Sample records for test reference year

  1. An analysis of reference laboratory (send out) testing: an 8-year experience in a large academic medical center.

    PubMed

    MacMillan, Donna; Lewandrowski, Elizabeth; Lewandrowski, Kent

    2004-01-01

    Utilization of outside reference laboratories for selected laboratory testing is common in the United States. However, relatively little data exist in the literature describing the scope and impact of these services. In this study, we reviewed use of reference laboratory testing at the Massachusetts General Hospital, a large urban academic medical center in Boston, Massachusetts. A retrospective review of hospital and laboratory administrative records over an 8-year period from fiscal years (FY) 1995-2002. Over the 8 years studied, reference laboratory expenses increased 4.2-fold and totaled 12.4% of the total laboratory budget in FY 2002. Total reference laboratory test volume increased 4-fold to 68,328 tests in FY 2002 but represented only 1.06% of the total test volume in the hospital. The menu of reference laboratory tests comprised 946 tests (65.7% of the hospital test menu) compared to 494 (34.3%) of tests performed in house. The average unit cost of reference laboratory tests was essentially unchanged but was approximately 13 times greater than the average unit cost in the hospital laboratory. Much of the growth in reference laboratory cost can be attributed to the addition of new molecular, genetic, and microbiological assays. Four of the top 10 tests with the highest total cost in 2002 were molecular diagnostic tests that were recently added to the test menu. Reference laboratory testing comprises a major component of hospital clinical laboratory services. Although send out tests represent a small percentage of the total test volume, these services account for the majority of the hospital laboratory test menu and a disproportionate percentage of laboratory costs.

  2. Health-related physical fitness measures: reference values and reference equations for use in clinical practice.

    PubMed

    Tveter, Anne Therese; Dagfinrud, Hanne; Moseng, Tuva; Holm, Inger

    2014-07-01

    To provide reference values and reference equations for frequently used clinical field tests of health-related physical fitness for use in clinical practice. Cross-sectional design. General community. Convenience sample of volunteers (N=370) between 18 and 90 years of age were recruited from a wide range of settings (ie, work sites, schools, community centers for older adults) and different geographic locations (ie, urban, suburban, rural) in southeastern Norway. Not applicable. The participants conducted 5 clinical field tests (6-minute walk test, stair test, 30-second sit-to-stand test, handgrip test, fingertip-to-floor test). The results of the field tests showed that performance remained unchanged until approximately 50 years of age; after that, performance deteriorated with increasing age. Grip strength (79%), meters walked in 6 minutes (60%), and seconds used on the stair test (59%) could be well predicted by age, sex, height, and weight in participants ≥50 years of age, whereas the performance on all tests was less well predicted in participants <50 years of age. The reference values and reference equations provided in this study may increase the applicability and interpretability of the 6-minute walk test, stair test, 30-second sit-to-stand test, handgrip test, and fingertip-to-floor test in clinical practice. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  3. Reference values for the muscle power sprint test in 6- to 12-year-old children.

    PubMed

    Douma-van Riet, Danielle; Verschuren, Olaf; Jelsma, Dorothee; Kruitwagen, Cas; Smits-Engelsman, Bouwien; Takken, Tim

    2012-01-01

    The aims of this study were (1) to develop centile reference values for anaerobic performance of Dutch children tested using the Muscle Power Sprint Test (MPST) and (2) to examine the test-retest reliability of the MPST. Children who were developing typically (178 boys and 201 girls) and aged 6 to 12 years (mean = 8.9 years) were recruited. The MPST was administered to 379 children, and test-retest reliability was examined in 47 children. MPST scores were transformed into centile curves, which were created using generalized additive models for location, scale, and shape. Height-related reference curves were created for both genders. Excellent (intraclass correlation coefficient = 0.98) test-retest reliability was demonstrated. The reference values for the MPST of children who are developing typically and aged 6 to 12 years can serve as a clinical standard in pediatric physical therapy practice. The MPST is a reliable and practical method for determining anaerobic performance in children.

  4. The value of cows in reference populations for genomic selection of new functional traits.

    PubMed

    Buch, L H; Kargo, M; Berg, P; Lassen, J; Sørensen, A C

    2012-06-01

    Today, almost all reference populations consist of progeny tested bulls. However, older progeny tested bulls do not have reliable estimated breeding values (EBV) for new traits. Thus, to be able to select for these new traits, it is necessary to build a reference population. We used a deterministic prediction model to test the hypothesis that the value of cows in reference populations depends on the availability of phenotypic records. To test the hypothesis, we investigated different strategies of building a reference population for a new functional trait over a 10-year period. The trait was either recorded on a large scale (30 000 cows per year) or on a small scale (2000 cows per year). For large-scale recording, we compared four scenarios where the reference population consisted of 30 sires; 30 sires and 170 test bulls; 30 sires and 2000 cows; or 30 sires, 2000 cows and 170 test bulls in the first year with measurements of the new functional trait. In addition to varying the make-up of the reference population, we also varied the heritability of the trait (h2 = 0.05 v. 0.15). The results showed that a reference population of test bulls, cows and sires results in the highest accuracy of the direct genomic values (DGV) for a new functional trait, regardless of its heritability. For small-scale recording, we compared two scenarios where the reference population consisted of the 2000 cows with phenotypic records or the 30 sires of these cows in the first year with measurements of the new functional trait. The results showed that a reference population of cows results in the highest accuracy of the DGV whether the heritability is 0.05 or 0.15, because variation is lost when phenotypic data on cows are summarized in EBV of their sires. The main conclusions from this study are: (i) the fewer phenotypic records, the larger effect of including cows in the reference population; (ii) for small-scale recording, the accuracy of the DGV will continue to increase for several years, whereas the increases in the accuracy of the DGV quickly decrease with large-scale recording; (iii) it is possible to achieve accuracies of the DGV that enable selection for new functional traits recorded on a large scale within 3 years from commencement of recording; and (iv) a higher heritability benefits a reference population of cows more than a reference population of bulls.

  5. 'Sportmotorische Bestandesaufnahme': criterion- vs. norm-based reference values of fitness tests for Swiss first grade children.

    PubMed

    Tomatis, Laura; Krebs, Andreas; Siegenthaler, Jessica; Murer, Kurt; de Bruin, Eling D

    2015-01-01

    Health is closely linked to physical activity and fitness. It is therefore important to monitor fitness in children. Although many reports on physical tests have been published, data comparison between studies is an issue. This study reports Swiss first grade norm values of fitness tests and compares these with criterion reference data. A total of 10,565 boys (7.18 ± 0.42 years) and 10,204 girls (7.14 ± 0.41 years) were tested for standing long jump, plate tapping, 20-m shuttle run, lateral jump and 20-m sprint. Average values for six-, seven- and eight-year-olds were analysed and reference curves for age were constructed. Z-values were generated for comparisons with criterion references reported in the literature. Results were better for all disciplines in seven-year-old first grade children compared to six-year-old children (p < 0.01). Eight-year-old children did not perform better compared to seven-year-old children in the sprint run (p = 0.11), standing long jump (p > 0.99) and shuttle run (p = 0.43), whereas they were better in all other disciplines compared to their younger peers. The average performance of boys was better than girls except for tapping at the age of 8 (p = 0.06). Differences in performance due to testing protocol and setting must be considered when test values from a first grade setting are compared to criterion-based benchmarks. In a classroom setting, younger children tended to have better results and older children tended to have worse outcomes when compared to their age group criterion reference values. Norm reference data are valid allowing comparison with other data generated by similar test protocols applied in a classroom setting.

