How Is Cancer Risk Measured?

MedlinePlus

... more groups. The people in one group (the control group ) may be given a standard screening test (if one exists) or no screening test. The ... for the human papillomavirus (HPV) and those who test negative for HPV. The ... Case-control studies Case-control studies are like cohort studies ...

An assessment of scientific and technical aspects of closed investigations of canine forensics DNA – case series from the University of California, Davis, USA

PubMed Central

Scharnhorst, Günther; Kanthaswamy, Sree

2011-01-01

Aim To describe and assess the scientific and technical aspects of animal forensic testing at the University of California, Davis. The findings and recommendations contained in this report are designed to assess the past, evaluate the present, and recommend reforms that will assist the animal forensic science community in providing the best possible services that comply with court standards and bear judicial scrutiny. Methods A batch of 32 closed files of domestic dog DNA cases processed at the University of California, Davis, between August 2003 and July 2005 were reviewed in this study. The case files comprised copies of all original paperwork, copies of the cover letter or final report, laboratory notes, notes on analyses, submission forms, internal chains of custody, printed images and photocopies of evidence, as well as the administrative and technical reviews of those cases. Results While the fundamental aspects of animal DNA testing may be reliable and acceptable, the scientific basis for forensic testing animal DNA needs to be improved substantially. In addition to a lack of standardized and validated genetic testing protocols, improvements are needed in a wide range of topics including quality assurance and quality control measures, sample handling, evidence testing, statistical analysis, and reporting. Conclusion This review implies that although a standardized panel of short tandem repeat and mitochondrial DNA markers and publicly accessible genetic databases for canine forensic DNA analysis are already available, the persistent lack of supporting resources, including standardized quality assurance and quality control programs, still plagues the animal forensic community. This report focuses on closed cases from the period 2003-2005, but extends its scope more widely to include other animal DNA forensic testing services. PMID:21674824

An assessment of scientific and technical aspects of closed investigations of canine forensics DNA--case series from the University of California, Davis, USA.

PubMed

Scharnhorst, Günther; Kanthaswamy, Sree

2011-06-01

To describe and assess the scientific and technical aspects of animal forensic testing at the University of California, Davis. The findings and recommendations contained in this report are designed to assess the past, evaluate the present, and recommend reforms that will assist the animal forensic science community in providing the best possible services that comply with court standards and bear judicial scrutiny. A batch of 32 closed files of domestic dog DNA cases processed at the University of California, Davis, between August 2003 and July 2005 were reviewed in this study. The case files comprised copies of all original paperwork, copies of the cover letter or final report, laboratory notes, notes on analyses, submission forms, internal chains of custody, printed images and photocopies of evidence, as well as the administrative and technical reviews of those cases. While the fundamental aspects of animal DNA testing may be reliable and acceptable, the scientific basis for forensic testing animal DNA needs to be improved substantially. In addition to a lack of standardized and validated genetic testing protocols, improvements are needed in a wide range of topics including quality assurance and quality control measures, sample handling, evidence testing, statistical analysis, and reporting. This review implies that although a standardized panel of short tandem repeat and mitochondrial DNA markers and publicly accessible genetic databases for canine forensic DNA analysis are already available, the persistent lack of supporting resources, including standardized quality assurance and quality control programs, still plagues the animal forensic community. This report focuses on closed cases from the period 2003-2005, but extends its scope more widely to include other animal DNA forensic testing services.

Using Quality Management Systems to Improve Test Development and Standards and to Promote Good Practice: A Case Study of Testing Italian as a Foreign Language

ERIC Educational Resources Information Center

Grego Bolli, Giuliana

2014-01-01

This article discusses the problem of quality in the production of language tests in the context of Italian language examinations. The concept of quality is closely related to the application of stated standards and related procedures. These standards, developed over the last thirty years, are mainly related to the concepts of the accountability…

Applying EALTA Guidelines as Baseline for the Foreign Language Proficiency Test in Turkey: The Case of YDS

ERIC Educational Resources Information Center

Kavakli, Nurdan; Arslan, Sezen

2017-01-01

Within the scope of educational testing and assessment, setting standards and creating guidelines as a code of practice provide more prolific and sustainable outcomes. In this sense, internationally accepted and regionally accredited principles are suggested for standardization in language testing and assessment practices. Herein, ILTA guidelines…

49 CFR 194.105 - Worst case discharge.

Code of Federal Regulations, 2013 CFR

2013-10-01

...: Prevention measure Standard Credit(percent) Secondary containment >100% NFPA 30 50 Built/repaired to API standards API STD 620/650/653 10 Overfill protection standards API RP 2350 5 Testing/cathodic protection API...

49 CFR 194.105 - Worst case discharge.

Code of Federal Regulations, 2010 CFR

2010-10-01

...: Prevention measure Standard Credit(percent) Secondary containment > 100% NFPA 30 50 Built/repaired to API standards API STD 620/650/653 10 Overfill protection standards API RP 2350 5 Testing/cathodic protection API...

49 CFR 194.105 - Worst case discharge.

Code of Federal Regulations, 2014 CFR

2014-10-01

...: Prevention measure Standard Credit(percent) Secondary containment >100% NFPA 30 50 Built/repaired to API standards API STD 620/650/653 10 Overfill protection standards API RP 2350 5 Testing/cathodic protection API...

49 CFR 194.105 - Worst case discharge.

Code of Federal Regulations, 2012 CFR

2012-10-01

...: Prevention measure Standard Credit(percent) Secondary containment > 100% NFPA 30 50 Built/repaired to API standards API STD 620/650/653 10 Overfill protection standards API RP 2350 5 Testing/cathodic protection API...

49 CFR 194.105 - Worst case discharge.

Code of Federal Regulations, 2011 CFR

2011-10-01

...: Prevention measure Standard Credit(percent) Secondary containment > 100% NFPA 30 50 Built/repaired to API standards API STD 620/650/653 10 Overfill protection standards API RP 2350 5 Testing/cathodic protection API...

PSAT Testing: Blunder Causes Staffing Reassignment

ERIC Educational Resources Information Center

Uribe, Patricia E.

2015-01-01

This case exemplifies the effects of high stakes standardized testing and accountability on education and school district personnel. The case focuses on a school counselor who inadvertently gave the students the actual PSAT (a preliminary college entrance exam) instead of a practice test during a college preparatory workshop. The error caused the…

The Teacher as Examiner of L2 Oral Tests: A Challenge to Standardization

ERIC Educational Resources Information Center

Sundqvist, Pia; Wikström, Peter; Sandlund, Erica; Nyroos, Lina

2018-01-01

The present paper looks at the issue of standardization in L2 oral testing. Whereas external examiners are frequently used globally, some countries opt for test-takers' own teachers as examiners instead. In the present study, Sweden is used as a case in point, with a focus on the mandatory, high-stakes, summative, ninth-grade national test in…

Comparing Standard and Selective Degradation DNA Extraction Methods: Results from a Field Experiment with Sexual Assault Kits^.

PubMed

Campbell, Rebecca; Pierce, Steven J; Sharma, Dhruv B; Shaw, Jessica; Feeney, Hannah; Nye, Jeffrey; Schelling, Kristin; Fehler-Cabral, Giannina

2017-01-01

A growing number of U.S. cities have large numbers of untested sexual assault kits (SAKs) in police property facilities. Testing older kits and maintaining current case work will be challenging for forensic laboratories, creating a need for more efficient testing methods. We evaluated selective degradation methods for DNA extraction using actual case work from a sample of previously unsubmitted SAKs in Detroit, Michigan. We randomly assigned 350 kits to either standard or selective degradation testing methods and then compared DNA testing rates and CODIS entry rates between the two groups. Continuation-ratio modeling showed no significant differences, indicating that the selective degradation method had no decrement in performance relative to customary methods. Follow-up equivalence tests indicated that CODIS entry rates for the two methods could differ by more than ±5%. Selective degradation methods required less personnel time for testing and scientific review than standard testing. © 2016 American Academy of Forensic Sciences.

How Well Does Physician Selection of Microbiologic Tests Identify Clostridium difficile and other Pathogens in Paediatric Diarrhoea? Insights Using Multiplex PCR-Based Detection

PubMed Central

Stockmann, Chris; Rogatcheva, Margarita; Harrel, Brian; Vaughn, Mike; Crisp, Rob; Poritz, Mark; Thatcher, Stephanie; Korgenski, Ernest K; Barney, Trenda; Daly, Judy; Pavia, Andrew T

2014-01-01

The objective of this study was to compare the aetiologic yield of standard of care microbiologic testing ordered by physicians with that of a multiplex PCR platform. Stool specimens obtained from children and young adults with gastrointestinal illness were evaluated by standard laboratory methods and a developmental version of the FilmArray Gastrointestinal Diagnostic System (FilmArray GI Panel), a rapid multiplex PCR platform that detects 23 bacterial, viral, and protozoal agents. Results were classified according to the microbiologic tests requested by the treating physician. A median of 3 (range 1-10) microbiologic tests were performed by the clinical laboratory during 378 unique diarrhoeal episodes. A potential aetiologic agent was identified in 46% of stool specimens by standard laboratory methods and in 65% of specimens tested using the FilmArray GI Panel (P<0.001). For those patients who only had Clostridium difficile testing requested, an alternative pathogen was identified in 29% of cases with the FilmArray GI Panel. Notably, 11 (12%) cases of norovirus were identified among children who only had testing for C. difficile ordered. Among those who had C. difficile testing ordered in combination with other tests, an additional pathogen was identified in 57% of stool specimens with the FilmArray GI Panel. For patients who had no C. difficile testing performed, the FilmArray GI Panel identified a pathogen in 63% of cases, including C. difficile in 8%. Physician-specified laboratory testing may miss important diarrhoeal pathogens. Additionally, standard laboratory testing is likely to underestimate co-infections with multiple infectious diarrhoeagenic agents. PMID:25599941

Qualification of the RSRM case membrane case-to-insulation bondline inspection using the Thiokol Corporation ultrasonic RSRM bondline inspection system

NASA Technical Reports Server (NTRS)

Cook, M.

1990-01-01

Qualification testing of Combustion Engineering's AMDATA Intraspect/98 Data Acquisition and Imaging System that applies to the redesigned solid rocket motor (RSRM) case membrane case-to-insulation bondline inspection was performed. Testing was performed at M-67, the Thiokol Corp. RSRM Assembly Facility. The purpose of the inspection was to verify the integrity of the case membrane case-to-insulation bondline. The case membrane scanner was calibrated on the redesigned solid rocket motor case segment calibration standard, which had an intentional 1.0 by 1.0 in. case-to-insulation unbond. The case membrane scanner was then used to scan a 20 by 20 in. membrane area of the case segment. Calibration of the scanner was then rechecked on the calibration standard to ensure that the calibration settings did not change during the case membrane scan. This procedure was successfully performed five times to qualify the unbond detection capability of the case membrane scanner.

The Uses and Abuses of Educational Testing: Chicanos as a Case in Point. Chapter 8.

ERIC Educational Resources Information Center

Valencia, Richard R.; Aburto, Sofia

A persistent problem in U.S. educational research has been how to explain the continuing low performance on standardized tests by certain racial and ethnic minority-group students, such as Chicanos. This chapter identifies abusive practices stemming from standardized testing that help to shape school failure among Chicano students, and discusses…

Multiple transfer standard for calibration and characterization of test setups for LED lamps and luminaires in industry

NASA Astrophysics Data System (ADS)

Sperling, A.; Meyer, M.; Pendsa, S.; Jordan, W.; Revtova, E.; Poikonen, T.; Renoux, D.; Blattner, P.

2018-04-01

Proper characterization of test setups used in industry for testing and traceable measurement of lighting devices by the substitution method is an important task. According to new standards for testing LED lamps, luminaires and modules, uncertainty budgets are requested because in many cases the properties of the device under test differ from the transfer standard used, which may cause significant errors, for example if a LED-based lamp is tested or calibrated in an integrating sphere which was calibrated with a tungsten lamp. This paper introduces a multiple transfer standard, which was designed not only to transfer a single calibration value (e.g. luminous flux) but also to characterize test setups used for LED measurements with additional provided and calibrated output features to enable the application of the new standards.

Applications of Automation Methods for Nonlinear Fracture Test Analysis

NASA Technical Reports Server (NTRS)

Allen, Phillip A.; Wells, Douglas N.

2013-01-01

As fracture mechanics material testing evolves, the governing test standards continue to be refined to better reflect the latest understanding of the physics of the fracture processes involved. The traditional format of ASTM fracture testing standards, utilizing equations expressed directly in the text of the standard to assess the experimental result, is self-limiting in the complexity that can be reasonably captured. The use of automated analysis techniques to draw upon a rich, detailed solution database for assessing fracture mechanics tests provides a foundation for a new approach to testing standards that enables routine users to obtain highly reliable assessments of tests involving complex, non-linear fracture behavior. Herein, the case for automating the analysis of tests of surface cracks in tension in the elastic-plastic regime is utilized as an example of how such a database can be generated and implemented for use in the ASTM standards framework. The presented approach forms a bridge between the equation-based fracture testing standards of today and the next generation of standards solving complex problems through analysis automation.

Group study of an "undercover" test for visuospatial neglect: invisible cancellation can reveal more neglect than standard cancellation.

PubMed

Wojciulik, E; Rorden, C; Clarke, K; Husain, M; Driver, J

2004-09-01

Visual neglect is a relatively common deficit after brain damage, particularly strokes. Cancellation tests provide standard clinical measures of neglect severity and deficits in daily life. A recent single-case study introduced a new variation on standard cancellation. Instead of making a visible mark on each target found, the patient made invisible marks (recorded with carbon paper underneath, for later scoring). Such invisible cancellation was found to reveal more neglect than cancellation with visible marks. Here we test the generality of this. Twenty three successive cases with suspected neglect each performed cancellation with visible or invisible marks. Neglect of contralesional targets was more pronounced with invisible marks. Indeed, about half of the patients only showed neglect in this version. For cases showing more neglect with invisible marks, stronger neglect of contralesional targets correlated with more revisits to ipsilesional targets for making additional invisible marks upon them. These results indicate that cancellation with invisible marks can reveal more neglect than standard cancellation with visible marks, while still providing a practical bedside test. Our observations may be consistent with recent proposals that demands on spatial working memory (required to keep track of previously found items only when marked invisibly) can exacerbate spatial neglect.

The Effects of Achievement Goal Orientation and English Language Usage on Student Standardized Test Performance

ERIC Educational Resources Information Center

Bolton, Richard Allen

2017-01-01

Students take standardized tests and in most cases, the results have implications not only to the students, but also teachers and administrators. The students' motivation to perform may be a factor, especially in the infrequent situations when there aren't consequences to the students, only the administration. The tests in the middle school years…

Fidelity of test development process within a national science grant

NASA Astrophysics Data System (ADS)

Brumfield, Teresa E.

In 2002, a math-science partnership (MSP) program was initiated by a national science grant. The purpose of the MSP program was to promote the development, implementation, and sustainability of promising partnerships among institutions of higher education, K-12 schools and school systems, as well as other important stakeholders. One of the funded projects included a teacher-scientist collaborative that instituted a professional development system to prepare teachers to use inquiry-based instructional modules. The MSP program mandated evaluations of its funded projects. One of the teacher-scientist collaborative project's outcomes specifically focused on teacher and student science content and process skills. In order to provide annual evidence of progress and to measure the impact of the project's efforts, and because no appropriate science tests were available to measure improvements in content knowledge of participating teachers and their students, the project contracted for the development of science tests. This dissertation focused on the process of test development within an evaluation and examined planned (i.e., expected) and actual (i.e., observed) test development, specifically concentrating on the factors that affected the actual test development process. Planned test development was defined as the process of creating tests according to the well-established test development procedures recommended by the AERA/APA/NCME 1999 Standards for Educational and Psychological Testing. Actual test development was defined as the process of creating tests as it actually took place. Because case study provides an in-depth, longitudinal examination of an event (i.e., case) in a naturalistic setting, it was selected as the appropriate methodology to examine the difference between planned and actual test development. The case (or unit of analysis) was the test development task, a task that was bounded by the context in which it occurred---and over which this researcher had no control---and by time. The purpose for studying the case was to gain a more in-depth, holistic understanding of the real-life test development task that took place within a project evaluation context. In particular, this case study investigated how the actual test development process was affected by: (1) the national and state (i.e., NC) science standards, (2) the NSF's definition of "evidence" in a project evaluation, (3) the MSP project's understanding of the role of the to-be-developed tests in their project evaluation, (4) the MSP project's understanding of the test development process, and (5) the MSP project's participants (e.g., teacher item-writers and scientists). From an investigation of this case, it was concluded that: (a) constructing psychometrically sound tests within an evaluation is not easy, (b) sufficient time and resources to construct such measures properly are seldom provided, and (c) test construction---at least within an evaluation---is not routine and unproblematic. Based upon the results from this case study, it was recommended that stakeholders (i.e., program managers, project directors, and evaluators) be familiar with the steps and standards used to develop psychometrically sound tests. Additionally, it was recommended that, for future research, a meta-analysis that examines only the test development process be conducted of all other MSP projects. A second suggested future research area was to establish a protocol that provides a systematic means by which to examine an existing or proposed MSP project for alignment with state science standards. Such a protocol would be cost-effective in that demonstrated alignment with state science standards would enable projects to use existing state science assessments, which must be in place, according to NCLB, by the 2007-2008 school year, to demonstrate student achievement. In this way, project directors and evaluators, typically with limited familiarity with the steps and standards by which psychometrically sound assessments are created, would not be placed in the role of test developer.

Standardized Testing in the Case of China and the Lessons to Be Learned for the U.S.

ERIC Educational Resources Information Center

Ozturgut, Osman

2011-01-01

The Chinese have been using standardized testing for centuries. Ancient Greeks have tried it for centuries since 5th and 4th BC. There is no evidence that they have become successful in educating their children through an imperial or elitist system. The impact of standardizing the education on a nation is significant. This is not only true for not…

IQ Scores Should Be Corrected for the Flynn Effect in High-Stakes Decisions

ERIC Educational Resources Information Center

Fletcher, Jack M.; Stuebing, Karla K.; Hughes, Lisa C.

2010-01-01

IQ test scores should be corrected for high stakes decisions that employ these assessments, including capital offense cases. If scores are not corrected, then diagnostic standards must change with each generation. Arguments against corrections, based on standards of practice, information present and absent in test manuals, and related issues,…

An Analysis of Grade 4 Teachers' Mathematical Instructional Strategies

ERIC Educational Resources Information Center

Wilson-Patrick, Dedra

2016-01-01

The standardized math test scores of approximately 48 African American and Hispanic students from 4 different classes at a rural Title I elementary school located in the southern United States decreased by 10 points on the Palmetto Assessment of State Standards Test. For this qualitative case study, purposive sampling was used to recruit four…

Progressing from initially ambiguous functional analyses: three case examples.

PubMed

Tiger, Jeffrey H; Fisher, Wayne W; Toussaint, Karen A; Kodak, Tiffany

2009-01-01

Most often functional analyses are initiated using a standard set of test conditions, similar to those described by Iwata, Dorsey, Slifer, Bauman, and Richman [Iwata, B. A., Dorsey, M. F., Slifer, K. J., Bauman, K. E., & Richman, G. S. (1994). Toward a functional analysis of self-injury. Journal of Applied Behavior Analysis, 27, 197-209 (Reprinted from Analysis and Intervention in Developmental Disabilities, 2, 3-20, 1982)]. These test conditions involve the careful manipulation of motivating operations, discriminative stimuli, and reinforcement contingencies to determine the events related to the occurrence and maintenance of problem behavior. Some individuals display problem behavior that is occasioned and reinforced by idiosyncratic or otherwise unique combinations of environmental antecedents and consequences of behavior, which are unlikely to be detected using these standard assessment conditions. For these individuals, modifications to the standard test conditions or the inclusion of novel test conditions may result in clearer assessment outcomes. The current study provides three case examples of individuals whose functional analyses were initially undifferentiated; however, modifications to the standard conditions resulted in the identification of behavioral functions and the implementation of effective function-based treatments.

Propeller aircraft interior noise model. II - Scale-model and flight-test comparisons

NASA Technical Reports Server (NTRS)

Willis, C. M.; Mayes, W. H.

1987-01-01

A program for predicting the sound levels inside propeller driven aircraft arising from sidewall transmission of airborne exterior noise is validated through comparisons of predictions with both scale-model test results and measurements obtained in flight tests on a turboprop aircraft. The program produced unbiased predictions for the case of the scale-model tests, with a standard deviation of errors of about 4 dB. For the case of the flight tests, the predictions revealed a bias of 2.62-4.28 dB (depending upon whether or not the data for the fourth harmonic were included) and the standard deviation of the errors ranged between 2.43 and 4.12 dB. The analytical model is shown to be capable of taking changes in the flight environment into account.

Influenza and respiratory syncytial virus are the major respiratory viruses detected from prospective testing of pediatric and adult coronial autopsies.

PubMed

Speers, David J; Moss, Daniel M; Minney-Smith, Cara; Levy, Avram; Smith, David W

2013-11-01

To ascertain the full mortality of influenza and other respiratory viruses, the testing of community autopsy specimens is essential. Respiratory virus PCR and culture were performed on 2418 fresh unfrozen respiratory samples collected from 1611 coronial cases where the death was either unknown or infection was suspected, from July 2007 to June 2011, to detect the common respiratory viruses in children and adults, using standardized microbiological testing. The respiratory virus positive rate was 8·3% (134 cases) with a peak of 28% (42 of 151 cases) in children under 10 years of age. Influenza virus was the commonest respiratory virus (50 cases, 3%), followed by respiratory syncytial virus (RSV) (30 cases, 2%). All tested respiratory viruses were found in children, most commonly adenovirus, enterovirus and RSV, and influenza A and RSV predominated in those over 60 years, but coinfection was uncommon. Almost all influenza cases occurred when influenza was widely circulating in the community but few were diagnosed pre-mortem. Influenza and RSV detection was associated with bronchitis or bronchiolitis in 7 (9%) of the 80 cases and caused pneumonia in 14 (0·8%) deaths overall. Our prospective review of respiratory viruses using standardized testing found a single lower respiratory tract autopsy specimen for respiratory virus PCR would detect most community infections at the time of death. © 2013 John Wiley & Sons Ltd.

The Social Networks and Paradoxes of the Opt-out Movement Amid the Common Core State Standards Implementation: The Case of New York

ERIC Educational Resources Information Center

Wang, Yinying

2017-01-01

Opting out of state standardized tests has recently become a movement--a series of grassroots, organized efforts to refuse to take high-stakes state standardized tests. In particular, the opt-out rates in the state of New York reached 20% in 2015 and 21% in 2016. This study aims to illustrate the social networks and examine the paradoxes that have…

A hybrid model for combining case-control and cohort studies in systematic reviews of diagnostic tests

PubMed Central

Chen, Yong; Liu, Yulun; Ning, Jing; Cormier, Janice; Chu, Haitao

2014-01-01

Systematic reviews of diagnostic tests often involve a mixture of case-control and cohort studies. The standard methods for evaluating diagnostic accuracy only focus on sensitivity and specificity and ignore the information on disease prevalence contained in cohort studies. Consequently, such methods cannot provide estimates of measures related to disease prevalence, such as population averaged or overall positive and negative predictive values, which reflect the clinical utility of a diagnostic test. In this paper, we propose a hybrid approach that jointly models the disease prevalence along with the diagnostic test sensitivity and specificity in cohort studies, and the sensitivity and specificity in case-control studies. In order to overcome the potential computational difficulties in the standard full likelihood inference of the proposed hybrid model, we propose an alternative inference procedure based on the composite likelihood. Such composite likelihood based inference does not suffer computational problems and maintains high relative efficiency. In addition, it is more robust to model mis-specifications compared to the standard full likelihood inference. We apply our approach to a review of the performance of contemporary diagnostic imaging modalities for detecting metastases in patients with melanoma. PMID:25897179

The relationship between clinical and standardized tests for hand-arm vibration syndrome.

PubMed

Poole, C J M; Mason, H; Harding, A-H

2016-06-01

Standardized laboratory tests are undertaken to assist the diagnosis and staging of hand-arm vibration syndrome (HAVS), but the strength of the relationship between the tests and clinical stages of HAVS is unknown. To assess the relationship between the results of thermal aesthesiometry (TA), vibrotactile (VT) thresholds and cold provocation (CP) tests with the modified Stockholm scales for HAVS and to determine whether the relationship is affected by finger skin temperature. Consecutive records of workers referred to a Tier 5 HAVS assessment centre from 2006 to 2015 were identified. The diagnosis and staging of cases was undertaken from the clinical information contained in the records. Cases with alternative or mixed diagnoses were excluded and staging performed according to the modified Stockholm scale without knowledge of the results of the standardized laboratory tests. A total of 279 cases of HAVS were analysed. Although there was a significant trend for sensorineural (SN) and vascular scores to increase with clinical stage (P < 0.01), there was no significant difference in scores between 2SN early and 2SN late or between 2SN late and 3SN. There was moderate correlation between the TA and VT scores and the clinical SN stages (r = 0.6). This correlation did not change when subjects were divided into those with a finger skin temperature <30 and >30°C. CP scores distributed bimodally and correlated poorly with clinical staging (r = 0.2). Standardized SN tests distinguish between the lower Stockholm stages, but not above 2SN early. This has implications for health surveillance and UK policy. © Crown copyright 2016.

Intraoperative Cochlear Implant Device Testing Utilizing an Automated Remote System: A Prospective Pilot Study.

PubMed

Lohmann, Amanda R; Carlson, Matthew L; Sladen, Douglas P

2018-03-01

Intraoperative cochlear implant device testing provides valuable information regarding device integrity, electrode position, and may assist with determining initial stimulation settings. Manual intraoperative device testing during cochlear implantation requires the time and expertise of a trained audiologist. The purpose of the current study is to investigate the feasibility of using automated remote intraoperative cochlear implant reverse telemetry testing as an alternative to standard testing. Prospective pilot study evaluating intraoperative remote automated impedance and Automatic Neural Response Telemetry (AutoNRT) testing in 34 consecutive cochlear implant surgeries using the Intraoperative Remote Assistant (Cochlear Nucleus CR120). In all cases, remote intraoperative device testing was performed by trained operating room staff. A comparison was made to the "gold standard" of manual testing by an experienced cochlear implant audiologist. Electrode position and absence of tip fold-over was confirmed using plain film x-ray. Automated remote reverse telemetry testing was successfully completed in all patients. Intraoperative x-ray demonstrated normal electrode position without tip fold-over. Average impedance values were significantly higher using standard testing versus CR120 remote testing (standard mean 10.7 kΩ, SD 1.2 vs. CR120 mean 7.5 kΩ, SD 0.7, p < 0.001). There was strong agreement between standard manual testing and remote automated testing with regard to the presence of open or short circuits along the array. There were, however, two cases in which standard testing identified an open circuit, when CR120 testing showed the circuit to be closed. Neural responses were successfully obtained in all patients using both systems. There was no difference in basal electrode responses (standard mean 195.0 μV, SD 14.10 vs. CR120 194.5 μV, SD 14.23; p = 0.7814); however, more favorable (lower μV amplitude) results were obtained with the remote automated system in the apical 10 electrodes (standard 185.4 μV, SD 11.69 vs. CR120 177.0 μV, SD 11.57; p value < 0.001). These preliminary data demonstrate that intraoperative cochlear implant device testing using a remote automated system is feasible. This system may be useful for cochlear implant programs with limited audiology support or for programs looking to streamline intraoperative device testing protocols. Future studies with larger patient enrollment are required to validate these promising, but preliminary, findings.

NONPARAMETRIC MANOVA APPROACHES FOR NON-NORMAL MULTIVARIATE OUTCOMES WITH MISSING VALUES

PubMed Central

He, Fanyin; Mazumdar, Sati; Tang, Gong; Bhatia, Triptish; Anderson, Stewart J.; Dew, Mary Amanda; Krafty, Robert; Nimgaonkar, Vishwajit; Deshpande, Smita; Hall, Martica; Reynolds, Charles F.

2017-01-01

Between-group comparisons often entail many correlated response variables. The multivariate linear model, with its assumption of multivariate normality, is the accepted standard tool for these tests. When this assumption is violated, the nonparametric multivariate Kruskal-Wallis (MKW) test is frequently used. However, this test requires complete cases with no missing values in response variables. Deletion of cases with missing values likely leads to inefficient statistical inference. Here we extend the MKW test to retain information from partially-observed cases. Results of simulated studies and analysis of real data show that the proposed method provides adequate coverage and superior power to complete-case analyses. PMID:29416225

Integrating GIS in the Middle School Curriculum: Impacts on Diverse Students' Standardized Test Scores

ERIC Educational Resources Information Center

Goldstein, Donna; Alibrandi, Marsha

2013-01-01

This case study conducted with 1,425 middle school students in Palm Beach County, Florida, included a treatment group receiving GIS instruction (256) and a control group without GIS instruction (1,169). Quantitative analyses on standardized test scores indicated that inclusion of GIS in middle school curriculum had a significant effect on student…

An evaluation of the discriminating power of an Integrated Ballistics Identification System® Heritage™system with the NIST standard cartridge case (Standard Reference Material 2461).

PubMed

Morris, Keith B; Law, Eric F; Jefferys, Roger L; Dearth, Elizabeth C; Fabyanic, Emily B

2017-11-01

Through analysis and comparison of firing pin, breech face, and ejector impressions, where appropriate, firearm examiners may connect a cartridge case to a suspect firearm with a certain likelihood in a criminal investigation. When a firearm is not present, an examiner may use the Integrated Ballistics Identification System (IBIS ® ), an automated search and retrieval system coupled with the National Integrated Ballistics Information Network (NIBIN), a database of images showing the markings on fired cartridge cases and bullets from crime scenes along with test fired firearms. For the purpose of measurement quality control of these IBIS ® systems the National Institute of Standards and Technology (NIST) initiated the Standard Reference Material (SRM) 2460/2461 standard bullets and cartridge cases project. The aim of this study was to evaluate the overall performance of the IBIS ® system by using NIST standard cartridge cases. By evaluating the resulting correlation scores, error rates, and percent recovery, both the variability between and within examiners when using IBIS ® , in addition to any inter- and intra-variability between SRM cartridge cases was observed. Copyright © 2017 Elsevier B.V. All rights reserved.

A Case Study of the Texas Teacher Study: Technical Report. Project: Effects of Testing Reforms and Standards.

ERIC Educational Resources Information Center

Shepard, Lorrie A.; And Others

The Texas Examination of Current Administrators and Teachers is a basic literacy test that was administered to 202,000 practicing educators in March 1986. An in-depth case study was undertaken to examine the effects of the test as an instrument of educational reform and policy making. The two-year study involved 10 separate data-collection phases…

40 CFR 62.15250 - May I conduct stack testing less often?

Code of Federal Regulations, 2012 CFR

2012-07-01

... 15 nanograms per dry standard cubic meter (total mass) for Class I units, or 30 nanograms per dry standard cubic meter (total mass) for Class II units, for 2 consecutive years. In this case, you may choose... per dry standard cubic meter (total mass) for Class I units, or 30 nanograms per dry standard cubic...

40 CFR 62.15250 - May I conduct stack testing less often?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 15 nanograms per dry standard cubic meter (total mass) for Class I units, or 30 nanograms per dry standard cubic meter (total mass) for Class II units, for 2 consecutive years. In this case, you may choose... per dry standard cubic meter (total mass) for Class I units, or 30 nanograms per dry standard cubic...

40 CFR 62.15250 - May I conduct stack testing less often?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 15 nanograms per dry standard cubic meter (total mass) for Class I units, or 30 nanograms per dry standard cubic meter (total mass) for Class II units, for 2 consecutive years. In this case, you may choose... per dry standard cubic meter (total mass) for Class I units, or 30 nanograms per dry standard cubic...

24 CFR 200.937 - Supplementary specific procedural requirements under HUD building product standards and...

Code of Federal Regulations, 2010 CFR

2010-04-01

... requirements under HUD building product standards and certification program for plastic bathtub units, plastic... procedural requirements under HUD building product standards and certification program for plastic bathtub... product certification program. In the case of plastic bathroom fixtures, testing and inspection shall be...

Evaluating the "TOEFL Junior"® Standard Test as a Measure of Progress for Young English Language Learners. Research Report. ETS RR-15-22

ERIC Educational Resources Information Center

Gu, Lin; Lockwood, John; Powers, Donald E.

2015-01-01

Standardized tests are often designed to provide only a snapshot of test takers' knowledge, skills, or abilities at a single point in time. Sometimes, however, they are expected to serve more demanding functions, one of them is assessing change in knowledge, skills, or ability over time because of learning effects.The latter is the case for the…

Syringe test screening of microbial gas production activity: Cases denitrification and biogas formation.

PubMed

Østgaard, Kjetill; Kowarz, Viktoria; Shuai, Wang; Henry, Ingrid A; Sposob, Michal; Haugen, Hildegunn Hegna; Bakke, Rune

2017-01-01

Mass produced plastic syringes may be applied as vessels for cheap, simple and large scale batch culture testing. As illustrated for the cases of denitrification and of biogas formation, metabolic activity was monitored by direct reading of the piston movement due to the gas volume formed. Pressure buildup due to friction was shown to be moderate. A piston pull and slide back routine can be applied before recording gas volume to minimize experimental errors due to friction. Inoculum handling and activity may be conveniently standardized as illustrated by applying biofilm carriers. A robust set of positive as well as negative controls ("blanks") should be included to ensure quality of the actual testing. The denitrification test showed saturation response at increasing amounts of inoculum in the form of adapted moving bed biofilm reactor (MBBR) carriers, with well correlated nitrate consumption vs. gas volume formed. As shown, the denitrification test efficiently screened different inocula at standardized substrates. Also, different substrates were successfully screened and compared at standardized inocula. The biogas potential test showed efficient screening of different substrates with effects of relative amounts of carbohydrate, protein, fat. A second case with CO 2 capture reclaimer waste as substrate demonstrated successful use of co-feeding to support waste treatment and how temperature effects on kinetics and stoichiometry can be observed. In total, syringe test screening of microbial gas production seems highly efficient at a low cost when properly applied. Copyright © 2016 Elsevier B.V. All rights reserved.

Modeling Multibody Stage Separation Dynamics Using Constraint Force Equation Methodology

NASA Technical Reports Server (NTRS)

Tartabini, Paul V.; Roithmayr, Carlos M.; Toniolo, Matthew D.; Karlgaard, Christopher D.; Pamadi, Bandu N.

2011-01-01

This paper discusses the application of the constraint force equation methodology and its implementation for multibody separation problems using three specially designed test cases. The first test case involves two rigid bodies connected by a fixed joint, the second case involves two rigid bodies connected with a universal joint, and the third test case is that of Mach 7 separation of the X-43A vehicle. For the first two cases, the solutions obtained using the constraint force equation method compare well with those obtained using industry- standard benchmark codes. For the X-43A case, the constraint force equation solutions show reasonable agreement with the flight-test data. Use of the constraint force equation method facilitates the analysis of stage separation in end-to-end simulations of launch vehicle trajectories

Model-Invariant Hybrid Computations of Separated Flows for RCA Standard Test Cases

NASA Technical Reports Server (NTRS)

Woodruff, Stephen

2016-01-01

NASA's Revolutionary Computational Aerosciences (RCA) subproject has identified several smooth-body separated flows as standard test cases to emphasize the challenge these flows present for computational methods and their importance to the aerospace community. Results of computations of two of these test cases, the NASA hump and the FAITH experiment, are presented. The computations were performed with the model-invariant hybrid LES-RANS formulation, implemented in the NASA code VULCAN-CFD. The model- invariant formulation employs gradual LES-RANS transitions and compensation for model variation to provide more accurate and efficient hybrid computations. Comparisons revealed that the LES-RANS transitions employed in these computations were sufficiently gradual that the compensating terms were unnecessary. Agreement with experiment was achieved only after reducing the turbulent viscosity to mitigate the effect of numerical dissipation. The stream-wise evolution of peak Reynolds shear stress was employed as a measure of turbulence dynamics in separated flows useful for evaluating computations.

Elementary School Teachers' Experiences in a Professional Learning Community Addressing the Gender Gap

ERIC Educational Resources Information Center

Boyles, Glenda F.

2011-01-01

International research and academic performance measures indicate that boys are scoring lower on standardized tests than girls in reading and writing. At the time of this study, boys had lower standardized test scores than girls in an elementary school in a southeastern state in the United States. The purpose of this qualitative case study was to…

Automated microaneurysm detection method based on double ring filter in retinal fundus images

NASA Astrophysics Data System (ADS)

Mizutani, Atsushi; Muramatsu, Chisako; Hatanaka, Yuji; Suemori, Shinsuke; Hara, Takeshi; Fujita, Hiroshi

2009-02-01

The presence of microaneurysms in the eye is one of the early signs of diabetic retinopathy, which is one of the leading causes of vision loss. We have been investigating a computerized method for the detection of microaneurysms on retinal fundus images, which were obtained from the Retinopathy Online Challenge (ROC) database. The ROC provides 50 training cases, in which "gold standard" locations of microaneurysms are provided, and 50 test cases without the gold standard locations. In this study, the computerized scheme was developed by using the training cases. Although the results for the test cases are also included, this paper mainly discusses the results for the training cases because the "gold standard" for the test cases is not known. After image preprocessing, candidate regions for microaneurysms were detected using a double-ring filter. Any potential false positives located in the regions corresponding to blood vessels were removed by automatic extraction of blood vessels from the images. Twelve image features were determined, and the candidate lesions were classified into microaneurysms or false positives using the rule-based method and an artificial neural network. The true positive fraction of the proposed method was 0.45 at 27 false positives per image. Forty-two percent of microaneurysms in the 50 training cases were considered invisible by the consensus of two co-investigators. When the method was evaluated for visible microaneurysms, the sensitivity for detecting microaneurysms was 65% at 27 false positives per image. Our computerized detection scheme could be improved for helping ophthalmologists in the early diagnosis of diabetic retinopathy.

Research Problems Associated with Limiting the Applied Force in Vibration Tests and Conducting Base-Drive Modal Vibration Tests

NASA Technical Reports Server (NTRS)

Scharton, Terry D.

1995-01-01

The intent of this paper is to make a case for developing and conducting vibration tests which are both realistic and practical (a question of tailoring versus standards). Tests are essential for finding things overlooked in the analyses. The best test is often the most realistic test which can be conducted within the cost and budget constraints. Some standards are essential, but the author believes more in the individual's ingenuity to solve a specific problem than in the application of standards which reduce problems (and technology) to their lowest common denominator. Force limited vibration tests and base-drive modal tests are two examples of realistic, but practical testing approaches. Since both of these approaches are relatively new, a number of interesting research problems exist, and these are emphasized herein.

Standardization Efforts for Mechanical Testing and Design of Advanced Ceramic Materials and Components

NASA Technical Reports Server (NTRS)

Salem, Jonathan A.; Jenkins, Michael G.

2003-01-01

Advanced aerospace systems occasionally require the use of very brittle materials such as sapphire and ultra-high temperature ceramics. Although great progress has been made in the development of methods and standards for machining, testing and design of component from these materials, additional development and dissemination of standard practices is needed. ASTM Committee C28 on Advanced Ceramics and ISO TC 206 have taken a lead role in the standardization of testing for ceramics, and recent efforts and needs in standards development by Committee C28 on Advanced Ceramics will be summarized. In some cases, the engineers, etc. involved are unaware of the latest developments, and traditional approaches applicable to other material systems are applied. Two examples of flight hardware failures that might have been prevented via education and standardization will be presented.

A Comparison of Higher-Order Thinking between the Common Core State Standards and the 2009 New Jersey Content Standards in High School

ERIC Educational Resources Information Center

Sforza, Dario; Tienken, Christopher H.; Kim, Eunyoung

2016-01-01

The creators and supporters of the Common Core State Standards claim that the Standards require greater emphasis on higher-order thinking than previous state standards in mathematics and English language arts. We used a qualitative case study design with content analysis methods to test the claim. We compared the levels of thinking required by the…

Laboratory diagnosis of Ebola virus disease and corresponding biosafety considerations in the China Ebola Treatment Center.

PubMed

Huang, Qing; Fu, Wei-Ling; You, Jian-Ping; Mao, Qing

2016-10-01

Ebola virus disease (EVD), caused by Ebola virus (EBOV), is a potent acute infectious disease with a high case-fatality rate. Etiological and serological EBOV detection methods, including techniques that involve the detection of the viral genome, virus-specific antigens and anti-virus antibodies, are standard laboratory diagnostic tests that facilitate confirmation or exclusion of EBOV infection. In addition, routine blood tests, liver and kidney function tests, electrolytes and coagulation tests and other diagnostic examinations are important for the clinical diagnosis and treatment of EVD. Because of the viral load in body fluids and secretions from EVD patients, all body fluids are highly contagious. As a result, biosafety control measures during the collection, transport and testing of clinical specimens obtained from individuals scheduled to undergo EBOV infection testing (including suspected, probable and confirmed cases) are crucial. This report has been generated following extensive work experience in the China Ebola Treatment Center (ETC) in Liberia and incorporates important information pertaining to relevant diagnostic standards, clinical significance, operational procedures, safety controls and other issues related to laboratory testing of EVD. Relevant opinions and suggestions are presented in this report to provide contextual awareness associated with the development of standards and/or guidelines related to EVD laboratory testing.

76 FR 58167 - Safety Standard for Play Yards

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-20

... standard and, in some cases, provide test results publicly. C. Incident Data The CPSC's Directorate for... Requirements''; and the Canadian standard, C.R.C., c. 932, ``Playpen Regulations.'' We considered the... the side rails. Some play yards collapsed into a V-shape. If a child's neck is caught in the V-shape...

MPT64 antigen detection test improves routine diagnosis of extrapulmonary tuberculosis in a low-resource setting: A study from the tertiary care hospital in Zanzibar.

PubMed

Jørstad, Melissa Davidsen; Marijani, Msafiri; Dyrhol-Riise, Anne Ma; Sviland, Lisbet; Mustafa, Tehmina

2018-01-01

Extrapulmonary tuberculosis (EPTB) is a diagnostic challenge. An immunochemistry-based MPT64 antigen detection test (MPT64 test) has reported higher sensitivity in the diagnosis of EPTB compared with conventional methods. The objective of this study was to implement and evaluate the MPT64 test in routine diagnostics in a low-resource setting. Patients with presumptive EPTB were prospectively enrolled at Mnazi Mmoja Hospital, Zanzibar, and followed to the end of treatment. Specimens collected were subjected to routine diagnostics, GeneXpert® MTB/RIF assay and the MPT64 test. The performance of the MPT64 test was assessed using a composite reference standard, defining the patients as tuberculosis (TB) cases or non-TB cases. Patients (n = 132) were classified as confirmed TB (n = 12), probable TB (n = 34), possible TB (n = 18), non-TB (n = 62) and uncategorized (n = 6) cases. Overall, in comparison to the composite reference standard for diagnosis, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the MPT64 test was 69%, 95%, 94%, 75% and 82%, respectively. The MPT64 test performance was best in TB lymphadenitis cases (n = 67, sensitivity 79%, specificity 97%) and in paediatric TB (n = 41, sensitivity 100%, specificity 96%). We show that the MPT64 test can be implemented in routine diagnostics in a low-resource setting and improves the diagnosis of EPTB, especially in TB lymphadenitis and in children.

Evaluation of the measurement uncertainty when measuring the resistance of solid isolating materials to tracking

NASA Astrophysics Data System (ADS)

Stare, E.; Beges, G.; Drnovsek, J.

2006-07-01

This paper presents the results of research into the measurement of the resistance of solid isolating materials to tracking. Two types of tracking were investigated: the proof tracking index (PTI) and the comparative tracking index (CTI). Evaluation of the measurement uncertainty in a case study was performed using a test method in accordance with the IEC 60112 standard. In the scope of the tests performed here, this particular test method was used to ensure the safety of electrical appliances. According to the EN ISO/IEC 17025 standard (EN ISO/IEC 17025), in the process of conformity assessment, the evaluation of the measurement uncertainty of the test method should be carried out. In the present article, possible influential parameters that are in accordance with the third and fourth editions of the standard IEC 60112 are discussed. The differences, ambiguities or lack of guidance referring to both editions of the standard are described in the article 'Ambiguities in technical standards—case study IEC 60112—measuring the resistance of solid isolating materials to tracking' (submitted for publication). Several hundred measurements were taken in the present experiments in order to form the basis for the results and conclusions presented. A specific problem of the test (according to the IEC 60112 standard) is the great variety of influential physical parameters (mechanical, electrical, chemical, etc) that can affect the results. At the end of the present article therefore, there is a histogram containing information on the contributions to the measurement uncertainty.

Simulation of Benchmark Cases with the Terminal Area Simulation System (TASS)

NASA Technical Reports Server (NTRS)

Ahmad, Nash'at; Proctor, Fred

2011-01-01

The hydrodynamic core of the Terminal Area Simulation System (TASS) is evaluated against different benchmark cases. In the absence of closed form solutions for the equations governing atmospheric flows, the models are usually evaluated against idealized test cases. Over the years, various authors have suggested a suite of these idealized cases which have become standards for testing and evaluating the dynamics and thermodynamics of atmospheric flow models. In this paper, simulations of three such cases are described. In addition, the TASS model is evaluated against a test case that uses an exact solution of the Navier-Stokes equations. The TASS results are compared against previously reported simulations of these banchmark cases in the literature. It is demonstrated that the TASS model is highly accurate, stable and robust.

Simulation of Benchmark Cases with the Terminal Area Simulation System (TASS)

NASA Technical Reports Server (NTRS)

Ahmad, Nashat N.; Proctor, Fred H.

2011-01-01

The hydrodynamic core of the Terminal Area Simulation System (TASS) is evaluated against different benchmark cases. In the absence of closed form solutions for the equations governing atmospheric flows, the models are usually evaluated against idealized test cases. Over the years, various authors have suggested a suite of these idealized cases which have become standards for testing and evaluating the dynamics and thermodynamics of atmospheric flow models. In this paper, simulations of three such cases are described. In addition, the TASS model is evaluated against a test case that uses an exact solution of the Navier-Stokes equations. The TASS results are compared against previously reported simulations of these benchmark cases in the literature. It is demonstrated that the TASS model is highly accurate, stable and robust.

40 CFR 51.357 - Test procedures and standards.

Code of Federal Regulations, 2014 CFR

2014-07-01

... invalid test condition, unsafe conditions, fast pass/fail algorithms, or, in the case of the on-board... using approved fast pass or fast fail algorithms and multiple pass/fail algorithms may be used during the test cycle to eliminate false failures. The transient test procedure, including algorithms and...

40 CFR 51.357 - Test procedures and standards.

Code of Federal Regulations, 2012 CFR

2012-07-01

... invalid test condition, unsafe conditions, fast pass/fail algorithms, or, in the case of the on-board... using approved fast pass or fast fail algorithms and multiple pass/fail algorithms may be used during the test cycle to eliminate false failures. The transient test procedure, including algorithms and...

40 CFR 51.357 - Test procedures and standards.

Code of Federal Regulations, 2011 CFR

2011-07-01

... invalid test condition, unsafe conditions, fast pass/fail algorithms, or, in the case of the on-board... using approved fast pass or fast fail algorithms and multiple pass/fail algorithms may be used during the test cycle to eliminate false failures. The transient test procedure, including algorithms and...

40 CFR 51.357 - Test procedures and standards.

Code of Federal Regulations, 2013 CFR

2013-07-01

... invalid test condition, unsafe conditions, fast pass/fail algorithms, or, in the case of the on-board... using approved fast pass or fast fail algorithms and multiple pass/fail algorithms may be used during the test cycle to eliminate false failures. The transient test procedure, including algorithms and...

Is high pressure liquid chromatography an effective screening tool for characterization of molecular defects in hemoglobinopathies?

PubMed

Moorchung, Nikhil; Phillip, Joseph; Sarkar, Ravi Shankar; Prasad, Rupesh; Dutta, Vibha

2013-01-01

Hemoglobinopathies constitute entities that are generated by either abnormal hemoglobin or thalassemias. high pressure liquid chromatography (HPLC) is one of the best methods for screening and detection of various hemoglobinopathies but it has intrinsic interpretive problems. The study was designed to evaluate the different mutations seen in cases of hemoglobinopathies and compare the same with screening tests. 68 patients of hemoglobinopathies were screened by HPLC. Mutation studies in the beta globin gene was performed using the polymerase chain reaction (PCR)-based allele-specific Amplification Refractory Mutation System (ARMS). Molecular analysis for the sickle cell mutation was done by standard methods. The IVS 1/5 mutation was the commonest mutation seen and it was seen in 26 (38.23%) of the cases. This was followed by the IVS 1/1, codon 41/42, codon 8/9, del 22 mutation, codon 15 mutation and the -619 bp deletion. No mutation was seen in eight cases. There was a 100% concordance between the sickle cell trait as diagnosed by HPLC and genetic testing. Our study underlies the importance of molecular testing in all cases of hemoglobinopathies. Although HPLC is a useful screening tool, molecular testing is very useful in accurately diagnosing the mutations. Molecular testing is especially applicable in cases with an abnormal hemoglobin (HbD, HbE and HbS) because there may be a concomitant inheritance of a beta thalassemia mutation. Molecular testing is the gold standard when it comes to the diagnosis of hemoglobinopathies.

Design and analysis of roll cage

NASA Astrophysics Data System (ADS)

Angadi, Gurusangappa; Chetan, S.

2018-04-01

Wildlife fire fighting vehicles are used to extinguish fires in forests, in this process vehicles face falling objects like rocks, tree branches and other objects. Also due to uneven conditions of the terrain like cliff edges, uneven surfaces etc. makes the vehicle to roll over and these can cause injuries to both the driver and the operator. Roll over of a vehicle is a common incident which makes fatal injuries to the operator and also stands next to the crash accidents. In order to reduce the injury level and continuous roll over of the vehicle it is necessary to equip suitable roll cage according to standards of vehicle. In this present work roll cage for pump operator in wildfire fighting vehicle is designed and analysis is carried out in computer simulated environment when seating position of operator seated outside of the cabin. According to NFPA 1906 standards wildlife fire apparatus, Design and Test procedures that are carried out in Hyperworks maintaining SAE J1194.1983 standards. G load case, roof crush analysis and pendulum impact analysis tests are carried out on roll cage to ensure the saftey of design. These load cases are considerd to satisfy the situation faced in forest terrain. In these test procedures roll cage is analysed for stresses and deformation in various load cases. After recording results these are compared with standards mentioned in SAE J1194.1983.

10 CFR 430.61 - Prohibited acts.

Code of Federal Regulations, 2011 CFR

2011-01-01

... OF ENERGY ENERGY CONSERVATION ENERGY CONSERVATION PROGRAM FOR CONSUMER PRODUCTS Certification and... standard or water conservation standard (in the case of faucets, showerheads, water closets, and urinals... covered products to a test laboratory designated by the Secretary; (3) Failure of a manufacturer to permit...

Progress in Quantitative Viral Load Testing: Variability and Impact of the WHO Quantitative International Standards

PubMed Central

Sun, Y.; Tang, L.; Procop, G. W.; Hillyard, D. R.; Young, S. A.; Caliendo, A. M.

2016-01-01

ABSTRACT It has been hoped that the recent availability of WHO quantitative standards would improve interlaboratory agreement for viral load testing; however, insufficient data are available to evaluate whether this has been the case. Results from 554 laboratories participating in proficiency testing surveys for quantitative PCR assays of cytomegalovirus (CMV), Epstein-Barr virus (EBV), BK virus (BKV), adenovirus (ADV), and human herpesvirus 6 (HHV6) were evaluated to determine overall result variability and then were stratified by assay manufacturer. The impact of calibration to international units/ml (CMV and EBV) on variability was also determined. Viral loads showed a high degree of interlaboratory variability for all tested viruses, with interquartile ranges as high as 1.46 log10 copies/ml and the overall range for a given sample up to 5.66 log10 copies/ml. Some improvement in result variability was seen when international units were adopted. This was particularly the case for EBV viral load results. Variability in viral load results remains a challenge across all viruses tested here; introduction of international quantitative standards may help reduce variability and does so more or less markedly for certain viruses. PMID:27852673

Constitutional Concerns in Drug Testing of Public Employees.

ERIC Educational Resources Information Center

Allred, Stephen

1987-01-01

Examines Fourth Amendment legal issues involved in drug testing of public employees. Discusses several recent court cases involving probable cause and reasonable suspicion to determine appropriate standards for individual situations. Outlines implications for public employers. Blanket drug testing is not permissable, though job applicants have…

Agreement between gastrointestinal panel testing and standard microbiology methods for detecting pathogens in suspected infectious gastroenteritis: Test evaluation and meta-analysis in the absence of a reference standard.

PubMed

Freeman, Karoline; Tsertsvadze, Alexander; Taylor-Phillips, Sian; McCarthy, Noel; Mistry, Hema; Manuel, Rohini; Mason, James

2017-01-01

Multiplex gastrointestinal pathogen panel (GPP) tests simultaneously identify bacterial, viral and parasitic pathogens from the stool samples of patients with suspected infectious gastroenteritis presenting in hospital or the community. We undertook a systematic review to compare the accuracy of GPP tests with standard microbiology techniques. Searches in Medline, Embase, Web of Science and the Cochrane library were undertaken from inception to January 2016. Eligible studies compared GPP tests with standard microbiology techniques in patients with suspected gastroenteritis. Quality assessment of included studies used tailored QUADAS-2. In the absence of a reference standard we analysed test performance taking GPP tests and standard microbiology techniques in turn as the benchmark test, using random effects meta-analysis of proportions. No study provided an adequate reference standard with which to compare the test accuracy of GPP and conventional tests. Ten studies informed a meta-analysis of positive and negative agreement. Positive agreement across all pathogens was 0.93 (95% CI 0.90 to 0.96) when conventional methods were the benchmark and 0.68 (95% CI: 0.58 to 0.77) when GPP provided the benchmark. Negative agreement was high in both instances due to the high proportion of negative cases. GPP testing produced a greater number of pathogen-positive findings than conventional testing. It is unclear whether these additional 'positives' are clinically important. GPP testing has the potential to simplify testing and accelerate reporting when compared to conventional microbiology methods. However the impact of GPP testing upon the management, treatment and outcome of patients is poorly understood and further studies are needed to evaluate the health economic impact of GPP testing compared with standard methods. The review protocol is registered with PROSPERO as CRD42016033320.

The impact of using standardized patients in psychiatric cases on the levels of motivation and perceived learning of the nursing students.

PubMed

Sarikoc, Gamze; Ozcan, Celale Tangul; Elcin, Melih

2017-04-01

The use of standardized patients is not very common in psychiatric nursing education and there has been no study conducted in Turkey. This study evaluated the impact of using standardized patients in psychiatric cases on the levels of motivation and perceived learning of the nursing students. This manuscript addressed the quantitative aspect of a doctoral thesis study in which both quantitative and qualitative methods were used. A pre-test and post-test were employed in the quantitative analysis in a randomized and controlled study design. The motivation scores, and interim and post-test scores for perceived learning were higher in the experimental group compared to pre-test scores and the scores of the control group. The students in the experimental group reported that they felt more competent about practical training in clinical psychiatry, as well as in performing interviews with patients having mental problems, and reported less anxiety about performing an interview when compared to students in the control group. It is considered that the inclusion of standardized patient methodology in the nursing education curriculum in order to improve the knowledge level and skills of students would be beneficial in the training of mental health nurses. Copyright © 2017 Elsevier Ltd. All rights reserved.

Standard of practice and Flynn Effect testimony in death penalty cases.

PubMed

Gresham, Frank M; Reschly, Daniel J

2011-06-01

The Flynn Effect is a well-established psychometric fact documenting substantial increases in measured intelligence test performance over time. Flynn's (1984) review of the literature established that Americans gain approximately 0.3 points per year or 3 points per decade in measured intelligence. The accurate assessment and interpretation of intellectual functioning becomes critical in death penalty cases that seek to determine whether an individual meets the criteria for intellectual disability and thereby is ineligible for execution under Atkins v. Virginia (2002) . We reviewed the literature on the Flynn Effect and demonstrated how failure to adjust intelligence test scores based on this phenomenon invalidates test scores and may be in violation of the Standards for Educational and Psychological Testing as well as the "Ethical Principles for Psychologists and Code of Conduct." Application of the Flynn Effect and score adjustments for obsolete norms clearly is supported by science and should be implemented by practicing psychologists.

Verification of a Constraint Force Equation Methodology for Modeling Multi-Body Stage Separation

NASA Technical Reports Server (NTRS)

Tartabini, Paul V.; Roithmayr, Carlos; Toniolo, Matthew D.; Karlgaard, Christopher; Pamadi, Bandu N.

2008-01-01

This paper discusses the verification of the Constraint Force Equation (CFE) methodology and its implementation in the Program to Optimize Simulated Trajectories II (POST2) for multibody separation problems using three specially designed test cases. The first test case involves two rigid bodies connected by a fixed joint; the second case involves two rigid bodies connected with a universal joint; and the third test case is that of Mach 7 separation of the Hyper-X vehicle. For the first two cases, the POST2/CFE solutions compared well with those obtained using industry standard benchmark codes, namely AUTOLEV and ADAMS. For the Hyper-X case, the POST2/CFE solutions were in reasonable agreement with the flight test data. The CFE implementation in POST2 facilitates the analysis and simulation of stage separation as an integral part of POST2 for seamless end-to-end simulations of launch vehicle trajectories.

Evaluation of the Eberline AMS-3A and AMS-4 Beta continuous air monitors

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

Johnson, M.L.; Sisk, D.R.

1996-03-01

Eberline AMS-3A-1 and AMS-4 beta continuous air monitors were tested against the criteria set forth in the ANSI Standards N42.18, Specification and Performance of On-site Instrumentation for Continuously Monitoring Radioactivity in Effluents, and ANSI N42.17B, Performance Specification for Health Physics Instrumentation - Occupational Airborne Radioactivity Monitoring Instrumentation. ANSI N42.18 does not, in general, specify testing procedures for demonstrating compliance with the criteria set forth in the standard; therefore, wherever possible, the testing procedures given in ANSI N42.17B were adopted. In all cases, the more restrictive acceptance criteria and/or the more demanding test conditions of the two standards were used.

[Methods for evaluating diagnostic tests in Enfermedades Infecciosas y Microbiología Clínica].

PubMed

Ramos, J M; Hernández, I

1998-04-01

In the field of infectious diseases and clinical microbiology, the evaluation of diagnostic tests (DT) is an important research area. The specific difficulties of this type of research has motivated that have not caught the severity methodological of others areas of clinical research. This article try to asses and characterize the methodology of articles about DT published in Enfermedades Infecciosas y Microbiología Clínica (EIMC) journal. Forty-five articles was selected in the EIMC journal during the 1990-1996 period, because of determinate the sensitivity and specificity of different DT. Methodological standards, extensively accepted was used. In all of articles, except one (98%) the gold standard was specified yours use, however in 4 studies (9%) include the DT in the gold standard (incorporation bias). The correct description of DT was reported in 75% of cases, but only in 11% cases the reproducibility of test was evaluated. The description of source of reference population, standard of inclusion and spectrum of composition was described in 58, 33 and 40% of articles, respectively. In 33% of studies presented workup bias, only 6% commented blind-analysis of results, and 11% presented indeterminate test results. Half of the studies reported test indexes for clinical subgroups, only one article (2%) provided numerical precision for test indexes, and only 7% reported receiver operating characteristics curves. The methodological quality of DT research in the EIMC journal may improve in different aspects of design and presentation of results.

Test methods for optical disk media characteristics (for 356 mm ruggedized magneto-optic media)

NASA Technical Reports Server (NTRS)

Podio, Fernando L.

1991-01-01

Standard test methods for computer storage media characteristics are essential and allow for conformance to media interchange standards. The test methods were developed for 356 mm two-sided laminated glass substrate with a magneto-optic active layer media technology. These test methods may be used for testing other media types, but in each case their applicability must be evaluated. Test methods are included for a series of different media characteristics, including operational, nonoperational, and storage environments; mechanical and physical characteristics; and substrate, recording layer, and preformat characteristics. Tests for environmental qualification and media lifetimes are also included. The best methods include testing conditions, testing procedures, a description of the testing setup, and the required calibration procedures.

ASTM Committee C28: International Standards for Properties and Performance of Advanced Ceramics, Three Decades of High-quality, Technically-rigorous Normalization

NASA Technical Reports Server (NTRS)

Jenkins, Michael G.; Salem, Jonathan A.

2016-01-01

Physical and mechanical properties and performance of advanced ceramics and glasses are difficult to measure correctly without the proper techniques. For over three decades, ASTM Committee C28 on Advanced Ceramics, has developed high quality, rigorous, full-consensus standards (e.g., test methods, practices, guides, terminology) to measure properties and performance of monolithic and composite ceramics that may be applied to glasses in some cases. These standards testing particulars for many mechanical, physical, thermal, properties and performance of these materials. As a result these standards provide accurate, reliable, repeatable and complete data. Within Committee C28 users, producers, researchers, designers, academicians, etc. have written, continually updated, and validated through round-robin test programs, nearly 50 standards since the Committees founding in 1986. This paper provides a retrospective review of the 30 years of ASTM Committee C28 including a graphical pictogram listing of C28 standards along with examples of the tangible benefits of advanced ceramics standards to demonstrate their practical applications.

Electronic delay ignition module for single bridgewire Apollo standard initiator

NASA Technical Reports Server (NTRS)

Ward, R. D.

1975-01-01

An engineering model and a qualification model of the EDIM were constructed and tested to Scout flight qualification criteria. The qualification model incorporated design improvements resulting from the engineering model tests. Compatibility with single bridgewire Apollo standard initiator (SBASI) was proven by test firing forty-five (45) SBASI's with worst case voltage and temperature conditions. The EDIM was successfully qualified for Scout flight application with no failures during testing of the qualification unit. Included is a method of implementing the EDIM into Scout vehicle hardware and the ground support equipment necessary to check out the system.

Evaluation of mycobactericidal activity of selected chemical disinfectants and antiseptics according to European standards

PubMed Central

Bocian, Ewa; Grzybowska, Wanda; Tyski, Stefan

2014-01-01

Background The history of the investigation of standardized mycobactericidal activity of disinfectants and antiseptics is not very long. There is growing interest among the manufacturers of disinfectants in carrying out research on the antimicrobial activities in accordance with European standards (EN). This research could facilitate the introduction of high-quality disinfectants to the market. The aim of this study was to evaluate the mycobactericidal activity of selected chemical disinfectants and antiseptics used in the medical and veterinary fields. Material/Methods This study included 19 products submitted to the National Medicines Institute in Poland for evaluation of mycobactericidal activity. These products contain in their composition active substances belonging to different chemical groups, including aldehydes, alcohols, amines, quaternary ammonium compounds, phenols, guanidine, and oxidizing compounds. This study, conducted according to the manufacturers’ description of the preparations, was carried out in accordance with European standards, which also met the Polish standards: PN-EN 14204: 2013, PN-EN 14348: 2006, and PN-EN 14563: 2012. Results Tested products for disinfection and antiseptics containing active substances from different chemical groups showed high mycobactericidal activity and met the requirements of the appropriate European standards in most cases. In the case of products containing guanidine and amine compounds, the concentration of active ingredients used in the test and the test conditions specified by the manufacturer did not provide the mycobactericidal activity required by the standards. Conclusions Prior to the launch of a new product on the market, it is important to establish the appropriate usage and testing conditions of the preparation, such as its practical concentration, contact time, and environment condition (clean or dirty). PMID:24755666

Decision Making for Borderline Cases in Pass/Fail Clinical Anatomy Courses: The Practical Value of the Standard Error of Measurement and Likelihood Ratio in a Diagnostic Test

ERIC Educational Resources Information Center

Severo, Milton; Silva-Pereira, Fernanda; Ferreira, Maria Amelia

2013-01-01

Several studies have shown that the standard error of measurement (SEM) can be used as an additional “safety net” to reduce the frequency of false-positive or false-negative student grading classifications. Practical examinations in clinical anatomy are often used as diagnostic tests to admit students to course final examinations. The aim of this…

A Case Study of an Aeronautical Systems Division System Program Office.

DTIC Science & Technology

1982-09-01

11111 -’.-- m 1 1.25 111111.4 1 1.6_ MICROCOPY RESOLUTION TEST CHART NATIONAL BUREAU OF STANDARDS-1963-A If. t 1’ I I( N 2> - .~.. * .~ .~-I ~ k~’ ~K ~r...office....assesses.................. 8 Section 11 The Standard Aircraft Sensor UnitProgram........ 32 Section III Terms and Defnition ...contracts with industry, (b) test programs with both industry and other DOD organizations, (c) aircraft production or modification programs with both

Development and testing of a tool for assessing and resolving medication-related problems in older adults in an ambulatory care setting: the individualized medication assessment and planning (iMAP) tool.

PubMed

Crisp, Ginny D; Burkhart, Jena Ivey; Esserman, Denise A; Weinberger, Morris; Roth, Mary T

2011-12-01

Medication is one of the most important interventions for improving the health of older adults, yet it has great potential for causing harm. Clinical pharmacists are well positioned to engage in medication assessment and planning. The Individualized Medication Assessment and Planning (iMAP) tool was developed to aid clinical pharmacists in documenting medication-related problems (MRPs) and associated recommendations. The purpose of our study was to assess the reliability and usability of the iMAP tool in classifying MRPs and associated recommendations in older adults in the ambulatory care setting. Three cases, representative of older adults seen in an outpatient setting, were developed. Pilot testing was conducted and a "gold standard" key developed. Eight eligible pharmacists consented to participate in the study. They were instructed to read each case, make an assessment of MRPs, formulate a plan, and document the information using the iMAP tool. Inter-rater reliability was assessed for each case, comparing the pharmacists' identified MRPs and recommendations to the gold standard. Consistency of categorization across reviewers was assessed using the κ statistic or percent agreement. The mean κ across the 8 pharmacists in classifying MRPs compared with the gold standard was 0.74 (range, 0.54-1.00) for case 1 and 0.68 (range, 0.36-1.00) for case 2, indicating substantial agreement. For case 3, percent agreement was 63% (range, 40%-100%). The mean κ across the 8 pharmacists when classifying recommendations compared with the gold standard was 0.87 (range, 0.58-1.00) for case 1 and 0.88 (range, 0.75-1.00) for case 2, indicating almost perfect agreement. For case 3, percent agreement was 68% (range, 40%-100%). Clinical pharmacists found the iMAP tool easy to use. The iMAP tool provides a reliable and standardized approach for clinical pharmacists to use in the ambulatory care setting to classify MRPs and associated recommendations. Future studies will explore the predictive validity of the tool on clinical outcomes such as health care utilization. Copyright © 2011 Elsevier HS Journals, Inc. All rights reserved.

Screening and surveillance. OSHA's medical surveillance provisions.

