning program. Validation of ICDAS II codes was done histologically. Intra- and inter-examiner reproducibility of ICDAS II severity scores were assessed before and after e-learning using (Fleiss's kappa). Results: The kappa values showed inter-examiner reproducibility ranged from 0.53 (ICDAS II code cut off ≥ 1) to 0.70 (ICDAS II code cut off ≥ 3) by undergraduates and 0.69 (ICDAS II code cut off ≥ 1) to 0.95 (ICDAS II code cut off ≥ 3) by graduates. The inter-examiner reproducibility ranged from 0.64 (ICDAS II code cut off ≥ 1) to 0.89 (ICDAS II code cut off ≥ 3). No statistically significant difference was found between both groups in intra-examiner agreements for assessing ICDAS II codes. A high statistically significant difference (P ≤ 0.01) in correct identification of codes 1, 2, and 4 from before to after e-learning were observed in both groups. The bias indices for the undergraduate group were higher than those of the graduate group. Conclusions: Early exposure of students to ICDAS II is a valuable method of teaching caries detection and its e-learning program significantly improves their caries diagnostic skills. PMID:25512730

Measurement of asthma control according to Global Initiative for Asthma guidelines: a comparison with the Asthma Control Questionnaire.

PubMed

Olaguibel, José María; Quirce, Santiago; Juliá, Berta; Fernández, Cristina; Fortuna, Ana María; Molina, Jesús; Plaza, Vicente

2012-06-22

Asthma Control Questionnaire (ACQ) is a validated tool to measure asthma control. Cut-off points that best discriminate "well-controlled" or "not well-controlled" asthma have been suggested from the analysis of a large randomized clinical trial but they may not be adequate for daily clinical practice. To establish cut-off points of the ACQ that best discriminate the level of control according to Global Initiative for Asthma (GINA) 2006 guidelines in patients with asthma managed at Allergology and Pulmonology Departments as well as Primary Care Centers in Spain. An epidemiological descriptive study, with prospective data collection. Asthma control following GINA-2006 classification and 7-item ACQ was assessed. The study population was split in two parts: 2/3 for finding the cut-off points (development population) and 1/3 for validating the results (validation population). A total of 1,363 stable asthmatic patients were included (mean age 38 ± 14 years, 60.3% women; 69.1% non-smokers). Patient classification according to GINA-defined asthma control was: controlled 13.6%, partially controlled 34.2%, and uncontrolled 52.3%. The ACQ cut-off points that better agreed with GINA-defined asthma control categories were calculated using receiver operating curves (ROC). The analysis showed that ACQ < 0.5 was the optimal cut-off point for "controlled asthma" (sensitivity 74.1%, specificity 77.5%) and 1.00 for "uncontrolled asthma" (sensitivity 73%, specificity 88.2%). Kappa index between GINA categories and ACQ was 0.62 (p < 0.001). The ACQ cut-off points associated with GINA-defined asthma control in a real-life setting were <0.5 for controlled asthma and ≥1 for uncontrolled asthma.

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.

Prevalence of obesity in Italian adolescents: does the use of different growth charts make the difference?

PubMed

De Carli, Luca; Spada, Elena; Milani, Silvano; Ganzit, Gian Pasquale; Ghizzoni, Lucia; Raia, Melissa; Coscia, Alessandra; Bertino, Enrico; Bo, Simona

2018-04-01

Since populations are becoming increasingly multi-ethnic, the use of local or international charts is a matter of debate. This study aimed to evaluate how the choice of cut-off thresholds affected prevalence of underweight (UW), overweight (OW), obesity (OB) in 1200 11-12-year Italian adolescents, and how their somatic growth depended on parental origin. The height, weight and body mass index were expressed as standard deviation score (SDS) using Italian (ISPED-2006) and UK (UK-1990) charts. The classification of UW/OW/OB was computed with the IOTF international cut-offs, and thresholds were identified as centiles corresponding to BMI values of 18.5/25.0/30.0 kg/m 2 at 18-year in ISPED-2006 or UK-1990 references. About 30% participants had non-Italian parents, above all from North-Africa and Romania. Referring to the UK-1990 charts, all groups showed negative mean SDS for height, and positive SDS for weight and BMI. Referring to the ISPED-2006 charts, all mean SDS were negative. Percentage of UW individuals was higher in accordance with ISPED-2006 than with UK-1990 charts, whereas percentages of OW/OB were higher with UK-1990 than ISPED-2006 charts. The results obtained using IOFT cut-offs were similar to UK-1990 cut-offs. These results were due to the different shape of age-dependent cut-off centiles. Independently by the parental origin, the percentages of adolescents classified as OW/OB were closer to the expected values using the ISPED-2006 then the UK-1990 cut-offs. The results suggested the use of the Italian references for adolescents with immigrant parents. The use of local charts seems more appropriate at least in Italian adolescents in the age range studied.

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.

Cross-validation of the Dot Counting Test in a large sample of credible and non-credible patients referred for neuropsychological testing.

PubMed

McCaul, Courtney; Boone, Kyle B; Ermshar, Annette; Cottingham, Maria; Victor, Tara L; Ziegler, Elizabeth; Zeller, Michelle A; Wright, Matthew

2018-01-18

To cross-validate the Dot Counting Test in a large neuropsychological sample. Dot Counting Test scores were compared in credible (n = 142) and non-credible (n = 335) neuropsychology referrals. Non-credible patients scored significantly higher than credible patients on all Dot Counting Test scores. While the original E-score cut-off of ≥17 achieved excellent specificity (96.5%), it was associated with mediocre sensitivity (52.8%). However, the cut-off could be substantially lowered to ≥13.80, while still maintaining adequate specificity (≥90%), and raising sensitivity to 70.0%. Examination of non-credible subgroups revealed that Dot Counting Test sensitivity in feigned mild traumatic brain injury (mTBI) was 55.8%, whereas sensitivity was 90.6% in patients with non-credible cognitive dysfunction in the context of claimed psychosis, and 81.0% in patients with non-credible cognitive performance in depression or severe TBI. Thus, the Dot Counting Test may have a particular role in detection of non-credible cognitive symptoms in claimed psychiatric disorders. Alternative to use of the E-score, failure on ≥1 cut-offs applied to individual Dot Counting Test scores (≥6.0″ for mean grouped dot counting time, ≥10.0″ for mean ungrouped dot counting time, and ≥4 errors), occurred in 11.3% of the credible sample, while nearly two-thirds (63.6%) of the non-credible sample failed one of more of these cut-offs. An E-score cut-off of 13.80, or failure on ≥1 individual score cut-offs, resulted in few false positive identifications in credible patients, and achieved high sensitivity (64.0-70.0%), and therefore appear appropriate for use in identifying neurocognitive performance invalidity.

Prevalence of thinness in children and adolescents in the Seychelles: comparison of two international growth references.

PubMed

Bovet, Pascal; Kizirian, Nathalie; Madeleine, George; Blössner, Monika; Chiolero, Arnaud

2011-06-09

Thinness in children and adolescents is largely under studied, a contrast with abundant literature on under-nutrition in infants and on overweight in children and adolescents. The aim of this study is to compare the prevalence of thinness using two recently developed growth references, among children and adolescents living in the Seychelles, an economically rapidly developing country in the African region. Weight and height were measured every year in all children of 4 grades (age range: 5 to 16 years) of all schools in the Seychelles as part of a routine school-based surveillance program. In this study we used data collected in 16,672 boys and 16,668 girls examined from 1998 to 2004. Thinness was estimated according to two growth references: i) an international survey (IS), defining three grades of thinness corresponding to a BMI of 18.5, 17.0 and 16.0 kg/m2 at age 18 and ii) the WHO reference, defined here as three categories of thinness (-1, -2 and -3 SD of BMI for age) with the second and third named "thinness" and "severe thinness", respectively. The prevalence of thinness was 21.4%, 6.4% and 2.0% based on the three IS cut-offs and 27.7%, 6.7% and 1.2% based on the WHO cut-offs. The prevalence of thinness categories tended to decrease according to age for both sexes for the IS reference and among girls for the WHO reference. The prevalence of the first category of thinness was larger with the WHO cut-offs than with the IS cut-offs while the prevalence of thinness of "grade 2" and thinness of "grade 3" (IS cut-offs) was similar to the prevalence of "thinness" and "severe thinness" (WHO cut-offs), respectively.

Chemotherapy and Your Mouth

MedlinePlus

... moist. • Drink a lot of water. • Suck ice chips. • Use sugarless gum or sugar-free hard candy. • ... Stay Away From • Sharp, crunchy foods, like taco chips, that could scrape or cut your mouth. • Foods ...

A sharp knife for high temperatures

NASA Technical Reports Server (NTRS)

Heisman, R. M.; Iceland, W. F.

1978-01-01

Electrically heated nickel-chrome-steel alloy knife may be used to cut heat resistant plastic felt and similar materials with relative ease. Blade made of commercially available alloy RA 330 retains edge at temperatures as high as 927 C.

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.

Differentiating the levels of risk for muscle dysmorphia among Hungarian male weightlifters: a factor mixture modeling approach.

PubMed

Babusa, Bernadett; Czeglédi, Edit; Túry, Ferenc; Mayville, Stephen B; Urbán, Róbert

2015-01-01

Muscle dysmorphia (MD) is a body image disturbance characterized by a pathological preoccupation with muscularity. The study aimed to differentiate the levels of risk for MD among weightlifters and to define a tentative cut-off score for the Muscle Appearance Satisfaction Scale (MASS) for the identification of high risk MD cases. Hungarian male weightlifters (n=304) completed the MASS, the Exercise Addiction Inventory, and specific exercise and body image related questions. For the differentiation of MD, factor mixture modeling was performed, resulting in three independent groups: low-, moderate-, and high risk MD groups. The estimated prevalence of high risk MD in this sample of weightlifters was 15.1%. To determine a cut-off score for the MASS, sensitivity and specificity analyses were performed and a cut-off point of 63 was suggested. The proposed cut-off score for the MASS can be useful for the early detection of high risk MD. Copyright © 2014 Elsevier Ltd. All rights reserved.

Relation of nutritional status to physiological outcomes after cardiac surgery in elderly patients with diabetes mellitus: a preliminary study.

PubMed

Izawa, Kazuhiro P; Watanabe, Satoshi

2016-12-01

To determine differences in physiological outcome (PO) based on the Geriatric Nutritional Risk Index (GNRI) and cut-off values for PO according to the GNRI in elderly post-cardiac surgery patients complicated by diabetes mellitus (DM). Thirty-five patients (72.9 years) were enrolled and divided by GNRI. Patient characteristics and PO of handgrip strength (HG), knee extensor muscle strength (KEMS), maximum gait speed (GS), and one-leg standing time (OLST) were compared between the groups, and cut-off values for PO were determined. These POs were significantly lower in the low-GNRI group (<92 points) than in the high-GNRI (≥92 points) group. The cut-off values for PO were HG, 22.7 kgf; KEMS, 41.5 %BW; GS, 1.2 m/sec; and OLST, 6.7 s. Nutritional status might influence PO following cardiac surgery. The cut-off values of PO reported here might be indicative of the need to improve patient nutritional status.

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

Role of neutrons and protons in entropy, spin cut off parameters, and moments of inertia

NASA Astrophysics Data System (ADS)

Razavi, R.

2013-07-01

The nuclear level densities, spin cut off parameters, and entropies have been extracted in 116-119Sn and 162,163Dy nuclei using superconducting theory, which includes nuclear pairing interaction. The results agree well with the recent data obtained from experimental level densities by the Oslo group for these nuclei. Also, the entropy excess ratio proposed by Razavi [R. Razavi, A.N. Behkami, S. Mohammadi, and M. Gholami, Phys. Rev. CPRVCAN0556-281310.1103/PhysRevC.86.047303 86, 047303 (2012)] for a proton and neutron as a function of nuclear temperature have been evaluated and are compared with the spin cut off excess ratio. The role of the neutron (proton) system is well determined by the entropy excess ratio as well as the spin cut off excess ratio. The moment of inertia for even-odd and even-even nuclei are also compared. The moment of inertia carried by a single hole is smaller than the single particle moment of inertia.

Establishing a standard definition for child overweight and obesity worldwide: international survey

PubMed Central

Cole, Tim J; Bellizzi, Mary C; Flegal, Katherine M; Dietz, William H

2000-01-01

Objective To develop an internationally acceptable definition of child overweight and obesity, specifying the measurement, the reference population, and the age and sex specific cut off points. Design International survey of six large nationally representative cross sectional growth studies. Setting Brazil, Great Britain, Hong Kong, the Netherlands, Singapore, and the United States. Subjects 97 876 males and 94 851 females from birth to 25 years of age. Main outcome measure Body mass index (weight/height2). Results For each of the surveys, centile curves were drawn that at age 18 years passed through the widely used cut off points of 25 and 30 kg/m2 for adult overweight and obesity. The resulting curves were averaged to provide age and sex specific cut off points from 2-18 years. Conclusions The proposed cut off points, which are less arbitrary and more internationally based than current alternatives, should help to provide internationally comparable prevalence rates of overweight and obesity in children. PMID:10797032

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

NASA Astrophysics Data System (ADS)

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

2016-08-01

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

Cutting thread at flexible endoscopy.

PubMed

Gong, F; Swain, P; Kadirkamanathan, S; Hepworth, C; Laufer, J; Shelton, J; Mills, T

1996-12-01

New thread-cutting techniques were developed for use at flexible endoscopy. A guillotine was designed to follow and cut thread at the endoscope tip. A new method was developed for guiding suture cutters. Efficacy of Nd: YAG laser cutting of threads was studied. Experimental and clinical experience with thread-cutting methods is presented. A 2.4 mm diameter flexible thread-cutting guillotine was constructed featuring two lateral holes with sharp edges through which sutures to be cut are passed. Standard suture cutters were guided by backloading thread through the cutters extracorporeally. A snare cutter was constructed to retrieve objects sewn to tissue. Efficacy and speed of Nd: YAG laser in cutting twelve different threads were studied. The guillotine cut thread faster (p < 0.05) than standard suture cutters. Backloading thread shortened time taken to cut thread (p < 0.001) compared with free-hand cutting. Nd: YAG laser was ineffective in cutting uncolored threads and slower than mechanical cutters. Results of thread cutting in clinical studies using sewing machine (n = 77 cutting episodes in 21 patients), in-vivo experiments (n = 156), and postsurgical cases (n = 15 over 15 years) are presented. New thread-cutting methods are described and their efficacy demonstrated in experimental and clinical studies.

Body composition-derived BMI cut-offs for overweight and obesity in Indians and Creoles of Mauritius: comparison with Caucasians

PubMed Central

Hunma, S; Ramuth, H; Miles-Chan, J L; Schutz, Y; Montani, J-P; Joonas, N; Dulloo, A G

2016-01-01

Background and Aims: Global estimates of overweight and obesity prevalence are based on the World Health Organisation (WHO) body mass index (BMI) cut-off values of 25 and 30 kg m−2, respectively. To validate these BMI cut-offs for adiposity in the island population of Mauritius, we assessed the relationship between BMI and measured body fat mass in this population according to gender and ethnicity. Methods: In 175 young adult Mauritians (age 20-42 years) belonging to the two main ethnic groups—Indians (South Asian descent) and Creoles (African/Malagasy descent), body weight, height and waist circumference (WC) were measured, total body fat assessed by deuterium oxide (D2O) dilution and trunk (abdominal) fat by segmental bioimpedance analysis. Results: Compared to body fat% predicted from BMI using Caucasian-based equations, body fat% assessed by D2O dilution in Mauritians was higher by 3–5 units in Indian men and women as well as in Creole women, but not in Creole men. This gender-specific ethnic difference in body composition between Indians and Creoles is reflected in their BMI–Fat% relationships, as well as in their WC–Trunk Fat% relationships. Overall, WHO BMI cut-offs of 25 and 30 kg m−2 for overweight and obesity, respectively, seem valid only for Creole men (~24 and 29.5, respectively), but not for Creole women whose BMI cut-offs are 2–4 units lower (21–22 for overweight; 27–28 for obese) nor for Indian men and women whose BMI cut-offs are 3–4 units lower (21–22 for overweight; 26–27 for obese). Conclusions: The use of BMI cut-off points for classifying overweight and obesity need to take into account both ethnicity and gender to avoid gross adiposity status misclassification in this population known to be at high risk for type-2 diabetes and cardiovascular diseases. This is particularly of importance in obesity prevention strategies both in clinical medicine and public health. PMID:27698347

Industrial Technology Modernization Program. Project 44. Modernize Facility Equipment and Processes. Volume 1. Revision 2. Phase 2

DTIC Science & Technology

1988-05-01

OF EXTRUSION HLSGFLN XRSO ICO-F XTUINPPER PATE CUT-OFF EXTRUSION I I 7 TUMBLE S TUMBLE HEAT &SORT TML I IEC SPANK & PIERCE P A SPANK & PIERCEI IF...implementation, the Walnut Cell will utilize 50% of the "As-Is" floor space. 106 -EGREflSEII HSL 59 i.CUT OFF EXTRUSION 2. SPANK & PIERCE I 3.DEGREASE 4...FEMALE MALE CUT-OFF EXTRUSION I HOUSNG HOUNG I SPANK & PIERCE SPANK & PIERCE I CLEAN I DEG SE I I DEGREASEI I C P P E R PL A TE I HEAT TREAT I HEAT

Multimodal far-field acoustic radiation pattern: An approximate equation

NASA Technical Reports Server (NTRS)

Rice, E. J.

1977-01-01

The far-field sound radiation theory for a circular duct was studied for both single mode and multimodal inputs. The investigation was intended to develop a method to determine the acoustic power produced by turbofans as a function of mode cut-off ratio. With reasonable simplifying assumptions the single mode radiation pattern was shown to be reducible to a function of mode cut-off ratio only. With modal cut-off ratio as the dominant variable, multimodal radiation patterns can be reduced to a simple explicit expression. This approximate expression provides excellent agreement with an exact calculation of the sound radiation pattern using equal acoustic power per mode.

Highly pH-responsive sensor based on amplified spontaneous emission coupled to colorimetry.

PubMed

Zhang, Qi; Castro Smirnov, Jose R; Xia, Ruidong; Pedrosa, Jose M; Rodriguez, Isabel; Cabanillas-Gonzalez, Juan; Huang, Wei

2017-04-07

We demonstrated a simple, directly-readable approach for high resolution pH sensing. The method was based on sharp changes in Amplified Spontaneous Emission (ASE) of a Stilbene 420 (ST) laser dye triggered by the pH-dependent absorption of Bromocresol Green (BG). The ASE threshold of BG:ST solution mixtures exhibited a strong dependence on BG absorption, which was drastically changed by the variations of the pH of BG solution. As a result, ASE on-off or off-on was observed with different pH levels achieved by ammonia doping. By changing the concentration of the BG solution and the BG:ST blend ratio, this approach allowed to detect pH changes with a sensitivity down to 0.05 in the 10-11 pH range.

Comparison of the Farr radioimmunoassay, 3 commercial enzyme immunoassays and Crithidia luciliae immunofluorescence test for diagnosis and activity assessment of systemic lupus erythematosus.

PubMed

Launay, David; Schmidt, Jean; Lepers, Sébastien; Mirault, Tristan; Lambert, Marc; Kyndt, Xavier; Reumaux, Dominique; Duhamel, Alain; Hachulla, Eric; Hatron, Pierre-Yves; Prin, Lionel; Dubucquoi, Sylvain

2010-07-04

Among anti-double-strand (ds)DNA antibody assays, Farr radioimmunoassay is decreasingly used because it requires radioactive material and is labor intensive. We evaluated the performance of Farr, three commercial enzyme immunoassays (EIAs) and the Crithidia luciliae immunofluorescence test (CLIFT) in systemic lupus erythematosus (SLE). Anti-dsDNA antibodies were determined in 99 SLE patients, 101 healthy subjects, and 53 patients with autoimmune rheumatic diseases. Farr performed better than the 3 EIAs and CLIFT for the diagnosis of SLE at the manufacturer's cut off and at the cut off set to achieve a specificity of 95%. To achieve a similar level of specificity, some EIAs had a decrease in sensitivity which was dramatic for some tests. Farr was also the best at distinguishing patients with quiescent to mildly active disease from patients with more active disease at the cut off value of 93 IU/ml. Using manufacturer's cut off did not allow distinguishing between patients with quiescent and active SLE. Farr was the best global test to assess the level of anti-dsDNA antibodies for both diagnosis and disease activity evaluation in SLE with adequately determined cut off values. Some EIA had low performances limiting their use in decision-making regarding diagnosis and/or treatment. Copyright 2010 Elsevier B.V. All rights reserved.

Nicotine cut-off value in human hair as a tool to distinguish active from passive smokers: A cross-sectional study in Japanese men.

PubMed

Tsuji, Masayoshi; Kanda, Hideyuki; Hayakawa, Takehito; Mori, Yayoi; Ito, Teruna; Hidaka, Tomoo; Kakamu, Takeyasu; Kumagai, Tomohiro; Osaki, Yoneatsu; Kawazoe, Miki; Sato, Sei; Fukushima, Tetsuhito

2017-07-19

Nicotine concentration in hair is a useful marker of tobacco exposure. Detection of nicotine in the hair of non-smokers indicates passive smoking. Accurate measurement of nicotine among active and passive smokers can help in smoking cessation programs or programs designed to prevent secondhand smoke exposure. To establish, using high-performance liquid chromatography-ultraviolet detection (HPLC/UV), a hair nicotine cut-off value to distinguish active from passive smokers. Hair samples were collected from randomly chosen Japanese men (n= 192) between 2009 and 2011. Nicotine and cotinine levels in hair were measured using HPLC/UV with column-switching. T-tests and chi-square tests were performed to compare active and passive smokers, while receiver operating characteristic curves were used to evaluate the effectiveness of the cut-off value. There were 69 active smokers and 123 passive smokers. The nicotine and cotinine concentrations in hair were significantly higher in active than in passive smokers (p< 0.01). The area under the curve for nicotine was 0.92. A hair nicotine cut-off value of 5.68 ng/mg, with a sensitivity of 94.2% and specificity of 87.0%, was identified as the optimal cut-off value for separating active from passive smokers. Nicotine and cotinine concentrations in hair clearly distinguished active from passive smokers.

A hybrid chip based on aerodynamics and electrostatics for the size-dependent classification of ultrafine and nano particles.

PubMed

Kim, Yong-Ho; Park, Dongho; Hwang, Jungho; Kim, Yong-Jun

2009-09-21

Conventional virtual impactors experience a large pressure drop when they classify particles according to size, in particular ultrafine particles smaller than 100 nm in diameter. Therefore, most virtual impactors have been used to classify particles larger than 100 nm. Their cut-off diameters are also fixed by the geometry of their flow channels. In the proposed virtual impactor, particles smaller than 100 nm are accelerated by applying DC potentials to an integrated electrode pair. By the electrical acceleration, the large pressure drop could be significantly decreased and new cut-off diameters smaller than 100 nm could be successfully added. The geometric cut-off diameter (GCD) of the proposed virtual impactor was designed to be 1.0 microm. Performances including the GCD and wall loss were examined by classifying dioctyl sebacate of 100 to 600 nm in size and carbon particles of 0.6 to 10 microm in size. The GCD was measured to be 0.95 microm, and the wall loss was highest at 1.1 microm. To add new cut-off diameters, monodisperse NaCl particles ranging from 15 to 70 nm were classified using the proposed virtual impactor with applying a DC potential of 0.25 to 3.0 kV. In this range of the potential, the new cut-off diameters ranging from 15 to 35 nm was added.

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.

Traumatic brain injury: It is all about definition.

PubMed

Savitsky, B; Givon, A; Rozenfeld, M; Radomislensky, I; Peleg, K

2016-01-01

TBI may be defined by different methods. Some may be most useful for immediate clinical purposes, however less optimal for epidemiologic research. Other methods, such as the Abbreviated Injury Score (AIS), may prove more beneficial for this task, if the cut-off-points for their categories are defined correctly. To reveal the optimal cut-off-points for AIS in definition of severity of TBI in order to ensure uniformity between future studies of TBI. Mortality of patients with TBI AIS 3, 4 was 1.9% and 2.9% respectively, comparing with 31.1% among TBI AIS 5+. Predictive discrimination ability of the model with cut-off-points of 5+ for TBI AIS (in comparison with other cut-off-points) was better. Patients with missing Glasgow Coma Scale (GCS) in the ED had an in-hospital mortality rate of 11.5%. In this group, 25% had critical TBI according to AIS. Normal GCS didn't indicate an absence of head injury, as, among patients with GCS 15 in the ED, 26% had serious/critical TBI injury. Moreover, 7% of patients with multiple injury and GCS 3-8 had another reason than head injury for unconsciousness. This study recommends the adoption of an AIS cut-off ≥ 5 as a valid definition of severe TBI in epidemiological studies, while AIS 3-4 may be defined as 'moderate' TBI and AIS 1-2 as 'mild'.

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

PubMed Central

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

2016-01-01

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

Computed tomography coronary stent imaging with iterative reconstruction: a trade-off study between medium kernel and sharp kernel.

PubMed

Zhou, Qijing; Jiang, Biao; Dong, Fei; Huang, Peiyu; Liu, Hongtao; Zhang, Minming

2014-01-01

To evaluate the improvement of iterative reconstruction in image space (IRIS) technique in computed tomographic (CT) coronary stent imaging with sharp kernel, and to make a trade-off analysis. Fifty-six patients with 105 stents were examined by 128-slice dual-source CT coronary angiography (CTCA). Images were reconstructed using standard filtered back projection (FBP) and IRIS with both medium kernel and sharp kernel applied. Image noise and the stent diameter were investigated. Image noise was measured both in background vessel and in-stent lumen as objective image evaluation. Image noise score and stent score were performed as subjective image evaluation. The CTCA images reconstructed with IRIS were associated with significant noise reduction compared to that of CTCA images reconstructed using FBP technique in both of background vessel and in-stent lumen (the background noise decreased by approximately 25.4% ± 8.2% in medium kernel (P

Validity of the Enzyme-linked Immunoelectrotransfer Blot (EITB) for naturally acquired porcine cysticercosis

PubMed Central

Jayashi, César M.; Gonzalez, Armando E.; Neyra, Ricardo Castillo; Rodríguez, Silvia; García, Hector H.; Lightowlers, Marshall W.

2017-01-01

The Enzyme-linked Immunoelectrotransfer Blot (EITB) has been used widely as a screening test for Taenia solium cysticercosis in swine. However, the relation between seropositivity and infection in pig populations from endemic areas has not been well defined. The aim of this study is to relate EITB seropositivity with infection and infection burden, analyse the trade-off between sensitivity and specificity with various cut-off points for the EITB assay, and finally describe the serology changes in a cohort of rural pigs raised under natural conditions. A group of 107 pigs that were used as controls during a vaccination field trial in Peru was our study population. The prevalence of porcine cysticercosis determined by necropsy examination was 16.82% (18/107) in these animals. Using EITB reactivity to ≥ 1 band as a cut-off point for the assay, the sensitivity was 88.89% (65.29-98.62, 95% CI) and the specificity was 48.31% (37.59-59.16, 95% CI). Comparing other cut-off points, involving up to as many as 7 reactive bands, a reactivity of ≥ 3 bands provided the best trade-offs in sensitivity and specificity. Using this cut-off point for the assay, the sensitivity was 77.77% (52.36 - 93.59, 95% CI) and the specificity was 76.40% (66.22 - 84.76, 95% CI). A significant association was found between cyst counts over 100 cysts and reactivity to ≥ 3 bands in the EITB assay (Fisher’s exact test, p<0.05). The results of this study suggest that the use of the EITB assay to study porcine cysticercosis may require setting different cut-offs under field and experimental conditions, and depending upon the objective of the screening process. PMID:24183647

OARSI-OMERACT definition of relevant radiological progression in hip/knee osteoarthritis.

PubMed

Ornetti, P; Brandt, K; Hellio-Le Graverand, M-P; Hochberg, M; Hunter, D J; Kloppenburg, M; Lane, N; Maillefert, J-F; Mazzuca, S A; Spector, T; Utard-Wlerick, G; Vignon, E; Dougados, M

2009-07-01

Joint space width (JSW) evaluated in millimeters on plain X-rays is the currently optimal recognized technique to evaluate osteoarthritis (OA) structural progression. Data obtained can be presented at the group level (e.g., mean+/-standard deviation of the changes). Such presentation makes difficult the interpretation of the clinical relevance of the reported results. Therefore, a presentation at the individual level (e.g., % progressors) seems more attractive but requires to determining a cut-off. Several methodologies have been proposed to define cut-offs in JSW: arbitrary chosen cut-off, cut-off based on the validity to predict a relevant end-point such as the requirement of total articular replacement or cut-off based on the measurement error such as smallest detectable difference (SDD). The objective of this OARSI-OMERACT initiative was to define a cut-off evaluated in millimeters on plain X-rays above which a change in JSW could be considered as relevant in patients with hip and knee OA. The first step consisted in a systematic literature research performed using Medline database up to July 2007 to obtain all manuscripts published between 1990 and 2007 reporting a cut-off value in JSW evaluated in millimeters at either the knee or hip level. The second step consisted in a consensus based on the best knowledge of the 11 experts with the support of the available evidence. Among the 506 articles selected by the search, 47 articles reported cut-off of JSW in millimeters. There was a broad heterogeneity in cut-off values, whatever the methodologies or the OA localization considered (e.g., from 0.12 to 0.84 mm and from 0.22 to 0.78 mm for Knee (seven studies) and hip (seven studies), respectively when considering the data obtained based on the reliability). Based on the data extracted in the literature, the expert committee proposed a definition of relevant change in JSW based on plain X-rays, on an absolute change of JSW in millimeters and on the measurement error e.g., calculation of the SDD using the Bland and Altman technique. The results of the analysis of JSW should be expressed in terms of a dichotomous variable (e.g., progressors yes/no): a patient with a change in JSW during the study over such SDD will fulfill the definition of "progressor". Moreover, the pilot study aimed at evaluating the measurement error should be designed to reflect the different characteristics of the primary study in which the analysis of the radiological findings will be based on (patient's characteristics, centers characteristics, readers). This initiative based on both an Evidence Based Medicine (Systematic Literature Research) and Expert Opinion approach resulted in a proposal of definition of relevant radiological progression in OA to be used as end-point in clinical trials and also recommendations on the conduct of the reliability study allowing such definition.

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

Small arms ammunition

DOEpatents

Huerta, Joseph

1992-01-01

An elongate projectile for small arms use has a single unitary mass with a hollow nose cavity defined by a sharp rigid cutting edge adapted to make initial contact with the target surface and cut therethrough. The projectile then enters the target mass in an unstable flight mode. The projectile base is substantially solid such that the nose cavity, while relatively deep, does not extend entirely through the base and the projectile center of gravity is aft of its geometric center.