  6. 49 CFR 572.140 - Incorporation by reference.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Child Crash Test Dummy, Alpha Version § 572.140 Incorporation by reference. (a) The following materials... entitled, “Parts List and Drawings, Subpart P Hybrid III 3-year-old child crash test dummy, (H-III3C, Alpha..., Disassembly and Inspection (PADI), Subpart P, Hybird III 3-year-old Child Crash Test Dummy, (H-III3C, Alpha...

  7. 49 CFR 572.140 - Incorporation by reference.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Child Crash Test Dummy, Alpha Version § 572.140 Incorporation by reference. (a) The following materials... entitled, “Parts List and Drawings, Subpart P Hybrid III 3-year-old child crash test dummy, (H-III3C, Alpha..., Disassembly and Inspection (PADI), Subpart P, Hybird III 3-year-old Child Crash Test Dummy, (H-III3C, Alpha...

  8. 49 CFR 572.140 - Incorporation by reference.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Child Crash Test Dummy, Alpha Version § 572.140 Incorporation by reference. (a) The following materials... entitled, “Parts List and Drawings, Subpart P Hybrid III 3-year-old child crash test dummy, (H-III3C, Alpha..., Disassembly and Inspection (PADI), Subpart P, Hybird III 3-year-old Child Crash Test Dummy, (H-III3C, Alpha...

  9. 49 CFR 572.140 - Incorporation by reference.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Child Crash Test Dummy, Alpha Version § 572.140 Incorporation by reference. (a) The following materials... entitled, “Parts List and Drawings, Subpart P Hybrid III 3-year-old child crash test dummy, (H-III3C, Alpha..., Disassembly and Inspection (PADI), Subpart P, Hybird III 3-year-old Child Crash Test Dummy, (H-III3C, Alpha...

  10. 49 CFR 572.140 - Incorporation by reference.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Child Crash Test Dummy, Alpha Version § 572.140 Incorporation by reference. (a) The following materials... entitled, “Parts List and Drawings, Subpart P Hybrid III 3-year-old child crash test dummy, (H-III3C, Alpha..., Disassembly and Inspection (PADI), Subpart P, Hybird III 3-year-old Child Crash Test Dummy, (H-III3C, Alpha...

  11. 49 CFR 572.120 - Incorporation by reference.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Child Test Dummy, Beta Version § 572.120 Incorporation by reference. (a) The following materials are... List and Drawings, Hybrid III Six-year-old Child Test Dummy (H-III6C, Beta Version) (June 2002... (vii) The Hybrid III Six-year-old Child Parts/Drawing List. (2) A procedures manual entitled...

  12. Determination of Age-Dependent Reference Ranges for Coagulation Tests Performed Using Destiny Plus.

    PubMed

    Arslan, Fatma Demet; Serdar, Muhittin; Merve Ari, Elif; Onur Oztan, Mustafa; Hikmet Kozcu, Sureyya; Tarhan, Huseyin; Cakmak, Ozgur; Zeytinli, Merve; Yasar Ellidag, Hamit

    2016-06-01

    In order to apply the right treatment for hemostatic disorders in pediatric patients, laboratory data should be interpreted with age-appropriate reference ranges. The purpose of this study was to determining age-dependent reference range values for prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen tests, and D-dimer tests. A total of 320 volunteers were included in the study with the following ages: 1 month - 1 year (n = 52), 2 - 5 years (n = 50), 6 - 10 years (n = 48), 11 - 17 years (n = 38), and 18 - 65 years (n = 132). Each volunteer completed a survey to exclude hemostatic system disorder. Using a nonparametric method, the lower and upper limits, including 95% distribution and 90% confidence intervals, were calculated. No statistically significant differences were found between PT and aPTT values in the groups consisting of children. Thus, the reference ranges were separated into child and adult age groups. PT and aPTT values were significantly higher in the children than in the adults. Fibrinogen values in the 6 - 10 age group and the adult age group were significantly higher than in the other groups. D-dimer levels were significantly lower in those aged 2 - 17; thus, a separate reference range was established. These results support other findings related to developmental hemostasis, confirming that adult and pediatric age groups should be evaluated using different reference ranges.

  13. Reproducibility of polycarbonate reference material in toxicity evaluation

    NASA Technical Reports Server (NTRS)

    Hilado, C. J.; Huttlinger, P. A.

    1981-01-01

    A specific lot of bisphenol A polycarbonate has been used for almost four years as the reference material for the NASA-USF-PSC toxicity screening test method. The reproducibility of the test results over this period of time indicate that certain plastics may be more suitable reference materials than the more traditional cellulosic materials.

  14. Reference Standards for Cardiorespiratory Fitness Measured With Cardiopulmonary Exercise Testing Using Cycle Ergometry: Data From the Fitness Registry and the Importance of Exercise National Database (FRIEND) Registry.

    PubMed

    Kaminsky, Leonard A; Imboden, Mary T; Arena, Ross; Myers, Jonathan

    2017-02-01

    The importance of cardiorespiratory fitness (CRF) is well established. This report provides newly developed standards for CRF reference values derived from cardiopulmonary exercise testing (CPX) using cycle ergometry in the United States. Ten laboratories in the United States experienced in CPX administration with established quality control procedures contributed to the "Fitness Registry and the Importance of Exercise: A National Database" (FRIEND) Registry from April 2014 through May 2016. Data from 4494 maximal (respiratory exchange ratio, ≥1.1) cycle ergometer tests from men and women (20-79 years) from 27 states, without cardiovascular disease, were used to develop these references values. Percentiles of maximum oxygen consumption (VO 2max ) for men and women were determined for each decade from age 20 years through age 79 years. Comparisons of VO 2max were made to reference data established with CPX data from treadmill data in the FRIEND Registry and previously published reports. As expected, there were significant differences between sex and age groups for VO 2max (P<.01). For cycle tests within the FRIEND Registry, the 50th percentile VO 2max of men and women aged 20 to 29 years declined from 41.9 and 31.0 mLO 2 /kg/min to 19.5 and 14.8 mLO 2 /kg/min for ages 70 to 79 years, respectively. The rate of decline in this cohort was approximately 10% per decade. The FRIEND Registry reference data will be useful in providing more accurate interpretations for the US population of CPX-measured VO 2max from exercise tests using cycle ergometry compared with previous approaches based on estimations of standard differences from treadmill testing reference values. Copyright © 2016 Mayo Foundation for Medical Education and Research. All rights reserved.

  15. Reference values of thirty-one frequently used laboratory markers for 75-year-old males and females

    PubMed Central

    Ryden, Ingvar; Lind, Lars

    2012-01-01

    Background We have previously reported reference values for common clinical chemistry tests in healthy 70-year-old males and females. We have now repeated this study 5 years later to establish reference values also at the age of 75. It is important to have adequate reference values for elderly patients as biological markers may change over time, and adequate reference values are essential for correct clinical decisions. Methods We have investigated 31 frequently used laboratory markers in 75-year-old males (n = 354) and females (n = 373) without diabetes. The 2.5 and 97.5 percentiles for these markers were calculated according to the recommendations of the International Federation of Clinical Chemistry. Results Reference values are reported for 75-year-old males and females for 31 frequently used laboratory markers. Conclusion There were minor differences between reference intervals calculated with and without individuals with cardiovascular diseases. Several of the reference intervals differed from Scandinavian reference intervals based on younger individuals (Nordic Reference Interval Project). PMID:22300333

  16. Reference values for 27 clinical chemistry tests in 70-year-old males and females.

    PubMed

    Carlsson, Lena; Lind, Lars; Larsson, Anders

    2010-01-01

    Reference values are usually defined based on blood samples from healthy men or nonpregnant women in the age range of 20-50 years. These values are not optimal for elderly patients, as many biological markers change over time and adequate reference values are important for correct clinical decisions. To validate NORIP (Nordic Reference Interval Project) reference values in a 70-year-old population. We studied 27 frequently used laboratory tests. The 2.5th and 97.5th percentiles for these markers were calculated according to the recommendations of the International Federation of Clinical Chemistry on the statistical treatment of reference values. Reference values are reported for plasma alanine aminotransferase, albumin, alkaline phosphatase, pancreas amylase, apolipoprotein A1, apolipoprotein B, aspartate aminotransferase, bilirubin, calcium, chloride, cholesterol, creatinine, creatine kinase, C-reactive protein, glucose, gamma-glutamyltransferase, HDL-cholesterol, iron, lactate dehydrogenase, LDL-cholesterol, magnesium, phosphate, potassium, sodium, transferrin, triglycerides, urate and urea. Reference values calculated from the whole population and a subpopulation without cardiovascular disease showed strong concordance. Several of the reference interval limits were outside the 90% CI of a Scandinavian population (NORIP). 2009 S. Karger AG, Basel.