PubMed

Papp, E M; Miller, A S

2000-02-01

The OSH Act requires OSHA to include provisions for medical examinations of employees in its standards. However, the specific test and examinations criteria are not outlined in the OSH Act. Instead, each standard has specific medical surveillance requirements. These are specific to the adverse health effects triggered by exposure to the hazardous substance. The OSHA uses the term medical surveillance to refer to its employee examination and testing provisions. Most occupational health professionals call this activity employee screening and reserve the term surveillance for aggregate analysis of population data. It is important to remember this distinction when referring to OSHA standards. Many standards are challenged in court resulting in changes to medical surveillance provisions of the standards. Some court decisions support OSHA's language. In either case, the court often sets precedents for future standards.

Applying a statistical PTB detection procedure to complement the gold standard.

PubMed

Noor, Norliza Mohd; Yunus, Ashari; Bakar, S A R Abu; Hussin, Amran; Rijal, Omar Mohd

2011-04-01

This paper investigates a novel statistical discrimination procedure to detect PTB when the gold standard requirement is taken into consideration. Archived data were used to establish two groups of patients which are the control and test group. The control group was used to develop the statistical discrimination procedure using four vectors of wavelet coefficients as feature vectors for the detection of pulmonary tuberculosis (PTB), lung cancer (LC), and normal lung (NL). This discrimination procedure was investigated using the test group where the number of sputum positive and sputum negative cases that were correctly classified as PTB cases were noted. The proposed statistical discrimination method is able to detect PTB patients and LC with high true positive fraction. The method is also able to detect PTB patients that are sputum negative and therefore may be used as a complement to the gold standard. Copyright © 2010 Elsevier Ltd. All rights reserved.

Providing Test Performance Feedback That Bridges Assessment and Instruction: The Case of Two Standardized English Language Tests in Japan

ERIC Educational Resources Information Center

Sawaki, Yasuyo; Koizumi, Rie

2017-01-01

This small-scale qualitative study considers feedback and results reported for two major large-scale English language tests administered in Japan: the Global Test of English Communication for Students (GTECfS) and the Eiken Test in Practical English Proficiency (Eiken). Specifically, it examines current score-reporting practices in student and…

Standards-Based Accountability in South Africa

ERIC Educational Resources Information Center

Taylor, Nick

2009-01-01

The implementation of standards-based accountability (SBA) interventions aimed at improving school performance often focuses on the testing component, at the expense of capacity building. This was the case in South Africa when a SBA programme was instituted by government in 2000, which was accompanied by substantial rises in senior certificate…

Incorporating personalized gene sequence variants, molecular genetics knowledge, and health knowledge into an EHR prototype based on the Continuity of Care Record standard.

PubMed

Jing, Xia; Kay, Stephen; Marley, Thomas; Hardiker, Nicholas R; Cimino, James J

2012-02-01

The current volume and complexity of genetic tests, and the molecular genetics knowledge and health knowledge related to interpretation of the results of those tests, are rapidly outstripping the ability of individual clinicians to recall, understand and convey to their patients information relevant to their care. The tailoring of molecular genetics knowledge and health knowledge in clinical settings is important both for the provision of personalized medicine and to reduce clinician information overload. In this paper we describe the incorporation, customization and demonstration of molecular genetic data (mainly sequence variants), molecular genetics knowledge and health knowledge into a standards-based electronic health record (EHR) prototype developed specifically for this study. We extended the CCR (Continuity of Care Record), an existing EHR standard for representing clinical data, to include molecular genetic data. An EHR prototype was built based on the extended CCR and designed to display relevant molecular genetics knowledge and health knowledge from an existing knowledge base for cystic fibrosis (OntoKBCF). We reconstructed test records from published case reports and represented them in the CCR schema. We then used the EHR to dynamically filter molecular genetics knowledge and health knowledge from OntoKBCF using molecular genetic data and clinical data from the test cases. The molecular genetic data were successfully incorporated in the CCR by creating a category of laboratory results called "Molecular Genetics" and specifying a particular class of test ("Gene Mutation Test") in this category. Unlike other laboratory tests reported in the CCR, results of tests in this class required additional attributes ("Molecular Structure" and "Molecular Position") to support interpretation by clinicians. These results, along with clinical data (age, sex, ethnicity, diagnostic procedures, and therapies) were used by the EHR to filter and present molecular genetics knowledge and health knowledge from OntoKBCF. This research shows a feasible model for delivering patient sequence variants and presenting tailored molecular genetics knowledge and health knowledge via a standards-based EHR system prototype. EHR standards can be extended to include the necessary patient data (as we have demonstrated in the case of the CCR), while knowledge can be obtained from external knowledge bases that are created and maintained independently from the EHR. This approach can form the basis for a personalized medicine framework, a more comprehensive standards-based EHR system and a potential platform for advancing translational research by both disseminating results and providing opportunities for new insights into phenotype-genotype relationships. Copyright © 2011 Elsevier Inc. All rights reserved.

A hierarchical Bayesian approach to adaptive vision testing: A case study with the contrast sensitivity function.

PubMed

Gu, Hairong; Kim, Woojae; Hou, Fang; Lesmes, Luis Andres; Pitt, Mark A; Lu, Zhong-Lin; Myung, Jay I

2016-01-01

Measurement efficiency is of concern when a large number of observations are required to obtain reliable estimates for parametric models of vision. The standard entropy-based Bayesian adaptive testing procedures addressed the issue by selecting the most informative stimulus in sequential experimental trials. Noninformative, diffuse priors were commonly used in those tests. Hierarchical adaptive design optimization (HADO; Kim, Pitt, Lu, Steyvers, & Myung, 2014) further improves the efficiency of the standard Bayesian adaptive testing procedures by constructing an informative prior using data from observers who have already participated in the experiment. The present study represents an empirical validation of HADO in estimating the human contrast sensitivity function. The results show that HADO significantly improves the accuracy and precision of parameter estimates, and therefore requires many fewer observations to obtain reliable inference about contrast sensitivity, compared to the method of quick contrast sensitivity function (Lesmes, Lu, Baek, & Albright, 2010), which uses the standard Bayesian procedure. The improvement with HADO was maintained even when the prior was constructed from heterogeneous populations or a relatively small number of observers. These results of this case study support the conclusion that HADO can be used in Bayesian adaptive testing by replacing noninformative, diffuse priors with statistically justified informative priors without introducing unwanted bias.

A hierarchical Bayesian approach to adaptive vision testing: A case study with the contrast sensitivity function

PubMed Central

Gu, Hairong; Kim, Woojae; Hou, Fang; Lesmes, Luis Andres; Pitt, Mark A.; Lu, Zhong-Lin; Myung, Jay I.

2016-01-01

Measurement efficiency is of concern when a large number of observations are required to obtain reliable estimates for parametric models of vision. The standard entropy-based Bayesian adaptive testing procedures addressed the issue by selecting the most informative stimulus in sequential experimental trials. Noninformative, diffuse priors were commonly used in those tests. Hierarchical adaptive design optimization (HADO; Kim, Pitt, Lu, Steyvers, & Myung, 2014) further improves the efficiency of the standard Bayesian adaptive testing procedures by constructing an informative prior using data from observers who have already participated in the experiment. The present study represents an empirical validation of HADO in estimating the human contrast sensitivity function. The results show that HADO significantly improves the accuracy and precision of parameter estimates, and therefore requires many fewer observations to obtain reliable inference about contrast sensitivity, compared to the method of quick contrast sensitivity function (Lesmes, Lu, Baek, & Albright, 2010), which uses the standard Bayesian procedure. The improvement with HADO was maintained even when the prior was constructed from heterogeneous populations or a relatively small number of observers. These results of this case study support the conclusion that HADO can be used in Bayesian adaptive testing by replacing noninformative, diffuse priors with statistically justified informative priors without introducing unwanted bias. PMID:27105061

Incorporating single-side sparing in models for predicting parotid dose sparing in head and neck IMRT

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

Yuan, Lulin, E-mail: lulin.yuan@duke.edu; Wu, Q. Jackie; Yin, Fang-Fang

2014-02-15

Purpose: Sparing of single-side parotid gland is a common practice in head-and-neck (HN) intensity modulated radiation therapy (IMRT) planning. It is a special case of dose sparing tradeoff between different organs-at-risk. The authors describe an improved mathematical model for predicting achievable dose sparing in parotid glands in HN IMRT planning that incorporates single-side sparing considerations based on patient anatomy and learning from prior plan data. Methods: Among 68 HN cases analyzed retrospectively, 35 cases had physician prescribed single-side parotid sparing preferences. The single-side sparing model was trained with cases which had single-side sparing preferences, while the standard model was trainedmore » with the remainder of cases. A receiver operating characteristics (ROC) analysis was performed to determine the best criterion that separates the two case groups using the physician's single-side sparing prescription as ground truth. The final predictive model (combined model) takes into account the single-side sparing by switching between the standard and single-side sparing models according to the single-side sparing criterion. The models were tested with 20 additional cases. The significance of the improvement of prediction accuracy by the combined model over the standard model was evaluated using the Wilcoxon rank-sum test. Results: Using the ROC analysis, the best single-side sparing criterion is (1) the predicted median dose of one parotid is higher than 24 Gy; and (2) that of the other is higher than 7 Gy. This criterion gives a true positive rate of 0.82 and a false positive rate of 0.19, respectively. For the bilateral sparing cases, the combined and the standard models performed equally well, with the median of the prediction errors for parotid median dose being 0.34 Gy by both models (p = 0.81). For the single-side sparing cases, the standard model overestimates the median dose by 7.8 Gy on average, while the predictions by the combined model differ from actual values by only 2.2 Gy (p = 0.005). Similarly, the sum of residues between the modeled and the actual plan DVHs is the same for the bilateral sparing cases by both models (p = 0.67), while the standard model predicts significantly higher DVHs than the combined model for the single-side sparing cases (p = 0.01). Conclusions: The combined model for predicting parotid sparing that takes into account single-side sparing improves the prediction accuracy over the previous model.« less

Incorporating single-side sparing in models for predicting parotid dose sparing in head and neck IMRT

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

Yuan, Lulin, E-mail: lulin.yuan@duke.edu; Wu, Q. Jackie; Yin, Fang-Fang

Purpose: Sparing of single-side parotid gland is a common practice in head-and-neck (HN) intensity modulated radiation therapy (IMRT) planning. It is a special case of dose sparing tradeoff between different organs-at-risk. The authors describe an improved mathematical model for predicting achievable dose sparing in parotid glands in HN IMRT planning that incorporates single-side sparing considerations based on patient anatomy and learning from prior plan data. Methods: Among 68 HN cases analyzed retrospectively, 35 cases had physician prescribed single-side parotid sparing preferences. The single-side sparing model was trained with cases which had single-side sparing preferences, while the standard model was trainedmore » with the remainder of cases. A receiver operating characteristics (ROC) analysis was performed to determine the best criterion that separates the two case groups using the physician's single-side sparing prescription as ground truth. The final predictive model (combined model) takes into account the single-side sparing by switching between the standard and single-side sparing models according to the single-side sparing criterion. The models were tested with 20 additional cases. The significance of the improvement of prediction accuracy by the combined model over the standard model was evaluated using the Wilcoxon rank-sum test. Results: Using the ROC analysis, the best single-side sparing criterion is (1) the predicted median dose of one parotid is higher than 24 Gy; and (2) that of the other is higher than 7 Gy. This criterion gives a true positive rate of 0.82 and a false positive rate of 0.19, respectively. For the bilateral sparing cases, the combined and the standard models performed equally well, with the median of the prediction errors for parotid median dose being 0.34 Gy by both models (p = 0.81). For the single-side sparing cases, the standard model overestimates the median dose by 7.8 Gy on average, while the predictions by the combined model differ from actual values by only 2.2 Gy (p = 0.005). Similarly, the sum of residues between the modeled and the actual plan DVHs is the same for the bilateral sparing cases by both models (p = 0.67), while the standard model predicts significantly higher DVHs than the combined model for the single-side sparing cases (p = 0.01). Conclusions: The combined model for predicting parotid sparing that takes into account single-side sparing improves the prediction accuracy over the previous model.« less

A rule-based software test data generator

NASA Technical Reports Server (NTRS)

Deason, William H.; Brown, David B.; Chang, Kai-Hsiung; Cross, James H., II

1991-01-01

Rule-based software test data generation is proposed as an alternative to either path/predicate analysis or random data generation. A prototype rule-based test data generator for Ada programs is constructed and compared to a random test data generator. Four Ada procedures are used in the comparison. Approximately 2000 rule-based test cases and 100,000 randomly generated test cases are automatically generated and executed. The success of the two methods is compared using standard coverage metrics. Simple statistical tests showing that even the primitive rule-based test data generation prototype is significantly better than random data generation are performed. This result demonstrates that rule-based test data generation is feasible and shows great promise in assisting test engineers, especially when the rule base is developed further.

Computing tools for implementing standards for single-case designs.

PubMed

Chen, Li-Ting; Peng, Chao-Ying Joanne; Chen, Ming-E

2015-11-01

In the single-case design (SCD) literature, five sets of standards have been formulated and distinguished: design standards, assessment standards, analysis standards, reporting standards, and research synthesis standards. This article reviews computing tools that can assist researchers and practitioners in meeting the analysis standards recommended by the What Works Clearinghouse: Procedures and Standards Handbook-the WWC standards. These tools consist of specialized web-based calculators or downloadable software for SCD data, and algorithms or programs written in Excel, SAS procedures, SPSS commands/Macros, or the R programming language. We aligned these tools with the WWC standards and evaluated them for accuracy and treatment of missing data, using two published data sets. All tools were tested to be accurate. When missing data were present, most tools either gave an error message or conducted analysis based on the available data. Only one program used a single imputation method. This article concludes with suggestions for an inclusive computing tool or environment, additional research on the treatment of missing data, and reasonable and flexible interpretations of the WWC standards. © The Author(s) 2015.

[Do we always correctly interpret the results of statistical nonparametric tests].

PubMed

Moczko, Jerzy A

2014-01-01

Mann-Whitney, Wilcoxon, Kruskal-Wallis and Friedman tests create a group of commonly used tests to analyze the results of clinical and laboratory data. These tests are considered to be extremely flexible and their asymptotic relative efficiency exceeds 95 percent. Compared with the corresponding parametric tests they do not require checking the fulfillment of the conditions such as the normality of data distribution, homogeneity of variance, the lack of correlation means and standard deviations, etc. They can be used both in the interval and or-dinal scales. The article presents an example Mann-Whitney test, that does not in any case the choice of these four nonparametric tests treated as a kind of gold standard leads to correct inference.

Five Data Validation Cases

ERIC Educational Resources Information Center

Simkin, Mark G.

2008-01-01

Data-validation routines enable computer applications to test data to ensure their accuracy, completeness, and conformance to industry or proprietary standards. This paper presents five programming cases that require students to validate five different types of data: (1) simple user data entries, (2) UPC codes, (3) passwords, (4) ISBN numbers, and…

Powassan Virus-A New Reemerging Tick-Borne Disease.

PubMed

Fatmi, Syed Soheb; Zehra, Rija; Carpenter, David O

2017-01-01

Powassan virus is a neurovirulent flavivirus consisting of two lineages causing meningoencephalitis. It is the only member of the tick-borne encephalitis serogroup which is present in mainland North America. With a total number of 27 cases from 1958 to 1998 and 98 cases from 1999 to 2016, reported cases have increased by 671% over the last 18 years. Powassan infection is transmitted by different tick species in different geographical regions. Ixodes scapularis is the primary vector that transmits the virus on the East Coast of US and Ixodes cookei in the Midwest and Canada, while Hemaphysalis longicornis is the vector in Russia. Powassan has no singular pathognomonic finding and presents with a wide spectrum of symptoms including severe neurological symptoms. The clinical challenge lies within the management of the disease as there is no standard diagnostic protocol and most cases are only diagnosed after a patient goes through an extensive workup for other infectious disease. The diagnosis is established by a combination of imaging and serologic tests. In case of Powassan meningoencephalitis, computed tomography scan and magnetic resonance imaging show vascular insults, which are also seen in cases of tick-borne encephalitis virus, another flavivirus of medical importance. Serologic tests are the gold standard for diagnosis, although testing is not widely available and only state health departments and Center for Disease Control and Prevention can perform Powassan-specific IgM antibody testing utilizing enzyme-linked immunosorbent assay and immunofluorescence antibody. Powassan is also of veterinary medical importance. Wildlife animals act as a reservoir to the pathogens, hence possessing threat to humans and domestic animals. This review highlights Powassan's neurotropic presentation, epidemiology, diagnostic challenges, and prevalence. Strong emphasis is placed on establishing diagnostic protocols, widespread Powassan-specific IgM testing, role of the vector in disease presentation, and necessary preventive research.

Value of stress ultrasound for the diagnosis of chronic ankle instability compared to manual anterior drawer test, stress radiography, magnetic resonance imaging, and arthroscopy.

PubMed

Cho, Jae Ho; Lee, Doo Hyung; Song, Hyung Keun; Bang, Joon Young; Lee, Kyung Tai; Park, Young Uk

2016-04-01

Clinicians frequently diagnose chronic ankle instability using the manual anterior drawer test and stress radiography. However, both examinations can yield incorrect results and do not reveal the extent of ankle instability. Stress ultrasound has been reported to be a new diagnostic tool for the diagnosis of chronic ankle instability. The purpose of this study was to assess the diagnostic value of stress ultrasound for chronic ankle instability compared to the manual anterior drawer test, stress radiography, magnetic resonance imaging (MRI), and arthroscopy. Twenty-eight consecutive patients who underwent ankle arthroscopy and subsequent modified Broström repair for treatment of chronic ankle instability were included. The arthroscopic findings were used as the reference standard. A standardized physical examination (manual anterior drawer test), stress radiography, MRI, and stress ultrasound were performed to assess the anterior talofibular ligament (ATFL) prior to operation. Ultrasound images were taken in the resting position and the maximal anterior drawer position. Grade 3 lateral instability was verified arthroscopically in all 28 cases with a clinical diagnosis (100%). Twenty-two cases showed grade III instability on the manual anterior drawer test (78.6%). Twenty-four cases displayed anterior translation exceeding 5 mm on stress radiography (86%), and talar tilt angle exceeded 15° in three cases (11 %). Nineteen cases displayed a partial chronic tear (change in thickness or signal intensity), and nine cases displayed complete tear on MRI (100%). Lax and wavy ATFL was evident on stress ultrasound in all cases (100 %). The mean value of the ATFL length was 2.8 ± 0.3 cm for the stressed condition and 2.1 ± 0.2 cm for the resting condition (p < 0.001). Stress ultrasound may be useful for the diagnosis of chronic ankle instability in addition to the manual anterior drawer test and stress radiography. III.

dsmcFoam+: An OpenFOAM based direct simulation Monte Carlo solver

NASA Astrophysics Data System (ADS)

White, C.; Borg, M. K.; Scanlon, T. J.; Longshaw, S. M.; John, B.; Emerson, D. R.; Reese, J. M.

2018-03-01

dsmcFoam+ is a direct simulation Monte Carlo (DSMC) solver for rarefied gas dynamics, implemented within the OpenFOAM software framework, and parallelised with MPI. It is open-source and released under the GNU General Public License in a publicly available software repository that includes detailed documentation and tutorial DSMC gas flow cases. This release of the code includes many features not found in standard dsmcFoam, such as molecular vibrational and electronic energy modes, chemical reactions, and subsonic pressure boundary conditions. Since dsmcFoam+ is designed entirely within OpenFOAM's C++ object-oriented framework, it benefits from a number of key features: the code emphasises extensibility and flexibility so it is aimed first and foremost as a research tool for DSMC, allowing new models and test cases to be developed and tested rapidly. All DSMC cases are as straightforward as setting up any standard OpenFOAM case, as dsmcFoam+ relies upon the standard OpenFOAM dictionary based directory structure. This ensures that useful pre- and post-processing capabilities provided by OpenFOAM remain available even though the fully Lagrangian nature of a DSMC simulation is not typical of most OpenFOAM applications. We show that dsmcFoam+ compares well to other well-known DSMC codes and to analytical solutions in terms of benchmark results.

[The requirements of standard and conditions of interchangeability of medical articles].

PubMed

Men'shikov, V V; Lukicheva, T I

2013-11-01

The article deals with possibility to apply specific approaches under evaluation of interchangeability of medical articles for laboratory analysis. The development of standardized analytical technologies of laboratory medicine and formulation of requirements of standards addressed to manufacturers of medical articles the clinically validated requirements are to be followed. These requirements include sensitivity and specificity of techniques, accuracy and precision of research results, stability of reagents' quality in particular conditions of their transportation and storage. The validity of requirements formulated in standards and addressed to manufacturers of medical articles can be proved using reference system, which includes master forms and standard samples, reference techniques and reference laboratories. This approach is supported by data of evaluation of testing systems for measurement of level of thyrotrophic hormone, thyroid hormones and glycated hemoglobin HB A1c. The versions of testing systems can be considered as interchangeable only in case of results corresponding to the results of reference technique and comparable with them. In case of absence of functioning reference system the possibilities of the Joined committee of traceability in laboratory medicine make it possible for manufacturers of reagent sets to apply the certified reference materials under development of manufacturing of sets for large listing of analytes.

Adult encephalitis surveillance: experiences from an Australian prospective sentinel site study.

PubMed

Eastwood, K; Paterson, B J; Levi, C; Givney, R; Loewenthal, M; DE Malmanche, T; Lai, K; Granerod, J; Durrheim, D N

2015-11-01

Few countries routinely collect comprehensive encephalitis data, yet understanding the epidemiology of this condition has value for clinical management, detecting novel and emerging pathogens, and guiding timely public health interventions. When this study was conducted there was no standardized diagnostic algorithm to aid identification of encephalitis or systematic surveillance for adult encephalitis. In July 2012 we tested three pragmatic surveillance options aimed at identifying possible adult encephalitis cases admitted to a major Australian hospital: hospital admissions searches, clinician notifications and laboratory test alerts (CSF herpes simplex virus requests). Eligible cases underwent structured laboratory investigation and a specialist panel arbitrated on the final diagnosis. One hundred and thirteen patients were initially recruited into the 10-month study; 20/113 (18%) met the study case definition, seven were diagnosed with infectious or immune-mediated encephalitis and the remainder were assigned alternative diagnoses. The laboratory alert identified 90% (102/113) of recruited cases including six of the seven cases of confirmed encephalitis suggesting that this may be a practical data source for case ascertainment. The application of a standardized diagnostic algorithm and specialist review by an expert clinical panel aided diagnosis of patients with encephalitis.

Pre-examination factors affecting molecular diagnostic test results and interpretation: A case-based approach.

PubMed

Payne, Deborah A; Baluchova, Katarina; Peoc'h, Katell H; van Schaik, Ron H N; Chan, K C Allen; Maekawa, Masato; Mamotte, Cyril; Russomando, Graciela; Rousseau, François; Ahmad-Nejad, Parviz

2017-04-01

Multiple organizations produce guidance documents that provide opportunities to harmonize quality practices for diagnostic testing. The International Organization for Standardization ISO 15189 standard addresses requirements for quality in management and technical aspects of the clinical laboratory. One technical aspect addresses the complexities of the pre-examination phase prior to diagnostic testing. The Committee for Molecular Diagnostics of the International Federation for Clinical Chemistry and Laboratory Medicine (also known as, IFCC C-MD) conducted a survey of international molecular laboratories and determined ISO 15189 to be the most referenced guidance document. In this review, the IFCC C-MD provides case-based examples illustrating the value of select pre-examination processes as these processes relate to molecular diagnostic testing. Case-based examples in infectious disease, oncology, inherited disease and pharmacogenomics address the utility of: 1) providing information to patients and users, 2) designing requisition forms, 3) obtaining informed consent and 4) maintaining sample integrity prior to testing. The pre-examination phase requires extensive and consistent communication between the laboratory, the healthcare provider and the end user. The clinical vignettes presented in this paper illustrate the value of applying select ISO 15189 recommendations for general laboratory to the more specialized area of Molecular Diagnostics. Copyright © 2016 Elsevier B.V. All rights reserved.

Process capability determination of new and existing equipment

NASA Technical Reports Server (NTRS)

Mcclelland, H. T.; Su, Penwen

1994-01-01

The objective of this paper is to illustrate a method of determining the process capability of new or existing equipment. The method may also be modified to apply to testing laboratories. Long term changes in the system may be determined by periodically making new test parts or submitting samples from the original set to the testing laboratory. The technique described has been developed through a series of projects in special topics manufacturing courses and graduate student projects. It will be implemented as a standard experiment in an advanced manufacturing course in a new Manufacturing Engineering program at the University of Wisconsin-Stout campus. Before starting a project of this nature, it is important to decide on the exact question to be answered. In this case, it is desired to know what variation can be reasonably expected in the next part, feature, or test result produced. Generally, this question is answered by providing the process capability or the average value of a measured characteristic of the part or process plus or minus three standard deviations. There are two general cases to be considered: the part or test is made in large quantities with little change, or the process is flexible and makes a large variety of parts. Both cases can be accommodated; however, the emphasis in this report is on short run situations.

Development of the Global Measles Laboratory Network.

PubMed

Featherstone, David; Brown, David; Sanders, Ray

2003-05-15

The routine reporting of suspected measles cases and laboratory testing of samples from these cases is the backbone of measles surveillance. The Global Measles Laboratory Network (GMLN) has developed standards for laboratory confirmation of measles and provides training resources for staff of network laboratories, reference materials and expertise for the development and quality control of testing procedures, and accurate information for the Measles Mortality Reduction and Regional Elimination Initiative. The GMLN was developed along the lines of the successful Global Polio Laboratory Network, and much of the polio laboratory infrastructure was utilized for measles. The GMLN has developed as countries focus on measles control activities following successful eradication of polio. Currently more than 100 laboratories are part of the global network and follow standardized testing and reporting procedures. A comprehensive laboratory accreditation process will be introduced in 2002 with six quality assurance and performance indicators.

ASTM Committee C28: International Standards for Properties and Performance of Advanced Ceramics-Three Decades of High-Quality, Technically-Rigorous Normalization

NASA Technical Reports Server (NTRS)

Jenkins, Michael G.; Salem, Jonathan A.

2016-01-01

Physical and mechanical properties and performance of advanced ceramics and glasses are difficult to measure correctly without the proper techniques. For over three decades, ASTM Committee C28 on Advanced Ceramics, has developed high-quality, technically-rigorous, full-consensus standards (e.g., test methods, practices, guides, terminology) to measure properties and performance of monolithic and composite ceramics that may be applied to glasses in some cases. These standards contain testing particulars for many mechanical, physical, thermal, properties and performance of these materials. As a result these standards are used to generate accurate, reliable, repeatable and complete data. Within Committee C28, users, producers, researchers, designers, academicians, etc. have written, continually updated, and validated through round-robin test programs, 50 standards since the Committee's founding in 1986. This paper provides a detailed retrospective of the 30 years of ASTM Committee C28 including a graphical pictogram listing of C28 standards along with examples of the tangible benefits of standards for advanced ceramics to demonstrate their practical applications.

Embedding Academic Literacy Support within the Electrical Engineering Curriculum: A Case Study

ERIC Educational Resources Information Center

Skinner, I.; Mort, P.

2009-01-01

This paper reports the integration of supplementary training in academic literacy, for those without the assumed entry standard, into a standard electrical engineering program without compromising any other educational objectives. All students who commenced an engineering degree were tested as part of their first session's assessment activities.…

Nationwide Standards Eyed Anew

ERIC Educational Resources Information Center

Olson, Lynn

2005-01-01

With the federal No Child Left Behind Act underscoring the wide variation in what states demand of their students, people on both sides of the political aisle are again making the case for national standards, curricula, and tests. It wasn't so long ago--during the Clinton and George H.W. Bush administrations--that similar proposals went down in…

Evaluative Case Study on the Efficacy of the ELPS Program in Mathematics

ERIC Educational Resources Information Center

Perez, Malia Ann

2013-01-01

The English Language Proficiency Standards (ELPS) program was developed to address the need to effectively integrate second language acquisition with quality content area instruction. English language learners (ELLs) have struggled on standardized tests and there has been little empirical evidence regarding the impact of the ELPS program on…

Examining the Role of the Principal: Case Study of a High-Poverty, High-Performing Rural Elementary School

ERIC Educational Resources Information Center

Coleman, Howard D.

2013-01-01

Since the inception of high-stakes standardized testing, schools have been labeled as either succeeding or failing based on student standardized assessment performance. If students perform adequately, the building principal receives acknowledgement for being an effective instructional leader. Conversely, if students perform poorly, the principal…

The Case against Intelligence Testing in Early Intervention.

ERIC Educational Resources Information Center

Neisworth, John T.; Bagnato, Stephen J.

1992-01-01

Major presumptions that underlie the use of early intelligence tests are presented and disputed, centering on the construct of early intelligence, reliability, prediction, standardized administration, professional acceptability, utility for decision making, and congruence with Public Law 99-457. Professional solidarity is urged in opposing the…

An entropy-based statistic for genomewide association studies.

PubMed

Zhao, Jinying; Boerwinkle, Eric; Xiong, Momiao

2005-07-01

Efficient genotyping methods and the availability of a large collection of single-nucleotide polymorphisms provide valuable tools for genetic studies of human disease. The standard chi2 statistic for case-control studies, which uses a linear function of allele frequencies, has limited power when the number of marker loci is large. We introduce a novel test statistic for genetic association studies that uses Shannon entropy and a nonlinear function of allele frequencies to amplify the differences in allele and haplotype frequencies to maintain statistical power with large numbers of marker loci. We investigate the relationship between the entropy-based test statistic and the standard chi2 statistic and show that, in most cases, the power of the entropy-based statistic is greater than that of the standard chi2 statistic. The distribution of the entropy-based statistic and the type I error rates are validated using simulation studies. Finally, we apply the new entropy-based test statistic to two real data sets, one for the COMT gene and schizophrenia and one for the MMP-2 gene and esophageal carcinoma, to evaluate the performance of the new method for genetic association studies. The results show that the entropy-based statistic obtained smaller P values than did the standard chi2 statistic.

A study on the protective activity of kefir against gastric ulcer.

PubMed

Orhan, Yahya T; Karagözlü, Cem; Sarioğlu, Sülen; Yilmaz, Osman; Murat, Nergiz; Gıdener, Sedef

2012-08-01

The effect of kefir on peptic ulcer disease was evaluated in an experimental model, with non-steroid anti-inflammatory drugs, together with the determination of gastric mucus secretion by quantitative digital histochemistry. The experimental group included 28 male albino Wistar rats. After a diet with standard rat bait for 7 days, 14 rats were fed with kefir for 7 days while the others were kept on the same diet. At the 14th day, indomethacin was injected to 7 of the rats fed on kefir and to 7 of the rats on standard rat bait. All the rats were sacrificed after 4 hours. Gastric erosion and ulceration were scored histopathologically. Mucosal mucus was quantified by image analysis, and periodic acid-Schiff stained area percentage was determined. Erosion and ulceration were identified only in cases that received indomethacin. In the cases on kefir, erosion was identified in 6 cases (86%) and ulceration in 1 case. Rats fed on standard diet had erosion in 4 cases (57%) and ulceration in 3 (43%), but the difference was statistically insignificant (Mann-Whitney test, p=0.25). The stained area percentage for gastric mucus was not different between the four groups (Kruskal-Wallis test, p=0.313). These findings suggest that kefir does not change gastric mucus secretion. Although statistically insignificant, as there were more cases with ulceration in cases on the rat diet, kefir might have a beneficial effect on peptic ulcer disease induced by non-steroid anti-inflammatory drug. This requires further evaluation in larger series.

The case against one-shot testing for initial dental licensure.

PubMed

Chambers, David W; Dugoni, Arthur A; Paisley, Ian

2004-03-01

High-stakes testing are expected to meet standards for cost-effectiveness, fairness, transparency, high reliability, and high validity. It is questionable whether initial licensure examinations in dentistry meet such standards. Decades of piecemeal adjustments in the system have resulted in limited improvement. The essential flaw in the system is reliance on a one-shot sample of a small segment of the skills, understanding, and supporting values needed for today's professional practice of dentistry. The "snapshot" approach to testing produces inherently substandard levels of reliability and validity. A three-step alternative is proposed: boards should (1) define the competencies required of beginning practitioners, (2) establish the psychometric standards needed to make defensible judgments about candidates, and (3) base licensure decisions only on portfolios of evidence that test for defined competencies at established levels of quality.

Assessment of capillary suction time (CST) test methodologies.

PubMed

Sawalha, O; Scholz, M

2007-12-01

The capillary suction time (CST) test is a commonly used method to measure the filterability and the easiness of removing moisture from slurry and sludge in numerous environmental and industrial applications. This study assessed several novel alterations of both the test methodology and the current standard capillary suction time (CST) apparatus. Twelve different papers including the standard Whatman No. 17 chromatographic paper were tested. The tests were run using four different types of sludge including a synthetic sludge, which was specifically developed for benchmarking purposes. The standard apparatus was altered by the introduction of a novel rectangular funnel instead of a standard circular one. A stirrer was also introduced to solve the problem of test inconsistency (e.g. high CST variability) particularly for heavy types of sludge. Results showed that several alternative papers, which are cheaper than the standard paper, can be used to estimate CST values accurately, and that the test repeatability can be improved in many cases and for different types of sludge. The introduction of the rectangular funnel demonstrated an obvious enhancement of test repeatability. The use of a stirrer to avoid sedimentation of heavy sludge did not have statistically significant impact on the CST values or the corresponding data variability. The application of synthetic sludge can support the testing of experimental methodologies and should be used for subsequent benchmarking purposes.

Cost-effectiveness of treating multidrug-resistant tuberculosis.

PubMed

Resch, Stephen C; Salomon, Joshua A; Murray, Megan; Weinstein, Milton C

2006-07-01

Despite the existence of effective drug treatments, tuberculosis (TB) causes 2 million deaths annually worldwide. Effective treatment is complicated by multidrug-resistant TB (MDR TB) strains that respond only to second-line drugs. We projected the health benefits and cost-effectiveness of using drug susceptibility testing and second-line drugs in a lower-middle-income setting with high levels of MDR TB. We developed a dynamic state-transition model of TB. In a base case analysis, the model was calibrated to approximate the TB epidemic in Peru, a setting with a smear-positive TB incidence of 120 per 100,000 and 4.5% MDR TB among prevalent cases. Secondary analyses considered other settings. The following strategies were evaluated: first-line drugs administered under directly observed therapy (DOTS), locally standardized second-line drugs for previously treated cases (STR1), locally standardized second-line drugs for previously treated cases with test-confirmed MDR TB (STR2), comprehensive drug susceptibility testing and individualized treatment for previously treated cases (ITR1), and comprehensive drug susceptibility testing and individualized treatment for all cases (ITR2). Outcomes were costs per TB death averted and costs per quality-adjusted life year (QALY) gained. We found that strategies incorporating the use of second-line drug regimens following first-line treatment failure were highly cost-effective compared to strategies using first-line drugs only. In our base case, standardized second-line treatment for confirmed MDR TB cases (STR2) had an incremental cost-effectiveness ratio of 720 dollars per QALY (8,700 dollars per averted death) compared to DOTS. Individualized second-line drug treatment for MDR TB following first-line failure (ITR1) provided more benefit at an incremental cost of 990 dollars per QALY (12,000 dollars per averted death) compared to STR2. A more aggressive version of the individualized treatment strategy (ITR2), in which both new and previously treated cases are tested for MDR TB, had an incremental cost-effectiveness ratio of 11,000 dollars per QALY (160,000 dollars per averted death) compared to ITR1. The STR2 and ITR1 strategies remained cost-effective under a wide range of alternative assumptions about treatment costs, effectiveness, MDR TB prevalence, and transmission. Treatment of MDR TB using second-line drugs is highly cost-effective in Peru. In other settings, the attractiveness of strategies using second-line drugs will depend on TB incidence, MDR burden, and the available budget, but simulation results suggest that individualized regimens would be cost-effective in a wide range of situations.

An Analysis of the 1992 New Jersey Grade 8 Early Warning Test.

ERIC Educational Resources Information Center

Tambini, Robert F.

The quality and the effectiveness of the 1992 New Jersey Grade 8 Early Warning Test (NJEWT) are assessed. Standardized tests possess clear advantages for educators, especially in the case of administration and scoring, but there are clear disadvantages as well, including the possibility of bias. Four criteria are applied to the NJEWT: adequacy,…

40 CFR 92.206 - Required information.

Code of Federal Regulations, 2012 CFR

2012-07-01

... locomotive engine. (c) Emission data, including exhaust methane data in the case of locomotives or locomotive engines subject to a non-methane hydrocarbon standard, on such locomotives or locomotive engines tested in... requirement to measure smoke emissions is waived for certification and production line testing of Tier 2...

40 CFR 92.206 - Required information.

Code of Federal Regulations, 2011 CFR

2011-07-01

... locomotive engine. (c) Emission data, including exhaust methane data in the case of locomotives or locomotive engines subject to a non-methane hydrocarbon standard, on such locomotives or locomotive engines tested in... requirement to measure smoke emissions is waived for certification and production line testing of Tier 2...

40 CFR 92.206 - Required information.

Code of Federal Regulations, 2013 CFR

2013-07-01

... locomotive engine. (c) Emission data, including exhaust methane data in the case of locomotives or locomotive engines subject to a non-methane hydrocarbon standard, on such locomotives or locomotive engines tested in... requirement to measure smoke emissions is waived for certification and production line testing of Tier 2...

40 CFR 92.206 - Required information.

Code of Federal Regulations, 2010 CFR

2010-07-01

... locomotive engine. (c) Emission data, including exhaust methane data in the case of locomotives or locomotive engines subject to a non-methane hydrocarbon standard, on such locomotives or locomotive engines tested in... requirement to measure smoke emissions is waived for certification and production line testing of Tier 2...

40 CFR 92.206 - Required information.

Code of Federal Regulations, 2014 CFR

2014-07-01

... locomotive engine. (c) Emission data, including exhaust methane data in the case of locomotives or locomotive engines subject to a non-methane hydrocarbon standard, on such locomotives or locomotive engines tested in... requirement to measure smoke emissions is waived for certification and production line testing of Tier 2...

ACCELERATION AND ENRICHMENT IN THE JUNIOR HIGH SCHOOL.

ERIC Educational Resources Information Center

COBAIN, HARRY; FORD, PAUL M.

STUDENTS WERE IDENTIFIED BY (1) TEACHER OBSERVATION, (2) SCHOOL GRADES, (3) GRADE PLACEMENT ON STANDARDIZED TESTS, (4) GRADES ON INTELLIGENCE TESTS, (5) PERSONALITY CHECK LISTS, (6) INTEREST INVENTORIES, (7) PARENT OBSERVATIONS, AND (8) INDIVIDUAL CASE STUDIES. THE OBJECTIVES OF EDUCATING THE ACADEMICALLY TALENTED WERE TO PROVIDE STIMULATING…

Preliminary evaluation of the impact of a Web-based HIV testing programme in Abruzzo Region on the prevention of late HIV presentation and associated mortality.

PubMed

Polilli, Ennio; Sozio, Federica; Di Stefano, Paola; Clerico, Luigi; Di Iorio, Giancarlo; Parruti, Giustino

2018-04-01

This study aimed to analyze the efficacy of a Web-based testing programme in terms of the prevention of late HIV presentation. The clinical characteristics of patients diagnosed with HIV via the Web-based testing programme were compared to those of patients diagnosed in parallel via standard diagnostic care procedures. This study included the clinical and demographic data of newly diagnosed HIV patients enrolled at the study clinic between February 2014 and June 2017. These patients were diagnosed either via standard diagnostic procedures or as a result of the Web-based testing programme. Eighty-eight new cases of HIV were consecutively enrolled; their mean age was 39.1±13.0 years. Fifty-nine patients (67%) were diagnosed through standard diagnostic procedures and 29 (33%) patients came from the Web-based testing programme. Late presentation (62% vs. 34%, p=0.01) and AIDS-defining conditions at presentation (13 vs. 1, p=0.02) were significantly more frequent in the standard care group than in the Web-based group; four of 13 patients with AIDS diagnosed under standard diagnostic procedures died, versus none in the Web-based testing group (p<0.001). Web-based recruitment for voluntary and free HIV testing helped to diagnose patients with less advanced HIV disease and no risk of death, from all at-risk groups, in comparison with standard care testing. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

The Effect of School Poverty on Racial Gaps in Tests Scores: The Case of the Minnesota Basic Standards Tests

ERIC Educational Resources Information Center

Myers, Samuel L.; Kim, Hyeoneui; Mandala, Cheryl

2004-01-01

A data from 1996,1998 and 1999 Minnesota comprehensive statewide testing on eight graders is used to analyze whether African American students perform worse than the white students who attend the poverty schools. The analyses conclude that African American-White test score gap is attributed more to the racial discriminations and racial treatments…

Effects of handcuffs on neuropsychological testing: Implications for criminal forensic evaluations.

PubMed

Biddle, Christine M; Fazio, Rachel L; Dyshniku, Fiona; Denney, Robert L

2018-01-01

Neuropsychological evaluations are increasingly performed in forensic contexts, including in criminal settings where security sometimes cannot be compromised to facilitate evaluation according to standardized procedures. Interpretation of nonstandardized assessment results poses significant challenges for the neuropsychologist. Research is limited in regard to the validation of neuropsychological test accommodation and modification practices that deviate from standard test administration; there is no published research regarding the effects of hand restraints upon neuropsychological evaluation results. This study provides preliminary results regarding the impact of restraints on motor functioning and common neuropsychological tests with a motor component. When restrained, performance on nearly all tests utilized was significantly impacted, including Trail Making Test A/B, a coding test, and several tests of motor functioning. Significant performance decline was observed in both raw scores and normative scores. Regression models are also provided in order to help forensic neuropsychologists adjust for the effect of hand restraints on raw scores of these tests, as the hand restraints also resulted in significant differences in normative scores; in the most striking case there was nearly a full standard deviation of discrepancy.

SFEMG in ocular myasthenia gravis diagnosis.

PubMed

Padua, L; Stalberg, E; LoMonaco, M; Evoli, A; Batocchi, A; Tonali, P

2000-07-01

In typical cases, the patient's history and clinical examination make it possible to diagnose ocular myasthenia gravis (OMG). But, in many cases a clear clinical picture is not present and OMG diagnosis is very difficult because gold diagnostic standard tests are not available. The diagnostic tests for OMG are usually unable to display a good sensitivity and specificity simultaneously. In this paper, we studied 86 cases submitted for suspected OMG. The patients were studied clinically and with various other tests used in OMG diagnosis (SFEMG, repetitive nerve stimulation, Ab anti AChR titration, tensilon test). SFEMG showed the highest sensitivity (100%) while Ab anti AChR showed the highest specificity (100%). To our knowledge this is the largest population of suspected OMG studied using most of the diagnostic parameters, reported in the literature.

Implementation of a virtual laboratory for training on sound insulation testing and uncertainty calculations in acoustic tests.

PubMed

Asensio, C; Gasco, L; Ruiz, M; Recuero, M

2015-02-01

This paper describes a methodology and case study for the implementation of educational virtual laboratories for practice training on acoustic tests according to international standards. The objectives of this activity are (a) to help the students understand and apply the procedures described in the standards and (b) to familiarize the students with the uncertainty in measurement and its estimation in acoustics. The virtual laboratory will not focus on the handling and set-up of real acoustic equipment but rather on procedures and uncertainty. The case study focuses on the application of the virtual laboratory for facade sound insulation tests according to ISO 140-5:1998 (International Organization for Standardization, Geneva, Switzerland, 1998), and the paper describes the causal and stochastic models and the constraints applied in the virtual environment under consideration. With a simple user interface, the laboratory will provide measurement data that the students will have to process to report the insulation results that must converge with the "virtual true values" in the laboratory. The main advantage of the virtual laboratory is derived from the customization of factors in which the student will be instructed or examined (for instance, background noise correction, the detection of sporadic corrupted observations, and the effect of instrument precision).

The Causal Effect of Student Mobility on Standardized Test Performance: A Case Study with Possible Implications for Accountability Mandates within the Elementary and Secondary Education Act.

PubMed

Selya, Arielle S; Engel-Rebitzer, Eden; Dierker, Lisa; Stephen, Eric; Rose, Jennifer; Coffman, Donna L; Otis, Mindy

2016-01-01

This paper presents a limited case study examining the causal inference of student mobility on standardized test performance, within one middle-class high school in suburban Connecticut. Administrative data were used from a district public high school enrolling 319 10th graders in 2010. Propensity score methods were used to estimate the causal effect of student mobility on Math, Science, Reading, and Writing portions of the Connecticut Academic Performance Test (CAPT), after matching mobile vs. stable students on gender, race/ethnicity, eligibility for free/reduced lunches, and special education status. Analyses showed that mobility was associated with lower performance in the CAPT Writing exam. Follow-up analyses revealed that this trend was only significant among those who were ineligible for free/reduced lunches, but not among eligible students. Additionally, mobile students who were ineligible for free/reduced lunches had lower performance in the CAPT Science exam according to some analyses. Large numbers of students transferring into a school district may adversely affect standardized test performance. This is especially relevant for policies that affect student mobility in schools, given the accountability measures in the No Child Left Behind that are currently being re-considered in the recent Every Student Succeeds Act.

The Causal Effect of Student Mobility on Standardized Test Performance: A Case Study with Possible Implications for Accountability Mandates within the Elementary and Secondary Education Act

PubMed Central

Selya, Arielle S.; Engel-Rebitzer, Eden; Dierker, Lisa; Stephen, Eric; Rose, Jennifer; Coffman, Donna L.; Otis, Mindy

2016-01-01

This paper presents a limited case study examining the causal inference of student mobility on standardized test performance, within one middle-class high school in suburban Connecticut. Administrative data were used from a district public high school enrolling 319 10th graders in 2010. Propensity score methods were used to estimate the causal effect of student mobility on Math, Science, Reading, and Writing portions of the Connecticut Academic Performance Test (CAPT), after matching mobile vs. stable students on gender, race/ethnicity, eligibility for free/reduced lunches, and special education status. Analyses showed that mobility was associated with lower performance in the CAPT Writing exam. Follow-up analyses revealed that this trend was only significant among those who were ineligible for free/reduced lunches, but not among eligible students. Additionally, mobile students who were ineligible for free/reduced lunches had lower performance in the CAPT Science exam according to some analyses. Large numbers of students transferring into a school district may adversely affect standardized test performance. This is especially relevant for policies that affect student mobility in schools, given the accountability measures in the No Child Left Behind that are currently being re-considered in the recent Every Student Succeeds Act. PMID:27486427

Critical Multimodal Literacy and the Common Core: Subversive Curriculum in the Age of Accountability

ERIC Educational Resources Information Center

Perttula, Jill

2017-01-01

The purpose of this case study research was to understand the ways in which an innovative, urban secondary English teacher (Ms. B) approached English Language Arts, when a set, standardized curriculum and testing were in place. The Common Core standards were prescribed within a required module-based presentation format. New literacies pedagogy…

A Progressive Case for Educational Standardization: How Not to Respond to the Spellings Report

ERIC Educational Resources Information Center

Graff, Gerald; Birkenstein, Cathy

2008-01-01

In responses from higher education to the 2006 report on Secretary of Education Margaret Spellings's Commission on the Future of Higher Education, "A Test of Leadership: Charting the Future of U.S. Higher Education," one particular argument is made repeatedly: that educational standardization of the sort implicitly called for in the…

Working within the System: The Effects of Standardized Testing on Education Outreach and Community Writing

ERIC Educational Resources Information Center

Parfitt, Elizabeth; Shane, Stephen

2016-01-01

This snapshot describes and reflects upon two case studies of community writing projects between Emerson College and Boston Public Schools. Emerson College students were asked to tutor 10th grade BPS students for the English Language Arts portion of the state standardized assessment. Through both quantitative results and qualitative reflection,…

Audit of a Scientific Data Center for Certification as a Trustworthy Digital Repository: A Case Study

NASA Astrophysics Data System (ADS)

Downs, R. R.; Chen, R. S.

2011-12-01

Services that preserve and enable future access to scientific data are necessary to ensure that the data that are being collected today will be available for use by future generations of scientists. Many data centers, archives, and other digital repositories are working to improve their ability to serve as long-term stewards of scientific data. Trust in sustainable data management and preservation capabilities of digital repositories can influence decisions to use these services to deposit or obtain scientific data. Building on the Open Archival Information System (OAIS) Reference Model developed by the Consultative Committee for Space Data Systems (CCSDS) and adopted by the International Organization for Standardization as ISO 14721:2003, new standards are being developed to improve long-term data management processes and documentation. The Draft Information Standard ISO/DIS 16363, "Space data and information transfer systems - Audit and certification of trustworthy digital repositories" offers the potential to evaluate digital repositories objectively in terms of their trustworthiness as long-term stewards of digital resources. In conjunction with this, the CCSDS and ISO are developing another draft standard for the auditing and certification process, ISO/DIS 16919, "Space data and information transfer systems - Requirements for bodies providing audit and certification of candidate trustworthy digital repositories". Six test audits were conducted of scientific data centers and archives in Europe and the United States to test the use of these draft standards and identify potential improvements for the standards and for the participating digital repositories. We present a case study of the test audit conducted on the NASA Socioeconomic Data and Applications Center (SEDAC) and describe the preparation, the audit process, recommendations received, and next steps to obtain certification as a trustworthy digital repository, after approval of the ISO/DIS standards.

Towards a Quantitative Performance Measurement Framework to Assess the Impact of Geographic Information Standards

NASA Astrophysics Data System (ADS)

Vandenbroucke, D.; Van Orshoven, J.; Vancauwenberghe, G.

2012-12-01

Over the last decennia, the use of Geographic Information (GI) has gained importance, in public as well as in private sector. But even if many spatial data and related information exist, data sets are scattered over many organizations and departments. In practice it remains difficult to find the spatial data sets needed, and to access, obtain and prepare them for using in applications. Therefore Spatial Data Infrastructures (SDI) haven been developed to enhance the access, the use and sharing of GI. SDIs consist of a set of technological and non-technological components to reach this goal. Since the nineties many SDI initiatives saw light. Ultimately, all these initiatives aim to enhance the flow of spatial data between organizations (users as well as producers) involved in intra- and inter-organizational and even cross-country business processes. However, the flow of information and its re-use in different business processes requires technical and semantic interoperability: the first should guarantee that system components can interoperate and use the data, while the second should guarantee that data content is understood by all users in the same way. GI-standards within the SDI are necessary to make this happen. However, it is not known if this is realized in practice. Therefore the objective of the research is to develop a quantitative framework to assess the impact of GI-standards on the performance of business processes. For that purpose, indicators are defined and tested in several cases throughout Europe. The proposed research will build upon previous work carried out in the SPATIALIST project. It analyzed the impact of different technological and non-technological factors on the SDI-performance of business processes (Dessers et al., 2011). The current research aims to apply quantitative performance measurement techniques - which are frequently used to measure performance of production processes (Anupindi et al., 2005). Key to reach the research objectives is a correct design of the test cases. The major challenge is: to set-up the analytical framework for analyzing the impact of GI-standards on the process performance, to define the appropriate indicators and to choose the right test cases. In order to do so, it is proposed to define the test cases as 8 pairs of organizations (see figure). The paper will present the state of the art of performance measurement in the context of work processes, propose a series of SMART indicators for describing the set-up and measure the performance, define the test case set-up and suggest criteria for the selection of the test cases, i.e. the organizational pairs. References Anupindi, R., Chopra, S., Deshmukh, S.D., Van Mieghem, J.A., & Zemel, E. (2006). Managing Business Process Flows: Principles of Operations Management. New-Jersey, USA: Prentice Hall. Dessers, D., Crompvoets, J., Janssen, K., Vancauwenberghe, G., Vandenbroucke, D. & Vanhaverbeke, L. (2011). SDI at work: The Spatial Zoning Plans Case. Leuven, Belgium: Katholieke Universiteit Leuven.

Practical Results from the Application of Model Checking and Test Generation from UML/SysML Models of On-Board Space Applications

NASA Astrophysics Data System (ADS)

Faria, J. M.; Mahomad, S.; Silva, N.

2009-05-01

The deployment of complex safety-critical applications requires rigorous techniques and powerful tools both for the development and V&V stages. Model-based technologies are increasingly being used to develop safety-critical software, and arguably, turning to them can bring significant benefits to such processes, however, along with new challenges. This paper presents the results of a research project where we tried to extend current V&V methodologies to be applied on UML/SysML models and aiming at answering the demands related to validation issues. Two quite different but complementary approaches were investigated: (i) model checking and the (ii) extraction of robustness test-cases from the same models. These two approaches don't overlap and when combined provide a wider reaching model/design validation ability than each one alone thus offering improved safety assurance. Results are very encouraging, even though they either fell short of the desired outcome as shown for model checking, or still appear as not fully matured as shown for robustness test case extraction. In the case of model checking, it was verified that the automatic model validation process can become fully operational and even expanded in scope once tool vendors help (inevitably) to improve the XMI standard interoperability situation. For the robustness test case extraction methodology, the early approach produced interesting results but need further systematisation and consolidation effort in order to produce results in a more predictable fashion and reduce reliance on expert's heuristics. Finally, further improvements and innovation research projects were immediately apparent for both investigated approaches, which point to either circumventing current limitations in XMI interoperability on one hand and bringing test case specification onto the same graphical level as the models themselves and then attempting to automate the generation of executable test cases from its standard UML notation.

Evaluation of the SD Bioline Cholera Rapid Diagnostic Test During the 2016 Cholera Outbreak in Lusaka, Zambia.

PubMed

Mwaba, John; Ferreras, Eva; Chizema-Kawesa, Elizabeth; Mwimbe, Daniel; Tafirenyika, Francis; Rauzier, Jean; Blake, Alexandre; Rakesh, Ankur; Poncin, Marc; Stoitsova, Savina; Kwenda, Geoffrey; Azman, Andrew S; Chewe, Orbrie; Serafini, Micaela; Lukwesa-Musyani, Chileshe; Cohuet, Sandra; Quilici, Marie-Laure; Luquero, Francisco J; Page, Anne-Laure

2018-05-31

To assess the performance of the SD Bioline Cholera Ag O1/O139 rapid diagnostic test (RDT) compared to a reference standard combining culture and PCR for the diagnosis of cholera cases during an outbreak. RDT and bacterial culture were performed on site using fresh stools collected from cholera suspected cases, and from stools enriched in alkaline peptone water. Dried stool samples on filter paper were tested for V. cholerae by PCR in Lusaka (as part of a laboratory technology transfer project) and at a reference laboratory in Paris, France. A sample was considered positive for cholera by the reference standard if any of the culture or PCR tests was positive for V. cholerae O1 or O139. Among the 170 samples tested with SD Bioline and compared to the reference standard, the RDT showed a sensitivity of 90.9% (95% CI: 81.3-96.6) and specificity of 95.0% (95% CI: 89.1-98.4). After enrichment, the sensitivity was 95.5% (95% CI: 87.3-99.1) and specificity 100% (5% CI: 96.5-100). The observed sensitivity and specificity were within recommendations set by the Global Task Force for Cholera Control on the use of cholera RDT (sensitivity=90% : specificity=85%). Although the sample size was small, our findings suggest that the SD Bioline RDT could be used in the field to rapidly alert public health officials to the likely presence of cholera cases when an outbreak is suspected. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Haemophilus haemolyticus Isolates Causing Clinical Disease

PubMed Central

Wang, Xin; Briere, Elizabeth C.; Katz, Lee S.; Cohn, Amanda C.; Clark, Thomas A.; Messonnier, Nancy E.; Mayer, Leonard W.

2012-01-01

We report seven cases of Haemophilus haemolyticus invasive disease detected in the United States, which were previously misidentified as nontypeable Haemophilus influenzae. All cases had different symptoms and presentations. Our study suggests that a testing scheme that includes reliable PCR assays and standard microbiological methods should be used in order to improve H. haemolyticus identification. PMID:22573587

Haemophilus haemolyticus isolates causing clinical disease.

PubMed

Anderson, Raydel; Wang, Xin; Briere, Elizabeth C; Katz, Lee S; Cohn, Amanda C; Clark, Thomas A; Messonnier, Nancy E; Mayer, Leonard W

2012-07-01

We report seven cases of Haemophilus haemolyticus invasive disease detected in the United States, which were previously misidentified as nontypeable Haemophilus influenzae. All cases had different symptoms and presentations. Our study suggests that a testing scheme that includes reliable PCR assays and standard microbiological methods should be used in order to improve H. haemolyticus identification.

Pragmatic Language Impairment: Case Studies of Social and Pragmatic Language Therapy

ERIC Educational Resources Information Center

Adams, Catherine; Baxendale, Janet; Lloyd, Julian; Aldred, Catherine

2005-01-01

The current position on speech and language intervention for children who have pragmatic language impairment (PLI) is limited by a lack of evidence to support practice. Two intervention outcome case studies of children with PLI, aimed at establishing efficacy, are presented in this paper. Standardized language tests and conversational sampling…

School Psychologists' Reported Perspectives on the "Larry P." Ban and Related Practices

ERIC Educational Resources Information Center

Dizon, Francis Gary

2013-01-01

The 1979 landmark case of "Larry P. v. Riles" continues to be one of the most debated topics in school psychology. In this case, Judge Peckham ruled that standardized, norm-referenced intelligence tests were culturally biased towards African-Americans, resulting in overrepresentation of African-Americans in Educably Mentally Retarded…

Test Standards for Contingency Base Waste-to-Energy Technologies

DTIC Science & Technology

2015-08-01

test runs are preferred to allow a more comprehensive statistical evaluation of the results. In 8 • Minimize the complexity , difficulty, and...with water or, in the case of cyanide - or sulfide-bearing wastes, when exposed to mild acidic or basic conditions; 4) explode when subjected to a

Rising Stars: High School's Change Process Produces Higher Test Scores.

ERIC Educational Resources Information Center

McCown, Claire; Runnebaum, Robert

2001-01-01

Presents Bishop Ward High School (Kansas) as a case study that has seen great improvements in standardized testing results by changing its approach. States that realignment of curriculum, adjusting instructional strategies, and accommodating students with special needs are important aspects of raising assessment scores in high schools. (CJW)

Accuracy of the clinical diagnosis of vaginitis compared with a DNA probe laboratory standard.

PubMed

Lowe, Nancy K; Neal, Jeremy L; Ryan-Wenger, Nancy A

2009-01-01

To estimate the accuracy of the clinical diagnosis of the three most common causes of acute vulvovaginal symptoms (bacterial vaginosis, candidiasis vaginitis, and trichomoniasis vaginalis) using a traditional, standardized clinical diagnostic protocol compared with a DNA probe laboratory standard. This prospective clinical comparative study had a sample of 535 active-duty United States military women presenting with vulvovaginal symptoms. Clinical diagnoses were made by research staff using a standardized protocol of history, physical examination including pelvic examination, determination of vaginal pH, vaginal fluid amines test, and wet-prep microscopy. Vaginal fluid samples were obtained for DNA analysis. The research clinicians were blinded to the DNA results. The participants described a presenting symptom of abnormal discharge (50%), itching/irritation (33%), malodor (10%), burning (4%), or others such as vulvar pain and vaginal discomfort. According to laboratory standard, there were 225 cases (42%) of bacterial vaginosis, 76 cases (14%) of candidiasis vaginitis, 8 cases (1.5%) of trichomoniasis vaginalis, 87 cases of mixed infections (16%), and 139 negative cases (26%). For each single infection, the clinical diagnosis had a sensitivity and specificity of 80.8% and 70.0% for bacterial vaginosis, 83.8% and 84.8% for candidiasis vaginitis, and 84.6% and 99.6% for trichomoniasis vaginalis when compared with the DNA probe standard. Compared with a DNA probe standard, clinical diagnosis is 81-85% sensitive and 70-99% specific for bacterial vaginosis, Candida vaginitis, and trichomoniasis. Even under research conditions that provided clinicians with sufficient time and materials to conduct a thorough and standardized clinical evaluation, the diagnosis and, therefore, subsequent treatment of these common vaginal problems remains difficult. II.

Feasibility of a Networked Air Traffic Infrastructure Validation Environment for Advanced NextGen Concepts

NASA Technical Reports Server (NTRS)

McCormack, Michael J.; Gibson, Alec K.; Dennis, Noah E.; Underwood, Matthew C.; Miller,Lana B.; Ballin, Mark G.

2013-01-01

Abstract-Next Generation Air Transportation System (NextGen) applications reliant upon aircraft data links such as Automatic Dependent Surveillance-Broadcast (ADS-B) offer a sweeping modernization of the National Airspace System (NAS), but the aviation stakeholder community has not yet established a positive business case for equipage and message content standards remain in flux. It is necessary to transition promising Air Traffic Management (ATM) Concepts of Operations (ConOps) from simulation environments to full-scale flight tests in order to validate user benefits and solidify message standards. However, flight tests are prohibitively expensive and message standards for Commercial-off-the-Shelf (COTS) systems cannot support many advanced ConOps. It is therefore proposed to simulate future aircraft surveillance and communications equipage and employ an existing commercial data link to exchange data during dedicated flight tests. This capability, referred to as the Networked Air Traffic Infrastructure Validation Environment (NATIVE), would emulate aircraft data links such as ADS-B using in-flight Internet and easily-installed test equipment. By utilizing low-cost equipment that is easy to install and certify for testing, advanced ATM ConOps can be validated, message content standards can be solidified, and new standards can be established through full-scale flight trials without necessary or expensive equipage or extensive flight test preparation. This paper presents results of a feasibility study of the NATIVE concept. To determine requirements, six NATIVE design configurations were developed for two NASA ConOps that rely on ADS-B. The performance characteristics of three existing in-flight Internet services were investigated to determine whether performance is adequate to support the concept. Next, a study of requisite hardware and software was conducted to examine whether and how the NATIVE concept might be realized. Finally, to determine a business case, economic factors were evaluated and a preliminary cost-benefit analysis was performed.

Detecting well casing leaks in Bangladesh using a salt spiking method

USGS Publications Warehouse

Stahl, M.O.; Ong, J.B.; Harvey, C.F.; Johnson, C.D.; Badruzzaman, A.B.M.; Tarek, M.H.; VanGeen, A.; Anderson, J.A.; Lane, J.W.

2014-01-01

We apply fluid-replacement logging in arsenic-contaminated regions of Bangladesh using a low-cost, down-well fluid conductivity logging tool to detect leaks in the cased section of wells. The fluid-conductivity tool is designed for the developing world: it is lightweight and easily transportable, operable by one person, and can be built for minimal cost. The fluid-replacement test identifies leaking casing by comparison of fluid conductivity logs collected before and after spiking the wellbore with a sodium chloride tracer. Here, we present results of fluid-replacement logging tests from both leaking and non-leaking casing from wells in Araihazar and Munshiganj, Bangladesh, and demonstrate that the low-cost tool produces measurements comparable to those obtained with a standard geophysical logging tool. Finally, we suggest well testing procedures and approaches for preventing casing leaks in Bangladesh and other developing countries.

Detecting well casing leaks in Bangladesh using a salt spiking method.

PubMed

Stahl, M O; Ong, J B; Harvey, C F; Johnson, C D; Badruzzaman, A B M; Tarek, M H; van Geen, A; Anderson, J A; Lane, J W

2014-09-01

We apply fluid-replacement logging in arsenic-contaminated regions of Bangladesh using a low-cost, down-well fluid conductivity logging tool to detect leaks in the cased section of wells. The fluid-conductivity tool is designed for the developing world: it is lightweight and easily transportable, operable by one person, and can be built for minimal cost. The fluid-replacement test identifies leaking casing by comparison of fluid conductivity logs collected before and after spiking the wellbore with a sodium chloride tracer. Here, we present results of fluid-replacement logging tests from both leaking and non-leaking casing from wells in Araihazar and Munshiganj, Bangladesh, and demonstrate that the low-cost tool produces measurements comparable to those obtained with a standard geophysical logging tool. Finally, we suggest well testing procedures and approaches for preventing casing leaks in Bangladesh and other developing countries. © 2014, National Ground Water Association.

Epidemiological and Clinical Features of Brucellosis in the Country of Georgia

PubMed Central

Akhvlediani, Tamar; Bautista, Christian T.; Garuchava, Natalia; Sanodze, Lia; Kokaia, Nora; Malania, Lile; Chitadze, Nazibrola; Sidamonidze, Ketevan; Rivard, Robert G.; Hepburn, Matthew J.; Nikolich, Mikeljon P.; Imnadze, Paata; Trapaidze, Nino

2017-01-01

Background Brucellosis is an endemic disease in the country of Georgia. According to the National Center for Disease Control and Public Health of Georgia (NCDC), the average annual number of brucellosis cases was 161 during 2008–2012. However, the true number of cases is thought to be higher due to underreporting. The aim of this study was to provide current epidemiological and clinical information and evaluate diagnostic methods used for brucellosis in Georgia. Methodology Adult patients were eligible for participation if they met the suspected or probable case definition for brucellosis. After consent participants were interviewed using a standardized questionnaire to collect information on socio-demographic characteristics, epidemiology, history of present illness, and clinical manifestation. For the diagnosis of brucellosis, culture and serological tests were used. Results A total of 81 participants were enrolled, of which 70 (86%) were from rural areas. Seventy-four percent of participants reported consuming unpasteurized milk products and 62% consuming undercooked meat products before symptom onset. Forty-one participants were positive by the Wright test and 33 (41%) were positive by blood culture. There was perfect agreement between the Huddelston and Wright tests (k = 1.0). Compared with blood culture (the diagnostic gold standard), ELISA IgG and total ELISA (IgG + IgM), the Wright test had fair (k = 0.12), fair (k = 0.24), and moderate (k = 0.52) agreement, respectively. Conclusions Consumption of unpasteurized milk products and undercooked meat were among the most common risk factors in brucellosis cases. We found poor agreement between ELISA tests and culture results. This report also serves as an initial indication that the suspected case definition for brucellosis surveillance purposes needs revision. Further research is needed to characterize the epidemiology and evaluate the performance of the diagnostic methods for brucellosis in Georgia. PMID:28107444

Epidemiological and Clinical Features of Brucellosis in the Country of Georgia.

PubMed

Akhvlediani, Tamar; Bautista, Christian T; Garuchava, Natalia; Sanodze, Lia; Kokaia, Nora; Malania, Lile; Chitadze, Nazibrola; Sidamonidze, Ketevan; Rivard, Robert G; Hepburn, Matthew J; Nikolich, Mikeljon P; Imnadze, Paata; Trapaidze, Nino

2017-01-01

Brucellosis is an endemic disease in the country of Georgia. According to the National Center for Disease Control and Public Health of Georgia (NCDC), the average annual number of brucellosis cases was 161 during 2008-2012. However, the true number of cases is thought to be higher due to underreporting. The aim of this study was to provide current epidemiological and clinical information and evaluate diagnostic methods used for brucellosis in Georgia. Adult patients were eligible for participation if they met the suspected or probable case definition for brucellosis. After consent participants were interviewed using a standardized questionnaire to collect information on socio-demographic characteristics, epidemiology, history of present illness, and clinical manifestation. For the diagnosis of brucellosis, culture and serological tests were used. A total of 81 participants were enrolled, of which 70 (86%) were from rural areas. Seventy-four percent of participants reported consuming unpasteurized milk products and 62% consuming undercooked meat products before symptom onset. Forty-one participants were positive by the Wright test and 33 (41%) were positive by blood culture. There was perfect agreement between the Huddelston and Wright tests (k = 1.0). Compared with blood culture (the diagnostic gold standard), ELISA IgG and total ELISA (IgG + IgM), the Wright test had fair (k = 0.12), fair (k = 0.24), and moderate (k = 0.52) agreement, respectively. Consumption of unpasteurized milk products and undercooked meat were among the most common risk factors in brucellosis cases. We found poor agreement between ELISA tests and culture results. This report also serves as an initial indication that the suspected case definition for brucellosis surveillance purposes needs revision. Further research is needed to characterize the epidemiology and evaluate the performance of the diagnostic methods for brucellosis in Georgia.