Determination of Passing Scores on Certification Examinations: An Unresolved Issue.

ERIC Educational Resources Information Center

Karni, Karen R.; Lofsness, Karen G.

1985-01-01

This study examined the results obtained from certification applicants and practitioners on a national certification examination for clinical laboratory scientists (medical technologists), using a modified Angoff procedure to establish the cut-off score. The major question of the investigation concerned whether the cut-off score was appropriate.…

Design and optimization of cascaded DCG based holographic elements for spectrum-splitting PV systems

NASA Astrophysics Data System (ADS)

Wu, Yuechen; Chrysler, Benjamin; Pelaez, Silvana Ayala; Kostuk, Raymond K.

2017-09-01

In this work, the technique of designing and optimizing broadband volume transmission holograms using dichromate gelatin (DCG) is summarized for solar spectrum-splitting application. Spectrum splitting photovoltaic system uses a series of single bandgap PV cells that have different spectral conversion efficiency properties to more fully utilize the solar spectrum. In such a system, one or more high performance optical filters are usually required to split the solar spectrum and efficiently send them to the corresponding PV cells. An ideal spectral filter should have a rectangular shape with sharp transition wavelengths. DCG is a near ideal holographic material for solar applications as it can achieve high refractive index modulation, low absorption and scattering properties and long-term stability to solar exposure after sealing. In this research, a methodology of designing and modeling a transmission DCG hologram using coupled wave analysis for different PV bandgap combinations is described. To achieve a broad diffraction bandwidth and sharp cut-off wavelength, a cascaded structure of multiple thick holograms is described. A search algorithm is also developed to optimize both single and two-layer cascaded holographic spectrum splitters for the best bandgap combinations of two- and three-junction SSPV systems illuminated under the AM1.5 solar spectrum. The power conversion efficiencies of the optimized systems under the AM1.5 solar spectrum are then calculated using the detailed balance method, and shows an improvement compared with tandem structure.

Sperm navigation along helical paths in 3D chemoattractant landscapes

PubMed Central

Jikeli, Jan F.; Alvarez, Luis; Friedrich, Benjamin M.; Wilson, Laurence G.; Pascal, René; Colin, Remy; Pichlo, Magdalena; Rennhack, Andreas; Brenker, Christoph; Kaupp, U. Benjamin

2015-01-01

Sperm require a sense of direction to locate the egg for fertilization. They follow gradients of chemical and physical cues provided by the egg or the oviduct. However, the principles underlying three-dimensional (3D) navigation in chemical landscapes are unknown. Here using holographic microscopy and optochemical techniques, we track sea urchin sperm navigating in 3D chemoattractant gradients. Sperm sense gradients on two timescales, which produces two different steering responses. A periodic component, resulting from the helical swimming, gradually aligns the helix towards the gradient. When incremental path corrections fail and sperm get off course, a sharp turning manoeuvre puts sperm back on track. Turning results from an ‘off' Ca2+ response signifying a chemoattractant stimulation decrease and, thereby, a drop in cyclic GMP concentration and membrane voltage. These findings highlight the computational sophistication by which sperm sample gradients for deterministic klinotaxis. We provide a conceptual and technical framework for studying microswimmers in 3D chemical landscapes. PMID:26278469

Sperm navigation along helical paths in 3D chemoattractant landscapes.

PubMed

Jikeli, Jan F; Alvarez, Luis; Friedrich, Benjamin M; Wilson, Laurence G; Pascal, René; Colin, Remy; Pichlo, Magdalena; Rennhack, Andreas; Brenker, Christoph; Kaupp, U Benjamin

2015-08-17

Sperm require a sense of direction to locate the egg for fertilization. They follow gradients of chemical and physical cues provided by the egg or the oviduct. However, the principles underlying three-dimensional (3D) navigation in chemical landscapes are unknown. Here using holographic microscopy and optochemical techniques, we track sea urchin sperm navigating in 3D chemoattractant gradients. Sperm sense gradients on two timescales, which produces two different steering responses. A periodic component, resulting from the helical swimming, gradually aligns the helix towards the gradient. When incremental path corrections fail and sperm get off course, a sharp turning manoeuvre puts sperm back on track. Turning results from an 'off' Ca(2+) response signifying a chemoattractant stimulation decrease and, thereby, a drop in cyclic GMP concentration and membrane voltage. These findings highlight the computational sophistication by which sperm sample gradients for deterministic klinotaxis. We provide a conceptual and technical framework for studying microswimmers in 3D chemical landscapes.

A comparison of bone-related biomarkers and CA27.29 to assess response to treatment of osseous metastatic breast cancer.

PubMed

Lüfter, D; Richter, A; Günther, S; Flath, B; Akrivakis, C; Geppert, R; Wernecke, K D; Possinger, K

2000-01-01

The assessment of bone metastases by clinical examination or imaging techniques is still considered unreliable. We compared a specific marker of bone resorption, urinary deoxypyridinoline (DPD)-crosslinks, with serum calcium (Ca), alkaline phosphatase (AP) and CA27.29, to evaluate the status of bone metastases in patients with breast cancer. Second morning voided urine was collected from 2 groups of patient (pts), those without evidence of disease (n = 118), and those with bone metastases (n = 85) under specific therapy plus pamidronate. DPD and CA27.29 were measured on the automated ACS180 system (Bayer Diagnostics, Tarrytown, NY, USA). Receiver operating characteristics (ROC) curves were established for each of the 4 biomarkers to determine whether they could distinguish the 2 subsets of pts with clinically sufficient validity, and to establish the corresponding cut-off values. Neither Ca nor AP was useful in discriminating the 2 subgroups. At a DPD cut-off of 13 nmol/mmol, we found a specificity of 69% and a sensitivity of 53% for diagnosing bone metastases. Best results, however, were seen for CA27.29. A cut-off value of 30 U/ml resulted in a specificity of 62% and a sensitivity of 81%. CA27.29 was the best parameter for the discrimination of stage IV breast cancer with bone metastases. The primary advantage of DPD lies in the monitoring of bone metastases under specific therapy.

Soro West: A non-seismically defined, fault cut-off prospect in the Papuan Fold and Thrust Belt, Papua New Guinea

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

Robinson, W.F.; Swift, C.M. Jr.

Soro West is a fault cut-off prospect located in the frontal portion of the Papuan Fold and Thrust Belt. Prospective Toro and Imburu sandstones are interpreted to be in the hanging wall of the Soro Thrust. Truncation against the thrust, both updip and through lateral ramps, provides the trapping mechanism. The Soro West Prospect was defined using geological, geochemical, remote sensing, and geophysical data. The definition and location of the trap is a primary risk and work was focused on this aspect. Surface geological data (lithology, strikes, and dips) topography and synthetic aperture radar imagery were incorporated into the evaluation.more » Statistical curvature analysis techniques helped define the shape of the structure and the locations of the lateral ramps. Strontium isotope analyses of Darai Limestone surface samples refined erosional levels using a locally-derived reference curve. Severe karst precludes the acquisition of coherent surface seismic data, so the primary geophysical tool used was magnetotellurics (MT). A detailed, pre-survey feasibility study defined expected responses from alternative structural models. The MT data demonstrated that the limestone at surface is underlain by thick conductive clastics and not another Darai Limestone sheet. The data also constrained the range of fault cut-off positions significantly. Multiple, three-dimensionally consistent, restorable alternative structural models were created using results from all analyses. These led to a positive assessment of the prospect and an exploratory test is to be drilled in 1996.« less

Category 3: Sound Generation by Interacting with a Gust

NASA Technical Reports Server (NTRS)

Scott, James R.

2004-01-01

The cascade-gust interaction problem is solved employing a time-domain approach. The purpose of this problem is to test the ability of a CFD/CAA code to accurately predict the unsteady aerodynamic and aeroacoustic response of a single airfoil to a two-dimensional, periodic vortical gust.Nonlinear time dependent Euler equations are solved using higher order spatial differencing and time marching techniques. The solutions indicate the generation and propagation of expected mode orders for the given configuration and flow conditions. The blade passing frequency (BPF) is cut off for this cascade while higher harmonic, 2BPF and 3BPF, modes are cut on.

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.

76 FR 39775 - Drawbridge Operation Regulation; Lafourche Bayou, Lafourche, LA

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-07

... deviation from the regulation governing the operation of the Cut Off vertical lift span bridge across the Lafourche Bayou, mile 36.3, at Cut Off, Lafourche Parish, LA. The deviation is necessary to perform major... INFORMATION CONTACT: If you have questions on this rule, call or e-mail Jim Wetherington, Bridge...

High harmonic generation at the tunneling ionization of atoms by intense laser radiation near the classical cut-off

NASA Astrophysics Data System (ADS)

Gets, A. V.; Krainov, V. P.

2018-01-01

The yield of spontaneous photons at the tunneling ionization of atoms by intense low-frequency laser radiation near the classical cut-off is estimated analytically by using the three-step model. The Bell-shaped dependence in the universal photon spectrum is explained qualitatively.

[Uniform analyzes of drugs in urine needed for rule of law].

PubMed

Hansson, Therese; Helander, Anders; Beck, Olof; Elmgren, Anders; Kugelberg, Fredrik; Kronstrand, Robert

2015-09-22

Drugs of abuse testing is used in various areas of society for detection and follow-up of drug use. In routine laboratory drug testing, immunoassays are employed for initial screening of specimens to indicate the presence of drugs. To confirm a positive screening test, a secondary analysis by mass spectrometry is performed. The "cut-off" is the pre-defined concentration threshold of a drug or drug metabolite above which the sample is considered positive. A reading below this level implies a negative test result. Swedish drug testing laboratories currently employ varying cut-offs to distinguish between a positive and a negative test result. Because a positive drug test may have serious legal consequences to the individual, it is of importance that testing is performed and judged equally, regardless of where it is performed. A national harmonization of cut-offs is therefore warranted. Based on data from four major Swedish drug testing laboratories, and considering the recommendations in international guidelines, a proposal for national harmonization of urine cut-offs for the most common set of drugs of abuse is presented.

HOMA1-IR and HOMA2-IR indexes in identifying insulin resistance and metabolic syndrome: Brazilian Metabolic Syndrome Study (BRAMS).

PubMed

Geloneze, Bruno; Vasques, Ana Carolina Junqueira; Stabe, Christiane França Camargo; Pareja, José Carlos; Rosado, Lina Enriqueta Frandsen Paez de Lima; Queiroz, Elaine Cristina de; Tambascia, Marcos Antonio

2009-03-01

To investigate cut-off values for HOMA1-IR and HOMA2-IR to identify insulin resistance (IR) and metabolic syndrome (MS), and to assess the association of the indexes with components of the MS. Nondiabetic subjects from the Brazilian Metabolic Syndrome Study were studied (n = 1,203, 18 to 78 years). The cut-off values for IR were determined from the 90th percentile in the healthy group (n = 297) and, for MS, a ROC curve was generated for the total sample. In the healthy group, HOMA-IR indexes were associated with central obesity, triglycerides and total cholesterol (p < 0.001). The cut-off values for IR were: HOMA1-IR > 2.7 and HOMA2-IR > 1.8; and, for MS were: HOMA1-IR > 2.3 (sensitivity: 76.8%; specificity: 66.7%) and HOMA2-IR > 1.4 (sensitivity: 79.2%; specificity: 61.2%). The cut-off values identified for HOMA1-IR and HOMA2-IR indexes have a clinical and epidemiological application for identifying IR and MS in Westernized admixtured multi-ethnic populations.

Piezosurgery to perform hyoid bone osteotomies in thyroglossal duct cyst surgery.

PubMed

Salgarelli, Attilio Carlo; Robiony, Massimo; Consolo, Ugo; Collini, Marco; Bellini, Pierantonio

2011-11-01

Ultrasonic bone-cutting surgery has been introduced as a feasible alternative to the conventional sharp instruments used in craniomaxillofacial surgery because of its precision and safety. The device used is unique in that the cutting action occurs when the tool is used on mineralized tissues and stops on soft tissues. This work describes the use of piezosurgery for hyoid bone resection in thyroglossal duct cyst surgery, briefly reviews the literature on the surgical technique, and reports our experience with 12 cases.

Protein C: a potential biomarker in severe sepsis and a possible tool for monitoring treatment with drotrecogin alfa (activated)

PubMed Central

Shorr, Andrew F; Nelson, David R; Wyncoll, Duncan LA; Reinhart, Konrad; Brunkhorst, Frank; Vail, George Matthew; Janes, Jonathan

2008-01-01

Introduction Drotrecogin alfa (activated; DrotAA) treatment, a 96-hour infusion, reduces 28-day mortality in severe sepsis to approximately 25%. The question remains whether a longer infusion or higher dose could increase rate of survival. The goal of this study was to identify a dependable, sensitive measure with which to monitor disease progression and response in patients during DrotAA treatment. Methods Data on severe sepsis patients included in PROWESS (placebo-controlled, double-blind, randomized study of 850 DrotAA and 840 placebo individuals) and ENHANCE (single-arm, open-label study of 2,375 DrotAA patients) studies were analyzed. In these studies, DrotAA (24 μg/kg per hour) or placebo was infused for 96 hours and patients were followed for 28 days. Data on six laboratory measures and five organ dysfunctions were systematically analyzed to identify a potential surrogate end-point for monitoring DrotAA therapy and predicting 28-day mortality at the end of therapy. To allow comparison across variables, sensitivity and specificity analyses identified cut-off values for preferred outcome, and relative risks for being above or below cut-offs were calculated, as was the 'proportion of treatment effect explained' (PTEE) to identify biomarkers that contribute to benefit from DrotAA. Results Protein C was the only variable that correlated with outcome across all analyses. Using placebo data, a baseline protein C under 40% was established as a useful predictor of outcome (odds ratio 2.12). Similar odds ratios were associated with cut-off values of other biomarkers, but the treatment benefit associated with DrotAA was significantly greater below the cut-off than above the cut-off only for protein C (relative risk for 28-day mortality 0.66 versus 0.88; P = 0.04). Protein C was the only end-of-infusion biomarker that potentially explained at least 50% of the benefit from DrotAA (PTEE 57.2%). The PTEE was 41% for cardiovascular Sequential Organ Failure Assessment score and for d-dimer. At the end of infusion (day 4), protein C categories (≤40%, 41% to 80%, and > 80%) remained significantly related to mortality, regardless of treatment assignment. Conclusion Based on systematic analyses of 11 variables measured in severe sepsis clinical trials, protein C was the only variable consistently correlated with both DrotAA treatment effect and survival. Further study is needed to determine whether longer infusions or higher doses of DrotAA would achieve the goal of normalizing protein C in more patients with severe sepsis. PMID:18394162

Phonon cross-plane transport and thermal boundary resistance: effect of heat source size and thermal boundary resistance on phonon characteristics

NASA Astrophysics Data System (ADS)

Ali, H.; Yilbas, B. S.

2016-09-01

Phonon cross-plane transport across silicon and diamond thin films pair is considered, and thermal boundary resistance across the films pair interface is examined incorporating the cut-off mismatch and diffusive mismatch models. In the cut-off mismatch model, phonon frequency mismatch for each acoustic branch is incorporated across the interface of the silicon and diamond films pair in line with the dispersion relations of both films. The frequency-dependent and transient solution of the Boltzmann transport equation is presented, and the equilibrium phonon intensity ratios at the silicon and diamond film edges are predicted across the interface for each phonon acoustic branch. Temperature disturbance across the edges of the films pair is incorporated to assess the phonon transport characteristics due to cut-off and diffusive mismatch models across the interface. The effect of heat source size, which is allocated at high-temperature (301 K) edge of the silicon film, on the phonon transport characteristics at the films pair interface is also investigated. It is found that cut-off mismatch model predicts higher values of the thermal boundary resistance across the films pair interface as compared to that of the diffusive mismatch model. The ratio of equilibrium phonon intensity due to the cut-off mismatch over the diffusive mismatch models remains >1 at the silicon edge, while it becomes <1 at the diamond edge for all acoustic branches.

Diagnostic accuracy of metronome-paced tachypnea to detect dynamic hyperinflation.

PubMed

Lahaije, Anke J M C; Willems, Laura M; van Hees, Hieronymus W H; Dekhuijzen, P N Richard; van Helvoort, Hanneke A C; Heijdra, Yvonne F

2013-01-01

This prospective study was carried out to investigate if metronome-paced tachypnea (MPT) can serve as an accurate diagnostic tool to identify patients with chronic obstructive pulmonary disease (COPD) who are susceptible to develop dynamic hyperinflation during exercise. Commonly, this is assessed by measuring change in inspiratory capacity (IC) during cardiopulmonary exercise testing (CPET), which, however, is complex and laborious. Fifty-three patients with COPD (FEV(1) 58 ± 22%pred) and 20 age-matched healthy subjects were characterized by lung function testing and performed CPET (reference standard) and MPT. The repeatability coefficient of IC (10·2%) was used as cut-off to classify subjects as hyperinflators during CPET. Subsequently, dynamic hyperinflation was measured after MPT. With receiver operating characteristic analysis, the optimal cut-off for MPT-induced dynamic hyperinflation was determined and sensitivity and specificity of MPT to identify hyperinflators were evaluated. With 10·2% decrease in IC as cut-off for CPET-induced dynamic hyperinflation, the optimal cut-off for MPT was 11·1% decrease in IC. Using these cut-offs, MPT had a sensitivity of 85% and specificity of 85% to identify the subjects who hyperinflated during CPET. The MPT test shows good overall accuracy to identify subjects who are susceptible to develop dynamic hyperinflation during CPET. Before considering the use of MPT as a screening tool for dynamic hyperinflation in COPD, sensitivity and specificity need further evaluation. © 2012 The Authors Clinical Physiology and Functional Imaging © 2012 Scandinavian Society of Clinical Physiology and Nuclear Medicine.

Waist circumference cut-off in relation to body mass index and percentage of body fat in adult women from Merida, Mexico.

PubMed

Datta Banik, Sudip; Dickinson, Federico

2015-01-01

Waist circumference (WC) as an index of central obesity is related to body mass index (BMI) and percent body fat (PBF). Waist circumference data were analyzed to identify a WC cut-off for adult women with respect to BMI-based obesity (≥ 30 kg/m²) and PBF. The sample was 138 women aged 22 to 41 years with Maya ancestry (based on surnames) in Merida, Yucatan, measured during 2011 - 2013. Anthropometric parameters included height, body weight (BW), and BMI. The PBF was estimated by bioelectrical impedance. Estimated cut-offs per centimeter WC (80 - 99 cm) were predicted by BMI for obesity (≥ 30 kg m⁻²; binomial: Yes = 1, No = 0) and PBF (continuous variable) using binary logistic regression analyses. Mean age was 32 years, mean BMI was 29 kg m(-2) and mean WC was 89 cm. The sample exhibited high PBF (44 %), and high rates of overweight (44%) and obesity (40%). The threshold WC (≥ 93 cm) had high sensitivity (80%), specificity (82%), Youden Index value (0.62), and correct classification rate (82%). The area under the receiver operating characteristic curve was 88 %. The WC ≥ 93 cm cut-off had corresponding values for mean BMI (34 kg m⁻²) and PBF (47%). The optimal WC cut-off at 93 cm significantly identified central obesity for BMI ≥ 30 kg m⁻² and PBF for this sample.

Evaluation of the Red Blood Cell Advanced Software Application on the CellaVision DM96.

PubMed

Criel, M; Godefroid, M; Deckers, B; Devos, H; Cauwelier, B; Emmerechts, J

2016-08-01

The CellaVision Advanced Red Blood Cell (RBC) Software Application is a new software for advanced morphological analysis of RBCs on a digital microscopy system. Upon automated precharacterization into 21 categories, the software offers the possibility of reclassification of RBCs by the operator. We aimed to define the optimal cut-off to detect morphological RBC abnormalities and to evaluate the precharacterization performance of this software. Thirty-eight blood samples of healthy donors and sixty-eight samples of hospitalized patients were analyzed. Different methodologies to define a cut-off between negativity and positivity were used. Sensitivity and specificity were calculated according to these different cut-offs using the manual microscopic method as the gold standard. Imprecision was assessed by measuring analytical within-run and between-run variability and by measuring between-observer variability. By optimizing the cut-off between negativity and positivity, sensitivities exceeded 80% for 'critical' RBC categories (target cells, tear drop cells, spherocytes, sickle cells, and parasites), while specificities exceeded 80% for the other RBC morphological categories. Results of within-run, between-run, and between-observer variabilities were all clinically acceptable. The CellaVision Advanced RBC Software Application is an easy-to-use software that helps to detect most RBC morphological abnormalities in a sensitive and specific way without increasing work load, provided the proper cut-offs are chosen. However, evaluation of the images by an experienced observer remains necessary. © 2016 John Wiley & Sons Ltd.

Diagnostic value of sputum adenosine deaminase (ADA) level in pulmonary tuberculosis.

PubMed

Binesh, Fariba; Jalali, Hadi; Zare, Mohammad Reza; Behravan, Farhad; Tafti, Arefeh Dehghani; Behnaz, Fatemah; Tabatabaee, Mohammad; Shahcheraghi, Seyed Hossein

2016-06-01

Tuberculosis is still a considerable health problem in many countries. Rapid diagnosis of this disease is important, and adenosine deaminase (ADA) has been used as a diagnostic test. The aim of this study was to assess the diagnostic value of ADA in the sputum of patients with pulmonary tuberculosis. The current study included 40 patients with pulmonary tuberculosis (culture positive, smear ±) and 42 patients with non tuberculosis pulmonary diseases (culture negative). ADA was measured on all of the samples. The median value of ADA in non-tuberculosis patients was 2.94 (4.2) U/L and 4.01 (6.54) U/L in tuberculosis patients, but this difference was not statistically significant (p=0.100). The cut-off point of 3.1 U/L had a sensitivity of 61% and a specificity of 53%, the cut-off point of 2.81 U/L had a sensitivity of 64% and a specificity of 50% and the cut-off point of 2.78 U/L had a sensitivity of 65% and a specificity of 48%. The positive predictive values for cut-off points of 3.1, 2.81 and 2.78 U/L were 55.7%, 57.44% and 69.23%, respectively. The negative predictive values for the abovementioned cut-off points were 56.75%, 57.14% and 55.88%, respectively. Our results showed that sputum ADA test is neither specific nor sensitive. Because of its low sensitivity and specificity, determination of sputum ADA for the diagnosis of pulmonary tuberculosis is not recommended.

Establishing IMMULITE® 2000 cut-off values for serum allergen-specific immunoglobulin and exploring their relationship to exhaled nitric oxide

PubMed Central

Evjenth, Bjørg; Hansen, Tonje E; Brekke, Ole-Lars; Holt, Jan

2014-01-01

Aim Paediatric cut-off values for serum allergen-specific IgE (sIgE) using the Siemens IMMULITE® 2000 system to diagnose allergic rhinoconjunctivitis have not been established. We aimed to determine cut-off levels for sIgE for 10 common inhalant allergens and to study the relationship between sIgE, total IgE and fractional exhaled nitric oxide (FENO). Methods We enrolled 243 schoolchildren, including 164 with allergic rhinoconjunctivitis. Parental interviews, skin prick tests, sIgE, total IgE, FENO measurements, spirometry and exercise tests were performed. Results Cut-off values with the best combined sensitivity and specificity were above the detection limit of the assay for seven of the ten allergens (0.23–1.1 kU/L). The overall accuracy of the IMMULITE® in detecting allergic rhinoconjunctivitis was good. sIgE was superior to total IgE and FENO in predicting allergic rhinoconjunctivitis to timothy, birch, mugwort, cat, dog and house dust mite. FENO was elevated in children with allergic rhinoconjunctivitis, irrespective of asthma. Conclusion Cut-off values for sIgE were dependent on the allergic phenotype and were above the IMMULITE® detection limit for seven of ten inhalant allergens. Consequently, using the detection limit for sIgE as the decision point would result in over-diagnosing allergic rhinoconjunctivitis. When measuring elevated FENO in children, allergic rhinoconjunctivitis should be suspected. PMID:24628428

[Validation of cut points of skeletal muscle mass index for identifying sarcopenia in Chilean older people].

PubMed

Lera, Lydia; Ángel, Bárbara; Sánchez, Hugo; Picrin, Yaisy; Hormazabal, María José; Quiero, Andrea; Albala, Cecilia

2014-09-28

To estimate and validate cut-off points of skeletal muscle mass index (SMI) in Chilean population, for using in an algorithm for a diagnosis of sarcopenia developed by European Working Group on Sarcopenia in Older People (EWGSOP). Secondary analysis of Cross-sectional data in 440 Chilean older subjects to estimate cut-off points of SMI determined by DEXA and predicted by an anthropometric equation. Afterward a cross-sectional validation in a sample of 164 older people was performed. Anthropometric measures, self-reported health status, physical performance tests and DEXA were carried out. Decreased muscle strength was defined as handgrip strength <15 kg in women and <27 kg in male. Cut-off points of SMI were defined as values under 20th percentile for DEXA measures and estimated through ROC curves for the anthropometric model. Biological validity of the algorithm was tested by contrasting the diagnosis with physical performance tests and functionality. Cut-off points of SMI obtained by DEXA were 7.19 kg/m² in men and 5.77 kg/m² in women and 7.45 kg/ m² and 5.88 kg/m², respectively for the predicted by the model. Sensibility and specificity of estimations vs DEXA measures were 80% and 92% in men and 77% and 89% in women. We obtained cut-off points of SMI for DEXA and for a prediction equation for older adults Chilean, with good sensibility and specificity for the measurement by DEXA. It will allow to apply the EWGSOP algorithm to the early diagnosis of sarcopenia and to develop programs for prevention, delay or reversion this syndrome. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Diagnostic Value of Isolated Mentalis Versus Mentalis Plus Upper Limb Electromyography in Idiopathic REM Sleep Behavior Disorder Patients Eventually Developing a Neurodegenerative Syndrome.

PubMed

Fernández-Arcos, Ana; Iranzo, Alex; Serradell, Mónica; Gaig, Carles; Guaita, Marc; Salamero, Manel; Santamaria, Joan

2017-04-01

To compare two electromyographic (EMG) montages, isolated mentalis muscle versus mentalis in combination with upper limb muscles in the baseline diagnostic video-polysomnography (V-PSG) of patients with idiopathic REM sleep behaviors disorder (IRBD) who eventually were diagnosed with a clinically defined neurodegenerative syndrome. Forty-nine patients were included. At baseline, diagnosis of RBD was based on a typical history of dream enactment behaviors plus V-PSG showing REM sleep with qualitative increased EMG activity and/or abnormal behaviors. Quantification of EMG activity (tonic, phasic and "any") in the mentalis and upper limb muscles (biceps brachii-BB, n = 36 or flexor digitorum superficialis-FDS, n = 13) was performed manually and compared with published cut-offs. Nine (18.4%) patients had either tonic or phasic EMG below the cut-offs for the isolated mentalis and four of them (11.1 %) also had values below the cut-off for the mentalis combined with BB. All 13 patients recorded with the FDS were above the mentalis combined with FDS cut-off. For the diagnosis of IRBD, sensitivity of isolated mentalis was 81.6% and of the combination of mentalis plus upper limb muscles was 91.8% (p = .03). Audiovisual analysis showed abnormal REM sleep behaviors in all nine patients with values below the cut-offs. Quantification of EMG activity in the upper limbs combined with the mentalis increases the ability to diagnose IRBD when compared with the isolated measurement of the mentalis. Detection of typical abnormal behaviors during REM sleep with audiovisual analysis is essential for the diagnosis of IRBD in patients with EMG values below the published cut-offs. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Diagnostic accuracy of HbA1c in diabetes between Eastern and Western.

PubMed

Yan, Shuang; Liu, Siying; Zhao, Yashuang; Zhang, Wencui; Sun, Xiaohui; Li, Jianing; Jiang, Fuli; Ju, Jiaming; Lang, Ning; Zhang, Yingqi; Zhou, Weiyu; Li, Qiang

2013-07-01

In 2010, the American Diabetes Association recommended the use of HbA1c as a diagnostic criterion for diabetes. However, HbA1c is not an accepted diagnostic tool for diabetes in Eastern Asia, because genetic differences compromise the standardization of the diagnostic cut-off point. This study evaluated differences in the use of HbA1c for diagnosing diabetes in Eastern and Western populations and investigated whether HbA1c cut-off point of ≥ 6.5% is diagnostic of diabetes in patients from Eastern Asia. Literature was obtained from MEDLINE, EMBASE and Cochrane databases. The pooled sensitivity and specificity of each HbA1c cut-off point were extracted and compared between Western and Eastern populations. Differences in the cut-off point for diagnosing diabetes in each region were compared by examining differences in the area under summary receiver operating characteristic (SROC) curves. Twelve publications from Eastern countries (n = 59,735) and 13 from Western countries (n = 22,954) were included in the analysis. Areas under SROC curves in the Eastern and Western groups were 0.9331 and 0.9120, respectively (P = 0.98). The cut-off point of the highest Youden index was 6.0%. At the HbA1c cut-off point of 6.5%, the pooled sensitivity and specificity were 58.7% and 98.4% for Eastern countries and 65.5% and 98.1% for Western countries, respectively. HbA1c exhibits the same diagnostic value for diabetes in Eastern and Western populations. In both populations, HbA1c levels > 6.0% identify the population at high risk of diabetes, and HbA1c > 6.5% is diagnostic of clinically established diabetes. © 2013 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.

Diagnostic utility of attenuation measurement (Hounsfield units) in computed tomography stonogram in predicting the radio-opacity of urinary calculi in plain abdominal radiographs.

PubMed

Chua, Michael E; Gatchalian, Glenn T; Corsino, Michael Vincent; Reyes, Buenaventura B

2012-10-01

(1) To determine the best cut-off level of Hounsfield units (HU) in the CT stonogram that would predict the appearance of a urinary calculi in plain KUB X-ray; (2) to estimate the sensitivity and specificity of the best cut-off HU; and (3) to determine whether stone size and location affect the in vivo predictability. A prospective cross-sectional study of patients aged 18-85 diagnosed with urolithiases on CT stonogram with concurrent plain KUB radiograph was conducted. Appearance of stones was recorded, and significant difference between radiolucent and radio-opaque CT attenuation level was determined using ANOVA. Receiver operating characteristics (ROC) curve determined the best HU cut-off value. Stone size and location were used for factor variability analysis. A total of 184 cases were included in this study, and the average urolithiasis size on CT stonogram was 0.84 cm (0.3-4.9 cm). On KUB X-ray, 34.2 % of the urolithiases were radiolucent and 65.8 % were radio-opaque. Mean value of CT Hounsfield unit for radiolucent stones was 358.25 (±156), and that for radio-opaque stones was 816.51 (±274). ROC curve determined the best cut-off value of HU at 498.5, with the sensitivity of 89.3 % and specificity of 87.3 %. For >4 mm stones, the sensitivity was 91.3 % and the specificity was 81.8 %. On the other hand, for =<4 mm stones, the sensitivity was 60 % and the specificity was 89.5 %. Based on the constructed ROC curve, a threshold value of 498.5 HU in CT stonogram was established as cut-off in determining whether a calculus is radio-opaque or radiolucent. The determined overall sensitivity and specificity of the set cut-off HU value are optimal. Stone size but not location affects the sensitivity and specificity.