  17. Determination of Age-Dependent Reference Ranges for Coagulation Tests Performed Using Destiny Plus

    PubMed Central

    Arslan, Fatma Demet; Serdar, Muhittin; Merve Ari, Elif; Onur Oztan, Mustafa; Hikmet Kozcu, Sureyya; Tarhan, Huseyin; Cakmak, Ozgur; Zeytinli, Merve; Yasar Ellidag, Hamit

    2016-01-01

    Background In order to apply the right treatment for hemostatic disorders in pediatric patients, laboratory data should be interpreted with age-appropriate reference ranges. Objectives The purpose of this study was to determining age-dependent reference range values for prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen tests, and D-dimer tests. Materials and Methods A total of 320 volunteers were included in the study with the following ages: 1 month - 1 year (n = 52), 2 - 5 years (n = 50), 6 - 10 years (n = 48), 11 - 17 years (n = 38), and 18 - 65 years (n = 132). Each volunteer completed a survey to exclude hemostatic system disorder. Using a nonparametric method, the lower and upper limits, including 95% distribution and 90% confidence intervals, were calculated. Results No statistically significant differences were found between PT and aPTT values in the groups consisting of children. Thus, the reference ranges were separated into child and adult age groups. PT and aPTT values were significantly higher in the children than in the adults. Fibrinogen values in the 6 - 10 age group and the adult age group were significantly higher than in the other groups. D-dimer levels were significantly lower in those aged 2 - 17; thus, a separate reference range was established. Conclusions These results support other findings related to developmental hemostasis, confirming that adult and pediatric age groups should be evaluated using different reference ranges. PMID:27617078

  18. Tests of the Dynamic Field Theory and The Spatial Precision Hypothesis: Capturing a Qualitative Developmental Transition in Spatial Working Memory

    ERIC Educational Resources Information Center

    Schutte, Anne R.; Spencer, John P.

    2009-01-01

    This study tested a dynamic field theory (DFT) of spatial working memory and an associated spatial precision hypothesis (SPH). Between 3 and 6 years of age, there is a qualitative shift in how children use reference axes to remember locations: 3-year-olds' spatial recall responses are biased toward reference axes after short memory delays, whereas…

  19. Trends in referral patterns, invasive management, and mortality in elderly patients referred for exercise stress testing.

    PubMed

    Bouzas-Mosquera, Alberto; Peteiro, Jesús; Broullón, Francisco J; Calviño-Santos, Ramón; Mosquera, Víctor X; Barbeito-Caamaño, Cayetana; Larrañaga-Moreira, José María; Maneiro-Melón, Nicolás; Álvarez-García, Nemesio; Vázquez-Rodríguez, José Manuel

    2015-12-01

    Scarce data are available on the temporal patterns in clinical characteristics and outcomes of elderly patients referred for exercise stress testing. We aimed to assess the trends in baseline characteristics, tests results, referrals for invasive management, and mortality in these patients. We evaluated 11,192 patients aged ≥65years who were referred for exercise stress testing between January 1998 and December 2013. Calendar years were grouped into four quadrennia (1998-2001, 2002-2005, 2006-2009, and 2010-2013), and trends in clinical characteristics of the patients, type and results of the tests, referrals for invasive management, and mortality across the different periods were assessed. Despite a progressive decrease in the proportion of patients with non-interpretable baseline electrocardiograms or prior history of coronary artery disease, there was a gradual and marked increase in the use of cardiac imaging from 32.8% in 1998-2001 to 67.6% in 2010-2013 (p<0.001). In addition, despite a gradual decline in the probability of positive exercise stress testing both without imaging (from 18.9 to 13.6%, p<0.001) and with imaging assessment (from 40.2 to 29.7%, p<0.001), the cumulative rate of coronary revascularization at 1year increased (from 10.8 to 13.7%, p<0.001). One-year mortality also decreased progressively from 3% to 1.6% (p<0.001). Among older adults referred for exercise stress testing, we observed a decline over time in the probability of inducible myocardial ischemia, an increase in the use of cardiac imaging and in the rate of coronary revascularization, and an improvement in the survival rate at 1year. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  20. Soy foods have low glycemic and insulin response indices in normal weight subjects.

    PubMed

    Blair, Robert M; Henley, E C; Tabor, Aaron

    2006-12-27

    Foods with a low glycemic index (GI) may provide a variety of health benefits. The objective of the present study was to measure the GI and insulin index (II) of select soy foods. The study was conducted in two parts with low-carbohydrate products being tested separately. In Experiment 1, subjects averaged 23.2 years of age with BMI = 22.0 kg/m2, while subjects in Experiment 2 averaged 23.9 years of age with BMI = 21.6 kg/m2. The reference (glucose) and test foods were served in portions containing 10 g of carbohydrates in Experiment 1 (two test foods) and 25 g of carbohydrates in Experiment 2 (four test foods). Subjects consumed the reference food twice and each test food once. For each test, subjects were instructed to consume a fixed portion of the reference food or test food together with 250 g of water within 12 min. Blood samples were collected before each test and at 15, 30, 45, 60, 90, and 120 min after consumption of reference or test foods to quantify glucose and insulin. Two-hour blood glucose and plasma insulin curves were constructed and areas under the curves were calculated. GI and II values for each subject and test food were calculated. In Experiment 1, both low-carbohydrate soy foods were shown to have significantly (P < 0.05) lower GI and II values than the reference food. In Experiment 2, three of the four test foods had significantly (P < 0.05) lower GI and II values than the reference food. All but one of the soy foods tested had a low GI, suggesting that soy foods may be an appropriate part of diets intended to improve control of blood glucose and insulin levels.