Subjective evaluation of next-generation video compression algorithms: a case study

NASA Astrophysics Data System (ADS)

De Simone, Francesca; Goldmann, Lutz; Lee, Jong-Seok; Ebrahimi, Touradj; Baroncini, Vittorio

2010-08-01

This paper describes the details and the results of the subjective quality evaluation performed at EPFL, as a contribution to the effort of the Joint Collaborative Team on Video Coding (JCT-VC) for the definition of the next-generation video coding standard. The performance of 27 coding technologies have been evaluated with respect to two H.264/MPEG-4 AVC anchors, considering high definition (HD) test material. The test campaign involved a total of 494 naive observers and took place over a period of four weeks. While similar tests have been conducted as part of the standardization process of previous video coding technologies, the test campaign described in this paper is by far the most extensive in the history of video coding standardization. The obtained subjective quality scores show high consistency and support an accurate comparison of the performance of the different coding solutions.

Towards reporting standards for neuropsychological study results: A proposal to minimize communication errors with standardized qualitative descriptors for normalized test scores.

PubMed

Schoenberg, Mike R; Rum, Ruba S

2017-11-01

Rapid, clear and efficient communication of neuropsychological results is essential to benefit patient care. Errors in communication are a lead cause of medical errors; nevertheless, there remains a lack of consistency in how neuropsychological scores are communicated. A major limitation in the communication of neuropsychological results is the inconsistent use of qualitative descriptors for standardized test scores and the use of vague terminology. PubMed search from 1 Jan 2007 to 1 Aug 2016 to identify guidelines or consensus statements for the description and reporting of qualitative terms to communicate neuropsychological test scores was conducted. The review found the use of confusing and overlapping terms to describe various ranges of percentile standardized test scores. In response, we propose a simplified set of qualitative descriptors for normalized test scores (Q-Simple) as a means to reduce errors in communicating test results. The Q-Simple qualitative terms are: 'very superior', 'superior', 'high average', 'average', 'low average', 'borderline' and 'abnormal/impaired'. A case example illustrates the proposed Q-Simple qualitative classification system to communicate neuropsychological results for neurosurgical planning. The Q-Simple qualitative descriptor system is aimed as a means to improve and standardize communication of standardized neuropsychological test scores. Research are needed to further evaluate neuropsychological communication errors. Conveying the clinical implications of neuropsychological results in a manner that minimizes risk for communication errors is a quintessential component of evidence-based practice. Copyright © 2017 Elsevier B.V. All rights reserved.

Hybrid Capture-Based Comprehensive Genomic Profiling Identifies Lung Cancer Patients with Well-Characterized Sensitizing Epidermal Growth Factor Receptor Point Mutations That Were Not Detected by Standard of Care Testing.

PubMed

Suh, James H; Schrock, Alexa B; Johnson, Adrienne; Lipson, Doron; Gay, Laurie M; Ramkissoon, Shakti; Vergilio, Jo-Anne; Elvin, Julia A; Shakir, Abdur; Ruehlman, Peter; Reckamp, Karen L; Ou, Sai-Hong Ignatius; Ross, Jeffrey S; Stephens, Philip J; Miller, Vincent A; Ali, Siraj M

2018-03-14

In our recent study, of cases positive for epidermal growth factor receptor ( EGFR ) exon 19 deletions using comprehensive genomic profiling (CGP), 17/77 (22%) patients with prior standard of care (SOC) EGFR testing results available were previously negative for exon 19 deletion. Our aim was to compare the detection rates of CGP versus SOC testing for well-characterized sensitizing EGFR point mutations (pm) in our 6,832-patient cohort. DNA was extracted from 40 microns of formalin-fixed paraffin-embedded sections from 6,832 consecutive cases of non-small cell lung cancer (NSCLC) of various histologies (2012-2015). CGP was performed using a hybrid capture, adaptor ligation-based next-generation sequencing assay to a mean coverage depth of 576×. Genomic alterations (pm, small indels, copy number changes and rearrangements) involving EGFR were recorded for each case and compared with prior testing results if available. Overall, there were 482 instances of EGFR exon 21 L858R (359) and L861Q (20), exon 18 G719X (73) and exon 20 S768I (30) pm, of which 103 unique cases had prior EGFR testing results that were available for review. Of these 103 cases, CGP identified 22 patients (21%) with sensitizing EGFR pm that were not detected by SOC testing, including 9/75 (12%) patients with L858R, 4/7 (57%) patients with L861Q, 8/20 (40%) patients with G719X, and 4/7 (57%) patients with S768I pm (some patients had multiple EGFR pm). In cases with available clinical data, benefit from small molecule inhibitor therapy was observed. CGP, even when applied to low tumor purity clinical-grade specimens, can detect well-known EGFR pm in NSCLC patients that would otherwise not be detected by SOC testing. Taken together with EGFR exon 19 deletions, over 20% of patients who are positive for EGFR -activating mutations using CGP are previously negative by SOC EGFR mutation testing, suggesting that thousands of such patients per year in the U.S. alone could experience improved clinical outcomes when hybrid capture-based CGP is used to inform therapeutic decisions. This study points out that genomic profiling, as based on hybrid capture next-generation sequencing, can identify lung cancer patients with point mutation in epidermal growth factor receptor (EGFR) missed by standard molecular testing who can likely benefit from anti-EGFR targeted therapy. Beyond the specific findings regarding false-negative point mutation testing for EGFR, this study highlights the need for oncologists and pathologists to be cognizant of the performance characteristics of testing deployed and the importance of clinical intuition in questioning the results of laboratory testing. © AlphaMed Press 2018.

A Comparison of Three Types of Test Development Procedures Using Classical and Latent Trait Methods.

ERIC Educational Resources Information Center

Benson, Jeri; Wilson, Michael

Three methods of item selection were used to select sets of 38 items from a 50-item verbal analogies test and the resulting item sets were compared for internal consistency, standard errors of measurement, item difficulty, biserial item-test correlations, and relative efficiency. Three groups of 1,500 cases each were used for item selection. First…

Testing under the Microscope: How Common Core-Aligned Assessments Place Demands on Time, Technology, and Connectivity

ERIC Educational Resources Information Center

Stephens, Wendy

2014-01-01

School librarians and other specialists should take note of the new wave of computer-based assessments required by the Common Core State Standards (CCSS), testing that is only now beginning to get off the ground. The new testing necessitates that districts possess the right hardware, install the requisite software, and, in some cases, create…

Roland: A Case for or Against NATO Standardization?

DTIC Science & Technology

1980-05-01

with often competing, even opposing, objectives in testing, financial auditing , cost estimating, reliability, value engineering, maintenance, training...supposedly mature system. Multilocation tests, early in the program when test beds and spare parts availability would be at a minimum, would require...Similar institutionalized conflicts resided in the audit community, which, under the Armed Services Procurement Regulation, was required to audit and

Recommended fine positioning test for the Development Test Flight (DTF-1) of the NASA Flight Telerobotic Servicer (FTS)

NASA Technical Reports Server (NTRS)

Dagalakis, N.; Wavering, A. J.; Spidaliere, P.

1991-01-01

Test procedures are proposed for the NASA DTF (Development Test Flight)-1 positioning tests of the FTS (Flight Telerobotic Servicer). The unique problems associated with the DTF-1 mission are discussed, standard robot performance tests and terminology are reviewed and a very detailed description of flight-like testing and analysis is presented. The major technical problem associated with DTF-1 is that only one position sensor can be used, which will be fixed at one location, with a working volume which is probably smaller than some of the robot errors to be measured. Radiation heating of the arm and the sensor could also cause distortions that would interfere with the test. Two robot performance testing committees have established standard testing procedures relevant to the DTF-1. Due to the technical problems associated with DTF-1, these procedures cannot be applied directly. These standard tests call for the use of several test positions at specific locations. Only one position, that of the position sensor, can be used by DTF-1. Off-line programming accuracy might be impossible to measure and in that case it will have to be replaced by forward kinetics accuracy.

Tensions in the field: teaching standards of practice in optometry case presentations.

PubMed

Spafford, Marlee M; Lingard, Lorelei; Schryer, Catherine F; Hrynchak, Patricia K

2004-10-01

Professional identity formation and its relationship to case presentations were studied in an optometry school's onsite clinic. Eight optometry students and six faculty optometrists were audio-recorded during 31 oral case presentations and the teaching exchanges related to them. Using convenience sampling, interviews were audio-recorded of four of the students and four of the optometrists from the field observations. After transcribing these audio-recordings, the research team members applied a grounded theory method to identify, test, and revise emergent themes. The theme reported herein pertains to communicating standards of practice. Faculty optometrists demonstrated three ways of communicating standards of practice to optometry students during case presentations: Official Way, Our Way, and My Way. Although there were differences between these standards, the rationale for the disparities was rarely explicitly articulated by the instructors to the students. Without this information, the incongruity among the standards was left to the students to interpret on their own. The risk created by faculty not articulating the rationale underlying standards of practice was that students misinterpreted the optometrists' ways as idiosyncratic. Thus, opportunities were missed in the educational setting to assist students in making responsible decisions, locating their position in practice, and shaping their professional identity. Competing responsibilities of patient care and student education left instructors with little time to articulate rationale for standards of practice. Therefore, educators must reflect on innovative ways to bring into relief the logic behind their actions when working with novices.

Accountability Policy Implementation and the Case of Smaller School District Capacity: Three Contrasting Cases that Examine the Flow and Use of NCLB Accountability Data

ERIC Educational Resources Information Center

Miller, Christopher L.

2010-01-01

The No Child Left Behind Act increases pressure on schools and districts to use standardized state test data. Seeking to learn about the process of turning accountability data into actionable information, this paper presents findings from three case studies of small to medium sized school districts. The study examines the flow of state science…

An audit of the contribution to post-mortem examination diagnosis of individual analyte results obtained from biochemical analysis of the vitreous.

PubMed

Mitchell, Rebecca; Charlwood, Cheryl; Thomas, Sunethra Devika; Bellis, Maria; Langlois, Neil E I

2013-12-01

Biochemical analysis of the vitreous humor from the eye is an accepted accessory test for post-mortem investigation of cause of death. Modern biochemical analyzers allow testing of a range of analytes from a sample. However, it is not clear which analytes should be requested in order to prevent unnecessary testing (and expense). The means and standard deviation of the values obtained from analysis of the vitreous humor for sodium, potassium, chloride, osmolality, glucose, ketones (β-hydroxybutyrate), creatinine, urea, calcium, lactate, and ammonia were calculated from which the contribution of each analyte was reviewed in the context of post-mortem findings and final cause of death. For sodium 32 cases were regarded as high (more than one standard deviation above the mean), from which 9 contributed to post-mortem diagnosis [drowning (4), heat related death (2), diabetic hyperglycemia (2), and dehydration (1)], but 25 low values (greater than one standard deviation below the mean) made no contribution. For chloride 29 high values contributed to 4 cases--3 drowning and 1 heat-related, but these were all previously identified by a high sodium level. There were 29 high and 35 low potassium values, none of which contributed to determining the final cause of death. Of 22 high values of creatinine, 12 contributed to a diagnosis of renal failure. From 32 high values of urea, 18 contributed to 16 cases of renal failure (2 associated with diabetic hyperglycemia), 1 heat-related death, and one case with dehydration. Osmolarity contributed to 12 cases (5 heat-related, 4 diabetes, 2 renal failure, and 1 dehydration) from 36 high values. There was no contribution from 32 high values and 19 low values of calcium and there was no contribution from 4 high and 2 low values of ammonia. There were 11 high values of glucose, which contributed to the diagnosis of 6 cases of diabetic hyperglycemia and 21 high ketone levels contributed to 8 cases: 4 diabetic ketosis, 3 hypothermia, 3 ketosis of unknown cause, and 2 alcohol related deaths. A high lactate was identified in 25 cases, which contributed to 1 case with a diagnosis of metformin toxicity (1), but none of the 22 low lactate values contributed. The results of this audit have been used to reduce vitreous biochemistry test requests for sodium, osmolality, glucose, ketones, urea, and creatinine in most cases. Critical appraisal of each part of the post-mortem process should be undertaken to provide evidence to justify any investigative methods used in an autopsy.

Improving Groundwater Data Interoperability: Results of the Second OGC Groundwater Interoperability Experiment

NASA Astrophysics Data System (ADS)

Lucido, J. M.; Booth, N.

2014-12-01

Interoperable sharing of groundwater data across international boarders is essential for the proper management of global water resources. However storage and management of groundwater data is often times distributed across many agencies or organizations. Furthermore these data may be represented in disparate proprietary formats, posing a significant challenge for integration. For this reason standard data models are required to achieve interoperability across geographical and political boundaries. The GroundWater Markup Language 1.0 (GWML1) was developed in 2010 as an extension of the Geography Markup Language (GML) in order to support groundwater data exchange within Spatial Data Infrastructures (SDI). In 2013, development of GWML2 was initiated under the sponsorship of the Open Geospatial Consortium (OGC) for intended adoption by the international community as the authoritative standard for the transfer of groundwater feature data, including data about water wells, aquifers, and related entities. GWML2 harmonizes GWML1 and the EU's INSPIRE models related to geology and hydrogeology. Additionally, an interoperability experiment was initiated to test the model for commercial, technical, scientific, and policy use cases. The scientific use case focuses on the delivery of data required for input into computational flow modeling software used to determine the flow of groundwater within a particular aquifer system. It involves the delivery of properties associated with hydrogeologic units, observations related to those units, and information about the related aquifers. To test this use case web services are being implemented using GWML2 and WaterML2, which is the authoritative standard for water time series observations, in order to serve USGS water well and hydrogeologic data via standard OGC protocols. Furthermore, integration of these data into a computational groundwater flow model will be tested. This submission will present the GWML2 information model and results of an interoperability experiment with a particular emphasis on the scientific use case.

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

Roper, J; Bradshaw, B; Godette, K

Purpose: To create a knowledge-based algorithm for prostate LDR brachytherapy treatment planning that standardizes plan quality using seed arrangements tailored to individual physician preferences while being fast enough for real-time planning. Methods: A dataset of 130 prior cases was compiled for a physician with an active prostate seed implant practice. Ten cases were randomly selected to test the algorithm. Contours from the 120 library cases were registered to a common reference frame. Contour variations were characterized on a point by point basis using principle component analysis (PCA). A test case was converted to PCA vectors using the same process andmore » then compared with each library case using a Mahalanobis distance to evaluate similarity. Rank order PCA scores were used to select the best-matched library case. The seed arrangement was extracted from the best-matched case and used as a starting point for planning the test case. Computational time was recorded. Any subsequent modifications were recorded that required input from a treatment planner to achieve an acceptable plan. Results: The computational time required to register contours from a test case and evaluate PCA similarity across the library was approximately 10s. Five of the ten test cases did not require any seed additions, deletions, or moves to obtain an acceptable plan. The remaining five test cases required on average 4.2 seed modifications. The time to complete manual plan modifications was less than 30s in all cases. Conclusion: A knowledge-based treatment planning algorithm was developed for prostate LDR brachytherapy based on principle component analysis. Initial results suggest that this approach can be used to quickly create treatment plans that require few if any modifications by the treatment planner. In general, test case plans have seed arrangements which are very similar to prior cases, and thus are inherently tailored to physician preferences.« less

Premise for Standardized Sepsis Models.

PubMed

Remick, Daniel G; Ayala, Alfred; Chaudry, Irshad; Coopersmith, Craig M; Deutschman, Clifford; Hellman, Judith; Moldawer, Lyle; Osuchowski, Marcin

2018-06-05

Sepsis morbidity and mortality exacts a toll on patients and contributes significantly to healthcare costs. Preclinical models of sepsis have been used to study disease pathogenesis and test new therapies, but divergent outcomes have been observed with the same treatment even when using the same sepsis model. Other disorders such as diabetes, cancer, malaria, obesity and cardiovascular diseases have used standardized, preclinical models that allow laboratories to compare results. Standardized models accelerate the pace of research and such models have been used to test new therapies or changes in treatment guidelines. The National Institutes of Health (NIH) mandated that investigators increase data reproducibility and the rigor of scientific experiments and has also issued research funding announcements about the development and refinement of standardized models. Our premise is that refinement and standardization of preclinical sepsis models may accelerate the development and testing of potential therapeutics for human sepsis, as has been the case with preclinical models for other disorders. As a first step towards creating standardized models, we suggest 1) standardizing the technical standards of the widely used cecal ligation and puncture model and 2) creating a list of appropriate organ injury and immune dysfunction parameters. Standardized sepsis models could enhance reproducibility and allow comparison of results between laboratories and may accelerate our understanding of the pathogenesis of sepsis.

Black-Box System Testing of Real-Time Embedded Systems Using Random and Search-Based Testing

NASA Astrophysics Data System (ADS)

Arcuri, Andrea; Iqbal, Muhammad Zohaib; Briand, Lionel

Testing real-time embedded systems (RTES) is in many ways challenging. Thousands of test cases can be potentially executed on an industrial RTES. Given the magnitude of testing at the system level, only a fully automated approach can really scale up to test industrial RTES. In this paper we take a black-box approach and model the RTES environment using the UML/MARTE international standard. Our main motivation is to provide a more practical approach to the model-based testing of RTES by allowing system testers, who are often not familiar with the system design but know the application domain well-enough, to model the environment to enable test automation. Environment models can support the automation of three tasks: the code generation of an environment simulator, the selection of test cases, and the evaluation of their expected results (oracles). In this paper, we focus on the second task (test case selection) and investigate three test automation strategies using inputs from UML/MARTE environment models: Random Testing (baseline), Adaptive Random Testing, and Search-Based Testing (using Genetic Algorithms). Based on one industrial case study and three artificial systems, we show how, in general, no technique is better than the others. Which test selection technique to use is determined by the failure rate (testing stage) and the execution time of test cases. Finally, we propose a practical process to combine the use of all three test strategies.

Capacity, consent, and mental health legislation: time for a new standard?

PubMed

O'Brien, Anthony J

2010-01-01

Recent international reforms in mental health legislation have introduced a capacity test as a criterion for civil commitment. There are proposals that a common test of incapacity should apply in both mental and physical health under a single legislative framework for all cases in which the normally accepted standard of informed consent for treatment is not met. Capacity is a complex concept, but can be reliably assessed in clinical practice. Nurses need to be involved in the policy debate about capacity and consent in mental health care.

SU-F-BRD-10: Lung IMRT Planning Using Standardized Beam Bouquet Templates

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

Yuan, L; Wu, Q J.; Yin, F

2014-06-15

Purpose: We investigate the feasibility of choosing from a small set of standardized templates of beam bouquets (i.e., entire beam configuration settings) for lung IMRT planning to improve planning efficiency and quality consistency, and also to facilitate automated planning. Methods: A set of beam bouquet templates is determined by learning from the beam angle settings in 60 clinical lung IMRT plans. A k-medoids cluster analysis method is used to classify the beam angle configuration into clusters. The value of the average silhouette width is used to determine the ideal number of clusters. The beam arrangements in each medoid of themore » resulting clusters are taken as the standardized beam bouquet for the cluster, with the corresponding case taken as the reference case. The resulting set of beam bouquet templates was used to re-plan 20 cases randomly selected from the database and the dosimetric quality of the plans was evaluated against the corresponding clinical plans by a paired t-test. The template for each test case was manually selected by a planner based on the match between the test and reference cases. Results: The dosimetric parameters (mean±S.D. in percentage of prescription dose) of the plans using 6 beam bouquet templates and those of the clinical plans, respectively, and the p-values (in parenthesis) are: lung Dmean: 18.8±7.0, 19.2±7.0 (0.28), esophagus Dmean: 32.0±16.3, 34.4±17.9 (0.01), heart Dmean: 19.2±16.5, 19.4±16.6 (0.74), spinal cord D2%: 47.7±18.8, 52.0±20.3 (0.01), PTV dose homogeneity (D2%-D99%): 17.1±15.4, 20.7±12.2 (0.03).The esophagus Dmean, cord D02 and PTV dose homogeneity are statistically better in the plans using the standardized templates, but the improvements (<5%) may not be clinically significant. The other dosimetric parameters are not statistically different. Conclusion: It's feasible to use a small number of standardized beam bouquet templates (e.g. 6) to generate plans with quality comparable to that of clinical plans. Partially supported by NIH/NCI under grant #R21CA161389 and a master research grant by Varian Medical System.« less

NeuroRecovery Network provides standardization of locomotor training for persons with incomplete spinal cord injury.

PubMed

Morrison, Sarah A; Forrest, Gail F; VanHiel, Leslie R; Davé, Michele; D'Urso, Denise

2012-09-01

To illustrate the continuity of care afforded by a standardized locomotor training program across a multisite network setting within the Christopher and Dana Reeve Foundation NeuroRecovery Network (NRN). Single patient case study. Two geographically different hospital-based outpatient facilities. This case highlights a 25-year-old man diagnosed with C4 motor incomplete spinal cord injury with American Spinal Injury Association Impairment Scale grade D. Standardized locomotor training program 5 sessions per week for 1.5 hours per session, for a total of 100 treatment sessions, with 40 sessions at 1 center and 60 at another. Ten-meter walk test and 6-minute walk test were assessed at admission and discharge across both facilities. For each of the 100 treatment sessions percent body weight support, average, and maximum treadmill speed were evaluated. Locomotor endurance, as measured by the 6-minute walk test, and overground gait speed showed consistent improvement from admission to discharge. Throughout training, the patient decreased the need for body weight support and was able to tolerate faster treadmill speeds. Data indicate that the patient continued to improve on both treatment parameters and walking function. Standardization across the NRN centers provided a mechanism for delivering consistent and reproducible locomotor training programs across 2 facilities without disrupting training or recovery progression. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Meta-analysis for the comparison of two diagnostic tests to a common gold standard: A generalized linear mixed model approach.

PubMed

Hoyer, Annika; Kuss, Oliver

2018-05-01

Meta-analysis of diagnostic studies is still a rapidly developing area of biostatistical research. Especially, there is an increasing interest in methods to compare different diagnostic tests to a common gold standard. Restricting to the case of two diagnostic tests, in these meta-analyses the parameters of interest are the differences of sensitivities and specificities (with their corresponding confidence intervals) between the two diagnostic tests while accounting for the various associations across single studies and between the two tests. We propose statistical models with a quadrivariate response (where sensitivity of test 1, specificity of test 1, sensitivity of test 2, and specificity of test 2 are the four responses) as a sensible approach to this task. Using a quadrivariate generalized linear mixed model naturally generalizes the common standard bivariate model of meta-analysis for a single diagnostic test. If information on several thresholds of the tests is available, the quadrivariate model can be further generalized to yield a comparison of full receiver operating characteristic (ROC) curves. We illustrate our model by an example where two screening methods for the diagnosis of type 2 diabetes are compared.

The use of multiwell culture plates in the duckweed toxicity test-a case study on Zn nanoparticles.

PubMed

Kalčíková, Gabriela; Marolt, Gregor; Kokalj, Anita Jemec; Gotvajn, Andreja Žgajnar

2018-06-11

Extensive production of nanomaterials of various properties needs to be coupled with rapid toxicity testing in order to provide information about their potential risks to the environment and human health. Miniaturization of toxicity tests may accelerate economical testing of nanomaterials, but is not a common practice. We describe a case study to miniaturize a commonly used toxicity test with plant duckweed Lemna minor. 6-well, 12-well and 24-well culture plates were used to assess their potential use for the duckweed toxicity test with potassium chloride as reference material. The results were compared to the standard test design using 100 mL glass beakers. The comparison showed that the best agreement was with the 6-well vessels. This set-up was further used for toxicity testing of zinc oxide nanoparticles (ZnO NP) and zinc chlorides. Zinc was not adsorbed onto either glass or plastic walls of the miniaturized system. We assume that in both vessels a fast agglomeration and settling of ZnO NP took place. Linear regression and statistical testing indicated a good correlation between the toxicity results obtained in the standard test and miniaturized 6-well vessels. The miniaturization of the test system for assessing the biological effect of nanomaterials on Lemna minor could become an appropriate alternative to the traditionally used high volume vessels. Copyright © 2018. Published by Elsevier B.V.

Finite element modeling of ROPS in static testing and rear overturns.

PubMed

Harris, J R; Mucino, V H; Etherton, J R; Snyder, K A; Means, K H

2000-08-01

Even with the technological advances of the last several decades, agricultural production remains one of the most hazardous occupations in the United States. Death due to tractor rollover is a prime contributor to this hazard. Standards for rollover protective structures (ROPS) performance and certification have been developed by groups such as the Society of Automotive Engineers (SAE) and the American Society of Agricultural Engineers (ASAE) to combat these problems. The current ROPS certification standard, SAE J2194, requires either a dynamic or static testing sequence or both. Although some ROPS manufacturers perform both the dynamic and static phases of SAE J2194 testing, it is possible for a ROPS to be certified for field operation using static testing alone. This research compared ROPS deformation response from a simulated SAE J2194 static loading sequence to ROPS deformation response as a result of a simulated rearward tractor rollover. Finite element analysis techniques for plastic deformation were used to simulate both the static and dynamic rear rollover scenarios. Stress results from the rear rollover model were compared to results from simulated static testing per SAE J2194. Maximum stress values from simulated rear rollovers exceeded maximum stress values recorded during simulated static testing for half of the elements comprising the uprights. In the worst case, the static model underpredicts dynamic model results by approximately 7%. In the best case, the static model overpredicts dynamic model results by approximately 32%. These results suggest the need for additional experimental work to characterize ROPS stress levels during staged overturns and during testing according to the SAE standard.

Exploring Support for the Extracurriculum in a Time of Fiscal Constraint and Standards-Based Reform: A Case Study of One Pennsylvania School District

ERIC Educational Resources Information Center

Murphy, Mark Patrick

2012-01-01

Although much has been researched and written about the value of extracurricular programs in U.S. public schools, few studies have addressed the combined effect that school reform initiatives, including myriad standardized tests, accountability measures, and massive financial crisis which have become more commonplace during periods of economic…

Differentiation of Mycobacterium tuberculosis complex from non-tubercular mycobacteria by nested multiplex PCR targeting IS6110, MTP40 and 32kD alpha antigen encoding gene fragments.

PubMed

Sinha, Pallavi; Gupta, Anamika; Prakash, Pradyot; Anupurba, Shampa; Tripathi, Rajneesh; Srivastava, G N

2016-03-12

Control of the global burden of tuberculosis is obstructed due to lack of simple, rapid and cost effective diagnostic techniques that can be used in resource poor-settings. To facilitate the early diagnosis of TB directly from clinical specimens, we have standardized and validated the use of nested multiplex PCR, targeting gene fragments IS6110, MTP40 and 32kD α-antigen encoding genes specific for Mycobacterium tuberculosis complex and non-tubercular mycobacteria (NTM), in comparison to smear microscopy, solid culture and single step multiplex PCR. The results were evaluated in comparison to a composite reference standard (CRS) comprising of microbiological results (smear and culture), clinical, radiological and cytopathological findings, clinical treatment and response to anti-tubercular therapy. The nested multiplex PCR (nMPCR) assay was evaluated to test its utility in 600 (535 pulmonary and 65 extra-pulmonary specimens) clinically suspected TB cases. All specimens were processed for smear, culture, single step multiplex PCR and nested multiplex PCR testing. Out of 535 screened pulmonary and 65 extra-pulmonary specimens, 329 (61.5%) and 19 (29.2%) cases were culture positive for M. tuberculosis. Based on CRS, 450 patients had "clinical TB" (definitive-TB, probable-TB and possible-TB). Remaining 150 were confirmed "non-TB" cases. For culture, the sensitivity was low, 79.3% for pulmonary and 54.3% for extra-pulmonary cases. The sensitivity and specificity results for nMPCR test were evaluated taken composite reference standard as a gold standard. The sensitivity of the nMPCR assay was 97.1% for pulmonary and 91.4% for extra-pulmonary TB cases with specificity of 100% and 93.3% respectively. Nested multiplex PCR using three gene primers is a rapid, reliable and highly sensitive and specific diagnostic technique for the detection and differentiation of M. tuberculosis complex from NTM genome and will be useful in diagnosing paucibacillary samples. Nested multiplex PCR assay was found to be better than single step multiplex PCR for assessing the diagnosis of TB.

The changing face of medical negligence law: from Bolam to Bolitho.

PubMed

Sooriakumaran, Prasanna

2008-06-01

The Bolam test was the standard by which medical negligence cases were judged. However, recently, the Bolitho case has resulted in a shift away from Bolam, with significant effects for all future negligence suits. Doctors need to have a thorough understanding of these issues in order to practice successfully in the current litiginous climate.

Comparative effectiveness of incorporating a hypothetical DCIS prognostic marker into breast cancer screening.

PubMed

Trentham-Dietz, Amy; Ergun, Mehmet Ali; Alagoz, Oguzhan; Stout, Natasha K; Gangnon, Ronald E; Hampton, John M; Dittus, Kim; James, Ted A; Vacek, Pamela M; Herschorn, Sally D; Burnside, Elizabeth S; Tosteson, Anna N A; Weaver, Donald L; Sprague, Brian L

2018-02-01

Due to limitations in the ability to identify non-progressive disease, ductal carcinoma in situ (DCIS) is usually managed similarly to localized invasive breast cancer. We used simulation modeling to evaluate the potential impact of a hypothetical test that identifies non-progressive DCIS. A discrete-event model simulated a cohort of U.S. women undergoing digital screening mammography. All women diagnosed with DCIS underwent the hypothetical DCIS prognostic test. Women with test results indicating progressive DCIS received standard breast cancer treatment and a decrement to quality of life corresponding to the treatment. If the DCIS test indicated non-progressive DCIS, no treatment was received and women continued routine annual surveillance mammography. A range of test performance characteristics and prevalence of non-progressive disease were simulated. Analysis compared discounted quality-adjusted life years (QALYs) and costs for test scenarios to base-case scenarios without the test. Compared to the base case, a perfect prognostic test resulted in a 40% decrease in treatment costs, from $13,321 to $8005 USD per DCIS case. A perfect test produced 0.04 additional QALYs (16 days) for women diagnosed with DCIS, added to the base case of 5.88 QALYs per DCIS case. The results were sensitive to the performance characteristics of the prognostic test, the proportion of DCIS cases that were non-progressive in the model, and the frequency of mammography screening in the population. A prognostic test that identifies non-progressive DCIS would substantially reduce treatment costs but result in only modest improvements in quality of life when averaged over all DCIS cases.

Validation of the Hwalek-Sengstock Elder Abuse Screening Test.

ERIC Educational Resources Information Center

Neale, Anne Victoria; And Others

Elder abuse is recognized as an under-detected and under-reported social problem. Difficulties in detecting elder abuse are compounded by the lack of a standardized, psychometrically valid instrument for case finding. The development of the Hwalek-Sengstock Elder Abuse Screening Test (H-S/EAST) followed a larger effort to identify indicators and…

Testing Cases under Title VII.

ERIC Educational Resources Information Center

Rothschild, Michael; Werden, Gregory J.

This paper discusses Congressional and judicial attempts to deal with the problem of employment practices which lead to discriminatory outcomes but which may not be discriminatory in intent. The use of paper and pencil tests as standards for hiring and promotion is focused on as an example of this type of employment practice. An historical account…

Making a nutritional assessment.

PubMed Central

Pencharz, P. B.

1982-01-01

The assessment of nutritional deficiencies depends on both clinical and laboratory diagnosis. The standard physical examination should be supplemented by nutritional anthropometry, consisting of accurate growth and skinfold measurements. A careful dietary history, preferably taken by a dietitian, is necessary to construct a record of past nutrient intake. Since biochemical abnormalities often appear before clinical signs of nutritional deficiency a battery of biochemical tests is sometimes needed. In unusual cases newer techniques of assessing body composition or immunologic or physiologic function may be required. In all cases the patient's physical state, nutritional intake and biochemical status must be related to age and sex standards. PMID:7139499

Building Energy Simulation Test for Existing Homes (BESTEST-EX) (Presentation)

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

Judkoff, R.; Neymark, J.; Polly, B.

2011-12-01

This presentation discusses the goals of NREL Analysis Accuracy R&D; BESTEST-EX goals; what BESTEST-EX is; how it works; 'Building Physics' cases; 'Building Physics' reference results; 'utility bill calibration' cases; limitations and potential future work. Goals of NREL Analysis Accuracy R&D are: (1) Provide industry with the tools and technical information needed to improve the accuracy and consistency of analysis methods; (2) Reduce the risks associated with purchasing, financing, and selling energy efficiency upgrades; and (3) Enhance software and input collection methods considering impacts on accuracy, cost, and time of energy assessments. BESTEST-EX Goals are: (1) Test software predictions of retrofitmore » energy savings in existing homes; (2) Ensure building physics calculations and utility bill calibration procedures perform up to a minimum standard; and (3) Quantify impact of uncertainties in input audit data and occupant behavior. BESTEST-EX is a repeatable procedure that tests how well audit software predictions compare to the current state of the art in building energy simulation. There is no direct truth standard. However, reference software have been subjected to validation testing, including comparisons with empirical data.« less

Assembling Appliances Standards from a Basket of Functions

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

Siderious, Hans-Paul; Meier, Alan

2014-08-11

Rapid innovation in product design challenges the current methodology for setting standards and labels, especially for electronics, software and networking. Major problems include defining the product, measuring its energy consumption, and choosing the appropriate metric and level for the standard. Most governments have tried to solve these problems by defining ever more specific product subcategories, along with their corresponding test methods and metrics. An alternative approach would treat each energy-using product as something that delivers a basket of functions. Then separate standards would be constructed for the individual functions that can be defined, tested, and evaluated. Case studies of thermostats,more » displays and network equipment are presented to illustrate the problems with the classical approach for setting standards and indicate the merits and drawbacks of the alternative. The functional approach appears best suited to products whose primary purpose is processing information and that have multiple functions.« less

Metropolitan Forensic Anthropology Team (MFAT) studies in identification: 1. Race and sex assessment by discriminant function analysis of the postcranial skeleton.

PubMed

Taylor, J V; DiBennardo, R; Linares, G H; Goldman, A D; DeForest, P R

1984-07-01

A case study is presented to demonstrate the utility of the team approach to the identification of human remains, and to illustrate a methodological innovation developed by MFAT. Case 1 represents the first of several planned case studies, each designed to present new methodological solutions to standard problems in identification. The present case describes a test, by application, of race and sex assessment of the postcranial skeleton by discriminant function analysis.

Evaluation of case management of uncomplicated malaria in Haiti: a national health facility survey, 2012.

PubMed

Landman, Keren Z; Jean, Samuel E; Existe, Alexandre; Akom, Eniko E; Chang, Michelle A; Lemoine, Jean Frantz; Mace, Kimberly E

2015-10-09

Malaria is a public health concern in Haiti, although there are limited data on its burden and case management. National malaria guidelines updated in 2012 recommend treatment with chloroquine and primaquine. In December 2012, a nationally-representative cross-sectional survey of health facilities (HFs) was conducted to determine malaria prevalence among febrile outpatients and malaria case management quality at baseline before scale-up of diagnostics and case management training. Among all 833 HFs nationwide, 30 were selected randomly, in proportion to total HFs per region, for 2-day evaluations. Survey teams inventoried HF material and human resources. Outpatients of all ages were screened for temperature >37.5 °C or history of fever; those without severe symptoms were consented and enrolled. Providers evaluated and treated enrolled patients according to HF standards; the survey teams documented provider-ordered diagnostic tests and treatment decisions. Facility-based test results [microscopy and malaria rapid diagnostic tests (RDTs)] were collected from HF laboratories. Blood smears for gold-standard microscopy, and dried blood spots for polymerase chain reaction (PCR) were obtained. Malaria diagnostic capacity, defined as completing a test for an enrolled patient or having adequate resources for RDTs or microscopy, was present in 11 (37 %) HFs. Among 459 outpatients screened, 257 (56 %) were febrile, of which 193 (75 %) were eligible, and 153 (80 %) were enrolled. Among 39 patients with facility-level malaria test results available on the survey day, 11 (28 %) were positive, of whom 6 (55 %) were treated with an anti-malarial. Twenty-seven (95 %) of the 28 patients testing negative were not treated with an anti-malarial. Of 114 patients without test results available, 35 (31 %) were presumptively treated for malaria. Altogether, 42 patients were treated with an anti-malarial, one (2 %) according to Haiti's 2012 guidelines. Of 140 gold-standard smears, none were positive, although one patient tested positive by PCR, a more sensitive technique. The national prevalence of malaria among febrile outpatients is estimated to be 0.5 % (95 % confidence interval 0-1.7 %). Malaria is an uncommon cause of fever in Haitian outpatients, and limited, often inaccurate, diagnostic capacity at baseline contributes to over diagnosis. Scale-up of diagnostics and training on new guidelines should improve malaria diagnosis and treatment in Haiti.

Using hybrid implicit Monte Carlo diffusion to simulate gray radiation hydrodynamics

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

Cleveland, Mathew A., E-mail: cleveland7@llnl.gov; Gentile, Nick

This work describes how to couple a hybrid Implicit Monte Carlo Diffusion (HIMCD) method with a Lagrangian hydrodynamics code to evaluate the coupled radiation hydrodynamics equations. This HIMCD method dynamically applies Implicit Monte Carlo Diffusion (IMD) [1] to regions of a problem that are opaque and diffusive while applying standard Implicit Monte Carlo (IMC) [2] to regions where the diffusion approximation is invalid. We show that this method significantly improves the computational efficiency as compared to a standard IMC/Hydrodynamics solver, when optically thick diffusive material is present, while maintaining accuracy. Two test cases are used to demonstrate the accuracy andmore » performance of HIMCD as compared to IMC and IMD. The first is the Lowrie semi-analytic diffusive shock [3]. The second is a simple test case where the source radiation streams through optically thin material and heats a thick diffusive region of material causing it to rapidly expand. We found that HIMCD proves to be accurate, robust, and computationally efficient for these test problems.« less

"I Feel Nervous... Very Nervous" Addressing Test Anxiety in Inner City Schools through Play and Performance

ERIC Educational Resources Information Center

Lobman, Carrie

2014-01-01

The intense focus on standardized tests has created a culture of anxiety in many inner-city schools. This article presents the findings of a case study of a test anxiety program that helped inner-city students and staffs deal more productively with anxiety through play, performance, and team building. According to the findings, the program created…

Powassan Virus—A New Reemerging Tick-Borne Disease

PubMed Central

Fatmi, Syed Soheb; Zehra, Rija; Carpenter, David O.

2017-01-01

Powassan virus is a neurovirulent flavivirus consisting of two lineages causing meningoencephalitis. It is the only member of the tick-borne encephalitis serogroup which is present in mainland North America. With a total number of 27 cases from 1958 to 1998 and 98 cases from 1999 to 2016, reported cases have increased by 671% over the last 18 years. Powassan infection is transmitted by different tick species in different geographical regions. Ixodes scapularis is the primary vector that transmits the virus on the East Coast of US and Ixodes cookei in the Midwest and Canada, while Hemaphysalis longicornis is the vector in Russia. Powassan has no singular pathognomonic finding and presents with a wide spectrum of symptoms including severe neurological symptoms. The clinical challenge lies within the management of the disease as there is no standard diagnostic protocol and most cases are only diagnosed after a patient goes through an extensive workup for other infectious disease. The diagnosis is established by a combination of imaging and serologic tests. In case of Powassan meningoencephalitis, computed tomography scan and magnetic resonance imaging show vascular insults, which are also seen in cases of tick-borne encephalitis virus, another flavivirus of medical importance. Serologic tests are the gold standard for diagnosis, although testing is not widely available and only state health departments and Center for Disease Control and Prevention can perform Powassan-specific IgM antibody testing utilizing enzyme-linked immunosorbent assay and immunofluorescence antibody. Powassan is also of veterinary medical importance. Wildlife animals act as a reservoir to the pathogens, hence possessing threat to humans and domestic animals. This review highlights Powassan’s neurotropic presentation, epidemiology, diagnostic challenges, and prevalence. Strong emphasis is placed on establishing diagnostic protocols, widespread Powassan-specific IgM testing, role of the vector in disease presentation, and necessary preventive research. PMID:29312918

Casing Tier 529.887-020; Sausage Packer; Skin Peeler 525.884-050; Sliced-Bacon Packer II; Packer 920.887-114 -- Technical Report on Standardization of the General Aptitude Test Battery.

ERIC Educational Resources Information Center

Manpower Administration (DOL), Washington, DC. U.S. Training and Employment Service.

The United States Training and Employment Service General Aptitude Test Battery (GATB), first published in 1947, has been included in a continuing program of research to validate the tests against success in many different occupations. The GATB consists of 12 tests which measure nine aptitudes: General Learning Ability; Verbal Aptitude; Numerical…

Competency to stand trial: rationalism, "contextualism" and other modest theories.

PubMed

Jan Brakel, S

2003-01-01

Determinations of competency to stand trial in criminal cases are complicated and rendered unpredictable by two sub-surface issues that are rarely articulated: (i) the place of the defendant's rationality in the substantive standard(s) for competency and (ii) the level or degree of incompetency required to stop the criminal process. The rare references to these issues, mostly indirect, that are made in the cases, commentary, and competency testing instruments devised (including those civil as well as criminal) are examined. The conclusion that emerges is that the level of capacity and rationality required of the defendant depends much on context-the type of case, its relative complexity, and the values and stakes implicated in the outcome. Copyright 2003 John Wiley & Sons, Ltd.

Comparative Study on High-Order Positivity-preserving WENO Schemes

NASA Technical Reports Server (NTRS)

Kotov, Dmitry V.; Yee, Helen M.; Sjogreen, Bjorn Axel

2013-01-01

The goal of this study is to compare the results obtained by non-positivity-preserving methods with the recently developed positivity-preserving schemes for representative test cases. In particular the more di cult 3D Noh and Sedov problems are considered. These test cases are chosen because of the negative pressure/density most often exhibited by standard high-order shock-capturing schemes. The simulation of a hypersonic nonequilibrium viscous shock tube that is related to the NASA Electric Arc Shock Tube (EAST) is also included. EAST is a high-temperature and high Mach number viscous nonequilibrium ow consisting of 13 species. In addition, as most common shock-capturing schemes have been developed for problems without source terms, when applied to problems with nonlinear and/or sti source terms these methods can result in spurious solutions, even when solving a conservative system of equations with a conservative scheme. This kind of behavior can be observed even for a scalar case (LeVeque & Yee 1990) as well as for the case consisting of two species and one reaction (Wang et al. 2012). For further information concerning this issue see (LeVeque & Yee 1990; Griffiths et al. 1992; Lafon & Yee 1996; Yee et al. 2012). This EAST example indicated that standard high-order shock-capturing methods exhibit instability of density/pressure in addition to grid-dependent discontinuity locations with insufficient grid points. The evaluation of these test cases is based on the stability of the numerical schemes together with the accuracy of the obtained solutions.

Aminopenicillin-associated exanthem: lymphocyte transformation testing revisited.

PubMed

Trautmann, A; Seitz, C S; Stoevesandt, J; Kerstan, A

2014-12-01

The lymphocyte transformation test (LTT) has been promoted as in-vitro test for diagnosis of drug hypersensitivity. For determination of statistical LTT sensitivity, series of patients with clinically uniform reactions followed by complete drug hypersensitivity work-up are mandatory. Assessment of LTT specificity requires control patients who tolerated exposure to the drug studied. To prospectively determine the diagnostic value of the LTT in a clinically and diagnostically well-defined series of patients. Patients with exanthematous skin eruptions after ampicillin (AMP) intake were included in this study. After exclusion or confirmation of delayed-onset allergic AMP hypersensitivity by skin and provocation testing, two independent LTTs were performed: one standard LTT and a modified LTT with additional anti-CD3/anti-CD28 monoclonal antibody stimulation. By testing, delayed-onset allergic AMP hypersensitivity was diagnosed in 11 patients and definitely ruled out in 26. The standard LTT reached a diagnostic sensitivity of 54.5% while the modified LTT yielded 72.7%. However, the methodical test modification resulted in a decline of specificity from 92.3% (standard LTT) to 76.9%. In cases of AMP-associated exanthems, the diagnostic value of the LTT compared with routine allergy testing is limited. When evaluating such exanthems, provocation testing remains the gold standard. Delayed reading of intradermal skin tests remains most useful to avoid positive provocation reactions. © 2014 John Wiley & Sons Ltd.

NREL Improves Building Energy Simulation Programs Through Diagnostic Testing (Fact Sheet)

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

Not Available

2012-01-01

This technical highlight describes NREL research to develop Building Energy Simulation Test for Existing Homes (BESTEST-EX) to increase the quality and accuracy of energy analysis tools for the building retrofit market. Researchers at the National Renewable Energy Laboratory (NREL) have developed a new test procedure to increase the quality and accuracy of energy analysis tools for the building retrofit market. The Building Energy Simulation Test for Existing Homes (BESTEST-EX) is a test procedure that enables software developers to evaluate the performance of their audit tools in modeling energy use and savings in existing homes when utility bills are available formore » model calibration. Similar to NREL's previous energy analysis tests, such as HERS BESTEST and other BESTEST suites included in ANSI/ASHRAE Standard 140, BESTEST-EX compares software simulation findings to reference results generated with state-of-the-art simulation tools such as EnergyPlus, SUNREL, and DOE-2.1E. The BESTEST-EX methodology: (1) Tests software predictions of retrofit energy savings in existing homes; (2) Ensures building physics calculations and utility bill calibration procedures perform to a minimum standard; and (3) Quantifies impacts of uncertainties in input audit data and occupant behavior. BESTEST-EX includes building physics and utility bill calibration test cases. The diagram illustrates the utility bill calibration test cases. Participants are given input ranges and synthetic utility bills. Software tools use the utility bills to calibrate key model inputs and predict energy savings for the retrofit cases. Participant energy savings predictions using calibrated models are compared to NREL predictions using state-of-the-art building energy simulation programs.« less

Validation of a fully automated HER2 staining kit in breast cancer.

PubMed

Moelans, Cathy B; Kibbelaar, Robby E; van den Heuvel, Marius C; Castigliego, Domenico; de Weger, Roel A; van Diest, Paul J

2010-01-01

Testing for HER2 amplification and/or overexpression is currently routine practice to guide Herceptin therapy in invasive breast cancer. At present, HER2 status is most commonly assessed by immunohistochemistry (IHC). Standardization of HER2 IHC assays is of utmost clinical and economical importance. At present, HER2 IHC is most commonly performed with the HercepTest which contains a polyclonal antibody and applies a manual staining procedure. Analytical variability in HER2 IHC testing could be diminished by a fully automatic staining system with a monoclonal antibody. 219 invasive breast cancers were fully automatically stained with the monoclonal antibody-based Oracle HER2 Bond IHC kit and manually with the HercepTest. All cases were tested for amplification with chromogenic in situ hybridization (CISH). HercepTest yielded an overall sharper membrane staining, with less cytoplasmic and stromal background than Oracle in 17% of cases. Overall concordance between both IHC techniques was 89% (195/219) with a kappa value of 0.776 (95% CI 0.698-0.854), indicating a substantial agreement. Most (22/24) discrepancies between HercepTest and Oracle showed a weaker staining for Oracle. Thirteen of the 24 discrepant cases were high-level HER2 amplified by CISH, and in 12 of these HercepTest IHC better reflected gene amplification status. All the 13 HER2 amplified discrepant cases were at least 2+ by HercepTest, while 10/13 of these were at least 2+ for Oracle. Considering CISH as gold standard, sensitivity of HercepTest and Oracle was 91% and 83%, and specificity was 94% and 98%, respectively. Positive and negative predictive values for HercepTest and Oracle were 90% and 95% for HercepTest and 96% and 91% for Oracle, respectively. Fully-automated HER2 staining with the monoclonal antibody in the Oracle kit shows a high level of agreement with manual staining by the polyclonal antibody in the HercepTest. Although Oracle shows in general some more cytoplasmic staining and may be slightly less sensitive in picking up HER2 amplified cases, it shows a higher specificity and may be considered as an alternative method to evaluate the HER2 expression in breast cancer with potentially less analytical variability.

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

PubMed

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

2017-02-01

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

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

PubMed Central

Johnson, Paul; Williams, Robin

2005-01-01

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

Diagnostic accuracy of loop-mediated isothermal amplification (LAMP) for screening patients with imported malaria in a non-endemic setting

PubMed Central

Ponce, Camille; Kaczorowski, Flora; Perpoint, Thomas; Miailhes, Patrick; Sigal, Alain; Javouhey, Etienne; Gillet, Yves; Jacquin, Laurent; Douplat, Marion; Tazarourte, Karim; Potinet, Véronique; Simon, Bruno; Lavoignat, Adeline; Bonnot, Guillaume; Sow, Fatimata; Bienvenu, Anne-Lise; Picot, Stéphane

2017-01-01

Background: Sensitive and easy-to-perform methods for the diagnosis of malaria are not yet available. Improving the limit of detection and following the requirements for certification are issues to be addressed in both endemic and non-endemic settings. The aim of this study was to test whether loop-mediated isothermal amplification of DNA (LAMP) may be an alternative to microscopy or real-time PCR for the screening of imported malaria cases in non-endemic area. Results: 310 blood samples associated with 829 suspected cases of imported malaria were tested during a one year period. Microscopy (thin and thick stained blood slides, reference standard) was used for the diagnosis. Real-time PCR was used as a standard of truth, and LAMP (Meridian Malaria Plus) was used as an index test in a prospective study conducted following the Standards for Reporting Diagnosis Accuracy Studies. In the 83 positive samples, species identification was P. falciparum (n = 66), P. ovale (n = 9), P. vivax (n = 3) P. malariae (n = 3) and 2 co-infections with P. falciparum + P.malariae. Using LAMP methods, 93 samples gave positive results, including 4 false-positives. Sensitivity, specificity, positive predictive value and negative predictive value for LAMP tests were 100%, 98.13%, 95.51%, and 100% compared to PCR. Conclusion: High negative predictive value, and limit of detection suggest that LAMP can be used for screening of imported malaria cases in non-endemic countries when expert microscopists are not immediately available. However, the rare occurrence of non-valid results and the need for species identification and quantification of positive samples preclude the use of LAMP as a single reference method. PMID:29251261

[Procedure of seed quality testing and seed grading standard of Prunus humilis].

PubMed

Wen, Hao; Ren, Guang-Xi; Gao, Ya; Luo, Jun; Liu, Chun-Sheng; Li, Wei-Dong

2014-11-01

So far there exists no corresponding quality test procedures and grading standards for the seed of Prunus humilis, which is one of the important source of base of semen pruni. Therefor we set up test procedures that are adapt to characteristics of the P. humilis seed through the study of the test of sampling, seed purity, thousand-grain weight, seed moisture, seed viability and germination percentage. 50 cases of seed specimens of P. humilis tested. The related data were analyzed by cluster analysis. Through this research, the seed quality test procedure was developed, and the seed quality grading standard was formulated. The seed quality of each grade should meet the following requirements: for first grade seeds, germination percentage ≥ 68%, thousand-grain weight 383 g, purity ≥ 93%, seed moisture ≤ 5%; for second grade seeds, germination percentage ≥ 26%, thousand-grain weight ≥ 266 g, purity ≥ 73%, seed moisture ≤9%; for third grade seeds, germination percentage ≥ 10%, purity ≥ 50%, thousand-grain weight ≥ 08 g, seed moisture ≤ 13%.

Antianaerobic Antimicrobials: Spectrum and Susceptibility Testing

PubMed Central

Wexler, Hannah M.; Goldstein, Ellie J. C.

2013-01-01

SUMMARY Susceptibility testing of anaerobic bacteria recovered from selected cases can influence the choice of antimicrobial therapy. The Clinical and Laboratory Standards Institute (CLSI) has standardized many laboratory procedures, including anaerobic susceptibility testing (AST), and has published documents for AST. The standardization of testing methods by the CLSI allows comparisons of resistance trends among various laboratories. Susceptibility testing should be performed on organisms recovered from sterile body sites, those that are isolated in pure culture, or those that are clinically important and have variable or unique susceptibility patterns. Organisms that should be considered for individual isolate testing include highly virulent pathogens for which susceptibility cannot be predicted, such as Bacteroides, Prevotella, Fusobacterium, and Clostridium spp.; Bilophila wadsworthia; and Sutterella wadsworthensis. This review describes the current methods for AST in research and reference laboratories. These methods include the use of agar dilution, broth microdilution, Etest, and the spiral gradient endpoint system. The antimicrobials potentially effective against anaerobic bacteria include beta-lactams, combinations of beta-lactams and beta-lactamase inhibitors, metronidazole, chloramphenicol, clindamycin, macrolides, tetracyclines, and fluoroquinolones. The spectrum of efficacy, antimicrobial resistance mechanisms, and resistance patterns against these agents are described. PMID:23824372

The Rise and Fall of a Standards Based Spelling Assessment: Did Spelling Improve or Is it Just Another Case of Teaching to the Test?

ERIC Educational Resources Information Center

Fenton, Ray; Stofflet, Fred; Straugh, Tom

This paper reports the creation, implementation, and discontinuation of a standards based spelling assessment program in Anchorage, Alaska. The program was initiated by the Anchorage school board as part of establishing district-wide performance goals for students in 1998-1999. Spelling was singled out for attention because of national discussions…

Comparison of Performance Characteristics of Aspergillus PCR in Testing a Range of Blood-Based Samples in Accordance with International Methodological Recommendations.

PubMed

Springer, Jan; White, P Lewis; Hamilton, Shanna; Michel, Denise; Barnes, Rosemary A; Einsele, Hermann; Löffler, Juergen

2016-03-01

Standardized methodologies for the molecular detection of invasive aspergillosis (IA) have been established by the European Aspergillus PCR Initiative for the testing of whole blood, serum, and plasma. While some comparison of the performance of Aspergillus PCR when testing these different sample types has been performed, no single study has evaluated all three using the recommended protocols. Standardized Aspergillus PCR was performed on 423 whole-blood pellets (WBP), 583 plasma samples, and 419 serum samples obtained from hematology patients according to the recommendations. This analysis formed a bicenter retrospective anonymous case-control study, with diagnosis according to the revised European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) consensus definitions (11 probable cases and 36 controls). Values for clinical performance using individual and combined samples were calculated. For all samples, PCR positivity was significantly associated with cases of IA (for plasma, P = 0.0019; for serum, P = 0.0049; and for WBP, P = 0.0089). Plasma PCR generated the highest sensitivity (91%); the sensitivities for serum and WBP PCR were 80% and 55%, respectively. The highest specificity was achieved when testing WBP (96%), which was significantly superior to the specificities achieved when testing serum (69%, P = 0.0238) and plasma (53%, P = 0.0002). No cases were PCR negative in all specimen types, and no controls were PCR positive in all specimens. This study confirms that Aspergillus PCR testing of plasma provides robust performance while utilizing commercial automated DNA extraction processes. Combining PCR testing of different blood fractions allows IA to be both confidently diagnosed and excluded. A requirement for multiple PCR-positive plasma samples provides similar diagnostic utility and is technically less demanding. Time to diagnosis may be enhanced by testing multiple contemporaneously obtained sample types. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

High-dose calcium stimulation test in a case of insulinoma masquerading as hysteria.

PubMed

Nakamura, Yoshio; Doi, Ryuichiro; Kohno, Yasuhiro; Shimono, Dai; Kuwamura, Naomitsu; Inoue, Koichi; Koshiyama, Hiroyuki; Imamura, Masayuki

2002-11-01

It is reported that some cases with insulinoma present with neuropsychiatric symptoms and are often misdiagnosed as psychosis. Here we report a case of insulinoma masquerading as hysteria, whose final diagnosis could be made using high-dose calcium stimulation test. A 28-yr-old woman was referred presenting with substupor, mutism, mannerism, restlessness, and incoherence. Laboratory examinations revealed hypoglycemia (33 mg/dL) and detectable insulin levels (9.7 microU/mL), suggesting the diagnosis of insulinoma. However, neither imaging studies nor selective arterial calcium injection (SACI) test with a conventional dose of calcium (0.025 mEq/kg) indicated the tumor. High-dose calcium injection (0.05 mEq/kg) evoked insulin secretion when injected into superior mesenteric artery. A solitary tumor in the head of the pancreas was resected, and her plasma glucose returned to normal. Postoperatively, iv injection of secretin resulted in a normal response of insulin, which was not found preoperatively. This case suggests the usefulness of the SACI test with high-dose of calcium in the case of insulinoma when the standard dose fails to detect such a tumor.

A comparison of fitness-case sampling methods for genetic programming

NASA Astrophysics Data System (ADS)

Martínez, Yuliana; Naredo, Enrique; Trujillo, Leonardo; Legrand, Pierrick; López, Uriel

2017-11-01

Genetic programming (GP) is an evolutionary computation paradigm for automatic program induction. GP has produced impressive results but it still needs to overcome some practical limitations, particularly its high computational cost, overfitting and excessive code growth. Recently, many researchers have proposed fitness-case sampling methods to overcome some of these problems, with mixed results in several limited tests. This paper presents an extensive comparative study of four fitness-case sampling methods, namely: Interleaved Sampling, Random Interleaved Sampling, Lexicase Selection and Keep-Worst Interleaved Sampling. The algorithms are compared on 11 symbolic regression problems and 11 supervised classification problems, using 10 synthetic benchmarks and 12 real-world data-sets. They are evaluated based on test performance, overfitting and average program size, comparing them with a standard GP search. Comparisons are carried out using non-parametric multigroup tests and post hoc pairwise statistical tests. The experimental results suggest that fitness-case sampling methods are particularly useful for difficult real-world symbolic regression problems, improving performance, reducing overfitting and limiting code growth. On the other hand, it seems that fitness-case sampling cannot improve upon GP performance when considering supervised binary classification.

Valid statistical inference methods for a case-control study with missing data.

PubMed

Tian, Guo-Liang; Zhang, Chi; Jiang, Xuejun

2018-04-01

The main objective of this paper is to derive the valid sampling distribution of the observed counts in a case-control study with missing data under the assumption of missing at random by employing the conditional sampling method and the mechanism augmentation method. The proposed sampling distribution, called the case-control sampling distribution, can be used to calculate the standard errors of the maximum likelihood estimates of parameters via the Fisher information matrix and to generate independent samples for constructing small-sample bootstrap confidence intervals. Theoretical comparisons of the new case-control sampling distribution with two existing sampling distributions exhibit a large difference. Simulations are conducted to investigate the influence of the three different sampling distributions on statistical inferences. One finding is that the conclusion by the Wald test for testing independency under the two existing sampling distributions could be completely different (even contradictory) from the Wald test for testing the equality of the success probabilities in control/case groups under the proposed distribution. A real cervical cancer data set is used to illustrate the proposed statistical methods.

A Case Study of Middle School Teachers' Preparations for High-Stakes Assessments

ERIC Educational Resources Information Center

Yeary, David Lee

2017-01-01

Students, educators, and schools across the country have been presented with challenges as a result of rigorous standards and high-complexity tests. The problem addressed in this case study was that teachers in a rural middle school in a southeastern state were preparing students to take a new high-stakes state-mandated assessment in English…

Case Study Analyses of Play Behaviors of 12-Month-Old Infants Later Diagnosed with Autism

ERIC Educational Resources Information Center

Mulligan, Shelley

2015-01-01

Case study research methodology was used to describe the play behaviors of three infants at 12 months of age, who were later diagnosed with an autism spectrum disorder. Data included standardized test scores, and analyses of video footage of semi-structured play sessions from infants identified as high risk for autism, because of having a sibling…

A Procedure for Testing the Difference between Effect Sizes.

ERIC Educational Resources Information Center

Lambert, Richard G.; Flowers, Claudia

A special case of the homogeneity of effect size test, as applied to pairwise comparisons of standardized mean differences, was evaluated. Procedures for comparing pairs of pretest to posttest effect sizes, as well as pairs of treatment versus control group effect sizes, were examined. Monte Carlo simulation was used to generate Type I error rates…

Unfair Treatment? The Case of Freedle, the SAT, and the Standardization Approach to Differential Item Functioning

ERIC Educational Resources Information Center

Santelices, Maria Veronica; Wilson, Mark

2010-01-01

In 2003, the "Harvard Educational Review" published a controversial article by Roy Freedle that claimed bias against African American students in the SAT college admissions test. Freedle's work stimulated national media attention and faced an onslaught of criticism from experts at the Educational Testing Service (ETS), the agency…

A Case Study: A Teacher's Instruction of Writing in Rural Northeast Mississippi

ERIC Educational Resources Information Center

Anderson-Crane, Betty

2008-01-01

When writing instructors use form (essay form) based upon state testing standards on the state rubric to guide students in writing, they may be teaching form to limit higher level thinking content (Albertson, 2004). Instructors may not feel confident enough in their teaching of writing for high-stakes' testing; therefore, they may instruct…

Leadership of Civic Learning: A Multiple Case Study of Two Middle Schools

ERIC Educational Resources Information Center

Molnar-Main, Stacie A.

2012-01-01

The nationwide focus on standardized testing, as outlined in the No Child Left Behind Legislation (NCLB, 2003), has prompted many public schools to focus their instruction on preparing students for high-stakes tests in literacy, math and science. While NCLB may be lauded for its intent to ameliorate achievement inequities among subgroups of…

Sporotrichin Skin Test for the Diagnosis of Sporotrichosis.

PubMed

Bonifaz, Alexandro; Toriello, Conchita; Araiza, Javier; Ramírez-Soto, Max C; Tirado-Sánchez, Andrés

2018-05-09

Sporotrichosis is the most common implantation mycosis caused by several species of the Sporothrix schenckii complex. The gold standard for diagnosis is concerned with the isolation of the fungus; although, fresh examinations, staining, and biopsies are also helpful for this purpose. The sporotrichin is an antigenic complex comprised of a peptide-rhamnomannan, which is relevant with respect to pathogenic fungi; it is primarily used for serological and skin testing. We present a study regarding the use of sporotrichin as a diagnostic aid for cutaneous sporotrichosis. Furthermore, 138 cases with suspicion of sporotrichosis were included, 55 of which were proven through cultures. Moreover, out of these 55 cases, 52 (94.5%) tested positive for sporotrichin, while the negative cases corresponded to the disseminated cutaneous forms. We observed a sensitivity of 94.5% and a specificity of 95.2%. We consider that the use of sporotrichin as a skin test helps us as an auxiliary diagnosis before a positive sample culture.

Development of a reliable simulation-based test for diagnostic abdominal ultrasound with a pass/fail standard usable for mastery learning.

PubMed

Østergaard, Mia L; Nielsen, Kristina R; Albrecht-Beste, Elisabeth; Konge, Lars; Nielsen, Michael B

2018-01-01

This study aimed to develop a test with validity evidence for abdominal diagnostic ultrasound with a pass/fail-standard to facilitate mastery learning. The simulator had 150 real-life patient abdominal scans of which 15 cases with 44 findings were selected, representing level 1 from The European Federation of Societies for Ultrasound in Medicine and Biology. Four groups of experience levels were constructed: Novices (medical students), trainees (first-year radiology residents), intermediates (third- to fourth-year radiology residents) and advanced (physicians with ultrasound fellowship). Participants were tested in a standardized setup and scored by two blinded reviewers prior to an item analysis. The item analysis excluded 14 diagnoses. Both internal consistency (Cronbach's alpha 0.96) and inter-rater reliability (0.99) were good and there were statistically significant differences (p < 0.001) between all four groups, except the intermediate and advanced groups (p = 1.0). There was a statistically significant correlation between experience and test scores (Pearson's r = 0.82, p < 0.001). The pass/fail-standard failed all novices (no false positives) and passed all advanced (no false negatives). All intermediate participants and six out of 14 trainees passed. We developed a test for diagnostic abdominal ultrasound with solid validity evidence and a pass/fail-standard without any false-positive or false-negative scores. • Ultrasound training can benefit from competency-based education based on reliable tests. • This simulation-based test can differentiate between competency levels of ultrasound examiners. • This test is suitable for competency-based education, e.g. mastery learning. • We provide a pass/fail standard without false-negative or false-positive scores.

Vigilance in industry: cosmetics and household cleaning products. Balance sheet of case report from 2005 to 2007.

PubMed

Kornfeld-Lecanu, S; Zajaczkowski, F; Dubourg, S; Martin, L; Lefort, S; Siest, S

2010-12-01

Unlike medicinal products, cosmetics are not subject to marketing authorization in France. Nevertheless, the Agence Francaise de Sécurité Sanitaire des Produits de Santé (AFSSAPS; French Agency for the Safety of Healthcare Products) has been working on the development of a cosmetovigilance system for several years, with the aim of establishing standard procedures for collecting adverse reactions to cosmetics from the manufacturers. To assess the incidence of skin reactions to cosmetics or household products. Unilever established its own 'vigilance' standard system in France in late 2003. This report describes the experience acquired from 2005 to 2007. Case reports were collected in compliance with a standard procedure. The cases were then analysed by the consultant dermatologist in accordance with a pharmacovigilance-based method (chronological criteria, clinical criteria, possible rechallenge test, patch tests). During the period 2005 to 2007, a total of 102,689 consumers contacted the consumer department, including 842 (0.82%) who reported skin reactions. After analysis of the collected data, 0.144 skin reaction cases per million units sold were found to be attributable to cosmetic or household products. The implementation of a structured vigilance system in the cosmetics and household products industry is an efficient tool for manufacturers, both for information purposes and for product improvement, as well as meeting the transparency requirements of health authorities and consumers. © 2010 The Author(s). Journal compilation © 2010 British Association of Dermatologists.

Cost-effectiveness of rapid syphilis screening in prenatal HIV testing programs in Haiti.

PubMed

Schackman, Bruce R; Neukermans, Christopher P; Fontain, Sandy N Nerette; Nolte, Claudine; Joseph, Patrice; Pape, Jean W; Fitzgerald, Daniel W

2007-05-01

New rapid syphilis tests permit simple and immediate diagnosis and treatment at a single clinic visit. We compared the cost-effectiveness, projected health outcomes, and annual cost of screening pregnant women using a rapid syphilis test as part of scaled-up prenatal testing to prevent mother-to-child HIV transmission in Haiti. A decision analytic model simulated health outcomes and costs separately for pregnant women in rural and urban areas. We compared syphilis syndromic surveillance (rural standard of care), rapid plasma reagin test with results and treatment at 1-wk follow-up (urban standard of care), and a new rapid test with immediate results and treatment. Test performance data were from a World Health Organization-Special Programme for Research and Training in Tropical Diseases field trial conducted at the GHESKIO Center Groupe Haitien d'Etude du Sarcome de Kaposi et des Infections Opportunistes in Port-au-Prince. Health outcomes were projected using historical data on prenatal syphilis treatment efficacy and included disability-adjusted life years (DALYs) of newborns, congenital syphilis cases, neonatal deaths, and stillbirths. Cost-effectiveness ratios are in US dollars/DALY from a societal perspective; annual costs are in US dollars from a payer perspective. Rapid testing with immediate treatment has a cost-effectiveness ratio of $6.83/DALY in rural settings and $9.95/DALY in urban settings. Results are sensitive to regional syphilis prevalence, rapid test sensitivity, and the return rate for follow-up visits. Integrating rapid syphilis testing into a scaled-up national HIV testing and prenatal care program would prevent 1,125 congenital syphilis cases and 1,223 stillbirths or neonatal deaths annually at a cost of $525,000. In Haiti, integrating a new rapid syphilis test into prenatal care and HIV testing would prevent congenital syphilis cases and stillbirths, and is cost-effective. A similar approach may be beneficial in other resource-poor countries that are scaling up prenatal HIV testing.