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

Validity of the rheumatoid arthritis impact of disease (RAID) score and definition of cut-off points for disease activity states in a population-based European cohort of patients with rheumatoid arthritis.

PubMed

Salaffi, Fausto; Di Carlo, Marco; Vojinovic, Jelena; Tincani, Angela; Sulli, Alberto; Soldano, Stefano; Andreoli, Laura; Dall'Ara, Francesca; Ionescu, Ruxandra; Simić Pašalić, Katarina; Balčune, Ineta; Ferraz-Amaro, Iván; Tlustochowicz, Malgorzata; Butrimienė, Irena; Punceviciene, Egle; Toroptsova, Natalia; Grazio, Simeon; Morović-Vergles, Jadranka; Masaryk, Pavol; Otsa, Kati; Bernardes, Miguel; Boyadzhieva, Vladimira; Cutolo, Maurizio

2018-05-01

To assess the validity of the rheumatoid arthritis impact of disease (RAID) for measuring disease activity of rheumatoid arthritis (RA) and to determine cut-off values for defining the disease activity states. A total of 622 RA patients from an European database have been included. Cross-validation was based on assessment of convergent and discriminant validity. Optimal cut-offs were determined against external criteria by calculating the respective 25th and 75th percentiles mean values of RAID. External criteria included definitions for remission (REM), low disease activity (LDA), moderate disease activity (MDA) and high disease activity (HDA), cut-offs of the 28-joint disease activity score-C-reactive protein (DAS28-CRP) score. The RAID showed a moderate degree of correlation with respect to DAS28-CRP (rho=0.417; P<0.0001). The receiver operating characteristic (ROC) curves to discriminate the ability of RAID to distinguish patients with active and non-active disease was very good with an area under the curve (AUC) of 0.847 (95% confidence interval [CI]: 0.816 to 0.878; P<0.0001). Based on the distributions of RAID in the different disease activity groups, we propose the following cut-off values for REM: RAID ≤3; for LDA: RAID >3 and ≤4; for MDA: RAID >4 and ≤6; for HDA: RAID >6. Mean RAID differed significantly between patients classified as REM, LDA, MDA or HDA (P=0.001). The cut-offs revealed good measurement characteristics in cross-validation analysis, had great discriminatory performance in distinguishing patients with different levels of disease activity and are suited for widespread use in everyday practice application and research. Copyright © 2017 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

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.

[The Alvarado score validation in diagnosing acute appendicitis in children at Braga Hospital].

PubMed

Gonçalves, Jean Pierre; Cerqueira, Arnaldo; Martins, Sofia

2011-12-01

Acute appendicitis (AA) is the leading cause of emergency abdominal surgery in children. The diagnosis is essentially clinical, but some methodologies, such as Alvarado score (AS), have been developed in order to avoid non-therapeutic laparotomy (15-30%). AS ≥ 5 or 6 is compatible with AA and is an indication for the patient to remain on observations, if AS ≥ 7 a laparotomy procedure may be indicated. To validate the AS for the AA diagnosis of children admitted at Braga Hospital. A validation study of diagnostic method (AS) using the histological examination as a gold standard. The study population consisted of 192 children (4-17 years) with abdominal pain that underwent appendectomy in the last 20 months (December 2008 to July 2010). It was determined the values of sensitivity (S), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), likelihood ratio (LR) and the ROC curve for three different cut-off points (SA =5, 6 and 7). We found that as the cut-off point of AS decreases progressively the sensitivity and specificity increases and reduces the VPN and VPP. Assuming a cut-off value of 5, only 18 children would be false negatives, instead of the 67 children if the cut-off point was 7 points. The analysis of ROC curves demonstrated a greater area under the curve for a cut-off equal to or greater than 5 (AUC = 70%). We recommend using a cut-off value of 5 points, since only 18 children with AA were initially classified as appendicitis unlikely, this value would increase to 67 patients for the SA value of ≥ 7. The AS is a valuable tool in screening children with abdominal pain for the diagnosis of AA. Nonetheless the diagnosis and final decision must be based on clinical and systematic reassessment of patients.

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

PubMed

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

2017-11-09

The optimal criteria applied to older Korean people have not been defined. We aimed to define clinically relevant cut-off points for older Korean people and to compare the predictive validity with other definitions of sarcopenia. Nine hundred and sixteen older Koreans (≥65 years) were included in this cross-sectional observational study. We used conditional inference tree analysis to determine cut-off points for height-adjusted grip strength (GS) and appendicular skeletal muscle mass (ASM), for use in the diagnosis of sarcopenia. We then compared the Korean sarcopenia criteria with the Foundation for the National Institutes of Health and Asian Working Group for Sarcopenia criteria, using frailty, assessed with the Korean Frailty Index, as an outcome variable. For men, a residual GS (GSre) of ≤ 0.25 was defined as weak, and a residual ASM (ASMre) of ≤ 1.29 was defined as low. Corresponding cut-off points for women were a GSre of ≤ 0.17 and an ASMre of ≤ 0.69. GSre and ASMre values were adjusted for height. In logistic regression analysis with new cut-off points, the adjusted odds ratios for pre-frail or frail status in the sarcopenia group were 3.23 (95% confidence interval [CI] 1.33-7.83) for the men and 1.74 (95% CI 0.91-3.35) for the women. In receiver operating characteristic curve analysis, the unadjusted area under the curve for Korean sarcopenia criteria in men and women were 0.653 and 0.608, respectively (p < .001). Our proposed cut-off points for low GS and low ASM should be useful in the diagnosis of sarcopenia in older Korean people. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Role of pharmacogenetics on deferasirox AUC and efficacy.

PubMed

Cusato, Jessica; Allegra, Sarah; De Francia, Silvia; Massano, Davide; Piga, Antonio; D'Avolio, Antonio

2016-04-01

We evaluated deferasirox pharmacokinetic according to SNPs in genes involved in its metabolism and elimination. Moreover, we defined a plasma area under the curve cut-off value predicting therapy response. Allelic discrimination was performed by real-time PCR. Drug plasma concentrations were measured by a high performance liquid chromatography system coupled with an ultraviolet method. Pharmacokinetic parameters were significantly influenced by UGT1A1 rs887829C>T, UGT1A3 rs1983023C>T and rs3806596A>G SNPs. Area under the curve cut-off values of 360 μg/ml/h for efficacy were here defined and 250 μg/ml/h for nonresponse was reported. UGT1A3 rs3806596GG and ABCG2 rs13120400CC genotypes were factors able to predict efficacy, whereas UGT1A3 rs3806596GG was a nonresponse predictor. These data show how screening patient's genetic profile may help clinicians to optimize iron chelation therapy with deferasirox.

Ariel 6 measurements of ultra-heavy cosmic ray fluxes in the region Z or = 48

NASA Technical Reports Server (NTRS)

Fowler, P. H.; Masheder, M. R. W.; Moses, R. T.; Walker, R. N. F.; Worley, A.; Gay, A. M.

1985-01-01

For this re-analysis of the Ariel VI data, the contribution of non Z square effects to the restricted energy loss and to Cerenkov radiation in the Bristol sphere has been evaluated using the Mott cross section ratios and the non-relativistic Bloch correction. Results obtained were similar in form to those derived for HEAO3 but with maximum deviations approximately 10% rather than 15% for the Mott term, corresponding to a thinner detector. Because of the large uncertainties in the parameters involved, no relativistic Bloch term was included. In addition the experiments on the HEAO detector make the application of a correction to the Cerenkov response of doubtful justification and none was applied in this analysis. An energy dependent correction was made using an effective energy calculated from the vertical cut-off for a given event. The maximum value of this correction was about 0.6% in Z for low cut-offs, declining to approximately zero by 10 GV.

A source array for generating higher order acoustic modes in circular ducts

NASA Technical Reports Server (NTRS)

Wyerman, B. R.; Reethof, G.

1976-01-01

A unique source array has been developed for the generation of both spinning and non-spinning higher order modes in a circular duct. The array consists of two concentric rings of sources. Through individual control of the response of each element, the array provided phase and amplitude control in the radial as well as circumferential directions. Radial modes shapes were measured in a 12-inch diameter anechoically-terminated hollow duct. These modes could be generated at their cut-off frequency and throughout a frequency range extending to the cut-off frequency for the next higher order radial mode. Comparisons are given between theory and experiment for the generation of specific modes. The radial dependence of the measured mode shapes was enhanced considerably by the design of this array. The results indicate a significant improvement over previous mode generation mechanisms. The contamination of the generated mode by additional spurious modes is also considered for variations between individual elements within the source array.

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).

Population-based colorectal cancer screening programmes using a faecal immunochemical test: should faecal haemoglobin cut-offs differ by age and sex?

PubMed

Arana-Arri, Eunate; Idigoras, Isabel; Uranga, Begoña; Pérez, Raquel; Irurzun, Ana; Gutiérrez-Ibarluzea, Iñaki; Fraser, Callum G; Portillo, Isabel

2017-08-29

The Basque Colorectal Cancer Screening Programme has both high participation rate and high compliance rate of colonoscopy after a positive faecal occult blood test (FIT). Although, colorectal cancer (CRC) screening with biannual (FIT) has shown to reduce CRC mortality, the ultimate effectiveness of the screening programmes depends on the accuracy of FIT and post-FIT colonoscopy, and thus, harms related to false results might not be underestimated. Current CRC screening programmes use a single faecal haemoglobin concentration (f-Hb) cut-off for colonoscopy referral for both sexes and all ages. We aimed to determine optimum f-Hb cut-offs by sex and age without compromising neoplasia detection and interval cancer proportion. Prospective cohort study using a single-sample faecal immunochemical test (FIT) on 444,582 invited average-risk subjects aged 50-69 years. A result was considered positive at ≥20 μg Hb/g faeces. Outcome measures were analysed by sex and age for a wide range of f-Hb cut-offs. We analysed 17,387 positive participants in the programme who underwent colonoscopy. Participation rate was 66.5%. Men had a positivity rate for f-Hb of 8.3% and women 4.8% (p < 0.0001). The detection rate for advanced neoplasia (cancer plus advanced adenoma) was 44.0‰ for men and 15.9‰ for women (p < 0.0001). The number of colonoscopies required decreased in both sexes and all age groups through increasing the f-Hb cut-off. However, the loss in CRC detection increased by up to 28.1% in men and 22.9% in women. CRC missed were generally at early stages (Stage I-II: from 70.2% in men to 66.3% in women). This study provides detailed outcomes in men and women of different ages at a range of f-Hb cut-offs. We found differences in positivity rates, neoplasia detection rate, number needed to screen, and interval cancers in men and women and in younger and older groups. However, there are factors other than sex and age to consider when consideration is given to setting the f-Hb cut-off.

Derivation & validation of glycosylated haemoglobin (HbA1c) cut-off value as a diagnostic test for type 2 diabetes in south Indian population

PubMed Central

Mohan, Alladi; Reddy, S. Aparna; Sachan, Alok; Sarma, K.V.S.; Kumar, D. Prabath; Panchagnula, Mahesh V.; Rao, P.V.L.N. Srinivasa; Kumar, B. Siddhartha; Krishnaprasanthi, P.

2016-01-01

Background & Objectives: Glycosylated haemoglobin (HbA1c) has been in use for more than a decade, as a diagnostic test for type 2 diabetes. Validity of HbA1c needs to be established in the ethnic population in which it is intended to be used. The objective of this study was to derive and validate a HbA1c cut-off value for the diagnosis of type 2 diabetes in the ethnic population of Rayalaseema area of south India. Methods: In this cross-sectional study, consecutive patients suspected to have type 2 diabetes underwent fasting plasma glucose (FPG) and 2 h post-load plasma glucose (2 h-PG) measurements after a 75 g glucose load and HbA1c estimation. They were classified as having diabetes as per the American Diabetes Association criteria [(FPG ≥7 mmol/l (≥126 mg/dl) and/or 2 h-PG ≥11.1 mmol/l (≥200 mg/dl)]. In the training data set (n = 342), optimum cut-off value of HbA1c for defining type 2 diabetes was derived by receiver-operator characteristic (ROC) curve method using oral glucose tolerance test results as gold standard. This cut-off was validated in a validation data set (n = 341). Results: On applying HbA1c cut-off value of >6.3 per cent (45 mmol/mol) to the training data set, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for diagnosing type 2 diabetes were calculated to be 90.6, 85.2, 80.8 and 93.0 per cent, respectively. When the same cut-off value was applied to the validation data set, sensitivity, specificity, PPV and NPV were 88.8, 81.9, 74.0 and 92.7 per cent, respectively, although the latter were consistently smaller than the proportions for the training data set, the differences being not significant. Interpretation & conclusions: HbA1c >6.3 per cent (45 mmol/mol) appears to be the optimal cut-off value for the diagnosis of type 2 diabetes applicable to the ethnic population of Rayalaseema area of Andhra Pradesh state in south India. PMID:27934801

Prevalence of suspected developmental delays in early infancy: results from a regional population-based longitudinal study.

PubMed

Valla, Lisbeth; Wentzel-Larsen, Tore; Hofoss, Dag; Slinning, Kari

2015-12-17

Prevalence estimates on suspected developmental delays (SDD) in young infants are scarce and a necessary first step for planning an early intervention. We investigated the prevalence of SDD at 4, 6 and 12 months, in addition to associations of SDD with gender, prematurity and maternal education. This study is based on a Norwegian longitudinal sample of 1555 infants and their parents attending well-baby clinics for regular health check-ups. Moreover, parents completed the Norwegian translation of the Ages and Stages Questionnaires (ASQ) prior to the check-up, with a corrected gestational age being used to determine the time of administration for preterm infants. Scores ≤ the established cut-offs in one or more of the five development areas: communication, gross motor, fine motor, problem solving and personal-social, which defined SDD for an infant were reported. Chi-square tests were performed for associations between the selected factors and SDD. According to established Norwegian cut-off points, the overall prevalence of SDD in one or more areas was 7.0 % (10.3 % US cut-off) at 4 months, 5.7 % (12.3 % US cut-off) at 6 months and 6.1 % (10.3 % US cut-off) at 12 months. The highest prevalence of SDD was in the gross motor area at all three time points. A gestational age of < 37 weeks revealed a significant association with the communication SDD at 4 months, and with the fine motor and personal social SDD at 6 months. Gender was significantly associated with the fine motor and problem solving SDD at 4 months and personal- social SDD at 6 months: as more boys than girls were delayed. No significant associations were found between maternal education and the five developmental areas of the ASQ. Our findings indicate prevalence rates of SDD between 5.7 and 7.0 % in Norwegian infants between 4 and 12 months of age based on the Norwegian ASQ cut-off points (10.3-12.3 %, US cut-off points). During the first year of life, delay is most frequent within the gross motor area. Special attention should be paid to infants born prematurely, as well as to boys. Separate norms for boys and girls should be considered for the ASQ.

Accuracy of the WHO’s body mass index cut-off points to measure gender- and age-specific obesity in middle-aged adults living in the city of Rio de Janeiro, Brazil

PubMed Central

Wollner, Materko; Paulo Roberto, Benchimol-Barbosa; Alysson Roncally, Silva Carvalho; Jurandir, Nadal; Edil, Luis Santos

2017-01-01

Introduction. Obesity is defined by the World Health Organization (WHO) as a disease characterized by the excessive accumulation of body fat. Obesity is considered a public health problem, leading to serious social, psychological and physical problems. However, the appropriate cut-off point of body mass index (BMI) based on body fat percentage (BF%) for classifying an individual as obese in middle-aged adults living in Rio de Janeiro remains unclear. Materials and methods. This was a prospective cross-sectional study comprising of 856 adults (413 men and 443 women) living in Rio de Janeiro, Brazil ranging from 30-59 years of age. The data were collected over a two year period (2010-2011), and all participants were underwent anthropometric evaluation. The gold standard was the percentage of body fat estimated by bioelectrical impedance analysis. The optimal sensitivity and specificity were attained by adjusting BMI cut-off values to predict obesity based on the WHO criteria: BF% >25% in men and >35% in women, according to the receiver operating characteristic curve (ROC) analysis adjusted for age and for the whole group. Results. The BMI cut-offs for predicting BF% were 29.9 kg/m2 in men and 24.9 kg/m2 in women. Conclusions The BMI that corresponded to a BF% previously defining obesity was similar to that of other Western populations for men but not for women. Furthermore, gender and age specific cut-off values are recommended in this population. Significance for public health World Health Organization (WHO) defines obesity as a disease characterized by the excessive accumulation of body fat. Obesity is considered a public health problem, leading to serious social, psychological and physical problems. The WHO suggested cut-off point for obesity is a body mass index (BMI) of 30 kg/m2, which is associated with morbidity and mortality. An important issue in the debate over measuring obesity concerns the use of BMI to define obesity across different populations. However, it is not clear, what is an appropriate cut-off point of BMI based on body fat percentage (BF%) to classify an individual as obese within gender-age groups and to distinguish categories of BF% in middle-aged adults living in the city of Rio de Janeiro. PMID:29071256

Identifying depression with the PHQ-2: A diagnostic meta-analysis.

PubMed

Manea, Laura; Gilbody, Simon; Hewitt, Catherine; North, Alice; Plummer, Faye; Richardson, Rachel; Thombs, Brett D; Williams, Bethany; McMillan, Dean

2016-10-01

There is interest in the use of very brief instruments to identify depression because of the advantages they offer in busy clinical settings. The PHQ-2, consisting of two questions relating to core symptoms of depression (low mood and loss of interest or pleasure), is one such instrument. A systematic review was conducted to identify studies that had assessed the diagnostic performance of the PHQ-2 to detect major depression. Embase, MEDLINE, PsychINFO and grey literature databases were searched. Reference lists of included studies and previous relevant reviews were also examined. Studies were included that used the standard scoring system of the PHQ-2, assessed its performance against a gold-standard diagnostic interview and reported data on its performance at the recommended (≥3) or an alternative cut-off point (≥2). After assessing heterogeneity, where appropriate, data from studies were combined using bivariate diagnostic meta-analysis to derive sensitivity, specificity, likelihood ratios and diagnostic odds ratios. 21 studies met inclusion criteria totalling N=11,175 people out of which 1529 had major depressive disorder according to a gold standard. 19 of the 21 included studies reported data for a cut-off point of ≥3. Pooled sensitivity was 0.76 (95% CI =0.68-0.82), pooled specificity was 0.87 (95% CI =0.82-0.90). However there was substantial heterogeneity at this cut-off (I(2)=81.8%). 17 studies reported data on the performance of the measure at cut-off point ≥2. Heterogeneity was I(2)=43.2% pooled sensitivity at this cut-off point was 0.91 (95% CI =0.85-0.94), and pooled specificity was 0.70 (95% CI =0.64-0.76). The generally lower sensitivity of the PHQ-2 at cut-off ≥3 than the original validation study (0.83) suggests that ≥2 may be preferable if clinicians want to ensure that few cases of depression are missed. However, in situations in which the prevalence of depression is low, this may result in an unacceptably high false-positive rate because of the associated modest specificity. These results, however, need to be interpreted with caution given the possibility of selectively reported cut-offs. Copyright © 2016. Published by Elsevier B.V.

UTILITY OF A SINGLE LATE-NIGHT PLASMA CORTISOL AND ACTH FOR THE DIAGNOSIS OF CUSHING SYNDROME.

PubMed

Jarial, Kush Dev Singh; Bhansali, Anil; Mukherjee, Kanchan K; Pal, Rimesh; Sharma, Akhilesh; Vashishtha, Rakesh K; Sukumar, Suja P; Sachdeva, Naresh; Walia, Rama

2018-02-01

To evaluate the diagnostic efficacy of various screening tests for the diagnosis of Cushing syndrome (CS). Thirty-five patients with CS and 16 patients of pseudo-CS were enrolled. Assessment of 24-h urinary free cortisol (UFC), late-night salivary cortisol (LNSC), overnight dexamethasone suppression test (ONDST), late-night plasma cortisol (LNPC), and adrenocorticotropic hormone (ACTH) on outpatient basis, and during sleep as well as in awake state after 48 hours of hospital admission. We found that 24-h UFC performed the best among the screening tests with sensitivity, specificity and areas under the curve (AUCs) of 96.0%, 99%, and 0.988, respectively, at a cut-off of 144.6 μg/24 h. A cut-off of 10.5 nmol/L for LNSC had sensitivity 85.7%, specificity 88.2%, and an AUC of 0.897. A cut-off of 412.4 nmol/L for LNPC on outpatient basis had sensitivity 88.2%, specificity 91.2%, and an AUC of 0.957. Cut-offs of 215 and 243.3 nmol/L for LNPC during sleep and awake states after acclimatization had sensitivity, specificity, and an AUC of 94.1%, 88.2%, and 0.958, respectively. An ONDST cut-off of 94.6 nmol/L provided sensitivity, specificity, and an AUC of 96.0%, 99.03% and 0.995, respectively. A cut-off of 30.3 pg/mL for late-night ACTH on outpatient basis had sensitivity 67.6%, specificity 99.9%, and an AUC 0.796.A cut-off of 22.6 pg/mL for ACTH during sleep state after acclimatization had sensitivity, specificity, and an AUC of 73.5%, 99.2%, and 0.827, respectively. UFC is the best screening test for CS. Furthermore, single measurements of LNPC and ACTH help to establish the diagnosis and ACTH dependency of CS in the majority of patients with CS. ACTH = adrenocorticotropic hormone AUC = area under the curve CRH = corticotropin-releasing hormone CS = Cushing syndrome ECLIA = electrochemiluminescence immuno-assay LDDST = low-dose dexamethasone suppression test LNPC = late-night plasma cortisol LNSC = late-night salivary cortisol ONDST = overnight dexamethasone suppression test RIA = radio-immuno assay UFC = urinary free cortisol.

An Evaluation of Sharp Cut Cyclones for Sampling Diesel Particulate Matter Aerosol in the Presence of Respirable Dust

PubMed Central

Cauda, Emanuele; Sheehan, Maura; Gussman, Robert; Kenny, Lee; Volkwein, Jon

2015-01-01

Two prototype cyclones were the subjects of a comparative research campaign with a diesel particulate matter sampler (DPMS) that consists of a respirable cyclone combined with a downstream impactor. The DPMS is currently used in mining environments to separate dust from the diesel particulate matter and to avoid interferences in the analysis of integrated samples and direct-reading monitoring in occupational environments. The sampling characteristics of all three devices were compared using ammonium fluorescein, diesel, and coal dust aerosols. With solid spherical test aerosols at low particle loadings, the aerodynamic size-selection characteristics of all three devices were found to be similar, with 50% penetration efficiencies (d50) close to the design value of 0.8 µm, as required by the US Mine Safety and Health Administration for monitoring occupational exposure to diesel particulate matter in US mining operations. The prototype cyclones were shown to have ‘sharp cut’ size-selection characteristics that equaled or exceeded the sharpness of the DPMS. The penetration of diesel aerosols was optimal for all three samplers, while the results of the tests with coal dust induced the exclusion of one of the prototypes from subsequent testing. The sampling characteristics of the remaining prototype sharp cut cyclone (SCC) and the DPMS were tested with different loading of coal dust. While the characteristics of the SCC remained constant, the deposited respirable coal dust particles altered the size-selection performance of the currently used sampler. This study demonstrates that the SCC performed better overall than the DPMS. PMID:25060240

[Scanning electron microscopic investigations of cutting edge quality in lamellar keratotomy using the Wavelight femtosecond laser (FS-200) : What influence do spot distance and an additional tunnel have?

PubMed

Hammer, T; Höche, T; Heichel, J

2018-01-01

Femtosecond lasers (fs-lasers) are established cutting instruments for the creation of LASIK flaps. Previous studies often showed even rougher surfaces after application of fs-laser systems compared to lamellar keratotomy with mechanical microkeratomes. When cutting the cornea with fs-lasers, an intrastromal gas development occurs, which has a potentially negative influence on the cutting quality if the gas cannot be dissipated; therefore, manufacturers have chosen the way of gas assimilation in so-called pockets. The investigated system creates a tunnel which opens under the conjunctiva. The aim of this study was to investigate the effects of a tunnel as well as the influence of different spot distances on the quality of cut surfaces and edges. In this experimental study on freshly enucleated porcine eyes (n = 15), the following cuts were carried out with the FS-200 (Wavelight, Erlangen, Germany): 1. standard setting (spot and line separation 8 µm), 2. with tunnel for gas drainage, 3. without gas-conducting tunnel, 4. with increased spot spacing (spot and line separation 9 μm instead of 8 μm) and 5. with reduced spot spacing (spot and line separation 7 μm instead of 8 μm). Subsequently, scanning electron microscopy (FEI Quanta 650, Hillsboro, OR) of the cut edges and surfaces as well as the gas drain tunnel were performed. The evaluation was based on an established score. The current fs-laser system (200 Hz) is able to create smooth cutting surfaces and sharp edges. The changed density of laser pulses compared to the standard settings with a reduced or increased distance between the pulses, did not achieve any further improvement in the surface quality. The gas-conducting tunnel could be detected by scanning electron microscope. In the case of cutting without a tunnel, roughened surfaces and irregularities on the cutting edges were found. When the FS-200 fs-laser is used, LASIK cuts with very smooth cut surfaces and sharp cutting edges are achieved. This is only valid as long as an additional tunnel with the fs-laser is placed under the conjunctiva. It can be assumed that the resulting gas is effectively drained through this tunnel. The installation of the tunnel represents a new possibility to replace previous techniques of gas assimilation in deeper lying cutting areas.

Cut-off values for classifying active children and adolescentes using the Physical Activity Questionnaire: PAQ-C and PAQ-ACut-off values for classifying active children and adolescents using the Physical Activity Questionnaire: PAQ-C and PAQ-A.

PubMed

Benítez-Porres, Javier; Alvero-Cruz, José Ramón; Sardinha, Luis B; López-Fernández, Iván; Carnero, Elvis A

2016-09-20

The Physical Activity Questionnaire for children and adolescents (PAQ-C & PAQ-A) has been widely used in research and field settings. However, there is a lack of information about its final score meaning. To determine PAQ-C and PAQ-A score cut-off values using physical activity (PA) thresholds objectively measured as reference criteria. 146 children (n = 83 boys, n = 63 girls) and 234 adolescents (n = 115 boys, n = 119 girls) participated in this study. Accelerometers (Actigraph GT3X) were used to assess objectively PA during one-week, afterwards PAQ was filled by the participants. As participants met or not the international PA recommendations for total, moderate-vigorous (MVPA) or light PA, three categorical variables of two levels were created. ROC curves procedure were carried out to obtain score cut-off points for identifying the positive category recommendation. ROC curves analysis estimated 2.75 and 2.73 score cut-off points to discriminate > 60 minutes of MVPA for PAQ-A and PAQ-C respectively (PAQ-A AUC = 0.68, p < 0.001 and PAQ-C; AUC = 0.55, p > 0.05). Also 60 minutes of MVPA was achieved with a total volume of 10,664 steps/day in children and 9,701 steps/day in adolescents. Our results suggest that PAQ-A can be a useful tool to classify adolescents as active or inactive following international recommendations as criteria. However, we could not find a significant cut-off for PAQ-C score.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-17

... DEPARTMENT OF HOMELAND SECURITY Coast Guard 33 CFR Parts 175 and 183 [Docket No. USCG-2009-0206] RIN 1825-AB34 Installation and Use of Engine Cut-Off Switches on Recreational Vehicles Correction Proposed Rule document 2011-14140 was inadvertently published in the Rules section of the issue of June 8...

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

PubMed

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

2017-05-01

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

[Validation of the nutritional index in Mexican pre-teens with the sensitivity and specificity method].

PubMed

Saucedo-Molina, T J; Gómez-Peresmitré, G

1998-01-01

To determine the diagnostic validity of the nutritional index (NI) in a sample of Mexican preadolescents. A total of 256 preadolescents, between 10 and 12 years old, male and female, students from Mexico City, were used to establish the diagnostic validity of NI using the sensitivity and specificity method. The findings show that the conventional NI cut-off points showed good sensitivity and specificity for the diagnosis of low weight, normality and obesity but not for overweight. When the cut-off points of NI were normalized, the sensitivity, specificity and prediction potency values were more suitable in all categories. When working with preadolescents, it is better to use the new cut-off points of NI, to obtain more reliable diagnosis.

High levels of FOXP3⁺ regulatory T cells in gastric MALT lymphoma predict responsiveness to Helicobacter pylori eradication.

PubMed

Iwaya, Yugo; Kobayashi, Motohiro; Momose, Masanobu; Hiraoka, Nobuyoshi; Sakai, Yasuhiro; Akamatsu, Taiji; Tanaka, Eiji; Ohtani, Haruo; Fukuda, Minoru; Nakayama, Jun

2013-10-01

Although Helicobacter pylori eradication is a first-line treatment of gastric MALT lymphoma, roughly 25% of patients do not respond to treatment. CD4⁺ FOXP3⁺ regulatory T (Treg) cells regulate immune responses in physiological conditions and various inflammatory conditions, including H. pylori-associated diseases. Our goal was to determine how Treg cells affect responsiveness to H. pylori eradication therapy. We performed dual immunohistochemistry for CD4 and FOXP3 to evaluate the prevalence of FOXP3⁺ Treg cells in the stomach of 63 patients with MALT lymphoma and 55 patients with chronic active gastritis. Receiver operating characteristic analysis was carried out to determine the best cut-off point in differentiating H. pylori eradication responders from nonresponders. Both the FOXP3⁺/CD4⁺ cell ratio and the absolute number of FOXP3⁺ cells per high-power field in MALT lymphoma were significantly greater in H. pylori eradication responders compared with nonresponders, suggesting that Treg cells function in regression mechanisms of MALT lymphomas. Cut-off points with good sensitivities and specificities were obtained to predict eradication outcome. A high number of Treg cells or a high ratio of Treg cells to the total number of CD4⁺ T cells in gastric MALT lymphoma could predict responsiveness to eradication therapy. © 2013 John Wiley & Sons Ltd.

Children's subjective emotional reactivity to affective pictures: gender differences and their antisocial correlates in an unselected sample of 7-11-year-olds.