  1. Soy foods have low glycemic and insulin response indices in normal weight subjects

    PubMed Central

    2006-01-01

    Background Foods with a low glycemic index (GI) may provide a variety of health benefits. The objective of the present study was to measure the GI and insulin index (II) of select soy foods. Methods The study was conducted in two parts with low-carbohydrate products being tested separately. In Experiment 1, subjects averaged 23.2 years of age with BMI = 22.0 kg/m2, while subjects in Experiment 2 averaged 23.9 years of age with BMI = 21.6 kg/m2. The reference (glucose) and test foods were served in portions containing 10 g of carbohydrates in Experiment 1 (two test foods) and 25 g of carbohydrates in Experiment 2 (four test foods). Subjects consumed the reference food twice and each test food once. For each test, subjects were instructed to consume a fixed portion of the reference food or test food together with 250 g of water within 12 min. Blood samples were collected before each test and at 15, 30, 45, 60, 90, and 120 min after consumption of reference or test foods to quantify glucose and insulin. Two-hour blood glucose and plasma insulin curves were constructed and areas under the curves were calculated. GI and II values for each subject and test food were calculated. Results In Experiment 1, both low-carbohydrate soy foods were shown to have significantly (P < 0.05) lower GI and II values than the reference food. In Experiment 2, three of the four test foods had significantly (P < 0.05) lower GI and II values than the reference food. Conclusion All but one of the soy foods tested had a low GI, suggesting that soy foods may be an appropriate part of diets intended to improve control of blood glucose and insulin levels. PMID:17192192

  2. Developmental gender differences in children in a virtual spatial memory task.

    PubMed

    León, Irene; Cimadevilla, José Manuel; Tascón, Laura

    2014-07-01

    Behavioral achievements are the product of brain maturation. During postnatal development, the medial temporal lobe completes its maturation, and children acquire new memory abilities. In recent years, virtual reality-based tasks have been introduced in the neuropsychology field to assess different cognitive functions. In this work, desktop virtual reality tasks are combined with classic psychometric tests to assess spatial abilities in 4- to 10-year-old children. Fifty boys and 50 girls 4-10-years of age participated in this study. Spatial reference memory and spatial working memory were assessed using a desktop virtual reality-based task. Other classic psychometric tests were also included in this work (e.g., the Corsi Block Tapping Test, digit tests, 10/36 Spatial Recall Test). In general terms, 4- and 5-year-old groups showed poorer performance than the older groups. However, 5-year-old children showed basic spatial navigation abilities with little difficulty. In addition, boys outperformed girls from the 6-8-year-old groups. Gender differences only emerged in the reference-memory version of the spatial task, whereas both sexes displayed similar performances in the working-memory version. There was general improvement in the performance of different tasks in children older than 5 years. However, results also suggest that brain regions involved in allocentric memory are functional even at the age of 5. In addition, the brain structures underlying reference memory mature later in girls than those required for the working memory.

  3. Neuromotor function in ship welders after cessation of manganese exposure.

    PubMed

    Wastensson, Gunilla; Sallsten, Gerd; Bast-Pettersen, Rita; Barregard, Lars

    2012-08-01

    The aim of the present study was to investigate whether previous long-term exposure to manganese (Mn) via inhalation of welding fumes can cause persistent impairment in neuromotor function even long after cessation of exposure. Quantitative tests of tremor, motor speed, manual dexterity, diadochokinesis, eye-hand coordination and postural stability were administered to 17 retired ship welders (mean age 69 years), with mean exposure time 28 years. The welders' exposure had ceased on average 18 years before the study. A cumulative exposure index (CEI) was calculated for each of the former welders. The welders were compared with 21 referents from the same shipyards (mean age was 66 years). Former welders performed less well than referents in the grooved pegboard test, and poorer performance was associated with CEI. The performance in most of the other neurobehavioral tests was similar between groups, but the welders tended to perform slightly better than the referents in tests demanding hand steadiness. The latter finding may be due to a training effect from their former working tasks or selection bias into or out of this occupation. In the present study of welders with previous welding fume exposure, former welders and referents performed similarly in most of the neurobehavioral tests. Previous adverse effects on the neuromotor system might have ceased, and decreased neuromotor function due to normal aging processes in both groups might have disguised any slight effect of previous Mn exposure. The poorer performance in the grooved pegboard test among welders may indicate an adverse effect on motor function of long-term exposure to Mn, but this finding has to be confirmed by other studies.

  4. Population based haematology reference ranges for old people in rural South-West Uganda.

    PubMed

    Mugisha, Joseph O; Seeley, Janet; Kuper, Hannah

    2016-09-07

    Haematology reference values are needed to interpret haematology results and make clinical decisions, but these have not been established for old people in sub-Saharan Africa. The objective of this study was to establish haematology reference values for people aged 50 years and above in Uganda, to compare the haematology reference values for those aged 65 years and over with those less than 65 years and to compare these haematology reference values with established haematology reference values for old people from high income countries. A total of 1449 people aged 50 years and above were recruited from the Medical Research Council/Uganda Virus Research Institute general population cohort between January 2012 and January 2013 (response rate 72.3 %). From the blood samples collected, we did haematology, HIV testing and malaria tests. We also obtained stool samples and tested them for hookworm infection. Questionnaire data were obtained through interviews. In the analysis, we excluded those with HIV infection, malaria infection, hookworm infection and those not feeling well at the time of recruitment. Medians and reference ranges for 12 haematology parameters were determined, based on the Clinical Laboratory and Standards institute's guidelines. In total, 903 people aged 50 years and above were included in the analysis with the majority 545 (60.3 %) being female. Men had significant difference in median haemoglobin, haematocrit, erythrocytes counts and white blood cells counts, which were higher than those of women. Women had significant difference in mean platelet counts and neutrophil percentages which were higher than those of men. Comparing those aged 65+ and those aged less than 65 years, the following parameters were significantly lower in those aged above 65 years: haemoglobin, haematocrit, erythrocytes counts, platelets and mean corpuscular volume. Compared to the reference intervals from old people in high income countries, all the haematology parameters from our study population were low. The differences between haematology reference ranges in old people compared to adults and the very old (65+) compared to those between 50 and 65 call for more population based studies using nationwide surveys to be carried out among old people in other study settings in Uganda and the rest of Africa to explore the differences in haematology reference ranges between these different age groups with a view of establishing whether there is need to have separate reference range for these different categories of old people.

  5. Reference Material Kydex(registered trademark)-100 Test Data Message for Flammability Testing

    NASA Technical Reports Server (NTRS)

    Engel, Carl D.; Richardson, Erin; Davis, Eddie

    2003-01-01

    The Marshall Space Flight Center (MSFC) Materials and Processes Technical Information System (MAPTIS) database contains, as an engineering resource, a large amount of material test data carefully obtained and recorded over a number of years. Flammability test data obtained using Test 1 of NASA-STD-6001 is a significant component of this database. NASA-STD-6001 recommends that Kydex 100 be used as a reference material for testing certification and for comparison between test facilities in the round-robin certification testing that occurs every 2 years. As a result of these regular activities, a large volume of test data is recorded within the MAPTIS database. The activity described in this technical report was undertaken to mine the database, recover flammability (Test 1) Kydex 100 data, and review the lessons learned from analysis of these data.

  6. Tests of the Dynamic Field Theory and the Spatial Precision Hypothesis: Capturing a Qualitative Developmental Transition in Spatial Working Memory

    PubMed Central

    Schutte, Anne R.; Spencer, John P.