Lorenzo P. v. Riles? Should the "Larry P." Prohibitions Be Extended to English Language Learners?: Considering Public Policy & IQ Testing in Schools

ERIC Educational Resources Information Center

Garcia, Ernest

2015-01-01

Other than being African American, little is known of Larry, the lead plaintiff in the legal case known as "Larry P. v. Riles" in 1971, which banned the use of standardized intelligence testing on African-American students in the State of California. As a result of such intelligence testing, Larry was diagnosed as being mildly mentally…

Process Definition and Modeling Guidebook. Version 01.00.02

DTIC Science & Technology

1992-12-01

material (and throughout the guidebook)process defnition is considered to be the act of representing the important characteristics of a process in a...characterized by software standards and guidelines, software inspections and reviews, and more formalized testing (including test plans, test sup- port tools...paper-based approach works well for training, examples, and possibly even small pilot projects and case studies. However, large projects will benefit from

Validation of asthma recording in electronic health records: a systematic review

PubMed Central

Nissen, Francis; Quint, Jennifer K; Wilkinson, Samantha; Mullerova, Hana; Smeeth, Liam; Douglas, Ian J

2017-01-01

Objective To describe the methods used to validate asthma diagnoses in electronic health records and summarize the results of the validation studies. Background Electronic health records are increasingly being used for research on asthma to inform health services and health policy. Validation of the recording of asthma diagnoses in electronic health records is essential to use these databases for credible epidemiological asthma research. Methods We searched EMBASE and MEDLINE databases for studies that validated asthma diagnoses detected in electronic health records up to October 2016. Two reviewers independently assessed the full text against the predetermined inclusion criteria. Key data including author, year, data source, case definitions, reference standard, and validation statistics (including sensitivity, specificity, positive predictive value [PPV], and negative predictive value [NPV]) were summarized in two tables. Results Thirteen studies met the inclusion criteria. Most studies demonstrated a high validity using at least one case definition (PPV >80%). Ten studies used a manual validation as the reference standard; each had at least one case definition with a PPV of at least 63%, up to 100%. We also found two studies using a second independent database to validate asthma diagnoses. The PPVs of the best performing case definitions ranged from 46% to 58%. We found one study which used a questionnaire as the reference standard to validate a database case definition; the PPV of the case definition algorithm in this study was 89%. Conclusion Attaining high PPVs (>80%) is possible using each of the discussed validation methods. Identifying asthma cases in electronic health records is possible with high sensitivity, specificity or PPV, by combining multiple data sources, or by focusing on specific test measures. Studies testing a range of case definitions show wide variation in the validity of each definition, suggesting this may be important for obtaining asthma definitions with optimal validity. PMID:29238227

Diagnostic Value of Leukocyte Esterase Test Strip Reagents for Rapid Clinical Diagnosis of Spontaneous Bacterial Peritonitis in Patients Admitted to Hospital Emergency Departments in Iran.

PubMed

Hashemian, Amir Masoud; Ahmadi, Koorosh; Zamani Moghaddam, Hamid; Zakeri, Hosein; Davoodi Navakh, Seyed Akbar; Sharifi, Mohammad Davood; Bahrami, Abdollah

2015-10-01

Spontaneous bacterial peritonitis (SBP) is a common and important clinical problem and is life-threatening in decompensated liver disease. Ascites fluid test by leukocyte esterase test strip has been recently proposed as an effective and rapid method to diagnose SBP in patients with cirrhosis. This study aimed to evaluate sensitivity and specificity of leukocyte esterase test strip in the diagnosis of SBP. The population of this research was all patients with cirrhosis and ascites admitted to the emergency room at Imam Reza (AS) hospital, Mashhad. A written consent was taken for inclusion in the study. 50 mL ascites sample was taken from all patients for use in a urine test strip (LER) (Urine Test Strips Convergys®Urine Matrix 11). The patient's ascites samples were evaluated for cell counting. Positive dipstick test for LER in this study considered as grade 3 +. The values of WBC > 500 cell/mm(3) or PMN > 250 cell/mm(3) considered as positive result of the gold standard method for the diagnosis of SBP. In this study, 100 patients with ascites due to cirrhosis, with an average age of 38.9 ± 6.54 years were evaluated. Twenty cases had positive results, of whom 17 cases were also detected based on the standard diagnostic criteria and other three cases were healthy individuals. Thus, sensitivity, specificity, positive and negative predictive values, and accuracy of the method were 95%, 96.3%, 85%, 97.5% and 95%, respectively. The use of leukocyte esterase urine dipstick test can be a quick and easy method in early diagnosis of SBP to start the treatment until preparation of SBP-cell count results.

Mold Testing or Sampling

EPA Pesticide Factsheets

In most cases, if visible mold growth is present, sampling is unnecessary. Since no EPA or other federal limits have been set for mold or mold spores, sampling cannot be used to check a building's compliance with federal mold standards.

Effects of imperfect test sensitivity and specificity on observational studies of influenza vaccine effectiveness.

PubMed

Jackson, Michael L; Rothman, Kenneth J

2015-03-10

The recently developed test-negative design is now standard for observational studies of influenza vaccine effectiveness (VE). It is unclear how influenza test misclassification biases test-negative VE estimates relative to VE estimates from traditional cohort or case-control studies. We simulated populations whose members may develop acute respiratory illness (ARI) due to influenza and to non-influenza pathogens. In these simulations, vaccination reduces the risk of influenza but not of non-influenza ARI. Influenza test sensitivity and specificity, risks of influenza and non-influenza ARI, and VE were varied across the simulations. In each simulation, we estimated influenza VE using a cohort design, a case-control design, and a test-negative design. In the absence of influenza test misclassification, all three designs accurately estimated influenza VE. In the presence of misclassification, all three designs underestimated VE. Bias in VE estimates was slightly greater in the test-negative design than in cohort or case-control designs. Assuming the use of highly sensitive and specific reverse-transcriptase polymerase chain reaction tests for influenza, bias in the test-negative studies was trivial across a wide range of realistic values for VE. Although influenza test misclassification causes more bias in test-negative studies than in traditional cohort or case-control studies, the difference is trivial for realistic combinations of attack rates, test sensitivity/specificity, and VE. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

PubMed

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

2018-05-25

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

Full-Field Strain Methods for Investigating Failure Mechanisms in Triaxial Braided Composites

NASA Technical Reports Server (NTRS)

Littell, Justin D.; Binienda, Wieslaw K.; Goldberg, Robert K.; Roberts, Gary D.

2008-01-01

Recent advancements in braiding technology have led to commercially viable manufacturing approaches for making large structures with complex shape out of triaxial braided composite materials. In some cases, the static load capability of structures made using these materials has been higher than expected based on material strength properties measured using standard coupon tests. A more detailed investigation of deformation and failure processes in large-unit-cell-size triaxial braid composites is needed to evaluate the applicability of standard test methods for these materials and to develop alternative testing approaches. This report presents some new techniques that have been developed to investigate local deformation and failure using digital image correlation techniques. The methods were used to measure both local and global strains during standard straight-sided coupon tensile tests on composite materials made with 12- and 24-k yarns and a 0 /+60 /-60 triaxial braid architecture. Local deformation and failure within fiber bundles was observed and correlations were made between these local failures and global composite deformation and strength.

The use of standard operating procedures in day case anterior cruciate ligament reconstruction.

PubMed

Khan, T; Jackson, W F; Beard, D J; Marfin, A; Ahmad, M; Spacie, R; Jones, R; Howes, S; Barker, K; Price, A J

2012-08-01

The current rate of day-case anterior cruciate ligament reconstruction (ACLR) in the UK remains low. Although specialised care pathways with standard operating procedures (SOPs) have been effective in reducing length of stay following some surgical procedures, this has not been previously reported for ACLR. We evaluate the effectiveness of SOPs for establishing day-case ACLR in a specialist unit. Fifty patients undergoing ACLR between May and September 2010 were studied prospectively ("study group"). SOPs were designed for pre-operative assessment, anaesthesia, surgical procedure, mobilisation and discharge. We evaluated length of stay, readmission rates, patient satisfaction and compliance to SOPs. A retrospective analysis of 50 patients who underwent ACLR prior to implementation of the day-case pathway was performed ("standard practice group"). Eighty percent of patients in the study group were discharged on the day of surgery (mean length of stay=5.3h) compared to 16% in the standard practice group (mean length of stay=21.6h). This difference was statistically significant (p<0.05, Mann-Whitney U test). All patients were satisfied with the day case pathway. Ninety-two percent of the study group were discharged on the day of surgery when all SOPs were followed and 46% where they were not. High rates of day-case ACLR with excellent patient satisfaction can be achieved with the use of a specialised patient pathway with SOPs. Copyright © 2011 Elsevier B.V. All rights reserved.

Validation of a standardized extraction method for formalin-fixed paraffin-embedded tissue samples.

PubMed

Lagheden, Camilla; Eklund, Carina; Kleppe, Sara Nordqvist; Unger, Elizabeth R; Dillner, Joakim; Sundström, Karin

2016-07-01

Formalin-fixed paraffin-embedded (FFPE) samples can be DNA-extracted and used for human papillomavirus (HPV) genotyping. The xylene-based gold standard for extracting FFPE samples is laborious, suboptimal and involves health hazards for the personnel involved. To compare extraction with the standard xylene method to a xylene-free method used in an HPV LabNet Global Reference Laboratory at the Centers for Disease Control (CDC); based on a commercial method with an extra heating step. Fifty FFPE samples were randomly selected from a national audit of all cervical cancer cases diagnosed in Sweden during 10 years. For each case-block, a blank-block was sectioned, as a control for contamination. For xylene extraction, the standard WHO Laboratory Manual protocol was used. For the CDC method, the manufacturers' protocol was followed except for an extra heating step, 120°C for 20min. Samples were extracted and tested in parallel with β-globin real-time PCR, HPV16 real-time PCR and HPV typing using modified general primers (MGP)-PCR and Luminex assays. For a valid result the blank-block had to be betaglobin-negative in all tests and the case-block positive for beta-globin. Overall, detection was improved with the heating method and the amount of HPV-positive samples increased from 70% to 86% (p=0.039). For all samples where HPV type concordance could be evaluated, there was 100% type concordance. A xylene-free and robust extraction method for HPV-DNA typing in FFPE material is currently in great demand. Our proposed standardized protocol appears to be generally useful. Copyright © 2016. Published by Elsevier B.V.

Isolating DNA from sexual assault cases: a comparison of standard methods with a nuclease-based approach

PubMed Central

2012-01-01

Background Profiling sperm DNA present on vaginal swabs taken from rape victims often contributes to identifying and incarcerating rapists. Large amounts of the victim’s epithelial cells contaminate the sperm present on swabs, however, and complicate this process. The standard method for obtaining relatively pure sperm DNA from a vaginal swab is to digest the epithelial cells with Proteinase K in order to solubilize the victim’s DNA, and to then physically separate the soluble DNA from the intact sperm by pelleting the sperm, removing the victim’s fraction, and repeatedly washing the sperm pellet. An alternative approach that does not require washing steps is to digest with Proteinase K, pellet the sperm, remove the victim’s fraction, and then digest the residual victim’s DNA with a nuclease. Methods The nuclease approach has been commercialized in a product, the Erase Sperm Isolation Kit (PTC Labs, Columbia, MO, USA), and five crime laboratories have tested it on semen-spiked female buccal swabs in a direct comparison with their standard methods. Comparisons have also been performed on timed post-coital vaginal swabs and evidence collected from sexual assault cases. Results For the semen-spiked buccal swabs, Erase outperformed the standard methods in all five laboratories and in most cases was able to provide a clean male profile from buccal swabs spiked with only 1,500 sperm. The vaginal swabs taken after consensual sex and the evidence collected from rape victims showed a similar pattern of Erase providing superior profiles. Conclusions In all samples tested, STR profiles of the male DNA fractions obtained with Erase were as good as or better than those obtained using the standard methods. PMID:23211019

Impact resistance and prescription compliance with AS/NZS 1337.6:2010.

PubMed

Dain, Stephen J; Ngo, Thao P T; Cheng, Brian B

2013-09-01

Australian/New Zealand Standard 1337.6 deals with prescription eye protection and has been in place since 2007. There have been many standards marking licences granted since then. The issue of the worst-case situations for assessment in a certification scheme, in particular -1.50 m(-1) lenses, has been the subject of discussion in Standards Australia/Standards New Zealand Committee SF-006. Given that a body of data from testing exists, this was explored to advise the Committee. Data from testing 40 sets of prescription eye protectors were analysed retrospectively for compliance with the impact and refractive power requirements in 2010-11. The testing had been carried out according to the methods of AS/NZS 1337.6:2007 under the terms and conditions of the accreditation of the Optics & Radiometry Laboratory by the National Association of Testing Authorities. No eye protector failed the low-impact resistance test. Failure rates of 1.6 per cent (two of the 40 sets) to the medium impact test and 1.6 per cent (three of the sets) to the medium impact test in the elevated temperature stability test were seen. These are too small for useful statistical analysis. Only -1.50 m(-1) lenses were in all failing sets and these lenses were over-represented in the failures and borderlines, especially compared with the +1.50 D lenses. Failures in prismatic power were equally distributed over all prescriptions. This over-representation of -1.50 m(-1) lenses was not related to the ocular/lens material or to the company manufacturing the eye protectors. The proposal is made that glazing lenses tightly to ensure they are retained in the frame on impact may result in unwanted refractive power in those lenses most prone to flex. These data support the proposal that -1.50 m(-1) lenses should form part of a worst-case testing regime in a certification scheme. © 2012 The Authors. Clinical and Experimental Optometry © 2012 Optometrists Association Australia.

Report on JANNAF panel on shotgun/relative quickness testing

NASA Technical Reports Server (NTRS)

Gould, R. A.

1980-01-01

As the need for more energetic solid propellants continues, a number of problems arises. One of these is the tendency of high energy propellants to transition from burning (deflagration) to detonation in regions where the propellant is present in small particle sizes; e.g., in case bonding areas of a motor after a rapid depressurization causes a shear zone at the bond interface as the stressed propellant and motor case relax at different rates. In an effort to determine the susceptibility of propellants to high strain rate break up (friability), and subsequent DDT, the propulsion community uses the shotgun/relative quickness test as one of a number of screening tests for new propellant formulations. Efforts to standardize test techniques and equipment are described.

Applying a Genetic Algorithm to Reconfigurable Hardware

NASA Technical Reports Server (NTRS)

Wells, B. Earl; Weir, John; Trevino, Luis; Patrick, Clint; Steincamp, Jim

2004-01-01

This paper investigates the feasibility of applying genetic algorithms to solve optimization problems that are implemented entirely in reconfgurable hardware. The paper highlights the pe$ormance/design space trade-offs that must be understood to effectively implement a standard genetic algorithm within a modem Field Programmable Gate Array, FPGA, reconfgurable hardware environment and presents a case-study where this stochastic search technique is applied to standard test-case problems taken from the technical literature. In this research, the targeted FPGA-based platform and high-level design environment was the Starbridge Hypercomputing platform, which incorporates multiple Xilinx Virtex II FPGAs, and the Viva TM graphical hardware description language.

Most Probable Fire Scenarios in Spacecraft and Extraterrestrial Habitats: Why NASA's Current Test 1 Might Not Always be Conservative

NASA Technical Reports Server (NTRS)

Olson, S. L.

2004-01-01

NASA's current method of material screening determines fire resistance under conditions representing a worst-case for normal gravity flammability - the Upward Flame Propagation Test (Test 1). Its simple pass-fail criteria eliminates materials that burn for more than 12 inches from a standardized ignition source. In addition, if a material drips burning pieces that ignite a flammable fabric below, it fails. The applicability of Test 1 to fires in microgravity and extraterrestrial environments, however, is uncertain because the relationship between this buoyancy-dominated test and actual extraterrestrial fire hazards is not understood. There is compelling evidence that the Test 1 may not be the worst case for spacecraft fires, and we don t have enough information to assess if it is adequate at Lunar or Martian gravity levels.

Most Probable Fire Scenarios in Spacecraft and Extraterrestrial Habitats: Why NASA's Current Test 1 Might Not Always Be Conservative

NASA Technical Reports Server (NTRS)

Olson, S. L.

2004-01-01

NASA s current method of material screening determines fire resistance under conditions representing a worst-case for normal gravity flammability - the Upward Flame Propagation Test (Test 1[1]). Its simple pass-fail criteria eliminates materials that burn for more than 12 inches from a standardized ignition source. In addition, if a material drips burning pieces that ignite a flammable fabric below, it fails. The applicability of Test 1 to fires in microgravity and extraterrestrial environments, however, is uncertain because the relationship between this buoyancy-dominated test and actual extraterrestrial fire hazards is not understood. There is compelling evidence that the Test 1 may not be the worst case for spacecraft fires, and we don t have enough information to assess if it is adequate at Lunar or Martian gravity levels.

Comparative study of dot enzyme immunoassay (Typhidot-M) and Widal test in the diagnosis of typhoid fever.

PubMed

Narayanappa, D; Sripathi, Rachana; Jagdishkumar, K; Rajani, H S

2010-04-01

We compared the sensitivity and specificity of Typhidot-M and Widal test with blood culture (gold standard) for diagnosing typhoid fever in 105 children aged 1-15 years admitted with clinical suspicion of typhoid fever. Of the 105 cases, blood culture was positive for S.typhi in 41 (39%) children, Widal test was positive in 48 (45.7%) and Typhidot-M was positive in 78 (74.3%) cases. Sensitivity and specificity of Typhidot-M was 92.6% and 37.5% while sensitivity and specificity of Widal test was 34.1% and 42.8%, respectively. In children with fever of less than 7 days duration, Typhidot-M was positive in 97%, compared to 24.2% by Widal test. Typhidot-M is a simple and sensitive test for early diagnosis of typhoid fever in children.

Prediction of forced expiratory volume in pulmonary function test using radial basis neural networks and k-means clustering.

PubMed

Manoharan, Sujatha C; Ramakrishnan, Swaminathan

2009-10-01

In this work, prediction of forced expiratory volume in pulmonary function test, carried out using spirometry and neural networks is presented. The pulmonary function data were recorded from volunteers using commercial available flow volume spirometer in standard acquisition protocol. The Radial Basis Function neural networks were used to predict forced expiratory volume in 1 s (FEV1) from the recorded flow volume curves. The optimal centres of the hidden layer of radial basis function were determined by k-means clustering algorithm. The performance of the neural network model was evaluated by computing their prediction error statistics of average value, standard deviation, root mean square and their correlation with the true data for normal, restrictive and obstructive cases. Results show that the adopted neural networks are capable of predicting FEV1 in both normal and abnormal cases. Prediction accuracy was more in obstructive abnormality when compared to restrictive cases. It appears that this method of assessment is useful in diagnosing the pulmonary abnormalities with incomplete data and data with poor recording.

Green and sustainable remediation (GSR) evaluation: framework, standards, and tool. A case study in Taiwan.

PubMed

Huang, Wen-Yen; Hung, Weiteng; Vu, Chi Thanh; Chen, Wei-Ting; Lai, Jhih-Wei; Lin, Chitsan

2016-11-01

Taiwan has a large number of poorly managed contaminated sites in need of remediation. This study proposes a framework, a set of standards, and a spreadsheet-based evaluation tool for implementing green and sustainable principles into remediation projects and evaluating the projects from this perspective. We performed a case study to understand how the framework would be applied. For the case study, we used a spreadsheet-based evaluation tool (SEFA) and performed field scale cultivation tests on a site contaminated with total petroleum hydrocarbons (TPHs). The site was divided into two lots: one treated by chemical oxidation and the other by bioremediation. We evaluated five core elements of green and sustainable remediation (GSR): energy, air, water resources, materials and wastes, and land and ecosystem. The proposed evaluation tool and field scale cultivation test were found to efficiently assess the effectiveness of the two remediation alternatives. The framework and related tools proposed herein can potentially be used to support decisions about the remediation of contaminated sites taking into account engineering management, cost effectiveness, and social reconciliation.

Bronchoalveolar lavage, serum angiotensin-converting enzyme, and /sup 67/Ga scanning in extrathoracic sarcoidosis

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

Wallaert, B.; Ramon, P.; Fournier, E.

1982-11-01

Results of bronchoalveolar lavage (BAL), 67Ga scanning, and serum angiotensin-converting enzyme (SACE) assay are compared in the assessment of pulmonary involvement in ten cases of extrathoracic sarcoidosis. Standard clinical, radiologic, and pulmonary function tests detected no pulmonary changes in these patients, but BAL demonstrated an increased alveolar lymphocytosis in eight of ten cases. SACE levels were increased in two cases, and the thoracic gallium uptake was normal in all cases. BAL appears to be the best technique for diagnosing latent pulmonary involvement in extrathoracic sarcoidosis.

Effect of information literacy training course on information literacy skills of undergraduate students of Isfahan University of Medical Sciences based on ACRL standards.

PubMed

Karimi, Zohreh; Ashrafi-Rizi, Hasan; Papi, Ahmad; Shahrzadi, Leila; Hassanzadeh, Akbar

2015-01-01

Information literacy is the basis for lifelong learning. Information literacy skills, especially for student in an environment that is full of information from multiple technologies are being developed is equally important. Information literacy is a set of cognitive and practical skills and like any other science, proper training is needed, and standard-based education is definitely better and evaluation would be easier. This study aimed to determine the impact of information literacy training course on information literacy skills of Isfahan University of Medical Sciences students based on ACRL standard in 2012. The study method is semi-experience with two group design (with pre-test and post-test) and applied. The data collection toll was a questionnaire assessing student's information literacy that developed by Davarpanah and Siamak and validity was confirmed by professional librarians and reliability as measured by Cronbach's alpha, was 0.83. The sample consisted of 50 undergraduate students from Isfahan University of Medical Sciences that by random sampling method was perch in both case and control groups. Before and after the training (once a week), a questionnaire was distributed between the two groups. This training was held in a classroom equipped with computers with internet access and in addition to training using brochures and librarian presentation, interactive methods such as discussion and exercises were used. The data were analyzed using SPSS version 20 software and two level of descriptive (mean and SD) and inferential statistics (t-test and t-paired). The results showed that the students' information literacy scores before the training was lower than average, so that in the control group was 32.96 and in the case group was 33.24; while information literacy scores in the case group significantly increased after the training (46.68). Also, the effect of education, respectively had a greater impact on the ability to access information (the second standard), ethics and legal use of information (the third standard), effective use of information (the fourth standard), critically evaluate information and its sources (the fifth standard). This study showed that the training was effective on enhancing students' information literacy skills as the greatest impact was on increasing the ability to access information. Due to low mean score information literacy in the context of object recognition, there is a need for more training in this area.

A method for predicting the noise levels of coannular jets with inverted velocity profiles

NASA Technical Reports Server (NTRS)

Russell, J. W.

1979-01-01

A coannular jet was equated with a single stream equivalent jet with the same mass flow, energy, and thrust. The acoustic characteristics of the coannular jet were then related to the acoustic characteristics of the single jet. Forward flight effects were included by incorporating a forward exponent, a Doppler amplification factor, and a Strouhal frequency shift. Model test data, including 48 static cases and 22 wind tunnel cases, were used to evaluate the prediction method. For the static cases and the low forward velocity wind tunnel cases, the spectral mean square pressure correlation coefficients were generally greater than 90 percent, and the spectral sound pressure level standard deviation were generally less than 3 decibels. The correlation coefficient and the standard deviation were not affected by changes in equivalent jet velocity. Limitations of the prediction method are also presented.

Prenatal diagnosis of i(18q) and dup(18q) cases by quantitative fluorescent PCR

PubMed Central

Castro-Volio, Isabel; Ortíz-Morales, Fernando; Valle-Bourrouet, Luisa; Malespín-Bendaña, Wendy

2013-01-01

Particular sonographic fetal malformations are common in chromosome 18 aberrations, requiring invasive prenatal tests to confirm the diagnosis. Karyotyping is the gold standard assay in these cases, although it is a high complexity, expensive and approximately 2 weeks turnaround time test. On the contrary, quantitative fluorescent PCR is considered an accurate, simple, low cost and rapid assay, particularly useful for the diagnosis of aneuploidies of chromosomes 13, 18 and 21 and for the detection of maternal cell contamination of the sample. Clinical presentation of two cases of rare chromosome 18 defects, diagnosed using both techniques. One case was an isochromosome and the other was a partial duplication. Quantitative fluorescent PCR was an invaluable tool for the cytogenetics laboratory PMID:24045756

Establishment of Religion in Primary and Secondary Schools.

ERIC Educational Resources Information Center

Underwood, Julie K.

1989-01-01

A modified analysis of the "Lemon" test as set forth in Supreme Court opinions is explained, and relevant lower court cases are reviewed. Determines that the modified standard is heightened and consistently applied within K-12 education activities. (MLF)

30 CFR 254.26 - What information must I include in the “Worst case discharge scenario” appendix?

Code of Federal Regulations, 2011 CFR

2011-07-01

... limits of current technology, for the range of environmental conditions anticipated at your facility; and... Society for Testing of Materials (ASTM) publication F625-94, Standard Practice for Describing...

Importance of the autocontrol crossmatch in human renal transplantation.

PubMed

Cross, D E; Greiner, R; Whittier, F C

1976-04-01

The killing of donor cells in the standard lymphocyte crossmatch is considered strong evidence for preformed antibodies in the recipients's serum. Moreover, it is generally accepted that presensitization has occurred if any of the stored sera kill the donor cells. In our hands, if either the current or the stored sera kill the donor cells, it precludes transplantation. In nine cases we discovered that the recipient's sera also killed the recipient's own lymphocytes, a positive autocontrol test, indicating that factors other than conventional preformed cytotoxic antibodies were responsible for the positive standard crossmatch. The nine patients who demonstrated a positive standard crossmatch and a positive autocontrol for those sera received cadaver allografts. None of the kidneys were rejected hyperacutely and all are functioning adequately. We conclude that the autocontrol crossmatch is an important adjunct for uncovering false positive reactions in the standard lymphocyte crossmatch test.

SAT Wars: The Case for Test-Optional College Admissions

ERIC Educational Resources Information Center

Soares, Joseph A., Ed.

2011-01-01

What can a college admissions officer safely predict about the future of a 17-year-old? Are the best and the brightest students the ones who can check off the most correct boxes on a multiple-choice exam? Or are there better ways of measuring ability and promise? In this penetrating and revealing look at high-stakes standardized admissions tests,…

The Story of an Arts Integration School on English-Language-Learner Development: A Qualitative Study of Collaboration, Integrity, and Confidence

ERIC Educational Resources Information Center

Ingraham, Nissa; Nuttall, Susanne

2016-01-01

This qualitative case study of a southwest regional elementary school used interviews, focus groups, and document collection to better understand how this arts-integrated school is meeting the needs of English-language learner (ELL) students, discerning increased test performance on state standardized tests. Data were analyzed using open coding.…

Case report: acquisition of three spoken languages by a child with a cochlear implant.

PubMed

Francis, Alexander L; Ho, Diana Wai Lam

2003-03-01

There have been only two reports of multilingual cochlear implant users to date, and both of these were postlingually deafened adults. Here we report the case of a 6-year-old early-deafened child who is acquiring Cantonese, English and Mandarin in Hong Kong. He and two age-matched peers with similar educational backgrounds were tested using common, standardized tests of vocabulary and expressive and receptive language skills (Peabody Picture Vocabulary Test (Revised) and Reynell Developmental Language Scales version II). Results show that this child is acquiring Cantonese, English and Mandarin to a degree comparable to two classmates with normal hearing and similar educational and social backgrounds.

Familial Mediterranean fever associated pyrin mutations in Greece

PubMed Central

Konstantopoulos, K; Kanta, A; Deltas, C; Atamian, V; Mavrogianni, D; Tzioufas, A; Kollainis, I; Ritis, K; Moutsopoulos, H

2003-01-01

Patients and methods: 62 patients fulfilling the Tel Hashomer diagnostic criteria for definite (33) or probable (29) FMF diagnosis were studied. Eight point mutations of pyrin gene were tested by standard methods. Of the 62 patients tested, 48 were Greek, four were Jewish, seven were Armenian, and three were Arab. Results: 42 patients were found to be homozygotes for pyrin mutations; 11 patients were found to carry only one of the tested mutations; in nine patients no mutations were detected. Conclusion: Molecular detection of pyrin gene mutations seems useful in confirming suspected cases, and in detecting asymptomatic cases, of Mediterranean fever in Greece. It may also be used as a screening tool within affected families. PMID:12695165

Electronic Information Standards to Support Obesity Prevention and Bridge Services Across Systems, 2010-2015.

PubMed

Wiltz, Jennifer L; Blanck, Heidi M; Lee, Brian; Kocot, S Lawrence; Seeff, Laura; McGuire, Lisa C; Collins, Janet

2017-10-26

Electronic information technology standards facilitate high-quality, uniform collection of data for improved delivery and measurement of health care services. Electronic information standards also aid information exchange between secure systems that link health care and public health for better coordination of patient care and better-informed population health improvement activities. We developed international data standards for healthy weight that provide common definitions for electronic information technology. The standards capture healthy weight data on the "ABCDs" of a visit to a health care provider that addresses initial obesity prevention and care: assessment, behaviors, continuity, identify resources, and set goals. The process of creating healthy weight standards consisted of identifying needs and priorities, developing and harmonizing standards, testing the exchange of data messages, and demonstrating use-cases. Healthy weight products include 2 message standards, 5 use-cases, 31 LOINC (Logical Observation Identifiers Names and Codes) question codes, 7 healthy weight value sets, 15 public-private engagements with health information technology implementers, and 2 technical guides. A logic model and action steps outline activities toward better data capture, interoperable systems, and information use. Sharing experiences and leveraging this work in the context of broader priorities can inform the development of electronic information standards for similar core conditions and guide strategic activities in electronic systems.

Electronic Information Standards to Support Obesity Prevention and Bridge Services Across Systems, 2010–2015

PubMed Central

Blanck, Heidi M.; Lee, Brian; Kocot, S. Lawrence; Seeff, Laura; McGuire, Lisa C.; Collins, Janet

2017-01-01

Electronic information technology standards facilitate high-quality, uniform collection of data for improved delivery and measurement of health care services. Electronic information standards also aid information exchange between secure systems that link health care and public health for better coordination of patient care and better-informed population health improvement activities. We developed international data standards for healthy weight that provide common definitions for electronic information technology. The standards capture healthy weight data on the “ABCDs” of a visit to a health care provider that addresses initial obesity prevention and care: assessment, behaviors, continuity, identify resources, and set goals. The process of creating healthy weight standards consisted of identifying needs and priorities, developing and harmonizing standards, testing the exchange of data messages, and demonstrating use-cases. Healthy weight products include 2 message standards, 5 use-cases, 31 LOINC (Logical Observation Identifiers Names and Codes) question codes, 7 healthy weight value sets, 15 public–private engagements with health information technology implementers, and 2 technical guides. A logic model and action steps outline activities toward better data capture, interoperable systems, and information use. Sharing experiences and leveraging this work in the context of broader priorities can inform the development of electronic information standards for similar core conditions and guide strategic activities in electronic systems. PMID:29072985

The significance of nanomaterial post-exposure responses in Daphnia magna standard acute immobilisation assay: Example with testing TiO2 nanoparticles.

PubMed

Novak, Sara; Jemec Kokalj, Anita; Hočevar, Matej; Godec, Matjaž; Drobne, Damjana

2018-05-15

One of the most widely used aquatic standarized tests for the toxicity screening of chemicals is the acute toxicity test with the freshwater crustacean Daphnia magna, which has also been applied in the toxicity screening of manufactured nanoparticles (NPs). However, in the case of non-soluble NPs most of the results of this test have showed no effect. The aim of the work presented here was to modify the standardized test by the least possible extent to make it more sensitive for non-soluble particles. The standard acute immobilisation assay with daphnids was modified by prolonging the exposure period and by measuring additional endpoints. Daphnids were exposed to TiO 2 NPs in a standard acute test (48h of exposure), a standard acute test (48h of exposure) followed by 24h recovery period in clean medium or a prolonged exposure in the NPs solutions totaling 72h. Together with immobility, the adsorption of NPs to body surfaces was also observed as an alternative measure of the NPs effects. Our results showed almost no effect of TiO 2 NPs on D. magna after the 48h standard acute test, while immobility was increased when the exposure period to TiO 2 NPs was prolonged from 48h to 72h. Even when daphnids were transferred to clean medium for additional 24h after 48h of exposure to TiO 2 NPs the immobility increased. We conclude that by transferring the daphnids to clean medium at the end of the 48h exposure to TiO 2 NPs, the delayed effects of the tested material can be seen. This methodological step could improve the sensitivity of D. magna test as a model in nanomaterial environmental risk assessment. Copyright © 2018 Elsevier Inc. All rights reserved.

An HIV testing conundrum: balancing the health and privacy considerations of multiple stakeholders.

PubMed

Russell, James A; Nelson, Sarah Bird

2012-12-01

Legal standards for HIV testing are evolving in an attempt to achieve an ethical equilibrium between the privacy rights of infected or potentially infected individuals and public health considerations that seek to limit the spread and severity of the disease through early recognition and treatment. Although guided by US Centers for Disease Control and Prevention recommendations, these standards are determined by state law. In this case, an ethical dilemma is presented and discussed in which the privacy interests of an HIV-infected individual come into conflict with the health considerations of an inadvertently exposed neurology resident and her unborn child, a conundrum amplified by the restricted HIV testing laws of the state in which the incident took place.

Testing the statistical compatibility of independent data sets

NASA Astrophysics Data System (ADS)

Maltoni, M.; Schwetz, T.

2003-08-01

We discuss a goodness-of-fit method which tests the compatibility between statistically independent data sets. The method gives sensible results even in cases where the χ2 minima of the individual data sets are very low or when several parameters are fitted to a large number of data points. In particular, it avoids the problem that a possible disagreement between data sets becomes diluted by data points which are insensitive to the crucial parameters. A formal derivation of the probability distribution function for the proposed test statistics is given, based on standard theorems of statistics. The application of the method is illustrated on data from neutrino oscillation experiments, and its complementarity to the standard goodness-of-fit is discussed.

Diagnostic efficacy of microscopy, rapid diagnostic test and polymerase chain reaction for malaria using bayesian latent class analysis.

PubMed

Saha, Sreemanti; Narang, Rahul; Deshmukh, Pradeep; Pote, Kiran; Anvikar, Anup; Narang, Pratibha

2017-01-01

The diagnostic techniques for malaria are undergoing a change depending on the availability of newer diagnostics and annual parasite index of infection in a particular area. At the country level, guidelines are available for selection of diagnostic tests; however, at the local level, this decision is made based on malaria situation in the area. The tests are evaluated against the gold standard, and if that standard has limitations, it becomes difficult to compare other available tests. Bayesian latent class analysis computes its internal standard rather than using the conventional gold standard and helps comparison of various tests including the conventional gold standard. In a cross-sectional study conducted in a tertiary care hospital setting, we have evaluated smear microscopy, rapid diagnostic test (RDT), and polymerase chain reaction (PCR) for diagnosis of malaria using Bayesian latent class analysis. We found the magnitude of malaria to be 17.7% (95% confidence interval: 12.5%-23.9%) among the study subjects. In the present study, the sensitivity of microscopy was 63%, but it had very high specificity (99.4%). Sensitivity and specificity of RDT and PCR were high with RDT having a marginally higher sensitivity (94% vs. 90%) and specificity (99% vs. 95%). On comparison of likelihood ratios (LRs), RDT had the highest LR for positive test result (175) and the lowest LR for negative test result (0.058) among the three tests. In settings like ours conventional smear microscopy may be replaced with RDT and as we move toward elimination and facilities become available PCR may be roped into detect cases with lower parasitaemia.

Experimental Evaluation of Grid Support Enabled PV Inverter Response to Abnormal Grid Conditions: Preprint

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

Nelson, Austin; Martin, Gregory; Hurtt, James

As revised interconnection standards for grid-tied photovoltaic (PV) inverters address new advanced grid support functions (GSFs), there is increasing interest in inverter performance in the case of abnormal grid conditions. The growth of GSF-enabled inverters has outpaced the industry standards that define their operation, although recently published updates to UL1741 with Supplement SA define test conditions for GSFs such as volt-var control, frequency-watt control, and volt-age/frequency ride-through, among others. A comparative experimental evaluation has been completed on four commercially available, three-phase PV inverters in the 24.0-39.8 kVA power range on their GSF capability and the effect on abnormal grid conditionmore » response. This study examines the impact particular GSF implementations have on run-on times during islanding conditions, peak voltages in load rejection overvoltage scenarios, and peak currents during single-phase and three-phase fault events for individual inverters. This report reviews comparative test data, which shows that GSFs have little impact on the metrics of interest in most tests cases.« less

Experimental Evaluation of Grid Support Enabled PV Inverter Response to Abnormal Grid Conditions

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

Nelson, Austin A; Martin, Gregory D; Hurtt, James

As revised interconnection standards for grid-tied photovoltaic (PV) inverters address new advanced grid support functions (GSFs), there is increasing interest in inverter performance in the case of abnormal grid conditions. The growth of GSF-enabled inverters has outpaced the industry standards that define their operation, although recently published updates to UL1741 Supplement SA define test conditions for GSFs such as volt-var control, frequency-watt control, and voltage/frequency ride-through, among others. This paper describes the results of a comparative experimental evaluation on four commercially available, three-phase PV inverters in the 24.0-39.8 kVA power range on their GSF capability and its effect on abnormalmore » grid condition response. The evaluation examined the impact particular GSF implementations have on run-on times during islanding conditions, peak voltages in load rejection overvoltage scenarios, and peak currents during single-phase and three-phase fault events for individual inverters. Testing results indicated a wide variance in the performance of GSF enabled inverters to various test cases.« less

Standard Methods for Bolt-Bearing Testing of Textile Composites

NASA Technical Reports Server (NTRS)

Portanova, M. A.; Masters, J. E.

1995-01-01

The response of three 2-D braided materials to bolt bearing loading was evaluated using data generated by Boeing Defense and Space Group in Philadelphia, PA. Three test methods, stabilized single shear, unstabilized single shear, and double shear, were compared. In general, these textile composites were found to be sensitive to bolt bearing test methods. The stabilized single shear method yielded higher strengths than the unstabilized single shear method in all cases. The double shear test method always produced the highest strengths but these results may be somewhat misleading. It is therefore recommended that standard material comparisons be made using the stabilized single shear test method. The effects of two geometric parameters, W/D and e/D, were also studied. An evaluation of the effect of the specimen width (W) to hole diameter (D) ratio concluded that bolt bearing responses were consistent with open hole tension results. A W/D ratio of 6 or greater should be maintained. The proximity of the hole to the specimen edge significantly affected strength. In all cases, strength was improved by increasing the ratio of the distance from the hole center to the specimen edge (e) to the hole diameter (D) above 2. An e/D ratio of 3 or greater is recommended.

Proposal for a screening test to evaluate the fate of organic micropollutants in activated sludge.

PubMed

Salvetti, Roberta; Vismara, Renato; Dal Ben, Ilaria; Gorla, Elena; Romele, Laura

2011-04-01

The concentrations of organic micropollutants are usually low in wastewaters (order of magnitude of mg L(-1)). However, their emission standards, especially in the case of carcinogenic and bioaccumulating substances, are often much lower (order of magnitude of microg L(-1)). Since these substances, in some cases, can be adsorbable or volatile, their removal via volatilization, biodegradation or sludge adsorption in a wastewater treatment plant (WWTP) becomes a significant feature to include in the usual design process, in order to verify the emission standards in gas and sludge too. In this study a simple screening batch test for the evaluation of the fate of organic micropollutants in water, air and sludge is presented. The test is set up by means of simple laboratory instruments and simulates an activated sludge tank process. In this study the results obtained for four substances with different chemical properties (i.e. toluene, benz(a)anthracene, phenol and benzene) are presented. The screening test proposed can be a useful tool to assess in about one month the fate of organic micropollutants in an activated sludge tank of a WWTP. Moreover, the test can constitute a useful support in the use of mathematical models, since it allows the verification of model results and the calibration of the reactions involved in the removal process.

Environmental contact factors in eczema and the results of patch testing Chinese patients with a modified European standard series of allergens.

PubMed

Li, Lin-Feng; Guo, Jing; Wang, Jing

2004-07-01

Environmental contact factors in eczema were investigated in China by clinical questionnaire and patch testing patients with a modified European standard series of allergens. 217 consecutive eczema patients were studied. Contact dermatitis (CD) was clinically diagnosed in 30% of the patients. Among the patients patch tested, 46 patients had clinically diagnosed allergic CD (ACD), 20 patients clinically had non-ACD (NACD) (including 16 cases of irritant contact dermatitis, 1 case of phototoxic contact reaction and 3 cases of asteatotic eczema) and 115 patients had clinically suspected ACD. 45 patients (98%) in the ACD group went on to have relevant patch test results. The most common ACD was from metals, fragrance materials, cosmetics and rubber materials. The most common contact allergens identified were nickel, fragrance mix, para-phenylenediamine (PPD), carba mix and thimerosal. No adverse reactions were observed to patch testing, except for pruritus in patch-test-positive patients. The positive rate of patch testing in ACD was much higher than that in NACD (98% versus 15%, P < 0.05, chi(2)-test). 60 (28%) patients had facial dermatitis (FD). Among these, 20 (33%) were confirmed as having ACD. 48 (22%) patients had hand dermatitis (HD). Among these, 7 (15%) were confirmed as having ACD. Fewer patients were confirmed as having ACD in the HD group than in the FD (15% versus 33%, P < 0.05, chi(2)-test). Although the difference was not significant, the total positivity rate in the HD group (55%) was lower than in the other groups. 65 (30%) patients had unclassified endogenous eczema (UEE). The total positive rate of patch testing in the UEE group (56%) was no different from that in the FD or HD groups. However, the relevance of positive patch tests was hard to determine in UEE. These results indicate that CD is common in eczema; relatively more patients with FD have ACD, while other factors, such as irritation, may play more of a role in HD. The total positive rate of patch testing in the UEE group was no different from that in the FD or HD groups, suggesting that patch testing should be stressed in UEE and the relevance of positive patch test results in UEE should be studied further. It is effective and safe to patch eczema patients with a modified European standard series of allergens in China.

Early recurrence in standard-risk medulloblastoma patients with the common idic(17)(p11.2) rearrangement

PubMed Central

Bien-Willner, Gabriel A.; López-Terrada, Dolores; Bhattacharjee, Meena B.; Patel, Kayuri U.; Stankiewicz, Paweł; Lupski, James R.; Pfeifer, John D.; Perry, Arie

2012-01-01

Medulloblastoma is diagnosed histologically; treatment depends on staging and age of onset. Whereas clinical factors identify a standard- and a high-risk population, these findings cannot differentiate which standard-risk patients will relapse and die. Outcome is thought to be influenced by tumor subtype and molecular alterations. Poor prognosis has been associated with isochromosome (i)17q in some but not all studies. In most instances, molecular investigations document that i17q is not a true isochromosome but rather an isodicentric chromosome, idic(17)(p11.2), with rearrangement breakpoints mapping within the REPA/REPB region on 17p11.2. This study explores the clinical utility of testing for idic(17)(p11.2) rearrangements using an assay based on fluorescent in situ hybridization (FISH). This test was applied to 58 consecutive standard- and high-risk medulloblastomas with a 5-year minimum of clinical follow-up. The presence of i17q (ie, including cases not involving the common breakpoint), idic(17)(p11.2), and histologic subtype was correlated with clinical outcome. Overall survival (OS) and disease-free survival (DFS) were consistent with literature reports. Fourteen patients (25%) had i17q, with 10 (18%) involving the common isodicentric rearrangement. The presence of i17q was associated with a poor prognosis. OS and DFS were poor in all cases with anaplasia (4), unresectable disease (7), and metastases at presentation (10); however, patients with standard-risk tumors fared better. Of these 44 cases, tumors with idic(17)(p11.2) were associated with significantly worse patient outcomes and shorter mean DFS. FISH detection of idic(17)(p11.2) may be useful for risk stratification in standard-risk patients. The presence of this abnormal chromosome is associated with early recurrence of medulloblastoma. PMID:22573308

Emerging Trends in the Volume and Format of Outside Examinations Submitted for Secondary Interpretation

PubMed Central

Hunt, Christopher H.; Wood, Christopher P.; Diehn, Felix E.; Eckel, Laurence J.; Schwartz, Kara M.; Erickson, Bradley J.

2014-01-01

OBJECTIVE The purpose of this article is to describe the trends of secondary interpretations, including the total volume and format of cases. MATERIALS AND METHODS This retrospective study involved all outside neuroradiology examinations submitted for secondary interpretation from November 2006 through December 2010. This practice utilizes consistent criteria and includes all images that cover the brain, neck, and spine. For each month, the total number of outside examinations and their format (i.e., hard-copy film, DICOM CD-ROM, or non-DICOM CD-ROM) were recorded. RESULTS There was no significant change in the volume of cases (1043 ± 131 cases/month; p = 0.46, two-sided Student t test). There was a significant decrease in the volume of hard-copy films submitted, with the mean number of examinations submitted per month on hard-copy film declining from 297 in 2007 to 57 in 2010 (p < 0.0001, Student t test). This decrease was mirrored by an increase in the mean number of cases submitted on CD-ROM (753 cases/month in 2007 and 1036 cases/month in 2010; p < 0.0001). Although most were submitted in DICOM format, there was almost a doubling of the volume of cases submitted on non-DICOM CD-ROM (mean number of non-DICOM CD-ROMs, nine cases/month in 2007 and 17 cases/month in 2010; p < 0.001). CONCLUSION There has been a significant decrease in the number of hard-copy films submitted for secondary interpretation. There has been almost a doubling of the volume of cases submitted in non-DICOM formats, which is unfortunate, given the many advantages of the internationally derived DICOM standard, including ease of archiving, standardized display, efficient review, improved interpretation, and quality of patient care. PMID:22451538

Emerging trends in the volume and format of outside examinations submitted for secondary interpretation.

PubMed

Hunt, Christopher H; Wood, Christopher P; Diehn, Felix E; Eckel, Laurence J; Schwartz, Kara M; Erickson, Bradley J

2012-04-01

The purpose of this article is to describe the trends of secondary interpretations, including the total volume and format of cases. This retrospective study involved all outside neuroradiology examinations submitted for secondary interpretation from November 2006 through December 2010. This practice utilizes consistent criteria and includes all images that cover the brain, neck, and spine. For each month, the total number of outside examinations and their format (i.e., hard-copy film, DICOM CD-ROM, or non-DICOM CD-ROM) were recorded. There was no significant change in the volume of cases (1043 ± 131 cases/month; p = 0.46, two-sided Student t test). There was a significant decrease in the volume of hard-copy films submitted, with the mean number of examinations submitted per month on hard-copy film declining from 297 in 2007 to 57 in 2010 (p < 0.0001, Student t test). This decrease was mirrored by an increase in the mean number of cases submitted on CD-ROM (753 cases/month in 2007 and 1036 cases/month in 2010; p < 0.0001). Although most were submitted in DICOM format, there was almost a doubling of the volume of cases submitted on non-DICOM CD-ROM (mean number of non-DICOM CD-ROMs, nine cases/month in 2007 and 17 cases/month in 2010; p < 0.001). There has been a significant decrease in the number of hard-copy films submitted for secondary interpretation. There has been almost a doubling of the volume of cases submitted in non-DICOM formats, which is unfortunate, given the many advantages of the internationally derived DICOM standard, including ease of archiving, standardized display, efficient review, improved interpretation, and quality of patient care.

Illinois court seeks new course in AIDS phobia cases.

PubMed

1997-07-25

The Illinois Court of Appeals ruled that plaintiffs cannot be compensated for negligent infliction of emotional distress unless there is a substantial, medically-verifiable possibility of contracting HIV. The new standard will impact a growing body of case law requiring plaintiffs to show that the fear of AIDS was predicated on actual exposure to the virus. Under the actual exposure rule, a plaintiff who injures himself with a hypodermic needle that had been used on an HIV-positive hospital patient could recover damages; another plaintiff whose needle puncture cannot be traced to HIV contamination could not be compensated. In Doe v. Northwestern University, six plaintiffs who received dental care from a university dental student who tested positive for HIV antibodies sued the university, alleging negligence. Although the plaintiff's fears of HIV infection were reasonable, the court found that they were not severe enough to warrant tort compensation since the plaintiffs had nothing to support their claims. In the case of [name removed] v. [Name removed], a medical clinic office manager, cut herself on a bloodstained scalpel left in a trash can by Dr. [name removed]. Eight months following the incident, [name removed] died of AIDS-related causes. Mrs. [Name removed] would have been entitled to recover damages under the actual exposure test; however, the case would not have prevailed under the Northwestern standard because it was known that Mrs. [Name removed] tested negative twice prior to learning of [name removed]'s AIDS diagnosis. Controversy within the Illinois courts about the actual exposure rule continues.

Fuel Economy and Emissions of a Vehicle Equipped with an Aftermarket Flexible-Fuel Conversion Kit

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

Thomas, John F; Huff, Shean P; West, Brian H

2012-04-01

The U.S. Environmental Protection Agency (EPA) grants Certificates of Conformity for alternative fuel conversion systems and also offers other forms of premarket registration of conversion kits for use in vehicles more than two model years old. Use of alternative fuels such as ethanol, natural gas, and propane are encouraged by the Energy Policy Act of 1992. Several original equipment manufacturers (OEMs) produce emissions-certified vehicles capable of using alternative fuels, and several alternative fuel conversion system manufacturers produce EPA-approved conversion systems for a variety of alternative fuels and vehicle types. To date, only one manufacturer (Flex Fuel U.S.) has received EPAmore » certifications for ethanol fuel (E85) conversion kits. This report details an independent evaluation of a vehicle with a legal installation of a Flex Fuel U.S. conversion kit. A 2006 Dodge Charger was baseline tested with ethanol-free certification gasoline (E0) and E20 (gasoline with 20 vol % ethanol), converted to flex-fuel operation via installation of a Flex Box Smart Kit from Flex Fuel U.S., and retested with E0, E20, E50, and E81. Test cycles included the Federal Test Procedure (FTP or city cycle), the highway fuel economy test (HFET), and the US06 test (aggressive driving test). Averaged test results show that the vehicle was emissions compliant on E0 in the OEM condition (before conversion) and compliant on all test fuels after conversion. Average nitrogen oxide (NOx) emissions exceeded the Tier 2/Bin 5 intermediate life NO{sub X} standard with E20 fuel in the OEM condition due to two of three test results exceeding this standard [note that E20 is not a legal fuel for non-flexible-fuel vehicles (non-FFVs)]. In addition, one E0 test result before conversion and one E20 test result after conversion exceeded the NOX standard, although the average result in these two cases was below the standard. Emissions of ethanol and acetaldehyde increased with increasing ethanol, while nonmethane organic gas and CO emissions remained relatively unchanged for all fuels and cycles. Higher fraction ethanol blends appeared to decrease NO{sub X} emissions on the FTP and HFET (after conversion). As expected, fuel economy (miles per gallon) decreased with increasing ethanol content in all cases.« less

Acute and sub-chronic toxicity of four cytostatic drugs in zebrafish.

PubMed

Kovács, Róbert; Bakos, Katalin; Urbányi, Béla; Kövesi, Judit; Gazsi, Gyöngyi; Csepeli, Andrea; Appl, Ádám János; Bencsik, Dóra; Csenki, Zsolt; Horváth, Ákos

2016-08-01

The acute and sub-chronic effects of four cytostatic drugs-5-fluorouracil (5-FU), cisplatin (CisPt), etoposide (ET) and imatinib mesylate (IM)-on zebrafish (Danio rerio) were investigated. Acute tests were carried out in a static system in accordance with the OECD guideline 203 for adult fish and the draft guideline for fish embryos (FET test) in order to find the LC50 values of the four cytostatic drugs. Early-life stage toxicity test on zebrafish was conducted according the OECD guideline 210 using the cytostatic drugs 5-FU and IM in a semistatic system with the objective of investigating the sub-chronic effects of the cytostatic drugs on fish. In adult fish, the cytostatic drugs 5-FU and ET did not pass the limit test, thus, are considered non-toxic. In case of cisplatin, LC50 was calculated at 64.5 mg L(-1), whereas in case of IM, LC50 was at 70.8 mg L(-1). In the FET test, LC50 of 5-FU at 72-h post fertilization (hpf) was 2441.6 mg L(-1). In case of CisPt, LC50 was 349.9 mg L(-1) at 48 hpf and it progressively decreased to 81.3 mg L(-1) at 120 hpf. In addition, CisPt caused a significant delay in the hatch of larvae. In case of ET, LC50 values were not calculable as they were higher than 300 mg L(-1) at which concentration the substance crystallized in the solution. LC50 values of IM were 48 hpf; 158.3 mg L(-1) , 72 hpf; 141.6 mg L(-1), 96 hpf; 118.0 mg L(-1), and 120 hpf; 65.9 mg L(-1). In the Early-life Stage Test with 5-FU, embryonic deformities were not detected during the tests. Regarding mortalities, the 10 mg L(-1) concentration can be considered as LOEC, as statistically significant difference in mortalities was detected in this group alone. Concerning dry body weight and standard length, 1 mg L(-1) is the LOEC. In case of IM, the highest tested concentration (10 mg L(-1)) can be considered LOEC for mortalities, however, the treatment did not have an effect on the other investigated parameters (dry and wet weight, standard length). All four cytostatic drugs were characterized by low toxicity in zebrafish in acute and sub-chronic tests.

When Increasing Stakes Need Not Mean Increasing Standards: The Case of the New York State Global History and Geography Exam

ERIC Educational Resources Information Center

Grant, S. G.; Derme-Insinna, Alison; Gradwell, Jill M.; Pullano, Lynn; Lauricella, Ann Marie; Tzezo, Kathryn

2002-01-01

In New York, state-level policymakers have invested considerable political and economic capital in new tests as both a measure of accountability and as a vehicle for increased educational standards. In this study, we look at how 9th and 10th grade global history teachers are making sense of the first administration of a new 10th grade global…

Aircraft Power-Plant Instruments

NASA Technical Reports Server (NTRS)

Sontag, Harcourt; Brombacher, W G

1934-01-01

This report supersedes NACA-TR-129 which is now obsolete. Aircraft power-plant instruments include tachometers, engine thermometers, pressure gages, fuel-quantity gages, fuel flow meters and indicators, and manifold pressure gages. The report includes a description of the commonly used types and some others, the underlying principle utilized in the design, and some design data. The inherent errors of the instrument, the methods of making laboratory tests, descriptions of the test apparatus, and data in considerable detail in the performance of commonly used instruments are presented. Standard instruments and, in cases where it appears to be of interest, those used as secondary standards are described. A bibliography of important articles is included.

Collagen-chitosan scaffold - Lauric acid plasticizer for skin tissue engineering on burn cases

NASA Astrophysics Data System (ADS)

Widiyanti, Prihartini; Setyadi, Ewing Dian; Rudyardjo, Djony Izak

2017-02-01

The prevalence of burns in the world is more than 800 cases per one million people each year and this is the second highest cause of death due to trauma after traffic accident. Many studies are turning to skin substitute methods of tissue engineering. The purpose of this study is to determine the composition of the collagen, chitosan, and lauric acid scaffold, as well as knowing the results of the characterization of the scaffold. The synthesis of chitosan collagen lauric acid scaffold as a skin tissue was engineered using freeze dried method. Results from making of collagen chitosan lauric acid scaffold was characterized physically, biologically and mechanically by SEM, cytotoxicity, biodegradation, and tensile strength. From the morphology test, the result obtained is that pore diameter size ranges from 94.11 to 140.1 µm for samples A,B,C,D, which are in the range of normal pore size 63-150 µm, while sample E has value below the standard which is about 37.87 to 47.36 µm. From cytotoxicity assay, the result obtained is the percentage value of living cells between 20.11 to 21.51%. This value is below 50% the standard value of living cells. Incompatibility is made possible because of human error mainly the replication of washing process over the standard. Degradation testing obtained values of 19.44% - 40% by weight which are degraded during the 7 days of observation. Tensile test results obtained a range of values of 0.192 - 3.53 MPa. Only sample A (3.53 MPa) and B (1.935 MPa) meet the standard values of skin tissue scaffold that is 1-24 MPa. Based on the results of the characteristics of this study, composite chitosan collagen scaffold with lauric acid plasticizer has a potential candidate for skin tissue engineering for skin burns cases.

Patch tests with fragrance materials and preservatives.

PubMed

de Groot, A C; Liem, D H; Nater, J P; van Ketel, W G

1985-02-01

179 patients suspected of cosmetic allergy were patch tested with a series of 16 fragrance materials and 9 preservatives. In 67 patients (37.4%), 1 or more of these substances gave positive reactions. In the group of fragrance materials, the largest numbers of positive patch test reactions were seen to isoeugenol, oak moss, geraniol, alpha-amylcinnamic alcohol, and a mixture of alpha-amylcinnamic aldehyde and alpha-hexylcinnamic aldehyde. The fragrance mix in the ICDRG standard series detected nearly 80% of cases of contact allergy to fragrance materials other than its constituents. In the group of preservatives, Kathon CG and quaternium-15 scored the highest number of positive reactions. It is argued that the commonly used patch test concentrations of 2% for oak moss and geraniol may be too low to detect all cases of sensitization.

Null but not void: considerations for hypothesis testing.

PubMed

Shaw, Pamela A; Proschan, Michael A

2013-01-30

Standard statistical theory teaches us that once the null and alternative hypotheses have been defined for a parameter, the choice of the statistical test is clear. Standard theory does not teach us how to choose the null or alternative hypothesis appropriate to the scientific question of interest. Neither does it tell us that in some cases, depending on which alternatives are realistic, we may want to define our null hypothesis differently. Problems in statistical practice are frequently not as pristinely summarized as the classic theory in our textbooks. In this article, we present examples in statistical hypothesis testing in which seemingly simple choices are in fact rich with nuance that, when given full consideration, make the choice of the right hypothesis test much less straightforward. Published 2012. This article is a US Government work and is in the public domain in the USA.

Applications of surface metrology in firearm identification

NASA Astrophysics Data System (ADS)

Zheng, X.; Soons, J.; Vorburger, T. V.; Song, J.; Renegar, T.; Thompson, R.

2014-01-01

Surface metrology is commonly used to characterize functional engineering surfaces. The technologies developed offer opportunities to improve forensic toolmark identification. Toolmarks are created when a hard surface, the tool, comes into contact with a softer surface and causes plastic deformation. Toolmarks are commonly found on fired bullets and cartridge cases. Trained firearms examiners use these toolmarks to link an evidence bullet or cartridge case to a specific firearm, which can lead to a criminal conviction. Currently, identification is typically based on qualitative visual comparison by a trained examiner using a comparison microscope. In 2009, a report by the National Academies called this method into question. Amongst other issues, they questioned the objectivity of visual toolmark identification by firearms examiners. The National Academies recommended the development of objective toolmark identification criteria and confidence limits. The National Institute of Standards and Technology (NIST) have applied its experience in surface metrology to develop objective identification criteria, measurement methods, and reference artefacts for toolmark identification. NIST developed the Standard Reference Material SRM 2460 standard bullet and SRM 2461 standard cartridge case to facilitate quality control and traceability of identifications performed in crime laboratories. Objectivity is improved through measurement of surface topography and application of unambiguous surface similarity metrics, such as the maximum value (ACCFMAX) of the areal cross correlation function. Case studies were performed on consecutively manufactured tools, such as gun barrels and breech faces, to demonstrate that, even in this worst case scenario, all the tested tools imparted unique surface topographies that were identifiable. These studies provide scientific support for toolmark evidence admissibility in criminal court cases.

In-flight speech intelligibility evaluation of a service member with sensorineural hearing loss: case report.

PubMed

Casto, Kristen L; Cho, Timothy H

2012-09-01

This case report describes the in-flight speech intelligibility evaluation of an aircraft crewmember with pure tone audiometric thresholds that exceed the U.S. Army's flight standards. Results of in-flight speech intelligibility testing highlight the inability to predict functional auditory abilities from pure tone audiometry and underscore the importance of conducting validated functional hearing evaluations to determine aviation fitness-for-duty.

Clinical utility of a single-item test for DSM-5 alcohol use disorder among outpatients with anxiety and depressive disorders.

PubMed

Bartoli, Francesco; Crocamo, Cristina; Biagi, Enrico; Di Carlo, Francesco; Parma, Francesca; Madeddu, Fabio; Capuzzi, Enrico; Colmegna, Fabrizia; Clerici, Massimo; Carrà, Giuseppe

2016-08-01

There is a lack of studies testing accuracy of fast screening methods for alcohol use disorder in mental health settings. We aimed at estimating clinical utility of a standard single-item test for case finding and screening of DSM-5 alcohol use disorder among individuals suffering from anxiety and mood disorders. We recruited adults consecutively referred, in a 12-month period, to an outpatient clinic for anxiety and depressive disorders. We assessed the National Institute on Alcohol Abuse and Alcoholism (NIAAA) single-item test, using the Mini- International Neuropsychiatric Interview (MINI), plus an additional item of Composite International Diagnostic Interview (CIDI) for craving, as reference standard to diagnose a current DSM-5 alcohol use disorder. We estimated sensitivity and specificity of the single-item test, as well as positive and negative Clinical Utility Indexes (CUIs). 242 subjects with anxiety and mood disorders were included. The NIAAA single-item test showed high sensitivity (91.9%) and specificity (91.2%) for DSM-5 alcohol use disorder. The positive CUI was 0.601, whereas the negative one was 0.898, with excellent values also accounting for main individual characteristics (age, gender, diagnosis, psychological distress levels, smoking status). Testing for relevant indexes, we found an excellent clinical utility of the NIAAA single-item test for screening true negative cases. Our findings support a routine use of reliable methods for rapid screening in similar mental health settings. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The Impact of Setting the Standards of Health Promoting Hospitals on Hospital Indicators in Iran

PubMed Central

Amiri, Mohammad; Khosravi, Ahmad; Riyahi, Leila

2016-01-01

Hospitals play a critical role in the health promotion of the society. This study aimed to determine the impact of establishing standards of health promoting hospitals on hospital indicators in Shahroud. This applied study was a quasi-experimental one which was conducted in 2013. Standards of health promoting hospitals were established as an intervention procedure in the Fatemiyeh hospital. Parameters of health promoting hospitals were compared in intervention and control hospitals before and after of intervention (6 months). The data were analyzed using chi-square and t-test. With the establishment of standards for health promotion hospitals, standard scores in intervention and control hospitals were found to be 72.26 ± 4.1 and 16.26 ± 7.5, respectively. T-test showed a significant difference between the mean scores of the hospitals under study (P = 0.001).The chi-square test also showed a significant relationship between patient satisfaction before and after the intervention so that patients’ satisfaction was higher after the intervention (P = 0.001). Commenting on the short-term or long-term positive impacts of establishing standards of health promoting hospitals on all hospital indicators is a bit difficult but preliminary results show the positive impact of the implementation of standards in case hospitals which has led to the improvement of many indicators in the hospital. PMID:27959930

Space and Missile Systems Center Standard: Test Requirements for Launch, Upper-Stage and Space Vehicles

DTIC Science & Technology

2014-09-05

adiabatic expansion of a perfect gas ; b. Contains a gas or liquid that would endanger personnel or equipment or create a mis- hap if released; or c...Guidelines for Liquid Rocket Engines 31. TOR-2013(3213)-6 Acoustic Testing on Production Space Vehicle (The Value of the Test and Deletion...materials used in space vehicles, interstages, payload adapters, payload fairings, motor cases, nozzles , propellant tanks, and over-wrapped pressure vessels

Evaluation of a standard test method for total hemispherical emittance of surfaces from 293K to 1673K

NASA Technical Reports Server (NTRS)

Compton, E. C.

1986-01-01

Emittance tests were made on samples of Rene' 41, Haynes 188, and Inconel 625 superalloy metals in an evaluation of a standard test method for determining total hemispherical emittances of surfaces from 293 K to 1673 K. The intent of this evaluation was to address any problems encountered, check repeatability of measured emittances, and gain experience in use of the test procedure. Five test specimens were fabricated to prescribe test dimensions and surfaces cleaned of oil and residue. Three of these specimens were without oxidized surfaces and two with oxidized surfaces. The oxidized specimens were Rene' 41 and Haynes 188. The tests were conducted in a vacuum where the samples were resistance-heated to various temperature levels ranging from 503 K to 1293 K. The calculated results for emittance, in the worst case, were repeatable to a maximum spread to + or - 4% from the mean of five sets of plotted data for each specimen.

Acute Respiratory Distress Syndrome, Sepsis, and Cognitive Decline: A Review and Case Study

PubMed Central

Jackson, James C.; Hopkins, Ramona O.; Miller, Russell R.; Gordon, Sharon M.; Wheeler, Arthur P.; Ely, E. Wesley

2013-01-01

The objective of this investigation is to review existing research pertaining to cognitive impairment and decline following critical illness and describe a case involving a 49-year-old female with sepsis and acute respiratory distress syndrome (ARDS) with no prior neurologic history who, compared to baseline neuropsychological test data, experienced dramatic cognitive decline and brain atrophy following treatment in the medical intensive care unit (ICU) at Vanderbilt University Medical Center. The patient participated in detailed clinical interviews and underwent comprehensive neuropsychological testing and neurological magnetic resonance imaging (MRI) at approximately 8 months and 3.5 years after ICU discharge. Compared to pre-ICU baseline test data, her intellectual function declined approximately 2 standard deviations from 139 to 106 (from the 99th to the 61st percentile) on a standardized intelligence test 8 months post-discharge, with little subsequent improvement. Initial diffusion tensor brain magnetic resonance imaging (DT-MRI) at the end of ICU hospitalization showed diffuse abnormal hyperintense areas involving predominately white matter in both hemispheres and the left cerebellum. A brain MRI nearly 4 years after ICU discharge demonstrated interval development of profound and generalized atrophy with sulcal widening and ventricular enlargement. The magnitude of cognitive decline experienced by ICU survivors is difficult to quantify due to the unavailability of pre-morbid neuropsychological data. The current case, conducted on a patient with baseline neuropsychological data, illustrates the trajectory of decline occurring after critical illness and ICU-associated brain injury with marked atrophy and concomitant cognitive impairments. PMID:19864995

Using standardized patients to assess the communication skills of graduating physicians for the comprehensive osteopathic medical licensing examination (COMLEX) level 2-performance evaluation (level 2-PE).