PubMed

Sharp, Carla; van Goozen, Stephanie; Goodyer, Ian

2006-02-01

Differential responses in terms of gender and antisocial behaviour in emotional reactivity to affective pictures using the International Affective Picture System (IAPS) have been demonstrated in adult and adolescent samples. Moreover, a quadratic relationship between the arousal (intensity) and valence (degree of unpleasantness) has been suggested. The picture perception methodology has rarely been applied to middle school-aged children. We examined the subjective ratings of emotional reactivity in children for: i) the relationship between arousal and valence, ii) gender differences, and iii) its association with measures of antisocial behaviour. Twenty-seven IAPS pictures were selected to cover a wide range of affective content and were individually administered to a non-referred community sample of 659 7-11-year-old children using a paper-and-pencil version. Concurrent symptoms of conduct disorder, oppositional defiance and psychopathy were collected from multiple sources (teacher-, parent- and self-report). A quadratic relationship between arousal and valence, similar to that previously reported in adults, was demonstrated. A gender difference was found for valence ratings, with girls rating aversive pictures more unpleasant than boys. No gender differences for arousal ratings were found. A significant difference was found between groups scoring above and below cut-off scores on measures of antisocial behaviour. Children above cut-off reported lower arousal to unpleasant pictures, but higher arousal to pleasant pictures. We confirmed that a paper-and-pencil version of the IAPS for evaluating emotion response to affectively valent and arousing stimuli can be used in school settings and that comparable gender differences in emotional reactivity can be found in children. The differential emotional reactivity of children above cut-off on measures of antisocial behaviour suggested these symptoms to be associated with a combination of increased reward and decreased punishment sensitivity.

Analysis of the scattering and absorption properties of ellipsoidal nanoparticle arrays for the design of full-color transparent screens

NASA Astrophysics Data System (ADS)

Monti, Alessio; Toscano, Alessandro; Bilotti, Filiberto

2017-06-01

The introduction of nanoparticles-based screens [C. W. Hsu, Nat. Commun. 5, 3152 (2014)] has paved the way to the realization of low-cost transparent displays with a wide viewing angle and scalability to large size. Despite the huge potentialities of this approach, the design of a nanoparticles array exhibiting a sharp scattering response in the optical spectrum is still a challenging task. In this manuscript, we investigate the suitability of ellipsoidal plasmonic nanoparticles for this purpose. First, we show that some trade-offs between the sharpness of the scattering response of the array and its absorption level apply. Starting from these considerations, we prove that prolate nanoparticles may be a plausible candidate for achieving the peculiar features required in transparent screen applications. An example of a full-color and almost-isotropic transparent screen is finally proposed and its robustness towards the geometrical inaccuracies that may arise during the fabrication process is assessed. All the analytical considerations, carried out through an analytical model taking into account the surface dispersion effect affecting the nanoparticles, are supported by a proper set of full-wave simulations.

Laser circular cutting of Kevlar sheets: Analysis of thermal stress filed and assessment of cutting geometry

NASA Astrophysics Data System (ADS)

Yilbas, B. S.; Akhtar, S. S.; Karatas, C.

2017-11-01

A Kevlar laminate has negative thermal expansion coefficient, which makes it difficult to machine at room temperaures using the conventional cutting tools. Contararily, laser machining of a Kevlar laminate provides advantages over the conventional methods because of the non-mechanical contact between the cutting tool and the workpiece. In the present study, laser circular cutting of Kevlar laminate is considered. The experiment is carried out to examine and evaluate the cutting sections. Temperature and stress fields formed in the cutting section are simulated in line with the experimental study. The influence of hole diameters on temperature and stress fields are investigated incorporating two different hole diameters. It is found that the Kevlar laminate cutting section is free from large size asperities such as large scale sideways burnings and attachemnt of charred residues. The maximum temperature along the cutting circumference remains higher for the large diameter hole than that of the small diameter hole. Temperature decay is sharp around the cutting section in the region where the cutting terminates. This, in turn, results in high temperature gradients and the thermal strain in the cutting region. von Mises stress remains high in the region where temperature gradients are high. von Mises stress follows similar to the trend of temperature decay around the cutting edges.

The use of vision-based image quality metrics to predict low-light performance of camera phones

NASA Astrophysics Data System (ADS)

Hultgren, B.; Hertel, D.

2010-01-01

Small digital camera modules such as those in mobile phones have become ubiquitous. Their low-light performance is of utmost importance since a high percentage of images are made under low lighting conditions where image quality failure may occur due to blur, noise, and/or underexposure. These modes of image degradation are not mutually exclusive: they share common roots in the physics of the imager, the constraints of image processing, and the general trade-off situations in camera design. A comprehensive analysis of failure modes is needed in order to understand how their interactions affect overall image quality. Low-light performance is reported for DSLR, point-and-shoot, and mobile phone cameras. The measurements target blur, noise, and exposure error. Image sharpness is evaluated from three different physical measurements: static spatial frequency response, handheld motion blur, and statistical information loss due to image processing. Visual metrics for sharpness, graininess, and brightness are calculated from the physical measurements, and displayed as orthogonal image quality metrics to illustrate the relative magnitude of image quality degradation as a function of subject illumination. The impact of each of the three sharpness measurements on overall sharpness quality is displayed for different light levels. The power spectrum of the statistical information target is a good representation of natural scenes, thus providing a defined input signal for the measurement of power-spectrum based signal-to-noise ratio to characterize overall imaging performance.

Analysis and Optimization of the Production Process of Cooked Sausage Meat Matrices

NASA Astrophysics Data System (ADS)

Diez, L.; Rauh, C.; Delgado, A.

2010-09-01

In the production of cooked sausages a critical step for product quality is the cutting process, where the comminuting and mixing of meat, fat, ice and spices are carried out. These processes take usually place in bowl cutters, which main control parameters are the working time, knife geometry (shape and sharpness) and rotational velocities of the knives and the bowl. The choice of the geometry and sharpness of the knives influences not only the meat matrix properties (mechanical, rheological, etc.) and, as a consequence, the sensory value of the sausages (size of connective tissue particles, water binding, etc.), but also the energetic demand for the production. However, the cutting process proves to be understood only fragmentarily due to the complex colloid chemical and mechanical behavior of the product. This is documented on the one hand by numerous knife types on the market, extremely empirical approach during determination of geometry and process parameters in practice as well as, on the other hand, by contradictory statements and explanation approaches of observed phenomena present in literature. The present contribution applies numerical simulations to analyze thermo fluid mechanical phenomena, e.g. shear stresses, during the cutting process of the non-Newtonian meat matrix. Combining these results with selected experimental investigations from literature, e.g. sensory properties, knife geometry, velocity of the knife and bowl, improvements of the cutting and mixing process are proposed using cognitive algorithms (Artificial neural networks) aiming at an optimization regarding energy and time demand and product quality.

Performance of TcI/TcVI/TcII Chagas-Flow ATE-IgG2a for universal and genotype-specific serodiagnosis of Trypanosoma cruzi infection

PubMed Central

Alessio, Glaucia Diniz; de Araújo, Fernanda Fortes; Côrtes, Denise Fonseca; Sales Júnior, Policarpo Ademar; Lima, Daniela Cristina; Gomes, Matheus de Souza; do Amaral, Laurence Rodrigues; Xavier, Marcelo Antônio Pascoal; Teixeira-Carvalho, Andréa; Martins-Filho, Olindo Assis; de Lana, Marta

2017-01-01

Distinct Trypanosoma cruzi genotypes have been considered relevant for patient management and therapeutic response of Chagas disease. However, typing strategies for genotype-specific serodiagnosis of Chagas disease are still unavailable and requires standardization for practical application. In this study, an innovative TcI/TcVI/TcII Chagas Flow ATE-IgG2a technique was developed with applicability for universal and genotype-specific diagnosis of T. cruzi infection. For this purpose, the reactivity of serum samples (percentage of positive fluorescent parasites-PPFP) obtained from mice chronically infected with TcI/Colombiana, TcVI/CL or TcII/Y strain as well as non-infected controls were determined using amastigote-AMA, trypomastigote-TRYPO and epimastigote-EPI in parallel batches of TcI, TcVI and TcII target antigens. Data demonstrated that “α-TcII-TRYPO/1:500, cut-off/PPFP = 20%” presented an excellent performance for universal diagnosis of T. cruzi infection (AUC = 1.0, Se and Sp = 100%). The combined set of attributes “α-TcI-TRYPO/1:4,000, cut-off/PPFP = 50%”, “α-TcII-AMA/1:1,000, cut-off/PPFP = 40%” and “α-TcVI-EPI/1:1,000, cut-off/PPFP = 45%” showed good performance to segregate infections with TcI/Colombiana, TcVI/CL or TcII/Y strain. Overall, hosts infected with TcI/Colombiana and TcII/Y strains displayed opposite patterns of reactivity with “α-TcI TRYPO” and “α-TcII AMA”. Hosts infected with TcVI/CL strain showed a typical interweaved distribution pattern. The method presented a good performance for genotype-specific diagnosis, with global accuracy of 69% when the population/prototype scenario include TcI, TcVI and TcII infections and 94% when comprise only TcI and TcII infections. This study also proposes a receiver operating reactivity panel, providing a feasible tool to classify serum samples from hosts infected with distinct T. cruzi genotypes, supporting the potential of this method for universal and genotype-specific diagnosis of T. cruzi infection. PMID:28333926

Association between insulin resistance and sustained virologic response in hepatitis C treatment, genotypes 1 versus 2 and 3: systematic literature review and meta-analysis.

PubMed

Laurito, Marcela Pezzoto; Parise, Edison Roberto

2013-01-01

Controversial results have been found in literature for the association between insulin resistance and sustained virologic response to standard chronic hepatitis C treatment. This study aims to provide a systematic literature review with meta-analysis, in order to evaluate if insulin resistance interferes with sustained virologic response in patients infected by the HCV genotype 1 versus HCV genotypes 2 and 3, undergoing treatment with interferon and ribavirin or pegylated interferon and ribavarin. Systematic search was performed on main electronic databases until May 2012. Primary outcome was sustained virologic response, defined as undetectable levels of HCV-RNA six months after the end of treatment. Meta-analytic measure was estimated using Dersimonian and Laird's method, using Stata software. Thirteen studies involving 2238 infected patients were included. There was a statistically significant association between insulin resistance and lower sustained virologic response rate, and this difference occurred in HCV genotype G1 (OR: 2.23; 95% CI: 1.59-3.13) and G2/G3 (OR: 4.45; 95% CI: 1.59-12.49). In addition, a difference was seen in the cut-offs used for defining insulin resistance by Homeostasis Model Assessment of Insulin Resistance. To minimize this limitation, sub-analysis that excluded the studies that did not use 2 as a cut-off value was performed and the results still demonstrated association between insulin resistance and sustained virologic response, for both genotypic groups. This meta-analysis provides evidence that elevated Homeostasis Model Assessment of Insulin Resistance is associated with a lower sustained virologic response rate in patients with hepatitis C treated with interferon and ribavirin or pegylated interferon and ribavarin, regardless of their genotype. Copyright © 2013 Elsevier Editora Ltda. All rights reserved.

Atomic scale study of nanocontacts

NASA Astrophysics Data System (ADS)

Buldum, A.; Ciraci, S.; Batra, Inder P.; Fong, C. Y.

1998-03-01

Nanocontact and subsequent pulling off a sharp Ni(111) tip on a Cu(110) surface are investigated by using molecular dynamics method with embedded atom model. As the contact is formed, the sharp tip experiences multiple jump to contact in the attractive force range. The contact interface develops discontinuously mainly due to disorder-order transformations which lead to disappearance of a layer and hence abrupt changes in the normal force variation. Atom exchange occurs in the repulsive range. The connective neck is reduced also discontinuously by pulling off the tip. The novel atomic structure of the neck under the tensile force is analyzed. We also presented a comperative study for the contact by a Si(111) tip on Si(111)-(2x1) surface.

Impact of ultrafiltration and nanofiltration of an industrial fish protein hydrolysate on its bioactive properties.

PubMed

Picot, Laurent; Ravallec, Rozenn; Fouchereau-Péron, Martine; Vandanjon, Laurent; Jaouen, Pascal; Chaplain-Derouiniot, Maryse; Guérard, Fabienne; Chabeaud, Aurélie; Legal, Yves; Alvarez, Oscar Martinez; Bergé, Jean-Pascal; Piot, Jean-Marie; Batista, Irineu; Pires, Carla; Thorkelsson, Gudjon; Delannoy, Charles; Jakobsen, Greta; Johansson, Inez; Bourseau, Patrick

2010-08-30

Numerous studies have demonstrated that in vitro controlled enzymatic hydrolysis of fish and shellfish proteins leads to bioactive peptides. Ultrafiltration (UF) and/or nanofiltration (NF) can be used to refine hydrolysates and also to fractionate them in order to obtain a peptide population enriched in selected sizes. This study was designed to highlight the impact of controlled UF and NF on the stability of biological activities of an industrial fish protein hydrolysate (FPH) and to understand whether fractionation could improve its content in bioactive peptides. The starting fish protein hydrolysate exhibited a balanced amino acid composition, a reproducible molecular weight (MW) profile, and a low sodium chloride content, allowing the study of its biological activity. Successive fractionation on UF and NF membranes allowed concentration of peptides of selected sizes, without, however, carrying out sharp separations, some MW classes being found in several fractions. Peptides containing Pro, Hyp, Asp and Glu were concentrated in the UF and NF retentates compared to the unfractionated hydrolysate and UF permeate, respectively. Gastrin/cholecystokinin-like peptides were present in the starting FPH, UF and NF fractions, but fractionation did not increase their concentration. In contrast, quantification of calcitonin gene-related peptide (CGRP)-like peptides demonstrated an increase in CGRP-like activities in the UF permeate, relative to the starting FPH. The starting hydrolysate also showed a potent antioxidant and radical scavenging activity, and a moderate angiotensin-converting enzyme (ACE)-1 inhibitory activity, which were not increased by UF and NF fractionation. Fractionation of an FPH using membrane separation, with a molecular weight cut-off adapted to the peptide composition, may provide an effective means to concentrate CGRP-like peptides and peptides enriched in selected amino acids. The peptide size distribution observed after UF and NF fractionation demonstrates that it is misleading to characterize the fractions obtained by membrane filtration according to the MW cut-off of the membrane only, as is currently done in the literature. Copyright (c) 2010 Society of Chemical Industry.

Crystallization kinetics, optical and dielectric properties of Li2OṡCdOṡBi2O3ṡSiO2 glasses

NASA Astrophysics Data System (ADS)

Rani, Saroj; Sanghi, Sujata; Ahlawat, Neetu; Agarwal, Ashish

2015-10-01

Crystallization kinetics, optical absorption and electrical behavior of lithium cadmium silicate glasses with different amount of bismuth oxide were investigated using non-isothermal crystallization approach, UV-VIS-NIR spectroscopy and impedance spectroscopy, respectively. These glasses were synthesized by normal melt quenching technique. Variation in physical properties, viz. density, molar volume with Bi2O3:SiO2 ratio were related to the structural changes occurring in the glasses. The glass transition temperature (Tg), crystalline peak temperature (Tp) and melting temperature (Tm) of these glasses were determined using differential scanning calorimeter at various heating rates. The dependence of Tg and Tp on heating rate has been used for the determination of the activation energy of glass transition and crystallization. Thermal stability parameters have revealed high stability of the glass prepared with 40 mol% of Bi2O3 content. The crystallization kinetics for the glasses was studied by using the Kissinger and modified Ozawa equations. Appearance of a sharp cut-off and a wide and reasonable transmission in VIS-NIR region makes these glasses suitable for IR transmission window. The cut-off wavelength, optical band gap and Urbach's energy have been analyzed and discussed in terms of changes in the glass structure. By analyzing the impedance spectra, the ac and dc conductivities, activation energy for dc conduction (Edc) and for relaxation (EM″) were calculated. The results obtained from dc conductivity confirm the network forming role of Cd2+ ion in the glasses. The scaling of the conductivity spectra has been used to interpret the temperature dependence of the relaxation dynamics. The observed conductivity spectra follows power law with exponent 's' which decreases with temperature and satisfies the correlated barrier hopping (CBH) model. The perfect overlying of normalized plots of electrical modulus on a single 'master curve' depicts temperature as well as composition independent dynamical process at several frequencies.

Effects of blade-vane ratio and rotor-stator spacing of fan noise with forward velocity

NASA Astrophysics Data System (ADS)

Woodward, R. P.; Glaser, F. W.

1981-08-01

A research fan stage was acoustically tested in an anechoic wind tunnel with a 41 m/sec tunnel flow. Two stator vane numbers giving cut-on and cut-off conditions were tested at three rotor-stator spacings ranging from about 0.5 to 2.0 rotor chords. These two stators were designed for similar aerodynamic performance. Hot film anemometer turbulence measurements were made at the leading edge of the stator for each spacing. The cut-off criterion strongly controlled the fundamental tone level at all spacings. The trends with spacing of the wake defect upwash component at the stator tip showed good agreement with the corresponding cut-on acoustic tone levels.

Some aspects of precise laser machining - Part 2: Experimental

NASA Astrophysics Data System (ADS)

Grabowski, Marcin; Wyszynski, Dominik; Ostrowski, Robert

2018-05-01

The paper describes the role of laser beam polarization on quality of laser beam machined cutting tool edge. In micromachining the preparation of the cutting tools in play a key role on dimensional accuracy, sharpness and the quality of the cutting edges. In order to assure quality and dimensional accuracy of the cutting tool edge it is necessary to apply laser polarization control. In the research diode pumped Nd:YAG 532nm pulse laser was applied. Laser beam polarization used in the research was linear (horizontal, vertical). The goal of the carried out research was to describe impact of laser beam polarization on efficiency of the cutting process and quality of machined parts (edge, surface) made of polycrystalline diamond (PCD) and cubic boron nitride (cBN). Application of precise cutting tool in micromachining has significant impact on the minimum uncut chip thickness and quality of the parts. The research was carried within the INNOLOT program funded by the National Centre for Research and Development.

[Homicide by stab to the neck with subsequent attempted suicide by cut to the neck].

PubMed

Olze, Heidi; Hosse, Ulrike; Rosenbaum, Frank; Schmeling, Andreas; Schneider, Volkmar

2005-01-01

A 37-year-old Turkish woman was fatally injured by her 65-year-old Turkish husband with a stab to the cervical region. After her death he inflicted a deep cut to his own neck, which he survived thanks to immediate medical assistance. To the authors' knowledge this combination of a homicidal stab to the neck and a suicidal cut to the neck has not been described before. Kosher butchering, which is common in the couple's traditional cultural environment, is discussed as possible reason for the choice of the neck as site for applying sharp violence. It may have induced the perpetrator to choose this anatomical region.

Body mass index for predicting hyperglycemia and serum lipid changes in Brazilian adolescents.

PubMed

Vieira, Ana Carolina R; Alvarez, Marlene M; Kanaan, Salim; Sichieri, Rosely; Veiga, Gloria V

2009-02-01

To determine the best cut-offs of body mass index for identifying alterations of blood lipids and glucose in adolescents. A probabilistic sample including 577 adolescent students aged 12-19 years in 2003 (210 males and 367 females) from state public schools in the city of Niterói, Southeastern Brazil, was studied. The Receiver Operating Characteristic curve was used to identify the best age-adjusted BMI cut-off for predicting high levels of serum total cholesterol (> or =150 mg/dL), LDL-C (> or =100 mg/dL), serum triglycerides (> or =100 mg/dL), plasma glucose (> 100 mg/dL) and low levels of HDL-C (< 45 mg/dL). Four references were used to calculate sensitivity and specificity of BMI cut-offs: one Brazilian, one international and two American. The most prevalent metabolic alterations (>50%) were: high total cholesterol and low HDL-C. BMI predicted high levels of triglycerides in males, high LDL-C in females, and high total cholesterol and the occurrence of three or more metabolic alterations in both males and females (areas under the curve range: 0.59 to 0.67), with low sensitivity (57%-66%) and low specificity (58%-66%). The best BMI cut-offs for this sample (20.3 kg/m(2) to 21.0 kg/m(2)) were lower than those proposed in the references studied. Although BMI values lower than the International cut-offs were better predictor of some metabolic abnormalities in Brazilian adolescents, overall BMI is not a good predictor of these abnormalities in this population.

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.

Hepascore and hyaluronic acid as markers of fibrosis in liver disease of mixed aetiology.

PubMed

Costelloe, Seán J; Theocharidou, Eleni; Tsochatzis, Emmanuel; Thalassinos, Evangelos; Martin, Nicholas; Fede, Guiseppe; Thomas, Michael; Burroughs, Anthony K

2015-03-01

To evaluate hyaluronic acid (HA) and Hepascore as diagnostic replacements for liver biopsy in a population with mixed liver disease. The utility of HA concentration and Hepascore for staging fibrosis, detecting any fibrosis and detecting advanced fibrosis, was assessed in 73 consecutive patients, with varied liver pathologies requiring biopsy. Subgroup analyses compared utility of disease-specific and universal cut-offs for HA and Hepascore. Forty-one patients (56.2%) had liver fibrosis on biopsy. HA and Hepascore varied significantly with METAVIR stage, although ranges overlapped, precluding their use in staging fibrosis. When detecting any fibrosis (METAVIR F1-F4), HA and Hepascore had areas under the receiver operator characteristic curve of 0.63 and 0.66, respectively, and approximately two-thirds of patients were correctly categorized using optimal cut-offs. For detection of advanced fibrosis (METAVIR F3/4), HA and Hepascore had areas under the receiver operator characteristic curve of 0.81 and 0.80, respectively, and three-quarters of patients were correctly categorized using optimal cut-offs. In subgroup analysis, locally derived, disease-specific cut-offs in hepatitis C virus patients yielded greatest diagnostic efficiency, whereas the tests performed worst in cryptogenic aetiologies. HA and Hepascore cannot accurately stage hepatic fibrosis in this population. Locally derived, disease-specific cut-offs for HA gave the higher diagnostic efficiency observed. Although HA and Hepascore may be useful where the disease aetiology is known, particularly in established hepatitis C virus, the high cost of false positives and false negatives are such that neither a reliable enough to replace biopsy without substantial further characterization.

Three screening methods for cognitive dysfunction using the Mini-Mental State Examination and Korean Dementia Screening Questionnaire.

PubMed

Choi, Seong Hye; Park, Moon Ho

2016-02-01

To screen for and determine cognitive dysfunction, cognitive tests and/or informant reports are commonly used. However, these cognitive tests and informant reports are not always available. The present study investigated three screening methods using the Mini-Mental State Examination (MMSE) as the cognitive test, and the Korean dementia screening questionnaire (KDSQ) as the informant report. Participants were recruited from the Korea Clinical Research Center for Dementia of South Korea, and included 2861 patients with Alzheimer's disease (dementia), 3519 patients with mild cognitive impairment and 1375 controls with no cognitive dysfunction. Three screening methods were tested: (i) MMSE alone (MMSE(cut-off) ); (ii) a conventional combination of MMSE and KDSQ (MMSE+KDSQ(cut-off) ); and (iii) a decision tree with MMSE and KDSQ (MMSE+KDSQ(decision tree) ). For discriminating any cognitive dysfunction from controls, MMSE+KDSQ(cut-off) had the highest area under the receiver operating characteristic curve (0.784). For discriminating dementia from controls, MMSE+KDSQ(cut-off) had the highest area under the receiver operating characteristic curve (0.899). For discriminating mild cognitive impairment from controls, MMSE(cut-off) had the highest area under the receiver operating characteristic curve (0.683). MMSE+KDSQ(decision tree) showed the highest sensitivity for all discriminations. For overall classification accuracy, MMSE+KDSQ(decision tree) had the highest value (70.0%). These three methods had different advantageous properties for screening and staging cognitive dysfunction. As there might be different availability across clinical settings, these three methods can be selected and used according to situational needs. © 2015 Japan Geriatrics Society.

Tumour thickness as a determinant of nodal metastasis in oral tongue carcinoma.

PubMed

Wang, Kejia; Veivers, David

2017-09-01

Tumour thickness is a strong predictor for cervical node involvement in oral cavity squamous cell carcinomas (SCCs), with a recent meta-analysis concluding a 4-mm optimal prognostic cut-off point. No consensus has been reached for the tumour thickness cut-off for oral tongue SCCs. A retrospective review of prospectively collected data from 112 patients by the Northern Sydney Cancer Centre (Australia) with primary oral tongue SCC was conducted. Tumour thickness was measured by standard histopathological techniques and cervical node involvement was determined either from neck dissection histopathology or by clinical and radiological follow-up. Neck dissection was performed in 78 patients (70%). Tumour thickness was a significant predictor of cervical node disease (P < 0.01), with a median tumour thickness of 5.5 mm. Cervical node metastasis rates for tumours <2, 2-3.9 and ≥4 mm thick were 10%, 42.1% and 46.5%, respectively. The rate of cervical node metastasis was significantly higher for patients with tumours thicker than a cut-off of 2 mm (odds ratio: 7.53, P < 0.01). A 4-mm thickness cut-off was also statistically significant (P < 0.05); however, the odds ratio was smaller at 2.52. Despite some previous evidence for a 4-mm tumour thickness cut-off in oral tongue SCCs, thinner tumours (2-3.9 mm) can also have a propensity for cervical node metastasis. Patients in this category require close monitoring for regional recurrence if they do not have a neck dissection. © 2016 Royal Australasian College of Surgeons.

Reference values for voluntary and stimulated single-fibre EMG using concentric needle electrodes: a multicentre prospective study.

PubMed

Kokubun, Norito; Sonoo, Masahiro; Imai, Tomihiro; Arimura, Yumiko; Kuwabara, Satoshi; Komori, Tetsuo; Kobayashi, Masahito; Nagashima, Takahide; Hatanaka, Yuki; Tsuda, Emiko; Misawa, Sonoko; Abe, Tatsuya; Arimura, Kimiyoshi

2012-03-01

The aim of this study is to establish reference values for single-fibre electromyography (SFEMG) using concentric needles in a prospective, multicentre study. Voluntary or stimulated SFEMG at the extensor digitorum communis (EDC) or frontalis (FRO) muscles was conducted in 56-63 of a total of 69 normal subjects below the age of 60years at six Japanese institutes. The cut-off values for mean consecutive difference (MCD) of individual potentials were calculated using +2.5 SD or 95% prediction limit (one-tail) of the upper 10th percentile MCD value for individual subjects. The cut-off values for individual MCD (+2.5 SD) were 56.8μs for EDC-V (voluntary SFEMG for EDC), 58.8μs for EDC-S (stimulated SFEMG for EDC), 56.8μs for FRO-V (voluntary SFEMG for FRO) and 51.0μs for FRO-S (stimulated SFEMG for FRO). The false positive rates using these cut-off values were around 2%. The +2.5 SD and 95% prediction limit might be two optimal cut-off values, depending on the clinical question. The obtained reference values were larger than those reported previously using concentric needles, but might better coincide with conventional values. This is the first multicentre study reporting reference values for SFEMG using concentric needles. The way to determine cut-off values and the statistically correct definition of the percentile were discussed. Copyright © 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Derivation and validation of a simple clinical risk-model in heart failure based on 6 minute walk test performance and NT-proBNP status--do we need specificity for sex and beta-blockers?

PubMed

Frankenstein, L; Goode, K; Ingle, L; Remppis, A; Schellberg, D; Nelles, M; Katus, H A; Clark, A L; Cleland, J G F; Zugck, C

2011-02-17

It is unclear whether risk prediction strategies in chronic heart failure (CHF) need to be specific for sex or beta-blockers. We examined this problem and developed and validated the consequent risk models based on 6-minute-walk-test and NT-proBNP. The derivation cohort comprised 636 German patients with systolic dysfunction. They were validated against 676 British patients with similar aetiology. ROC-curves for 1-year mortality identified cut-off values separately for specificity (none, sex, beta-blocker, both). Patients were grouped according to number of cut-offs met (group I/II/III - 0/1/2 cut-offs). Widest separation between groups was achieved with sex- and beta-blocker-specific cut offs. In the derivation population, 1-year mortality was 0%, 8%, 31% for group I, II and III, respectively. In the validation population, 1-year rates in the three risk groups were 2%, 7%, 14%, respectively, after application of the same cut-offs. Risk stratification for CHF should perhaps take sex and beta-blocker usage into account. We derived and independently validated relevant risk models based on 6-minute-walk-tests and NT-proBNP. Specifying sex and use of beta-blockers identified three distinct sub-groups with widely differing prognosis. In clinical practice, it may be appropriate to tailor the intensity of follow-up and/or the treatment strategy according to the risk-group. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

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.

Study on Platinum Coating Depth in Focused Ion Beam Diamond Cutting Tool Milling and Methods for Removing Platinum Layer.

PubMed

Choi, Woong Kirl; Baek, Seung Yub

2015-09-22

In recent years, nanomachining has attracted increasing attention in advanced manufacturing science and technologies as a value-added processes to control material structures, components, devices, and nanoscale systems. To make sub-micro patterns on these products, micro/nanoscale single-crystal diamond cutting tools are essential. Popular non-contact methods for the macro/micro processing of diamond composites are pulsed laser ablation (PLA) and electric discharge machining (EDM). However, for manufacturing nanoscale diamond tools, these machining methods are not appropriate. Despite diamond's extreme physical properties, diamond can be micro/nano machined relatively easily using a focused ion beam (FIB) technique. In the FIB milling process, the surface properties of the diamond cutting tool is affected by the amorphous damage layer caused by the FIB gallium ion collision and implantation and these influence the diamond cutting tool edge sharpness and increase the processing procedures. To protect the diamond substrate, a protection layer-platinum (Pt) coating is essential in diamond FIB milling. In this study, the depth of Pt coating layer which could decrease process-induced damage during FIB fabrication is investigated, along with methods for removing the Pt coating layer on diamond tools. The optimum Pt coating depth has been confirmed, which is very important for maintaining cutting tool edge sharpness and decreasing processing procedures. The ultra-precision grinding method and etching with aqua regia method have been investigated for removing the Pt coating layer. Experimental results show that when the diamond cutting tool width is bigger than 500 nm, ultra-precision grinding method is appropriate for removing Pt coating layer on diamond tool. However, the ultra-precision grinding method is not recommended for removing the Pt coating layer when the cutting tool width is smaller than 500 nm, because the possibility that the diamond cutting tool is damaged by the grinding process will be increased. Despite the etching method requiring more procedures to remove the Pt coating layer after FIB milling, it is a feasible method for diamond tools with under 500 nm width.

Reversibly pH-responsive polyurethane membranes for on-demand intravaginal drug delivery.