    2009-01-01

    This study tested a dynamic field theory (DFT) of spatial working memory and an associated spatial precision hypothesis (SPH). Between three and six years of age there is a qualitative shift in how children use reference axes to remember locations: 3-year-olds’ spatial recall responses are biased toward reference axes after short memory delays, whereas 6-year-olds’ responses are biased away from reference axes. According to the DFT and the SPH, quantitative improvements over development in the precision of excitatory and inhibitory working memory processes lead to this qualitative shift. Simulations of the DFT in Experiment 1 predict that improvements in precision should cause the spatial range of targets attracted toward a reference axis to narrow gradually over development with repulsion emerging and gradually increasing until responses to most targets show biases away from the axis. Results from Experiment 2 with 3- to 5-year-olds support these predictions. Simulations of the DFT in Experiment 3 quantitatively fit the empirical results and offer insights into the neural processes underlying this developmental change. PMID:19968430

  7. Reference values for 34 frequently used laboratory tests in 80-year-old men and women.

    PubMed

    Helmersson-Karlqvist, Johanna; Ridefelt, Peter; Lind, Lars; Larsson, Anders

    2016-10-01

    Reference values are usually based on blood samples from healthy individuals in the age range 20-50 years. Most patients seeking health care are older than this reference population. Many reference intervals are age dependent and there is thus a need to have appropriate reference intervals also for elderly individuals. We analyzed a group of frequently used laboratory tests in an 80-year-old population (n=531, 266 females and 265 males). The 2.5th and 97.5th percentiles for these markers were calculated according to the International Federation of Clinical Chemistry guidelines on the statistical treatment of reference values. Reference values are reported for serum alanine transaminase (ALT), albumin, alkaline phosphatase, pancreatic amylase, apolipoprotein A1, apolipoprotein B, apolipoprotein B/apolipoprotein A1 ratio, aspartate aminotransferase (AST), AST/ALT ratio, bilirubin, calcium, calprotectin, cholesterol, HDL-cholesterol, creatinine kinase (CK), creatinine, creatinine estimated GFR, C-reactive protein, cystatin C, cystatin C estimated GFR, gamma-glutamyltransferase (GGT), iron, iron saturation, lactate dehydrogenase (LDH), magnesium, phosphate, transferrin, triglycerides, urate, urea, zinc, hemoglobin, platelet count and white blood cell count. The upper reference limit for creatinine and urea was significantly increased while the lower limit for iron and albumin was decreased in this elderly population in comparison with the population in the Nordic Reference Interval Project (NORIP). Reference values calculated from the whole population and a subpopulation without cardiovascular disease showed strong concordance. Several of the reference interval limits were outside the 90% confidence interval of NORIP. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Association of Reference Pricing for Diagnostic Laboratory Testing With Changes in Patient Choices, Prices, and Total Spending for Diagnostic Tests.

    PubMed

    Robinson, James C; Whaley, Christopher; Brown, Timothy T

    2016-09-01

    Prices for laboratory and other clinical services vary widely. Employers and insurers increasingly are adopting "reference pricing" policies to create incentives for patients to select lower-priced facilities. To measure the association between implementation of reference pricing and patient choice of laboratory, test prices, patient out-of-pocket spending, and insurer spending. We conducted an observational study of changes in laboratory pricing and selection by employees of a large national grocery firm (n = 30 415) before and after the firm implemented a reference pricing policy for laboratory services and compared the findings with changes over the same period for policy holders of a large national insurer that did not implement reference pricing (n = 181 831). The grocery firm established a maximum payment limit at the 60th percentile of the distribution of prices for each laboratory test in each region. Employees were provided with data on prices at all laboratories through a mobile digital platform. Patients selecting a laboratory that charged more than the payment limit were required to pay the full difference themselves. A total of 2.13 million claims were analyzed for 285 types of in vitro diagnostic tests between 2010 and 2013. Patient choice of laboratory, price paid per test, patient out-of-pocket costs, and employer spending. Compared with trends in prices paid by insurance policy holders not subject to reference pricing, and after adjusting for characteristics of tests and patients, implementation of reference pricing was associated with a 31.9% reduction (95% CI, 20.6%-41.6%) in average price paid per test by the third year of the program. In these 3 years, total spending on laboratory tests declined by $2.57 million (95% CI, $1.59-$3.35 million). Out-of-pocket costs by patients declined by $1.05 million (95% CI, $0.73-$1.37 million). Spending by the employer declined by $1.70 million (95% CI, $0.92-$2.48 million). When combined with access to price information, reference pricing was associated with patient choice of lower-cost laboratories and reductions in prices and payments by both employer and employees.

  9. King-Devick Test reference values and associations with balance measures in high school American football players.

    PubMed

    Alsalaheen, B; Haines, J; Yorke, A; Diebold, J

    2016-02-01

    The King-Devick test appears to be a promising tool in screening for concussions. However, limited evidence exists on the baseline associations between the K-D test and age and baseline screening tools used after concussion. Additionally, there are no published reference values for the K-D test in high school football players. The K-D test, the Balance Error Scoring System, and the Limits of Stability (LOS) test were administered to 157 high school football players. Additionally, a subsample of 62 participants completed the test twice to examine the reliability of K-D test. There was no relationship between the K-D test and the BESS, or the reaction time and directional control of LOS test. Students aged between 16 and 18 years demonstrated faster K-D test performance compared to students between 13 and 15 years of age. However, there was no association between K-D test and history of concussion. The reliability of the K-D test was (ICC2,1 = 0.89), and the minimal detectable change was 6.10 s. Normative reference values for high school football players are presented in this study. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. 49 CFR 572.141 - General description.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES 3-year-Old Child Crash Test Dummy, Alpha Version § 572.141 General description. (a) The Hybrid III 3-year-old child dummy is described by the following materials: (1) Technical drawings and specifications package 210-0000 (refer to...

  11. Plaque, caries level and oral hygiene habits in young patients receiving orthodontic treatment.

    PubMed

    Martignon, S; Ekstrand, K R; Lemos, M I; Lozano, M P; Higuera, C

    2010-09-01

    To assess plaque, caries, and oral hygiene habits amongst patients receiving fixed-orthodontic treatment at the Dental-Clinic, Universidad-El-Bosque, Bogotá, Colombia. Test-group: 74 12-29-year-olds receiving fixed-orthodontic treatment; reference-group: 63 12-29-year-olds before they started the orthodontic treatment. Visual examinations (one examiner) recorded the following: Ortho-plaque-Index (OPI) expressed per patient as good, fair and poor-oral-hygiene. Caries was scored with the modified-ICDAS-II criteria as: 0-sound; 1B/1W-brown/white-opacity-after-air-drying; 2B/2W-brown/white-opacity-without-air-drying; 3-microcavity; 4-underlying-shadow; 5/6-distinct/extensive-cavity. Filled/missing surfaces due-to-caries and caries-lesions on buccal surfaces at three sites around the brackets were recorded. A 7-item self-administered oral-hygiene habits' questionnaire was used. Chi-square test revealed that the oral-hygiene level was significantly better in the reference group compared to the test group (p < 0.05). The traditional mean DMF-S was 6.7 +/- 6.3 in the test- and 6.2 +/- 5.9 in the reference-group (p > 0.05). When adding modified-ICDAS-II lesions scores 1-4, the figure increased to 23.6 +/- 9.4 in the test- and to 13.6 +/- 10.3 in the reference-group (p < 0.001). A total of 96% had > or = 1 white-opacity in the test group versus 56% in the reference group (P < 0.001). In the test-group the buccal-surfaces accounted for most white-opacities and close to 1/3 of these lesions on the upper-anterior teeth were located around the brackets. The questionnaire disclosed that 58% in the test- vs. 44% in the reference-group did not accept having dental caries lesions during the orthodontic treatment. The results showed a high prevalence of white-opacities related to orthodontic appliances and indicate the need to implement preventive programmes at the dental clinic.

  12. 49 CFR 572.70 - Incorporation by reference.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES 6-Year-Old Child § 572.70... Technologies, 9000 Virginia Manor Rd., Beltsville, MD 20705, Telephone (301) 210-5600, Fax (301) 210-5607. (2) A User's Manual entitled, “Six-Year-Old Size Child Test Dummy SA106C,” October 28, 1991, is...

  13. 49 CFR 572.70 - Incorporation by reference.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES 6-Year-Old Child § 572.70... Technologies, 9000 Virginia Manor Rd., Beltsville, MD 20705, Telephone (301) 210-5600, Fax (301) 210-5607. (2) A User's Manual entitled, “Six-Year-Old Size Child Test Dummy SA106C,” October 28, 1991, is...