PubMed

Weidner, Angela C; Gimpel, John R; Boulet, John R; Solomon, Mia

2010-01-01

Standardized patients can be trained to assess the communication and interpersonal skills of medical students and graduates. The purpose of this study is to present data to support the psychometric adequacy of the communication ratings provided by standardized patients. Using the data from testing of 3, 450 examinees over a 1-year period, a number of psychometric analyses were undertaken. These included a variance component analysis, the calculation of various validity coefficients, the comparison of communication ratings for select examinee cohorts and case characteristics, and the investigation of some potential sources of score invalidity. Communication skills scores are moderately correlated to other competencies (knowledge, skills) and may be influenced by candidate characteristics such as gender and English language proficiency. They are not dependant on the age of the examinees, the clinical case content, or the gender of the standardized patients. For a multistation assessment, a reasonably precise and valid estimate of a candidate's communication ability can be obtained from trained standardized patients.

Multilevel principal component analysis (mPCA) in shape analysis: A feasibility study in medical and dental imaging.

PubMed

Farnell, D J J; Popat, H; Richmond, S

2016-06-01

Methods used in image processing should reflect any multilevel structures inherent in the image dataset or they run the risk of functioning inadequately. We wish to test the feasibility of multilevel principal components analysis (PCA) to build active shape models (ASMs) for cases relevant to medical and dental imaging. Multilevel PCA was used to carry out model fitting to sets of landmark points and it was compared to the results of "standard" (single-level) PCA. Proof of principle was tested by applying mPCA to model basic peri-oral expressions (happy, neutral, sad) approximated to the junction between the mouth/lips. Monte Carlo simulations were used to create this data which allowed exploration of practical implementation issues such as the number of landmark points, number of images, and number of groups (i.e., "expressions" for this example). To further test the robustness of the method, mPCA was subsequently applied to a dental imaging dataset utilising landmark points (placed by different clinicians) along the boundary of mandibular cortical bone in panoramic radiographs of the face. Changes of expression that varied between groups were modelled correctly at one level of the model and changes in lip width that varied within groups at another for the Monte Carlo dataset. Extreme cases in the test dataset were modelled adequately by mPCA but not by standard PCA. Similarly, variations in the shape of the cortical bone were modelled by one level of mPCA and variations between the experts at another for the panoramic radiographs dataset. Results for mPCA were found to be comparable to those of standard PCA for point-to-point errors via miss-one-out testing for this dataset. These errors reduce with increasing number of eigenvectors/values retained, as expected. We have shown that mPCA can be used in shape models for dental and medical image processing. mPCA was found to provide more control and flexibility when compared to standard "single-level" PCA. Specifically, mPCA is preferable to "standard" PCA when multiple levels occur naturally in the dataset. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Stratification period and germination of Douglas-fir seed from Oregon seed orchards: two case studies.

Treesearch

Frank C. Sorenson

1991-01-01

Effect of stratification period (S) and incubation temperature (T) on germination be- havior were tested by using two groups of Douglas-fir orchard seedlots that had given low germination percentages in standard tests. One group of seedlots that had experienced different cone-drying regimes, but otherwise were treated comparably, were germinated at T = 15 and 25 °C...

Writing Progression of Students with Limited English Proficiency on Texas State Exams

ERIC Educational Resources Information Center

Heckman, Jill S.

2009-01-01

One of the purposes of this study was to examine whether or not the present and past standardized tests in the state of Texas had any positive impact on the writing abilities of the limited English proficient (LEP) Mexican-American students. Another objective of the study was to determine if one test was more effective than another. In this case,…

Survey Definitions of Gout for Epidemiologic Studies: Comparison With Crystal Identification as the Gold Standard.

PubMed

Dalbeth, Nicola; Schumacher, H Ralph; Fransen, Jaap; Neogi, Tuhina; Jansen, Tim L; Brown, Melanie; Louthrenoo, Worawit; Vazquez-Mellado, Janitzia; Eliseev, Maxim; McCarthy, Geraldine; Stamp, Lisa K; Perez-Ruiz, Fernando; Sivera, Francisca; Ea, Hang-Korng; Gerritsen, Martijn; Scire, Carlo A; Cavagna, Lorenzo; Lin, Chingtsai; Chou, Yin-Yi; Tausche, Anne-Kathrin; da Rocha Castelar-Pinheiro, Geraldo; Janssen, Matthijs; Chen, Jiunn-Horng; Cimmino, Marco A; Uhlig, Till; Taylor, William J

2016-12-01

To identify the best-performing survey definition of gout from items commonly available in epidemiologic studies. Survey definitions of gout were identified from 34 epidemiologic studies contributing to the Global Urate Genetics Consortium (GUGC) genome-wide association study. Data from the Study for Updated Gout Classification Criteria (SUGAR) were randomly divided into development and test data sets. A data-driven case definition was formed using logistic regression in the development data set. This definition, along with definitions used in GUGC studies and the 2015 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) gout classification criteria were applied to the test data set, using monosodium urate crystal identification as the gold standard. For all tested GUGC definitions, the simple definition of "self-report of gout or urate-lowering therapy use" had the best test performance characteristics (sensitivity 82%, specificity 72%). The simple definition had similar performance to a SUGAR data-driven case definition with 5 weighted items: self-report, self-report of doctor diagnosis, colchicine use, urate-lowering therapy use, and hyperuricemia (sensitivity 87%, specificity 70%). Both of these definitions performed better than the 1977 American Rheumatism Association survey criteria (sensitivity 82%, specificity 67%). Of all tested definitions, the 2015 ACR/EULAR criteria had the best performance (sensitivity 92%, specificity 89%). A simple definition of "self-report of gout or urate-lowering therapy use" has the best test performance characteristics of existing definitions that use routinely available data. A more complex combination of features is more sensitive, but still lacks good specificity. If a more accurate case definition is required for a particular study, the 2015 ACR/EULAR gout classification criteria should be considered. © 2016, American College of Rheumatology.

Transscrotal Near Infrared Spectroscopy as a Diagnostic Test for Testis Torsion in Pediatric Acute Scrotum: A Prospective Comparison to Gold Standard Diagnostic Test Study.

PubMed

Schlomer, Bruce J; Keays, Melise A; Grimsby, Gwen M; Granberg, Candace F; DaJusta, Daniel G; Menon, Vani S; Ostrov, Lauren; Sheth, Kunj R; Hill, Martinez; Sanchez, Emma J; Harrison, Clanton B; Jacobs, Micah A; Huang, Rong; Burgu, Berk; Hennes, Halim; Baker, Linda A

2017-09-01

A rapid test for testicular torsion in children may obviate the delay for testicular ultrasound. In this study we assessed testicular tissue percent oxygen saturation (%StO2) measured by transscrotal near infrared spectroscopy as a diagnostic test for pediatric testicular torsion. This was a prospective comparison to a gold standard diagnostic test study that evaluated near infrared spectroscopy %StO2 readings to diagnose testicular torsion. The gold standard for torsion diagnosis was standard clinical care. From 2013 to 2015 males with acute scrotum for more than 1 month and who were less than 18 years old were recruited. Near infrared spectroscopy %StO2 readings were obtained for affected and unaffected testes. Near infrared spectroscopy Δ%StO2 was calculated as unaffected minus affected reading. The utility of near infrared spectroscopy Δ%StO2 to diagnose testis torsion was described with ROC curves. Of 154 eligible patients 121 had near infrared spectroscopy readings. Median near infrared spectroscopy Δ%StO2 in the 36 patients with torsion was 2.0 (IQR -4.2 to 9.8) vs -1.7 (IQR -8.7 to 2.0) in the 85 without torsion (p=0.004). AUC for near infrared spectroscopy as a diagnostic test was 0.66 (95% CI 0.55-0.78). Near infrared spectroscopy Δ%StO2 of 20 or greater had a positive predictive value of 100% and a sensitivity of 22.2%. Tanner stage 3-5 cases without scrotal edema or with pain for 12 hours or less had an AUC of 0.91 (95% CI 0.86-1.0) and 0.80 (95% CI 0.62-0.99), respectively. In all children near infrared spectroscopy readings had limited utility in diagnosing torsion. However, in Tanner 3-5 cases without scrotal edema or with pain 12 hours or less, near infrared spectroscopy discriminated well between torsion and nontorsion. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Mixed Model Association with Family-Biased Case-Control Ascertainment.

PubMed

Hayeck, Tristan J; Loh, Po-Ru; Pollack, Samuela; Gusev, Alexander; Patterson, Nick; Zaitlen, Noah A; Price, Alkes L

2017-01-05

Mixed models have become the tool of choice for genetic association studies; however, standard mixed model methods may be poorly calibrated or underpowered under family sampling bias and/or case-control ascertainment. Previously, we introduced a liability threshold-based mixed model association statistic (LTMLM) to address case-control ascertainment in unrelated samples. Here, we consider family-biased case-control ascertainment, where case and control subjects are ascertained non-randomly with respect to family relatedness. Previous work has shown that this type of ascertainment can severely bias heritability estimates; we show here that it also impacts mixed model association statistics. We introduce a family-based association statistic (LT-Fam) that is robust to this problem. Similar to LTMLM, LT-Fam is computed from posterior mean liabilities (PML) under a liability threshold model; however, LT-Fam uses published narrow-sense heritability estimates to avoid the problem of biased heritability estimation, enabling correct calibration. In simulations with family-biased case-control ascertainment, LT-Fam was correctly calibrated (average χ 2 = 1.00-1.02 for null SNPs), whereas the Armitage trend test (ATT), standard mixed model association (MLM), and case-control retrospective association test (CARAT) were mis-calibrated (e.g., average χ 2 = 0.50-1.22 for MLM, 0.89-2.65 for CARAT). LT-Fam also attained higher power than other methods in some settings. In 1,259 type 2 diabetes-affected case subjects and 5,765 control subjects from the CARe cohort, downsampled to induce family-biased ascertainment, LT-Fam was correctly calibrated whereas ATT, MLM, and CARAT were again mis-calibrated. Our results highlight the importance of modeling family sampling bias in case-control datasets with related samples. Copyright © 2017 American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

Indirect supportive evidence for diagnosis of tuberculosis-related uveitis: from the tuberculin skin test to the new interferon gamma release assays.

PubMed

Llorenç, Víctor; González-Martin, Julian; Keller, Johannes; Rey, Amanda; Pelegrín, Laura; Mesquida, Marina; Adán, Alfredo

2013-03-01

To evaluate clinical and paraclinical parameters for the indirect diagnosis of tuberculosis-related uveitis (TRU). Prospective 2-year study in a tertiary referral centre. Patients with clinically suspected TRU were recruited. Demographical and clinical data were recorded. QuantiFERON(®) -TB Gold (QFT), tuberculosis skin test (TST) and pulmonary X-ray were performed, and other possible uveitis aetiologies were ruled out. Further investigations were also performed case by case after consultation. After final assessment, standard antituberculosis therapy was started if TRU was considered highly probable. Finally, diagnosis of TRU was established according to current criteria and set as gold standard. Strength of association for TRU was determined by odds ratio and compared by appropriate tests. Concordance and binary classification tests were also assessed.   The study included 103 patients, 54 men and 49 women. Mean age 45.6 years. Sixty-eight patients were Spanish-born and 35 were foreign-born. Final diagnosis included 33 (32%) cases of TRU and 70 (67%) cases with other diagnoses. Asian origin (OR = 3.50, p = 0.046), previous tuberculosis (TB) contact (OR = 2.61, p = 0.026), TB in the past (OR = 6.18, p = 0.004) and associated retinal vasculitis (OR = 7.85, p < 0.001) were significantly related to TRU. Sensitivity (S) and specificity (Sp) of the TST and QFT did not differ significantly (S 87% versus 90% and Sp 85% versus 82%, respectively) with fair agreement (k = 0.607). In a Western urban multi-ethnic population, patients from Asia, TB history or contact in the past and vasculitis are at higher risk of TRU. TST and QF are complementary providing enough S and Sp to support the diagnosis. © 2012 The Authors. Acta Ophthalmologica © 2012 Acta Ophthalmologica Scandinavica Foundation.

Pretraining and posttraining assessment of residents' performance in the fourth accreditation council for graduate medical education competency: patient communication skills.

PubMed

Chandawarkar, Rajiv Y; Ruscher, Kimberly A; Krajewski, Aleksandra; Garg, Manish; Pfeiffer, Carol; Singh, Rekha; Longo, Walter E; Kozol, Robert A; Lesnikoski, Beth; Nadkarni, Prakash

2011-08-01

Structured communication curricula will improve surgical residents' ability to communicate effectively with patients. A prospective study approved by the institutional review board involved 44 University of Connecticut general surgery residents. Residents initially completed a written baseline survey to assess general communication skills awareness. In step 1 of the study, residents were randomized to 1 of 2 simulations using standardized patient instructors to mimic patients receiving a diagnosis of either breast or rectal cancer. The standardized patient instructors scored residents' communication skills using a case-specific content checklist and Master Interview Rating Scale. In step 2 of the study, residents attended a 3-part interactive program that comprised (1) principles of patient communication; (2) experiences of a surgeon (role as physician, patient, and patient's spouse); and (3) role-playing (3-resident groups played patient, physician, and observer roles and rated their own performance). In step 3, residents were retested as in step 1, using a crossover case design. Scores were analyzed using Wilcoxon signed rank test with a Bonferroni correction. Case-specific performance improved significantly, from a pretest content checklist median score of 8.5 (65%) to a posttest median of 11.0 (84%) (P = .005 by Wilcoxon signed rank test for paired ordinal data)(n = 44). Median Master Interview Rating Scale scores changed from 58.0 before testing (P = .10) to 61.5 after testing (P = .94). Difference between overall rectal cancer scores and breast cancer scores also were not significant. Patient communication skills need to be taught as part of residency training. With limited training, case-specific skills (herein, involving patients with cancer) are likely to improve more than general communication skills.

Chronic pesticide poisoning from persistent low-dose exposures in Ecuadorean floriculture workers: toward validating a low-cost test battery.

PubMed

Breilh, Jaime; Pagliccia, Nino; Yassi, Annalee

2012-01-01

Chronic pesticide poisoning is difficult to detect. We sought to develop a low-cost test battery for settings such as Ecuador's floriculture industry. First we had to develop a case definition; as with all occupational diseases a case had to have both sufficient effective dose and associated health effects. For the former, using canonical discriminant analysis, we found that adding measures of protection and overall environmental stressors to occupational category and duration of exposure was useful. For the latter, factor analysis suggested three distinct manifestations of pesticide poisoning. We then determined sensitivity and specificity of various combinations of symptoms and simple neurotoxicity tests from the Pentox questionnaire, and found that doing so increased sensitivity and specificity compared to use of acethylcholinesterase alone--the current screening standard. While sensitivity and specificity varied with different case definitions, our results support the development of a low-cost test battery for screening in such settings.

[Methodology of psychiatric case histories].

PubMed

Scherbaum, N; Mirzaian, E

1999-05-01

This paper deals with the methodology of psychiatric case histories. Three types of case histories are differentiated. The didactic case history teaches about the typical aspects of a psychiatric disorder or treatment by using an individual patient as an example. In the heuristic case history the individual case gives rise to challenging established concepts or to generate new hypotheses. Such hypotheses drawn from inductive reasoning have then to be tested using representative samples. The focus of hermeneutic case histories is the significance of pathological behaviour and experience in the context of the biography of an individual patient. So-called psychopathographies of important historical figures can also be differentiated according to these types. Based on these methodological considerations, quality standards for the named types of case histories are stated.

Standardization of Nomenclature and Causality Assessment in Drug-Induced Liver Injury: Summary of a Clinical Research Workshop

PubMed Central

Fontana, Robert J.; Seeff, Leonard B.; Andrade, Raúl J.; Björnsson, Einar; Day, Christopher P.; Serrano, Jose; Hoofnagle, Jay H.

2013-01-01

Idiosyncratic drug-induced liver injury (DILI) is an important but relatively infrequent cause of potentially severe acute and chronic liver injury. The aim of this clinical research workshop was to review and attempt to standardize the current nomenclature and terminology used in DILI research. Because DILI is a diagnosis of exclusion, selected elements of the medical history, laboratory tests, and previous reports were proposed to improve causality assessment. Definitions and diagnostic criteria regarding the onset of DILI, evolution of liver injury, risk factors, and mandatory testing versus optional testing for competing causes were reviewed. In addition, the role of intentional and inadvertent rechallenge, liver histology, and host genetic polymorphisms in establishing the diagnosis and prognosis of DILI were reviewed. Consensus was established regarding the need to develop a web-of-knowledge database that provides concise, reliable, and updated information on cases of liver injury due to drugs and herbal and dietary supplements. In addition, the need to develop drug-specific computerized causality assessment methods that are derived from prospectively phenotyped cases was a high priority. Proposed scales for grading DILI severity and assessing the likelihood of an agent causing DILI and written criteria for improving the reliability, accuracy, and reproducibility of expert opinion were reviewed. Finally, the unique challenges of assessing causality in children, patients with underlying liver disease, and subjects taking herbal and dietary supplements were discussed. Conclusion: Workshop participants concluded that multicenter referral networks enrolling patients with suspected DILI according to standardized methodologies are needed. These networks should also collect biological samples that may provide crucial insights into the mechanism(s) of DILI with the ultimate aim of preventing future cases of DILI. PMID:20564754

An Improved Correction for Range Restricted Correlations Under Extreme, Monotonic Quadratic Nonlinearity and Heteroscedasticity.

PubMed

Culpepper, Steven Andrew

2016-06-01

Standardized tests are frequently used for selection decisions, and the validation of test scores remains an important area of research. This paper builds upon prior literature about the effect of nonlinearity and heteroscedasticity on the accuracy of standard formulas for correcting correlations in restricted samples. Existing formulas for direct range restriction require three assumptions: (1) the criterion variable is missing at random; (2) a linear relationship between independent and dependent variables; and (3) constant error variance or homoscedasticity. The results in this paper demonstrate that the standard approach for correcting restricted correlations is severely biased in cases of extreme monotone quadratic nonlinearity and heteroscedasticity. This paper offers at least three significant contributions to the existing literature. First, a method from the econometrics literature is adapted to provide more accurate estimates of unrestricted correlations. Second, derivations establish bounds on the degree of bias attributed to quadratic functions under the assumption of a monotonic relationship between test scores and criterion measurements. New results are presented on the bias associated with using the standard range restriction correction formula, and the results show that the standard correction formula yields estimates of unrestricted correlations that deviate by as much as 0.2 for high to moderate selectivity. Third, Monte Carlo simulation results demonstrate that the new procedure for correcting restricted correlations provides more accurate estimates in the presence of quadratic and heteroscedastic test score and criterion relationships.

Alpha-fetoprotein and its value for predicting pregnancy outcomes – a re-evaluation

PubMed Central

Darouich, Ayham Alhaj; Liehr, Thomas; Weise, Anja; Schlembach, Dietmar; Schleußner, Ekkehart; Kiehntopf, Michael; Schreyer, Isolde

2015-01-01

Introduction Alpha-fetoprotein (AFP) concentrations can be determined framing others from invasively acquired amnion fluid (AF-AFP). While the biological role of AFP remains unclear it is well known that AFP-levels can be altered in connection with specific clinical and/or genetic alterations of the fetus. Materials and Method here a retrospective study based on 3,119 singleton and 56 twin pregnancies is presented. The standard levels of amnion fluid derived alpha-fetoprotein level (AF-AFP) between 12th and 36th weeks of gestation were determined. Additionally, acetylcholinesterase (AChE) test results for 63 cases, ultrasonography results for 32 cases and abnormal karyotypic findings for 100 cases were available for selected cases. Results and Discussion according to the present data the AF-AFP test is reliable and provides expected test results in terms of population studies. However, individual AF-AFP test results can be subject to high individual variations. In this study AF-AFP multiple of medians (MoM) over 1.7 were indicative for neuronal tube defects and/or omphalocele in only 6.3% of the cases, while such AF-AFP values were hints on severe sonographic signs in 62% of the cases. Also, altered AF-AFP concentrations were present in 82% of cytogenetically abnormal cases. Overall, even though predicative value of the AF-AFP-test is matter of discussion it continues to be widely applied in invasive prenatal diagnostics. This study indicates that it only can be applied reliably in combination with other tests like banding cytogenetics, ultrasonography and all embedded in well-established genetic counseling. PMID:27358693

GeneXpert MTB/RIF Assay for the Diagnosis of Tuberculous Lymphadenitis on Concentrated Fine Needle Aspirates in High Tuberculosis Burden Settings.

PubMed

Tadesse, Mulualem; Abebe, Gemeda; Abdissa, Ketema; Aragaw, Dossegnaw; Abdella, Kedir; Bekele, Alemayehu; Bezabih, Mesele; Apers, Ludwig; de Jong, Bouke C; Rigouts, Leen

2015-01-01

The diagnosis of tuberculous lymphadenitis (TBL) remains challenging. The routinely used methods (cytology and smear microscopy) have sub-optimal sensitivity. Recently, WHO recommends GeneXpert to be used as the initial diagnostic test in patients suspected of having extra-pulmonary tuberculosis (EPTB). However, this was a conditional recommendation due to very low-quality evidence available and more studies are needed. In this study we evaluated the performance of Xpert for the diagnosis of TBL on concentrated fine needle aspirates (FNA) in Southwest Ethiopia. FNA was collected from presumptive TBL cases. Two smears were prepared from each aspirate and processed for cytology and conventional microscopy. The remaining aspirate was treated with N-acetyl-L-cysteine-NaOH and centrifuged for 15minutes at 3000g. The concentrated sediment was used for culture and Xpert test. Capilia TB-Neo test was used to differentiate M. tuberculosis complex (MTBC) from non-tuberculous mycobacteria (NTM). Composite bacteriological methods (culture and/or smear microscopy) were considered as a reference standard. Out of 143 enrolled suspects, 64.3% (92/143) were confirmed TBL cases by the composite reference standard (CRS). Xpert detected M. tuberculosis complex (MTBC) in 60.1% (86/143) of the presumptive TBL cases. The sensitivity of Xpert compared to CRS was 87.8% [95% CI: 81.0-94.5] and specificity 91.1% [95% CI: 82.8-99.4]. The sensitivity was 27.8% for smear microscopy and 80% for cytology compared to CRS. Cytology showed the lowest specificity (57.8%). Xpert was positive in 4 out of 45 culture- and smear-negative cases. Among 47 cytomorphologically non-TBL cases, 15 were positive on Xpert. More than half of Xpert-positive cases were in the range of very low cut-off threshold values (28

Causation in negligence: from anti-jurisprudence to principle--individual responsibility as the cornerstone for the attribution of liability.

PubMed

Bagaric, Mirko; Erbacher, Sharon

2011-06-01

Causation is one of the most esoteric and poorly defined legal principles. The common law standards of the "but for" test and common sense are, in reality, code for unconstrained judicial choice. This leads to a high degree of unpredictability in negligence cases. Changes to the causation standard following the torts reforms have done nothing to inject principle into this area of law: the concept of "appropriateness" is no more illuminating than common sense. Despite this, the trend of recent High Court decisions offers some prospect of clarifying the test for causation. Key themes to emerge are an increased emphasis on individual responsibility and the associated concept of coherency with other legal standards. This article examines the doctrinal reasons underpinning the increasingly important role of these ideals and suggests how they can be accommodated into the test for causation to inject greater coherence and predictability into this area of law.

Study on validity of a rapid diagnostic test kit versus light microscopy for malaria diagnosis in Ahmedabad city, India.

PubMed

Vyas, S; Puwar, B; Patel, V; Bhatt, G; Kulkarni, S; Fancy, M

2014-05-01

Light microscopy of blood smears for diagnosis of malaria in the field has several limitations, notably delays in diagnosis. This study in Ahmedabad in Gujarat State, India, evaluated the diagnostic performance of a rapid diagnostic test for malaria (SD Bioline Malaria Ag P.f/Pan) versus blood smear examination as the gold standard. All fever cases presenting at 13 urban health centres were subjected to rapid diagnostic testing and thick and thin blood smears. A total of 677 cases with fever were examined; 135 (20.0%) tested positive by rapid diagnostic test and 86 (12.7%) by blood smear. The sensitivity of the rapid diagnostic test for malaria was 98.8%, specificity was 91.5%, positive predictive value 63.0% and negative predictive value 99.8%. For detection of Plasmodium falciparum the sensitivity of rapid diagnostic test was 100% and specificity was 97.3%. The results show the acceptability of the rapid test as an alternative to light microscopy in the field setting.

Mechanics of cantilever beam: Implementation and comparison of FEM and MLPG approach

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

Trobec, Roman

2016-06-08

Two weak form solution approaches for partial differential equations, the well known meshbased finite element method and the newer meshless local Petrov Galerkin method are described and compared on a standard test case - mechanics of cantilever beam. The implementation, solution accuracy and calculation complexity are addressed for both approaches. We found out that FEM is superior in most standard criteria, but MLPG has some advantages because of its flexibility that results from its general formulation.

An Efficient Implementation of the Nwat-MMGBSA Method to Rescore Docking Results in Medium-Throughput Virtual Screenings

NASA Astrophysics Data System (ADS)

Maffucci, Irene; Hu, Xiao; Fumagalli, Valentina; Contini, Alessandro

2018-03-01

Nwat-MMGBSA is a variant of MM-PB/GBSA based on the inclusion of a number of explicit water molecules that are the closest to the ligand in each frame of a molecular dynamics trajectory. This method demonstrated improved correlations between calculated and experimental binding energies in both protein-protein interactions and ligand-receptor complexes, in comparison to the standard MM-GBSA. A protocol optimization, aimed to maximize efficacy and efficiency, is discussed here considering penicillopepsin, HIV1-protease, and BCL-XL as test cases. Calculations were performed in triplicates on both classic HPC environments and on standard workstations equipped by a GPU card, evidencing no statistical differences in the results. No relevant differences in correlation to experiments were also observed when performing Nwat-MMGBSA calculations on 4 ns or 1 ns long trajectories. A fully automatic workflow for structure-based virtual screening, performing from library set-up to docking and Nwat-MMGBSA rescoring, has then been developed. The protocol has been tested against no rescoring or standard MM-GBSA rescoring within a retrospective virtual screening of inhibitors of AmpC β-lactamase and of the Rac1-Tiam1 protein-protein interaction. In both cases, Nwat-MMGBSA rescoring provided a statistically significant increase in the ROC AUCs of between 20% and 30%, compared to docking scoring or to standard MM-GBSA rescoring.

[Evaluation of Xpert® MTB/RIF technique for Mycobacterium tuberculosis complex detection in extra-respiratory specimens].

PubMed

García, Patricia; Balcells, M Elvira; Castillo, Claudia; Miranda, Carolina; Geoffroy, Enrique; Román, Juan C; Wozniak, Aniela

2017-08-01

Extra-pulmonary tuberculosis (TB) represents the 26.2% of total TB cases in Chile. Culture is the gold standard method, but the process is extremely slow. Xpert®MTB/RIF technique detects Mycobacterium tuberculosis complex (MTBc) through real time PCR in less than 3 h. However, it has been validated only for respiratory specimens. We aimed to determine the performance of Xpert®MTB/RIF test in detecting MTBc in extra-respiratory specimens compared with a combined gold standard consisting in a positive (liquid and solid) mycobacterial culture and/or a positive validated molecular method (q-RPC, Cobas®TaqMan®-MTB). Fifty extra-respiratory specimens were analyzed, from which 25 were positive and 25 negative for MTBc based on the combined gold standard. The 25 positive specimens had a positive result by Xpert®MTB/RIF; from the 25 negative specimens, 24 had a negative result and one had a positive result. We obtained an overall concordance of 98% between Xpert®MTB/RIF and the combined gold standard. Xpert®MTB/RIF test was able to detect 12 smear-negative specimens and 3 culture-negative specimens, all of them corresponding to extra-pulmonary TB cases. Xpert®MTB/RIF showed similar sensitivity to q-RPC in detecting MTBc in extra-respiratory specimens. This procedure allowed a substantial reduction in the time of diagnosis.

Relationship between endobronchial ultrasound‐guided (EBUS)‐transbronchial needle aspiration utility and computed tomography staging, node size at EBUS, and positron emission tomography scan node standard uptake values: A retrospective analysis

PubMed Central

Marchand, Clare

2017-01-01

Background Endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) diagnoses and stages mediastinal lymph node pathology. This retrospective study determined the relationship between EBUS‐TBNA utility and non‐small cell lung cancer (NSCLC) stage, lymph node size, and positron emission tomography (PET) standard uptake values (SUV), and the utility of neck ultrasound in bulky mediastinal disease. Methods Data of 284 consecutive patients who had undergone EBUS‐TBNA was collected. Two hundred patients had suspected NSCLC, with 148 confirmed NSCLC cases. The diagnostic utility of EBUS‐TBNA was determined according to NSCLC stage, EBUS lymph node size, PET SUV, use in distal metastases, and mutation testing. The utility of neck ultrasound for N3 disease was calculated in patients with bulky mediastinal disease. Results EBUS‐TBNA was well tolerated with 97% sensitivity in distant metastatic disease, avoiding the need for distal metastases biopsy in 81% of cases. It had equivalent diagnostic accuracy in all NSCLC stages and in lymph nodes <10 mm, <20 mm or >20 mm (sensitivity >92% in all cases), with no mutation testing failures. EBUS‐TBNA had 33% sensitivity in PET indolent (SUV < 4) nodes and 79% sensitivity in PET active nodes (SUV > 4). EBUS‐TBNA diagnosed 12 cases of lymphoma without flow cytometry. Conclusions The use of EBUS‐TBNA meant that distant metastatic biopsy was avoided in 81% of cases, performing well irrespective of cancer stage, node size, and facilitating mutation testing. Neck ultrasound failed to detect N3 disease in patients with bulky mediastinal disease. EBUS‐TBNA had a sensitivity of 33% for metastases in PET negative nodes, highlighting PET limitations. PMID:28436173

Influence of test procedures on the thermomechanical properties of a 55NiTi shape memory alloy

NASA Astrophysics Data System (ADS)

Padula, Santo A., II; Gaydosh, Darrell J.; Noebe, Ronald D.; Bigelow, Glen S.; Garg, Anita; Lagoudas, Dimitris; Karaman, Ibrahim; Atli, Kadri C.

2008-03-01

Over the past few decades, binary NiTi shape memory alloys have received attention due to their unique mechanical characteristics, leading to their potential use in low-temperature, solid-state actuator applications. However, prior to using these materials for such applications, the physical response of these systems to mechanical and thermal stimuli must be thoroughly understood and modeled to aid designers in developing SMA-enabled systems. Even though shape memory alloys have been around for almost five decades, very little effort has been made to standardize testing procedures. Although some standards for measuring the transformation temperatures of SMA's are available, no real standards exist for determining the various mechanical and thermomechanical properties that govern the usefulness of these unique materials. Consequently, this study involved testing a 55NiTi alloy using a variety of different test methodologies. All samples tested were taken from the same heat and batch to remove the influence of sample pedigree on the observed results. When the material was tested under constant-stress, thermal-cycle conditions, variations in the characteristic material responses were observed, depending on test methodology. The transformation strain and irreversible strain were impacted more than the transformation temperatures, which only showed an affect with regard to applied external stress. In some cases, test methodology altered the transformation strain by 0.005-0.01mm/mm, which translates into a difference in work output capability of approximately 2 J/cm 3 (290 in•lbf/in 3). These results indicate the need for the development of testing standards so that meaningful data can be generated and successfully incorporated into viable models and hardware. The use of consistent testing procedures is also important when comparing results from one research organization to another. To this end, differences in the observed responses will be presented, contrasted and rationalized, in hopes of eventually developing standardized testing procedures for shape memory alloys.

Influence of Test Procedures on the Thermomechanical Properties of a 55NiTi Shape Memory Alloy

NASA Technical Reports Server (NTRS)

Padula, Santo A., II; Gaydosh, Darrell J.; Noebe, Ronald D.; Bigelow, Glen S.; Garg, Anita; Lagoudas, Dimitris; Karaman, Ibrahim; Atli, Kadri C.

2008-01-01

Over the past few decades, binary NiTi shape memory alloys have received attention due to their unique mechanical characteristics, leading to their potential use in low-temperature, solid-state actuator applications. However, prior to using these materials for such applications, the physical response of these systems to mechanical and thermal stimuli must be thoroughly understood and modeled to aid designers in developing SMA-enabled systems. Even though shape memory alloys have been around for almost five decades, very little effort has been made to standardize testing procedures. Although some standards for measuring the transformation temperatures of SMA s are available, no real standards exist for determining the various mechanical and thermomechanical properties that govern the usefulness of these unique materials. Consequently, this study involved testing a 55NiTi alloy using a variety of different test methodologies. All samples tested were taken from the same heat and batch to remove the influence of sample pedigree on the observed results. When the material was tested under constant-stress, thermal-cycle conditions, variations in the characteristic material responses were observed, depending on test methodology. The transformation strain and irreversible strain were impacted more than the transformation temperatures, which only showed an affect with regard to applied external stress. In some cases, test methodology altered the transformation strain by 0.005-0.01mm/mm, which translates into a difference in work output capability of approximately 2 J/cu cm (290 in!lbf/cu in). These results indicate the need for the development of testing standards so that meaningful data can be generated and successfully incorporated into viable models and hardware. The use of consistent testing procedures is also important when comparing results from one research organization to another. To this end, differences in the observed responses will be presented, contrasted and rationalized, in hopes of eventually developing standardized testing procedures for shape memory alloys.

Identifying and processing the gap between perceived and actual agreement in breast pathology interpretation.

PubMed

Carney, Patricia A; Allison, Kimberly H; Oster, Natalia V; Frederick, Paul D; Morgan, Thomas R; Geller, Berta M; Weaver, Donald L; Elmore, Joann G

2016-07-01

We examined how pathologists' process their perceptions of how their interpretations on diagnoses for breast pathology cases agree with a reference standard. To accomplish this, we created an individualized self-directed continuing medical education program that showed pathologists interpreting breast specimens how their interpretations on a test set compared with a reference diagnosis developed by a consensus panel of experienced breast pathologists. After interpreting a test set of 60 cases, 92 participating pathologists were asked to estimate how their interpretations compared with the standard for benign without atypia, atypia, ductal carcinoma in situ and invasive cancer. We then asked pathologists their thoughts about learning about differences in their perceptions compared with actual agreement. Overall, participants tended to overestimate their agreement with the reference standard, with a mean difference of 5.5% (75.9% actual agreement; 81.4% estimated agreement), especially for atypia and were least likely to overestimate it for invasive breast cancer. Non-academic affiliated pathologists were more likely to more closely estimate their performance relative to academic affiliated pathologists (77.6 vs 48%; P=0.001), whereas participants affiliated with an academic medical center were more likely to underestimate agreement with their diagnoses compared with non-academic affiliated pathologists (40 vs 6%). Before the continuing medical education program, nearly 55% (54.9%) of participants could not estimate whether they would overinterpret the cases or underinterpret them relative to the reference diagnosis. Nearly 80% (79.8%) reported learning new information from this individualized web-based continuing medical education program, and 23.9% of pathologists identified strategies they would change their practice to improve. In conclusion, when evaluating breast pathology specimens, pathologists do a good job of estimating their diagnostic agreement with a reference standard, but for atypia cases, pathologists tend to overestimate diagnostic agreement. Many participants were able to identify ways to improve.

A Case-Controlled Study of Altered Visual Art Production in Alzheimer’s and FTLD

PubMed Central

Rankin, Katherine P.; Liu, Anli A.; Howard, Sara; Slama, Hilary; Hou, Craig. E.; Shuster, Karen; Miller, Bruce L.

2009-01-01

Objective To characterize dementia-induced changes in visual art production. Background While case studies show altered visual artistic production in some patients with neurodegenerative disease, no case-controlled studies have quantified this phenomenon across groups of patients. Method Forty-nine subjects [18 Alzheimer’s disease (AD), 9 Frontotemporal Dementia (FTD), 9 Semantic Dementia (SD), 15 healthy older controls (NC)] underwent formal neuropsychological testing of visuospatial, perceptual, and creative functioning, and produced four drawings. Subjective elements of drawings were rated by an expert panel that was blind to diagnosis. Results Despite equal performance on standard visuospatial tests, dementia groups produced distinct patterns of artistic features that were significantly different from NCs. FTDs used more disordered composition and less active mark-making (p<0.05). Both FTDs and SDs drawings were rated as more bizarre and demonstrated more facial distortion than NCs (p<0.05). Also, SDs drastically failed a standardized test of divergent creativity. ADs artwork was more similar to controls than to FTDs or SDs, but showed a more muted color palette (p<0.05) and trends toward including fewer details, less ordered compositions, and occasional facial distortion. Conclusions These group differences in artistic style likely resulted from disease-specific focal neurodegeneration, and elucidate the contributions of particular brain regions to the production of visual art. PMID:17356345

Revisiting the Rossby Haurwitz wave test case with contour advection

NASA Astrophysics Data System (ADS)

Smith, Robert K.; Dritschel, David G.

2006-09-01

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

A ridge tracking algorithm and error estimate for efficient computation of Lagrangian coherent structures.

PubMed

Lipinski, Doug; Mohseni, Kamran

2010-03-01

A ridge tracking algorithm for the computation and extraction of Lagrangian coherent structures (LCS) is developed. This algorithm takes advantage of the spatial coherence of LCS by tracking the ridges which form LCS to avoid unnecessary computations away from the ridges. We also make use of the temporal coherence of LCS by approximating the time dependent motion of the LCS with passive tracer particles. To justify this approximation, we provide an estimate of the difference between the motion of the LCS and that of tracer particles which begin on the LCS. In addition to the speedup in computational time, the ridge tracking algorithm uses less memory and results in smaller output files than the standard LCS algorithm. Finally, we apply our ridge tracking algorithm to two test cases, an analytically defined double gyre as well as the more complicated example of the numerical simulation of a swimming jellyfish. In our test cases, we find up to a 35 times speedup when compared with the standard LCS algorithm.

A Low-Cost Inkjet-Printed Glucose Test Strip System for Resource-Poor Settings.

PubMed

Gainey Wilson, Kayla; Ovington, Patrick; Dean, Delphine

2015-06-12

The prevalence of diabetes is increasing in low-resource settings; however, accessing glucose monitoring is extremely difficult and expensive in these regions. Work is being done to address the multitude of issues surrounding diabetes care in low-resource settings, but an affordable glucose monitoring solution has yet to be presented. An inkjet-printed test strip solution is being proposed as a solution to this problem. The use of a standard inkjet printer is being proposed as a manufacturing method for low-cost glucose monitoring test strips. The printer cartridges are filled with enzyme and dye solutions that are printed onto filter paper. The result is a colorimetric strip that turns a blue/green color in the presence of blood glucose. Using a light-based spectroscopic reading, the strips show a linear color change with an R(2) = .99 using glucose standards and an R(2) = .93 with bovine blood. Initial testing with bovine blood indicates that the strip accuracy is comparable to the International Organization for Standardization (ISO) standard 15197 for glucose testing in the 0-350 mg/dL range. However, further testing with human blood will be required to confirm this. A visible color gradient was observed with both the glucose standard and bovine blood experiment, which could be used as a visual indicator in cases where an electronic glucose meter was unavailable. These results indicate that an inkjet-printed filter paper test strip is a feasible method for monitoring blood glucose levels. The use of inkjet printers would allow for local manufacturing to increase supply in remote regions. This system has the potential to address the dire need for glucose monitoring in low-resource settings. © 2015 Diabetes Technology Society.

Supreme Court of the United States Syllabus: San Antonio Independent School District Et. Al. v. Rodriguez Et. Al. Appeal from the United States District Court for the Western District of Texas. No. 71-1332, Argued October 12, 1972 -- Decided March 21, 1973.

ERIC Educational Resources Information Center

Supreme Court of the U. S., Washington, DC.

In this landmark educational finance opinion (presented here in full) the U.S. Supreme Court held that the Texas case was not a proper case in which to examine a State's laws under standards of strict judicial scrutiny. That test, according to the Court, is reserved for cases involving laws that operate to the disadvantage of suspect classes or…

The National Ballistics Imaging Comparison (NBIC) project.

PubMed

Song, J; Vorburger, T V; Ballou, S; Thompson, R M; Yen, J; Renegar, T B; Zheng, A; Silver, R M; Ols, M

2012-03-10

In response to the guidelines issued by the American Society of Crime Laboratory Directors/Laboratory Accreditation Board (ASCLD/LAB-International) to establish traceability and quality assurance in U.S. crime laboratories, a NIST/ATF joint project entitled National Ballistics Imaging Comparison (NBIC) was initialized in 2008. The NBIC project aims to establish a National Traceability and Quality System for ballistics identifications in crime laboratories within the National Integrated Ballistics Information Network (NIBIN) of the U.S. NIST Standard Reference Material (SRM) 2460 bullets and 2461 cartridge cases are used as reference standards. 19 ballistics examiners from 13 U.S. crime laboratories participated in this project. They each performed 24 periodic image acquisitions and correlations of the SRM bullets and cartridge cases over the course of a year, but one examiner only participated in Phase 1 tests of SRM cartridge case. The correlation scores were collected by NIST for statistical analyses, from which control charts and control limits were developed for the proposed Quality System and for promoting future assessments and accreditations for firearm evidence in U.S. forensic laboratories in accordance with the ISO 17025 Standard. Published by Elsevier Ireland Ltd.

Technology transfer through a network of standard methods and recommended practices - The case of petrochemicals

NASA Astrophysics Data System (ADS)

Batzias, Dimitris F.; Karvounis, Sotirios

2012-12-01

Technology transfer may take place in parallel with cooperative action between companies participating in the same organizational scheme or using one another as subcontractor (outsourcing). In this case, cooperation should be realized by means of Standard Methods and Recommended Practices (SRPs) to achieve (i) quality of intermediate/final products according to specifications and (ii) industrial process control as required to guarantee such quality with minimum deviation (corresponding to maximum reliability) from preset mean values of representative quality parameters. This work deals with the design of the network of SRPs needed in each case for successful cooperation, implying also the corresponding technology transfer, effectuated through a methodological framework developed in the form of an algorithmic procedure with 20 activity stages and 8 decision nodes. The functionality of this methodology is proved by presenting the path leading from (and relating) a standard test method for toluene, as petrochemical feedstock in the toluene diisocyanate production, to the (6 generations distance upstream) performance evaluation of industrial process control systems (ie., from ASTM D5606 to BS EN 61003-1:2004 in the SRPs network).

Flammability of gas mixtures. Part 1: fire potential.

PubMed

Schröder, Volkmar; Molnarne, Maria

2005-05-20

International and European dangerous substances and dangerous goods regulations refer to the standard ISO 10156 (1996). This standard includes a test method and a calculation procedure for the determination of the flammability of gases and gas mixtures in air. The substance indices for the calculation, the so called "Tci values", which characterise the fire potential, are provided as well. These ISO Tci values are derived from explosion diagrams of older literature sources which do not take into account the test method and the test apparatus. However, since the explosion limits are influenced by apparatus parameters, the Tci values and lower explosion limits, given by the ISO tables, are inconsistent with those measured according to the test method of the same standard. In consequence, applying the ISO Tci values can result in wrong classifications. In this paper internationally accepted explosion limit test methods were evaluated and Tci values were derived from explosion diagrams. Therefore, an "open vessel" method with flame propagation criterion was favoured. These values were compared with the Tci values listed in ISO 10156. In most cases, significant deviations were found. A detailed study about the influence of inert gases on flammability is the objective of Part 2.

The NASA Experience in Aeronautical R&D: Three Case Studies with Analysis

DTIC Science & Technology

1989-03-01

84 A noise exposure calculation typically starts with flyover values fur a given giound station (measured in EPNdB), adds a penalty of 10 dB for events...ft sideline station for a 150,000-pound aircraft. 1 0 4 Extrapolating this to the standard FAR-36 sideline station implies 82.5 EPNdB. QCGAT. In 1975...34 (AIM) developed at Lewis and tested in their Plumbrook hypersonic test facility. The SAM was regeneratively cooled with liquid hydrogen and was tested

Rapid Point of Care Detection of HPV-Associated Malignancies | Division of Cancer Prevention

Cancer.gov

Despite the development of effective human papillomavirus (HPV) vaccines, it has been estimated that there will be over 200,000 new cases and over 100,000 deaths due to cervical cancer by 2020 in India, which has 25% of the global burden of cases. Cervical cancer screening by Pap smears and HPV DNA testing has become standard of care in the US and Europe, but has been too

Stem loop-mediated isothermal amplification test: comparative analysis with classical LAMP and PCR in detection of Entamoeba histolytica in Kenya.

PubMed

Mwendwa, Fridah; Mbae, Cecilia K; Kinyua, Johnson; Mulinge, Erastus; Mburugu, Gitonga Nkanata; Njiru, Zablon K

2017-03-31

Entamoeba histolytica, the causative agent for amoebiasis is a considerable burden to population in the developing countries where it accounts for over 50 million infections. The tools for detection of amoebiasis are inadequate and diagnosis relies on microscopy which means a significant percent of cases remain undiagnosed. Moreover, tests formats that can be rapidly applied in rural endemic areas are not available. In this study, a loop-mediated isothermal test (LAMP) based on 18S small subunit ribosomal RNA gene was designed with extra reaction accelerating primers (stem primers) and compared with the published LAMP and PCR tests in detection of E. histolytica DNA in clinical samples. The stem LAMP test indicated shorter time to results by an average 11 min and analytical sensitivity of 10 -7 (~30 pg/ml) compared to the standard LAMP and PCR which showed sensitivities levels of 10 -5 (~3 ng/ml) and 10 -4 (~30 ng/ml) respectively using tenfold serial dilution of DNA. In the analysis of clinical specimens positive for Entamoeba spp. trophozoites and cysts using microscopy, the stem LAMP test detected E. histolytica DNA in 36/126, standard LAMP test 20/126 and PCR 17/126 cases respectively. There was 100% agreement in detection of the stem LAMP test product using fluorescence of SYTO-9 dye in real time machine, through addition of 1/10 dilution of SYBR ® Green I and electrophoresis in 2% agarose gel stained with ethidium bromide. The stem LAMP test developed in this study indicates potential towards detection of E. histolytica.

Drug and herb induced liver injury: Council for International Organizations of Medical Sciences scale for causality assessment

PubMed Central

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

2014-01-01

Causality assessment of suspected drug induced liver injury (DILI) and herb induced liver injury (HILI) is hampered by the lack of a standardized approach to be used by attending physicians and at various subsequent evaluating levels. The aim of this review was to analyze the suitability of the liver specific Council for International Organizations of Medical Sciences (CIOMS) scale as a standard tool for causality assessment in DILI and HILI cases. PubMed database was searched for the following terms: drug induced liver injury; herb induced liver injury; DILI causality assessment; and HILI causality assessment. The strength of the CIOMS lies in its potential as a standardized scale for DILI and HILI causality assessment. Other advantages include its liver specificity and its validation for hepatotoxicity with excellent sensitivity, specificity and predictive validity, based on cases with a positive reexposure test. This scale allows prospective collection of all relevant data required for a valid causality assessment. It does not require expert knowledge in hepatotoxicity and its results may subsequently be refined. Weaknesses of the CIOMS scale include the limited exclusion of alternative causes and qualitatively graded risk factors. In conclusion, CIOMS appears to be suitable as a standard scale for attending physicians, regulatory agencies, expert panels and other scientists to provide a standardized, reproducible causality assessment in suspected DILI and HILI cases, applicable primarily at all assessing levels involved. PMID:24653791

Relative efficiency and accuracy of two Navier-Stokes codes for simulating attached transonic flow over wings

NASA Technical Reports Server (NTRS)

Bonhaus, Daryl L.; Wornom, Stephen F.

1991-01-01

Two codes which solve the 3-D Thin Layer Navier-Stokes (TLNS) equations are used to compute the steady state flow for two test cases representing typical finite wings at transonic conditions. Several grids of C-O topology and varying point densities are used to determine the effects of grid refinement. After a description of each code and test case, standards for determining code efficiency and accuracy are defined and applied to determine the relative performance of the two codes in predicting turbulent transonic wing flows. Comparisons of computed surface pressure distributions with experimental data are made.

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

PubMed

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

2014-01-02

The Xpert MTB/RIF assay has garnered significant interest as a sensitive and rapid diagnostic tool to improve detection of sensitive and drug resistant tuberculosis. However, most existing literature has described the performance of MTB/RIF testing only in study conditions; little information is available on its use in routine case finding. TB REACH is a multi-country initiative focusing on innovative ways to improve case notification. We selected a convenience sample of nine TB REACH projects for inclusion to cover a range of implementers, regions and approaches. Standard quarterly reports and machine data from the first 12 months of MTB/RIF implementation in each project were utilized to analyze patient yields, rifampicin resistance, and failed tests. Data was collected from September 2011 to March 2013. A questionnaire was implemented and semi-structured interviews with project staff were conducted to gather information on user experiences and challenges. All projects used MTB/RIF testing for people with suspected TB, as opposed to testing for drug resistance among already diagnosed patients. The projects placed 65 machines (196 modules) in a variety of facilities and employed numerous case-finding strategies and testing algorithms. The projects consumed 47,973 MTB/RIF tests. Of valid tests, 7,195 (16.8%) were positive for MTB. A total of 982 rifampicin resistant results were found (13.6% of positive tests). Of all tests conducted, 10.6% failed. The need for continuous power supply was noted by all projects and most used locally procured solutions. There was considerable heterogeneity in how results were reported and recorded, reflecting the lack of standardized guidance in some countries. The findings of this study begin to fill the gaps among guidelines, research findings, and real-world implementation of MTB/RIF testing. Testing with Xpert MTB/RIF detected a large number of people with TB that routine services failed to detect. The study demonstrates the versatility and impact of the technology, but also outlines various surmountable barriers to implementation. The study is not representative of all early implementer experiences with MTB/RIF testing but rather provides an overview of the shared issues as well as the many different approaches to programmatic MTB/RIF implementation.

Effect of information literacy training course on information literacy skills of undergraduate students of Isfahan University of Medical Sciences based on ACRL standards

PubMed Central

Karimi, Zohreh; Ashrafi-rizi, Hasan; Papi, Ahmad; Shahrzadi, Leila; Hassanzadeh, Akbar

2015-01-01

Background: Information literacy is the basis for lifelong learning. Information literacy skills, especially for student in an environment that is full of information from multiple technologies are being developed is equally important. Information literacy is a set of cognitive and practical skills and like any other science, proper training is needed, and standard-based education is definitely better and evaluation would be easier. This study aimed to determine the impact of information literacy training course on information literacy skills of Isfahan University of Medical Sciences students based on ACRL standard in 2012. Materials and Methods: The study method is semi-experience with two group design (with pre-test and post-test) and applied. The data collection toll was a questionnaire assessing student's information literacy that developed by Davarpanah and Siamak and validity was confirmed by professional librarians and reliability as measured by Cronbach's alpha, was 0.83. The sample consisted of 50 undergraduate students from Isfahan University of Medical Sciences that by random sampling method was perch in both case and control groups. Before and after the training (once a week), a questionnaire was distributed between the two groups. This training was held in a classroom equipped with computers with internet access and in addition to training using brochures and librarian presentation, interactive methods such as discussion and exercises were used. The data were analyzed using SPSS version 20 software and two level of descriptive (mean and SD) and inferential statistics (t-test and t-paired). Results: The results showed that the students’ information literacy scores before the training was lower than average, so that in the control group was 32.96 and in the case group was 33.24; while information literacy scores in the case group significantly increased after the training (46.68). Also, the effect of education, respectively had a greater impact on the ability to access information (the second standard), ethics and legal use of information (the third standard), effective use of information (the fourth standard), critically evaluate information and its sources (the fifth standard). Conclusion: This study showed that the training was effective on enhancing students’ information literacy skills as the greatest impact was on increasing the ability to access information. Due to low mean score information literacy in the context of object recognition, there is a need for more training in this area. PMID:27462618

Development of Technologies for Early Detection and Stratification of Breast Cancer

DTIC Science & Technology

2015-10-01

fatal disease progression, or in the cases of over-treatment, unnecessary physical and emotional trauma.4 ELISA, the most common immunoassay for...laboratory to discover new biomarkers that meet these requirements within serum so that a simple blood test can be implemented. We are also working to...microspheres and tested first on standard samples. Assay performance characteristics will be determined to ascertain that they will address

The Divergent Thinking of Basic Skills of Sciences Process Skills of Life Aspects on Natural Sciences Subject in Indonesian Elementary School Students

ERIC Educational Resources Information Center

Subali, Bambang; Paidi; Mariyam, Siti

2016-01-01

This research aims at measuring the divergent thinking of basic skills of science process skills (SPS) of life aspects in Natural Sciences subjects on Elementary School. The test instruments used in this research have been standardized through the development of instruments. In this case, the tests were tried out to 3070 students. The results of…

[Implementation of quality standard UNE-EN ISO/IEC 17043 in the External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology].

PubMed

Poveda Gabaldón, Marta; Ovies, María Rosario; Orta Mira, Nieves; Serrano, M del Remedio Guna; Avila, Javier; Giménez, Alicia; Cardona, Concepción Gimeno

2011-12-01

The quality standard "UNE-EN-ISO 17043: 2010. Conformity assessment. General requirements for proficiency testing" applies to centers that organize intercomparisons in all areas. In the case of clinical microbiology laboratories, these intercomparisons must meet the management and technical standards required to achieve maximum quality in the performance of microbiological analysis and the preparation of test items (sample, product, data or other information used in the proficiency test) to enable them to be accredited. Once accredited, these laboratories can operate as a tool for quality control laboratories and competency assessment. In Spain, accreditation is granted by the Spanish Accreditation Body [Entidad Nacional de Acreditación (ENAC)]. The objective of this review is to explain how to apply the requirements of the standard to laboratories providing intercomparisons in the field of clinical microbiology (the organization responsible for all the tasks related to the development and operation of a proficiency testing program). This requires defining the scope and specifying the technical requirements (personnel management, control of equipment, facilities and environment, the design of the proficiency testing and data analysis for performance evaluation, communication with participants and confidentiality) and management requirements (document control, purchasing control, monitoring of complaints / claims, non-compliance, internal audits and management reviews). Copyright © 2011 Elsevier España S.L. All rights reserved.

Measurement of heterophil antibody and antibodies to EB viral capsid antigen IgG and IgM in suspected cases of infectious mononucleosis.

PubMed

Blake, J M; Edwards, J M; Fletcher, W; McSwiggan, D A; Pereira, M S

1976-09-01

The EBV IgG titres in acute and convalescent specimens from 97 cases of infectious mononucleosis were compared with titres from acute and convalescent sera from 96 students with illnesses resembling infectious mononucleosis but without heterophil antibody, EB IgM or EB IgG seroconversion; and also with titres from 91 healthy students known to have had EB IgG antibody for at least six months. These titres were related to the titre of the Research Standard A.66/235 for infectious mononucleosis serum prepared by the National Institute for Biological Standards and Control. Serial sera were tested for heterophil antibody and EBVCA specific IgG and IgM from 61 university students with infectious mononucleosis. The period of persistence of heterophil antibody and EBV IgM after illness was outlined from the results of the tests. Single sera from 406 patients in hospital or general practice sent to the diagnostic laboratory for heterophil antibody tests were also tested for EBV antibodies without prior knowledge of the heterophil antibody result. The close agreement between heterophil antibody and EBV IgM results is shown. False positive EB IgM results were correlated with the presence of rheumatoid factor.

Mechanical Testing of Polymeric Composites for Aircraft Applications: Standards, Requirements and Limitations

NASA Astrophysics Data System (ADS)

Chinchan, Levon; Shevtsov, Sergey; Soloviev, Arcady; Shevtsova, Varvara; Huang, Jiun-Ping

The high-loaded parts of modern aircrafts and helicopters are often produced from polymeric composite materials. Such materials consist of reinforcing fibers, packed by layers with the different angles, and resin, which uniformly distributes the structural stresses between fibers. These composites should have an orthotropic symmetry of mechanical properties to obtain the desirable spatial distribution of elastic moduli consistent to the external loading pattern. Main requirements to the aircraft composite materials are the specified elastic properties (9 for orthotropic composite), long-term strength parameters, high resistance against the environmental influences, low thermal expansion to maintain the shape stability. These properties are ensured by an exact implementation of technological conditions and many testing procedures performed with the fibers, resin, prepregs and ready components. Most important mechanical testing procedures are defined by ASTM, SACMA and other standards. However in each case the wide diversity of components (dimensions and lay-up of fibers, rheological properties of thermosetting resins) requires a specific approach to the sample preparation, testing, and numerical processing of the testing results to obtain the veritable values of tested parameters. We pay the special attention to the cases where the tested specimens are cut not from the plates recommended by standards, but from the ready part manufactured with the specific lay-up, tension forces on the reinforcing fiber at the filament winding, and curing schedule. These tests can provide most useful information both for the composite structural design and to estimate a quality of the ready parts. We consider an influence of relation between specimen dimensions and pattern of the fibers winding (or lay-up) on the results of mechanical testing for determination of longitudinal, transverse and in-plane shear moduli, an original numerical scheme for reconstruction of in-plane shear modulus measured by the modified Iosipescu method which use finite element based numerical processing and indicative data preliminary obtained by the short-beam test. The sensitivity and ability to decoupling the values of in-plane and interlaminar shear moduli obtained by the sample twisting test is studied and discussed.

The case-only test for gene-environment interaction is not uniformly powerful: an empirical example

PubMed Central

Wu, Chen; Chang, Jiang; Ma, Baoshan; Miao, Xiaoping; Zhou, Yifeng; Liu, Yu; Li, Yun; Wu, Tangchun; Hu, Zhibin; Shen, Hongbing; Jia, Weihua; Zeng, Yixin; Lin, Dongxin; Kraft, Peter

2016-01-01

The case-only test has been proposed as a more powerful approach to detect gene-environment (G×E) interactions. This approach assumes that the genetic and environmental factors are independent. While it is well known that Type I error rate will increase if this assumption is violated, it is less widely appreciated that gene-environment correlation can also lead to power loss. We illustrate this phenomenon by comparing the performance of the case-only test to other approaches to detect G×E interactions in a genome-wide association study of esophageal squamous carcinoma (ESCC) in Chinese populations. Some of these approaches do not use information on the correlation between exposure and genotype (standard logistic regression), while others seek to use this information in a robust fashion to boost power without increasing Type I error (two-step, empirical Bayes and cocktail methods). G×E interactions were identified involving drinking status and two regions containing genes in the alcohol metabolism pathway, 4q23 and 12q24. Although the case-only test yielded the most significant tests of G×E interaction in the 4q23 region, the case-only test failed to identify significant interactions in the 12q24 region which were readily identified using other approaches. The low power of the case-only test in the 12q24 region is likely due to the strong inverse association between the SNPs in this region and drinking status. This example underscores the need to consider multiple approaches to detect gene-environment interactions, as different tests are more or less sensitive to different alternative hypotheses and violations of the gene-environment independence assumption. PMID:23595356

How TK-TD and population models for aquatic macrophytes could support the risk assessment for plant protection products.

PubMed

Hommen, Udo; Schmitt, Walter; Heine, Simon; Brock, Theo Cm; Duquesne, Sabine; Manson, Phil; Meregalli, Giovanna; Ochoa-Acuña, Hugo; van Vliet, Peter; Arts, Gertie

2016-01-01

This case study of the Society of Environmental Toxicology and Chemistry (SETAC) workshop MODELINK demonstrates the potential use of mechanistic effects models for macrophytes to extrapolate from effects of a plant protection product observed in laboratory tests to effects resulting from dynamic exposure on macrophyte populations in edge-of-field water bodies. A standard European Union (EU) risk assessment for an example herbicide based on macrophyte laboratory tests indicated risks for several exposure scenarios. Three of these scenarios are further analyzed using effect models for 2 aquatic macrophytes, the free-floating standard test species Lemna sp., and the sediment-rooted submerged additional standard test species Myriophyllum spicatum. Both models include a toxicokinetic (TK) part, describing uptake and elimination of the toxicant, a toxicodynamic (TD) part, describing the internal concentration-response function for growth inhibition, and a description of biomass growth as a function of environmental factors to allow simulating seasonal dynamics. The TK-TD models are calibrated and tested using laboratory tests, whereas the growth models were assumed to be fit for purpose based on comparisons of predictions with typical growth patterns observed in the field. For the risk assessment, biomass dynamics are predicted for the control situation and for several exposure levels. Based on specific protection goals for macrophytes, preliminary example decision criteria are suggested for evaluating the model outputs. The models refined the risk indicated by lower tier testing for 2 exposure scenarios, while confirming the risk associated for the third. Uncertainties related to the experimental and the modeling approaches and their application in the risk assessment are discussed. Based on this case study and the assumption that the models prove suitable for risk assessment once fully evaluated, we recommend that 1) ecological scenarios be developed that are also linked to the exposure scenarios, and 2) quantitative protection goals be set to facilitate the interpretation of model results for risk assessment. © 2015 SETAC.

Comparing the ISO-recommended and the cumulative data-reduction algorithms in S-on-1 laser damage test by a reverse approach method

NASA Astrophysics Data System (ADS)

Zorila, Alexandru; Stratan, Aurel; Nemes, George

2018-01-01

We compare the ISO-recommended (the standard) data-reduction algorithm used to determine the surface laser-induced damage threshold of optical materials by the S-on-1 test with two newly suggested algorithms, both named "cumulative" algorithms/methods, a regular one and a limit-case one, intended to perform in some respects better than the standard one. To avoid additional errors due to real experiments, a simulated test is performed, named the reverse approach. This approach simulates the real damage experiments, by generating artificial test-data of damaged and non-damaged sites, based on an assumed, known damage threshold fluence of the target and on a given probability distribution function to induce the damage. In this work, a database of 12 sets of test-data containing both damaged and non-damaged sites was generated by using four different reverse techniques and by assuming three specific damage probability distribution functions. The same value for the threshold fluence was assumed, and a Gaussian fluence distribution on each irradiated site was considered, as usual for the S-on-1 test. Each of the test-data was independently processed by the standard and by the two cumulative data-reduction algorithms, the resulting fitted probability distributions were compared with the initially assumed probability distribution functions, and the quantities used to compare these algorithms were determined. These quantities characterize the accuracy and the precision in determining the damage threshold and the goodness of fit of the damage probability curves. The results indicate that the accuracy in determining the absolute damage threshold is best for the ISO-recommended method, the precision is best for the limit-case of the cumulative method, and the goodness of fit estimator (adjusted R-squared) is almost the same for all three algorithms.

Test of the cosmic transparency with the standard candles and the standard ruler

NASA Astrophysics Data System (ADS)

Chen, Jun

In this paper, the cosmic transparency is constrained by using the latest baryon acoustic oscillation (BAO) data and the type Ia supernova data with a model-independent method. We find that a transparent universe is consistent with observational data at the 1σ confidence level, except for the case of BAO+ Union 2.1 without the systematic errors where a transparent universe is favored only at the 2σ confidence level. To investigate the effect of the uncertainty of the Hubble constant on the test of the cosmic opacity, we assume h to be a free parameter and obtain that the observations favor a transparent universe at the 1σ confidence level.

Allergic contact dermatitis from the synthetic fragrances Lyral and acetyl cedrene in separate underarm deodorant preparations.

PubMed

Handley, J; Burrows, D

1994-11-01

The case is reported of a 28-year-old man who developed allergic contact dermatitis from 2 synthetic fragrance ingredients, Lyral (3- and 4-(4-hydroxy-4-methylpentyl)-3-cyclohexene-1-aldehyde) and acetyl cedrene, in separate underarm deodorant preparations. The implications of the patient's negative patch test reactions to the European standard series (Trolab) and cosmetics and fragrance series (both Chemotechnique Diagnostics) are discussed. The importance is stressed of patch testing with the patient's own preparations when cosmetic dermatitis is suspected, and of identifying and reporting offending fragrance ingredients, with a view possibly to updating the European standard series and commercially available cosmetics and fragrance series.

Automated detection and classification of major retinal vessels for determination of diameter ratio of arteries and veins

NASA Astrophysics Data System (ADS)

Muramatsu, Chisako; Hatanaka, Yuji; Iwase, Tatsuhiko; Hara, Takeshi; Fujita, Hiroshi

2010-03-01

Abnormalities of retinal vasculatures can indicate health conditions in the body, such as the high blood pressure and diabetes. Providing automatically determined width ratio of arteries and veins (A/V ratio) on retinal fundus images may help physicians in the diagnosis of hypertensive retinopathy, which may cause blindness. The purpose of this study was to detect major retinal vessels and classify them into arteries and veins for the determination of A/V ratio. Images used in this study were obtained from DRIVE database, which consists of 20 cases each for training and testing vessel detection algorithms. Starting with the reference standard of vasculature segmentation provided in the database, major arteries and veins each in the upper and lower temporal regions were manually selected for establishing the gold standard. We applied the black top-hat transformation and double-ring filter to detect retinal blood vessels. From the extracted vessels, large vessels extending from the optic disc to temporal regions were selected as target vessels for calculation of A/V ratio. Image features were extracted from the vessel segments from quarter-disc to one disc diameter from the edge of optic discs. The target segments in the training cases were classified into arteries and veins by using the linear discriminant analysis, and the selected parameters were applied to those in the test cases. Out of 40 pairs, 30 pairs (75%) of arteries and veins in the 20 test cases were correctly classified. The result can be used for the automated calculation of A/V ratio.

Mining Peripheral Arterial Disease Cases from Narrative Clinical Notes Using Natural Language Processing

PubMed Central

Afzal, Naveed; Sohn, Sunghwan; Abram, Sara; Scott, Christopher G.; Chaudhry, Rajeev; Liu, Hongfang; Kullo, Iftikhar J.; Arruda-Olson, Adelaide M.

2016-01-01

Objective Lower extremity peripheral arterial disease (PAD) is highly prevalent and affects millions of individuals worldwide. We developed a natural language processing (NLP) system for automated ascertainment of PAD cases from clinical narrative notes and compared the performance of the NLP algorithm to billing code algorithms, using ankle-brachial index (ABI) test results as the gold standard. Methods We compared the performance of the NLP algorithm to 1) results of gold standard ABI; 2) previously validated algorithms based on relevant ICD-9 diagnostic codes (simple model) and 3) a combination of ICD-9 codes with procedural codes (full model). A dataset of 1,569 PAD patients and controls was randomly divided into training (n= 935) and testing (n= 634) subsets. Results We iteratively refined the NLP algorithm in the training set including narrative note sections, note types and service types, to maximize its accuracy. In the testing dataset, when compared with both simple and full models, the NLP algorithm had better accuracy (NLP: 91.8%, full model: 81.8%, simple model: 83%, P<.001), PPV (NLP: 92.9%, full model: 74.3%, simple model: 79.9%, P<.001), and specificity (NLP: 92.5%, full model: 64.2%, simple model: 75.9%, P<.001). Conclusions A knowledge-driven NLP algorithm for automatic ascertainment of PAD cases from clinical notes had greater accuracy than billing code algorithms. Our findings highlight the potential of NLP tools for rapid and efficient ascertainment of PAD cases from electronic health records to facilitate clinical investigation and eventually improve care by clinical decision support. PMID:28189359

Comparison between Siriraj mite allergen vaccine and standardized commercial mite vaccine by skin prick testing in normal Thai adults.