PubMed

Kim, Seungil; Chen, Yufei; Ho, Emmanuel A; Liu, Song

2017-01-01

To provide better protection for women against sexually transmitted infections, on-demand intravaginal drug delivery was attempted by synthesizing reversibly pH-sensitive polyether-polyurethane copolymers using poly(ethylene glycol) (PEG) and 1,4-bis(2-hydroxyethyl)piperazine (HEP). Chemical structure and thermo-characteristics of the synthesized polyurethanes were confirmed by attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR), 1 H-nuclear magnetic resonance ( 1 H-NMR), and melting point testing. Membranes were cast by solvent evaporation method using the prepared pH-sensitive polyurethanes. The impact of varying pH on membrane swelling and surface morphology was evaluated via swelling ratio change and scanning electron microscopy (SEM). The prepared pH-responsive membranes showed two times higher swelling ratio at pH 4 than pH 7 and pH-triggered switchable surface morphology change. The anionic anti-inflammatory drug diclofenac sodium (NaDF) was used as a model compound for release studies. The prepared pH-responsive polyurethane membranes allowed continuous NaDF release for 24h and around 20% release of total NaDF within 3h at pH 7 but little-to-no drug release at pH 4.5. NaDF permeation across the prepared membranes demonstrated a reversible pH-responsiveness. The pH-responsive polyurethane membranes did not show any noticeable negative impact on vaginal epithelial cell viability or induction of pro-inflammatory cytokine production compared to controls. Overall, the non-cytotoxic HEP-based pH-responsive polyurethane demonstrated its potential to be used in membrane-based implants such as intravaginal rings to achieve on-demand "on-and-off" intravaginal drug delivery. A reversible and sharp switch between "off" and "on" drug release is achieved for the first time through new pH-sensitive polyurethane membranes, which can serve as window membranes in reservoir-type intravaginal rings for on-demand drug delivery to prevent sexually transmitted infections (STIs). Close to zero drug release occurs at the normal vaginal pH (4.5) for minimal side effects. Drug release is only triggered by elevation of pH to 7 during heterosexual intercourse. The reversibly sharp and fast "on-and-off" switch arises from the creative incorporation of a pH-sensitive monomer in the soft segment of polyurethane. This polyurethane biomaterial holds great potential to better protect women who are generally at higher risk and are more vulnerable to STIs. Copyright © 2016 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

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.

The utility of the Edmonton Symptom Assessment System in screening for anxiety and depression.

PubMed

Bagha, S M; Macedo, A; Jacks, L M; Lo, C; Zimmermann, C; Rodin, G; Li, M

2013-01-01

The Edmonton Symptom Assessment System (ESAS) is a common screening tool in cancer, although its validity for distress screening is unproven. Here, screening performance of the ESAS anxiety (ESAS-A) and depression (ESAS-D) items were validated against the anxiety [Generalised Anxiety Disorder-7 (GAD-7)] and depression [Patient Health Questionnaire-9 (PHQ-9)] subscales of the PHQ. A total of 1215 cancer patients completed the Distress Assessment and Response Tool (DART), a computerised distress screening instrument. Spearman's rank correlation coefficients and receiver operating characteristic curve analyses were used to evaluate the ability of ESAS-A and ESAS-D to identify moderate distress (GAD-7/PHQ-9 ≥ 10). Spearman's rank correlation coefficients comparing ESAS-A and ESAS-D with GAD-7 and PHQ-9 were 0.74 and 0.72 respectively. Areas under the receiver operating characteristic curves were 0.89 and 0.88 for anxiety and depression respectively. A cut-off of ≥3 on ESAS-A demonstrated a sensitivity of 0.91, specificity of 0.68, positive predictive value of 0.34 and negative predictive value of 0.97. A cut-off of ≥2 on the ESAS-D demonstrated a sensitivity of 0.86, specificity of 0.72, positive predictive value of 0.46 and negative predictive value of 0.95. High sensitivities of ESAS-A and ESAS-D at certain cut-offs suggest they have use in ruling-out distress. However, their low specificities indicate secondary screening is needed to rule-in anxiety or depression for case-finding. © 2012 Blackwell Publishing Ltd.

Use of the Pediatric Symptom Checklist for the detection of psychosocial problems in preventive child healthcare

PubMed Central

Reijneveld, Sijmen A; Vogels, Anton GC; Hoekstra, Femke; Crone, Matty R

2006-01-01

Background Early detection and treatment of psychosocial problems by preventive child healthcare may lead to considerable health benefits, and a short questionnaire could support this aim. The aim of this study was to assess whether the Dutch version of the US Pediatric Symptom checklist (PSC) is valid and suitable for the early detection of psychosocial problems among children. Methods We included 687 children (response 84.3%) aged 7–12 undergoing routine health assessments in nine Preventive Child Health Services across the Netherlands. Child health professionals interviewed and examined children and parents. Before the interview, parents completed an authorised Dutch translation of the PSC and the Child Behavior Checklist (CBCL). The CBCL and data on the child's current treatment status were used as criteria for the validity of the PSC. Results The consistency of the Dutch PSC was good (Cronbach alpha 0.89). The area under the ROC curve using the CBCL as a criterion was 0.94 (95% confidence interval 0.92 to 0.96). At the US cut-off (28 and above), the prevalence rate of an increased score and sensitivity were lower than in the USA. At a lower cut-off (22 and above), sensitivity and specificity were similar to that of the US version (71.7% and 93.0% respectively). Information on the PSC also helped in the identification of children with elevated CBCL Total Problems Scores, above solely clinical judgment. Conclusion The PSC is also useful for the early detection of psychosocial problems in preventive child healthcare outside the USA, especially with an adjusted cut-off. PMID:16872535

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…

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.

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

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.

Prevalence of overweight and obesity among children aged 2-5 years in Bahrain: a comparison between two reference standards.

PubMed

Al-Raees, Ghada Y; Al-Amer, Maryam A; Musaiger, Abdulrahman O; D'Souza, Reshma

2009-01-01

A cross-sectional study was carried out on Bahraini preschoolers aged 2-5 years (354 males and 344 females) to determine the prevalence of overweight and obesity using the World Health Organization and the International Obesity Task Force cut-off values. Weight and height were recorded and body mass index (BMI) was calculated to determine the proportion of overweight and obesity. Using the World Health Organization percentile cut-off values, overweight (12.3%) and obesity (8.4%) was higher in females between 2 and <4 years of age whereas, the proportion of both overweight (8.4%) and obesity (7.2%) were higher in males between 4 and <6 years of age. Relative to the International Obesity Task Force indicators, the World Health Organization cut-off values produced nearly a 2-fold increase in both overweight and obesity at most ages. It is therefore important to ensure that the same cut-off reference values are used to define overweight and obesity particularly in preschoolers. Shifting to the new World Health Organization child growth standards may have important implications for child health programmes.

Plastic covering on airfoil structure provides smooth uninterrupted surface

NASA Technical Reports Server (NTRS)

Kinzler, J. A.; Fehrenkamp, L. G.; Heffernam, J. T.; Lee, W. S.

1975-01-01

Primed surface is covered with adhesive. Sheet of plastic film is stretched over adhesive and mechanical holder is used to apply tension to ends of sheet to make it conform to surface of airfoil. After adhesive cures, plastic can be trimmed with sharp cutting tool.

Propagation of waves in elliptic ducts. A theoretical study. [in view of jet engine compressor noise reduction

NASA Technical Reports Server (NTRS)

Baskaran, S.

1974-01-01

The cut-off frequencies for high order circumferential modes were calculated for various eccentricities of an elliptic duct section. The problem was studied with a view to the reduction of jet engine compressor noise by elliptic ducts, instead of circular ducts. The cut-off frequencies for even functions decrease with increasing eccentricity. The third order eigen frequencies are oscillatory as the eccentricity increases for odd functions. The eigen frequencies decrease for higher order odd functions inasmuch as, for higher orders, they assume the same values as those for even functions. Deformation of a circular pipe into an elliptic one of sufficiently large eccentricity produces only a small reduction in the cut-off frequency, provided the area of the pipe section is kept invariable.

From stable to unstable anomaly-induced inflation

NASA Astrophysics Data System (ADS)

Netto, Tibério de Paula; Pelinson, Ana M.; Shapiro, Ilya L.; Starobinsky, Alexei A.

2016-10-01

Quantum effects derived through conformal anomaly lead to an inflationary model that can be either stable or unstable. The unstable version requires a large dimensionless coefficient of about 5× {10}^8 in front of the {R}^2 term that results in the inflationary regime in the R+{R}^2 ("Starobinsky") model being a generic intermediate attractor. In this case the non-local terms in the effective action are practically irrelevant, and there is a `graceful exit' to a low curvature matter-like dominated stage driven by high-frequency oscillations of R - scalarons, which later decay to pairs of all particles and antiparticles, with the amount of primordial scalar (density) perturbations required by observations. The stable version is a genuine generic attractor, so there is no exit from it. We discuss a possible transition from stable to unstable phases of inflation. It is shown that this transition is automatic if the sharp cut-off approximation is assumed for quantum corrections in the period of transition. Furthermore, we describe two different quantum mechanisms that may provide a required large {R}^2-term in the transition period.

An Experimental Study of the Effect of Judges' Knowledge of Item Data on Two Forms of the Angoff Standard Setting Method.

ERIC Educational Resources Information Center

Garrido, Mariquita; Payne, David A.

Minimum competency cut-off scores on a statistics exam were estimated under four conditions: the Angoff judging method with item data (n=20), and without data available (n=19); and the Modified Angoff method with (n=19), and without (n=19) item data available to judges. The Angoff method required free response percentage estimates (0-100) percent,…

Simple criteria to predict margin involvement after chemoradiotherapy and sphincter-sparing for low rectal cancer.

PubMed

Dumont, F; Tilly, C; Dartigues, P; Goéré, D; Honoré, C; Elias, D

2015-09-01

Low rectal cancers carry a high risk of circumferential margin involvement (CRM+). The anatomy of the lower part of the rectum and a long course of chemoradiotherapy (CRT) limit the accuracy of imaging to predict the CRM+. Additional criteria are required. Eighty six patients undergoing rectal resection with a sphincter-sparing procedure after CRT for low rectal cancer between 2000 and 2013 were retrospectively reviewed. Risk factors of CRM+ and the cut-off number of risk factors required to accurately predict the CRM+ were analyzed. The CRM+ rate was 9.3% and in the multivariate analysis, the significant risk factors were a tumor size exceeding 3 cm, poor response to CRT and a fixed tumor. The best cut-off to predict CRM+ was the presence of 2 risk factors. Patients with 0-1 and 2-3 risk factors had a CRM+ respectively in 1.3% and 50% of cases and a 3-year recurrence rate of 7% and 35% after a median follow-up of 50 months. Poor response, a residual tumor greater than 3 cm and a fixed tumor are predictive of CRM+. Sphincter sparing is an oncological safety procedure for patients with 0-1 criteria but not for patients with 2-3 criteria. Copyright © 2015 Elsevier Ltd. All rights reserved.

Frequency weighting for vibration-induced white finger compatible with exposure-response models.

PubMed

Brammer, Anthony J; Pitts, Paul M

2012-01-01

An analysis has been performed to derive a frequency weighting for the development of vibration-induced white finger (VWF). It employs a model to compare health risks for pairs of population groups that are selected to have similar health outcomes from operating power tools or machines with markedly different acceleration spectra (rock drills, chain saws, pavement breakers and motorcycles). The model defines the Relative Risk, RR(f(trial)), which is constructed from the ratio of daily exposures and includes a trial frequency weighting that is applied to the acceleration spectra. The trial frequency weighting consists of a frequency-independent primary frequency range, and subordinate frequency ranges in which the response to vibration diminishes, with cut-off frequencies that are changed to influence the magnitude of RR(f(trial)). The frequency weighting so derived when RR(f(trial)) = 1 is similar to those obtained by other methods (W(hf), W(hT)). It consists of a frequency independent range from about 25 Hz to 500 Hz (-3 dB frequencies), with an amplitude cut-off rate of 12 dB/octave below 25 Hz and above 500 Hz. The range is compatible with studies of vasoconstriction in persons with VWF. The results provide further evidence that the ISO frequency weighting may be inappropriate for assessing the risk of developing VWF.

[The morphological features of skin wounds inflicted by joinery hand saws designed for different types of sawing].

PubMed

Sarkisian, B A; Azarov, P A

2014-01-01

The objective of the present work was to study the morphological features of skin wounds inflicted by joinery hand saws designed for longitudinal, transverse, and mixed sawing. A total of 60 injuries to the thigh skin inflicted by the recurring and reciprocating saw movements were simulated. The hand saws had 5 mm high "sharp" and "blunt"-tipped teeth. The analysis of the morphological features of the wounds revealed differences in their length and depth, shape of edge cuts and defects, and the relief of the walls depending on the sawtooth sharpness and the mode of sawing. It is concluded that morphological features of the wounds may be used to determine the type of the saw, the sharpness of its teeth, the direction and frequency of its movements.

Method and device for stand-off laser drilling and cutting

DOEpatents

Copley, John A.; Kwok, Hoi S.; Domankevitz, Yacov

1989-09-26

A device for perforating material and a method of stand-off drilling using a laser. In its basic form a free-running laser beam creates a melt on the target and then a Q-switched short duration pulse is used to remove the material through the creation of a laser detonation wave. The advantage is a drilling/cutting method capable of working a target at lengthy stand-off distance. The device may employ 2 lasers or a single one operated in a free-running/Q-switched dual mode.

Does cone beam CT actually ameliorate stab wound analysis in bone?

PubMed

Gaudio, D; Di Giancamillo, M; Gibelli, D; Galassi, A; Cerutti, E; Cattaneo, C

2014-01-01

This study aims at verifying the potential of a recent radiological technology, cone beam CT (CBCT), for the reproduction of digital 3D models which may allow the user to verify the inner morphology of sharp force wounds within the bone tissue. Several sharp force wounds were produced by both single and double cutting edge weapons on cancellous and cortical bone, and then acquired by cone beam CT scan. The lesions were analysed by different software (a DICOM file viewer and reverse engineering software). Results verified the limited performances of such technology for lesions made on cortical bone, whereas on cancellous bone reliable models were obtained, and the precise morphology within the bone tissues was visible. On the basis of such results, a method for differential diagnosis between cutmarks by sharp tools with a single and two cutting edges can be proposed. On the other hand, the metrical computerised analysis of lesions highlights a clear increase of error range for measurements under 3 mm. Metric data taken by different operators shows a strong dispersion (% relative standard deviation). This pilot study shows that the use of CBCT technology can improve the investigation of morphological stab wounds on cancellous bone. Conversely metric analysis of the lesions as well as morphological analysis of wound dimension under 3 mm do not seem to be reliable.

Analysis of a quantitative PCR assay for CMV infection in liver transplant recipients: an intent to find the optimal cut-off value.

PubMed

Martín-Dávila, P; Fortún, J; Gutiérrez, C; Martí-Belda, P; Candelas, A; Honrubia, A; Barcena, R; Martínez, A; Puente, A; de Vicente, E; Moreno, S

2005-06-01

Preemptive therapy required highly predictive tests for CMV disease. CMV antigenemia assay (pp65 Ag) has been commonly used for rapid diagnosis of CMV infection. Amplification methods for early detection of CMV DNA are under analysis. To compare two diagnostic methods for CMV infection and disease in this population: quantitative PCR (qPCR) performed in two different samples, plasma and leukocytes (PMNs) and using a commercial diagnostic test (COBAS Amplicor Monitor Test) versus pp65 Ag. Prospective study conducted in liver transplant recipients from February 2000 to February 2001. Analyses were performed on 164 samples collected weekly during early post-transplant period from 33 patients. Agreements higher than 78% were observed between the three assays. Optimal qPCR cut-off values were calculated using ROC curves for two specific antigenemia values. For antigenemia >or=10 positive cells, the optimal cut-off value for qPCR in plasma was 1330 copies/ml, with a sensitivity (S) of 58% and a specificity (E) of 98% and the optimal cut-off value for qPCR-cells was 713 copies/5x10(6) cells (S:91.7% and E:86%). Using a threshold of antigenemia >or=20 positive cells, the optimal cut-off values were 1330 copies/ml for qPCR-plasma (S 87%; E 98%) and 4755 copies/5x10(6) cells for qPCR-cells (S 87.5%; E 98%). Prediction values for the three assays were calculated in patients with CMV disease (9 pts; 27%). Considering the assays in a qualitative way, the most sensitive was CMV PCR in cells (S: 100%, E: 54%, PPV: 40%; NPV: 100%). Using specific cut-off values for disease detection the sensitivity, specificity, PPV and NPV for antigenemia >or=10 positive cells were: 89%; 83%; 67%; 95%, respectively. For qPCR-cells >or=713 copies/5x10(6) cells: 100%; 54%; 33% and 100% and for plasma-qPCR>or=1330 copies/ml: 78%, 77%, 47%, 89% respectively. Optimal cut-off for viral load performed in plasma and cells can be obtained for the breakpoint antigenemia value recommended for initiating preemptive therapy with high specificities and sensitivities. Diagnostic assays like CMV pp65 Ag and quantitative PCR for CMV have similar efficiency and could be recommended as methods of choice for diagnosis and monitoring of active CMV infection after transplantation.

Urban and Education Disparity for Autism Spectrum Disorders in Taiwan Birth Cohort Study

ERIC Educational Resources Information Center

Lung, For-Wey; Chiang, Tung-Liang; Lin, Shio-Jean; Shu, Bih-Ching

2017-01-01

This study aimed to determine the optimal cut-off for autism spectrum disorder (ASD) screening in 66-month-old children, and to explore the distribution of ASD screening and diagnosis in Taiwan. The Taiwan Birth Cohort Study dataset was used (N = 20,095). The Modified Checklist for Autism in Toddlers (M-CHAT) cut-off point of 13/14 was considered…

White oak epicotyl emergence and 1-0 seedling growth from surgically altered germinating acorns

Treesearch

Shi-Jean Susana Sung; Paul P. Kormanik; Stanley J. Zarnoch

2010-01-01

Open-pollinated white oak (Quercus alba L.) acorns were collected and stored at 4 °C in November 2004. Three days before sowing in early December, we treated germinating acorns in five ways: no surgery (C); one half of the radical cut off (HR); whole radicle cut off (WR); one cotyledonary petiole severed (OP); and both cotyledonary petioles severed,...

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

Code of Federal Regulations, 2010 CFR

2010-04-01

... § 1.585-7 Elective cut-off method of changing from the reserve method of section 585. (a) General rule... section, and the bank must include in income any excess balance in this reserve, as required by paragraph...-disqualification loans—(1) In general. A bank that makes the election allowed by paragraph (a) of this section must...

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

ERIC Educational Resources Information Center

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

2013-01-01

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

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

ERIC Educational Resources Information Center

Looney, Marilyn A.; Gilbert, Jennie

2012-01-01

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

Action-oriented colour-coded foot length calliper for primary healthcare workers as a proxy for birth weight & gestational period.

PubMed

Pratinidhi, Asha K; Bagade, Abhijit C; Kakade, Satish V; Kale, Hemangi P; Kshirsagar, Vinayak Y; Babar, Rohini; Bagal, Shilpa

2017-03-01

Foot length of the newborn has a good correlation with the birth weight and is recommended to be used as a proxy measure. There can be variations in the measurement of foot length. A study was, therefore, carried out to develop a foot length calliper for accurate foot length measurement and to find cut-off values for birth weight and gestational age groups to be used by primary healthcare workers. This study was undertaken on 645 apparently healthy newborn infants with known gestational age. Nude birth weight was taken within 24 h of birth on a standard electronic weighing machine. A foot length calliper was developed. Correlation between foot length and birth weight as well as gestational age was calculated. Correctness of cut-off values was tested using another set of 133 observations on the apparently healthy newborns. Action-oriented colour coding was done to make it easy for primary healthcare workers to use it. There was a significant correlation of foot length with birth weight (r=0.75) and gestational age (r=0.63). Cut-off values for birth weight groups were 6.1, 6.8 and 7.3 cm and for gestational age of 6.1, 6.8 and 7.0 cm. Correctness of these cut-off values ranged between 77.1 and 95.7 per cent for birth weight and 60-93.3 per cent for gestational age. Considering 2.5 kg as cut-off between normal birth weight and low birth weight (LBW), cut-off values of 6.1, 6.8 and 7.3 were chosen. Action-oriented colour coding was done by superimposing the colours on the scale of the calliper, green indicating home care, yellow indicating supervised home care, orange indicating care at newborn care units at primary health centres and red indicating Neonatal Intensive Care Unit care for infants. A simple device was developed so that the primary health care workers and trained Accredited Social Health Activist workers can identify the risk of LBW in the absence of accurate weighing facilities and decide on the type of care needed by the newborn and take action accordingly.

Validation of the AUDIT-C in adults seeking help with their drinking online.

PubMed

Khadjesari, Zarnie; White, Ian R; McCambridge, Jim; Marston, Louise; Wallace, Paul; Godfrey, Christine; Murray, Elizabeth

2017-01-04

The abbreviated Alcohol Use Disorder Identification Test for Consumption (AUDIT-C) is rapidly becoming the alcohol screening tool of choice for busy practitioners in clinical settings and by researchers keen to limit assessment burden and reactivity. Cut-off scores for detecting drinking above recommended limits vary by population, setting, country and potentially format. This validation study aimed to determine AUDIT-C thresholds that indicated risky drinking among a population of people seeking help over the Internet. The data in this study were collected in the pilot phase of the Down Your Drink trial, which recruited people seeking help over the Internet and randomised them to a web-based intervention or an information-only website. Sensitivity, specificity, and positive and negative likelihood ratios were calculated for AUDIT-C scores, relative to weekly consumption that indicated drinking above limits and higher risk drinking. Receiver-operating characteristic (ROC) curves were created to assess the performance of different cut-off scores on the AUDIT-C for men and women. Past week alcohol consumption was used as the reference-standard and was collected via the TOT-AL, a validated online measure of past week drinking. AUDIT-C scores were obtained from 3720 adults (2053 female and 1667 male) searching the internet for help with drinking, mostly from the UK. The area under the ROC curve for risky drinking was 0.84 (95% CI 0.80, 0.87) (female) and 0.80 (95% CI 0.76, 0.84) (male). AUDIT-C cut-off scores for detecting risky drinking that maximise the sum of sensitivity and specificity were ≥8 for women and ≥8 for men; whereas those identifying the highest proportion of correctly classified individuals were ≥4 for women and ≥5 for men. AUDIT-C cut-off scores for detecting higher risk drinking were also calculated. AUDIT-C cut-off scores for identifying alcohol consumption above weekly limits in this largely UK based study population were substantially higher than those reported in other validation studies. Researchers and practitioners should select AUDIT-C cut-off scores according to the purpose of identifying risky drinkers and hence the relative importance of sensitivity and/or specificity.

The role of ascitic fluid viscosity in differentiating the nature of ascites and in the prediction of renal impairment and duration of ICU stay.

PubMed

Hanafy, Amr S

2016-09-01

Serum-ascites albumin gradient (SAAG) has been used in the classification of ascites for the last 20 years but it has some drawbacks. This study searches for possible correlations between ascitic fluid viscosity and the etiology of ascites, renal impairment, and length of ICU stay. The study was conducted in Zagazig University Hospital, Egypt. It included 240 patients with ascites due to various causes. The patients were divided into two groups: the cirrhotic ascites group, which included 120 patients, and the noncirrhotic ascites group, which included 120 patients. Ascitic patients on medical management with diuretics, antibiotics, paracentesis, and infusion of plasma or albumin were excluded.The laboratory analysis included routine investigations to detect the cause of ascites as well as specific investigations such as ascitic fluid viscosity using a falling ball viscosimeter (microviscosimeter) at 37°C. The mean ascitic viscosity of patients with SAAG at least 1.1 was 1.16±0.56, which was associated with serum creatinine 1.35±0.52 mg/dl and ICU stay of 3.3±1.2 days. In patients with SAAG less than 1.1 g/dl, the mean ascitic viscosity was 2.98±0.87, with serum creatinine 2.1±0.56 mg/dl and ICU stay of 7.1±1.3 days. Ascitic viscosity can discriminate ascites due to portal hypertension from those associated with nonportal hypertension at a cut-off value of 1.65; it can predict renal impairment in hepatic patients at a cut-off of 1.35 and long ICU stay at a cut-off of 1.995 using receiver operating characteristic analysis. Ascitic viscosity measurement is rapid, inexpensive, and requires small sample volumes. Ascitic viscosity can discriminate ascites due to portal hypertension from those associated with nonportal hypertension at a cut-off value of 1.65. It can predict renal impairment in hepatic patients at a cut-off of 1.35 and long ICU stay at a cut-off of 1.995.

Data analytics identify glycated haemoglobin co-markers for type 2 diabetes mellitus diagnosis.

PubMed

Jelinek, Herbert F; Stranieri, Andrew; Yatsko, Andrew; Venkatraman, Sitalakshmi

2016-08-01

Glycated haemoglobin (HbA1c) is being more commonly used as an alternative test for the identification of type 2 diabetes mellitus (T2DM) or to add to fasting blood glucose level and oral glucose tolerance test results, because it is easily obtained using point-of-care technology and represents long-term blood sugar levels. HbA1c cut-off values of 6.5% or above have been recommended for clinical use based on the presence of diabetic comorbidities from population studies. However, outcomes of large trials with a HbA1c of 6.5% as a cut-off have been inconsistent for a diagnosis of T2DM. This suggests that a HbA1c cut-off of 6.5% as a single marker may not be sensitive enough or be too simple and miss individuals at risk or with already overt, undiagnosed diabetes. In this study, data mining algorithms have been applied on a large clinical dataset to identify an optimal cut-off value for HbA1c and to identify whether additional biomarkers can be used together with HbA1c to enhance diagnostic accuracy of T2DM. T2DM classification accuracy increased if 8-hydroxy-2-deoxyguanosine (8-OhdG), an oxidative stress marker, was included in the algorithm from 78.71% for HbA1c at 6.5% to 86.64%. A similar result was obtained when interleukin-6 (IL-6) was included (accuracy=85.63%) but with a lower optimal HbA1c range between 5.73 and 6.22%. The application of data analytics to medical records from the Diabetes Screening programme demonstrates that data analytics, combined with large clinical datasets can be used to identify clinically appropriate cut-off values and identify novel biomarkers that when included improve the accuracy of T2DM diagnosis even when HbA1c levels are below or equal to the current cut-off of 6.5%. Copyright © 2016 Elsevier Ltd. All rights reserved.

Round-off errors in cutting plane algorithms based on the revised simplex procedure

NASA Technical Reports Server (NTRS)

Moore, J. E.

1973-01-01

This report statistically analyzes computational round-off errors associated with the cutting plane approach to solving linear integer programming problems. Cutting plane methods require that the inverse of a sequence of matrices be computed. The problem basically reduces to one of minimizing round-off errors in the sequence of inverses. Two procedures for minimizing this problem are presented, and their influence on error accumulation is statistically analyzed. One procedure employs a very small tolerance factor to round computed values to zero. The other procedure is a numerical analysis technique for reinverting or improving the approximate inverse of a matrix. The results indicated that round-off accumulation can be effectively minimized by employing a tolerance factor which reflects the number of significant digits carried for each calculation and by applying the reinversion procedure once to each computed inverse. If 18 significant digits plus an exponent are carried for each variable during computations, then a tolerance value of 0.1 x 10 to the minus 12th power is reasonable.

Alterations of channel parameters in response to river regulation works since 1840 on the Lower Tisza River (Hungary)

NASA Astrophysics Data System (ADS)

Kiss, Tímea; Fiala, Károly; Sipos, György

2008-06-01

In the last few years an increase in the frequency and magnitude of floods was detected on the Tisza River, endangering large areas of Hungary. The causes of these record floods were complex, including both natural and human induced factors. This paper focuses on river management works and their effect on planimetric and cross-sectional parameters, with special attention to the flood conductivity changes to the river channel. During 19th century river regulation works, half of the total length of the Tisza River was altered by cut-offs, while in the 20th century mostly revetments and groynes were constructed. Subsequently, horizontal and vertical channel parameters have changed considerably due to semi-natural bed processes. In order to reveal changes, hydrological map series (1842, 1890, 1929, 1957, 1976 and 1999) and cross-sectional surveys from the same dates were analysed. Prior to the intensive human interventions (before 1890s) the river's course was highly sinuous with some very sharp bends. Due to cut-offs both the length and sinuosity of the Tisza River decreased by 35%, while the lengths of straight sections and the river's slope doubled. As a consequence the river incised by up to 3.8 m until the 1929 survey, resulting better flood conductivity, which improved flood safety. In the 1920s river management favoured bank stabilisation in order to stop the lateral migration of the channel. Despite these measures, meander development has continued, however, in a distorted manner. This is reflected by the opposing processes of lengthening centre-line on the one hand and gradually decreasing radius of curvature on the other. These processes can be explained by the continuous development of natural point-bars on the convex bank, and the lack of lateral retreat on the concave stabilised bank. The width of the river decreased by 17-45%, while its mean and maximum depth increased by 5-48%. The area of cross-sections influenced by revetments decreased by 6-19%, resulting in a 6-15% decline in flood conductivity. The non-stabilised sections were influenced by upstream revetments. Therefore, their parameters show similar changes, but with a smaller rate. At present, the flood conductivity of the channel is worse than it was in its natural state. In all, it was found that the ongoing process of cross-sectional distortion is a significant factor in increasing flood stage and hazard, and high floods can be expected more frequently in the future partly due to this factor.

Eardrum repair

MedlinePlus

... is filled with liquid. There may be sharp, shooting pains off and on soon after the surgery. ... Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David ...

The assessment of fatigue: Psychometric qualities and norms for the Checklist individual strength.

PubMed

Worm-Smeitink, M; Gielissen, M; Bloot, L; van Laarhoven, H W M; van Engelen, B G M; van Riel, P; Bleijenberg, G; Nikolaus, S; Knoop, H

2017-07-01

The Checklist Individual Strength (CIS) measures four dimensions of fatigue: Fatigue severity, concentration problems, reduced motivation and activity. On the fatigue severity subscale, a cut-off score of 35 is used. This study 1) investigated the psychometric qualities of the CIS; 2) validated the cut-off score for severe fatigue and 3) provided norms. Representatives of the Dutch general population (n=2288) completed the CIS. The factor structure was investigated using an exploratory factor analysis. Internal consistency and test-retest reliability were determined. Concurrent validity was assessed in two additional samples by correlating the CIS with other fatigue scales (Chalder Fatigue Questionnaire, MOS Short form-36 Vitality subscale, EORTC QLQ-C30 fatigue subscale). To validate the fatigue severity cut-off score, a Receiver Operating Characteristics analysis was performed with patients referred to a chronic fatigue treatment centre (n=5243) and a healthy group (n=1906). Norm scores for CIS subscales were calculated for the general population, patients with chronic fatigue syndrome (CFS; n=1407) and eight groups with other medical conditions (n=1411). The original four-factor structure of the CIS was replicated. Internal consistency (α=0.84-0.95) and test-retest reliability (r=0.74-0.86) of the subscales were high. Correlations with other fatigue scales were moderate to high. The 35 points cut-off score for severe fatigue is appropriate, but, given the 17% false positive rate, should be adjusted to 40 for research in CFS. The CIS is a valid and reliable tool for the assessment of fatigue, with a validated cut-off score for severe fatigue that can be used in clinical practice. Copyright © 2017. Published by Elsevier Inc.