  14. 49 CFR 572.70 - Incorporation by reference.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES 6-Year-Old Child § 572.70... Technologies, 9000 Virginia Manor Rd., Beltsville, MD 20705, Telephone (301) 210-5600, Fax (301) 210-5607. (2) A User's Manual entitled, “Six-Year-Old Size Child Test Dummy SA106C,” October 28, 1991, is...

  15. 49 CFR 572.70 - Incorporation by reference.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES 6-Year-Old Child § 572.70... Technologies, 9000 Virginia Manor Rd., Beltsville, MD 20705, Telephone (301) 210-5600, Fax (301) 210-5607. (2) A User's Manual entitled, “Six-Year-Old Size Child Test Dummy SA106C,” October 28, 1991, is...

  16. 49 CFR 572.70 - Incorporation by reference.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES 6-Year-Old Child § 572.70... Technologies, 9000 Virginia Manor Rd., Beltsville, MD 20705, Telephone (301) 210-5600, Fax (301) 210-5607. (2) A User's Manual entitled, “Six-Year-Old Size Child Test Dummy SA106C,” October 28, 1991, is...

  17. How Toddlers and Preschoolers Learn to Uniquely Identify Referents for Others: A Training Study

    ERIC Educational Resources Information Center

    Matthews, Danielle; Lieven, Elena; Tomasello, Michael

    2007-01-01

    This training study investigates how children learn to refer to things unambiguously. Two hundred twenty-four children aged 2.6, 3.6, and 4.6 years were pre- and post-tested for their ability to request stickers from a dense array. Between test sessions, children were assigned to a training condition in which they (a) asked for stickers from an…

  18. Observations on the predictive value of short-term stake tests

    Treesearch

    Stan Lebow; Bessie Woodward; Patricia Lebow

    2008-01-01

    This paper compares average ratings of test stakes after 3, 4, 5, and 7 years exposure to their subsequent ratings after 11 years. Average ratings from over 200 treatment groups exposed in plots in southern Mississippi were compared to average ratings of a reference preservative. The analysis revealed that even perfect ratings after three years were not a reliable...

  19. Accuracy of a Rapid Diagnostic Test (Cypress Chagas Quick Test®) for the Diagnosis of Chronic Chagas Disease in a Nonendemic Area: A Retrospective Longitudinal Study.

    PubMed

    Angheben, Andrea; Staffolani, Silvia; Anselmi, Mariella; Tais, Stefano; Degani, Monica; Gobbi, Federico; Buonfrate, Dora; Gobbo, Maria; Bisoffi, Zeno

    2017-11-01

    We analyzed the accuracy of Chagas Quick Test ® , a rapid diagnostic test, for the diagnosis of chronic Chagas disease through a retrospective study on a cohort of 669 patients consecutively examined at a single reference center in Italy, during a 7-year period. We observed high concordance with serological reference standard but low accuracy for screening purposes (sensitivity/specificity: 82.8%/98.7%) at least in our nonendemic context.

  20. Physical fitness reference standards in European children: the IDEFICS study.

    PubMed

    De Miguel-Etayo, P; Gracia-Marco, L; Ortega, F B; Intemann, T; Foraita, R; Lissner, L; Oja, L; Barba, G; Michels, N; Tornaritis, M; Molnár, D; Pitsiladis, Y; Ahrens, W; Moreno, L A

    2014-09-01

    A low fitness status during childhood and adolescence is associated with important health-related outcomes, such as increased future risk for obesity and cardiovascular diseases, impaired skeletal health, reduced quality of life and poor mental health. Fitness reference values for adolescents from different countries have been published, but there is a scarcity of reference values for pre-pubertal children in Europe, using harmonised measures of fitness in the literature. The IDEFICS study offers a good opportunity to establish normative values of a large set of fitness components from eight European countries using common and well-standardised methods in a large sample of children. Therefore, the aim of this study is to report sex- and age-specific fitness reference standards in European children. Children (10,302) aged 6-10.9 years (50.7% girls) were examined. The test battery included: the flamingo balance test, back-saver sit-and-reach test (flexibility), handgrip strength test, standing long jump test (lower-limb explosive strength) and 40-m sprint test (speed). Moreover, cardiorespiratory fitness was assessed by a 20-m shuttle run test. Percentile curves for the 1st, 3rd, 10th, 25th, 50th, 75th, 90th, 97th and 99th percentiles were calculated using the General Additive Model for Location Scale and Shape (GAMLSS). Our results show that boys performed better than girls in speed, lower- and upper-limb strength and cardiorespiratory fitness, and girls performed better in balance and flexibility. Older children performed better than younger children, except for cardiorespiratory fitness in boys and flexibility in girls. Our results provide for the first time sex- and age-specific physical fitness reference standards in European children aged 6-10.9 years.

  1. [The Study of Health in Pomerania (SHIP) reference values for cardiopulmonary exercise testing].

    PubMed

    Gläser, S; Ittermann, T; Schäper, C; Obst, A; Dörr, M; Spielhagen, T; Felix, S B; Völzke, H; Bollmann, T; Opitz, C F; Warnke, C; Koch, B; Ewert, R

    2013-01-01

    The interpretation of gas exchange measured by cardiopulmonary exercise testing (CPET) depends on reliable reference values. Within the population based Study of Health in Pomerania (SHIP) CPET was assessed in 1706 volunteers. The assessment based on symptom limited exercise tests on a bicycle in a sitting position according to a modified Jones protocol. CPET was embedded in an extensive examination program. After the exclusion of active smokers and volunteers with evidence of cardiopulmonary and musculoskeletal disorders the reference population comprised 616 healthy subjects (333 women) aged 25 to 85 years. Reference equations including upper and/or lower limits based on quantile regression were assessed. All values were corrected for the most important influencing factors.This study provides reference equations for gas exchange and exercise capacity assessed within a population in Germany. © Georg Thieme Verlag KG Stuttgart · New York.

  2. Novel reference radiation fields for pulsed photon radiation installed at PTB.

    PubMed

    Klammer, J; Roth, J; Hupe, O

    2012-09-01

    Currently, ∼70 % of the occupationally exposed persons in Germany are working in pulsed radiation fields, mainly in the medical sector. It has been known for a few years that active electronic dosemeters exhibit considerable deficits or can even fail completely in pulsed fields. Type test requirements for dosemeters exist only for continuous radiation. Owing to the need of a reference field for pulsed photon radiation and accordingly to the upcoming type test requirements for dosemeters in pulsed radiation, the Physikalisch-Technische Bundesanstalt has developed a novel X-ray reference field for pulsed photon radiation in cooperation with a manufacturer. This reference field, geared to the main applications in the field of medicine, has been well characterised and is now available for research and type testing of dosemeters in pulsed photon radiation.