PubMed

Visitsunthorn, Nualanong; Pacharn, Punchama; Jirapongsananuruk, Orathai; Weeravejsukit, Sirirat; Sripramong, Chaweewan; Sookrung, Nitat; Bunnag, Chaweewan

2010-03-01

House dust mite is a major cause of allergic asthma and rhinitis in Thai population. Skin prick test (SPT) is a useful tool for the diagnosis of the IgE-mediated reactions. The imported commercial mite vaccine for SPT is available but it is relatively expensive. Aim of this study is to compare Siriraj Mite Allergen Vaccine (SMAV) with standardized commercial mite allergen vaccine by skin prick testing in normal Thai adults. A double blind, self-controlled study between the SMAV and standardized commercial mite allergen vaccine was performed by SPT in 17 normal Thai adult males and non-pregnant or non-lactating females aged 18-60 years. The study showed that 35.29 % of non atopic adults had positive SPT reaction to Dp and Df of both SMAV and standardized commercial mite allergen vaccine. Mean wheal and flare diameters from SPT of Dp and Df of SMAV showed strong correlation with standardized commercial mite allergen vaccine (r= 0.768 and 0.897 in Dp and Df respectively, p <0.001). The intraclass correlation was also excellent (0.893 and 0.775 in Dp and Df respectively). There was no significant difference in wheal and flare diameter between SMAV and standardized commercial mite allergen vaccine. No systemic or large local reaction was found in any of the study cases.

Fatigue testing of metric bolts fitted with lip-type nuts

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

Dragoni, E.

This paper addresses the effect of the external shape of lip-type nuts on the fatigue strength of commercial M10 bolts loaded in tension. Evolving from the standard configuration, six nut geometries are compared, characterized by lips of different shape (cylindrical, tapered or both) and length. Testing and statistical treatment of the data are performed in accordance with a JSME standard involving 14 specimens for each geometry. Within the class of merely cylindrical lips, only limited advantages over the standard assembly are detected. In particular, the bolt strength remains mostly unaffected by lengthening of the lip beyond one third of themore » nut height. Conversely, tapering of the lip end so as to thin its wall around the entry section of the bolt results in substantial improvements. In this case, the strength increase is roughly proportional to the taper length. Adoption of a tapered lip covering two thirds of the nut height enhances the bolt strength by about one fourth with respect to the standard geometry.« less

Incidental Lewy Body Disease: Clinical Comparison to a Control Cohort

PubMed Central

Adler, Charles H.; Connor, Donald J.; Hentz, Joseph G.; Sabbagh, Marwan N.; Caviness, John N.; Shill, Holly A.; Noble, Brie; Beach, Thomas G.

2010-01-01

Limited clinical information has been published on cases pathologically diagnosed with incidental Lewy body disease (ILBD). Standardized, longitudinal movement and cognitive data was collected on a cohort of subjects enrolled in the Sun Health Research Institute Brain and Body Donation Program. Of 277 autopsied subjects who had antemortem clinical evaluations within the previous 3 years, 76 did not have Parkinson’s disease, a related disorder, or dementia of which 15 (20%) had ILBD. Minor extrapyramidal signs were common in subjects with and without ILBD. Cognitive testing revealed an abnormality in the ILBD group in the Trails B test only. ILBD cases had olfactory dysfunction; however, sample size was very small. This preliminary report revealed ILBD cases have movement and cognitive findings that for the most part were not out of proportion to similarly assessed and age-similar cases without Lewy bodies. Larger sample size is needed to have the power to better assess group differences. PMID:20175211

Automated Extraction of Formalin-Fixed, Paraffin-Embedded Tissue for High-Risk Human Papillomavirus Testing of Head and Neck Squamous Cell Carcinomas Using the Roche Cobas 4800 System.

PubMed

Kerr, Darcy A; Sweeney, Brenda; Arpin, Ronald N; Ring, Melissa; Pitman, Martha B; Wilbur, David C; Faquin, William C

2016-08-01

-Testing for high-risk human papillomavirus (HR-HPV) in head and neck squamous cell carcinomas (HNSCCs) is important for both prognostication and clinical management. Several testing platforms are available for HR-HPV; however, effective alternative automated approaches are needed. -To assess the performance of the automated Roche cobas 4800 HPV real-time polymerase chain reaction-based system on formalin-fixed, paraffin-embedded HNSCC specimens and compare results with standard methods of in situ hybridization (ISH) and p16 immunohistochemistry. -Formalin-fixed, paraffin-embedded samples of HNSCC were collected from archival specimens in the Department of Pathology, Massachusetts General Hospital (Boston), and prepared using the automated system by deparaffinization and dehydration followed by tissue lysis. Samples were integrated into routine cervical cytology testing runs by cobas. Corresponding formalin-fixed, paraffin-embedded samples were evaluated for HR-HPV by ISH and p16 by immunohistochemistry. Discrepant cases were adjudicated by polymerase chain reaction. -Sixty-two HNSCC samples were analyzed using the automated cobas system, ISH, and immunohistochemistry. Fifty-two percent (n = 32 of 62) of formalin-fixed, paraffin-embedded tumors were positive for HR-HPV by cobas. Eighty-eight percent (n = 28 of 32) of cases were the HPV 16 subtype and 12% (n = 4 of 32) were other HR-HPV subtypes. Corresponding testing with ISH was concordant in 92% (n = 57 of 62) of cases. Compared with the adjudication polymerase chain reaction standard, there were 3 false-positive cases by cobas. -Concordance in HNSCC HR-HPV status between cobas and ISH was more than 90%. The cobas demonstrated a sensitivity of 100% and a specificity of 91% for detection of HR-HPV. Advantages favoring cobas include its automation, cost efficiency, objective results, and ease of performance.

Assessing Adaptive Functioning in Death Penalty Cases after Hall and DSM-5.

PubMed

Hagan, Leigh D; Drogin, Eric Y; Guilmette, Thomas J

2016-03-01

DSM-5 and Hall v. Florida (2014) have dramatically refocused attention on the assessment of adaptive functioning in death penalty cases. In this article, we address strategies for assessing the adaptive functioning of defendants who seek exemption from capital punishment pursuant to Atkins v. Virginia (2002). In particular, we assert that evaluations of adaptive functioning should address assets as well as deficits; seek to identify credible and reliable evidence concerning the developmental period and across the lifespan; distinguish incapacity from the mere absence of adaptive behavior; adhere faithfully to test manual instructions for using standardized measures of adaptive functioning; and account for potential bias on the part of informants. We conclude with brief caveats regarding the standard error of measurement (SEM) in light of Hall, with reference to examples of ordinary life activities that directly illuminate adaptive functioning relevant to capital cases. © 2016 American Academy of Psychiatry and the Law.

Diagnostic power of laboratory tests for hereditary spherocytosis: a comparison study in 150 patients grouped according to molecular and clinical characteristics

PubMed Central

Bianchi, Paola; Fermo, Elisa; Vercellati, Cristina; Marcello, Anna P.; Porretti, Laura; Cortelezzi, Agostino; Barcellini, Wilma; Zanella, Alberto

2012-01-01

Background The laboratory diagnosis of hereditary spherocytosis commonly relies on NaCl-based or glycerol-based red cell osmotic fragility tests; more recently, an assay directly targeting the hereditary spherocytosis molecular defect (eosin-5′-maleimide-binding test) has been proposed. None of the available tests identifies all cases of hereditary spherocytosis. Design and Methods We compared the performances of the eosin-5′-maleimide-binding test, NaCl-osmotic fragility studies on fresh and incubated blood, the glycerol lysis test, the acidified glycerol lysis test, and the Pink test on a series of 150 patients with hereditary spherocytosis grouped according to clinical phenotype and the defective protein, with the final aim of finding the combination of tests associated with the highest diagnostic power, even in the mildest cases of hereditary spherocytosis. Results The eosin-5′-maleimide-binding test had a sensitivity of 93% and a specificity of 98% for detecting hereditary spherocytosis: the sensitivity was independent of the type and amount of molecular defect and of the clinical phenotype. The acidified glycerol lysis test and Pink test showed comparable sensitivity (95% and 91%). The sensitivity of NaCl osmotic fragility tests, commonly considered the gold standard for the diagnosis of hereditary spherocytosis, was 68% on fresh blood and 81% on incubated blood, and further decreased in compensated cases (53% and 64%, respectively). The combination of the eosin-5′-maleimide-binding test and acidified glycerol lysis test enabled all patients with hereditary spherocytosis to be identified. The eosin-5′-maleimide-binding test showed the greatest disease specificity. Conclusions Each type of test fails to diagnose some cases of hereditary spherocytosis. The association of an eosin-5′-maleimide-binding test and an acidified glycerol lysis test enabled identification of all patients with hereditary spherocytosis in this series and, therefore, represents a currently effective diagnostic strategy for hereditary spherocytosis including mild/compensated cases. PMID:22058213

Robust Mean and Covariance Structure Analysis through Iteratively Reweighted Least Squares.

ERIC Educational Resources Information Center

Yuan, Ke-Hai; Bentler, Peter M.

2000-01-01

Adapts robust schemes to mean and covariance structures, providing an iteratively reweighted least squares approach to robust structural equation modeling. Each case is weighted according to its distance, based on first and second order moments. Test statistics and standard error estimators are given. (SLD)

40 CFR 86.004-28 - Compliance with emission standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... factor may not be appropriate in cases where testing variability is significantly greater than engine-to-engine variability. Multiplicative deterioration factors must be specified to one more significant figure... regenerations are increasing exhaust gas temperature to remove sulfur from an adsorber or increasing exhaust gas...

Simulations for the Assessment of Counselling Skills.

ERIC Educational Resources Information Center

Smit, Gertrude N.; van der Molen, Henk T.

1996-01-01

A Dutch undergraduate course in professional counseling skills uses simulation to test students' ability to conduct an initial client interview, using standardized case histories. A study investigated the effectiveness of the method with 160 course participants, 77 non-participants, and 12 professional counselors and found it useful for…

Sustaining Arts Programs in Public Education

ERIC Educational Resources Information Center

Dunstan, David

2016-01-01

The purpose of this qualitative research case study was to investigate leadership and funding decisions that determine key factors responsible for sustaining arts programs in public schools. While the educational climate, financial constraints, and standardized testing continue to impact arts programs in public education, Eastland High School, the…

Cost-Effectiveness of One-Time Hepatitis C Screening Strategies Among Adolescents and Young Adults in Primary Care Settings.

PubMed

Assoumou, Sabrina A; Tasillo, Abriana; Leff, Jared A; Schackman, Bruce R; Drainoni, Mari-Lynn; Horsburgh, C Robert; Barry, M Anita; Regis, Craig; Kim, Arthur Y; Marshall, Alison; Saxena, Sheel; Smith, Peter C; Linas, Benjamin P

2018-01-18

High hepatitis C virus (HCV) rates have been reported in young people who inject drugs (PWID). We evaluated the clinical benefit and cost-effectiveness of testing among youth seen in communities with a high overall number of reported HCV cases. We developed a decision analytic model to project quality-adjusted life years (QALYs), costs (2016 US$), and incremental cost-effectiveness ratios (ICERs) of 9 strategies for 1-time testing among 15- to 30-year-olds seen at urban community health centers. Strategies differed in 3 ways: targeted vs routine testing, rapid finger stick vs standard venipuncture, and ordered by physician vs by counselor/tester using standing orders. We performed deterministic and probabilistic sensitivity analyses (PSA) to evaluate uncertainty. Compared to targeted risk-based testing (current standard of care), routine testing increased the lifetime medical cost by $80 and discounted QALYs by 0.0013 per person. Across all strategies, rapid testing provided higher QALYs at a lower cost per QALY gained and was always preferred. Counselor-initiated routine rapid testing was associated with an ICER of $71000/QALY gained. Results were sensitive to offer and result receipt rates. Counselor-initiated routine rapid testing was cost-effective (ICER <$100000/QALY) unless the prevalence of PWID was <0.59%, HCV prevalence among PWID was <16%, reinfection rate was >26 cases per 100 person-years, or reflex confirmatory testing followed all reactive venipuncture diagnostics. In PSA, routine rapid testing was the optimal strategy in 90% of simulations. Routine rapid HCV testing among 15- to 30-year-olds may be cost-effective when the prevalence of PWID is >0.59%. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

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

Ma, Y; Lacroix, F; Lavallee, M

Purpose: To evaluate the commercially released Collapsed Cone convolution-based(CCC) dose calculation module of the Elekta OncentraBrachy(OcB) treatment planning system(TPS). Methods: An allwater phantom was used to perform TG43 benchmarks with single source and seventeen sources, separately. Furthermore, four real-patient heterogeneous geometries (chestwall, lung, breast and prostate) were used. They were selected based on their clinical representativity of a class of clinical anatomies that pose clear challenges. The plans were used as is(no modification). For each case, TG43 and CCC calculations were performed in the OcB TPS, with TG186-recommended materials properly assigned to ROIs. For comparison, Monte Carlo simulation was runmore » for each case with the same material scheme and grid mesh as TPS calculations. Both modes of CCC (standard and high quality) were tested. Results: For the benchmark case, the CCC dose, when divided by that of TG43, yields hot-n-cold spots in a radial pattern. The pattern of the high mode is denser than that of the standard mode and is representative of angular dicretization. The total deviation ((hot-cold)/TG43) is 18% for standard mode and 11% for high mode. Seventeen dwell positions help to reduce “ray-effect”, with the total deviation to 6% (standard) and 5% (high), respectively. For the four patient cases, CCC produces, as expected, more realistic dose distributions than TG43. A close agreement was observed between CCC and MC for all isodose lines, from 20% and up; the 10% isodose line of CCC appears shifted compared to that of MC. The DVH plots show dose deviations of CCC from MC in small volume, high dose regions (>100% isodose). For patient cases, the difference between standard and high modes is almost undiscernable. Conclusion: OncentraBrachy CCC algorithm marks a significant dosimetry improvement relative to TG43 in real-patient cases. Further researches are recommended regarding the clinical implications of the above observations. Support provided by a CIHR grant and CCC system provided by Elekta-Nucletron.« less

Adaptive Offset Correction for Intracortical Brain Computer Interfaces

PubMed Central

Homer, Mark L.; Perge, János A.; Black, Michael J.; Harrison, Matthew T.; Cash, Sydney S.; Hochberg, Leigh R.

2014-01-01

Intracortical brain computer interfaces (iBCIs) decode intended movement from neural activity for the control of external devices such as a robotic arm. Standard approaches include a calibration phase to estimate decoding parameters. During iBCI operation, the statistical properties of the neural activity can depart from those observed during calibration, sometimes hindering a user’s ability to control the iBCI. To address this problem, we adaptively correct the offset terms within a Kalman filter decoder via penalized maximum likelihood estimation. The approach can handle rapid shifts in neural signal behavior (on the order of seconds) and requires no knowledge of the intended movement. The algorithm, called MOCA, was tested using simulated neural activity and evaluated retrospectively using data collected from two people with tetraplegia operating an iBCI. In 19 clinical research test cases, where a nonadaptive Kalman filter yielded relatively high decoding errors, MOCA significantly reduced these errors (10.6 ±10.1%; p<0.05, pairwise t-test). MOCA did not significantly change the error in the remaining 23 cases where a nonadaptive Kalman filter already performed well. These results suggest that MOCA provides more robust decoding than the standard Kalman filter for iBCIs. PMID:24196868

Adaptive offset correction for intracortical brain-computer interfaces.

PubMed

Homer, Mark L; Perge, Janos A; Black, Michael J; Harrison, Matthew T; Cash, Sydney S; Hochberg, Leigh R

2014-03-01

Intracortical brain-computer interfaces (iBCIs) decode intended movement from neural activity for the control of external devices such as a robotic arm. Standard approaches include a calibration phase to estimate decoding parameters. During iBCI operation, the statistical properties of the neural activity can depart from those observed during calibration, sometimes hindering a user's ability to control the iBCI. To address this problem, we adaptively correct the offset terms within a Kalman filter decoder via penalized maximum likelihood estimation. The approach can handle rapid shifts in neural signal behavior (on the order of seconds) and requires no knowledge of the intended movement. The algorithm, called multiple offset correction algorithm (MOCA), was tested using simulated neural activity and evaluated retrospectively using data collected from two people with tetraplegia operating an iBCI. In 19 clinical research test cases, where a nonadaptive Kalman filter yielded relatively high decoding errors, MOCA significantly reduced these errors ( 10.6 ± 10.1% ; p < 0.05, pairwise t-test). MOCA did not significantly change the error in the remaining 23 cases where a nonadaptive Kalman filter already performed well. These results suggest that MOCA provides more robust decoding than the standard Kalman filter for iBCIs.

Self-regulated learning in a dynamic coaching model for supporting college students with traumatic brain injury: two case reports.

PubMed

Kennedy, Mary R T; Krause, Miriam O

2011-01-01

To describe a program that integrates self-regulated learning theory with supported education for college students with traumatic brain injury using a dynamic coaching model; to demonstrate the feasibility of developing and implementing such a program; and to identify individualized outcomes. Case study comparisons. University setting. Two severely injured students with cognitive impairments. A dynamic coaching model of supported education which incorporated self-regulated learning was provided for students with traumatic brain injury while attending college. Outcomes were both short and long term including decontextualized standardized test scores, self-reported academic challenges, number and specificity of reported strategies, grades on assignments, number of credits completed versus attempted, and changes in academic status and campus life. Students improved on graded assignments after strategy instruction and reported using more strategies by the end of the year. Students completed most of the credits they attempted, were in good academic standing, and made positive academic decisions. Performance on decontextualized tests pre- and postintervention was variable. It is feasible to deliver a hybrid supported education program that is dynamically responsive to individual students' needs and learning styles. Reasons for including both functional and standardized test outcomes are discussed.

Clinical Validation of Targeted Next Generation Sequencing for Colon and Lung Cancers

PubMed Central

D’Haene, Nicky; Le Mercier, Marie; De Nève, Nancy; Blanchard, Oriane; Delaunoy, Mélanie; El Housni, Hakim; Dessars, Barbara; Heimann, Pierre; Remmelink, Myriam; Demetter, Pieter; Tejpar, Sabine; Salmon, Isabelle

2015-01-01

Objective Recently, Next Generation Sequencing (NGS) has begun to supplant other technologies for gene mutation testing that is now required for targeted therapies. However, transfer of NGS technology to clinical daily practice requires validation. Methods We validated the Ion Torrent AmpliSeq Colon and Lung cancer panel interrogating 1850 hotspots in 22 genes using the Ion Torrent Personal Genome Machine. First, we used commercial reference standards that carry mutations at defined allelic frequency (AF). Then, 51 colorectal adenocarcinomas (CRC) and 39 non small cell lung carcinomas (NSCLC) were retrospectively analyzed. Results Sensitivity and accuracy for detecting variants at an AF >4% was 100% for commercial reference standards. Among the 90 cases, 89 (98.9%) were successfully sequenced. Among the 86 samples for which NGS and the reference test were both informative, 83 showed concordant results between NGS and the reference test; i.e. KRAS and BRAF for CRC and EGFR for NSCLC, with the 3 discordant cases each characterized by an AF <10%. Conclusions Overall, the AmpliSeq colon/lung cancer panel was specific and sensitive for mutation analysis of gene panels and can be incorporated into clinical daily practice. PMID:26366557

Synthesizing Information From Language Samples and Standardized Tests in School-Age Bilingual Assessment

PubMed Central

Pham, Giang

2017-01-01

Purpose Although language samples and standardized tests are regularly used in assessment, few studies provide clinical guidance on how to synthesize information from these testing tools. This study extends previous work on the relations between tests and language samples to a new population—school-age bilingual speakers with primary language impairment—and considers the clinical implications for bilingual assessment. Method Fifty-one bilingual children with primary language impairment completed narrative language samples and standardized language tests in English and Spanish. Children were separated into younger (ages 5;6 [years;months]–8;11) and older (ages 9;0–11;2) groups. Analysis included correlations with age and partial correlations between language sample measures and test scores in each language. Results Within the younger group, positive correlations with large effect sizes indicated convergence between test scores and microstructural language sample measures in both Spanish and English. There were minimal correlations in the older group for either language. Age related to English but not Spanish measures. Conclusions Tests and language samples complement each other in assessment. Wordless picture-book narratives may be more appropriate for ages 5–8 than for older children. We discuss clinical implications, including a case example of a bilingual child with primary language impairment, to illustrate how to synthesize information from these tools in assessment. PMID:28055056

The effect of contact lens materials on disinfection activity of polyquaternium-1 and myristamidopropyl dimethylamine multipurpose solution against Staphylococcus aureus.

PubMed

Shoff, Megan E; Lucas, Anne D; Phillips, K Scott; Brown, Jennifer N; Hitchins, Victoria M; Eydelman, Malvina B

2012-11-01

This study examined the interaction of seven different lens materials with a multipurpose solution (MPS) containing the disinfectants polyquaternium-1 (0.001%) and myristamidopropyl dimethylamine (0.0005%). The objective of this study was to determine whether the different lens materials affect the concentration of a disinfectant in this commercially available MPS and the efficacy of the disinfectant against Staphylococcus aureus. Silicone hydrogel lenses (galyfilcon A, senofilcon A, comfilcon A, enfilcon A, balafilcon A, and lotrafilcon B) and a conventional hydrogel lens (etafilcon A) were soaked in polypropylene lens cases filled with commercially available MPS containing 0.001% polyquaternium-1 and 0.0005% myristamidopropyl dimethylamine for 6, 12, 24, 72, and 168 hours. Empty lens cases were also filled with MPS. After each time point, solutions from cases containing the seven types of lenses and controls were assayed for activity against S. aureus according to International Standards Organization 14729 standard with modifications. Test solutions were analyzed for polyquaternium-1 and myristamidopropyl dimethylamine concentration at each time point. The concentration of polyquaternium-1 and myristamidopropyl dimethylamine remaining in the lens cases was reduced only slightly over time. Storage with the lenses did not adversely affect biocidal efficacy of the solution, and in some cases, it was significantly better (P=0.0029). The efficacy of this polyquaternium-1 and myristamidopropyl dimethylamine MPS to kill S. aureus was not adversely affected by the presence of lens materials soaking in the cases. Thus, current methods for performing solution antimicrobial testing should be reevaluated.

Impact of HIPAA’s Minimum Necessary Standard on Genomic Data Sharing

PubMed Central

Evans, Barbara J.; Jarvik, Gail P.

2017-01-01

Purpose This article provides a brief introduction to the HIPAA Privacy Rule’s minimum necessary standard, which applies to sharing of genomic data, particularly clinical data, following 2013 Privacy Rule revisions. Methods This research used the Thomson Reuters Westlaw™ database and law library resources in its legal analysis of the HIPAA privacy tiers and the impact of the minimum necessary standard on genomic data-sharing. We considered relevant example cases of genomic data-sharing needs. Results In a climate of stepped-up HIPAA enforcement, this standard is of concern to laboratories that generate, use, and share genomic information. How data-sharing activities are characterized—whether for research, public health, or clinical interpretation and medical practice support—affects how the minimum necessary standard applies and its overall impact on data access and use. Conclusion There is no clear regulatory guidance on how to apply HIPAA’s minimum necessary standard when considering the sharing of information in the data-rich environment of genomic testing. Laboratories that perform genomic testing should engage with policy-makers to foster sound, well-informed policies and appropriate characterization of data-sharing activities to minimize adverse impacts on day-to-day workflows. PMID:28914268

Impact of HIPAA's minimum necessary standard on genomic data sharing.

PubMed

Evans, Barbara J; Jarvik, Gail P

2018-04-01

This article provides a brief introduction to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule's minimum necessary standard, which applies to sharing of genomic data, particularly clinical data, following 2013 Privacy Rule revisions. This research used the Thomson Reuters Westlaw database and law library resources in its legal analysis of the HIPAA privacy tiers and the impact of the minimum necessary standard on genomic data sharing. We considered relevant example cases of genomic data-sharing needs. In a climate of stepped-up HIPAA enforcement, this standard is of concern to laboratories that generate, use, and share genomic information. How data-sharing activities are characterized-whether for research, public health, or clinical interpretation and medical practice support-affects how the minimum necessary standard applies and its overall impact on data access and use. There is no clear regulatory guidance on how to apply HIPAA's minimum necessary standard when considering the sharing of information in the data-rich environment of genomic testing. Laboratories that perform genomic testing should engage with policy makers to foster sound, well-informed policies and appropriate characterization of data-sharing activities to minimize adverse impacts on day-to-day workflows.

Is there a link between infant botulism and sudden infant death? Bacteriological results obtained in central Germany.

PubMed

Böhnel, H; Behrens, S; Loch, P; Lube, K; Gessler, F

2001-10-01

Despite the fact that botulism was described in Germany for the first time by Kerner in 1820, the disease is almost forgotten in this country. Only about 10-20 cases of classical botulism (intoxication) are recorded every year, including 1-2 cases of clinical infant botulism. As we assumed a high incidence of botulism to be connected with cases of sudden infant death (SID), we undertook the research work presented here. From every case of unexpected infant death up to 12 months of age, standardised specimens (blood, liver and intestine) were taken at autopsy. They were tested for the presence of botulinum neurotoxin (BoNT) and/or bacterial forms of Clostridium botulinum with subsequent BoNT neutralisation tests by the international standard mouse bioassay. Age, sex, pathological findings and season were recorded. Over a 5-year period, 75 samples including 57 SID cases were tested. Free toxin was found in nine and bacterial forms were detected in six samples. Toxin neutralisation revealed the definite presence of BoNT/BoNT producing bacteria (mainly type E), whereas another 11 toxin tests were inconclusive. According to international literature, these 15 cases are to be interpreted as infant botulism. the results show a remarkable incidence of infant botulism without any known previous medical history, partly hidden as sudden infant death. We propose to systematically search for botulism in connection with sudden infant death.

Noninvasive prenatal testing of trisomies 21 and 18 by massively parallel sequencing of maternal plasma DNA in twin pregnancies.

PubMed

Huang, Xuan; Zheng, Jing; Chen, Min; Zhao, Yangyu; Zhang, Chunlei; Liu, Lifu; Xie, Weiwei; Shi, Shuqiong; Wei, Yuan; Lei, Dongzhu; Xu, Chenming; Wu, Qichang; Guo, Xiaoling; Shi, Xiaomei; Zhou, Yi; Liu, Qiufang; Gao, Ya; Jiang, Fuman; Zhang, Hongyun; Su, Fengxia; Ge, Huijuan; Li, Xuchao; Pan, Xiaoyu; Chen, Shengpei; Chen, Fang; Fang, Qun; Jiang, Hui; Lau, Tze Kin; Wang, Wei

2014-04-01

The objective of this study is to assess the performance of noninvasive prenatal testing for trisomies 21 and 18 on the basis of massively parallel sequencing of cell-free DNA from maternal plasma in twin pregnancies. A double-blind study was performed over 12 months. A total of 189 pregnant women carrying twins were recruited from seven hospitals. Maternal plasma DNA sequencing was performed to detect trisomies 21 and 18. The fetal karyotype was used as gold standard to estimate the sensitivity and specificity of sequencing-based noninvasive prenatal test. There were nine cases of trisomy 21 and two cases of trisomy 18 confirmed by karyotyping. Plasma DNA sequencing correctly identified nine cases of trisomy 21 and one case of trisomy 18. The discordant case of trisomy 18 was an unusual case of monozygotic twin with discordant fetal karyotype (one normal and the other trisomy 18). The sensitivity and specificity of maternal plasma DNA sequencing for fetal trisomy 21 were both 100% and for fetal trisomy 18 were 50% and 100%, respectively. Our study further supported that sequencing-based noninvasive prenatal testing of trisomy 21 in twin pregnancies could be achieved with a high accuracy, which could effectively avoid almost 95% of invasive prenatal diagnosis procedures. © 2013 John Wiley & Sons, Ltd.

The Need for a Shear Stress Calibration Standard

NASA Technical Reports Server (NTRS)

Scott, Michael A.

2004-01-01

By surveying current research of various micro-electro mechanical systems (MEMS) shear stress sensor development efforts we illustrate the wide variety of methods used to test and characterize these sensors. The different methods of testing these sensors make comparison of results difficult in some cases, and also this comparison is further complicated by the different formats used in reporting the results of these tests. The fact that making these comparisons can be so difficult at times clearly illustrates a need for standardized testing and reporting methodologies. This need indicates that the development of a national or international standard for the calibration of MEMS shear stress sensors should be undertaken. As a first step towards the development of this standard, two types of devices are compared and contrasted. The first type device is a laminar flow channel with two different versions considered: the first built with standard manufacturing techniques and the second with advanced precision manufacturing techniques. The second type of device is a new concept for creating a known shear stress consisting of a rotating wheel with the sensor mounted tangentially to the rim and positioned in close proximity to the rim. The shear stress generated by the flow at the sensor position is simply tau = (mu)r(omega)/h, where mu is the viscosity of the ambient gas, r the wheel radius, omega the angular velocity of the wheel, and h the width of the gap between the wheel rim and the sensor. Additionally, issues related to the development of a standard for shear stress calibration are identified and discussed.

(Meth)Acrylate Occupational Contact Dermatitis in Nail Salon Workers: A Case Series.

PubMed

DeKoven, Samuel; DeKoven, Joel; Holness, D Linn

Recently, many cases of acrylate-associated allergic contact dermatitis have appeared among nail salon workers. Common acrylate-containing products in nail salons include traditional nail polish, ultraviolet-cured shellac nail polish, ultraviolet-cured gel nails, and press-on acrylic nails. Nail salon technicians seen in the occupational medicine clinic in 2015 and 2016 were identified, and their patch test results and clinical features were summarized. Patch testing was done with the Chemotechnique (Meth)Acrylate nail series, and either the North American Standard series or the North American Contact Dermatitis Group screening series. Six patients were identified, all women, ages 38 to 58. Common presentations included erythematous dermatitis of the dorsa of the hands, palms, and forearms and fissures on the fingertips. Less common sites of eruptions included the periorbital region, cheeks, posterior ears, neck, sacral area, lateral thighs, and dorsa of the feet. All patients reacted to hydroxyethyl methacrylate, and 5 patients reacted to ethyl acrylate. Each patient also reacted to (meth)acrylates that are not found on either standard series, including ethyleneglycol dimethacrylate, 2-hydroxypropyl methacrylate, and 2-hydroxyethyl acrylate. The authors report 6 cases of allergic contact dermatitis to acrylates in nail technicians seen over the past year, representing a new trend in their clinic. These cases are reflective of a growing trend of nail technicians with allergic contact dermatitis associated with occupational (meth)acrylate exposure. Efforts to improve prevention are needed.

Harmonization in laboratory medicine: Requests, samples, measurements and reports.

PubMed

Plebani, Mario

2016-01-01

In laboratory medicine, the terms "standardization" and "harmonization" are frequently used interchangeably as the final goal is the same: the equivalence of measurement results among different routine measurement procedures over time and space according to defined analytical and clinical quality specifications. However, the terms define two distinct, albeit closely linked, concepts based on traceability principles. The word "standardization" is used when results for a measurement are equivalent and traceable to the International System of Units (SI) through a high-order primary reference material and/or a reference measurement procedure (RMP). "Harmonization" is generally used when results are equivalent, but neither a high-order primary reference material nor a reference measurement procedure is available. Harmonization is a fundamental aspect of quality in laboratory medicine as its ultimate goal is to improve patient outcomes through the provision of accurate and actionable laboratory information. Patients, clinicians and other healthcare professionals assume that clinical laboratory tests performed by different laboratories at different times on the same sample and specimen can be compared, and that results can be reliably and consistently interpreted. Unfortunately, this is not necessarily the case, because many laboratory test results are still highly variable and poorly standardized and harmonized. Although the initial focus was mainly on harmonizing and standardizing analytical processes and methods, the scope of harmonization now also includes all other aspects of the total testing process (TTP), such as terminology and units, report formats, reference intervals and decision limits as well as tests and test profiles, requests and criteria for interpretation. Several projects and initiatives aiming to improve standardization and harmonization in the testing process are now underway. Laboratory professionals should therefore step up their efforts to provide interchangeable and comparable laboratory information in order to ultimately assure better diagnosis and treatment in patient care.

Assessment of a novel biomechanical fracture model for distal radius fractures

PubMed Central

2012-01-01

Background Distal radius fractures (DRF) are one of the most common fractures and often need surgical treatment, which has been validated through biomechanical tests. Currently a number of different fracture models are used, none of which resemble the in vivo fracture location. The aim of the study was to develop a new standardized fracture model for DRF (AO-23.A3) and compare its biomechanical behavior to the current gold standard. Methods Variable angle locking volar plates (ADAPTIVE, Medartis) were mounted on 10 pairs of fresh-frozen radii. The osteotomy location was alternated within each pair (New: 10 mm wedge 8 mm / 12 mm proximal to the dorsal / volar apex of the articular surface; Gold standard: 10 mm wedge 20 mm proximal to the articular surface). Each specimen was tested in cyclic axial compression (increasing load by 100 N per cycle) until failure or −3 mm displacement. Parameters assessed were stiffness, displacement and dissipated work calculated for each cycle and ultimate load. Significance was tested using a linear mixed model and Wald test as well as t-tests. Results 7 female and 3 male pairs of radii aged 74 ± 9 years were tested. In most cases (7/10), the two groups showed similar mechanical behavior at low loads with increasing differences at increasing loads. Overall the novel fracture model showed a significant different biomechanical behavior than the gold standard model (p < 0,001). The average final loads resisted were significantly lower in the novel model (860 N ± 232 N vs. 1250 N ± 341 N; p = 0.001). Conclusion The novel biomechanical fracture model for DRF more closely mimics the in vivo fracture site and shows a significantly different biomechanical behavior with increasing loads when compared to the current gold standard. PMID:23244634

Repeatability Modeling for Wind-Tunnel Measurements: Results for Three Langley Facilities

NASA Technical Reports Server (NTRS)

Hemsch, Michael J.; Houlden, Heather P.

2014-01-01

Data from extensive check standard tests of seven measurement processes in three NASA Langley Research Center wind tunnels are statistically analyzed to test a simple model previously presented in 2000 for characterizing short-term, within-test and across-test repeatability. The analysis is intended to support process improvement and development of uncertainty models for the measurements. The analysis suggests that the repeatability can be estimated adequately as a function of only the test section dynamic pressure over a two-orders- of-magnitude dynamic pressure range. As expected for low instrument loading, short-term coefficient repeatability is determined by the resolution of the instrument alone (air off). However, as previously pointed out, for the highest dynamic pressure range the coefficient repeatability appears to be independent of dynamic pressure, thus presenting a lower floor for the standard deviation for all three time frames. The simple repeatability model is shown to be adequate for all of the cases presented and for all three time frames.

Structural Dynamics Modeling of HIRENASD in Support of the Aeroelastic Prediction Workshop

NASA Technical Reports Server (NTRS)

Wieseman, Carol; Chwalowski, Pawel; Heeg, Jennifer; Boucke, Alexander; Castro, Jack

2013-01-01

An Aeroelastic Prediction Workshop (AePW) was held in April 2012 using three aeroelasticity case study wind tunnel tests for assessing the capabilities of various codes in making aeroelasticity predictions. One of these case studies was known as the HIRENASD model that was tested in the European Transonic Wind Tunnel (ETW). This paper summarizes the development of a standardized enhanced analytical HIRENASD structural model for use in the AePW effort. The modifications to the HIRENASD finite element model were validated by comparing modal frequencies, evaluating modal assurance criteria, comparing leading edge, trailing edge and twist of the wing with experiment and by performing steady and unsteady CFD analyses for one of the test conditions on the same grid, and identical processing of results.

Medicolegal affairs. International Academy of Cytology Task Force summary. Diagnostic Cytology Towards the 21st Century: An International Expert Conference and Tutorial.

PubMed

Frable, W J; Austin, R M; Greening, S E; Collins, R J; Hillman, R L; Kobler, T P; Koss, L G; Mitchell, H; Perey, R; Rosenthal, D L; Sidoti, M S; Somrak, T M

1998-01-01

Increasing litigation over alleged false negative cervical cytologic (CC) smears threatens the viability of this test for cervical cancer detection. The problem appears to be largely American but is beginning to appear in some other countries. In the vast majority of cases there is either a settlement or jury verdict for the plaintiff based largely on the testimony of expert witnesses. Cases are judged on an individual basis without significant consideration of the general performance of the CC smear in laboratories operating in compliance with a wide array of laboratory regulations and with documented and comprehensive quality control practices in place. It is acknowledged that there are problem laboratories and cytology practitioners. There is an emerging issue of automated preparation and screening devices and issues of informed patient consent. Cytology professionals have done an extraordinary and commendable job of educating the public about the benefits of the CC smear. We have been less successful and conscientious about explaining and defining the limitations of the CC test. There is a need for public and professional education as to the benefits and limitations of the CC smear for cervical cancer detection. The process suggested is to work with women's groups, public health agencies, government agencies, and state and national legislatures and to coordinate professional committees working on liability issues. Contextual information could be included with the CC smear report to indicate that a negative report confers a low probability of developing cervical cancer. It is suggested that appropriate language and a menu of statements be developed. Increased efforts should be directed to physician education with respect to informed consent concerning the benefits and limitations of CC smear testing and the application of new technology to improve smear accuracy. The process should include development of appropriate statements on the use of alternative technology. The profession should develop "process guidelines" for review of CC smears in the context of possible litigation, including standardized methods for blind slide review of smears that reduce or eliminate context and outcome bias. It is suggested that review panels be anonymous, that the process be standardized and that there be limitations on liability for participating organizations. Professional cytopathology and pathology societies should formulate acceptable guidelines for expert witnesses. The standards should be applicable to both defendant and plaintiff experts. All materials to the extent practical, including consultant opinions, should be available for peer review. Professional cytopathology and pathology societies should monitor expert testimony for objectivity and scientific accuracy. For the near future, litigation will continue to focus on false negative CC smears on a case-by-case basis. Laboratories and individuals can reduce the risk of malpractice liability by directing their attention to proactive quality control and quality assurance methods. In the final analysis, consumer education about the benefits and limitations of the test is key to limiting malpractice claims. To stem the tide of continued medicolegal challenges to the integrity of cytology practice, the cytology community has now focused its efforts on developing and utilizing standards that convey to patients, attorneys and cytologists the contemporary status of and reasonable expectations for the practice of cytology. Guidelines such as those for uniform reporting terminology and clinical management of cervical abnormalities form the basis of cytology practice standards on which legal standards of practice can be based. Consensus conference reports, clinical management trials and scientifically valid studies of false negative rates that analyze the type, frequency and cause of missed cases represent sounder methods of establishing defensible

An early evaluation of clinical and economic costs and benefits of implementing point of care NAAT tests for Chlamydia trachomatis and Neisseria gonorrhoea in genitourinary medicine clinics in England.

PubMed

Turner, Katherine M E; Round, Jeff; Horner, Patrick; Macleod, John; Goldenberg, Simon; Deol, Arminder; Adams, Elisabeth J

2014-03-01

To estimate the costs and benefits of clinical pathways incorporating a point of care (POC) nucleic acid amplification test (NAAT) for chlamydia and gonorrhoea in genitourinary medicine (GUM) clinics compared with standard off-site laboratory testing. We simulated 1.2 million GUM clinic attendees in England. A simulation in Microsoft Excel was developed to compare existing standard pathways of management for chlamydia and gonorrhoea with a POC NAAT. We conducted scenario analyses to evaluate the robustness of the model findings. The primary outcome was the incremental cost-effectiveness ratio. Secondary outcomes included the number of inappropriate treatments, complications and transmissions averted. The baseline cost of using the point of POC NAAT was £103.9 million compared with £115.6 million for standard care. The POC NAAT was also associated with a small increase of 46 quality adjusted life years, making the new test both more effective and cheaper. Over 95 000 inappropriate treatments might be avoided by using a POC NAAT. Patients receive diagnosis and treatment on the same day as testing, which may also prevent 189 cases of pelvic inflammatory disease and 17 561 onward transmissions annually. Replacing standard laboratory tests for chlamydia and gonorrhoea with a POC test could be cost saving and patients would benefit from more accurate diagnosis and less unnecessary treatment. Overtreatment currently accounts for about a tenth of the reported treatments for chlamydia and gonorrhoea and POC NAATs would effectively eliminate the need for presumptive treatment.

The dilemma of diagnostic testing for Prader-Willi syndrome

PubMed Central

Hung, Dorothy

2017-01-01

Although Prader-Willi syndrome (PWS) is a well-described clinical dysmorphic syndrome, DNA testing is required for a definitive diagnosis. A definitive diagnosis can be made in approximately 99% of cases using DNA testing; there are a number of DNA tests that can be used for this purpose, although there is no set standard algorithm of testing. The dilemma arises because of the complex genetic mechanisms at the basis of PWS, which need to be elucidated. To establish the molecular mechanism with a complete work up, involves at least 2 tests. Here we discuss the commonly used tests currently available and suggest a cost—effective approach to diagnostic testing. PMID:28164030

Cause and motivation in cases of non-fatal drug overdoses in opiate addicts.

PubMed

Pfab, R; Eyer, F; Jetzinger, E; Zilker, Thomas

2006-01-01

Drug overdose (OD) is a frequent incident among opiate addicts. Survivors of ODs are at risk for additional and eventually fatal ODs. ODs may be classified as accidental (aOD) or deliberate (dOD). Investigations into the connection between OD and suicide attempts have led to insconsistent results. (1) to determine how many non-fatal ODs were dODs and how many were aODs; (2) to determine how many cases of dODs were motivated by explicit or by ambivalent suicidal intentions; (3) to determine how many cases of aODs had causes that might respond to preventative measures; (4) to compare the addiction histories of dODs and aODs; (5) to compare the drugs causing the ODs; and (6) to compare the severity of the ODs in both groups. Prospective study utilizing a standardized questionnaire to evaluate opiate-addicted patients admitted to our treatment unit for OD. All cases underwent standardized drug testing to identify drug use patterns. Seventy-four cases of OD underwent standardized interviews after awakening. Forty-three percent of the cases were dOD. Cases of dOD had significantly more OA in substitution programs, more previous ODs, and more often consumed methadone and cocaine. Among dODs, 22.5% had suicidal intention and 9.6% were ambivalent about committing suicide; background motivations were most often conflicts with spouses. Fifty-seven percent of the cases were aOD. Cases of aODs had significantly more potential lethal intoxications and had heroin detected more frequently. aODs happened with unexpected pure heroin (46%), in combination with alcohol (36%), as relapse after abstinence (40%) or after institutionalized treatment (19%). This group should be accessible for targeted education.

Teicoplanin allergy - an emerging problem in the anaesthetic allergy clinic.

PubMed

Savic, L C; Garcez, T; Hopkins, P M; Harper, N J N; Savic, S

2015-10-01

Anaphylaxis to teicoplanin appears to be extremely rare, with only one confirmed case report worldwide. Two anaesthetic allergy clinics in the UK have received a number of suspected cases referred for investigation, and we present here the first case series of teicoplanin allergy. We investigated 20 cases of suspected teicoplanin allergy, identified from the two clinics over a period of two years. We devised a set of five criteria to categorize the certainty of their diagnosis. These included: (1) reaction within 15 min of administration of teicoplanin, (2) ≥2 features of anaphylaxis present, (3) positive skin testing or challenge testing, (4) raised serum mast cell tryptase (MCT), (5) alternative diagnosis excluded. Based on these criteria we defined the likelihood of IgE-mediated allergy to teicoplanin as: definite-met all criteria; probable-met criteria 1.2 and 5, plus 3 or 4; uncertain-met criteria 1.2 and 5; excluded- any others. We identified 7 'definite', 7 'probable' and 2 'uncertain' cases of teicoplanin allergy. Four cases were excluded. IgE-mediated anaphylaxis to teicoplanin appears to be more common than previously thought. This is true even if only definitive cases are considered. Investigation of teicoplanin allergy is hampered by the lack of standardized skin test concentrations. In some cases, there was a severe clinical reaction, but without any skin test evidence of histamine release. The mechanism of reaction in these cases is not known and requires further study. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Oromucosal film preparations: classification and characterization methods.

PubMed

Preis, Maren; Woertz, Christina; Kleinebudde, Peter; Breitkreutz, Jörg

2013-09-01

Recently, the regulatory authorities have enlarged the variety of 'oromucosal preparations' by buccal films and orodispersible films. Various film preparations have entered the market and pharmacopoeias. Due to the novelty of the official monographs, no standardized characterization methods and quality specifications are included. This review reports the methods of choice to characterize oromucosal film preparations with respect to biorelevant characterization and quality control. Commonly used dissolution tests for other dosage forms are not transferable for films in all cases. Alternatives and guidance on decision, which methods are favorable for film preparations are discussed. Furthermore, issues about requirements for film dosage forms are reflected. Oromucosal film preparations offer a wide spectrum of opportunities. There are a lot of suggestions in the literature on how to control the quality of these innovative products, but no standardized tests are available. Regulatory authorities need to define the standards and quality requirements more precisely.

Building a Case for Blocks as Kindergarten Mathematics Learning Tools

ERIC Educational Resources Information Center

Kinzer, Cathy; Gerhardt, Kacie; Coca, Nicole

2016-01-01

Kindergarteners need access to blocks as thinking tools to develop, model, test, and articulate their mathematical ideas. In the current educational landscape, resources such as blocks are being pushed to the side and being replaced by procedural worksheets and academic "seat time" in order to address standards. Mathematics research…

From Exploratory Talk to Abstract Reasoning: A Case for Far Transfer?

ERIC Educational Resources Information Center

Webb, Paul; Whitlow, J. W., Jr.; Venter, Danie

2017-01-01

Research has shown improvements in science, mathematics, and language scores when classroom discussion is employed in school-level science and mathematics classes. Studies have also shown statistically and practically significant gains in children's reasoning abilities as measured by the Raven's Standard Progressive Matrices test when employing…

Teacher Identity and Reform: Intersections within School Culture

ERIC Educational Resources Information Center

Bower, Heather Ann; Parsons, Eileen R. Carlton

2016-01-01

In the era of school accountability, school reform programs aimed at shifting school culture are often implemented in an attempt to increase student achievement as measured by standardized test scores. This ethnographic case study was conducted in Hawk Elementary, a low-performing, high-poverty school. Quantitative and qualitative data collected…

The Case of Public Schools in Argentina

ERIC Educational Resources Information Center

Adrogue, Cecilia; Orlicki, Maria Eugenia

2013-01-01

As Argentina presents problems of malnutrition, the federal in-school feeding program has become a key policy because it provides an important nutritional intervention during a relevant growth period. This paper estimates the effect of the program on academic performance--measured by standardized test scores--with a difference in difference model,…

Bioinformatic genome comparisons for taxonomic and phylogenic assignments using Aeromonas as a test case

USDA-ARS?s Scientific Manuscript database

Prokaryotic taxonomy is the underpinning of microbiology, providing a framework for the proper identification and naming of organisms. The 'gold standard' of bacterial species delineation is the overall genome similarity as determined by DNA-DNA hybridization (DDH), a technically rigorous yet someti...

Two black hole initial data

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

Leski, Szymon

2005-06-15

The Misner initial data are a standard example of time-symmetric initial data with two apparent horizons. Compact formulae describing such data are presented in the cases of equal or nonequal masses (i.e. isometric or nonisometric horizons). The interaction energy in the 'Schwarzschild + test-particle' limit of the Misner data is analyzed.

Allocating Resources for Learning Support: A Case Study.

ERIC Educational Resources Information Center

Sharp, Stephen

2000-01-01

Examines how learning-support resources are allocated to Scottish secondary schools, drawing on data from an Edinburgh education authority. Although a rationale for allocating resources based on socioeconomic indices can be constructed, basing decisions on a combination of standardized attainment tests and special-needs audits is preferable.…

Search and Seizure: What Your School's Rights Are.

ERIC Educational Resources Information Center

Stefkovich, Jacqueline A.; O'Brien, G. Michaele

1996-01-01

Unlike most school-security strategies, search and seizure procedures can be largely determined by studying landmark court cases. The U.S. Supreme Court set standards for conducting school searches in "New Jersey v. T.L.O." (1985) and for drug testing student athletes in "Vernonia School District v. Acton" (1995). School…

Practical Approaches to Outcomes Assessment: The Undergraduate Major in Foreign Languages and Literatures.

ERIC Educational Resources Information Center

Liskin-Gasparro, Judith E.

1995-01-01

Discusses specific instruments and procedures that university-level foreign languages and literatures departments can use in outcomes-assessment of their undergraduate majors, including standardized tests, oral assessments, questionnaires, and portfolios. Case studies of outcomes-assessment programs in language departments at the University of…

The Influence of Educational Experience on the Development of Cognitive Skills as Measured in Formal Tests and Experiments: A Case Study from the Mexican States of Yucatan and Quintana Roo. Final Report.

ERIC Educational Resources Information Center

Sharp, Donald W.; Cole, Michael

The major purpose of the research reported was to assess whether developmental changes in performance on standard psychological tests may be more a reflection of educational experience than maturation or traditional socialization practices. The investigation was reported in three phases: 1) description of the general and specific experimental…

Ultraviolet Radiation Round-Robin Testing of Various Backsheets for Photovoltaic Modules

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

Koehl, Michael; Ballion, Amal; Lee, Yu-Hsien

2015-06-14

Durability testing of materials exposed to natural weathering requires testing of the ultraviolet (UV) stability, especially for polymeric materials. The type approval testing of photovoltaic (PV) modules according to standards IEC 61215 and IEC 61646, which includes a so-called UV preconditioning test with a total UV dose of 15 kWh/m2, does not correspond to the real loads during lifetime. Between 3%-10% of the UV radiation has to be in the spectral range between 280 and 320 nm (UV-B) in the recent editions of the standards. However, the spectral distribution of the radiation source is very important because different samples showmore » very individual spectral sensitivity for the radiation offered. Less than 6% of the intensity of solar radiation exists in the UV range. In the case of an increase of the intensity of the light source for accelerating the UV test, overheating of the samples would have to be prevented more rigorously and the temperature of the samples have to be measured to avoid misinterpretation of the test results.« less

Efficient logistic regression designs under an imperfect population identifier.

PubMed

Albert, Paul S; Liu, Aiyi; Nansel, Tonja

2014-03-01

Motivated by actual study designs, this article considers efficient logistic regression designs where the population is identified with a binary test that is subject to diagnostic error. We consider the case where the imperfect test is obtained on all participants, while the gold standard test is measured on a small chosen subsample. Under maximum-likelihood estimation, we evaluate the optimal design in terms of sample selection as well as verification. We show that there may be substantial efficiency gains by choosing a small percentage of individuals who test negative on the imperfect test for inclusion in the sample (e.g., verifying 90% test-positive cases). We also show that a two-stage design may be a good practical alternative to a fixed design in some situations. Under optimal and nearly optimal designs, we compare maximum-likelihood and semi-parametric efficient estimators under correct and misspecified models with simulations. The methodology is illustrated with an analysis from a diabetes behavioral intervention trial. © 2013, The International Biometric Society.

Influence of case-based e-learning on students' performance in point-of-care ultrasound courses: a randomized trial.

PubMed

Hempel, Dorothea; Sinnathurai, Sivajini; Haunhorst, Stephanie; Seibel, Armin; Michels, Guido; Heringer, Frank; Recker, Florian; Breitkreutz, Raoul

2016-08-01

Theoretical knowledge, visual perception, and sensorimotor skills are key elements in ultrasound education. Classroom-based presentations are used routinely to teach theoretical knowledge, whereas visual perception and sensorimotor skills typically require hands-on training (HT). We aimed to compare the effect of classroom-based lectures versus a case-based e-learning (based on clinical cases only) on the hands-on performance of trainees during an emergency ultrasound course. This is a randomized, controlled, parallel-group study. Sixty-two medical students were randomized into two groups [group 1 (G1) and group 2 (G2)]. G1 (n=29) was subjected to a precourse e-learning, based on 14 short screencasts (each 5 min), an on-site discussion (60 min), and a standardized HT session on the day of the course. G2 (n=31) received classroom-based presentations on the day of the course before an identical HT session. Both groups completed a multiple-choice (MC) pretest (test A), a practical postcourse test (objective structured clinical exam), and MC tests directly after the HT (test B) and 1 day after the course (test C). The Mann-Whitney U-test was used for statistical analysis. G1 performed markedly better in test A (median 84.2, 25%; 75% percentile: 68.5; 92.2) compared with G2 (65.8; 53.8; 80.4), who had not participated in case-based e-learning (P=0.0009). No differences were found in the objective structured clinical exam, test B, and test C. e-learning exclusively based on clinical cases is an effective method of education in preparation for HT sessions and can reduce attendance time in ultrasound courses.

Fission matrix-based Monte Carlo criticality analysis of fuel storage pools

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

Farlotti, M.; Ecole Polytechnique, Palaiseau, F 91128; Larsen, E. W.

2013-07-01

Standard Monte Carlo transport procedures experience difficulties in solving criticality problems in fuel storage pools. Because of the strong neutron absorption between fuel assemblies, source convergence can be very slow, leading to incorrect estimates of the eigenvalue and the eigenfunction. This study examines an alternative fission matrix-based Monte Carlo transport method that takes advantage of the geometry of a storage pool to overcome this difficulty. The method uses Monte Carlo transport to build (essentially) a fission matrix, which is then used to calculate the criticality and the critical flux. This method was tested using a test code on a simplemore » problem containing 8 assemblies in a square pool. The standard Monte Carlo method gave the expected eigenfunction in 5 cases out of 10, while the fission matrix method gave the expected eigenfunction in all 10 cases. In addition, the fission matrix method provides an estimate of the error in the eigenvalue and the eigenfunction, and it allows the user to control this error by running an adequate number of cycles. Because of these advantages, the fission matrix method yields a higher confidence in the results than standard Monte Carlo. We also discuss potential improvements of the method, including the potential for variance reduction techniques. (authors)« less

Examining the Usefulness of ISO 10819 Anti-Vibration Glove Certification.

PubMed

Budd, Diandra; House, Ron

2017-03-01

Anti-vibration gloves are commonly worn to reduce hand-arm vibration exposure from work with hand-held vibrating tools when higher priority and more effective controls are unavailable. For gloves to be marketed as 'anti-vibration' they must meet the vibration transmissibility criteria described in the International Organization for Standardization (ISO) standard 10819 (2013). Several issues exist with respect to the methodology used for glove testing as well as the requirements for glove design and composition in ISO 10819 (2013). The true usefulness of anti-vibration gloves at preventing hand-arm vibration syndrome (HAVS) is controversial, given that their performance is dependent on tool vibration characteristics and the anthropometrics of workers in real working conditions. The major risk associated with the use of anti-vibration gloves is that it will give employees and employers a false sense of protection against the negative effects of hand-transmitted vibration. This commentary examines the limitations of the current international standards for anti-vibration glove testing and certification, thereby calling into question the degree of protection that anti-vibration gloves provide against HAVS, and cautioning users to consider both their benefits and potential drawbacks on a case-by-case basis. © The Author 2017. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

Synergistic relationships between Analytical Chemistry and written standards.

PubMed

Valcárcel, Miguel; Lucena, Rafael

2013-07-25

This paper describes the mutual impact of Analytical Chemistry and several international written standards (norms and guides) related to knowledge management (CEN-CWA 14924:2004), social responsibility (ISO 26000:2010), management of occupational health and safety (OHSAS 18001/2), environmental management (ISO 14001:2004), quality management systems (ISO 9001:2008) and requirements of the competence of testing and calibration laboratories (ISO 17025:2004). The intensity of this impact, based on a two-way influence, is quite different depending on the standard considered. In any case, a new and fruitful approach to Analytical Chemistry based on these relationships can be derived. Copyright © 2013 Elsevier B.V. All rights reserved.

International Standards for Properties and Performance of Advanced Ceramics - 30 years of Excellence

NASA Technical Reports Server (NTRS)

Jenkins, Michael G.; Salem, Jonathan A.; Helfinstine, John; Quinn, George D.; Gonczy, Stephen T.

2016-01-01

Mechanical and physical properties/performance of brittle bodies (e.g., advanced ceramics and glasses) can be difficult to measure correctly unless the proper techniques are used. For three decades, ASTM Committee C28 on Advanced Ceramics, has developed numerous full-consensus standards (e.g., test methods, practices, guides, terminology) to measure various properties and performance of a monolithic and composite ceramics and coatings that, in some cases, may be applicable to glasses. These standards give the "what, how, how not, why, why not, etc." for many mechanical, physical, thermal, properties and performance of advanced ceramics. Use of these standards provides accurate, reliable, repeatable and complete data. Involvement in ASTM Committee C28 has included users, producers, researchers, designers, academicians, etc. who write, continually update, and validate through round robin test programmes, more than 45 standards in the 30 years since the Committee's inception in 1986. Included in this poster is a pictogram of the ASTM Committee C28 standards and how to obtain them either as i) individual copies with full details or ii) a complete collection in one volume. A listing of other ASTM committees of interest is included. In addition, some examples of the tangible benefits of standards for advanced ceramics are employed to demonstrate their practical application.

Author Response to Sabour (2018), "Comment on Hall et al. (2017), 'How to Choose Between Measures of Tinnitus Loudness for Clinical Research? A Report on the Reliability and Validity of an Investigator-Administered Test and a Patient-Reported Measure Using Baseline Data Collected in a Phase IIa Drug Trial'".

PubMed

Hall, Deborah A; Mehta, Rajnikant L; Fackrell, Kathryn

2018-03-08

The authors respond to a letter to the editor (Sabour, 2018) concerning the interpretation of validity in the context of evaluating treatment-related change in tinnitus loudness over time. The authors refer to several landmark methodological publications and an international standard concerning the validity of patient-reported outcome measurement instruments. The tinnitus loudness rating performed better against our reported acceptability criteria for (face and convergent) validity than did the tinnitus loudness matching test. It is important to distinguish between tests that evaluate the validity of measuring treatment-related change over time and tests that quantify the accuracy of diagnosing tinnitus as a case and non-case.

Is it time to sound an alarm about false-positive cell-free DNA testing for fetal aneuploidy?

PubMed

Mennuti, Michael T; Cherry, Athena M; Morrissette, Jennifer J D; Dugoff, Lorraine

2013-11-01

Testing cell-free DNA (cfDNA) in maternal blood samples has been shown to have very high sensitivity for the detection of fetal aneuploidy with very low false-positive results in high-risk patients who undergo invasive prenatal diagnosis. Recent observation in clinical practice of several cases of positive cfDNA tests for trisomy 18 and trisomy 13, which were not confirmed by cytogenetic testing of the pregnancy, may reflect a limitation of the positive predictive value of this quantitative testing, particularly when it is used to detect rare aneuploidies. Analysis of a larger number of false-positive cases is needed to evaluate whether these observations reflect the positive predictive value that should be expected. Infrequently, mechanisms (such as low percentage mosaicism or confined placental mosaicism) might also lead to positive cfDNA testing that is not concordant with standard prenatal cytogenetic diagnosis. The need to explore these and other possible causes of false-positive cfDNA testing is exemplified by 2 of these cases. Additional evaluation of cfDNA testing in clinical practice and a mechanism for the systematic reporting of false-positive and false-negative cases will be important before this test is offered widely to the general population of low-risk obstetric patients. In the meantime, incorporating information about the positive predictive value in pretest counseling and in clinical laboratory reports is recommended. These experiences reinforce the importance of offering invasive testing to confirm cfDNA results before parental decision-making. Copyright © 2013 Mosby, Inc. All rights reserved.

The COBATEST network: a platform to perform monitoring and evaluation of HIV community-based testing practices in Europe and conduct operational research.

PubMed

Fernàndez-López, L; Reyes-Urueña, J; Agustí, C; Kustec, T; Klavs, I; Casabona, C

2016-01-01

The European project "HIV community-based testing practices in Europe" (HIV-COBATEST) has contributed to the establishment of a network of community-based voluntary counselling and testing services (CBVCTs) that monitors and evaluates HIV testing activity in the communities. The objective of this paper is to describe the data that have been collected during 2014 by the COBATEST network in order to provide an insight into testing activity of CBVCTs in Europe. Members of the CBVCT network share common instruments for data collection and data entry. The network has a common database that allows global data analysis and comparison between different centres. In 2014, 40 CBVCTs of 18 European countries were participating in the network, and, from those, 20 CBVCTs were using the common COBATEST data collection tools. In these 20 CBVCTs, a total of 9266 HIV screening tests were performed on 8554 people, of which 1.58% (135/8554) were reactive and 51.1% (69/135) confirmed positive. Five cases were false positives, and 84.1% (58/69) of the confirmed positive cases were linked to care. Most of the tested individuals were men (70.8%), between 21 and 35 years of age (57.6%) and natives (67.1%). A higher proportion of men who had sex with men (MSM) (38.8%; 3267/8554) were tested compared to heterosexual men (27.7%) and women (23.5%). Rapid blood test was used in 78.5% of the cases and mostly performed in CBVCT offices (88.3%). Among sex workers (SWs), the percentage of reactive screening tests was particularly high (4.0%), especially among male SWs (7.7%) as compared to other risk groups, such as MSM (3.1%). The COBATEST network contributes to the availability of standardized information about the activity and impact of CBVCT centres in Europe. This information and standardized tools can help improve these services and inform decision-makers to better contextualize these interventions within their national HIV-prevention programmes.

Modification of CMV DNA detection from dried blood spots for diagnosing congenital CMV infection.

PubMed

Binda, Sandro; Caroppo, Simona; Didò, Patrizia; Primache, Valeria; Veronesi, Licia; Calvario, Agata; Piana, Andrea; Barbi, Maria

2004-07-01

Detection of viral DNA in dried blood spots using the Guthrie card (DBS test) is a reliable and practical method of diagnosing congenital cytomegalovirus (CMV) infection. The test lends itself to epidemiological studies to establish the prevalence of the infection, but also to neonatal screening for secondary prevention of sequelae. These applications would be facilitated if it were possible to use smaller samples and do the test on pools of individual cases. To ascertain whether doing the test on smaller, pooled samples still accurately identifies neonates with congenital CMV infection. We tested DBS from: (A) 39 laboratory reference cases; (B) 156 neonates suspected of having congenital CMV infection; (C) 119 children examined for the retrospective diagnosis of congenital CMV; (D) mock specimens prepared with known amounts of viral DNA. The test using only one third of the usual amount of dried blood was 100% sensitive and specific compared to the standard DBS test (A) and to viral isolation (A and B). Pools of three single cases gave the same results as viral isolation (B) and the small-sample test (B and C). All the versions of the test gave a detection limit of 400 copies/ml. The modified procedure can accurately diagnose congenital CMV infection. It achieves savings in both the patient material and the costs of testing.

Testing methods and techniques: Strength of materials and components. A compilation

NASA Technical Reports Server (NTRS)

1971-01-01

The methods, techniques, and devices used in testing the mechanical properties of various materials are presented. Although metals and metal alloys are featured prominently, some of the items describe tests on a variety of other materials, from concrete to plastics. Many of the tests described are modifications of standard testing procedures, intended either to adapt them to different materials and conditions, or to make them more rapid and accurate. In either case, the approaches presented can result in considerable cost savings and improved quality control. The compilation is presented in two sections. The first deals specifically with material strength testing; the second treats the special category of fracture and fatigue testing.

Evolving binary classifiers through parallel computation of multiple fitness cases.

PubMed

Cagnoni, Stefano; Bergenti, Federico; Mordonini, Monica; Adorni, Giovanni

2005-06-01

This paper describes two versions of a novel approach to developing binary classifiers, based on two evolutionary computation paradigms: cellular programming and genetic programming. Such an approach achieves high computation efficiency both during evolution and at runtime. Evolution speed is optimized by allowing multiple solutions to be computed in parallel. Runtime performance is optimized explicitly using parallel computation in the case of cellular programming or implicitly taking advantage of the intrinsic parallelism of bitwise operators on standard sequential architectures in the case of genetic programming. The approach was tested on a digit recognition problem and compared with a reference classifier.

An omnibus test for family-based association studies with multiple SNPs and multiple phenotypes.

PubMed

Lasky-Su, Jessica; Murphy, Amy; McQueen, Matthew B; Weiss, Scott; Lange, Christoph

2010-06-01

We propose an omnibus family-based association test (MFBAT) that can be applied to multiple markers and multiple phenotypes and that has only one degree of freedom. The proposed test statistic extends current FBAT methodology to incorporate multiple markers as well as multiple phenotypes. Using simulation studies, power estimates for the proposed methodology are compared with the standard methodologies. On the basis of these simulations, we find that MFBAT substantially outperforms other methods, including haplotypic approaches and doing multiple tests with single single-nucleotide polymorphisms (SNPs) and single phenotypes. The practical relevance of the approach is illustrated by an application to asthma in which SNP/phenotype combinations are identified and reach overall significance that would not have been identified using other approaches. This methodology is directly applicable to cases in which there are multiple SNPs, such as candidate gene studies, cases in which there are multiple phenotypes, such as expression data, and cases in which there are multiple phenotypes and genotypes, such as genome-wide association studies that incorporate expression profiles as phenotypes. This program is available in the PBAT analysis package.

Contribution of diagnostic tests for the etiological assessment of uveitis, data from the ULISSE study (Uveitis: Clinical and medicoeconomic evaluation of a standardized strategy of the etiological diagnosis).

PubMed

Grumet, Pierre; Kodjikian, Laurent; de Parisot, Audrey; Errera, Marie-Hélène; Sedira, Neila; Heron, Emmanuel; Pérard, Laurent; Cornut, Pierre-Loïc; Schneider, Christelle; Rivière, Sophie; Ollé, Priscille; Pugnet, Grégory; Cathébras, Pascal; Manoli, Pierre; Bodaghi, Bahram; Saadoun, David; Baillif, Stéphanie; Tieulie, Nathalie; Andre, Marc; Chiambaretta, Frédéric; Bonin, Nicolas; Bielefeld, Philip; Bron, Alain; Mouriaux, Frédéric; Bienvenu, Boris; Vicente, Stéphanie; Bin, Sylvie; Labetoulle, Marc; Broussolle, Christiane; Jamilloux, Yvan; Decullier, Evelyne; Sève, Pascal

2018-04-01

ULISSE is the only study that prospectively assessed the efficiency of a standardized strategy, compared to an open strategy for the etiologic diagnosis of uveitis. Our aim was to evaluate the diagnostic yield of the tests prescribed in the ULISSE study to clarify their relevance. ULISSE is a non-inferiority, prospective, multicenter and cluster randomized study. The standardized strategy is a two-steps strategy: in the first step, common standard tests were performed, and in the second step, tests were guided by the clinical and anatomic type of uveitis. We reported the relevance of the diagnostic tests used in the standardized strategy, as well as the profitability of the tests that were prescribed to more than twenty patients in each group. Based on diagnostic criteria, either an ophthalmologist, or an internist, established the profitability of a test by considering whether the test lead to a diagnosis or not. Among the 676 patients included (standardized 303; open 373), a diagnosis was made for 152 (50.4%) in the standardized group and 203 (54.4%) in the open group. The most common entities were HLA-B27 associated uveitis (22%), spondyloarthritis (11%), sarcoidosis (18%), tuberculosis (10.7%) and herpes virus infections (8.5%). Among the first step's systematic tests, tuberculin skin test was the most contributive investigation (17.1%), followed by chest X-ray (8.4%), C reactive protein and ESR (6.6% and 5.1%), complete blood count (2.2%) and VDRL (2.0%). The second step's most often contributive tests were: HLA B27 (56.3%), chest-CT (30.3%) and angiotensin converting enzyme (ACE) (16.5%). HLA B27 and ACE were significantly more contributive in the standardized group than in the open group. Immunological tests were never contributive. Among the free investigations, or among the investigations guided by clinical or paraclinical findings, the most often contributive tests were: Quantiferon® (24%), electrophoresis of serum protein (7.8%) and sacroiliac imagery (46.4%). Intracellular serologies (1.7%), serum calcium (2.1%) and hepatic tests (3.3%) were exceptionally contributive. Among the third intention tests, labial salivary gland biopsies were contributive in 17.9% of cases, but the profitability of other invasive investigations (anterior chamber tap, vitrectomy, bronchoscopy and lumbar puncture) or specialized imagery (18F-FDG PET, Brain MRI) could not be determined since these test were rarely performed. Only a few diagnostic tests are useful for the etiological assessment of uveitis. They are often cheap, simple, more often guided by the clinical findings, and lead to an etiological diagnosis in most patients. On the other hand, some tests are never or exceptionally contributive, such as immunological tests or intracellular serologies. Further studies are required to evaluate the profitability of third intention imagery and invasive investigations. Copyright © 2018 Elsevier B.V. All rights reserved.