Interpretation of diagnostic data: 4. How to do it with a more complex table.

PubMed

1983-10-15

A more complex table is especially useful when a diagnostic test produces a wide range of results and your patient's levels are near one of the extremes. The following guidelines will be useful: Identify the several cut-off points that could be used. Fill in a complex table along the lines of Table I, showing the numbers of patients at each level who have and do not have the target disorder. Generate a simple table for each cut-off point, as in Table II, and determine the sensitivity (TP rate) and specificity (TN rate) at each of them. Select the cut-off point that makes the most sense for your patient's test result and proceed as in parts 2 and 3 of our series. Alternatively, construct an ROC curve by plotting the TP and FP rates that attend each cut-off point. If you keep your tables and ROC curves close at hand, you will gradually accumulate a set of very useful guides. However, if you looked very hard at what was happening, you will probably have noticed that they are not very useful for patients whose test results fall in the middle zones, or for those with just one positive result of two tests; the post-test likelihood of disease in these patients lurches back and forth past 50%, depending on where the cut-off point is. We will show you how to tackle this problem in part 5 of our series. It involves some maths, but you will find that its very powerful clinical application can be achieved with a simple nomogram or with some simple calculations.

The Optimal Cut-Off Value of Neutrophil-to-Lymphocyte Ratio for Predicting Prognosis in Adult Patients with Henoch–Schönlein Purpura

PubMed Central

Park, Chan Hyuk; Han, Dong Soo; Jeong, Jae Yoon; Eun, Chang Soo; Yoo, Kyo-Sang; Jeon, Yong Cheol; Sohn, Joo Hyun

2016-01-01

Background The development of gastrointestinal (GI) bleeding and end-stage renal disease (ESRD) can be a concern in the management of Henoch–Schönlein purpura (HSP). We aimed to evaluate whether the neutrophil-to-lymphocyte ratio (NLR) is associated with the prognosis of adult patients with HSP. Methods Clinical data including the NLR of adult patients with HSP were retrospectively analyzed. Patients were classified into three groups as follows: (a) simple recovery, (b) wax & wane without GI bleeding, and (c) development of GI bleeding. The optimal cut-off value was determined using a receiver operating characteristics curve and the Youden index. Results A total of 66 adult patients were enrolled. The NLR was higher in the GI bleeding group than in the simple recovery or wax & wane group (simple recovery vs. wax & wane vs. GI bleeding; median [IQR], 2.32 [1.61–3.11] vs. 3.18 [2.16–3.71] vs. 7.52 [4.91–10.23], P<0.001). For the purpose of predicting simple recovery, the optimal cut-off value of NLR was 3.18, and the sensitivity and specificity were 74.1% and 75.0%, respectively. For predicting development of GI bleeding, the optimal cut-off value was 3.90 and the sensitivity and specificity were 87.5% and 88.6%, respectively. Conclusions The NLR is useful for predicting development of GI bleeding as well as simple recovery without symptom relapse. Two different cut-off values of NLR, 3.18 for predicting an easy recovery without symptom relapse and 3.90 for predicting GI bleeding can be used in adult patients with HSP. PMID:27073884

Prevalence of Bovine Tuberculosis in Egyptian Cattle and the Standardization of the Interferon-gamma Assay as an Ancillary Test.

PubMed

Abdellrazeq, G S; Elnaggar, M M; Osman, H S; Davis, W C; Singh, M

2016-10-01

Bovine tuberculosis (bTB) caused primarily by Mycobacterium bovis continues to cause significant losses in the cattle industry and is a major public health problem. Despite its worldwide application, the IFN-γ assay has not been applied in Egypt. The aim of this study was to determine the appropriate cut-off value of IFN-γ assay to complement the skin test screening in Egypt. The relative sensitivity (Ser ) of PPD and antigen cocktail-based IFN-γ assays (IFN-γ-BA and IFN-γ-EC) was analysed retrospectively, relative to bTB confirmatory tests (culture and PCR), using single cervical tuberculin (SCT) test reactors during 2011-2013. The absolute specificity (Sp) was studied using blood samples collected from cattle from one bTB-free herd. Analysis of the bTB database-generated sheets indicates the infection rate had decreased from 2009 to 2012 and then increased in 2013. The disease is concentrated in the Egyptian Nile Delta and Valley relative to elsewhere in the country. The cut-offs for IFN-γ-EC assay could be optimized to provide higher sensitivity, comparable to cut-offs for IFN-γ-BA assay. Data analysis suggests (PPDbOD  > 0.1, PPDbOD  - NILOD  > 0.05 and PPDbOD  > PPDaOD ) and (ECOD  - NILOD  ≥ 0.1) cut-off strategies to get optimal IFN-γ-BA and IFN-γ-EC assays results respectively. To our knowledge, this is the first report describing the prevalence of bTB in cattle in Egypt and pointing out the appropriate cut-off criteria to optimize IFN-γ assay as a routine ancillary test for diagnosis of bTB in Egypt. © 2014 Blackwell Verlag GmbH.

The impact of lowering the cut-off value on the sensitivity of the Platelia Elisa IgG (Bio-Rad) test for toxoplasmosis diagnosis

PubMed Central

Mouri, Oussama; Kendjo, Eric; Touafek, Feriel; Fekkar, Arnaud; Konte, Ousmane; Imbert, Sebastien; Courtin, Régis; Mazier, Dominique; Paris, Luc

2015-01-01

Determining specific immune status against Toxoplasma gondii is essential for assessing the risk of reactivation in immunocompromised patients or defining serological monitoring and appropriate prophylactic measures during pregnancy. In France, toxoplasmosis serological screening requires systematic testing for IgM and IgG antibodies. The Platelia Toxo IgG and IgM test (Bio-Rad) is one of the most widely used tests for anti-toxoplasmic antibody detection. We performed a study on 384 sera, including 123 IgG negative (<6 IU/mL) and 261 IgG equivocal (6–9 IU/mL) sera tested with Platelia Toxo IgG and collected during routine screening at Pitié-Salpêtrière Hospital, Paris, France to determine the best-performing IgG titer cut-off value. Out of these 383 sera, 298 were IgM negative by Platelia Toxo IgM and 86 were IgM positive. All sera were also tested against Toxo IgG II LD BIO western blot test as confirmation. Our results indicated that an IgG titer cut-off value of ≥4.4 IU/mL for the Platelia Toxo IgG met the definition of positivity, a value significantly lower than that indicated by the manufacturers. In the presence of IgM antibodies, the IgG titer cut-off decreased significantly to a value ≥0.2 IU/mL. This latter cut-off also allowed adequate diagnosis of proven toxoplasmosis seroconversion in 76.7% of cases (33/43). Our findings may improve toxoplasmosis care by reducing therapeutic intervention time and eliminating the need for further serological monitoring. PMID:26187780

The role of serum transferrin receptor in the diagnosis of iron deficiency.

PubMed

Remacha, A F; Sarda, M P; Parellada, M; Ubeda, J; Manteiga, R

1998-11-01

Iron deficiency anemia (IDA) is often associated with inflammatory disorders. The most conventional parameters of iron metabolism are therefore affected, making the evaluation of iron status difficult. Serum transferrin receptor (sTfR) levels are raised in iron deficiency but are not influenced by inflammatory changes. The aim of this study was to investigate the role of sTfR in differentiating IDA with inflammatory features. A diagnostic study of sTfR measured by immunoassay was carried out in IDA and anemia of chronic disorders (ACD). The cut-off points of sTfR and the ratio of sTfR/serum ferritin, which were obtained after comparing IDA and ACD, were applied to a group of 64 patients with mixed iron patterns (MIX) (16 with ACD and 48 with IDA). The best cut-off point of sTfR between IDA and ACD was 4.7 mg/L. Applying this cut-off to the MIX group, an efficiency of 87% was obtained (sensitivity 92% and specificity 81%). This level of sTfR correctly classified 53 out of 64 cases of the MIX group (83%). Using the ratio of sTfRx 100/serum ferritin, the best cut-off point was 8 (efficiency 100%), which correctly classified 62 out of 64 cases of the MIX group (97%). This study demonstrates that sTfR in conjunction with other iron parameters is very useful in iron deficiency evaluation, especially in hospital practice. Iron treatment should be considered in patients with mixed patterns of iron status, in which the diagnosis of IDA versus ACD is difficult, when the levels of sTfR exceed the cut-off point.

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.

Phototoxicity of B-RAF inhibitors: Exclusively due to UVA radiation and rapidly regressive.

PubMed

Gabeff, Romain; Dutartre, Hervé; Khammari, Amir; Boisrobert, Aurélie; Nguyen, Jean-Michel; Quereux, Gaëlle; Brocard, Anabelle; Saint-Jean, Mélanie; Peuvrel, Lucie; Dreno, Brigitte

2015-01-01

New targeted melanoma therapies such as B-RAF inhibitors have shown high and promising clinical benefit but have cutaneous side-effects, including photosensitivity, which is triggered in the UVA radiation spectrum. However, visible spectrum implication has not yet been investigated. We conducted a study to determine whether visible light also contributes to the phototoxicity action spectrum of vemurafenib. The secondary end points were to determine the time to complete regression of the phototoxicity post-vemurafenib discontinuation and whether there was a significant difference between the UVA radiation immediate reactivity cut-offs, in patients treated with vemurafenib vs. those treated with dabrafenib. This prospective, observational study included patients with B-RAF mutant metastatic melanoma: 34 patients treated with vemurafenib and 9 with dabrafenib. The visible-light phototest results in patients treated with vemurafenib were all negative before and after 2 months of treatment. The UVA radiation phototests conducted 1 or 2 weeks post-vemurafenib discontinuation in 4 patients showed a normalised UVA-radiation reactivity cut-off. UVA radiation phototests after 2 months of treatment were conducted for all patients. The UVA radiation reactivity cut-off had been lowered for 30 patients (88%) on vemurafenib and 3 patients (33%) on dabrafenib. The median UVA radiation reactivity cut-off was 12 J/cm(2) for the patients on vemurafenib and 20 J/cm(2) for the patients on dabrafenib. B-RAF inhibitor phototoxicity is exclusively triggered by UVA radiation and resolves rapidly post-treatment discontinuation. A significant difference between the UVA immediate reactivity cut-offs, vemurafenib vs. dabrafenib, explains the difference in the clinical photosensitivity rates reported in the clinical trials.

Performance of a commercial serum ELISA for the detection of antibodies to Neospora caninum in whole and skim milk samples.

PubMed

Byrem, T M; Bartlett, P C; Donohue, H; Voisinet, B D; Houseman, J T

2012-11-23

Control of Neospora caninum infection in cattle depends on specific, ante-mortem detection of infected animals and limiting their use as breeding stock or by culling. The objective of the present study was to determine appropriate cut-off values and diagnostic performance of a milk ELISA test using whole and skim milk in a commercial serum ELISA test (IDEXX Neospora Ab). Serum and milk samples were obtained from a total of 475 lactating cows from two herds with and two herds without a previous history of N. caninum-associated abortion. Overall seroprevalence determined by the ELISA was 18.3%. Compared to serum ELISA values, correlation and overall performance assessed by receiver operating characteristic analysis was higher when either whole or skim milk samples were diluted 1:2 compared to undiluted or 1:5 diluted samples. Diagnostic performance for analysis of whole and skim milk was compared at cut-off values that achieved a desired operating characteristic of at least 95% specificity. For whole milk diluted 1:2 and a cut-off of 0.14 (S/P ratio), sensitivity and kappa values were 74.7% (95% CI 64.3-83.4) and 0.70 (95% CI 0.61-0.78), respectively. For skim milk diluted 1:2 and a cut-off of 0.30, sensitivity and kappa values were 77.0% (95% CI 66.8-85.4) and 0.72 (95% CI 0.64-0.80), respectively. Using the selected cut-offs, the IDEXX Neospora Ab Test is equally suited for the analysis of whole and skim milk as a screening tool in neosporosis control programs. Copyright © 2012 Elsevier B.V. All rights reserved.

Feasibility of α-fetoprotein as a diagnostic tool for hepatocellular carcinoma in Korea

PubMed Central

Ahn, Dae Geon; Kim, Hyung Joon; Kang, Hyun; Lee, Hyun Woong; Bae, Si Hyun; Lee, Joon Hyoek; Paik, Yong Han; Lee, June Sung

2016-01-01

Background/Aims: The aim of this study was to evaluate the feasibility of α-fetoprotein (AFP) as a diagnostic tool for hepatocellular carcinoma (HCC) in Korean patients. Methods: We retrospectively reviewed the medical records of HCC and cirrhosis patients at three hospitals. For each HCC patient, a cirrhosis patient matched for age, sex, etiology, and Child-Pugh classification was selected by simple random sampling. The performance of AFP in the diagnosis of HCC was determined using receiver operating characteristic curve analysis. Results: A total of 732 patients with HCC or cirrhosis were selected for each case and the control groups. The mean age was 54 years, and 72.4% of patients were male. The mean serum AFP levels in the HCC group and cirrhosis group were 3,315.6 and 117.2 ng/mL, respectively (p < 0.001). The area under the receiver operating characteristic curve for all HCC patients was 0.757. The sensitivity, specificity, and positive predictive value of AFP was 50.55%, 87.70%, and 80.43%, respectively, at a cut-off of 20 ng/mL; 37.70%, 95.90%, and 90.20%, respectively, at a cut-off of 100 ng/mL, and 30.05%, 97.27%, and 91.67%, respectively, at a cut-off of 200 ng/mL. A cut-off of 100 ng/mL was more sensitive than one of 200 ng/mL with equivalent specificity and positive predictive value. Conclusions: The cut-off AFP value for early-stage HCC was 17.4 ng/mL. Our study cautiously suggests that AFP has a role in the diagnosis of HCC, and that the appropriate value of AFP for the diagnosis of HCC may be 100 ng/mL rather than 200 ng/mL. PMID:26767857

Feasibility of α-fetoprotein as a diagnostic tool for hepatocellular carcinoma in Korea.

PubMed

Ahn, Dae Geon; Kim, Hyung Joon; Kang, Hyun; Lee, Hyun Woong; Bae, Si Hyun; Lee, Joon Hyoek; Paik, Yong Han; Lee, June Sung

2016-01-01

The aim of this study was to evaluate the feasibility of α-fetoprotein (AFP) as a diagnostic tool for hepatocellular carcinoma (HCC) in Korean patients. We retrospectively reviewed the medical records of HCC and cirrhosis patients at three hospitals. For each HCC patient, a cirrhosis patient matched for age, sex, etiology, and Child-Pugh classification was selected by simple random sampling. The performance of AFP in the diagnosis of HCC was determined using receiver operating characteristic curve analysis. A total of 732 patients with HCC or cirrhosis were selected for each case and the control groups. The mean age was 54 years, and 72.4% of patients were male. The mean serum AFP levels in the HCC group and cirrhosis group were 3,315.6 and 117.2 ng/mL, respectively (p < 0.001). The area under the receiver operating characteristic curve for all HCC patients was 0.757. The sensitivity, specificity, and positive predictive value of AFP was 50.55%, 87.70%, and 80.43%, respectively, at a cut-off of 20 ng/mL; 37.70%, 95.90%, and 90.20%, respectively, at a cut-off of 100 ng/mL, and 30.05%, 97.27%, and 91.67%, respectively, at a cut-off of 200 ng/mL. A cut-off of 100 ng/mL was more sensitive than one of 200 ng/mL with equivalent specificity and positive predictive value. The cut-off AFP value for early-stage HCC was 17.4 ng/mL. Our study cautiously suggests that AFP has a role in the diagnosis of HCC, and that the appropriate value of AFP for the diagnosis of HCC may be 100 ng/mL rather than 200 ng/mL.

Modified Cut-Off Value of the Urine Protein-To-Creatinine Ratio Is Helpful for Identifying Patients at High Risk for Chronic Kidney Disease: Validation of the Revised Japanese Guideline.

PubMed

Yamamoto, Hiroyuki; Yamamoto, Kyoko; Yoshida, Katsumi; Shindoh, Chiyohiko; Takeda, Kyoko; Monden, Masami; Izumo, Hiroko; Niinuma, Hiroyuki; Nishi, Yutaro; Niwa, Koichiro; Komatsu, Yasuhiro

2015-11-01

Chronic kidney disease (CKD) is a global public health issue, and strategies for its early detection and intervention are imperative. The latest Japanese CKD guideline recommends that patients without diabetes should be classified using the urine protein-to-creatinine ratio (PCR) instead of the urine albumin-to-creatinine ratio (ACR); however, no validation studies are available. This study aimed to validate the PCR-based CKD risk classification compared with the ACR-based classification and to explore more accurate classification methods. We analyzed two previously reported datasets that included diabetic and/or cardiovascular patients who were classified into early CKD stages. In total, 860 patients (131 diabetic patients and 729 cardiovascular patients, including 193 diabetic patients) were enrolled. We assessed the CKD risk classification of each patient according to the estimated glomerular filtration rate and the ACR-based or PCR-based classification. The use of the cut-off value recommended in the current guideline (PCR 0.15 g/g creatinine) resulted in risk misclassification rates of 26.0% and 16.6% for the two datasets. The misclassification was primarily caused by underestimation. Moderate to substantial agreement between each classification was achieved: Cohen's kappa, 0.56 (95% confidence interval, 0.45-0.69) and 0.72 (0.67-0.76) in each dataset, respectively. To improve the accuracy, we tested various candidate PCR cut-off values, showing that a PCR cut-off value of 0.08-0.10 g/g creatinine resulted in improvement in the misclassification rates and kappa values. Modification of the PCR cut-off value would improve its efficacy to identify high-risk populations who will benefit from early intervention.

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

PubMed

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

2015-09-01

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

Insulin resistance in obese children and adolescents: HOMA-IR cut-off levels in the prepubertal and pubertal periods.

PubMed

Kurtoğlu, Selim; Hatipoğlu, Nihal; Mazıcıoğlu, Mümtaz; Kendirici, Mustafa; Keskin, Mehmet; Kondolot, Meda

2010-01-01

Childhood obesity is associated with an increased risk for insulin resistance. The underlying mechanism for the physiological increase in insulin levels in puberty is not clearly understood. The aim of the present study was to determine the cut-off values for homeostasis model assessment for insulin resistance (HOMA-IR) in obese children and adolescents according to gender and pubertal status. Two hundred and eight obese children and adolescents (141 girls, 127 boys) aged between 5 and 18 years were included in the study. The children were divided into prepubertal and pubertal groups. A standard oral glucose tolerance test (OGTT) was carried out in all children. A total insulin level exceeding 300 μU/mL in the blood samples, collected during the test period, was taken as the insulin resistance criterion. Cut-off values for HOMA-IR were calculated by receiver operating characteristic (ROC) analysis. In the prepubertal period, the rate of insulin resistance was found to be 37% in boys and 27.8% in girls,while in the pubertal period, this rate was 61.7% in boys and 66.7% in girls. HOMA-IR cut-off values for insulin resistance in the prepubertal period were calculated to be 2.67 (sensitivity 88.2%, specificity 65.5%) in boys and 2.22 (sensitivity 100%, specificity 42.3%) in girls, and in the pubertal period, they were 5.22 (sensitivity 56%, specificity 93.3%) in boys and 3.82 (sensitivity 77.1%, specificity 71.4%) in girls. Since gender, obesity and pubertal status are factors affecting insulin resistance, cut-off values which depend on gender and pubertal status, should be used in evaluation of insulin resistance.

The impact of lowering the cut-off value on the sensitivity of the Platelia Elisa IgG (Bio-Rad) test for toxoplasmosis diagnosis.

PubMed

Mouri, Oussama; Kendjo, Eric; Touafek, Feriel; Fekkar, Arnaud; Konte, Ousmane; Imbert, Sebastien; Courtin, Régis; Mazier, Dominique; Paris, Luc

2015-01-01

Determining specific immune status against Toxoplasma gondii is essential for assessing the risk of reactivation in immunocompromised patients or defining serological monitoring and appropriate prophylactic measures during pregnancy. In France, toxoplasmosis serological screening requires systematic testing for IgM and IgG antibodies. The Platelia Toxo IgG and IgM test (Bio-Rad) is one of the most widely used tests for anti-toxoplasmic antibody detection. We performed a study on 384 sera, including 123 IgG negative (<6 IU/mL) and 261 IgG equivocal (6-9 IU/mL) sera tested with Platelia Toxo IgG and collected during routine screening at Pitié-Salpêtrière Hospital, Paris, France to determine the best-performing IgG titer cut-off value. Out of these 383 sera, 298 were IgM negative by Platelia Toxo IgM and 86 were IgM positive. All sera were also tested against Toxo IgG II LD BIO western blot test as confirmation. Our results indicated that an IgG titer cut-off value of ≥4.4 IU/mL for the Platelia Toxo IgG met the definition of positivity, a value significantly lower than that indicated by the manufacturers. In the presence of IgM antibodies, the IgG titer cut-off decreased significantly to a value ≥0.2 IU/mL. This latter cut-off also allowed adequate diagnosis of proven toxoplasmosis seroconversion in 76.7% of cases (33/43). Our findings may improve toxoplasmosis care by reducing therapeutic intervention time and eliminating the need for further serological monitoring. © O. Mouri et al., published by EDP Sciences, 2015.

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

PubMed

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

2016-10-01

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

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

PubMed

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

2017-06-01

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

A receiver operated curve-based evaluation of change in sensitivity and specificity of cotinine urinalysis for detecting active tobacco use.

PubMed

Balhara, Yatan Pal Singh; Jain, Raka

2013-01-01

Tobacco use has been associated with various carcinomas including lung, esophagus, larynx, mouth, throat, kidney, bladder, pancreas, stomach, and cervix. Biomarkers such as concentration of cotinine in the blood, urine, or saliva have been used as objective measures to distinguish nonusers and users of tobacco products. A change in the cut-off value of urinary cotinine to detect active tobacco use is associated with a change in sensitivity and sensitivity of detection. The current study aimed at assessing the impact of using different cut-off thresholds of urinary cotinine on sensitivity and specificity of detection of smoking and smokeless tobacco product use among psychiatric patients. All the male subjects attending the psychiatry out-patient department of the tertiary care multispecialty teaching hospital constituted the sample frame for the current study in a cross-sectionally. Quantitative urinary cotinine assay was done by using ELISA kits of Calbiotech. Inc., USA. We used the receiver operating characteristic (ROC) curve to assess the sensitivity and specificity of various cut-off values of urinary cotinine to identify active smokers and users of smokeless tobacco products. ROC analysis of urinary cotinine levels in detection of self-reported smoking provided the area under curve (AUC) of 0.434. Similarly, the ROC analysis of urinary cotinine levels in detection of self-reported smoking revealed AUC of 0.44. The highest sensitivity and specificity of 100% for smoking were detected at the urinary cut-off value greater than or equal to 2.47 ng/ml. The choice of cut-off value of urinary cotinine used to distinguish nonusers form active users of tobacco products impacts the sensitivity as well as specificity of detection.

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.

Gender Difference in Internet Use and Internet Problems among Quebec High School Students.

PubMed

Dufour, Magali; Brunelle, Natacha; Tremblay, Joel; Leclerc, Danielle; Cousineau, Marie-Marthe; Khazaal, Yasser; Légaré, Andrée-Anne; Rousseau, Michel; Berbiche, Djamal

2016-10-01

There are presently no data available concerning Internet addiction (IA) problems among adolescents in Canada and the province of Quebec. The goal of this study is thus to document and compare the influence of gender on Internet use and addiction. The study data were collected from a larger research project on gambling among adolescents. Activities conducted online (applications used and time spent) as well as answers to the Internet Addiction Test (IAT) were collected from 3938 adolescents from grades 9 to 11. The two most often employed cut-off points for the IAT in the literature were documented: (40-69 and 70+) and (50+). Boys spent significantly more time on the Internet than did girls. A greater proportion of the girls made intense use of social networks, whereas a greater proportion of the boys made intense use of massively multiplayer online role-playing games, online games, and adult sites. The proportion of adolescents with a potential IA problem varied according to the cut-off employed. When the cut-off was set at 70+, 1.3% of the adolescents were considered to have an IA, while 41.7% were seen to be at risk. At a 50+ cut-off, 18% of the adolescents were considered to have a problem. There was no significant difference between the genders concerning the proportion of adolescents considered to be at risk or presenting IA problems. Finally, analysis of the percentile ranks would seem to show that a cut-off of 50+ better describes the category of young people at risk. The results of this study make it possible to document Internet use and IA in a large number of Quebec adolescents. © The Author(s) 2016.

The diagnostic value of skin prick testing in children with food allergy.

PubMed

Hill, David J; Heine, Ralf G; Hosking, Clifford S

2004-10-01

The diagnostic accuracy of the skin prick test (SPT) in food allergy is controversial. We have developed diagnostic cut-off levels for SPT in children with allergy to cow milk, egg and peanut. Based on 555 open food challenges in 467 children (median age 3.0 yr) we defined food-specific SPT weal diameters that were '100% diagnostic' for allergy to cow milk (>or=8 mm), egg (>or=7 mm) and peanut (>or=8 mm). In children < 2 yr of age, the corresponding weal diameters were >or=6 mm, >or=5 mm and >or=4 mm, respectively. These SPT cut-off levels were prospectively validated in 90 consecutive children

Impact of age on the diagnostic performances and cut-offs of APRI and FIB-4 for significant fibrosis and cirrhosis in chronic hepatitis B.

PubMed

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

2017-07-11

Assessing the diagnostic performances of APRI and FIB-4 using age as a categorical marker. 822 chronic hepatitis B (CHB) patients were included. Using METAVIR scoring system as a reference, the performances of APRI and FIB-4 were compared between patients aged≥30 and patients aged<30 years. The APRI AUROC in patients aged<30 years was lower than that in patients aged≥30 years for significant fibrosis (0.61 vs 0.70, p<0.001) and cirrhosis (0.64 vs 0.78, p<0.001). The FIB-4 AUROC in patients aged<30 years was lower than that in patients aged≥30 years for significant fibrosis (0.57 vs 0.65, p<0.001) and cirrhosis (0.63 vs 0.72, p<0.001). Using specificity≥90%, the APRI cut-off in patients aged<30 years was lower than patients aged≥30 years for significant fibrosis (1.0 vs 1.2) and cirrhosis (1.2 vs 1.5). Using sensitivity≥90%, the APRI cut-off in patients aged<30 years was also lower than patients aged≥30 years for significant fibrosis (0.2 vs 0.4) and cirrhosis (0.3 vs 0.5). Using specificity≥90%, the FIB-4 cut-off in patients aged<30 years was lower than that in patients aged≥30 years for significant fibrosis (1.2 vs 2.1) and cirrhosis (1.4 vs 2.6). Using sensitivity≥90%, the FIB-4 cut-off in patients aged<30 years was also lower than that in patients aged≥30 years for significant fibrosis (0.5 vs 0.8) and cirrhosis (0.8 vs 1.2). Evaluation of the diagnostic performances of APRI and FIB-4 should take age into consideration.

Is quantitative PCR for the pneumolysin (ply) gene useful for detection of pneumococcal lower respiratory tract infection?

PubMed

Abdeldaim, G; Herrmann, B; Korsgaard, J; Olcén, P; Blomberg, J; Strålin, K

2009-06-01

The pneumolysin (ply) gene is widely used as a target in PCR assays for Streptococcus pneumoniae in respiratory secretions. However, false-positive results with conventional ply-based PCR have been reported. The aim here was to study the performance of a quantitative ply-based PCR for the identification of pneumococcal lower respiratory tract infection (LRTI). In a prospective study, fibreoptic bronchoscopy was performed in 156 hospitalized adult patients with LRTI and 31 controls who underwent bronchoscopy because of suspicion of malignancy. Among the LRTI patients and controls, the quantitative ply-based PCR applied to bronchoalveolar lavage (BAL) fluid was positive at >or=10(3) genome copies/mL in 61% and 71% of the subjects, at >or=10(5) genome copies/mL in 40% and 58% of the subjects, and at >or=10(7) genome copies/mL in 15% and 3.2% of the subjects, respectively. Using BAL fluid culture, blood culture, and/or a urinary antigen test, S. pneumoniae was identified in 19 LRTI patients. As compared with these diagnostic methods used in combination, quantitative ply-based PCR showed sensitivities and specificities of 89% and 43% at a cut-off of 10(3) genome copies/mL, of 84% and 66% at a cut-off of 10(5) genome copies/mL, and of 53% and 90% at a cut-off of 10(7) genome copies/mL, respectively. In conclusion, a high cut-off with the quantitative ply-based PCR was required to reach acceptable specificity. However, as a high cut-off resulted in low sensitivity, quantitative ply-based PCR does not appear to be clinically useful. Quantitative PCR methods for S. pneumoniae using alternative gene targets should be evaluated.

AUDIT and AUDIT-C as screening instruments for alcohol problem use in adolescents.

PubMed

Liskola, Joni; Haravuori, Henna; Lindberg, Nina; Niemelä, Solja; Karlsson, Linnea; Kiviruusu, Olli; Marttunen, Mauri

2018-07-01

The Alcohol Use Disorders Identification Test (AUDIT) is commonly used in adults to screen for harmful alcohol consumption but few studies exist on its use among adolescents. Our aim was to validate the AUDIT and its derivative consumption questionnaire (AUDIT-C) as screening instruments for the detection of problem use of alcohol in adolescents. 621 adolescents (age-range, 12-19 years) were drawn from clinical and population samples who completed the AUDIT questionnaire. Psychiatric diagnoses were assessed using K-SADS-PL. A rating based on the K-SADS-PL was used to assess alcohol use habits, alcohol use disorders, screening and symptom criteria questions. Screening performance of the AUDIT and AUDIT-C sum scores and Receiver Operating Characteristic (ROC) curves were calculated. The diagnostic odds ratios (dOR) were calculated to express the overall discrimination between cut-offs. Comparisons of ROC between the AUDIT and AUDIT-C pairs indicated a slightly better test performance by AUDIT for the whole sample and in a proportion of the subsamples. Optimal cut-off value for the AUDIT was ≥5 (sensitivity 0.931, specificity 0.772, dOR 45.22; 95% CI: 24.72-83.57) for detecting alcohol problem use. The corresponding optimal cut-off value for the AUDIT-C was ≥3 in detecting alcohol problem use (sensitivity 0.952, specificity 0.663, dOR 39.31; 95% CI: 19.46-78.97). Agreement between the AUDIT and AUDIT-C using these cut-off scores was high at 91.9%. Our results for the cut-off scores for the early detection of alcohol problem use in adolescents are ≥5 for AUDIT, and ≥3 for AUDIT-C. Copyright © 2018 Elsevier B.V. All rights reserved.