  3. First Definition of Reference Intervals of Liver Function Tests in China: A Large-Population-Based Multi-Center Study about Healthy Adults

    PubMed Central

    Zhang, Chuanbao; Guo, Wei; Huang, Hengjian; Ma, Yueyun; Zhuang, Junhua; Zhang, Jie

    2013-01-01

    Background Reference intervals of Liver function tests are very important for the screening, diagnosis, treatment, and monitoring of liver diseases. We aim to establish common reference intervals of liver function tests specifically for the Chinese adult population. Methods A total of 3210 individuals (20–79 years) were enrolled in six representative geographical regions in China. Analytes of ALT, AST, GGT, ALP, total protein, albumin and total bilirubin were measured using three analytical systems mainly used in China. The newly established reference intervals were based on the results of traceability or multiple systems, and then validated in 21 large hospitals located nationwide qualified by the National External Quality Assessment (EQA) of China. Results We had been established reference intervals of the seven liver function tests for the Chinese adult population and found there were apparent variances of reference values for the variables for partitioning analysis such as gender(ALT, GGT, total bilirubin), age(ALP, albumin) and region(total protein). More than 86% of the 21 laboratories passed the validation in all subgroup of reference intervals and overall about 95.3% to 98.8% of the 1220 validation results fell within the range of the new reference interval for all liver function tests. In comparison with the currently recommended reference intervals in China, the single side observed proportions of out of range of reference values from our study for most of the tests deviated significantly from the nominal 2.5% such as total bilirubin (15.2%), ALP (0.2%), albumin (0.0%). Most of reference intervals in our study were obviously different from that of other races. Conclusion These used reference intervals are no longer applicable for the current Chinese population. We have established common reference intervals of liver function tests that are defined specifically for Chinese population and can be universally used among EQA-approved laboratories located all over China. PMID:24058449

  4. Assessing fundamental motor skills in Belgian children aged 3-8 years highlights differences to US reference sample.

    PubMed

    Bardid, Farid; Huyben, Floris; Lenoir, Matthieu; Seghers, Jan; De Martelaer, Kristine; Goodway, Jacqueline D; Deconinck, Frederik J A

    2016-06-01

    This study aimed to understand the fundamental motor skills (FMS) of Belgian children using the process-oriented Test of Gross Motor Development, Second Edition (TGMD-2) and to investigate the suitability of using the United States (USA) test norms in Belgium. FMS were assessed using the TGMD-2. Gender, age and motor performance were examined in 1614 Belgian children aged 3-8 years (52.1% boys) and compared with the US reference sample. More proficient FMS performance was found with increasing age, from 3 to 6 years for locomotor skills and 3 to 7 years for object control skills. Gender differences were observed in object control skills, with boys performing better than girls. In general, Belgian children had lower levels of motor competence than the US reference sample, specifically for object control skills. The score distribution of the Belgian sample was skewed, with 37.4% scoring below average and only 6.9% scoring above average. This study supported the usefulness of the TGMD-2 as a process-oriented instrument to measure gross motor development in early childhood in Belgium. However, it also demonstrated that caution is warranted when using the US reference norms. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  5. Reference data on reaction time and aging using the Nintendo Wii Balance Board: A cross-sectional study of 354 subjects from 20 to 99 years of age.

    PubMed

    Blomkvist, Andreas W; Eika, Fredrik; Rahbek, Martin T; Eikhof, Karin D; Hansen, Mette D; Søndergaard, Malene; Ryg, Jesper; Andersen, Stig; Jørgensen, Martin G

    2017-01-01

    Falls among older adults is one of the major public health challenges facing the rapidly changing demography. The valid assessment of reaction time (RT) and other well-documented risk factors for falls are mainly restricted to specialized clinics due to the equipment needed. The Nintendo Wii Balance Board has the potential to be a multi-modal test and intervention instrument for these risk factors, however, reference data are lacking. To provide RT reference data and to characterize the age-related changes in RT measured by the Nintendo Wii Balance Board. Healthy participants were recruited at various locations and their RT in hands and feet were tested by six assessors using the Nintendo Wii Balance Board. Reference data were analysed and presented in age-groups, while the age-related change in RT was tested and characterized with linear regression models. 354 participants between 20 and 99 years of age were tested. For both hands and feet, mean RT and its variation increased with age. There was a statistically significant non-linear increase in RT with age. The averaged difference between male and female was significant, with males being faster than females for both hands and feet. The averaged difference between dominant and non-dominant side was non-significant. This study reported reference data with percentiles for a new promising method for reliably testing RT. The RT data were consistent with previously known effects of age and gender on RT.

  6. Reference data on reaction time and aging using the Nintendo Wii Balance Board: A cross-sectional study of 354 subjects from 20 to 99 years of age

    PubMed Central

    Rahbek, Martin T.; Eikhof, Karin D.; Hansen, Mette D.; Søndergaard, Malene; Ryg, Jesper; Andersen, Stig; Jørgensen, Martin G.

    2017-01-01

    Background Falls among older adults is one of the major public health challenges facing the rapidly changing demography. The valid assessment of reaction time (RT) and other well-documented risk factors for falls are mainly restricted to specialized clinics due to the equipment needed. The Nintendo Wii Balance Board has the potential to be a multi-modal test and intervention instrument for these risk factors, however, reference data are lacking. Objective To provide RT reference data and to characterize the age-related changes in RT measured by the Nintendo Wii Balance Board. Method Healthy participants were recruited at various locations and their RT in hands and feet were tested by six assessors using the Nintendo Wii Balance Board. Reference data were analysed and presented in age-groups, while the age-related change in RT was tested and characterized with linear regression models. Results 354 participants between 20 and 99 years of age were tested. For both hands and feet, mean RT and its variation increased with age. There was a statistically significant non-linear increase in RT with age. The averaged difference between male and female was significant, with males being faster than females for both hands and feet. The averaged difference between dominant and non-dominant side was non-significant. Conclusion This study reported reference data with percentiles for a new promising method for reliably testing RT. The RT data were consistent with previously known effects of age and gender on RT. PMID:29287063

  7. Methodology and preliminary results of a systematic literature review of ante-mortem and post-mortem diagnostic tests for bovine tuberculosis.

    PubMed

    Downs, Sara H; Parry, Jessica E; Upton, Paul A; Broughan, Jennifer M; Goodchild, Anthony V; Nuñez-Garcia, Javier; Greiner, Matthias; Abernethy, Darrell A; Cameron, Angus R; Cook, Alasdair J; de la Rua-Domenech, Ricardo; Gunn, Jane; Pritchard, Elizabeth; Rhodes, Shelley; Rolfe, Simon; Sharp, Michael; Vordermeier, H Martin; Watson, Eamon; Welsh, Michael; Whelan, Adam O; Woolliams, John A; More, Simon J; Clifton-Hadley, Richard S

    2018-05-01

    A systematic review was conducted to identify studies with data for statistical meta-analyses of sensitivity (Se) and specificity (Sp) of ante-mortem and post-mortem diagnostic tests for bovine tuberculosis (bTB) in cattle. Members of a working group (WG) developed and tested search criteria and developed a standardised two-stage review process, to identify primary studies with numerator and denominator data for test performance and an agreed range of covariate data. No limits were applied to year, language, region or type of test in initial searches of electronic databases. In stage 1, titles and available abstracts were reviewed. References that complied with stage 1 selection criteria were reviewed in entirety and agreed data were extracted from references that complied with stage 2 selection criteria. At stage 1, 9782 references were reviewed and 261 (2.6%) passed through to stage 2 where 215 English language references were each randomly allocated to two of 18 WG reviewers and 46 references in other languages were allocated to native speakers. Agreement regarding eligibility between reviewers of the same reference at stage 2 was moderate (Kappa statistic = 0.51) and a resolution procedure was conducted. Only 119 references (published 1934-2009) were identified with eligible performance estimates for one or more of 14 different diagnostic test types; despite a comprehensive search strategy and the global impact of bTB. Searches of electronic databases for diagnostic test performance data were found to be nonspecific with regard to identifying references with diagnostic test Se or Sp data. Guidelines for the content of abstracts to research papers reporting diagnostic test performance are presented. The results of meta-analyses of the sensitivity and specificity of the tests, and of an evaluation of the methodological quality of the source references, are presented in accompanying papers (Nuñez-Garcia et al., 2017; Downs et al., 2017). Copyright © 2017. Published by Elsevier B.V.

  8. Age dependency for coagulation parameters in paediatric populations. Results of a multicentre study aimed at defining the age-specific reference ranges.