Research of Medical Expenditure among Inpatients with Unstable Angina Pectoris in a Single Center

PubMed Central

Wu, Suo-Wei; Pan, Qi; Chen, Tong; Wei, Liang-Yu; Xuan, Yong; Wang, Qin; Li, Chao; Song, Jing-Chen

2017-01-01

Background: With the rising incidence as well as the medical expenditure among patients with unstable angina pectoris, the research aimed to investigate the inpatient medical expenditure through the combination of diagnosis-related groups (DRGs) among patients with unstable angina pectoris in a Grade A tertiary hospital to conduct the referential standards of medical costs for the diagnosis. Methods: Single-factor analysis and multiple linear stepwise regression method were used to investigate 3933 cases between 2014 and 2016 in Beijing Hospital (China) whose main diagnosis was defined as unstable angina pectoris to determine the main factors influencing the inpatient medical expenditure, and decision tree method was adopted to establish the model of DRGs grouping combinations. Results: The major influential factors of inpatient medical expenditure included age, operative method, therapeutic effects as well as comorbidity and complications (CCs) of the disease, and the 3933 cases were divided into ten DRGs by four factors: age, CCs, therapeutic effects, and the type of surgery with corresponding inpatient medical expenditure standards setup. Data of nonparametric test on medical costs among different groups were all significant (P < 0.001, by Kruskal-Wallis test), with R2 = 0.53 and coefficient of variation (CV) = 0.524. Conclusions: The classification of DRGs by adopting the type of surgery as the main branch node to develop cost control standards in inpatient treatment of unstable angina pectoris is conducive in standardizing the diagnosis and treatment behaviors of the hospital and reducing economic burdens among patients. PMID:28639566

Research of Medical Expenditure among Inpatients with Unstable Angina Pectoris in a Single Center.

PubMed

Wu, Suo-Wei; Pan, Qi; Chen, Tong; Wei, Liang-Yu; Xuan, Yong; Wang, Qin; Li, Chao; Song, Jing-Chen

2017-07-05

With the rising incidence as well as the medical expenditure among patients with unstable angina pectoris, the research aimed to investigate the inpatient medical expenditure through the combination of diagnosis-related groups (DRGs) among patients with unstable angina pectoris in a Grade A tertiary hospital to conduct the referential standards of medical costs for the diagnosis. Single-factor analysis and multiple linear stepwise regression method were used to investigate 3933 cases between 2014 and 2016 in Beijing Hospital (China) whose main diagnosis was defined as unstable angina pectoris to determine the main factors influencing the inpatient medical expenditure, and decision tree method was adopted to establish the model of DRGs grouping combinations. The major influential factors of inpatient medical expenditure included age, operative method, therapeutic effects as well as comorbidity and complications (CCs) of the disease, and the 3933 cases were divided into ten DRGs by four factors: age, CCs, therapeutic effects, and the type of surgery with corresponding inpatient medical expenditure standards setup. Data of nonparametric test on medical costs among different groups were all significant (P < 0.001, by Kruskal-Wallis test), with R2 = 0.53 and coefficient of variation (CV) = 0.524. The classification of DRGs by adopting the type of surgery as the main branch node to develop cost control standards in inpatient treatment of unstable angina pectoris is conducive in standardizing the diagnosis and treatment behaviors of the hospital and reducing economic burdens among patients.

Fermionic extensions of the Standard Model in light of the Higgs couplings

NASA Astrophysics Data System (ADS)

Bizot, Nicolas; Frigerio, Michele

2016-01-01

As the Higgs boson properties settle, the constraints on the Standard Model extensions tighten. We consider all possible new fermions that can couple to the Higgs, inspecting sets of up to four chiral multiplets. We confront them with direct collider searches, electroweak precision tests, and current knowledge of the Higgs couplings. The focus is on scenarios that may depart from the decoupling limit of very large masses and vanishing mixing, as they offer the best prospects for detection. We identify exotic chiral families that may receive a mass from the Higgs only, still in agreement with the hγγ signal strength. A mixing θ between the Standard Model and non-chiral fermions induces order θ 2 deviations in the Higgs couplings. The mixing can be as large as θ ˜ 0 .5 in case of custodial protection of the Z couplings or accidental cancellation in the oblique parameters. We also notice some intriguing effects for much smaller values of θ, especially in the lepton sector. Our survey includes a number of unconventional pairs of vector-like and Majorana fermions coupled through the Higgs, that may induce order one corrections to the Higgs radiative couplings. We single out the regions of parameters where hγγ and hgg are unaffected, while the hγZ signal strength is significantly modified, turning a few times larger than in the Standard Model in two cases. The second run of the LHC will effectively test most of these scenarios.

Special electronic distance meter calibration for precise engineering surveying industrial applications

NASA Astrophysics Data System (ADS)

Braun, Jaroslav; Štroner, Martin; Urban, Rudolf

2015-05-01

All surveying instruments and their measurements suffer from some errors. To refine the measurement results, it is necessary to use procedures restricting influence of the instrument errors on the measured values or to implement numerical corrections. In precise engineering surveying industrial applications the accuracy of the distances usually realized on relatively short distance is a key parameter limiting the resulting accuracy of the determined values (coordinates, etc.). To determine the size of systematic and random errors of the measured distances were made test with the idea of the suppression of the random error by the averaging of the repeating measurement, and reducing systematic errors influence of by identifying their absolute size on the absolute baseline realized in geodetic laboratory at the Faculty of Civil Engineering CTU in Prague. The 16 concrete pillars with forced centerings were set up and the absolute distances between the points were determined with a standard deviation of 0.02 millimetre using a Leica Absolute Tracker AT401. For any distance measured by the calibrated instruments (up to the length of the testing baseline, i.e. 38.6 m) can now be determined the size of error correction of the distance meter in two ways: Firstly by the interpolation on the raw data, or secondly using correction function derived by previous FFT transformation usage. The quality of this calibration and correction procedure was tested on three instruments (Trimble S6 HP, Topcon GPT-7501, Trimble M3) experimentally using Leica Absolute Tracker AT401. By the correction procedure was the standard deviation of the measured distances reduced significantly to less than 0.6 mm. In case of Topcon GPT-7501 is the nominal standard deviation 2 mm, achieved (without corrections) 2.8 mm and after corrections 0.55 mm; in case of Trimble M3 is nominal standard deviation 3 mm, achieved (without corrections) 1.1 mm and after corrections 0.58 mm; and finally in case of Trimble S6 is nominal standard deviation 1 mm, achieved (without corrections) 1.2 mm and after corrections 0.51 mm. Proposed procedure of the calibration and correction is in our opinion very suitable for increasing of the accuracy of the electronic distance measurement and allows the use of the common surveying instrument to achieve uncommonly high precision.

High prevalence of multidrug-resistant tuberculosis among patients with rifampicin resistance using GeneXpert Mycobacterium tuberculosis/rifampicin in Ghana.

PubMed

Boakye-Appiah, Justice K; Steinmetz, Alexis R; Pupulampu, Peter; Ofori-Yirenkyi, Stephen; Tetteh, Ishmael; Frimpong, Michael; Oppong, Patrick; Opare-Sem, Ohene; Norman, Betty R; Stienstra, Ymkje; van der Werf, Tjip S; Wansbrough-Jones, Mark; Bonsu, Frank; Obeng-Baah, Joseph; Phillips, Richard O

2016-06-01

Drug-resistant strains of tuberculosis (TB) represent a major threat to global TB control. In low- and middle-income countries, resource constraints make it difficult to identify and monitor cases of resistance using drug susceptibility testing and culture. Molecular assays such as the GeneXpert Mycobacterium tuberculosis/rifampicin may prove to be a cost-effective solution to this problem in these settings. The objective of this study is to evaluate the use of GeneXpert in the diagnosis of pulmonary TB since it was introduced into two tertiary hospitals in Ghana in 2013. A 2-year retrospective audit of clinical cases involving patients who presented with clinically suspected TB or documented TB not improving on standard therapy and had samples sent for GeneXpert testing. GeneXpert identified 169 cases of TB, including 17 cases of rifampicin-resistant TB. Of the seven cases with final culture and drug susceptibility testing results, six demonstrated further drug resistance and five of these were multidrug-resistant TB. These findings call for a scale-up of TB control in Ghana and provide evidence that the expansion of GeneXpert may be an optimal means to improve case finding and guide treatment of drug-resistant TB in this setting. Copyright © 2016. Published by Elsevier Ltd.

Anaplastic lymphoma kinase (ALK) gene rearrangement in non-small cell lung cancer (NSCLC): results of a multi-centre ALK-testing.

PubMed

V Laffert, Maximilian; Warth, Arne; Penzel, Roland; Schirmacher, Peter; Jonigk, Danny; Kreipe, Hans; Schildhaus, Hans-Ulrich; Merkelbach-Bruse, Sabine; Büttner, Reinhard; Reu, Simone; Kerler, Rosi; Jung, Andreas; Kirchner, Thomas; Wölfel, Cornelius; Petersen, Iver; Rodriguez, Regulo; Jochum, Wolfram; Bartsch, Holger; Fisseler-Eckhoff, Annette; Berg, Erika; Lenze, Dido; Dietel, Manfred; Hummel, Michael

2013-08-01

The reliable identification of non-small cell lung cancers (NSCLC) with chromosomal breaks in the gene of the anaplastic lymphoma kinase (ALK) is crucial for the induction of therapy with ALK-inhibitors. In order to ensure a reliable detection of ALK-breaks by means of fluorescence in situ hybridization (FISH) testing, round robin tests are essential. In preparation of a nation (German)-wide round robin test we initiated a pre-testing phase involving 8 experts in FISH-diagnostics to identify NSCLC cases (n = 10) with a pre-tested ALK-status. In addition, ALK immunohistochemistry (IHC) was performed to assess ALK protein expression. Sections derived from a tissue microarray, each consisting of 3 cores from 10 NSCLC cases, were independently tested for ALK protein expression by IHC and genomic ALK-breaks by FISH involving 8 institutes of pathology. Based on a pre-screening, 5 cases were identified to be clearly ALK-break negative, whereas the remaining 5 cases were ALK-break positive including one case with low percentage (20%) of positive cells. The latter had been additionally tested by RT-PCR. The 5 unequivocal ALK-break negative NSCLC were almost consistently scored negative by means of FISH and IHC by all 8 experts. Interestingly, 4 of the 5 cases with pre-defined ALK-breaks revealed homogenous FISH results whereas IHC for the detection of ALK protein expression showed heterogeneous results. The remaining case (low number of ALK-break positive cells) was scored negative by 3 experts and positive by the other 5. RT-PCR revealed the expression of an EML4-ALK fusion gene variant 1. ALK-break negative NSCLC cases revealed concordant homogeneous results by means of FISH and IHC (score 0-1) by all 8 experts. Discordant FISH results were raised in one ALK-break positive case with a low number of affected tumor cells. The remaining 4 ALK-break positive cases revealed concordant FISH data whereas the ALK-IHC revealed very diverse results. The cases with concordant FISH results provide an excellent basis for round robin ALK-FISH testing. As long as standardized ALK-IHC protocols are missing, ALK protein expression cannot by regarded as the method of choice for identification of patients eligible for treatment with ALK inhibitors. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Alkaline peptone water enrichment with a dipstick test to quickly detect and monitor cholera outbreaks.

PubMed

Bwire, Godfrey; Orach, Christopher Garimoi; Abdallah, Dauda; Debes, Amanda Kay; Kagirita, Atek; Ram, Malathi; Sack, David A

2017-11-21

Detection, confirmation and monitoring of cholera outbreaks in many developing countries including Uganda is a big challenge due to lack of the required resources and the time the test takes. Culture method which takes 24-48 h to get the feedback and requires highly skilled laboratory staff plus other complex resources is the standard test. This study evaluated the new cholera rapid detection method that relies on Crystal VC dipsticks after enrichment with alkaline peptone water (APW) against the culture method for monitoring the progress of cholera outbreaks in rural setting. We conducted the study between March and June 2015. Fresh stool samples and rectal swabs were incubated in 1% APW for 6 h at room temperature before testing with RDT following the manufacturer's instruction. The same stool sample was cultured to isolate V. cholerae in the standard manner. We also reviewed patient registers to epidemiologically describe the cholera epidemic. We tested stool from 102 consenting suspected cholera patients reporting during daytime at Bwera Hospital (n = 69), Kilembe Mines Hospital (n = 4) and Kinyabwama Health Centre (n = 29). Ninety one (91) samples were positive and nine samples were negative according to both methods. One (1) sample was positive only by dipstick and one sample was positive only by culture (sensitivity of 99%, specificity of 90%, Positive Predictive Value of 99% and Negative Predictive Value of 90%). Overall, 146 suspected cholera cases and two deaths, (case fatality rate of 1.36%) were recorded during the study period. Among the cases aged 1-9 years, 63% (50/79) were males while in those aged 20-49 years, 76% (34/45) were females. Our findings showed that the modified dipstick test after enrichment with 1% APW had high level of accuracy in detection of V. cholerae and is quick, affordable alternative cholera outbreak monitoring tool in resource constrained settings. However, culture method should remain for cholera epidemic confirmation, for monitoring of antibiotic sensitivity and for production of pure isolates for molecular characterization. Further studies should be done to better understand the observed age and sex case distribution, in Kasese district.

[Guidelines for the management of point-of care testing nonconformities according to the EN ISO 22870].

PubMed

Houlbert, C; Annaix, V; Szymanowicz, A; Vassault, A; Guimont, M C; Pernet, P

2012-02-01

In this paper, guidelines are proposed to fulfill the requirements of EN ISO 22870 standard regarding the management of point-of-care testing (POCT) nonconformities. In the first part, the main nonconformities that may affect POCT are given, the means for resolution and the control of adverse events are proposed. In the second part, we propose recommendations in case of unavailability of a point-of-care testing device from the occurring of the adverse event, to the restarting of the device.

False-positive buprenorphine EIA urine toxicology results due to high dose morphine: a case report.

PubMed

Tenore, Peter L

2012-01-01

In monitoring a patient with chronic pain who was taking high-dose morphine and oxycodone with weekly urine enzymatic immunoassay (EIA) toxicology testing, the authors noted consistent positives for buprenorphine. The patient was not taking buprenorphine, and gas chromatography/mass spectroscopy (GCMS) testing on multiple samples revealed no buprenorphine, indicating a case of false-positive buprenorphine EIAs in a high-dose opiate case. The authors discontinued oxycodone for a period of time and then discontinued morphine. Urine monitoring with EIAs and GCMS revealed false-positive buprenorphine EIAs, which remained only when the patient was taking morphine. When taking only oxycodone and no morphine, urine samples became buprenorphine negative. When morphine was reintroduced, false-positive buprenorphine results resumed. Medical practitioners should be aware that high-dose morphine (with morphine urine levels turning positive within the 15,000 to 28,000 mg/mL range) may produce false-positive buprenorphine EIAs with standard urine EIA toxicology testing.

Private traits and attributes are predictable from digital records of human behavior.

PubMed

Kosinski, Michal; Stillwell, David; Graepel, Thore

2013-04-09

We show that easily accessible digital records of behavior, Facebook Likes, can be used to automatically and accurately predict a range of highly sensitive personal attributes including: sexual orientation, ethnicity, religious and political views, personality traits, intelligence, happiness, use of addictive substances, parental separation, age, and gender. The analysis presented is based on a dataset of over 58,000 volunteers who provided their Facebook Likes, detailed demographic profiles, and the results of several psychometric tests. The proposed model uses dimensionality reduction for preprocessing the Likes data, which are then entered into logistic/linear regression to predict individual psychodemographic profiles from Likes. The model correctly discriminates between homosexual and heterosexual men in 88% of cases, African Americans and Caucasian Americans in 95% of cases, and between Democrat and Republican in 85% of cases. For the personality trait "Openness," prediction accuracy is close to the test-retest accuracy of a standard personality test. We give examples of associations between attributes and Likes and discuss implications for online personalization and privacy.

A standard test case suite for two-dimensional linear transport on the sphere: results from a collection of state-of-the-art schemes

NASA Astrophysics Data System (ADS)

Lauritzen, P. H.; Ullrich, P. A.; Jablonowski, C.; Bosler, P. A.; Calhoun, D.; Conley, A. J.; Enomoto, T.; Dong, L.; Dubey, S.; Guba, O.; Hansen, A. B.; Kaas, E.; Kent, J.; Lamarque, J.-F.; Prather, M. J.; Reinert, D.; Shashkin, V. V.; Skamarock, W. C.; Sørensen, B.; Taylor, M. A.; Tolstykh, M. A.

2013-09-01

Recently, a standard test case suite for 2-D linear transport on the sphere was proposed to assess important aspects of accuracy in geophysical fluid dynamics with a "minimal" set of idealized model configurations/runs/diagnostics. Here we present results from 19 state-of-the-art transport scheme formulations based on finite-difference/finite-volume methods as well as emerging (in the context of atmospheric/oceanographic sciences) Galerkin methods. Discretization grids range from traditional regular latitude-longitude grids to more isotropic domain discretizations such as icosahedral and cubed-sphere tessellations of the sphere. The schemes are evaluated using a wide range of diagnostics in idealized flow environments. Accuracy is assessed in single- and two-tracer configurations using conventional error norms as well as novel diagnostics designed for climate and climate-chemistry applications. In addition, algorithmic considerations that may be important for computational efficiency are reported on. The latter is inevitably computing platform dependent, The ensemble of results from a wide variety of schemes presented here helps shed light on the ability of the test case suite diagnostics and flow settings to discriminate between algorithms and provide insights into accuracy in the context of global atmospheric/ocean modeling. A library of benchmark results is provided to facilitate scheme intercomparison and model development. Simple software and data-sets are made available to facilitate the process of model evaluation and scheme intercomparison.

A standard test case suite for two-dimensional linear transport on the sphere: results from a collection of state-of-the-art schemes

NASA Astrophysics Data System (ADS)

Lauritzen, P. H.; Ullrich, P. A.; Jablonowski, C.; Bosler, P. A.; Calhoun, D.; Conley, A. J.; Enomoto, T.; Dong, L.; Dubey, S.; Guba, O.; Hansen, A. B.; Kaas, E.; Kent, J.; Lamarque, J.-F.; Prather, M. J.; Reinert, D.; Shashkin, V. V.; Skamarock, W. C.; Sørensen, B.; Taylor, M. A.; Tolstykh, M. A.

2014-01-01

Recently, a standard test case suite for 2-D linear transport on the sphere was proposed to assess important aspects of accuracy in geophysical fluid dynamics with a "minimal" set of idealized model configurations/runs/diagnostics. Here we present results from 19 state-of-the-art transport scheme formulations based on finite-difference/finite-volume methods as well as emerging (in the context of atmospheric/oceanographic sciences) Galerkin methods. Discretization grids range from traditional regular latitude-longitude grids to more isotropic domain discretizations such as icosahedral and cubed-sphere tessellations of the sphere. The schemes are evaluated using a wide range of diagnostics in idealized flow environments. Accuracy is assessed in single- and two-tracer configurations using conventional error norms as well as novel diagnostics designed for climate and climate-chemistry applications. In addition, algorithmic considerations that may be important for computational efficiency are reported on. The latter is inevitably computing platform dependent. The ensemble of results from a wide variety of schemes presented here helps shed light on the ability of the test case suite diagnostics and flow settings to discriminate between algorithms and provide insights into accuracy in the context of global atmospheric/ocean modeling. A library of benchmark results is provided to facilitate scheme intercomparison and model development. Simple software and data sets are made available to facilitate the process of model evaluation and scheme intercomparison.

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

Mohapi, N.; Hees, A.; Larena, J., E-mail: n.mohapi@gmail.com, E-mail: a.hees@ru.ac.za, E-mail: j.larena@ru.ac.za

The Einstein Equivalence Principle is a fundamental principle of the theory of General Relativity. While this principle has been thoroughly tested with standard matter, the question of its validity in the Dark sector remains open. In this paper, we consider a general tensor-scalar theory that allows to test the equivalence principle in the Dark sector by introducing two different conformal couplings to standard matter and to Dark matter. We constrain these couplings by considering galactic observations of strong lensing and of velocity dispersion. Our analysis shows that, in the case of a violation of the Einstein Equivalence Principle, data favourmore » violations through coupling strengths that are of opposite signs for ordinary and Dark matter. At the same time, our analysis does not show any significant deviations from General Relativity.« less

Breast enlargement after two reduction mastoplasties: a case report.

PubMed

Mottura, A Aldo

2007-01-01

In 1989, a bilateral breast reduction was performed for a large-breasted woman. She returned 1 year later with bilateral breast enlargement as severe as in the original case. The operation was repeated but in a more aggressive way. She became pregnant 2 years later, and both her small breasts began to grow again until they became gigantic. Hormonal tests showed results within the standard limits, and no medical treatment was effective. After the delivery, her breasts reduced in size spontaneously.

Flexible Case - Grain Interaction in Ballistic Weapon Systems. Volume I. Technical Accomplishments.

DTIC Science & Technology

1976-10-01

Summary of Test Measurements for Motor No. 2 K-i Appendix I Software Documentation and User ’s Manual L-1 Multiplexor Driver Program for the F Varian...the - .4 case. Thus, any force applied to the steel pl ug causes a slight deflectionof the strain gaged element that can be interpreted as a stress...were extruded by manual pressure.The failure gages were installed in a similar manner with the exception that they were bonded in place with standard AGC

A case of nosocomial Legionnaires' disease: The importance of early diagnosis, adequate prevention and eradication measures.

PubMed

Lucardie, A; Rogiers, Ph; Floré, K

2016-02-03

This case-report describes a patient with confirmed nosocomial Legionnaires' disease, a diagnosis which should be suspected when pneumonia does not respond to empiric therapy with beta-lactam antibiotics, or develops in the presence of certain risk factors. Culture is currently the golden standard for diagnosis, although the use of more modern techniques, such as a combination of urinary antigen testing and polymerase chain reaction, are on the rise. Specific detection and eradication methods are discussed.

Is It Working? Distractor Analysis Results from the Test Of Astronomy STandards (TOAST) Assessment Instrument

NASA Astrophysics Data System (ADS)

Slater, Stephanie

2009-05-01

The Test Of Astronomy STandards (TOAST) assessment instrument is a multiple-choice survey tightly aligned to the consensus learning goals stated by the American Astronomical Society - Chair's Conference on ASTRO 101, the American Association of the Advancement of Science's Project 2061 Benchmarks, and the National Research Council's National Science Education Standards. Researchers from the Cognition in Astronomy, Physics and Earth sciences Research (CAPER) Team at the University of Wyoming's Science and Math Teaching Center (UWYO SMTC) have been conducting a question-by-question distractor analysis procedure to determine the sensitivity and effectiveness of each item. In brief, the frequency each possible answer choice, known as a foil or distractor on a multiple-choice test, is determined and compared to the existing literature on the teaching and learning of astronomy. In addition to having statistical difficulty and discrimination values, a well functioning assessment item will show students selecting distractors in the relative proportions to how we expect them to respond based on known misconceptions and reasoning difficulties. In all cases, our distractor analysis suggests that all items are functioning as expected. These results add weight to the validity of the Test Of Astronomy STandards (TOAST) assessment instrument, which is designed to help instructors and researchers measure the impact of course-length duration instructional strategies for undergraduate science survey courses with learning goals tightly aligned to the consensus goals of the astronomy education community.

Evaluating effectiveness of dynamic soundfield system in the classroom.

PubMed

da Cruz, Aline Duarte; Alves Silvério, Kelly Cristina; Da Costa, Aline Roberta Aceituno; Moret, Adriane Lima Mortari; Lauris, José Roberto Pereira; de Souza Jacob, Regina Tangerino

2016-01-01

Research has reported on the use of soundfield amplification devices in the classroom. However, no study has used standardized tests to determine the potential advantages of the dynamic soundfield system for normally hearing students and for the teacher's voice. Our aim was to evaluate the impact of using dynamic soundfield system on the noise of the classroom, teacher's voice and students' academic performance. This was a prospective cohort study in which 20 student participants enrolled in the third year of basic education were divided into two groups (i.e., control and experimental); their teacher participated. The experimental group was exposed to the dynamic soundfield system for 3 consecutive months. The groups were assessed using standardized tests to evaluate their academic performance. Further, questionnaires and statements were collected on the participants' experience of using the soundfield system. We statistically analyzed the results to compare the academic performance of the control group with that of the experimental group. In all cases, a significance level of P < .05 was adopted. Use of the dynamic soundfield system was effective for improving the students' academic performance on standardized tests for reading, improving the teacher's speech intelligibility, and reducing the teacher's vocal strain. The dynamic soundfield system minimizes the impact of noise in the classroom as demonstrated by the mensuration of the signal-to-noise ratio (SNR) and pupil performance on standardized tests for reading and student and teacher ratings of amplification system effectiveness.

Group Sequential Testing of the Predictive Accuracy of a Continuous Biomarker with Unknown Prevalence

PubMed Central

Koopmeiners, Joseph S.; Feng, Ziding

2015-01-01

Group sequential testing procedures have been proposed as an approach to conserving resources in biomarker validation studies. Previously, Koopmeiners and Feng (2011) derived the asymptotic properties of the sequential empirical positive predictive value (PPV) and negative predictive value curves, which summarize the predictive accuracy of a continuous marker, under case-control sampling. A limitation of their approach is that the prevalence can not be estimated from a case-control study and must be assumed known. In this manuscript, we consider group sequential testing of the predictive accuracy of a continuous biomarker with unknown prevalence. First, we develop asymptotic theory for the sequential empirical PPV and NPV curves when the prevalence must be estimated, rather than assumed known in a case-control study. We then discuss how our results can be combined with standard group sequential methods to develop group sequential testing procedures and bias-adjusted estimators for the PPV and NPV curve. The small sample properties of the proposed group sequential testing procedures and estimators are evaluated by simulation and we illustrate our approach in the context of a study to validate a novel biomarker for prostate cancer. PMID:26537180

A survey of current practices for genomic sequencing test interpretation and reporting processes in US laboratories.

PubMed

O'Daniel, Julianne M; McLaughlin, Heather M; Amendola, Laura M; Bale, Sherri J; Berg, Jonathan S; Bick, David; Bowling, Kevin M; Chao, Elizabeth C; Chung, Wendy K; Conlin, Laura K; Cooper, Gregory M; Das, Soma; Deignan, Joshua L; Dorschner, Michael O; Evans, James P; Ghazani, Arezou A; Goddard, Katrina A; Gornick, Michele; Farwell Hagman, Kelly D; Hambuch, Tina; Hegde, Madhuri; Hindorff, Lucia A; Holm, Ingrid A; Jarvik, Gail P; Knight Johnson, Amy; Mighion, Lindsey; Morra, Massimo; Plon, Sharon E; Punj, Sumit; Richards, C Sue; Santani, Avni; Shirts, Brian H; Spinner, Nancy B; Tang, Sha; Weck, Karen E; Wolf, Susan M; Yang, Yaping; Rehm, Heidi L

2017-05-01

While the diagnostic success of genomic sequencing expands, the complexity of this testing should not be overlooked. Numerous laboratory processes are required to support the identification, interpretation, and reporting of clinically significant variants. This study aimed to examine the workflow and reporting procedures among US laboratories to highlight shared practices and identify areas in need of standardization. Surveys and follow-up interviews were conducted with laboratories offering exome and/or genome sequencing to support a research program or for routine clinical services. The 73-item survey elicited multiple choice and free-text responses that were later clarified with phone interviews. Twenty-one laboratories participated. Practices highly concordant across all groups included consent documentation, multiperson case review, and enabling patient opt-out of incidental or secondary findings analysis. Noted divergence included use of phenotypic data to inform case analysis and interpretation and reporting of case-specific quality metrics and methods. Few laboratory policies detailed procedures for data reanalysis, data sharing, or patient access to data. This study provides an overview of practices and policies of experienced exome and genome sequencing laboratories. The results enable broader consideration of which practices are becoming standard approaches, where divergence remains, and areas of development in best practice guidelines that may be helpful.Genet Med advance online publication 03 Novemeber 2016.

Quantitative Sensory Testing and Current Perception Threshold Testing in Patients With Chronic Pain Following Lower Extremity Fracture.

PubMed

Griffioen, Mari A; Greenspan, Joel D; Johantgen, Meg; Von Rueden, Kathryn; O'Toole, Robert V; Dorsey, Susan G; Renn, Cynthia L

2018-01-01

Chronic pain is a significant problem for patients with lower extremity injuries. While pain hypersensitivity has been identified in many chronic pain conditions, it is not known whether patients with chronic pain following lower extremity fracture report pain hypersensitivity in the injured leg. To quantify and compare peripheral somatosensory function and sensory nerve activation thresholds in persons with chronic pain following lower extremity fractures with a cohort of persons with no history of lower extremity fractures. This was a cross-sectional study where quantitative sensory testing and current perception threshold testing were conducted on the injured and noninjured legs of cases and both legs of controls. A total of 14 cases and 28 controls participated in the study. Mean time since injury at the time of testing for cases was 22.3 (standard deviation = 12.1) months. The warmth detection threshold ( p = .024) and nerve activation thresholds at 2,000 Hz ( p < .001) and 250 Hz ( p = .002), respectively, were significantly higher in cases compared to controls. This study suggests that patients with chronic pain following lower extremity fractures may experience hypoesthesia in the injured leg, which contrasts with the finding of hyperesthesia previously observed in other chronic pain conditions but is in accord with patients with nerve injuries and surgeries. This is the first study to examine peripheral sensory nerve function at the site of injury in patients with chronic pain following lower extremity fractures using quantitative sensory testing and current perception threshold testing.

Congenital syphilis: refining newborn evaluation and management in Shenzhen, southern China.

PubMed

Wu, Da-Dong; Hong, Fu-Chang; Feng, Tie-Jian; Liu, Xiao-Li; Lin, Li-Jun; Tian, Li-Shan; Qiu, Li-Xia

2010-08-01

Consistent definitions of congenital syphilis are critical for determining true incidences and setting up targets of elimination. This study aimed to assess the evaluation and management of infants at high risk of congenital syphilis with an antenatal syphilis-screening programme in the Shenzhen SEZ and to develop feasible definitions for the detection of congenital syphilis in China. A retrospective study was conducted of all standardised records of pregnant women with positive syphilis between 2003 and 2007. Infants at high risk of congenital syphilis were evaluated by laboratory tests at birth and longitudinal follow-up. A screening test-positive congenital syphilis case was defined based on a positive 19S-IgM-FTA-ABS result at birth. Assuming that 19S-IgM-FTA-ABS was the gold standard, the sensitivity and specificity of the ascertainment methods were calculated. During the study period, 1010 live infants were born to women with active syphilis during pregnancy. 19S-IgM-FTA-ABS detected 42 screening-positive congenital syphilis cases and another nine cases were identified by longitudinal follow-up only. Using 19S-IgM-FTA-ABS as the gold standard, 'fourfold rapid plasma reagin (RPR) titres' had the highest sensitivity and specificity compared with the other two follow-up methods. 19S-IgM-FTA-ABS makes congenital syphilis case classification simpler and faster for newborns. In areas where 19S-IgM-FTA-ABS is not available, comparing newborn RPR titres with maternal titres can be an alternative method. Meanwhile, positive follow-up results act as treatment indicators for older infants. As congenital syphilis definitions vary over the country, the Shenzhen programme suggested a practical model for surveillance and treatment in areas with or without available 19S-IgM-FTA-ABS testing.

Mining peripheral arterial disease cases from narrative clinical notes using natural language processing.

PubMed

Afzal, Naveed; Sohn, Sunghwan; Abram, Sara; Scott, Christopher G; Chaudhry, Rajeev; Liu, Hongfang; Kullo, Iftikhar J; Arruda-Olson, Adelaide M

2017-06-01

Lower extremity peripheral arterial disease (PAD) is highly prevalent and affects millions of individuals worldwide. We developed a natural language processing (NLP) system for automated ascertainment of PAD cases from clinical narrative notes and compared the performance of the NLP algorithm with billing code algorithms, using ankle-brachial index test results as the gold standard. We compared the performance of the NLP algorithm to (1) results of gold standard ankle-brachial index; (2) previously validated algorithms based on relevant International Classification of Diseases, Ninth Revision diagnostic codes (simple model); and (3) a combination of International Classification of Diseases, Ninth Revision codes with procedural codes (full model). A dataset of 1569 patients with PAD and controls was randomly divided into training (n = 935) and testing (n = 634) subsets. We iteratively refined the NLP algorithm in the training set including narrative note sections, note types, and service types, to maximize its accuracy. In the testing dataset, when compared with both simple and full models, the NLP algorithm had better accuracy (NLP, 91.8%; full model, 81.8%; simple model, 83%; P < .001), positive predictive value (NLP, 92.9%; full model, 74.3%; simple model, 79.9%; P < .001), and specificity (NLP, 92.5%; full model, 64.2%; simple model, 75.9%; P < .001). A knowledge-driven NLP algorithm for automatic ascertainment of PAD cases from clinical notes had greater accuracy than billing code algorithms. Our findings highlight the potential of NLP tools for rapid and efficient ascertainment of PAD cases from electronic health records to facilitate clinical investigation and eventually improve care by clinical decision support. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Examination of the Measurement of Absorption Using the Reverberant Room Method for Highly Absorptive Acoustic Foam

NASA Technical Reports Server (NTRS)

Hughes, William O.; McNelis, Anne M.; Chris Nottoli; Eric Wolfram

2015-01-01

The absorption coefficient for material specimens are needed to quantify the expected acoustic performance of that material in its actual usage and environment. The ASTM C423-09a standard, "Standard Test Method for Sound Absorption and Sound Absorption Coefficients by the Reverberant Room Method" is often used to measure the absorption coefficient of material test specimens. This method has its basics in the Sabine formula. Although widely used, the interpretation of these measurements are a topic of interest. For example, in certain cases the measured Sabine absorption coefficients are greater than 1.0 for highly absorptive materials. This is often attributed to the diffraction edge effect phenomenon. An investigative test program to measure the absorption properties of highly absorbent melamine foam has been performed at the Riverbank Acoustical Laboratories. This paper will present and discuss the test results relating to the effect of the test materials' surface area, thickness and edge sealing conditions. A follow-on paper is envisioned that will present and discuss the results relating to the spacing between multiple piece specimens, and the mounting condition of the test specimen.

Test accommodations for individuals with neurological conditions completing the NIH Toolbox-Cognition Battery: An evaluation of frequency and appropriateness.

PubMed

Magasi, Susan; Harniss, Mark; Tulsky, David S; Cohen, Matthew L; Heaton, Robert K; Heinemann, Allen W

2017-11-01

First, to evaluate the frequency with which individuals with neurological conditions require test administration accommodations for the NIH Toolbox-Cognition Battery (NIHTB-CB). Second, to evaluate the appropriateness of accommodations provided by administrators, including adherence to NIHTB-CB Reasonable Accommodations Guidelines. Adults with traumatic brain injury, spinal cord injury, or stroke (n = 604) completed the NIHTB-CB and other assessments as part of a multisite study. We provide a descriptive, secondary analysis of test administrator notes to determine use and appropriateness of accommodations. Of the 604 participants, 450 (75%) completed the NIHTB-CB using standard administration procedures, but 137 (22.6%) encountered accessibility challenges that required accommodations. Participants with motor function impairments were most likely to receive at least 1 of 3 kinds of accommodations: (a) use of nonstandard methods of entering responses using standard input devices, (b) use of alternate input devices, or (c) help from the test administrator to enter a response. Fatigue and/or impulsivity led to nonstandard administration by 48 (7.9%) individuals. Post hoc audit of test administrator notes revealed that despite careful instructions and supervision, 49 (56.3%) of the accommodated administrations breached standardization and scores could not be interpreted using test norms. Although the NIHTB-CB was developed for individuals without neurological impairment, most individuals with neurological conditions completed the standardized administration without accommodations. When accommodations were needed, administrators did not adhere to the official Reasonable Accommodations Guidelines in more than half of the cases. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Public health consequences of a false-positive laboratory test result for Brucella--Florida, Georgia, and Michigan, 2005.

PubMed

2008-06-06

Human brucellosis, a nationally notifiable disease, is uncommon in the United States. Most human cases have occurred in returned travelers or immigrants from regions where brucellosis is endemic, or were acquired domestically from eating illegally imported, unpasteurized fresh cheeses. In January 2005, a woman aged 35 years who lived in Nassau County, Florida, received a diagnosis of brucellosis, based on results of a Brucella immunoglobulin M (IgM) enzyme immunoassay (EIA) performed in a commercial laboratory using analyte specific reagents (ASRs); this diagnosis prompted an investigation of dairy products in two other states. Subsequent confirmatory antibody testing by Brucella microagglutination test (BMAT) performed at CDC on the patient's serum was negative. The case did not meet the CDC/Council of State and Territorial Epidemiologists' (CSTE) definition for a probable or confirmed brucellosis case, and the initial EIA result was determined to be a false positive. This report summarizes the case history, laboratory findings, and public health investigations. CDC recommends that Brucella serology testing only be performed using tests cleared or approved by the Food and Drug Administration (FDA) or validated under the Clinical Laboratory Improvement Amendments (CLIA) and shown to reliably detect the presence of Brucella infection. Results from these tests should be considered supportive evidence for recent infection only and interpreted in the context of a clinically compatible illness and exposure history. EIA is not considered a confirmatory Brucella antibody test; positive screening test results should be confirmed by Brucella-specific agglutination (i.e., BMAT or standard tube agglutination test) methods.

Installation Restoration Program Phase 2. Confirmation/Quantification Stage 2.

DTIC Science & Technology

1988-04-03

MOORE STANDARD OPERATING PROCEDURES WORK PRACTICES 1. Smoking, eating, drinking, and chewing tobacco are prohibited in the contaminated or...meter and detector are transported in a protective foam-lined case. The cell is tested before going into the field using the test feature and is...available prior to the start-up of field work, the 1"o1l ,ii . rvicts, materials, work space, and items of equipment to zu F.Vft. the nt1 tor

Descriptive and inferential statistical methods used in burns research.

PubMed

Al-Benna, Sammy; Al-Ajam, Yazan; Way, Benjamin; Steinstraesser, Lars

2010-05-01

Burns research articles utilise a variety of descriptive and inferential methods to present and analyse data. The aim of this study was to determine the descriptive methods (e.g. mean, median, SD, range, etc.) and survey the use of inferential methods (statistical tests) used in articles in the journal Burns. This study defined its population as all original articles published in the journal Burns in 2007. Letters to the editor, brief reports, reviews, and case reports were excluded. Study characteristics, use of descriptive statistics and the number and types of statistical methods employed were evaluated. Of the 51 articles analysed, 11(22%) were randomised controlled trials, 18(35%) were cohort studies, 11(22%) were case control studies and 11(22%) were case series. The study design and objectives were defined in all articles. All articles made use of continuous and descriptive data. Inferential statistics were used in 49(96%) articles. Data dispersion was calculated by standard deviation in 30(59%). Standard error of the mean was quoted in 19(37%). The statistical software product was named in 33(65%). Of the 49 articles that used inferential statistics, the tests were named in 47(96%). The 6 most common tests used (Student's t-test (53%), analysis of variance/co-variance (33%), chi(2) test (27%), Wilcoxon & Mann-Whitney tests (22%), Fisher's exact test (12%)) accounted for the majority (72%) of statistical methods employed. A specified significance level was named in 43(88%) and the exact significance levels were reported in 28(57%). Descriptive analysis and basic statistical techniques account for most of the statistical tests reported. This information should prove useful in deciding which tests should be emphasised in educating burn care professionals. These results highlight the need for burn care professionals to have a sound understanding of basic statistics, which is crucial in interpreting and reporting data. Advice should be sought from professionals in the fields of biostatistics and epidemiology when using more advanced statistical techniques. Copyright 2009 Elsevier Ltd and ISBI. All rights reserved.

The definition of pneumonia, the assessment of severity, and clinical standardization in the Pneumonia Etiology Research for Child Health study.

PubMed

Scott, J Anthony G; Wonodi, Chizoba; Moïsi, Jennifer C; Deloria-Knoll, Maria; DeLuca, Andrea N; Karron, Ruth A; Bhat, Niranjan; Murdoch, David R; Crawley, Jane; Levine, Orin S; O'Brien, Katherine L; Feikin, Daniel R

2012-04-01

To develop a case definition for the Pneumonia Etiology Research for Child Health (PERCH) project, we sought a widely acceptable classification that was linked to existing pneumonia research and focused on very severe cases. We began with the World Health Organization's classification of severe/very severe pneumonia and refined it through literature reviews and a 2-stage process of expert consultation. PERCH will study hospitalized children, aged 1-59 months, with pneumonia who present with cough or difficulty breathing and have either severe pneumonia (lower chest wall indrawing) or very severe pneumonia (central cyanosis, difficulty breastfeeding/drinking, vomiting everything, convulsions, lethargy, unconsciousness, or head nodding). It will exclude patients with recent hospitalization and children with wheeze whose indrawing resolves after bronchodilator therapy. The PERCH investigators agreed upon standard interpretations of the symptoms and signs. These will be maintained by a clinical standardization monitor who conducts repeated instruction at each site and by recurrent local training and testing.

The Definition of Pneumonia, the Assessment of Severity, and Clinical Standardization in the Pneumonia Etiology Research for Child Health Study

PubMed Central

Wonodi, Chizoba; Moïsi, Jennifer C.; Deloria-Knoll, Maria; DeLuca, Andrea N.; Karron, Ruth A.; Bhat, Niranjan; Murdoch, David R.; Crawley, Jane; Levine, Orin S.; O’Brien, Katherine L.; Feikin, Daniel R.

2012-01-01

To develop a case definition for the Pneumonia Etiology Research for Child Health (PERCH) project, we sought a widely acceptable classification that was linked to existing pneumonia research and focused on very severe cases. We began with the World Health Organization’s classification of severe/very severe pneumonia and refined it through literature reviews and a 2-stage process of expert consultation. PERCH will study hospitalized children, aged 1–59 months, with pneumonia who present with cough or difficulty breathing and have either severe pneumonia (lower chest wall indrawing) or very severe pneumonia (central cyanosis, difficulty breastfeeding/drinking, vomiting everything, convulsions, lethargy, unconsciousness, or head nodding). It will exclude patients with recent hospitalization and children with wheeze whose indrawing resolves after bronchodilator therapy. The PERCH investigators agreed upon standard interpretations of the symptoms and signs. These will be maintained by a clinical standardization monitor who conducts repeated instruction at each site and by recurrent local training and testing. PMID:22403224

Measuring Pressure Has a New Standard

NASA Technical Reports Server (NTRS)

2002-01-01

The Force-Balanced Piston Gauge (FPG) tests and calibrates instrumentation operating in the low pressure range. The system provides a traceable, primary calibration standard for measuring pressures in the range of near 0 to 15 kPa (2.2 psi) in both gauge and absolute measurement modes. The hardware combines a large area piston-cylinder with a load cell measuring the force resulting from pressures across the piston. The mass of the piston can be tared out, allowing measurement to start from zero. A pressure higher than the measured pressure, which keeps the piston centered, lubricates an innovative conical gap located between the piston and the cylinder, eliminating the need for piston rotation. A pressure controller based on the control of low gas flow automates the pressure control. DHI markets the FPG as an automated primary standard for very low-gauge and absolute pressures. DHI is selling the FPG to high-end metrology laboratories on a case by case basis, with a full commercial release to follow.

Epidemiology and Trends in Incidence of Kidney Cancer in Iran.

PubMed

Mirzaei, Maryam; Pournamdar, Zahra; Salehiniya, Hamid

2015-01-01

Kidney cancer has shown an increasing trend in recent decades. This study aimed to determine change in the incidence rate between 2003 and 2009 in Iran. In this study, national cancer registry data were used. Crude incidence rates were calculated per 100,000 and age-standardized incidence rates (ASRs) were computed using the direct standardization method and the world standard population. Significant trend of incidence rates was examined by the Cochran-Armitage test for linear trend. A total of 6,944 cases of kidney cancer were reported. The incidence cases increased from 595 patients in 2003 to 1,387 patients in 2009. Sex ratio (male to female) was 1.67. ASR also increased from 1.18 in 2003 to 2.52 in 2009 per 100,000, but the increasing trend was not significant. A slow increasing trend of incidence rate was observed in the study population. This may be due to an increase of risk factors. It is suggested to perform a study on risk factors for the cancer.

Is routine postoperative gastrografin study needed after laparoscopic sleeve gastrectomy? Experience of 712 cases.

PubMed

Wahby, M; Salama, A F; Elezaby, A F; Belgrami, F; Abd Ellatif, M E; El-Kaffas, H F; Al-Katary, M

2013-11-01

The current standard of care is to perform a postoperative gastrografin study following laparoscopic sleeve gastrectomy (LSG) to detect leakage or obstruction. This study evaluated the usefulness of this routine procedure. A retrospective chart review was performed in December 2012. All patients had routine intraoperative methylene blue testing to check for possible leakage from the staple line, and any leaking points were oversewn. We also performed postoperative contrast study (gastrografin) routinely in the first 24-48 h for all patients. From June 2007 to December 2012, 712 cases underwent LSG during the study period. Patients included in this study were 556 women (78.1%) and 156 men (21.9%). The mean age was 35 years. The mean BMI was 48 kg/m2. The operative time was 107 ± 29 min, and there were no conversions to open surgery. Intraoperative methylene blue test detected leakage in 28 cases (3.93%). Postoperative contrast study (gastrografin) was negative for leakage in all cases. Computed tomography (CT) scan with oral contrast study detected leakage in 1.4% (ten cases); none of these cases were detected by regular contrast study. Our study showed that intraoperative methylene blue test for leakage is a very sensitive and effective method for detecting leakage during sleeve gastrectomy and should be done routinely in all cases. Routine postoperative contrast study is not needed to detect leakage unless clinically indicated in selected cases, and in such cases contrast-enhanced CT scans are the modality of choice.

Test Cases for Flutter of the Benchmark Models Rectangular Wings on the Pitch and Plunge Apparatus

NASA Technical Reports Server (NTRS)

Bennett, Robert M.

2000-01-01

The supercritical airfoil was chosen as a relatively modem airfoil for comparison. The BOO12 model was tested first. Three different types of flutter instability boundaries were encountered, a classical flutter boundary, a transonic stall flutter boundary at angle of attack, and a plunge instability near M = 0.9 and for zero angle of attack. This test was made in air and was Transonic Dynamics Tunnel (TDT) Test 468. The BSCW model (for Benchmark SuperCritical Wing) was tested next as TDT Test 470. It was tested using both with air and a heavy gas, R-12, as a test medium. The effect of a transition strip on flutter was evaluated in air. The B64AOlO model was subsequently tested as TDT Test 493. Some further analysis of the experimental data for the BOO12 wing is presented. Transonic calculations using the parameters for the BOO12 wing in a two-dimensional typical section flutter analysis are given. These data are supplemented with data from the Benchmark Active Controls Technology model (BACT) given and in the next chapter of this document. The BACT model was of the same planform and airfoil as the BOO12 model, but with spoilers and a trailing edge control. It was tested in the heavy gas R-12, and was instrumented mostly at the 60 per cent span. The flutter data obtained on PAPA and the static aerodynamic test cases from BACT serve as additional data for the BOO12 model. All three types of flutter are included in the BACT Test Cases. In this report several test cases are selected to illustrate trends for a variety of different conditions with emphasis on transonic flutter. Cases are selected for classical and stall flutter for the BSCW model, for classical and plunge for the B64AOlO model, and for classical flutter for the BOO12 model. Test Cases are also presented for BSCW for static angles of attack. Only the mean pressures and the real and imaginary parts of the first harmonic of the pressures are included in the data for the test cases, but digitized time histories have been archived. The data for the test cases are available as separate electronic files. An overview of the model and tests is given, the standard formulary for these data is listed, and some sample results are presented.

Clinical evaluation and validation of laboratory methods for the diagnosis of Bordetella pertussis infection: Culture, polymerase chain reaction (PCR) and anti-pertussis toxin IgG serology (IgG-PT).

PubMed

Lee, Adria D; Cassiday, Pamela K; Pawloski, Lucia C; Tatti, Kathleen M; Martin, Monte D; Briere, Elizabeth C; Tondella, M Lucia; Martin, Stacey W

2018-01-01

The appropriate use of clinically accurate diagnostic tests is essential for the detection of pertussis, a poorly controlled vaccine-preventable disease. The purpose of this study was to estimate the sensitivity and specificity of different diagnostic criteria including culture, multi-target polymerase chain reaction (PCR), anti-pertussis toxin IgG (IgG-PT) serology, and the use of a clinical case definition. An additional objective was to describe the optimal timing of specimen collection for the various tests. Clinical specimens were collected from patients with cough illness at seven locations across the United States between 2007 and 2011. Nasopharyngeal and blood specimens were collected from each patient during the enrollment visit. Patients who had been coughing for ≤ 2 weeks were asked to return in 2-4 weeks for collection of a second, convalescent blood specimen. Sensitivity and specificity of each diagnostic test were estimated using three methods-pertussis culture as the "gold standard," composite reference standard analysis (CRS), and latent class analysis (LCA). Overall, 868 patients were enrolled and 13.6% were B. pertussis positive by at least one diagnostic test. In a sample of 545 participants with non-missing data on all four diagnostic criteria, culture was 64.0% sensitive, PCR was 90.6% sensitive, and both were 100% specific by LCA. CRS and LCA methods increased the sensitivity estimates for convalescent serology and the clinical case definition over the culture-based estimates. Culture and PCR were most sensitive when performed during the first two weeks of cough; serology was optimally sensitive after the second week of cough. Timing of specimen collection in relation to onset of illness should be considered when ordering diagnostic tests for pertussis. Consideration should be given to including IgG-PT serology as a confirmatory test in the Council of State and Territorial Epidemiologists (CSTE) case definition for pertussis.

Ending Social Promotion Without Leaving Children Behind: The Case of New York City

ERIC Educational Resources Information Center

McCombs, Jennifer Sloan, Ed.; Kirby, Sheila Nataraj, Ed.; Mariano, Louis T., Ed.

2009-01-01

Many states and school districts are implementing test-based requirements for promotion at key transitional points in students' schooling careers, thus ending the practice of "social promotion"--promoting students who have failed to meet academic standards and requirements for that grade. In 2003-2004, the New York City Department of…

Computing Integrated Ratings from Heterogeneous Phenotypic Assessments: A Case Study of Lettuce Postharvest Quality and Downy Mildew Resistance

USDA-ARS?s Scientific Manuscript database

Comparing performance of a large number of accessions simultaneously is not always possible. Typically, only subsets of all accessions are tested in separate trials with only some (or none) of the accessions overlapping between subsets. Using standard statistical approaches to combine data from such...

20 CFR Appendix C to Part 625 - Standard for Fraud and Overpayment Detection

Code of Federal Regulations, 2012 CFR

2012-04-01

... paid to them in a sufficient proportion of cases to test the effectiveness of the agency's procedures... overpayments, such a unit or individual might, for example: (a) Investigate information on suspected benefit.... Comparisons of benefit payments with employment records are commonly made either by post-audit or by industry...

20 CFR Appendix C to Part 625 - Standard for Fraud and Overpayment Detection

Code of Federal Regulations, 2011 CFR

2011-04-01

... paid to them in a sufficient proportion of cases to test the effectiveness of the agency's procedures... overpayments, such a unit or individual might, for example: (a) Investigate information on suspected benefit.... Comparisons of benefit payments with employment records are commonly made either by post-audit or by industry...

20 CFR Appendix C to Part 625 - Standard for Fraud and Overpayment Detection

Code of Federal Regulations, 2014 CFR

2014-04-01

... paid to them in a sufficient proportion of cases to test the effectiveness of the agency's procedures... overpayments, such a unit or individual might, for example: (a) Investigate information on suspected benefit.... Comparisons of benefit payments with employment records are commonly made either by post-audit or by industry...

76 FR 37831 - Petitions for Modification of Application of Existing Mandatory Safety Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-28

... strata breakage for the mine; (2) to facilitate methane drainage, degasification casing of suitable... on the shift prior to mining through the well. The methane monitor(s) on the continuous mining.... (8) When mining is in progress, tests for methane will be made with a hand-held methane detector at...

Multilingual Literacies: Invisible Representation of Literacy in a Rural Classroom

ERIC Educational Resources Information Center

Kiramba, Lydiah Kananu

2017-01-01

In many countries, educational policies typically mandate school activities that promote a homogeneous and narrow range of academic literacies for all learners despite the diverse nature of human learning. This ethnographic case study examines how a 12-year-old Kenyan fourth-grade student performing below average on all standardized tests used…

29 CFR 793.11 - Combination announcer, news editor and chief engineer.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 3 2012-07-01 2012-07-01 false Combination announcer, news editor and chief engineer. 793...)(9) OF THE FAIR LABOR STANDARDS ACT Requirements for Exemption § 793.11 Combination announcer, news... as a news editor. In such cases, the primary employment test under the section 13(b)(9) exemption...

29 CFR 793.11 - Combination announcer, news editor and chief engineer.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 3 2014-07-01 2014-07-01 false Combination announcer, news editor and chief engineer. 793...)(9) OF THE FAIR LABOR STANDARDS ACT Requirements for Exemption § 793.11 Combination announcer, news... as a news editor. In such cases, the primary employment test under the section 13(b)(9) exemption...

29 CFR 793.11 - Combination announcer, news editor and chief engineer.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 3 2013-07-01 2013-07-01 false Combination announcer, news editor and chief engineer. 793...)(9) OF THE FAIR LABOR STANDARDS ACT Requirements for Exemption § 793.11 Combination announcer, news... as a news editor. In such cases, the primary employment test under the section 13(b)(9) exemption...

Unalienated Recognition as a Feature of Democratic Schooling

ERIC Educational Resources Information Center

Rheingold, Alison

2012-01-01

The current era of standards and accountability in U.S. public schooling narrows recognition and assessment to an almost exclusive focus on the production of test scores as legitimate markers of student achievement. This climate prevents rather than encourages democratic forms of exchange within and across social worlds. Via a case study of one…

Standard of Practice and Flynn Effect Testimony in Death Penalty Cases

ERIC Educational Resources Information Center

Gresham, Frank M.; Reschly, Daniel J.

2011-01-01

The Flynn Effect is a well-established psychometric fact documenting substantial increases in measured intelligence test performance over time. Flynn's (1984) review of the literature established that Americans gain approximately 0.3 points per year or 3 points per decade in measured intelligence. The accurate assessment and interpretation of…

ABO Mistyping of cis-AB Blood Group by the Automated Microplate Technique.

PubMed

Chun, Sejong; Ryu, Mi Ra; Cha, Seung-Yeon; Seo, Ji-Young; Cho, Duck

2018-01-01

The cis -AB phenotype, although rare, is the relatively most frequent of ABO subgroups in Koreans. To prevent ABO mistyping of cis -AB samples, our hospital has applied a combination of the manual tile method with automated devices. Herein, we report cases of ABO mistyping detected by the combination testing system. Cases that showed discrepant results by automated devices and the manual tile method were evaluated. These samples were also tested by the standard tube method. The automated devices used in this study were a QWALYS-3 and Galileo NEO. Exons 6 and 7 of the ABO gene were sequenced. 13 cases that had the cis -AB allele showed results suggestive of the cis -AB subgroup by manual methods, but were interpreted as AB by either automated device. This happened in 87.5% of these cases by QWALYS-3 and 70.0% by Galileo NEO. Genotyping results showed that 12 cases were ABO*cis-AB01/ABO*O01 or ABO*cis-AB01/ABO*O02 , and one case was ABO*cis-AB01/ ABO*A102. Cis -AB samples were mistyped as AB by the automated microplate technique in some cases. We suggest that the manual tile method can be a simple supplemental test for the detection of the cis -AB phenotype, especially in countries with relatively high cis- AB prevalence.

Diagnosis of aerobic vaginitis by quantitative real-time PCR.

PubMed

Rumyantseva, T A; Bellen, G; Savochkina, Y A; Guschin, A E; Donders, G G G

2016-07-01

To evaluate a real-time PCR-based technique to quantify bacteria associated with aerobic vaginitis (AV) as a potential test. Vaginal samples from 100 women were tested by wet-mount microscopy, gram stain and quantitative real-time PCR targeting Enterobacteriacea, Staphylococcus spp., Streptococcus spp., Enterococcus spp., Escherichia coli, Streptococcus agalactiae, S. aureus; Lactobacillus spp. AV diagnosis obtained by wet-mount microscopy was used as reference. Some level of AV was diagnosed in 23 (23.7 %) cases. Various concentrations of Enterobacteriacea, Staphylococcus spp., Streptococcus spp. were detected an all patients. Enterococcus spp. were detected in 76 (78.3 %) cases. Summarized concentrations of aerobes were tenfold higher in AV-positive compared to AV-negative cases [7.30lg vs 6.06lg (p = 0.02)]. Concentrations of aerobes in severe, moderate and light AV cases did not vary significantly (p = 0.14). Concentration of lactobacilli was 1000-fold lower in AV-positive cases compared to normal cases (5.3lg vs 8.3lg, p < 0.0001). Streptococcus spp. dominated in the majority of AV-positive cases [19/22 (86.4 %) samples]. The relation of high loads of aerobes to the low numbers of Lactobacilli are a reliable marker for the presence of AV and could substitute microscopy as a test. PCR may be a good standardized substitution for AV diagnosis in settings where well-trained microscopists are lacking.

Standard penetration test-based probabilistic and deterministic assessment of seismic soil liquefaction potential

USGS Publications Warehouse

Cetin, K.O.; Seed, R.B.; Der Kiureghian, A.; Tokimatsu, K.; Harder, L.F.; Kayen, R.E.; Moss, R.E.S.

2004-01-01

This paper presents'new correlations for assessment of the likelihood of initiation (or triggering) of soil liquefaction. These new correlations eliminate several sources of bias intrinsic to previous, similar correlations, and provide greatly reduced overall uncertainty and variance. Key elements in the development of these new correlations are (1) accumulation of a significantly expanded database of field performance case histories; (2) use of improved knowledge and understanding of factors affecting interpretation of standard penetration test data; (3) incorporation of improved understanding of factors affecting site-specific earthquake ground motions (including directivity effects, site-specific response, etc.); (4) use of improved methods for assessment of in situ cyclic shear stress ratio; (5) screening of field data case histories on a quality/uncertainty basis; and (6) use of high-order probabilistic tools (Bayesian updating). The resulting relationships not only provide greatly reduced uncertainty, they also help to resolve a number of corollary issues that have long been difficult and controversial including: (1) magnitude-correlated duration weighting factors, (2) adjustments for fines content, and (3) corrections for overburden stress. ?? ASCE.

Vascular and nerve damage in workers exposed to vibrating tools. The importance of objective measurements of exposure time.

PubMed

Gerhardsson, Lars; Balogh, Istvan; Hambert, Per-Arne; Hjortsberg, Ulf; Karlsson, Jan-Erik

2005-01-01

The aim of the present study was to compare the development of vibration white fingers (VWF) in workers in relation to different ways of exposure estimation, and their relationship to the standard ISO 5349, annex A. Nineteen vibration exposed (grinding machines) male workers completed a questionnaire followed by a structured interview including questions regarding their estimated hand-held vibration exposure. Neurophysiological tests such as fractionated nerve conduction velocity in hands and arms, vibrotactile perception thresholds and temperature thresholds were determined. The subjective estimation of the mean daily exposure-time to vibrating tools was 192 min (range 18-480 min) among the workers. The estimated mean exposure time calculated from the consumption of grinding wheels was 42 min (range 18-60 min), approximately a four-fold overestimation (Wilcoxon's signed ranks test, p<0.001). Thus, objective measurements of the exposure time, related to the standard ISO 5349, which in this case were based on the consumption of grinding wheels, will in most cases give a better basis for adequate risk assessment than self-exposure assessment.

Failure of the public health testing program for ballast water treatment systems.

PubMed

Cohen, Andrew N; Dobbs, Fred C

2015-02-15

Since 2004, an international testing program has certified 53 shipboard treatment systems as meeting ballast water discharge standards, including limits on certain microbes to prevent the spread of human pathogens. We determined how frequently certification tests failed a minimum requirement for a meaningful evaluation, that the concentration of microbes in the untreated (control) discharge must exceed the regulatory limit for treated discharges. In 95% of cases where the result was accepted as evidence that the treatment system reduced microbes to below the regulatory limit, the discharge met the limit even without treatment. This shows that the certification program for ballast water treatment systems is dysfunctional in protecting human health. In nearly all cases, the treatment systems would have equally well "passed" these tests even if they had never been turned on. Protocols must require minimum concentrations of targeted microbes in test waters, reflecting the upper range of concentrations in waters where ships operate. Copyright © 2014 Elsevier Ltd. All rights reserved.

Analysis of messy data with heteroscedastic in mean models

NASA Astrophysics Data System (ADS)

Trianasari, Nurvita; Sumarni, Cucu

2016-02-01

In the analysis of the data, we often faced with the problem of data where the data did not meet some assumptions. In conditions of such data is often called data messy. This problem is a consequence of the data that generates outliers that bias or error estimation. To analyze the data messy, there are three approaches, namely standard analysis, transform data and data analysis methods rather than a standard. Simulations conducted to determine the performance of a third comparative test procedure on average often the model variance is not homogeneous. Data simulation of each scenario is raised as much as 500 times. Next, we do the analysis of the average comparison test using three methods, Welch test, mixed models and Welch-r test. Data generation is done through software R version 3.1.2. Based on simulation results, these three methods can be used for both normal and abnormal case (homoscedastic). The third method works very well on data balanced or unbalanced when there is no violation in the homogenity's assumptions variance. For balanced data, the three methods still showed an excellent performance despite the violation of the assumption of homogeneity of variance, with the requisite degree of heterogeneity is high. It can be shown from the level of power test above 90 percent, and the best to Welch method (98.4%) and the Welch-r method (97.8%). For unbalanced data, Welch method will be very good moderate at in case of heterogeneity positive pair with a 98.2% power. Mixed models method will be very good at case of highly heterogeneity was negative negative pairs with power. Welch-r method works very well in both cases. However, if the level of heterogeneity of variance is very high, the power of all method will decrease especially for mixed models methods. The method which still works well enough (power more than 50%) is Welch-r method (62.6%), and the method of Welch (58.6%) in the case of balanced data. If the data are unbalanced, Welch-r method works well enough in the case of highly heterogeneous positive positive or negative negative pairs, there power are 68.8% and 51% consequencly. Welch method perform well enough only in the case of highly heterogeneous variety of positive positive pairs with it is power of 64.8%. While mixed models method is good in the case of a very heterogeneous variety of negative partner with 54.6% power. So in general, when there is a variance is not homogeneous case, Welch method is applied to the data rank (Welch-r) has a better performance than the other methods.

Instabilities of geared couplings: Theory and practice

NASA Technical Reports Server (NTRS)

Kirk, R. G.; Mondy, R. E.; Murphy, R. C.

1982-01-01

The use of couplings for high speed turbocompressors or pumps is essential to transmit power from the driver. Typical couplings are either of the lubricated gear or dry diaphragm type design. Gear couplings have been the standard design for many years and recent advances in power and speed requirements have pushed the standard design criteria to the limit. Recent test stand and field data on continuous lube gear type couplings have forced a closer examination of design tolerances and concepts to avoid operational instabilities. Two types of mechanical instabilities are reviewed in this paper: (1) entrapped fluid, and (2) gear mesh instability resulting in spacer throw-out onset. Test stand results of these types of instabilities and other directly related problems are presented together with criteria for proper coupling design to avoid these conditions. An additional test case discussed shows the importance of proper material selection and processing and what can happen to an otherwise good design.

New bone post-processing tools in forensic imaging: a multi-reader feasibility study to evaluate detection time and diagnostic accuracy in rib fracture assessment.

PubMed

Glemser, Philip A; Pfleiderer, Michael; Heger, Anna; Tremper, Jan; Krauskopf, Astrid; Schlemmer, Heinz-Peter; Yen, Kathrin; Simons, David

2017-03-01

The aim of this multi-reader feasibility study was to evaluate new post-processing CT imaging tools in rib fracture assessment of forensic cases by analyzing detection time and diagnostic accuracy. Thirty autopsy cases (20 with and 10 without rib fractures in autopsy) were randomly selected and included in this study. All cases received a native whole body CT scan prior to the autopsy procedure, which included dissection and careful evaluation of each rib. In addition to standard transverse sections (modality A), CT images were subjected to a reconstruction algorithm to compute axial labelling of the ribs (modality B) as well as "unfolding" visualizations of the rib cage (modality C, "eagle tool"). Three radiologists with different clinical and forensic experience who were blinded to autopsy results evaluated all cases in a random manner of modality and case. Rib fracture assessment of each reader was evaluated compared to autopsy and a CT consensus read as radiologic reference. A detailed evaluation of relevant test parameters revealed a better accordance to the CT consensus read as to the autopsy. Modality C was the significantly quickest rib fracture detection modality despite slightly reduced statistic test parameters compared to modalities A and B. Modern CT post-processing software is able to shorten reading time and to increase sensitivity and specificity compared to standard autopsy alone. The eagle tool as an easy to use tool is suited for an initial rib fracture screening prior to autopsy and can therefore be beneficial for forensic pathologists.

Detection of rare blood group, Bombay (Oh) phenotype patients and management by acute normovolemic hemodilution.