Shallow Slip Localization Along Megathrusts: Investigating the Role of Scaly Fabric

NASA Astrophysics Data System (ADS)

Vannucchi, P.

2015-12-01

Scaly fabric is classically interpreted as a low strain-rate structure, resulting from progressive shearing with episodic formation and destruction of oriented and flattened clay layers and aggregates. Scientific Ocean drilling of the Japan Trench in response to the 2011 Tohoku-Oki EQ sampled the active plate-boundary décollement zone in a place of known, large, and very recent displacement. The visual inspection of core material from the plate boundary décollement reveals a clay layer with scaly fabric, cut by a sharp discontinuity that may be the record of co-seismic slip (Chester et al., 2013). This result brought to the need to re-evaluate the role and the characteristics of scaly fabric. Scaly fabric is the typical meso/microstructure marking the location of slip concentration in all the active décollements cored near the trench (i.e. Barbados, Nankai, Costa Rica, Japan Trench) and in analogue fossil examples cropping out onland. Scaly fabric tends to form self-similar patterns, and usually areas with smaller phacoids are interpreted as more deformed. We know that scaliness develops in the early stages of deformation, that the slip surfaces defining the phacoids are sharp and they do not occur randomly, that they grow and coalesce forming a progressively finer anastomosing network, and that eventually the anastomoising slip surfaces are "enhanced" or "cut" by straight slip surfaces. Advances in identifying detailed evolutionary history of slip localization from scaly fabric to discrete surfaces have been paralleled by laboratory experiments. Here we try to summarize direct and indirect information on physical properties of clay layers deformed at shallow depth and, possibly, their links to the seismic cycle. These challenges include future work on the role of scaly fabric on earthquake deformation along faults.

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

PubMed

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

2016-09-01

The activities of two hydrophilic (ascorbic acid and Trolox) and two hydrophobic (α-tocopherol and BHT) antioxidants were measured by reaction with a series of 4-alkanoyloxyTEMPO radical probes 1 in buffered (pH 7), aqueous, micellar solutions of reduced Triton-X 100. In all cases, a cut-off effect was observed, in line with previous observations of the same effect for the partitioning of probe series 1 in this medium. These results support an interpretation of the cut-off effect in food emulsions, based on the "amphiphobic" nature of either the antioxidants or probes: competition between two molecular moieties, for the micellar hydrophobic core, tends to expose a reacting fragment differently to a more hydrophilic microenvironment, as the probe or antioxidant hydrophobicity increases. Copyright © 2016 Elsevier Ltd. All rights reserved.

Unifying decoherence and the Heisenberg Principle

NASA Astrophysics Data System (ADS)

Janssens, Bas

2017-08-01

We exhibit three inequalities involving quantum measurement, all of which are sharp and state independent. The first inequality bounds the performance of joint measurement. The second quantifies the trade-off between the measurement quality and the disturbance caused on the measured system. Finally, the third inequality provides a sharp lower bound on the amount of decoherence in terms of the measurement quality. This gives a unified description of both the Heisenberg uncertainty principle and the collapse of the wave function.

The diagnostic utility of the Rarely Missed Index of the Wechsler Memory Scale-Third Edition in detecting response bias in an adult male incarcerated setting.

PubMed

D'Amato, Christopher P; Denney, Robert L

2008-09-01

The purpose of this study was to utilize a known-group research design to evaluate the diagnostic utility of the Rarely Missed Index (RMI) of the Wechsler Memory Scale-Third Edition [Wechsler, D. (1997). Wechsler Adult Intelligence Test-3rd Edition. San Antonio, TX: The Psychological Corporation] in assessing response bias in an adult male incarcerated setting. Archival data from a sample of 60 adult male inmates who presented for neuropsychological testing were reviewed. Evaluees were assigned to one of two groups; probable malingerers (PM; n=30) and a group of valid test responders (n=30) (1999). Using the recommended cut-off score of 136 or less, the sensitivity of the RMI was extremely low at 33%. Its specificity was 83%. The positive predictive power of the RMI with the published base rate of 22.8 was 38%; with a negative predictive power of 81%. The positive predictive power of the RMI with a published base rate of 70.5 was 82%. The negative predictive power using a base rate of 70.5% was 34%. Results of the receiver operating characteristics (ROC) analysis indicated that the RMI score with a cut-off 136 or less performed only slightly better than chance in delineating probable malingerers from valid responders in this setting. Overall, the findings suggest that the RMI may not be a reliable index for detecting response bias in this setting and perhaps in similar settings.

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.

United States Air Force Role in Mass Atrocity Response Operations

DTIC Science & Technology

2012-05-17

Factsheet, http://www.af.mil/information/factsheets/factsheet.asp?id=122 (accessed November 29, 2011). 28 electromagnetic spectrum. The mission...crew can then forward gathered information in a variety of formats to a wide range of consumers via Rivet Joint’s extensive communications suite.”71...130H and EC-130J, they can effectively cut off internal electromagnetic communication and replace it with their own local narrative, such as the video

Strength of inserts in titanium alloy machining

NASA Astrophysics Data System (ADS)

Kozlov, V.; Huang, Z.; Zhang, J.

2016-04-01

In this paper, a stressed state of a non-worn cutting wedge in a machined titanium alloy (Ti6Al2Mo2Cr) is analyzed. The distribution of contact loads on the face of a cutting tool was obtained experimentally with the use of a ‘split cutting tool’. Calculation of internal stresses in the indexable insert made from cemented carbide (WC8Co) was carried out with the help of ANSYS 14.0 software. Investigations showed that a small thickness of the cutting insert leads to extremely high compressive stresses near the cutting edge, stresses that exceed the ultimate compressive strength of cemented carbide. The face and the base of the insert experience high tensile stresses, which approach the ultimate tensile strength of cemented carbide and increase a probability of cutting insert destruction. If the thickness of the cutting insert is bigger than 5 mm, compressive stresses near the cutting edge decrease, and tensile stresses on the face and base decrease to zero. The dependences of the greatest normal and tangential stresses on thickness of the cutting insert were found. Abbreviation and symbols: m/s - meter per second (cutting speed v); mm/r - millimeter per revolution (feed rate f); MPa - mega Pascal (dimension of specific contact loads and stresses); γ - rake angle of the cutting tool [°] α - clearance angle of the sharp cutting tool [°].

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

ERIC Educational Resources Information Center

Oladele, Babatunde

2017-01-01

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

The Role of TPS and TPA in the Diagnostics of Distant Metastases.

PubMed

Kucera, Radek; Topolcan, Ondrej; Fiala, Ondrej; Kinkorova, Judita; Treska, Vladislav; Zedníková, Ilona; Slouka, David; Simanek, Vaclav; Safanda, Martin; Babuska, Vaclav

2016-02-01

The aim of the study was to assess the degree to which tissue polypeptide antigen (TPA) and tissue polypeptide-specific antigen (TPS), as well as carcinoembryonic antigen (CEA), can assist in the detection of distant metastases. We assessed 157 patients with colorectal and breast cancer divided into two groups. The first was a group of patients with cancer at stages 1, 2 and 3; the second was a group of patients with cancer at stage 4 with metastasis. We found significantly higher levels of all biomarkers in the metastatic group compared to the group with cancer at stages 1-3 (p<0.0001). The calculated area under the receiver operating characteristic (ROC) curve was 0.9929 for TPS, 0.9337 for TPA and 0.7234 for CEA. The cut-off was calculated for each biomarker at 95% specificity, TPS cut-off=255 IU/l (sensitivity 95%), TPA cut-off=200 IU/l (sensitivity 70%) and CEA cut-off=18 μg/l (sensitivity 37%). We suggest combining CEA with TPS or TPA in the detection of distant metastases or using only cytokeratins. This approach can significantly increase the quality of detection of the metastatic process. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

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.

The Fourier transforms for the spatially homogeneous Boltzmann equation and Landau equation

NASA Astrophysics Data System (ADS)

Meng, Fei; Liu, Fang

2018-03-01

In this paper, we study the Fourier transforms for two equations arising in the kinetic theory. The first equation is the spatially homogeneous Boltzmann equation. The Fourier transform of the spatially homogeneous Boltzmann equation has been first addressed by Bobylev (Sov Sci Rev C Math Phys 7:111-233, 1988) in the Maxwellian case. Alexandre et al. (Arch Ration Mech Anal 152(4):327-355, 2000) investigated the Fourier transform of the gain operator for the Boltzmann operator in the cut-off case. Recently, the Fourier transform of the Boltzmann equation is extended to hard or soft potential with cut-off by Kirsch and Rjasanow (J Stat Phys 129:483-492, 2007). We shall first establish the relation between the results in Alexandre et al. (2000) and Kirsch and Rjasanow (2007) for the Fourier transform of the Boltzmann operator in the cut-off case. Then we give the Fourier transform of the spatially homogeneous Boltzmann equation in the non cut-off case. It is shown that our results cover previous works (Bobylev 1988; Kirsch and Rjasanow 2007). The second equation is the spatially homogeneous Landau equation, which can be obtained as a limit of the Boltzmann equation when grazing collisions prevail. Following the method in Kirsch and Rjasanow (2007), we can also derive the Fourier transform for Landau equation.

Peripheral resolution and contrast sensitivity: Effects of stimulus drift.

PubMed

Venkataraman, Abinaya Priya; Lewis, Peter; Unsbo, Peter; Lundström, Linda

2017-04-01

Optimal temporal modulation of the stimulus can improve foveal contrast sensitivity. This study evaluates the characteristics of the peripheral spatiotemporal contrast sensitivity function in normal-sighted subjects. The purpose is to identify a temporal modulation that can potentially improve the remaining peripheral visual function in subjects with central visual field loss. High contrast resolution cut-off for grating stimuli with four temporal frequencies (0, 5, 10 and 15Hz drift) was first evaluated in the 10° nasal visual field. Resolution contrast sensitivity for all temporal frequencies was then measured at four spatial frequencies between 0.5 cycles per degree (cpd) and the measured stationary cut-off. All measurements were performed with eccentric optical correction. Similar to foveal vision, peripheral contrast sensitivity is highest for a combination of low spatial frequency and 5-10Hz drift. At higher spatial frequencies, there was a decrease in contrast sensitivity with 15Hz drift. Despite this decrease, the resolution cut-off did not vary largely between the different temporal frequencies tested. Additional measurements of contrast sensitivity at 0.5 cpd and resolution cut-off for stationary (0Hz) and 7.5Hz stimuli performed at 10, 15, 20 and 25° in the nasal visual field also showed the same characteristics across eccentricities. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

On the high energy cut-off of accreting sources: Is general relativity relevant?

NASA Astrophysics Data System (ADS)

Tamborra, Francesco; Papadakis, Iossif; Dovčiak, Michal; Svoboda, Jiři

2018-04-01

The hard X-ray emission observed in accreting compact sources is believed to be produced by inverse Compton scattering of soft photons arising from the accretion disc by energetic electrons thermally distributed above the disc, the so-called X-ray corona. Many independent observations suggest that such coronae should be compact and located very close to the black hole. In this case, general relativistic (GR) effects should play an important role to the continuum X-ray emission from these sources, and, in particular, in the observed high energy cut-off, which is a measure of the intrinsic temperature of the corona. Our results show that the energy shift between the observed and intrinsic high energy cut-off due to GR effects can be as large as two to eight times, depending on the geometry and size of the corona as well as its inclination. We provide estimates of this energy shift in the case of a lamp-post and a flat, rotating corona, around a Kerr and a Schwartzschild black hole, for various inclinations, and coronal sizes. These values could be useful to correct the observed high energy cut-off and/or coronal temperatures, either in the case of individual or large sample of objects.

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

PubMed

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

2015-03-01

Ketamine is a powerful anesthetic drug used in both human and veterinary surgery, but it is also commonly misused because of its psychotropic properties. Since the abuse of this drug has been reported in many countries worldwide, its determination in hair samples is offered as a specialist test by hundreds of laboratories. However, unlike other common drugs of abuse, a cut-off level for ketamine in hair has not been fixed yet. Therefore, aim of this study is to propose a concentration value for ketamine in hair analysis, in order to discriminate between chronic and occasional use, and between active use and external contamination. After considering the chemical properties of this molecule, and the experimental data collected in our laboratory or reported in several other published studies, we propose a cut-off level of 0.5ng/mg, as indicative of repeated exposure to ketamine. Additionally, we suggest that the detection of the metabolite norketamine should be mandatory to prove active intake and exclude false positive result from external contamination. Thus, a reasonable cut-off value for norketamine could be fixed at 0.1ng/mg, while the minimal concentration ratio norketamine/ketamine may be positively established at 0.05. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The Danish test battery for auditory processing disorder evaluated with patient and control data.

PubMed

Raben Pedersen, Ellen

2018-06-10

This study evaluates the Danish test battery for auditory processing disorder (APD). The battery consists of four behavioural tests, two speech and two non-speech stimuli tests. The evaluation includes determination of: (1) new cut-off values (pass-fail criteria), (2) the sensitivity and the specificity of the entire test battery and (3) the failure rate of different test combinations. For each test in the battery, cut-off values were determined using the weighted Youden index. Applying the newly derived cut-off values, the distribution of failing specific test combinations was determined. A group of 112 children diagnosed with APD (57 boys, 55 girls, aged 6-16 years) and a control group containing 158 children without auditory problems (75 boys, 83 girls, aged 6-16 years). Cut-off values for different weights of the sensitivity and the specificity have been determined. Using the criterion that at least two tests have to be failed for APD to be suspected, the sensitivity and the specificity of the entire test battery were 95.3% and 91.6%, respectively. Some test combinations were found to have higher failure rates than others. Due to the high sensitivity and specificity the test battery has good predictive value in APD assessment.

It Takes Two to Tango: Arctic Influence on Mid-Latitude Weather is State-Dependent

NASA Astrophysics Data System (ADS)

Francis, J. A.; Vavrus, S. J.; Cohen, J. L.

2016-12-01

Since the late 1990s the Arctic has been warming two to three times faster than mid-latitude regions, a phenomenon known as Arctic amplification (AA). During the first half of 2016, AA reached a new record high value. This disproportionate warming is expected to influence the large-scale atmospheric circulation of the northern hemisphere, but understanding exactly how, where, when, and under what conditions has been an active and controversial topic of research. Observational studies of the atmospheric response are challenged by the short record of AA in a noisy environment, while modeling efforts have produced mixed results owing in part to deficiencies in both capturing the full signal of AA and simulating highly amplified atmospheric features (such as blocks, cut-off lows, and sharp ridging). Despite these challenges, progress in understanding the effects of AA on mid-latitude weather has been steady. In this presentation, we will discuss a new hypothesis and supporting evidence suggesting that the influence of regional AA depends on the background state of the large-scale circulation. Long-lived sea-surface temperature patterns in mid-latitudes, such as the Pacific Decadal Oscillation, favor particular ridge/trough configurations that affect the magnitude of AA's influence on weather patterns. These relationships vary both regionally and seasonally. As AA continues to strengthen with unabated rising concentrations of greenhouse gases, the mechanisms by which AA affects mid-latitude weather, particularly extreme events, may become clearer. The record-breaking AA of 2016 and associated extreme mid-latitude weather events may be a preview of the "new normal" in a warmer world.

Reflectivity Spectra for Commonly Used Reflectors

NASA Astrophysics Data System (ADS)

Janecek, Martin

2012-06-01

Monte Carlo simulations play an important role in developing and evaluating the performance of radiation detection systems. To accurately model a reflector in an optical Monte Carlo simulation, the reflector's spectral response has to be known. We have measured the reflection coefficient for many commonly used reflectors for wavelengths from 250 nm to 800 nm. The reflectors were also screened for fluorescence and angular distribution changes with wavelength. The reflectors examined in this work include several polytetrafluoroethylene (PTFE) reflectors, Spectralon, GORE diffuse reflector, titanium dioxide paint, magnesium oxide, nitrocellulose filter paper, Tyvek paper, Lumirror, Melinex, ESR films, and aluminum foil. All PTFE films exhibited decreasing reflectivity with longer wavelengths due to transmission. To achieve >;0.95 reflectivity in the 380 to 500 nm range, the PTFE films have to be at least 0.5 mm thick-nitrocellulose is a good alternative if a thin diffuse reflector is needed. Several of the reflectors have sharp declines in reflectivity below a cut-off wavelength, including TiO2 (420 nm), ESR film (395 nm), nitrocellulose (330 nm), Lumirror (325 nm), and Melinex (325 nm). PTFE-like reflectors were the only examined reflectors that had reflectivity above 0.90 for wavelengths below 300 nm. Lumirror, Melinex, and ESR film exhibited fluorescence. Lumirror and Melinex are excited by wavelengths between 320 and 420 nm and have their emission peaks located at 440 nm, while ESR film is excited by wavelengths below 400 nm and the emission peak is located at 430 nm. Lumirror and Melinex also exhibited changing angular distributions with wavelength.

Delta II Mars Pathfinder

NASA Technical Reports Server (NTRS)

1998-01-01

Final preparations for lift off of the DELTA II Mars Pathfinder Rocket are shown. Activities include loading the liquid oxygen, completing the construction of the Rover, and placing the Rover into the Lander. After the countdown, important visual events include the launch of the Delta Rocket, burnout and separation of the three Solid Rocket Boosters, and the main engine cutoff. The cutoff of the main engine marks the beginning of the second stage engine. After the completion of the second stage, the third stage engine ignites and then cuts off. Once the third stage engine cuts off spacecraft separation occurs.

Development of a lemon cutting machine.

PubMed

Hrishikesh Tavanandi, A; Deepak, S; Venkateshmurthy, K; Raghavarao, K S M S

2014-12-01

Cutting of lemon and other similar fruits is conventionally done manually by sharp knife, which is labor intensive and often un-hygienic. In the present work, a device has been designed and developed for cutting of lemon hygienically into four pieces of similar shape based on stationery cutters and rotating centralizing/locating slit plate concept. Machine has a unique knife assembly consisting of two bird wing shaped knives, joined by welding perpendicularly to a vertical knife, so that the lemon can be cut into four pieces in a single sweep. Six numbers of rotating centralizing/locating slit plates are welded on to the side plates and the plates carry a groove on its inner face, to enable the wing shaped knife to complete the horizontal cut. The rotating slit plates, having centralizing angle of 90°, are rotated by an electric geared motor. The prototype machine has capacity of over 5,000 lemons/h with a power consumption of 0.11 kW.

Observation of three-dimensional internal structure of steel materials by means of serial sectioning with ultrasonic elliptical vibration cutting.

PubMed

Fujisaki, K; Yokota, H; Nakatsuchi, H; Yamagata, Y; Nishikawa, T; Udagawa, T; Makinouchi, A

2010-01-01

A three-dimensional (3D) internal structure observation system based on serial sectioning was developed from an ultrasonic elliptical vibration cutting device and an optical microscope combined with a high-precision positioning device. For bearing steel samples, the cutting device created mirrored surfaces suitable for optical metallography, even for long-cutting distances during serial sectioning of these ferrous materials. Serial sectioning progressed automatically by means of numerical control. The system was used to observe inclusions in steel materials on a scale of several tens of micrometers. Three specimens containing inclusions were prepared from bearing steels. These inclusions could be detected as two-dimensional (2D) sectional images with resolution better than 1 mum. A three-dimensional (3D) model of each inclusion was reconstructed from the 2D serial images. The microscopic 3D models had sharp edges and complicated surfaces.

Urinary 8-hydroxy-2'-deoxyguanosine as a novel biomarker for predicting cardiac events and evaluating the effectiveness of carvedilol treatment in patients with chronic systolic heart failure.

PubMed

Susa, Takehisa; Kobayashi, Shigeki; Tanaka, Takeo; Murakami, Wakako; Akashi, Shintaro; Kunitsugu, Ichiro; Okuda, Shinichi; Doi, Masahiro; Wada, Yasuaki; Nao, Tomoko; Yamada, Jutaro; Ueyama, Takeshi; Okamura, Takayuki; Yano, Masafumi; Matsuzaki, Masunori

2012-01-01

The authors recently reported that urinary 8-hydroxy-2'-deoxyguanosine (U8-OHdG) derived from cardiac tissue reflects clinical status and cardiac dysfunction severity in patients with chronic heart failure (CHF). The aim of the present study was to investigate whether U8-OHdG levels can accurately predict cardiac events in CHF patients and their response to β-blocker treatment. Plasma brain natriuretic peptide (BNP) and U8-OHdG levels were measured in 186 consecutive CHF patients before discharge. Patients were then prospectively followed (median follow-up, 649 days) with endpoints of cardiac death or hospitalization due to progressive heart failure. From receiver operating characteristic curve analysis, cut-offs were 12.4ng/mg creatinine (Cr) for U8-OHdG and 207pg/ml for BNP. On multivariate Cox analysis, U8-OHdG and BNP were independent predictors of cardiac events. Patients were classified into 4 groups according to U8-OHdG and BNP cut-offs. The hazard ratio for cardiac events in patients with BNP ≥207pg/ml and U8-OHdG ≥12.4ng/mg Cr was 16.2 compared with approximately 4 for patients with only 1 indicator above its respective cut-off. Furthermore, carvedilol therapy was initiated in 30 CHF patients. In responders (≥10% increase in left ventricular ejection fraction [LVEF] or ≥1 class decrease in New York Heart Association [NYHA] class), U8-OHdG levels decreased significantly along with improved NYHA class, LVEF, and BNP levels after treatment. U8-OHdG may be a useful biomarker for predicting cardiac events and evaluating β-blocker therapy effectiveness in CHF patients.

LWIR and VLWIR detectors development at SOFRADIR for space applications

NASA Astrophysics Data System (ADS)

Terrier, Bertrand; Delannoy, Anne; Chorier, Philippe; Maillard, Magalie; Rubaldo, Laurent

2010-10-01

SOFRADIR is one of the leading companies involved in the development and manufacturing of infrared detectors. Its offer covers the infrared spectrum from visible range (0.4 μm) up to very long wavelength range (15 μm). The need in this last field is driven by space activities, especially by meteorological instruments using imagery or spectrometry. In the frame of Meteosat Third Generation mission, ESA has launched pre-development activities to address the critical equipments for risk reduction. VLWIR detectors for FCI and IRS have been considered as challenging ones and thus SOFRADIR has been involved for manufacturing and testing 2D arrays with long cut-off wavelength (14.9μm at 50K) in order to evaluate their compliance to MTG requirements as far as dark current behaviour, quantum efficiency, photoresponse uniformity, spatial response, operability and reliability are concerned. In parallel, trends of space and tactical applications call for dark current reduction technology in order to improve systems performances in terms of operating temperature and signal to noise ratio. In the frame of its common laboratory DEFIR with CEA-LETI, Sofradir has developed a new MCT p on n technology to answer this need. First demonstrations were made with success (640x512, pitch 15μm and cut-off 9.5μm) and Sofradir is now industrializing this technology in particular for tactical application. Thanks to the communality between space and tactical activity at Sofradir, these results will benefit advantageously also to space activity. In this paper, we present a review of latest Sofradir results concerning LWIR and VLWIR technology. In particular, latest data, concerning development and characterization of generic VLWIR technology up to 15 μm cut-off wavelength, are presented as well as data concerning the promising p on n LWIR technology.

Prevalence of swallowing and speech problems in daily life after chemoradiation for head and neck cancer based on cut-off scores of the patient-reported outcome measures SWAL-QOL and SHI.

PubMed

Rinkel, Rico N; Verdonck-de Leeuw, Irma M; Doornaert, Patricia; Buter, Jan; de Bree, Remco; Langendijk, Johannes A; Aaronson, Neil K; Leemans, C René

2016-07-01

The objective of this study is to assess swallowing and speech outcome after chemoradiation therapy for head and neck cancer, based on the patient-reported outcome measures Swallowing Quality of Life Questionnaire (SWAL-QOL) and Speech Handicap Index (SHI), both provided with cut-off scores. This is a cross-sectional study. Department of Otolaryngology/Head and Neck Surgery of a University Medical Center. Sixty patients, 6 months to 5 years after chemoradiation for head and neck squamous cell carcinoma. Swallowing Quality of Life Questionnaire (SWAL-QOL) and SHI, both validated in Dutch and provided with cut-off scores. Associations were tested between the outcome measures and independent variables (age, gender, tumor stage and site, and radiotherapy technique, time since treatment, comorbidity and food intake). Fifty-two patients returned the SWAL-QOL and 47 the SHI (response rate 87 and 78 %, respectively). Swallowing and speech problems were present in 79 and 55 %, respectively. Normal food intake was noticed in 45, 35 % had a soft diet and 20 % tube feeding. Patients with soft diet and tube feeding reported more swallowing problems compared to patients with normal oral intake. Tumor subsite was significantly associated with swallowing outcome (less problems in larynx/hypopharynx compared to oral/oropharynx). Radiation technique was significantly associated with psychosocial speech problems (less problems in patients treated with IMRT). Swallowing and (to a lesser extent) speech problems in daily life are frequently present after chemoradiation therapy for head and neck cancer. Future prospective studies will give more insight into the course of speech and swallowing problems after chemoradiation and into efficacy of new radiation techniques and swallowing and speech rehabilitation programs.

Therapeutic drug monitoring of thiopurine metabolites in adult thiopurine tolerant IBD patients on maintenance therapy.

PubMed

Gilissen, Lennard P L; Wong, Dennis R; Engels, Leopold G J B; Bierau, Jörgen; Bakker, Jaap A; Paulussen, Aimée D C; Romberg-Camps, Mariëlle J; Stronkhorst, Arnold; Bus, Paul; Bos, Laurens P; Hooymans, Piet M; Stockbrügger, Reinhold W; Neef, Cees; Masclee, Ad A M

2012-07-01

Therapeutic drug monitoring of active metabolites of thiopurines, azathioprine and 6-mercaptopurine, is relatively new. The proposed therapeutic threshold level of the active 6-thioguanine nucleotides (6-TGN) is ≥235 pmol/8×10(8) erythrocytes. The aim of this prospective cross-sectional study was to compare 6-TGN levels in adult thiopurine tolerant IBD patients with an exacerbation with those in remission, and to determine the therapeutic 6-TGN cut-off level. Hundred IBD patients were included. Outcome measures were thiopurine metabolite levels, calculated therapeutic 6-TGN cut-off level, CDAI/CAI scores, thiopurine dose and TPMT enzyme activity. Forty-one patients had an exacerbation, 59 patients were in remission. In 17% of all patients 6-TGN levels were compatible with non-compliance. The median 6-TGN levels were not significantly different between the exacerbation and remission group (227 versus 263 pmol/8×10(8) erythrocytes, p=0.29). The previous reported therapeutic 6-TGN cut-off level of 235 pmol/8×10(8) erythrocytes was confirmed in this study. Twenty-six of the 41 patients (63%) with active disease had 6-TGN levels below this threshold and 24 of 59 IBD patients (41%) in clinical remission (p=0.04). Thiopurine non-compliance occurs frequently both in active and quiescent disease. 6-TGN levels below or above the therapeutic threshold are associated with a significant higher chance of IBD exacerbation and remission, respectively. These data support the role of therapeutic drug monitoring in thiopurine maintenance therapy in IBD to reveal non-compliance or underdosing, and can be used as a practical tool to optimize thiopurine therapy, especially in case of thiopurine non-response. Copyright © 2011 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

α-Fetoprotein is a surrogate marker for predicting treatment failure in telaprevir-based triple combination therapy for genotype 1b chronic hepatitis C Japanese patients with the IL28B minor genotype.

PubMed

Shimada, Noritomo; Tsubota, Akihito; Atsukawa, Masanori; Abe, Hiroshi; Ika, Makiko; Kato, Keizo; Sato, Yoshiyuki; Kondo, Chisa; Sakamoto, Choitsu; Tanaka, Yasuhito; Aizawa, Yoshio

2014-03-01

Even when treated with telaprevir-based triple therapy, some patients fail to achieve a sustained virological response. This study identified factors related closely to treatment failure. A total of 146 Japanese genotype 1b chronic hepatitis C patients were enrolled in this prospective, multicenter study and received a 24-week regimen of triple therapy. The end-of-treatment response rate was significantly lower in patients with the interleukin 28B (IL28B) (rs8099917) non-TT genotype (85.2%) than in those with the TT genotype (100%, P = 0.0002). Multiple logistic regression analysis identified high α-fetoprotein levels as an independent factor related to non-end-of-treatment response in patients with the non-TT genotype. A cut-off value of 20 ng/ml was determined for a non-end-of-treatment response; sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were 75.0%, 95.7%, 75.0%, 75.0%, and 92.6%, respectively. Multiple logistic regression analysis for a sustained virological response identified the IL28B TT genotype, low α-fetoprotein levels, non-responders, and a rapid virological response. The sustained virological response rate was significantly lower in patients with the non-TT genotype (59.3%) than in those with the TT genotype (96.7%, P < 0.0001). In patients with the non-TT genotype, α-fetoprotein was the most significant predictor for non-sustained virological response by univariate analysis. A cut-off value of 7.4 ng/ml α-fetoprotein was determined for non-sustained virological response; sensitivity, specificity, PPV, NPV, and accuracy were 63.6%, 87.5%, 77.8%, 77.8%, and 77.8%, respectively. For the non-TT patients, serum α-fetoprotein levels may be a surrogate marker for predicting treatment failure in telaprevir-based therapy for genotype 1b chronic hepatitis C. © 2013 Wiley Periodicals, Inc.

Numerical modelling of orthogonal cutting: application to woodworking with a bench plane.

PubMed

Nairn, John A

2016-06-06

A numerical model for orthogonal cutting using the material point method was applied to woodcutting using a bench plane. The cutting process was modelled by accounting for surface energy associated with wood fracture toughness for crack growth parallel to the grain. By using damping to deal with dynamic crack propagation and modelling all contact between wood and the plane, simulations could initiate chip formation and proceed into steady-state chip propagation including chip curling. Once steady-state conditions were achieved, the cutting forces became constant and could be determined as a function of various simulation variables. The modelling details included a cutting tool, the tool's rake and grinding angles, a chip breaker, a base plate and a mouth opening between the base plate and the tool. The wood was modelled as an anisotropic elastic-plastic material. The simulations were verified by comparison to an analytical model and then used to conduct virtual experiments on wood planing. The virtual experiments showed interactions between depth of cut, chip breaker location and mouth opening. Additional simulations investigated the role of tool grinding angle, tool sharpness and friction.

Drilling Holes in Graphite/Epoxy Composites

NASA Technical Reports Server (NTRS)

Daniels, J. G.; Ledbetter, Frank E., III; Penn, B. G.; White, W. L.