PubMed

Shrivastava, Manisha; Navaid, Seema; Peethambarakshan, A; Agrawal, Kalpana; Khan, Athar

2015-01-01

Due to lack of correct blood grouping practices, the rare Bombay Oh phenotype may be missed, subjecting patients to the risk of severe hemolytic transfusion reaction. In the absence of blood donor registry, transfusion management of patients needing immediate surgery is a challenge. This study presents detection of rare Bombay Oh phenotype patients and their management by acute peri-operative acute normovolemic hemodilution (ANH) in a hospital from central India. Blood grouping of patients and blood donors with a standard tube method was carried out and samples identified as rare Bombay phenotype were confirmed by saliva inhibition test. Surgical management of cases needing transfusion was done by ANH, as per the British Committee for Standards in Hematology guidelines. The incidence of Bombay phenotype was 0.002% or 1 in 51,924 in the study. Amongst three cases (patients) identified as Bombay phenotype, one was Bombay Oh, Rh negative. Two cases were missed in the first instance and one case actually did not require transfusion. In the absence of a blood donor registry for Bombay phenotype, the cases needing transfusion were successfully managed with ANH in the operation theatre. A simple test like blood grouping should be done with serious intention with incorporation of both forward and reverse grouping, so that no patient receives wrong blood leading to fatal hemolysis due to transfusion. ANH is a cost-effective transfusion option for suitable patients. Appropriate clinical decision making, use of strategies to decrease peri-operative blood losses and cost-effective country based planning could be more widely applied to improve clinical transfusion practice.

Improving Hispanic students' performance on science standardized tests: Successful practices from four elementary campuses

NASA Astrophysics Data System (ADS)

Gonzalez, Yvonne Lynne

This qualitative, descriptive multiple case study took place in a Southwest Texas city bordering Mexico. The study examined specific resources and practices used in four different exemplary-rated elementary school campuses, with standardized test data reflecting 93% or more of their 5th-grade Hispanic student population passing the state mandated standardized science test. The sample for this study included one principal, one assistant principal, and three 5th-grade teachers from each campus. In total, the sample participants consisted of four principals, four assistant principals, and 12 5th-grade teachers. Data collection involved conducting in-depth, semi-structured interviews guided by five literature-based, researcher-generated questions. Fifth grade teachers and administrators reflected and reported upon their pedagogy for best practices in helping Hispanic students achieve success. Analysis of the data revealed eight themes: (a) successful schools have committed teachers, an environment conducive to learning, and incorporate best practices that work for all students; (b) curriculum alignment is very important; (c) teachers have access to a variety of resources; (d) teacher collaboration and planning is very important; (e) science camps, science reviews, and hands-on centers are effective in preparing students for the standardized test; (f) the most effective instructional practices include high emphasis on vocabulary, hands-on and differentiated instruction, and the 5E Model; (g) teachers see value in self-contained, dual-language classes; and (h) professional development and performance feedback are important to educators. The results of this study provide educational leaders with specific science instructional resources, practices, and interventions proven effective for the 5 th-grade Hispanic student population in passing the science state standardized test.

Sulfide stress cracking failures of 12Cr and 17-4PH stainless steel wellhead equipment

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

Thompson, R.M.; Kohut, G.B.; Canfield, D.R.

1991-03-01

In this paper sulfide stress cracking case histories of 12 Cr and 17-4PH stainless steel tubing hangers are presented along with the results of NACE Standard TM0177 laboratory tests performed on the failed material. Even though the hangers both met NACE Standard MR0175-88 hardness requirements, failure still occurred. These failures demonstrate the limitations of these alloys in high H{sub 2}S service even when MR0175 requirements are met. The need for better usage guidelines is discussed.

Lost in Translation: the Case for Integrated Testing

NASA Technical Reports Server (NTRS)

Young, Aaron

2017-01-01

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

Comprehensive evaluation of the child with intellectual disability or global developmental delays.

PubMed

Moeschler, John B; Shevell, Michael

2014-09-01

Global developmental delay and intellectual disability are relatively common pediatric conditions. This report describes the recommended clinical genetics diagnostic approach. The report is based on a review of published reports, most consisting of medium to large case series of diagnostic tests used, and the proportion of those that led to a diagnosis in such patients. Chromosome microarray is designated as a first-line test and replaces the standard karyotype and fluorescent in situ hybridization subtelomere tests for the child with intellectual disability of unknown etiology. Fragile X testing remains an important first-line test. The importance of considering testing for inborn errors of metabolism in this population is supported by a recent systematic review of the literature and several case series recently published. The role of brain MRI remains important in certain patients. There is also a discussion of the emerging literature on the use of whole-exome sequencing as a diagnostic test in this population. Finally, the importance of intentional comanagement among families, the medical home, and the clinical genetics specialty clinic is discussed. Copyright © 2014 by the American Academy of Pediatrics.

Using 4+ to grade near-normal muscle strength does not improve agreement.

PubMed

O'Neill, Søren; Jaszczak, Sofie Louise Thomsen; Steffensen, Anne Katrine Søndergaard; Debrabant, Birgit

2017-01-01

Manual assessment of muscle strength is often graded using the ordinal Medical Research Council (MRC) scale. The scale has a number of inherent weaknesses, including poorly defined limits between grades '4' and '5' and very large differences in the span of muscle strength encompassed by each of the six grades. It is not necessarily obvious how to convert a manual muscle test finding into an MRC grade. Several modifications which include intermediate grades have been suggested to improve the MRC scale and the current study examines whether agreement improves and variation in ratings decrease, with an intermediate grade between '4' and '5', in circumstances where such a grade would seem appropriate. The present study examined the hypothesis, that a modified MRC-scale which included the commonly used '4+' option, resulted in greater agreement between clinicians compared to the standard MRC-scale. A questionnaire containing five simple clinical cases were distributed to a large convenience sample of chiropractors in Northern Europe, with instructions to grade the described muscle strength findings using the MRC scale. The scale was adapted (with/without an intermediate '4+' grade) depending on the preference of the individual respondent. The cases were designed in such a way as to suggest a muscle weakness in the grey area between '4' and '5', i.e. grade '4+' on the modified MRC scale. A total of 225 questionnaires were returned (7% response rate). The average percentage agreement (across cases) in the standard MRC group was 64% [range 51%: 73%] (grade '4' in all cases). In the modified MRC group, the corresponding findings was 48% [38%: 74%] (grade '4' or '4+' in all cases). The mean average deviation analogue in the standard MRC group was 0.34 (range 0.34: 0.40), compared to 0.51 (range 0.39: 0.73) in the modified MRC group, indicating greater dispersion of scores in the modified MRC group. The Fleiss kappa was 0.02 ( p  < 0.001) and 0.13 ( p  < 0.001), respectively. Contrary to the original hypothesis, introduction of a '4+' grade did not clearly improve agreement or variability of ratings, despite eliminating the physical muscle testing by providing written descriptions of test findings and specifically designing these to suggest a weakness of grade '4+'.

The sensitivity and specificity of Lassa virus IgM by ELISA as screening tool at early phase of Lassa fever infection.

PubMed

Ibekwe, Titus S; Nwegbu, Maxwell M; Asogun, Daniel; Adomeh, Donatus I; Okokhere, Peter O

2012-10-01

Early diagnosis, prompt treatment, and disease containment are vital measures in the management of Lassa fever (LF), a lethal and contagious arenaviral hemorrhagic disease prevalent in West Africa. Lassa Virus (LAV)-specific Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) test, the gold standard for diagnosis, is unavailable in most centers. Serologic detection of LAV IgM is a more accessible tool and this work was to investigate its adequacy as an early marker for LF. A prospective case-control study conducted July 2007-March 2011 in a tertiary referral health center in Nigeria. Blood samples for test and control were evaluated for Lassa specific antigens and IgM using RT-PCR (primers S36+ and LVS 339) and indirect ELISA (Lassa Nucleo-protein (NP)-Antigen) respectively. RT-PCR outcome was used as standard to test for the sensitivity and specificity of IgM. Of the 37 confirmed cases of LF infection by RT-PCR, 21 (57%) were IgM positive. Amongst the 35 confirmed negative cases (control group), eight were IgM positive. The diagnostic sensitivity and specificity of the IgM assay were 57% and 77% respectively. The negative and positive predictive values of the IgM serological assay were 63% and 72%, respectively, while the efficiency of the test was 67%. The specificity and sensitivity of IgM as a screening tool for early detection of LF appear weak and, hence, the need for a reliable LF "rapid screening kit" since RT-PCR is unavailable in most centers. In the interim, "high clinical index of suspicion," irrespective of IgM status, requires urgent referral to confirmatory centers.

Clinical and epidemiological features of typhoid fever in Pemba, Zanzibar: assessment of the performance of the WHO case definitions.

PubMed

Thriemer, Kamala; Ley, Benedikt; Ley, Benedikt B; Ame, Shaali S; Deen, Jaqueline L; Pak, Gi Deok; Chang, Na Yoon; Hashim, Ramadhan; Schmied, Wolfgang Hellmut; Busch, Clara Jana-Lui; Nixon, Shanette; Morrissey, Anne; Puri, Mahesh K; Ochiai, R Leon; Wierzba, Thomas; Clemens, John D; Ali, Mohammad; Jiddawi, Mohammad S; von Seidlein, Lorenz; Ali, Said M

2012-01-01

The gold standard for diagnosis of typhoid fever is blood culture (BC). Because blood culture is often not available in impoverished settings it would be helpful to have alternative diagnostic approaches. We therefore investigated the usefulness of clinical signs, WHO case definition and Widal test for the diagnosis of typhoid fever. Participants with a body temperature ≥37.5°C or a history of fever were enrolled over 17 to 22 months in three hospitals on Pemba Island, Tanzania. Clinical signs and symptoms of participants upon presentation as well as blood and serum for BC and Widal testing were collected. Clinical signs and symptoms of typhoid fever cases were compared to other cases of invasive bacterial diseases and BC negative participants. The relationship of typhoid fever cases with rainfall, temperature, and religious festivals was explored. The performance of the WHO case definitions for suspected and probable typhoid fever and a local cut off titre for the Widal test was assessed. 79 of 2209 participants had invasive bacterial disease. 46 isolates were identified as typhoid fever. Apart from a longer duration of fever prior to admission clinical signs and symptoms were not significantly different among patients with typhoid fever than from other febrile patients. We did not detect any significant seasonal patterns nor correlation with rainfall or festivals. The sensitivity and specificity of the WHO case definition for suspected and probable typhoid fever were 82.6% and 41.3% and 36.3 and 99.7% respectively. Sensitivity and specificity of the Widal test was 47.8% and 99.4 both forfor O-agglutinin and H- agglutinin at a cut-off titre of 1:80. Typhoid fever prevalence rates on Pemba are high and its clinical signs and symptoms are non-specific. The sensitivity of the Widal test is low and the WHO case definition performed better than the Widal test.

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

PubMed Central

2014-01-01

Background The Xpert MTB/RIF assay has garnered significant interest as a sensitive and rapid diagnostic tool to improve detection of sensitive and drug resistant tuberculosis. However, most existing literature has described the performance of MTB/RIF testing only in study conditions; little information is available on its use in routine case finding. TB REACH is a multi-country initiative focusing on innovative ways to improve case notification. Methods We selected a convenience sample of nine TB REACH projects for inclusion to cover a range of implementers, regions and approaches. Standard quarterly reports and machine data from the first 12 months of MTB/RIF implementation in each project were utilized to analyze patient yields, rifampicin resistance, and failed tests. Data was collected from September 2011 to March 2013. A questionnaire was implemented and semi-structured interviews with project staff were conducted to gather information on user experiences and challenges. Results All projects used MTB/RIF testing for people with suspected TB, as opposed to testing for drug resistance among already diagnosed patients. The projects placed 65 machines (196 modules) in a variety of facilities and employed numerous case-finding strategies and testing algorithms. The projects consumed 47,973 MTB/RIF tests. Of valid tests, 7,195 (16.8%) were positive for MTB. A total of 982 rifampicin resistant results were found (13.6% of positive tests). Of all tests conducted, 10.6% failed. The need for continuous power supply was noted by all projects and most used locally procured solutions. There was considerable heterogeneity in how results were reported and recorded, reflecting the lack of standardized guidance in some countries. Conclusions The findings of this study begin to fill the gaps among guidelines, research findings, and real-world implementation of MTB/RIF testing. Testing with Xpert MTB/RIF detected a large number of people with TB that routine services failed to detect. The study demonstrates the versatility and impact of the technology, but also outlines various surmountable barriers to implementation. The study is not representative of all early implementer experiences with MTB/RIF testing but rather provides an overview of the shared issues as well as the many different approaches to programmatic MTB/RIF implementation. PMID:24383553

Review: domestic animal forensic genetics - biological evidence, genetic markers, analytical approaches and challenges.

PubMed

Kanthaswamy, S

2015-10-01

This review highlights the importance of domestic animal genetic evidence sources, genetic testing, markers and analytical approaches as well as the challenges this field is facing in view of the de facto 'gold standard' human DNA identification. Because of the genetic similarity between humans and domestic animals, genetic analysis of domestic animal hair, saliva, urine, blood and other biological material has generated vital investigative leads that have been admitted into a variety of court proceedings, including criminal and civil litigation. Information on validated short tandem repeat, single nucleotide polymorphism and mitochondrial DNA markers and public access to genetic databases for forensic DNA analysis is becoming readily available. Although the fundamental aspects of animal forensic genetic testing may be reliable and acceptable, animal forensic testing still lacks the standardized testing protocols that human genetic profiling requires, probably because of the absence of monetary support from government agencies and the difficulty in promoting cooperation among competing laboratories. Moreover, there is a lack in consensus about how to best present the results and expert opinion to comply with court standards and bear judicial scrutiny. This has been the single most persistent challenge ever since the earliest use of domestic animal forensic genetic testing in a criminal case in the mid-1990s. Crime laboratory accreditation ensures that genetic test results have the courts' confidence. Because accreditation requires significant commitments of effort, time and resources, the vast majority of animal forensic genetic laboratories are not accredited nor are their analysts certified forensic examiners. The relevance of domestic animal forensic genetics in the criminal justice system is undeniable. However, further improvements are needed in a wide range of supporting resources, including standardized quality assurance and control protocols for sample handling, evidence testing, statistical analysis and reporting that meet the rules of scientific acceptance, reliability and human forensic identification standards. © 2015 Stichting International Foundation for Animal Genetics.

Diagnostic Accuracy of Chinese Medicine Diagnosis Scale of Phlegm and Blood Stasis Syndrome in Coronary Heart Disease: A Study Protocol.

PubMed

Liu, Xiao-Qi; Peng, Dan-Hong; Wang, Yan-Ping; Xie, Rong; Chen, Xin-Lin; Yu, Chun-Quan; Li, Xian-Tao

2018-05-03

Phlegm and blood stasis syndrome (PBSS) is one of the main syndromes in coronary heart disease (CHD). Syndromes of Chinese medicine (CM) are lack of quantitative and easyimplementation diagnosis standards. To quantify and standardize the diagnosis of PBSS, scales are usually applied. To evaluate the diagnostic accuracy of CM diagnosis scale of PBSS in CHD. Six hundred patients with stable angina pectoris of CHD, 300 in case group and 300 in control group, will be recruited from 5 hospitals across China. Diagnosis from 2 experts will be considered as the "gold standard". The study design consists of 2 phases: pilot test is used to evaluate the reliability and validity, and diagnostic test is used to assess the diagnostic accuracy of the scale, including sensitivity, specififi city, likelihood ratio and area under the receiver operator characteristic (ROC) curve. This study will evaluate the diagnostic accuracy of CM diagnosis scale of PBSS in CHD. The consensus of 2 experts may not be ideal as a "gold standard", and itself still requires further study. (No. ChiCTR-OOC-15006599).

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

PubMed

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

2014-01-01

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

The perception of isoluminant coloured stimuli of amblyopic eye and defocused eye

NASA Astrophysics Data System (ADS)

Krumina, Gunta; Ozolinsh, Maris; Ikaunieks, Gatis

2008-09-01

In routine eye examination the visual acuity usually is determined using standard charts with black letters on a white background, however contrast and colour are important characteristics of visual perception. The purpose of research was to study the perception of isoluminant coloured stimuli in the cases of true and simulated amlyopia. We estimated difference in visual acuity with isoluminant coloured stimuli comparing to that for high contrast black-white stimuli for true amblyopia and simulated amblyopia. Tests were generated on computer screen. Visual acuity was detected using different charts in two ways: standard achromatic stimuli (black symbols on a white background) and isoluminant coloured stimuli (white symbols on a yellow background, grey symbols on blue, green or red background). Thus isoluminant tests had colour contrast only but had no luminance contrast. Visual acuity evaluated with the standard method and colour tests were studied for subjects with good visual acuity, if necessary using the best vision correction. The same was performed for subjects with defocused eye and with true amblyopia. Defocus was realized with optical lenses placed in front of the normal eye. The obtained results applying the isoluminant colour charts revealed worsening of the visual acuity comparing with the visual acuity estimated with a standard high contrast method (black symbols on a white background).

Artificial intelligence techniques applied to the development of a decision–support system for diagnosing celiac disease

PubMed Central

Tenório, Josceli Maria; Hummel, Anderson Diniz; Cohrs, Frederico Molina; Sdepanian, Vera Lucia; Pisa, Ivan Torres; de Fátima Marin, Heimar

2013-01-01

Background Celiac disease (CD) is a difficult-to-diagnose condition because of its multiple clinical presentations and symptoms shared with other diseases. Gold-standard diagnostic confirmation of suspected CD is achieved by biopsying the small intestine. Objective To develop a clinical decision–support system (CDSS) integrated with an automated classifier to recognize CD cases, by selecting from experimental models developed using intelligence artificial techniques. Methods A web-based system was designed for constructing a retrospective database that included 178 clinical cases for training. Tests were run on 270 automated classifiers available in Weka 3.6.1 using five artificial intelligence techniques, namely decision trees, Bayesian inference, k-nearest neighbor algorithm, support vector machines and artificial neural networks. The parameters evaluated were accuracy, sensitivity, specificity and area under the ROC curve (AUC). AUC was used as a criterion for selecting the CDSS algorithm. A testing database was constructed including 38 clinical CD cases for CDSS evaluation. The diagnoses suggested by CDSS were compared with those made by physicians during patient consultations. Results The most accurate method during the training phase was the averaged one-dependence estimator (AODE) algorithm (a Bayesian classifier), which showed accuracy 80.0%, sensitivity 0.78, specificity 0.80 and AUC 0.84. This classifier was integrated into the web-based decision–support system. The gold-standard validation of CDSS achieved accuracy of 84.2% and k = 0.68 (p < 0.0001) with good agreement. The same accuracy was achieved in the comparison between the physician’s diagnostic impression and the gold standard k = 0. 64 (p < 0.0001). There was moderate agreement between the physician’s diagnostic impression and CDSS k = 0.46 (p = 0.0008). Conclusions The study results suggest that CDSS could be used to help in diagnosing CD, since the algorithm tested achieved excellent accuracy in differentiating possible positive from negative CD diagnoses. This study may contribute towards developing of a computer-assisted environment to support CD diagnosis. PMID:21917512

Artificial intelligence techniques applied to the development of a decision-support system for diagnosing celiac disease.

PubMed

Tenório, Josceli Maria; Hummel, Anderson Diniz; Cohrs, Frederico Molina; Sdepanian, Vera Lucia; Pisa, Ivan Torres; de Fátima Marin, Heimar

2011-11-01

Celiac disease (CD) is a difficult-to-diagnose condition because of its multiple clinical presentations and symptoms shared with other diseases. Gold-standard diagnostic confirmation of suspected CD is achieved by biopsying the small intestine. To develop a clinical decision-support system (CDSS) integrated with an automated classifier to recognize CD cases, by selecting from experimental models developed using intelligence artificial techniques. A web-based system was designed for constructing a retrospective database that included 178 clinical cases for training. Tests were run on 270 automated classifiers available in Weka 3.6.1 using five artificial intelligence techniques, namely decision trees, Bayesian inference, k-nearest neighbor algorithm, support vector machines and artificial neural networks. The parameters evaluated were accuracy, sensitivity, specificity and area under the ROC curve (AUC). AUC was used as a criterion for selecting the CDSS algorithm. A testing database was constructed including 38 clinical CD cases for CDSS evaluation. The diagnoses suggested by CDSS were compared with those made by physicians during patient consultations. The most accurate method during the training phase was the averaged one-dependence estimator (AODE) algorithm (a Bayesian classifier), which showed accuracy 80.0%, sensitivity 0.78, specificity 0.80 and AUC 0.84. This classifier was integrated into the web-based decision-support system. The gold-standard validation of CDSS achieved accuracy of 84.2% and k=0.68 (p<0.0001) with good agreement. The same accuracy was achieved in the comparison between the physician's diagnostic impression and the gold standard k=0. 64 (p<0.0001). There was moderate agreement between the physician's diagnostic impression and CDSS k=0.46 (p=0.0008). The study results suggest that CDSS could be used to help in diagnosing CD, since the algorithm tested achieved excellent accuracy in differentiating possible positive from negative CD diagnoses. This study may contribute towards developing of a computer-assisted environment to support CD diagnosis. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Toxicity of two imidazolium ionic liquids, [bmim][BF4] and [omim][BF4], to standard aquatic test organisms: Role of acetone in the induced toxicity.

PubMed

Tsarpali, Vasiliki; Dailianis, Stefanos

2015-07-01

The main goal of this study was to investigate the toxicity of the imidazolium-based ionic liquids (ILs), [bmim][BF4] (1-butyl-3-methylimidazolium tetrafluoroborate) and [omim][BF4] (1-octyl-3-methylimidazolium tetrafluoroborate), in battery of standard aquatic toxicity test organisms. Specifically, exposure of the algae Scenedesmus rubescens, crustaceans Thamnocephalus platyurus and Artemia franciscana, rotifers Brachionus calyciflorus and Brachionus plicatilis and bivalve Mytilus galloprovincialis to different concentrations of [bmim][BF4], [omim][BF4] and/or a binary mixture of [bmim][BF4]-[omim][BF4] (1:1) with or without acetone (carrier solvent), revealed that solvent can differentially mediate ILs' toxic profile. Acetone's ability to differentially affect ILs' cation's alkyl chain length, as well as the hydrolysis of [BF4(-)] anions was evident. Given that the toxic potency of the tested ILs seemed to be equal or even higher (in some cases) than those of conventional organic solvents, the present study revealed that the characterization of imidazolium-based ILs as "green solvents" should not be generalized, at least in case of their natural occurrence in mixtures with organic solvents, such as acetone. Copyright © 2015 Elsevier Inc. All rights reserved.

Outbreak of Serratia marcescens Bloodstream Infections in Patients Receiving Parenteral Nutrition Prepared by a Compounding Pharmacy

PubMed Central

Gupta, Neil; Hocevar, Susan N.; Moulton-Meissner, Heather A.; Stevens, Kelly M.; McIntyre, Mary G.; Jensen, Bette; Kuhar, David T.; Noble-Wang, Judith A.; Schnatz, Rick G.; Becker, Shawn C.; Kastango, Eric S.; Shehab, Nadine; Kallen, Alexander J.

2014-01-01

Background. Compounding pharmacies often prepare parenteral nutrition (PN) and must adhere to rigorous standards to avoid contamination of the sterile preparation. In March 2011, Serratia marcescens bloodstream infections (BSIs) were identified in 5 patients receiving PN from a single compounding pharmacy. An investigation was conducted to identify potential sources of contamination and prevent further infections. Methods. Cases were defined as S. marcescens BSIs in patients receiving PN from the pharmacy between January and March 2011. We reviewed case patients’ clinical records, evaluated pharmacy compounding practices, and obtained epidemiologically directed environmental cultures. Molecular relatedness of available Serratia isolates was determined by pulsed-field gel electrophoresis (PFGE). Results. Nineteen case patients were identified; 9 died. The attack rate for patients receiving PN in March was 35%. No case patients were younger than 18 years. In October 2010, the pharmacy began compounding and filter-sterilizing amino acid solution for adult PN using nonsterile amino acids due to a national manufacturer shortage. Review of this process identified breaches in mixing, filtration, and sterility testing practices. S. marcescens was identified from a pharmacy water faucet, mixing container, and opened amino acid powder. These isolates were indistinguishable from the outbreak strain by PFGE. Conclusions. Compounding of nonsterile amino acid components of PN was initiated due to a manufacturer shortage. Failure to follow recommended compounding standards contributed to an outbreak of S. marcescens BSIs. Improved adherence to sterile compounding standards, critical examination of standards for sterile compounding from nonsterile ingredients, and more rigorous oversight of compounding pharmacies is needed to prevent future outbreaks. PMID:24729502

Efficiency of Nested-PCR in Detecting Asymptomatic Cases toward Malaria Elimination Program in an Endemic Area of Iran.

PubMed

Turki, Habibollah; Raeisi, Ahmad; Malekzadeh, Kianoosh; Ghanbarnejad, Amin; Zoghi, Samaneh; Yeryan, Masoud; Abedi Nejad, Masoumeh; Mohseni, Fatemeh; Shekari, Mohammad

2015-01-01

The aim of this study was to detect low parasite and asymptomatic malaria infections by means of three malaria diagnostic tests, in a low transmission region of Minab district, Hormozgan Province, southern Iran. Blood samples of 200 healthy volunteers from Bagh-e-Malek area were evaluated using microscopic, rapid diagnostic tests (RDT) and nested-PCR to inspect malaria parasite. The results showed no Plasmodium parasite in subjects by means of microscopy and RDT. However, 3 P. vivax positive samples (1.5%) were discovered by Nested-PCR while microscopy and RDT missed the cases. Microscopy as the gold standard method and RDT correctly identified 98.5% of cases, and molecular analysis is sensitive and reliable, especially in the detection of "asymptomatic" infections for active case surveillance. Regarding the existence of asymptomatic malaria in endemic area of Hormozgan, Iran, nested-PCR could be considered as a sensitive tool to interrupt malaria transmission in the country, beside the microscopic and RDT methods.

[The planning of resource support of secondary medical care in hospital].

PubMed

Kungurov, N V; Zil'berberg, N V

2010-01-01

The Ural Institute of dermatovenerology and immunopathology developed and implemented the software concerning the personalized total recording of medical services and pharmaceuticals. The Institute also presents such software as listing of medical services, software module of calculation of financial costs of implementing full standards of secondary medical care in case of chronic dermatopathy, reference book of standards of direct specific costs on laboratory and physiotherapy services, reference book of pharmaceuticals, testing systems and consumables. The unified information system of management recording is a good technique to substantiate the costs of the implementation of standards of medical care, including high-tech care with taking into account the results of total calculation of provided medical services.

Grimstone v Epsom and St Helier University Hospitals NHS Trust: (It's Not) Hip To Be Square.

PubMed

Austin, Louise V

2017-11-24

In Montgomery v Lanarkshire Health Board [2015] UKSC 11 the Supreme Court redefined the standard of disclosure in informed consent to medical treatment, rejecting the application of the doctor-focused Bolam standard in favour of one focused on what was significant to patients. In Grimstone v Epsom and St Helier University Hospitals NHS Trust [2015] EWHC 3756 (QB), despite acknowledging a new standard now applied, McGowan J nevertheless used the Bolam test to determine liability for non-disclosure. This illustrates ongoing judicial deference to the medical profession and this case commentary explores that decision and its implications. © The Author 2017. Published by Oxford University Press.

Enhanced cephalomedullary nail lag screw placement and intraoperative tip-apex distance measurement with a novel computer assisted surgery system.

PubMed

Kuhl, Mitchell; Beimel, Claudia

2016-10-01

The goal of this study was to evaluate the ability of a novel computer assisted surgery system to guide ideal placement of a lag screw during cephalomedullary nailing and then accurately measure the tip-apex distance (TAD) measurement intraoperatively. Retrospective case review. Level II trauma hospital. The initial 98 consecutive clinical cases treated with a cephalomedullary nail in conjunction with a novel computer assisted surgery system were retrospectively reviewed. A novel computer assisted surgery system was utilized to enhance lag screw placement during cephalomedullary nailing procedures. The computer assisted surgery system calculates the TAD intraoperatively after final lag screw placement. The ideal TAD was considered to be within a range of 5mm-20mm. The ability of the computer assisted surgery system (CASS) to assist in placement of a lag screw within the ideal TAD was evaluated. Intraoperative TAD measurements provided by the computer assisted surgery system were then compared to standard postoperative TAD measurements on PACS (picture archiving and communication system) images to determine whether these measurements are equivalent. 79 cases (80.6%) were available with complete information for a retrospective review. All cases had CASS TAD and PACS TAD measurements >5mm and<20mm. In addition, no significant difference could be detected between the intraoperative CASS TAD and the postoperative PACS TAD (p=0.374, Wilcoxon Test; p=0.174, paired T-Test). A cut-out rate of 0% was observed in all patients who were treated with CASS in this case series (95% CI: 0 - 3.01%). The novel computer assisted surgery system tested here is an effective and reliable adjunct that can be utilized for optimal lag screw placement in cephalomedullary nailing procedures. The computer assisted surgery system provides an accurate intraoperative TAD measurement that is equivalent to the standard postoperative measurement utilizing PACS images. Therapeutic Level IV. Copyright © 2016 Elsevier Ltd. All rights reserved.

Determining the optimal approach to identifying individuals with chronic obstructive pulmonary disease: The DOC study.

PubMed

Ronaldson, Sarah J; Dyson, Lisa; Clark, Laura; Hewitt, Catherine E; Torgerson, David J; Cooper, Brendan G; Kearney, Matt; Laughey, William; Raghunath, Raghu; Steele, Lisa; Rhodes, Rebecca; Adamson, Joy

2018-06-01

Early identification of chronic obstructive pulmonary disease (COPD) results in patients receiving appropriate management for their condition at an earlier stage in their disease. The determining the optimal approach to identifying individuals with chronic obstructive pulmonary disease (DOC) study was a case-finding study to enhance early identification of COPD in primary care, which evaluated the diagnostic accuracy of a series of simple lung function tests and symptom-based case-finding questionnaires. Current smokers aged 35 or more were invited to undertake a series of case-finding tools, which comprised lung function tests (specifically, spirometry, microspirometry, peak flow meter, and WheezoMeter) and several case-finding questionnaires. The effectiveness of these tests, individually or in combination, to identify small airways obstruction was evaluated against the gold standard of spirometry, with the quality of spirometry tests assessed by independent overreaders. The study was conducted with general practices in the Yorkshire and Humberside area, in the UK. Six hundred eighty-one individuals met the inclusion criteria, with 444 participants completing their study appointments. A total of 216 (49%) with good-quality spirometry readings were included in the analysis. The most effective case-finding tools were found to be the peak flow meter alone, the peak flow meter plus WheezoMeter, and microspirometry alone. In addition to the main analysis, where the severity of airflow obstruction was based on fixed ratios and percent of predicted values, sensitivity analyses were conducted by using lower limit of normal values. This research informs the choice of test for COPD identification; case-finding by use of the peak flow meter or microspirometer could be used routinely in primary care for suspected COPD patients. Only those testing positive to these tests would move on to full spirometry, thereby reducing unnecessary spirometric testing. © 2018 John Wiley & Sons, Ltd.

Dengue fever in patients admitted in tertiary care hospitals in Pakistan.

PubMed

Munir, Muhammad Arif; Alam, Syed Ejaz; Khan, Zareef Uddin; Saeed, Quaid; Arif, Ambreen; Iqbal, Rizwan; Saqib, Muhammad Arif Nadeem; Qureshi, Huma

2014-05-01

To assess the gaps in the diagnosis and management of dengue fever cases. The retrospective descriptive analytical study was done with a case record analysis of patients with dengue fever admitted from January to December 2010 at five tertiary care hospitals in different Pakistani cities. Using a questionnaire, information was gathered on demography, haematological profile, management, use of blood and platelet transfusions and the outcome. For comparison, data of serologically-confirmed dengue patients from a private laboratory in Islamabad was collected to see the age, gender and month-wise distribution of cases tested over the same period. SPSS 16 was used for statistical analysis. Out of the 841 confirmed dengue cases, 514 (79%) were males and 139 (21%) females. The overall mean age was 31.3 +/- 14.0 years. Dengue fever was seen in 653 (78%) and dengue haemorrhagic fever (DHF) in 188 (22%) patients. Most cases were between 20 and 49 years of age. A gradual increase in dengue fever and dengue haemorrhagic fever was seen from August, with a peak in October/November. Tourniquet test was done only in 20 (2.3%) cases, out of which 11 (55%) were positive and 9 (45%) were negative. Serial haematocrit was not done in any case. Total deaths were 5 (0.6%). Most cases were seen in October/November with the majority being in the 20-39 age group. Tourniquet test and serial haematocrit were infrequently used. No standard national guidelines were employed.

Repeat testing of low-level HIV-1 RNA: assay performance and implementation in clinical trials.

PubMed

White, Kirsten; Garner, Will; Wei, Lilian; Eron, Joseph J; Zhong, Lijie; Miller, Michael D; Martin, Hal; Plummer, Andrew; Tran-Muchowski, Cecilia; Lindstrom, Kim; Porter, James; Piontkowsky, David; Light, Angela; Reiske, Heinz; Quirk, Erin

2018-05-15

Assess the performance of HIV-1 RNA repeat testing of stored samples in cases of low-level viremia during clinical trials. Prospective and retrospective analysis of randomized clinical trial samples and reference standards. To evaluate assay variability of the Cobas AmpliPrep/Cobas TaqMan HIV-1 Test, v2.0, three separate sources of samples were utilized: the World Health Organization (WHO) HIV reference standard (assayed using 50 independent measurements at six viral loads <200 copies/ml), retrospective analysis of four to six aliquots of plasma samples from four clinical trial participants, and prospective repeat testing of 120 samples from participants in randomized trials with low-level viremia. The TaqMan assay on the WHO HIV-1 RNA standards at viral loads <200 copies/ml performed within the expected variability according to assay specifications. However, standards with low viral loads of 36 and 18 copies/ml reported values of ≥ 50 copies/ml in 66 and 18% of tests, respectively. In participants treated with antiretrovirals who had unexpected viremia of 50-200 copies/ml after achieving <50 copies/ml, retesting of multiple aliquots of stored plasma found <50 copies/ml in nearly all cases upon retesting (14/15; 93%). Repeat testing was prospectively implemented in four clinical trials for all samples with virologic rebound of 50-200 copies/ml (n = 120 samples from 92 participants) from which 42% (50/120) had a retest result of less than 50 copies/ml and 58% (70/120) retested ≥ 50 copies/ml. The TaqMan HIV-1 RNA assay shows variability around 50 copies/ml that affects clinical trial results and may impact clinical practice. In participants with a history of viral load suppression, unexpected low-level viremia may be because of assay variability rather than low drug adherence or true virologic failure. Retesting a stored aliquot of the same sample may differentiate between assay variability and virologic failure as the source of viremia. This retesting strategy could save time, money, and anxiety for patients and their providers, as well as decrease follow-up clinic visits without increasing the risk of virologic failure and resistance development.

Case definition for clinical and subclinical bacterial kidney disease (BKD) in Atlantic Salmon (Salmo salar L.) in New Brunswick, Canada.

PubMed

Boerlage, A S; Stryhn, H; Sanchez, J; Hammell, K L

2017-03-01

Bacterial kidney disease (BKD) is considered an important cause of loss in salmon aquaculture in Atlantic Canada. Causative agent of BKD is the Gram-positive bacteria Renibacterium salmoninarum. Infected salmon are often asymptomatic (subclinical infection), and the disease is considered chronic. One of the challenges in quantifying information from farm production and health records is the application of a standardized case definition. Case definitions for farm-level and cage-level clinical and subclinical BKD were developed using retrospective longitudinal data from aquaculture practices in New Brunswick, Canada, combining (i) industry records of weekly production data including mortalities, (ii) field observations for BKD using reports of veterinarians and/or fish health technicians, (iii) diagnostic submissions and test results and (iv) treatments used to control BKD. Case definitions were evaluated using veterinarians' expert judgements as reference standard. Eighty-nine and 66% of sites and fish groups, respectively, were associated with BKD at least once. For BKD present (subclinical or clinical), sensitivity and specificity of the case definition were 75-100% varying between event, fish group, site cycle and level (site pen). For clinical BKD, sensitivities were 29-64% and specificities 91-100%. Industry data can be used to develop sensitive case definitions. © 2016 John Wiley & Sons Ltd.

Tellurium notebooks-An environment for reproducible dynamical modeling in systems biology.

PubMed

Medley, J Kyle; Choi, Kiri; König, Matthias; Smith, Lucian; Gu, Stanley; Hellerstein, Joseph; Sealfon, Stuart C; Sauro, Herbert M

2018-06-01

The considerable difficulty encountered in reproducing the results of published dynamical models limits validation, exploration and reuse of this increasingly large biomedical research resource. To address this problem, we have developed Tellurium Notebook, a software system for model authoring, simulation, and teaching that facilitates building reproducible dynamical models and reusing models by 1) providing a notebook environment which allows models, Python code, and narrative to be intermixed, 2) supporting the COMBINE archive format during model development for capturing model information in an exchangeable format and 3) enabling users to easily simulate and edit public COMBINE-compliant models from public repositories to facilitate studying model dynamics, variants and test cases. Tellurium Notebook, a Python-based Jupyter-like environment, is designed to seamlessly inter-operate with these community standards by automating conversion between COMBINE standards formulations and corresponding in-line, human-readable representations. Thus, Tellurium brings to systems biology the strategy used by other literate notebook systems such as Mathematica. These capabilities allow users to edit every aspect of the standards-compliant models and simulations, run the simulations in-line, and re-export to standard formats. We provide several use cases illustrating the advantages of our approach and how it allows development and reuse of models without requiring technical knowledge of standards. Adoption of Tellurium should accelerate model development, reproducibility and reuse.

New Whole-House Solutions Case Study: Evaluating Through-Wall Air Transfer Fans, Pittsburgh, Pennsylvania

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

None

2014-10-01

In this project, Building America team IBACOS performed field testing in a new construction unoccupied test house in Pittsburgh, Pennsylvania, to evaluate heating, ventilating, and air conditioning (HVAC) distribution systems during heating, cooling, and midseason conditions. The team evaluated a market-available through-wall air transfer fan system that provides air to the bedrooms.The relative ability of this system was considered with respect to relevant Air Conditioning Contractors of America and ASHRAE standards for house temperature uniformity and stability.

Surgical implications and variability in the use of the flat epithelial atypia diagnosis on breast biopsy specimens.

PubMed

Samples, Laura S; Rendi, Mara H; Frederick, Paul D; Allison, Kimberly H; Nelson, Heidi D; Morgan, Thomas R; Weaver, Donald L; Elmore, Joann G

2017-08-01

Flat epithelial atypia (FEA) is a relatively new diagnostic term with uncertain clinical significance for surgical management. Any implied risk of invasive breast cancer associated with FEA is contingent upon diagnostic reproducibility, yet little is known regarding its use. Pathologists in the Breast Pathology Study interpreted one of four 60-case test sets, one slide per case, constructed from 240 breast biopsy specimens. An electronic data form with standardized diagnostic categories was used; participants were instructed to indicate all diagnoses present. We assessed participants' use of FEA as a diagnostic term within: 1) each test set; 2) 72 cases classified by reference as benign without FEA; and 3) six cases classified by reference as FEA. 115 pathologists participated, providing 6900 total independent assessments. Notation of FEA ranged from 0% to 35% of the cases interpreted, with most pathologists noting FEA on 4 or more test cases. At least one participant noted FEA in 34 of the 72 benign non-FEA cases. For the 6 reference FEA cases, participant agreement with the case reference FEA diagnosis ranged from 17% to 52%; diagnoses noted by participating pathologists for these FEA cases included columnar cell hyperplasia, usual ductal hyperplasia, atypical lobular hyperplasia, and atypical ductal hyperplasia. We observed wide variation in the diagnosis of FEA among U.S. pathologists. This suggests that perceptions of diagnostic criteria and any implied risk associated with FEA may also vary. Surgical excision following a core biopsy diagnosis of FEA should be reconsidered and studied further. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Hand eczema in children. Clinical and epidemiological study of the population referred to a tertiary hospital].

PubMed

Ortiz-Salvador, José María; Subiabre-Ferrer, Daniela; García Rabasco, Ana; Esteve-Martínez, Altea; Zaragoza-Ninet, Violeta; Alegre de Miquel, Víctor

2017-08-21

Hand eczema is a frequent disease in adults. Diagnosing the cause of hand eczema is difficult due to different classifications. There is lack of evidence on hand eczema and its causes in children. A total of 389 children between 0 and 16 years were identified between 1996 and 2016, from whom 42 (10.8%) with exclusively hand eczema were selected. In all cases a standard battery of epicutaneous patch tests was performed, as well as additional batteries depending on the clinical suspicion. The clinical and epidemiological features of these children were recorded and compared against children with eczema in other locations. The 42 children with hand eczema included 25 (60.5%) girls, and 17 (40.5%) boys, with a mean age of 10.6 +- 3.9 years, and did not differ from that of children with eczema in other locations. The definitive diagnosis after patch-testing was Atopic Dermatitis in 15 cases, Allergic Contact Dermatitis in 14 patients, Endogenous Vesiculous Eczema in 6 cases, Endogenous Hyperkeratotic Eczema in 5 cases, and Irritant Contact Dermatitis in 2 cases. The most frequent allergens detected were thiomersal (9 cases), nickel (5 cases), mercury (5 cases), and cobalt (4 cases). Hand eczema is a common condition in children. The most common cause is atopic dermatitis, although cases of allergic contact dermatitis manifesting as hand eczema are not uncommon. Any child with eczema of hands in whom an allergic cause is suspected should be referred for patch- testing. Copyright © 2017. Publicado por Elsevier España, S.L.U.

Contact and photocontact allergy to oxybenzone.

PubMed

Lenique, P; Machet, L; Vaillant, L; Bensaïd, P; Muller, C; Khallouf, R; Lorette, G

1992-03-01

The purpose of this study was to determine the frequency of contact allergy and photocontact allergy to sunscreens. A consecutive series of 54 patients with suspected clinical photosensitivity were assessed. All had the same standardized photobiological investigation from January 1989 to December 1990, including patch tests and photopatch tests with 6 sunscreen agents. Oxybenzone was found to cause 4 cases of allergic contact dermatitis (with photoaggravation in 2), and 3 cases of photocontact dermatitis (13% of patients). This is probably due to the wide distribution of oxybenzone in sunscreens and other cosmetics, 2 patients with polymorphic light eruption and persistent light reactivity, respectively, were regular sunscreen users. Photobiological investigation is necessary to ensure accurate diagnosis, since sunscreen contact or photocontact allergy may simulate other photosensitivity eruptions.

Development of novel optical fiber sensors for measuring tilts and displacements of geotechnical structures

NASA Astrophysics Data System (ADS)

Pei, Hua-Fu; Yin, Jian-Hua; Jin, Wei

2013-09-01

Two kinds of innovative sensors based on optical fiber sensing technologies have been proposed and developed for measuring tilts and displacements in geotechnical structures. The newly developed tilt sensors are based on classical beam theory and were successfully used to measure the inclinations in a physical model test. The conventional inclinometers including in-place and portable types, as a key instrument, are very commonly used in geotechnical engineering. In this paper, fiber Bragg grating sensing technology is used to measure strains along a standard inclinometer casing and these strains are used to calculate the lateral and/or horizontal deflections of the casing using the beam theory and a finite difference method. Finally, the monitoring results are verified by laboratory tests.

How are genetic test results being used by Australian life insurers?

PubMed

Barlow-Stewart, K; Liepins, M; Doble, A; Otlowski, M

2018-06-11

In Australia, the USA and many Asian countries the life insurance industry is self-regulated. Individuals must disclose genetic test results known to them in applications for new or updated policies including cover for critical care, income protection and death. There is limited information regarding how underwriting decisions are made for policies with such disclosures. The Australian Financial Services Council (FSC) provided de-identified data collected on applications with genetic test result disclosure from its life insurance member companies 2010-2013 to enable repetition of an independent examination undertaken of applications 1999-2003: age; gender; genetic condition; testing result; decision-maker; and insurance cover. Data was classified as to test result alone or additional other factors relevant to risk and decision. Where necessary, the FSC facilitated clarification by insurers. 345/548 applications related to adult-onset conditions. The genetic test result solely influenced the decision in 165/345 applications: positive (n = 23), negative (n = 139) and pending (n = 3). Detailed analyses of the decisions in each of these result categories are presented with specific details of 11 test cases. Policies with standard decisions were provided for all negative test results with evidence of reassessment of previous non-standard decisions and 20/23 positive results with recognition of risk reduction strategies. Disclosure of positive results for breast/ovarian cancer, Lynch syndrome and hereditary spastic paraplegia, and three pending results, generated non-standard decisions. The examination demonstrates some progress in addressing concerns in regard to utilisation of genetic test information but the self-regulatory system in Australia only goes some way in meeting internationally recommended best practice.

SU-E-T-608: Performance Comparison of Four Commercial Treatment Planning Systems Applied to Intensity-Modulated Radiotherapy

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

Cao, Y; Li, R; Chi, Z

Purpose: To compare the performances of four commercial treatment planning systems (TPS) used for the intensity-modulated radiotherapy (IMRT). Methods: Ten patients of nasopharyngeal (4 cases), esophageal (3 cases) and cervical (3 cases) cancer were randomly selected from a 3-month IMRT plan pool at one radiotherapy center. For each patient, four IMRT plans were newly generated by using four commercial TPS (Corvus, Monaco, Pinnacle and Xio), and then verified with Matrixx (two-dimensional array/IBA Company) on Varian23EX accelerator. A pass rate (PR) calculated from the Gamma index by OminiPro IMRT 1.5 software was evaluated at four plan verification standards (1%/1mm, 2%/2mm, 3%/3mm,more » 4%/4mm and 5%/5mm) for each treatment plan. Overall and multiple pairwise comparisons of PRs were statistically conducted by analysis of covariance (ANOVA) F and LSD tests among four TPSs. Results: Overall significant (p>0.05) differences of PRs were found among four TPSs with F test values of 3.8 (p=0.02), 21.1(>0.01), 14.0 (>0.01), 8.3(>0.01) at standards of 1%/1mm to 4%/4mm respectively, except at 5%/5mm standard with 2.6 (p=0.06). All means (standard deviation) of PRs at 3%/3mm of 94.3 ± 3.3 (Corvus), 98.8 ± 0.8 (Monaco), 97.5± 1.7 (Pinnacle), 98.4 ± 1.0 (Xio) were above 90% and met clinical requirement. Multiple pairwise comparisons had not demonstrated a consistent low or high pattern on either TPS. Conclusion: Matrixx dose verification results show that the validation pass rates of Monaco and Xio plans are relatively higher than those of the other two; Pinnacle plan shows slight higher pass rate than Corvus plan; lowest pass rate was achieved by the Corvus plan among these four kinds of TPS.« less

Agile deployment and code coverage testing metrics of the boot software on-board Solar Orbiter's Energetic Particle Detector

NASA Astrophysics Data System (ADS)

Parra, Pablo; da Silva, Antonio; Polo, Óscar R.; Sánchez, Sebastián

2018-02-01

In this day and age, successful embedded critical software needs agile and continuous development and testing procedures. This paper presents the overall testing and code coverage metrics obtained during the unit testing procedure carried out to verify the correctness of the boot software that will run in the Instrument Control Unit (ICU) of the Energetic Particle Detector (EPD) on-board Solar Orbiter. The ICU boot software is a critical part of the project so its verification should be addressed at an early development stage, so any test case missed in this process may affect the quality of the overall on-board software. According to the European Cooperation for Space Standardization ESA standards, testing this kind of critical software must cover 100% of the source code statement and decision paths. This leads to the complete testing of fault tolerance and recovery mechanisms that have to resolve every possible memory corruption or communication error brought about by the space environment. The introduced procedure enables fault injection from the beginning of the development process and enables to fulfill the exigent code coverage demands on the boot software.

Exercise testing in children with Wolff-Parkinson-White syndrome: what is its value?

PubMed

Dalili, M; Vahidshahi, K; Aarabi-Moghaddam, M Y; Rao, J Y; Brugada, P

2014-10-01

This study was conducted to evaluate the accuracy of exercise testing for predicting accessory pathway characteristics in children with Wolff-Parkinson-White (WPW) syndrome. The study enrolled 37 children with WPW syndrome and candidates for invasive electrophysiologic study (EPS). Exercise testing was performed for all the study participants before the invasive study. Data from the invasive EPS were compared with findings from the exercise testing. The sudden disappearance of the delta (Δ) wave was seen in 10 cases (27 %). No significant correlation was found between the Δ wave disappearance and the antegrade effective refractory period of the accessory pathway (AERP-AP) or the shortest pre-excited RR interval (SPERRI). The sensitivity, specificity, and positive and negative predictive values of Δ wave disappearance, based on AERP-AP as gold standard, were respectively 29.4, 80, 71.4, and 40 %. The corresponding values with SPERRI as the gold standard were respectively 23.8, 71.4, 71.4 and 23.8 %. Exercise testing has a medium to low rate of accuracy in detecting low-risk WPW syndrome patients in the pediatric age group.

Comparative tests of bench equipment for fuel control system testing of gas-turbine engine

NASA Astrophysics Data System (ADS)

Shendaleva, E. V.

2018-04-01

The relevance of interlaboratory comparative researches is confirmed by attention of world metrological community to this field of activity. Use of the interlaboratory comparative research methodology not only for single gages collation, but also for bench equipment complexes, such as modeling stands for fuel control system testing of gas-turbine engine, is offered. In this case a comparative measure of different bench equipment will be the control fuel pump. Ensuring traceability of measuring result received at test benches of various air enterprises, development and introduction of national standards to practice of bench tests and, eventually, improvement of quality and safety of a aircraft equipment is result of this approach.

A probability model for evaluating the bias and precision of influenza vaccine effectiveness estimates from case-control studies.

PubMed

Haber, M; An, Q; Foppa, I M; Shay, D K; Ferdinands, J M; Orenstein, W A

2015-05-01

As influenza vaccination is now widely recommended, randomized clinical trials are no longer ethical in many populations. Therefore, observational studies on patients seeking medical care for acute respiratory illnesses (ARIs) are a popular option for estimating influenza vaccine effectiveness (VE). We developed a probability model for evaluating and comparing bias and precision of estimates of VE against symptomatic influenza from two commonly used case-control study designs: the test-negative design and the traditional case-control design. We show that when vaccination does not affect the probability of developing non-influenza ARI then VE estimates from test-negative design studies are unbiased even if vaccinees and non-vaccinees have different probabilities of seeking medical care against ARI, as long as the ratio of these probabilities is the same for illnesses resulting from influenza and non-influenza infections. Our numerical results suggest that in general, estimates from the test-negative design have smaller bias compared to estimates from the traditional case-control design as long as the probability of non-influenza ARI is similar among vaccinated and unvaccinated individuals. We did not find consistent differences between the standard errors of the estimates from the two study designs.

International Experience in Standards and Labeling Programs for Rice Cookers

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

Zhou, Nan; Zheng, Nina

China has had an active program on energy efficiency standards for household appliances since the mid-1990s. Rice cooker is among the first to be subject to such mandatory regulation, since it is one of the most prevalent electric appliances in Chinese households. Since first introduced in 1989, the minimum energy efficiency standard for rice cookers has not been revised. Therefore, the potential for energy saving is considerable. Initial analysis from CNIS indicates that potential carbon savings is likely to reach 7.6 million tons of CO2 by the 10th year of the standard implementation. Since September 2007, CNIS has been workingmore » with various groups to develop the new standard for rice cookers. With The Energy Foundation's support, LBNL has assisted CNIS in the revision of the minimum energy efficiency standard for rice cookers that is expected to be effective in 2009. Specifically, work has been in the following areas: assistance in developing consumer survey on usage pattern of rice cookers, review of international standards, review of international test procedures, comparison of the international standards and test procedures, and assessment of technical options of reducing energy use. This report particularly summarizes the findings of reviewing international standards and technical options of reducing energy consumption. The report consists of an overview of rice cooker standards and labeling programs and testing procedures in Hong Kong, South Korea, Japan and Thailand, and Japan's case study in developing energy efficiency rice cooker technologies and rice cooker efficiency programs. The results from the analysis can be summarized as the follows: Hong Kong has a Voluntary Energy Efficiency Labeling scheme for electric rice cookers initiated in 2001, with revision implemented in 2007; South Korea has both MEPS and Mandatory Energy Efficiency Label targeting the same category of rice cookers as Hong Kong; Thailand's voluntary endorsement labeling program is similar to Hong Kong in program design but has 5 efficiency grades; Japan's program is distinct in its adoption of the 'Top Runner' approach, in which, the future efficiency standards is set based on the efficiency levels of the most efficient product in the current domestic market. Although the standards are voluntary, penalties can still be evoked if the average efficiency target is not met. Both Hong Kong and South Korea's tests involve pouring water into the inner pot equal to 80% of its rated volume; however, white rice is used as a load for its tests in Hong Kong whereas no rice is used for tests in South Korea. In Japan's case, water level specified by the manufactures is used and milled rice is used as a load only partially in the tests. Moreover, Japan does not conduct heat efficiency test but its energy consumption measurements tests are much more complex, with 4 different tests are conducted to determine the annual average energy consumption. Hong Kong and Thailand both set Minimum Allowable Heat Efficiency for different rated wattages. The energy efficiency requirements are identical except that the minimum heat efficiency in Thailand is 1 percentage point higher for all rated power categories. In South Korea, MEPS and label's energy efficiency grades are determined by the rice cooker's Rated Energy Efficiency for induction, non-induction, pressure, nonpressure rice cookers. Japan's target standard values are set for electromagnetic induction heating products and non-electromagnetic induction heating products by different size of rice cookers. Specific formulas are used by type and size depending on the mass of water evaporation of the rice cookers. Japan has been the leading country in technology development of various types of rice cookers, and developed concrete energy efficiency standards for rice cookers. However, as consumers in Japan emphasize the deliciousness of cooked rice over other factors, many types of models were developed to improve the taste of cooked rice. Nonetheless, the efficiency of electromagnetic induction heating (IH) rice cookers in warm mode has improved approximately 12 percent from 1993 to 2004 due to the 'low temperature warming method' developed by manufacturers. The Energy Conservation Center of Japan (IEEJ) releases energy saving products database on the web regularly, on which the energy saving performance of each product is listed and ranked. Energy saving in rice cookers mostly rest with insulation of the pot. Technology developed to improve the energy efficiency of the rice cookers includes providing vacuum layers on both side of the pot, using copper-plated materials, and double stainless layer lid that can be heated and steam can run in between the two layers to speed the heating process.« less

How to Avoid a Learning Curve in Stapedotomy: A Standardized Surgical Technique.

PubMed

Kwok, Pingling; Gleich, Otto; Dalles, Katharina; Mayr, Elisabeth; Jacob, Peter; Strutz, Jürgen

2017-08-01

To evaluate, whether a learning curve for beginners in stapedotomy can be avoided by using a prosthesis with thermal memory-shape attachment in combination with a standardized laser-assisted surgical technique. Retrospective case review. Tertiary referral center. Fifty-eight ears were operated by three experienced surgeons and compared with a group of 12 cases operated by a beginner in stapedotomy. Stapedotomy. Difference of pure-tone audiometry thresholds measured before and after surgery. The average postoperative gain for air conduction in the frequencies below 2 kHz was 20 to 25 dB and decreased for the higher frequencies. Using the Mann-Whitney-U test for comparing mean gain between experienced and inexperienced surgeons showed no significant difference (p = 0.281 at 4 kHz and p > 0.7 for the other frequencies). A Spearman rank correlation of the postoperative gain for air- and bone-conduction thresholds was obtained at each test frequency for the first 12 patients consecutively treated with a thermal memory-shape attachment prosthesis by two experienced and one inexperienced surgeon. This analysis does not support the hypothesis of a "learning effect" that should be associated with an improved outcome for successively treated patients. It is possible to avoid a learning curve in stapes surgery by applying a thermal memory-shape prosthesis in a standardized laser-assisted surgical procedure.

[Serodiagnosis of toxoplasmosis: a comparative multicenter study of a standard scale through various actual tests and expression of the results in international units. Groupe de travail toxoplasmose du Contrôle national de qualité en parasotologie. Syndicat des fabricants de réactifs de laboratoire. Groupe de travail standardisation des tests sérologiques du Réseau européen de lutte contre la toxoplasmose congénitale].

PubMed

Petithory, J C; Ambroise-Thomas, P; De Loye, J; Pelloux, H; Goullier-Fleuret, A; Milgram, M; Buffard, C; Garin, J P

1996-01-01

Reported are the results of a multicentre study involving 40 laboratories that was carried out in France to assess all the currently available methods used for the serodiagnosis of toxoplasmosis. For this purpose 10 batches of control sera were prepared with titres in the range 0-260 IU per ml. These sera were tested in nine laboratories using immunofluorescence methods; in three laboratories using dye tests; in forty laboratories using enzyme-linked immunosorbent assay; in four laboratories using direct agglutination and haemagglutination; in seven laboratories using the high-sensitivity IgG agglutination test; and in three laboratories using the latex agglutination test. In this way, 70 series of titrations were carried out using seven procedures and the results were compared with those obtained using the WHO reference serum in 15 cases, with the French national E6 serum in 16 other cases, and in 39 cases using 15 reference sera supplied by the reagent manufacturers. Rigorous comparison of the tests was not possible in all cases because one aim of the study was to ensure that the tests were carried out under the usual working conditions that prevailed in the participating laboratories. The results obtained indicate that the serological tests currently available for toxoplasmosis are acceptable for its serodiagnosis. Presentation of the titres in IU has advantages; however, caution is required since the definition of IU varies according to the test and reagents used. It is therefore essential that the conditions and limits for a positive reaction be carefully defined in each case, especially for commercially available kits.

Study of bacterial meningitis in children below 5 years with comparative evaluation of gram staining, culture and bacterial antigen detection.

PubMed

Yadhav Ml, Kala

2014-04-01

Bacterial meningitis is one of the most serious infections seen in infants and children, which is associated with acute complications and chronic morbidity. Infections of Central Nervous System (CNS) still dominate the scene of childhood neurological disorders in most of the developing tropical countries. To isolate, identify and determine the antibiotic susceptibility patterns of pathogens associated with bacterial meningitis. We also aimed to comparatively evaluate of Gram staining, culture and bacterial antigen detection in cerebrospinal fluid samples. Present comparative study included 100 CSF samples of children below the age of 5 years, who were clinically suspected meningitis cases. The samples were subjected to Gram staining, culture and Latex agglutination test (LAT). The organisms isolated in the study were characterized and antibiotic susceptibility test was done according to standard guidelines. It was done by using Gaussian test. Of the 100 cases, 24 were diagnosed as Acute bacterial meningitis (ABM) cases by. Gram staining, culture and latex agglutination test. 21 (87.5%) cases were culture positive, with 2 cases being positive for polymicrobial isolates. Gram staining was positive in 17 (70.53%) cases and LAT was positive in 18 (33.33%) cases. Streptococcus pneumoniae was the predominant organism which was isolated and it was sensitive to antibiotics. In the present study, male to female ratio was 1.27:1, which showed a male preponderance. With the combination of Gram staining, culture, and LAT, 100% sensitivity and specificity can be achieved (p < 0.001). Gram staining and LAT can detect 85% of cases of ABM. Bacterial meningitis is a medical emergency and making an early diagnosis and providing treatment early are life saving and they reduce chronic morbidity.

Contrasting Medical and Legal Standards of Evidence: A Precision Medicine Case Study

PubMed Central

Marchant, Gary E.; Scheckel, Kathryn; Campos-Outcalt, Doug

2016-01-01

Precis As the health care system transitions to a precision medicine approach that tailors clinical care to the genetic profile of the individual patient, there is a potential tension between the clinical uptake of new technologies by providers and the legal system’s expectation of the standard of care in applying such technologies. We examine this tension by comparing the type of evidence that physicians and courts are likely to rely on in determining a duty to recommend pharmacogenetic testing of patients prescribed the oral anti-coagulant drug warfarin. There is a large body of inconsistent evidence and factors for and against such testing, but physicians and courts are likely to weigh this evidence differently. The potential implications for medical malpractice risk are evaluated and discussed. PMID:27256135

Criteria-based audit to improve quality of care of foetal distress: standardising obstetric care at a national referral hospital in a low resource setting, Tanzania.

PubMed

Mgaya, Andrew H; Litorp, Helena; Kidanto, Hussein L; Nyström, Lennarth; Essén, Birgitta

2016-11-08

In Tanzania, substandard intrapartum management of foetal distress contributes to a third of perinatal deaths, and the majority are term deliveries. We conducted a criteria-based audit with feedback to determine whether standards of diagnosis and management of foetal distress would be improved in a low-resource setting. During 2013-2015, a criteria-based audit was performed at the national referral hospital in Dar es Salaam. Case files of deliveries with a diagnosis of foetal distress were identified and audited. Two registered nurses under supervision of a nurse midwife, a specialist obstetrician and a consultant obstetrician, reviewed the case files. Criteria for standard diagnosis and management of foetal distress were developed based on international and national guidelines, and literature reviews, and then, stepwise applied, in an audit cycle. During the baseline audit, substandard care was identified, and recommendations for improvement of care were proposed and implemented. The effect of the implementations was assessed by the differences in percentage of standard diagnosis and management between the baseline and re-audit, using Chi-square test or Fisher's exact test, when appropriate. In the baseline audit and re-audit, 248 and 251 deliveries with a diagnosis of foetal distress were identified and audited, respectively. The standard of diagnosis increased significantly from 52 to 68 % (p < 0.001). Standards of management improved tenfold from 0.8 to 8.8 % (p < 0.001). Improved foetal heartbeat monitoring using a Fetal Doppler was the major improvement in diagnoses, while change of position of the mother and reduced time interval from decision to perform caesarean section to delivery were the major improvements in management (all p < 0.001). Percentage of cases with substandard diagnosis and management was significantly reduced in both referred public and non-referred private patients (all p ≤ 0.01) but not in non-referred public and referred private patients. The criteria-based audit was able to detect substandard diagnosis and management of foetal distress and improved care using feedback and available resources.

Laboratory Diagnosis of Infective Endocarditis

PubMed Central

Liesman, Rachael M.; Pritt, Bobbi S.; Maleszewski, Joseph J.

2017-01-01

ABSTRACT Infective endocarditis is life-threatening; identification of the underlying etiology informs optimized individual patient management. Changing epidemiology, advances in blood culture techniques, and new diagnostics guide the application of laboratory testing for diagnosis of endocarditis. Blood cultures remain the standard test for microbial diagnosis, with directed serological testing (i.e., Q fever serology, Bartonella serology) in culture-negative cases. Histopathology and molecular diagnostics (e.g., 16S rRNA gene PCR/sequencing, Tropheryma whipplei PCR) may be applied to resected valves to aid in diagnosis. Herein, we summarize recent knowledge in this area and propose a microbiologic and pathological algorithm for endocarditis diagnosis. PMID:28659319

Using information technology for an improved pharmaceutical care delivery in developing countries. Study case: Benin.

PubMed

Edoh, Thierry Oscar; Teege, Gunnar

2011-10-01

One of the problems in health care in developing countries is the bad accessibility of medicine in pharmacies for patients. Since this is mainly due to a lack of organization and information, it should be possible to improve the situation by introducing information and communication technology. However, for several reasons, standard solutions are not applicable here. In this paper, we describe a case study in Benin, a West African developing country. We identify the problem and the existing obstacles for applying standard ECommerce solutions. We develop an adapted system approach and describe a practical test which has shown that the approach has the potential of actually improving the pharmaceutical care delivery. Finally, we consider the security aspects of the system and propose an organizational solution for some specific security problems.

Effects of Course Experiences on Self-Efficacy in Teaching Math: A Case Study of Preservice Elementary Teachers

ERIC Educational Resources Information Center

Ogden, Michele A.

2012-01-01

Elementary students' math achievement in the United States is mediocre in comparison to that of students in other countries. Students in California perform below the national average on standardized tests. Reform efforts in mathematics education aim at proficiency in fact fluency, procedural knowledge, conceptual knowledge, and application of…

The Case against Exit Exams. Policy Brief

ERIC Educational Resources Information Center

Hyslop, Anne

2014-01-01

In the 2013-14 school year, twenty-four states required students to be proficient on standardized tests in order to graduate from high school. But starting next year, and in the years to come, states will launch more rigorous, college- and career-ready assessments aligned to the Common Core. As they do so, they should revisit the stakes on these…

Online High School Student Achievement on State-Issued Standardized Tests: A Case Study

ERIC Educational Resources Information Center

Gifford, William M., III

2017-01-01

Online education has increased greatly in recent years among K-12 learners and post-secondary learners. Online learning provides opportunities such as course remediation or access to courses not typically offered, which have benefited many learners. The growth of online learning has also presented educators with challenges as well. Students in…

Use of the recreation opportunity spectrum in natural protected area planning and management

Treesearch

Gustavo Perez-Verdin; Martha E. Lee; Deborah J. Chavez

2008-01-01

The use of the Recreation Opportunity Spectrum (ROS) framework, widely used in planning and managing wildland recreation in the United States, was tested for managing recreation opportunities in southern Durango, Mexico. Two natural protected areas were used as case studies to evaluate the ROS criteria and standards for land classification of outdoor recreation...

20 CFR Appendix C to Part 614 - Standard for Fraud and Overpayment Detection

Code of Federal Regulations, 2014 CFR

2014-04-01

... to claimants' entitlement to benefits paid to them in a sufficient proportion of cases to test the... connection with the detection of overpayments, such a unit or individual might, for example: (a) Investigate... post-audit or by industry surveys. The so-called “post-audit” is a matching of central office wage...

20 CFR Appendix C to Part 614 - Standard for Fraud and Overpayment Detection

Code of Federal Regulations, 2013 CFR

2013-04-01

... to claimants' entitlement to benefits paid to them in a sufficient proportion of cases to test the... connection with the detection of overpayments, such a unit or individual might, for example: (a) Investigate... post-audit or by industry surveys. The so-called “post-audit” is a matching of central office wage...

20 CFR Appendix C to Part 617 - Standard for Fraud and Overpayment Detection

Code of Federal Regulations, 2012 CFR

2012-04-01

... cases to test the effectiveness of the agency's procedures for the prevention of payments which are not... might, for example: (a) Investigate information on suspected benefit fraud received from any agency... records are comonly made either by post-audit or by industry surveys. The so-called “post-audit” is a...

20 CFR Appendix C to Part 614 - Standard for Fraud and Overpayment Detection

Code of Federal Regulations, 2012 CFR

2012-04-01

... to claimants' entitlement to benefits paid to them in a sufficient proportion of cases to test the... connection with the detection of overpayments, such a unit or individual might, for example: (a) Investigate... post-audit or by industry surveys. The so-called “post-audit” is a matching of central office wage...

20 CFR Appendix C to Part 617 - Standard for Fraud and Overpayment Detection

Code of Federal Regulations, 2014 CFR

2014-04-01

... cases to test the effectiveness of the agency's procedures for the prevention of payments which are not... might, for example: (a) Investigate information on suspected benefit fraud received from any agency... records are comonly made either by post-audit or by industry surveys. The so-called “post-audit” is a...

20 CFR Appendix C to Part 614 - Standard for Fraud and Overpayment Detection

Code of Federal Regulations, 2011 CFR

2011-04-01

... to claimants' entitlement to benefits paid to them in a sufficient proportion of cases to test the... connection with the detection of overpayments, such a unit or individual might, for example: (a) Investigate... post-audit or by industry surveys. The so-called “post-audit” is a matching of central office wage...