1986-01-01

Slurry of silicon carbide powder in water fed onto bit while drilling. Slurry contains about 60 percent silicon carbide by weight. Slurry recirculated by low-power pump. With slurry, dull tools cut as fast as, or faster than, sharp ones. Holes drilled rapidly and efficiently regardless of ply orientation; whether unidirectional, quasi-isotropic symmetrical, or cross-ply.

46 CFR 164.018-11 - Approval tests.

Code of Federal Regulations, 2012 CFR

2012-10-01

... the following test methods described in Federal Specification L-S-300: (1) Test conditions. (2) Test... sharp knife from each corner to the corner diagonally opposite so that an “X” is formed. The cuts must...— (1) The L-S-300 procedure for measuring reflective intensity; or (2) The procedure for measuring...

46 CFR 164.018-11 - Approval tests.

Code of Federal Regulations, 2010 CFR

2010-10-01

... the following test methods described in Federal Specification L-S-300: (1) Test conditions. (2) Test... sharp knife from each corner to the corner diagonally opposite so that an “X” is formed. The cuts must...— (1) The L-S-300 procedure for measuring reflective intensity; or (2) The procedure for measuring...

46 CFR 164.018-11 - Approval tests.

Code of Federal Regulations, 2011 CFR

2011-10-01

... the following test methods described in Federal Specification L-S-300: (1) Test conditions. (2) Test... sharp knife from each corner to the corner diagonally opposite so that an “X” is formed. The cuts must...— (1) The L-S-300 procedure for measuring reflective intensity; or (2) The procedure for measuring...

46 CFR 164.018-11 - Approval tests.

Code of Federal Regulations, 2014 CFR

2014-10-01

... the following test methods described in Federal Specification L-S-300: (1) Test conditions. (2) Test... sharp knife from each corner to the corner diagonally opposite so that an “X” is formed. The cuts must...— (1) The L-S-300 procedure for measuring reflective intensity; or (2) The procedure for measuring...

46 CFR 164.018-11 - Approval tests.

Code of Federal Regulations, 2013 CFR

2013-10-01

... the following test methods described in Federal Specification L-S-300: (1) Test conditions. (2) Test... sharp knife from each corner to the corner diagonally opposite so that an “X” is formed. The cuts must...— (1) The L-S-300 procedure for measuring reflective intensity; or (2) The procedure for measuring...

National Program for Inspection of Non-Federal Dams. Durepo Brook Dam (ME 00348) Saint John River Basin, Limestone, Maine. Phase I Inspection Report.

DTIC Science & Technology

1981-09-01

EXPOLSED BY THE CUT OFF TRE NCHI ESLAVA - ’’ON SHALL Of THOROIUGHLY CLEANED AND INSPLCTLD BY THE - tNGITIIEk PRIOR TO THE PIACIMENT OF THE CIJYOFF TRENCH...concrete impact basin. A grass lined earth cut emergency spillway is provided adjacent to to the right abutment. A sediment and municipal water storage pool...0 698, METHOD CUT OFF SENCI SPIL LWAY EXCAVATION owC CU R:EPRESENTED BY MATERIl. INITEST PIT TP-5(aZ To a’ oR S:ORROW AREA Re I REPRESE NTED CONS

30 CFR 70.220 - Status change reports.

Code of Federal Regulations, 2014 CFR

2014-07-01

... to all miners expected to wear a CPDM. The training shall be completed prior to a miner wearing a... cutting machine. On the cutting machine operator or on the cutting machine within 36 inches inby the normal working position; (2) Conventional section blasting off the solid. On the loading machine operator...

30 CFR 70.207 - Bimonthly sampling; mechanized mining units.

Code of Federal Regulations, 2012 CFR

2012-07-01

... sampling device as follows: (1) Conventional section using cutting machine. On the cutting machine operator or on the cutting machine within 36 inches inby the normal working position; (2) Conventional section shooting off the solid. On the loading machine operator or on the loading machine within 36 inches inby the...

30 CFR 70.207 - Bimonthly sampling; mechanized mining units.

Code of Federal Regulations, 2014 CFR

2014-07-01

... sampling device as follows: (1) Conventional section using cutting machine. On the cutting machine operator or on the cutting machine within 36 inches inby the normal working position; (2) Conventional section shooting off the solid. On the loading machine operator or on the loading machine within 36 inches inby the...

30 CFR 70.207 - Bimonthly sampling; mechanized mining units.

Code of Federal Regulations, 2013 CFR

2013-07-01

... sampling device as follows: (1) Conventional section using cutting machine. On the cutting machine operator or on the cutting machine within 36 inches inby the normal working position; (2) Conventional section shooting off the solid. On the loading machine operator or on the loading machine within 36 inches inby the...

On-line coupled high performance liquid chromatography-gas chromatography for the analysis of contamination by mineral oil. Part 2: migration from paperboard into dry foods: interpretation of chromatograms.

PubMed

Biedermann, Maurus; Grob, Koni

2012-09-14

Mineral oil hydrocarbons are complex as well as varying mixtures and produce correspondingly complex chromatograms (on-line HPLC-GC-FID as described in Part 1): mostly humps of unresolved components are obtained, sometimes with sharp peaks on top. Chromatograms may also contain peaks of hydrocarbons from other sources which need to be subtracted from the mineral oil components. The review focuses on the interpretation and integration of chromatograms related to food contamination by mineral oil from paperboard boxes (off-set printing inks and recycled fibers), if possible distinguishing between various sources of mineral oil. Typical chromatograms are shown for relevant components and interferences as well as food samples encountered on the market. Details are pointed out which may provide relevant information. Integration is shown for examples of paperboard packaging materials as well as various foods. Finally the uncertainty of the analysis and limit of quantitation are discussed for specific examples. They primarily result from the interpretation of the chromatogram, manually placing the baseline and cuts for taking off extraneous components. Without previous enrichment, the limit of quantitation is between around 0.1 mg/kg for foods with a low fat content and 2.5 mg/kg for fats and oils. The measurement uncertainty can be kept clearly below 20% for most samples. Copyright © 2012 Elsevier B.V. All rights reserved.

DC and small-signal physical models for the AlGaAs/GaAs high electron mobility transistor

NASA Technical Reports Server (NTRS)

Sarker, J. C.; Purviance, J. E.

1991-01-01

Analytical and numerical models are developed for the microwave small-signal performance, such as transconductance, gate-to-source capacitance, current gain cut-off frequency and the optimum cut-off frequency of the AlGaAs/GaAs High Electron Mobility Transistor (HEMT), in both normal and compressed transconductance regions. The validated I-V characteristics and the small-signal performances of four HeMT's are presented.

A description of disordered eating behaviors in Latino males

PubMed Central

Reyes-Rodríguez, Mae Lynn; Sala, Margarita; Von Holle, Ann; Unikel, Claudia; Bulik, Cynthia M.; Cámara-Fuentes, Luis; Suárez-Torres, Alba

2011-01-01

Objective To explore disordered eating and eating disorders (ED) in Latino males. Participants 722 male college students from a larger prevalence study conducted in the University of Puerto Rico (UPR) system. Method Participants were selected from a list of sections of required courses for first-year students on each campus. Self report instruments were used to explore ED symptoms (EAT-26 & BULIT-26) and depression (BDI). Results Overall, 2.26% scored above the cut-off point on the BULIT-R and 5.08% score above the cut-off point on the EAT-26. Of the males, 4.43% reported sufficient frequency and severity to approximate DSM-IV criteria for BN. Depression symptomatology was found in those who scored above the cut-off point on both instruments of ED. Conclusion College health practitioners should be aware of disordered eating in Latino males and include them in efforts to detect disordered eating behaviors in college students. PMID:21308586

Traveling wave electrode design of electro-optically modulated coupled-cavity surface-emitting lasers.

PubMed

Zujewski, Mateusz; Thienpont, Hugo; Panajotov, Krassimir

2012-11-19

We present a novel design of an electro-optically modulated coupled-cavity vertical-cavity surface-emitting laser (CC-VCSEL) with traveling wave electrodes of the modulator cavity, which allows to overcome the RC time constant of a traditional lumped electrode structures. The CC-VCSEL optical design is based on longitudinal mode switching which has recently experimentally demonstrated a record modulation speed. We carry out segmented transmission line electrical design of the modulator cavity in order to compensate for the low impedance of the modulator section and to match the 50 Ω electrical network. We have optimized two types of highly efficient modulator structures reaching -3 dB electrical cut-off frequency of f(cut-off) = 330 GHz with maximum reflection of -22 dB in the range from f(LF) = 100 MHz to f(cut-off) and 77 - 89% modulation efficiency.

[Validation of the Eating Attitudes Test as a screening instrument for eating disorders in general population].

PubMed

Peláez-Fernández, María Angeles; Ruiz-Lázaro, Pedro Manuel; Labrador, Francisco Javier; Raich, Rosa María

2014-02-20

To validate the best cut-off point of the Eating Attitudes Test (EAT-40), Spanish version, for the screening of eating disorders (ED) in the general population. This was a transversal cross-sectional study. The EAT-40 Spanish version was administered to a representative sample of 1.543 students, age range 12 to 21 years, in the Region of Madrid. Six hundred and two participants (probable cases and a random sample of controls) were interviewed. The best diagnostic prediction was obtained with a cut-off point of 21, with sensitivity: 88.2%; specificity: 62.1%; positive predictive value: 17.7%; negative predictive value: 62.1%. Use of a cut-off point of 21 is recommended in epidemiological studies of eating disorders in the Spanish general population. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Seismic analysis of the frame structure reformed by cutting off column and jacking based on stiffness ratio

NASA Astrophysics Data System (ADS)

Zhao, J. K.; Xu, X. S.

2017-11-01

The cutting off column and jacking technology is a method for increasing story height, which has been widely used and paid much attention in engineering. The stiffness will be changed after the process of cutting off column and jacking, which directly affects the overall seismic performance. It is usually necessary to take seismic strengthening measures to enhance the stiffness. A five story frame structure jacking project in Jinan High-tech Zone was taken as an example, and three finite element models were established which contains the frame model before lifting, after lifting and after strengthening. Based on the stiffness, the dynamic time-history analysis was carried out to research its seismic performance under the EL-Centro seismic wave, the Taft seismic wave and the Tianjin artificial seismic wave. The research can provide some guidance for the design and construction of the entire jack lifting structure.

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

NASA Astrophysics Data System (ADS)

He, Lingbing; Jiang, Jin-Cheng

2017-07-01

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

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.

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.

A novel fast-neutron detector concept for energy-selective imaging and imaging spectroscopy.

PubMed

Cortesi, M; Dangendorf, V; Zboray, R; Prasser, H-M

2014-07-01

We present and discuss the operational principle of a new fast-neutron detector concept suitable for either energy-selective imaging or for imaging spectroscopy. The detector is comprised of a series of energy-selective stacks of converter foils immersed in a noble-gas based mixture, coupled to a position-sensitive charge readout. Each foil in the various stacks is made of two layers of different thicknesses, fastened together: a hydrogen-rich (plastic) layer for neutron-to-proton conversion, and a hydrogen-free coating to selectively stop/absorb the recoil protons below a certain energy cut-off. The neutron-induced recoil protons, that escape the converter foils, release ionization electrons in the gas gaps between consecutive foils. The electrons are then drifted towards and localized by a position-sensitive charge amplification and readout stage. Comparison of the images detected by stacks with different energy cut-offs allows energy-selective imaging. Neutron energy spectrometry is realized by analyzing the responses of a sufficient large number of stacks of different energy response and unfolding techniques. In this paper, we present the results of computer simulation studies and discuss the expected performance of the new detector concept. Potential applications in various fields are also briefly discussed, in particularly, the application of energy-selective fast-neutron imaging for nuclear safeguards application, with the aim of determining the plutonium content in Mixed Oxide (MOX) fuels.

Validating the UNICEF/Washington Group Child Functioning Module for Fijian schools to identify seeing, hearing and walking difficulties.

PubMed

Sprunt, Beth; Hoq, Monsurul; Sharma, Umesh; Marella, Manjula

2017-09-20

This study investigated the seeing, hearing and walking questions of the UNICEF/Washington Group Child Functioning Module and the inter-rater reliability between teachers and parents as proxy respondents. Cross-sectional diagnostic accuracy study, two-gate design with representative sampling, comparing Module responses to reference standard assessments for 472 primary aged students in Fiji. Receiver operating characteristic curves were constructed to determine the area under the curve and optimal cut-off points. Areas under the curves ranged from 0.823 to 0.889 indicating "good" diagnostic accuracy. Inter-rater reliability between parent and teacher responses was "good" to "excellent". The optimal cut-off determined by the Youden Index was "some difficulty" however a wide spread of impairment levels were found in this category with most children either having none or substantial impairments. The diagnostic accuracy of the Module seeing, hearing and walking questions appears acceptable with either parents or teachers as proxy respondents. For education systems, use of the cut-off "some difficulty" with accompanying clinical assessment may be important to capture children who require services and learning supports and avoid potentially misleading categorization. Given the high proportion of the sample from special schools research is required to further test the Module in mainstream schools. Implications for rehabilitation Identification of children who are at risk of disability in Fiji is important to enable planning, monitoring and evaluating access to quality inclusive education. The UNICEF/Washington Group Child Functioning Module appears to be a practical and effective tool that can be used by teachers to identify children at risk of disability. Children identified on the UNICEF/Washington Group Child Functioning Module as having "some difficulty" or higher levels of difficulty in relation to vision, hearing or walking should be referred for further assessment and services. Rehabilitation services in Fiji need to prepare for greater numbers of referrals as the Ministry of Education increasingly rolls out the inclusive education policy, which includes identification by schools of children at risk of disability.

Status of two-color and large format HgCdTe FPA technology at Raytheon Vision Systems

NASA Astrophysics Data System (ADS)

Smith, E. P. G.; Bornfreund, R. E.; Kasai, I.; Pham, L. T.; Patten, E. A.; Peterson, J. M.; Roth, J. A.; Nosho, B. Z.; De Lyon, T. J.; Jensen, J. E.; Bangs, J. W.; Johnson, S. M.; Radford, W. A.

2006-02-01

Raytheon Vision Systems (RVS) is developing two-color and large format single color FPAs fabricated from molecular beam epitaxy (MBE) grown HgCdTe triple layer heterojunction (TLHJ) wafers on CdZnTe substrates and double layer heterojunction (DLHJ) wafers on Si substrates, respectively. MBE material growth development has resulted in scaling TLHJ growth on CdZnTe substrates from 10cm2 to 50cm2, long-wavelength infrared (LWIR) DLHJ growth on 4-inch Si substrates and the first demonstration of mid-wavelength infrared (MWIR) DLHJ growth on 6-inch Si substrates with low defect density (<1000cm -2) and excellent uniformity (composition<0.1%, cut-off wavelength Δcenter-edge<0.1μm). Advanced FPA fabrication techniques such as inductively coupled plasma (ICP) etching are being used to achieve high aspect ratio mesa delineation of individual detector elements with benefits to detector performance. Recent two-color detectors with MWIR and LWIR cut-off wavelengths of 5.5μm and 10.5μm, respectively, exhibit significant improvement in 78K LW performance with >70% quantum efficiency, diffusion limited reverse bias dark currents below 300pA and RA products (zero field-of-view, +150mV bias) in excess of 1×103 Ωcm2. Two-color 20μm unit-cell 1280×720 MWIR/LWIR FPAs with pixel response operability approaching 99% have been produced and high quality simultaneous imaging of the spectral bands has been achieved by mating the FPA to a readout integrated circuit (ROIC) with Time Division Multiplexed Integration (TDMI). Large format mega pixel 20μm unit-cell 2048×2048 and 25μm unit-cell 2560×512 FPAs have been demonstrated using DLHJ HgCdTe growth on Si substrates in the short wavelength infrared (SWIR) and MWIR spectral range. Recent imaging of 30μm unit-cell 256×256 LWIR FPAs with 10.0-10.7μm 78K cut-off wavelength and pixel response operability as high as 99.7% show the potential for extending HgCdTe/Si technology to LWIR wavelengths.

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.

Incidence of burnout in Spanish nursing professionals: a longitudinal study.

PubMed

Grau-Alberola, Ester; Gil-Monte, Pedro R; García-Juesas, Juan Antonio; Figueiredo-Ferraz, Hugo

2010-08-01

Burnout is a psychological response to chronic work-related stress of an interpersonal and emotional nature that appears in professionals in service organizations who work in direct contact with the clients or end-users of the organization. The purpose of this study was to examine the incidence of burnout in a sample of staff nurses. The study was longitudinal, and not randomized. The gap between time 1 (T1) and time 2 (T2) was 1 year. The data were gathered using an anonymous and self-applied questionnaire in different units of 13 Spanish hospitals. The sample consisted of 316 staff nurses, 53 males (16.8%) and 262 females (83.2%). The percentage of the response obtained was 31.37% of all the questionnaires distributed in T1, and 83.77% of all the questionnaires handed out in T2. The characteristics of the sample were stable over time. Burnout was evaluated by the Maslach Burnout Inventory (MBI-HSS). Descriptive statistics, percentages, and t-test analyses were conducted. The prevalence of burnout was different according to the approach used: (a) following the cut-off points from the American manual, the prevalence was 2.84% in T1 and 1.89% in T2; and considering the clinically derived cut-off points obtained in Holland, the percentage was 1.26% in T1 and .94% in T2. The results only confirmed the hypothesis formulated applying the American cut-off points in T1. There was a significant increase in the levels of emotional exhaustion from T1 to T2, but there were no significant changes in the levels of personal accomplishment or depersonalization from T1 to T2. When the scores on the three dimensions of the MBI were considered together, a decrease in the incidence of burnout was obtained from T1 to T2. The prevalence of burnout in staff nurses can be modified over time, depending on the criteria used to estimate the prevalence. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

Action-oriented colour-coded foot length calliper for primary healthcare workers as a proxy for birth weight & gestational period

PubMed Central

Pratinidhi, Asha K.; Bagade, Abhijit C.; Kakade, Satish V.; Kale, Hemangi P.; Kshirsagar, Vinayak Y.; Babar, Rohini; Bagal, Shilpa

2017-01-01

Background & objectives: Foot length of the newborn has a good correlation with the birth weight and is recommended to be used as a proxy measure. There can be variations in the measurement of foot length. A study was, therefore, carried out to develop a foot length calliper for accurate foot length measurement and to find cut-off values for birth weight and gestational age groups to be used by primary healthcare workers. Methods: This study was undertaken on 645 apparently healthy newborn infants with known gestational age. Nude birth weight was taken within 24 h of birth on a standard electronic weighing machine. A foot length calliper was developed. Correlation between foot length and birth weight as well as gestational age was calculated. Correctness of cut-off values was tested using another set of 133 observations on the apparently healthy newborns. Action-oriented colour coding was done to make it easy for primary healthcare workers to use it. Results: There was a significant correlation of foot length with birth weight (r=0.75) and gestational age (r=0.63). Cut-off values for birth weight groups were 6.1, 6.8 and 7.3 cm and for gestational age of 6.1, 6.8 and 7.0 cm. Correctness of these cut-off values ranged between 77.1 and 95.7 per cent for birth weight and 60-93.3 per cent for gestational age. Considering 2.5 kg as cut-off between normal birth weight and low birth weight (LBW), cut-off values of 6.1, 6.8 and 7.3 were chosen. Action-oriented colour coding was done by superimposing the colours on the scale of the calliper, green indicating home care, yellow indicating supervised home care, orange indicating care at newborn care units at primary health centres and red indicating Neonatal Intensive Care Unit care for infants. Interpretation & conclusions: A simple device was developed so that the primary health care workers and trained Accredited Social Health Activist workers can identify the risk of LBW in the absence of accurate weighing facilities and decide on the type of care needed by the newborn and take action accordingly. PMID:28749397

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

Transparency of the 2 μm (5000 cm-1) methane window in Titan's atmosphere and impact on retrieved surface reflectivity

NASA Astrophysics Data System (ADS)

Rannou, Pascal; Seignovert, Benoit; Le Mouélic, Stéphane; Sotin, Christophe

2016-10-01

The study of Titan properties with remote sensing relies on a good knowledge of the atmosphere properties. The in-situ observations made by Huygens combined with recent advances in the definition of methane properties enable to model and interpret observations with a very good accuracy. Thanks to these progresses, we can analyze in this work the observations made at the limb of Titan in order to retrieve information on the haze properties as its vertical profiles and its spectral behaviour along the VIMS/Cassini range (from 0.88 to 5.1 μm). However, for applications to real atmospheres, one need to account for the widening of the spectroscopic lines (e.g., Voigt profile) and apply an empirical cut-off of the far wings. In general, this is a multiplying function of the wavenumber, f(ν), applied to the Voigt profile that allows a faster decay of the wing profile beyond a given distance from the center of the line ν0 : f(ν)=1 if |ν- ν0| ≤ Δν, and f(ν)=exp(-|ν- ν0|/ σ) if |ν- ν0| > Δν. Although the 2-μm window is apparently straitforward to model, it appears that the standard cut-off parameters (that is Δν ~ 26 cm-1 and σ ~ 120 cm-1) which is used for other windows in Titan's atmosphere is not adequat for this window. Other sets of parameter must be used to reproduce Titan spectrum at 2 μm. However, there is no convergence of the results between these works and a large variety of cut-off parameters are used. Alternatively, it was found that some gas absorptions (ethane and another unknown gas) leave a signature around 2-μm and also affect the transparency in this window. In our study we make an exhaustive investigation on the cut-off parameters to determine which are the best couples of parameters to fit the 2-μm window. We also evaluated how gaseous absorptions can allow to reach a satisfactory agreement and, especially, if it allows to match observations with the standard cut-off. Finally, we investigate the impact of the different solutions (different cut-off, with or without supplementary absorptions) on the retrieved surface albedo.

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

Accuracy estimation of an indirect ELISA for the detection of West Nile Virus antibodies in wild birds using a latent class model.

PubMed

Tamba, Marco; Caminiti, Antonino; Prosperi, Alice; Desprès, Philippe; Lelli, Davide; Galletti, Giorgio; Moreno, Ana; Paternoster, Giulia; Santi, Annalisa; Licata, Elio; Lecollinet, Sylvie; Gelmini, Luca; Rugna, Gianluca; Procopio, Anna; Lavazza, Antonio

2017-10-01

West Nile virus (WNV) and Usutu virus (USUV), genus Flavivirus, are members of the Japanese encephalitis virus antigenic complex, and are maintained primarily in an enzootic cycle between mosquitoes and birds. WNV is zoonotic, and poses a threat to public health, especially in relation to blood transfusion. Serosurveillance of wild birds is suitable for early detection of WNV circulation, although concerns remain to be addressed as regards i) the type of test used, whether ELISA, virus neutralization test (VNT), plaque reduction neutralization test (PRNT), ii) the reagents (antigens, revealing antibodies), iii) the different bird species involved, and iv) potential cross-reactions with other Flaviviruses, such as USUV. The authors developed an indirect IgG ELISA with pan-avian specificity using EDIII protein as antigen and a monoclonal antibody (mAb 1A3) with broad reactivity for avian IgG. A total of 140 serum samples were collected from juvenile European magpies (Pica pica) in areas where both WNV and USUV were co-circulating. The samples were then tested using this in-house ELISA and VNT in parallel. Estimation of test accuracy was performed using different Bayesian two latent class models. At a cut-off set at an optical density percentage (OD%) of 15, the ELISA showed a posterior median of diagnostic sensitivity (DSe) of 88% (95%PCI: 73-99%) and a diagnostic specificity (DSp) of 86% (95%PCI: 68-99%). At this cut-off, ELISA and VNT (cut-off 1/10) performances were comparable: DSe=91% (95%PCI: 79-99%), and DSp=77% (95%PCI: 59-98%). With the cut-off increased to 30 OD%, the ELISA DSe dropped to 78% (95%PCI: 52-99%), and the DSp rose to 94% (95%PCI: 83-100%). In field conditions, the cut-off that yields the best accuracy for the ELISA appears to correspond to 15 OD%. In areas where other Flaviviruses are circulating, however, it might be appropriate to raise the cut-off to 30 OD% in order to achieve higher specificity and reduce the detection of seropositive birds infected by other Flaviviruses, such as USUV. Copyright © 2017 Elsevier B.V. All rights reserved.

PRospective Imaging of CErvical cancer and neoadjuvant treatment (PRICE) study: role of ultrasound to predict partial response in locally advanced cervical cancer patients undergoing chemoradiation and radical surgery.

PubMed

Testa, A C; Ferrandina, G; Moro, F; Pasciuto, T; Moruzzi, M C; De Blasis, I; Mascilini, F; Foti, E; Autorino, R; Collarino, A; Gui, B; Zannoni, G F; Gambacorta, M A; Valentini, A L; Rufini, V; Scambia, G

2018-05-01

Chemoradiation-based neoadjuvant treatment followed by radical surgery is an alternative therapeutic strategy for locally advanced cervical cancer (LACC), but ultrasound variables used to predict partial response to neoadjuvant treatment are not well defined. Our goal was to analyze prospectively the potential role of transvaginal ultrasound in early prediction of partial pathological response, assessed in terms of residual disease at histology, in a large, single-institution series of LACC patients triaged to neoadjuvant treatment followed by radical surgery. Between October 2010 and June 2014, we screened 108 women with histologically documented LACC Stage IB2-IVA, of whom 88 were included in the final analysis. Tumor volume, three-dimensional (3D) power Doppler indices and contrast parameters were obtained before (baseline examination) and after 2 weeks of treatment. The pathological response was defined as complete (absence of any residual tumor after treatment) or partial (microscopic and/or macroscopic residual tumor at pathological examination). Complete-response and partial-response groups were compared and receiver-operating characteristics (ROC) curves were generated for ultrasound variables that were statistically significant on univariate analysis to evaluate their diagnostic ability to predict partial pathological response. There was a complete pathological response to neoadjuvant therapy in 40 (45.5%) patients and a partial response in 48 (54.5%). At baseline examination, tumor volume did not differ between the two groups. However, after 2 weeks of neoadjuvant treatment, the tumor volume was significantly greater in patients with partial response than it was in those with complete response (P = 0.019). Among the 3D vascular indices, the vascularization index (VI) was significantly lower in the partial-response compared with the complete-response group, both before and after 2 weeks of treatment (P = 0.037 and P = 0.024, respectively). At baseline examination in the contrast analysis, women with partial response had lower tumor peak enhancement (PE) as well as lower tumor wash-in rate (WiR) and longer tumor rise time (RT) compared with complete responders (P = 0.006, P = 0.003, P = 0.038, respectively). There was no difference in terms of contrast parameters after 2 weeks of treatment. ROC-curve analysis of baseline parameters showed that the best cut-offs for predicting partial pathological response were 41.5% for VI (sensitivity, 63.6%; specificity, 66.7%); 16123.5 auxiliary units for tumor PE (sensitivity, 47.9%; specificity, 84.2%); 7.8 s for tumor RT (sensitivity, 68.8%; specificity, 57.9%); and 4902 for tumor WiR (sensitivity, 77.1%; specificity, 60.5%). ROC curves of parameters after 2 weeks of treatment showed that the best cut-off for predicting partial pathological response was 18.1 cm 3 for tumor volume (sensitivity, 70.8%; specificity 60.0%) and 39.5% for VI (sensitivity; 62.5%; specificity, 73.5%). Ultrasound and contrast parameters differ between LACC patients with complete response and those with partial response before and after 2 weeks of neoadjuvant treatment. However, neither ultrasound parameters before treatment nor those after 2 weeks of treatment had cut-off values with acceptable sensitivity and specificity for predicting partial pathological response to neoadjuvant therapy. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

Can adaptive threshold-based metabolic tumor volume (MTV) and lean body mass corrected standard uptake value (SUL) predict prognosis in head and neck cancer patients treated with definitive radiotherapy/chemoradiotherapy?

PubMed

Akagunduz, Ozlem Ozkaya; Savas, Recep; Yalman, Deniz; Kocacelebi, Kenan; Esassolak, Mustafa

2015-11-01

To evaluate the predictive value of adaptive threshold-based metabolic tumor volume (MTV), maximum standardized uptake value (SUVmax) and maximum lean body mass corrected SUV (SULmax) measured on pretreatment positron emission tomography and computed tomography (PET/CT) imaging in head and neck cancer patients treated with definitive radiotherapy/chemoradiotherapy. Pretreatment PET/CT of the 62 patients with locally advanced head and neck cancer who were treated consecutively between May 2010 and February 2013 were reviewed retrospectively. The maximum FDG uptake of the primary tumor was defined according to SUVmax and SULmax. Multiple threshold levels between 60% and 10% of the SUVmax and SULmax were tested with intervals of 5% to 10% in order to define the most suitable threshold value for the metabolic activity of each patient's tumor (adaptive threshold). MTV was calculated according to this value. We evaluated the relationship of mean values of MTV, SUVmax and SULmax with treatment response, local recurrence, distant metastasis and disease-related death. Receiver-operating characteristic (ROC) curve analysis was done to obtain optimal predictive cut-off values for MTV and SULmax which were found to have a predictive value. Local recurrence-free (LRFS), disease-free (DFS) and overall survival (OS) were examined according to these cut-offs. Forty six patients had complete response, 15 had partial response, and 1 had stable disease 6 weeks after the completion of treatment. Median follow-up of the entire cohort was 18 months. Of 46 complete responders 10 had local recurrence, and of 16 partial or no responders 10 had local progression. Eighteen patients died. Adaptive threshold-based MTV had significant predictive value for treatment response (p=0.011), local recurrence/progression (p=0.050), and disease-related death (p=0.024). SULmax had a predictive value for local recurrence/progression (p=0.030). ROC curves analysis revealed a cut-off value of 14.00 mL for MTV and 10.15 for SULmax. Three-year LRFS and DFS rates were significantly lower in patients with MTV ≥ 14.00 mL (p=0.026, p=0.018 respectively), and SULmax≥10.15 (p=0.017, p=0.022 respectively). SULmax did not have a significant predictive value for OS whereas MTV had (p=0.025). Adaptive threshold-based MTV and SULmax could have a role in predicting local control and survival in head and neck cancer patients. Copyright © 2015 Elsevier Inc. All rights reserved.

X-Z-Theta cutting method

DOEpatents

Bieg, Lothar F.

1993-01-12

A method for machining a workpiece. The method includes the use of a rotary cutting tool mounted on the end of a movable arm. The arm is adapted to move in a plane perpendicular to the axis of rotation of the cutting tool. The cutting tool has cutting teeth to cut chips of material off of the workpiece in a predetermined size and shape to facilitate better removal of the chips from the workpiece. The teeth can be of different type and length to permit the tool to both rough cut and finish cut the workpiece during machining. The total depth of cut is divided by the number of tool teeth, so that the longest tool always performs the finishing cut.

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

NASA Astrophysics Data System (ADS)

Hall, Richard L.

2007-12-01

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