    PubMed

    Toulon, Pierre; Berruyer, Micheline; Brionne-François, Marie; Grand, François; Lasne, Dominique; Telion, Caroline; Arcizet, Julien; Giacomello, Roberta; De Pooter, Neila

    2016-07-04

    Understanding of developmental haemostasis is critical to ensure optimal prevention, diagnosis, and treatment of haemorrhagic and thrombotic diseases in children. As coagulation test results are known to be dependent on the reagents/analysers used, it is recommended for each laboratory to define the age-dependent reference ranges by using its own technical condition. That study was carried out in seven centers to establish age-specific reference ranges using the same reagents and analyser. Plasma samples were obtained from 1437 paediatric patients from the following age groups: 15 days-4 weeks (n=36), 1-5 months (n=320), 6-12 months (n=176), 1-5 years (n=507), 6-10 years (n=132) and 11-17 years (n=262). Indication of coagulation testing was pre-operative screening for non-acute diseases in most cases. PT values were similar in the different age groups to those in adults, whereas longer aPTTs were demonstrated in the younger children. Plasma levels of all clotting factors, except for FV, were significantly decreased (p<0.0001) in the youngest children, adult values being usually reached before the end of the first year. The same applied to antithrombin, protein C/S, and plasminogen. In contrast, FVIII and VWF levels were elevated in the youngest children and returned to adult values within six months. The same applied to D-dimer levels, which were found elevated, particularly until six months of life, until puberty. These data suggest that most coagulation test results are highly dependent on age, mainly during the first year of life, and that age-specific reference ranges must be used to ensure proper evaluation of coagulation in children.

  9. Neurologic outcomes of toxic oil syndrome patients 18 years after the epidemic.

    PubMed Central

    de la Paz, Manuel Posada; Philen, Rossanne M; Gerr, Fredric; Letz, Richard; Ferrari Arroyo, Maria José; Vela, Lydia; Izquierdo, Maravillas; Arribas, Concepción Martín; Borda, Ignacio Abaitua; Ramos, Alejandro; Mora, Cristina; Matesanz, Gloria; Roldán, Maria Teresa; Pareja, Juan

    2003-01-01

    Toxic oil syndrome (TOS) resulted from consumption of rapeseed oil denatured with 2% aniline and affected more than 20,000 persons. Eighteen years after the epidemic, many patients continue to report neurologic symptoms that are difficult to evaluate using conventional techniques. We conducted an epidemiologic study to determine whether an exposure to toxic oil 18 years ago was associated with current adverse neurobehavioral effects. We studied a case group of 80 adults exposed to toxic oil 18 years ago and a referent group of 79 adult age- and sex-frequency-matched unexposed subjects. We interviewed subjects for demographics, health status, exposures to neurotoxicants, and responses to the Kaufman Brief Intelligence Test (K-BIT), Programa Integrado de Exploracion Neuropsicologica (PIEN), and Goldberg depression questionnaires and administered quantitative neurobehavioral and neurophysiologic tests by computer or trained nurses. The groups did not differ with respect to educational background or other critical variables. We examined associations between case and referent groups and the neurobehavioral and neurophysiologic outcomes of interest. Decreased distal strength of the dominant and nondominant hands and increased vibrotactile thresholds of the fingers and toes were significantly associated with exposure to toxic oil. Finger tapping, simple reaction time latency, sequence B latency, symbol digit latency, and auditory digit span were also significantly associated with exposure. Case subjects also had statistically significantly more neuropsychologic symptoms compared with referents. Using quantitative neurologic tests, we found significant adverse central and peripheral neurologic effects in a group of TOS patients 18 years after exposure to toxic oil when compared with a nonexposed referent group. These effects were not documented by standard clinical examination and were found more frequently in women. PMID:12896854

  10. Neurologic outcomes of toxic oil syndrome patients 18 years after the epidemic.

    PubMed

    de la Paz, Manuel Posada; Philen, Rossanne M; Gerr, Fredric; Letz, Richard; Ferrari Arroyo, Maria José; Vela, Lydia; Izquierdo, Maravillas; Arribas, Concepción Martín; Borda, Ignacio Abaitua; Ramos, Alejandro; Mora, Cristina; Matesanz, Gloria; Roldán, Maria Teresa; Pareja, Juan

    2003-08-01

    Toxic oil syndrome (TOS) resulted from consumption of rapeseed oil denatured with 2% aniline and affected more than 20,000 persons. Eighteen years after the epidemic, many patients continue to report neurologic symptoms that are difficult to evaluate using conventional techniques. We conducted an epidemiologic study to determine whether an exposure to toxic oil 18 years ago was associated with current adverse neurobehavioral effects. We studied a case group of 80 adults exposed to toxic oil 18 years ago and a referent group of 79 adult age- and sex-frequency-matched unexposed subjects. We interviewed subjects for demographics, health status, exposures to neurotoxicants, and responses to the Kaufman Brief Intelligence Test (K-BIT), Programa Integrado de Exploracion Neuropsicologica (PIEN), and Goldberg depression questionnaires and administered quantitative neurobehavioral and neurophysiologic tests by computer or trained nurses. The groups did not differ with respect to educational background or other critical variables. We examined associations between case and referent groups and the neurobehavioral and neurophysiologic outcomes of interest. Decreased distal strength of the dominant and nondominant hands and increased vibrotactile thresholds of the fingers and toes were significantly associated with exposure to toxic oil. Finger tapping, simple reaction time latency, sequence B latency, symbol digit latency, and auditory digit span were also significantly associated with exposure. Case subjects also had statistically significantly more neuropsychologic symptoms compared with referents. Using quantitative neurologic tests, we found significant adverse central and peripheral neurologic effects in a group of TOS patients 18 years after exposure to toxic oil when compared with a nonexposed referent group. These effects were not documented by standard clinical examination and were found more frequently in women.

  11. Neural correlates of Self and its interaction with memory in healthy adolescents

    PubMed Central

    Dégeilh, Fanny; Guillery-Girard, Bérengère; Dayan, Jacques; Gaubert, Malo; Chételat, Gael; Egler, Pierre-Jean; Baleyte, Jean-Marc; Eustache, Francis; Viard, Armelle

    2015-01-01

    Adolescence is marked by the development of personal identity and is associated with structural and functional changes in brain regions associated with Self processing. Yet, little is known about the neural correlates of self-reference processing and self-reference effect in adolescents. This fMRI study consists in a self-reference paradigm followed by a recognition test proposed to 30 healthy adolescents aged 13–18 years old. Results showed that the rostral anterior cingulate cortex is specifically involved in self-reference processing and that this specialization develops gradually from 13 to 18 years old. The self-reference effect is associated with increased brain activation changes during encoding, suggesting that the beneficial effect of Self on memory may occur at encoding of self-referential information, rather than at retrieval. PMID:26443236

  12. Towards a Reference Curve for the Grades of Each Course

    ERIC Educational Resources Information Center

    Al-Saleh, Mohammad Fraiwan; Ali, Dareen; Dahshal, Laila

    2010-01-01

    A grade-reference curve (GRC) can be constructed for any course based on the grades of a course in the last several years. Among other things, the reference curve of a course can be used to test for any abnormality in the current semester's grades of a course. It can be a very important document about the course that serves students, teachers and…

  13. The Athletic Skills Track: Age- and gender-related normative values of a motor skills test for 4- to 12-year-old children.

    PubMed

    Hoeboer, J J A A M; Ongena, G; Krijger-Hombergen, M; Stolk, E; Savelsbergh, G J P; de Vries, S I

    2018-02-07

    The aim of the presented study is to provide age- and gender-related normative values and MQ values for a motor skills test, the Athletic Skills Track, among 4- to 12-year-old children. Cross-sectional. In 2016, a total of 7977 Dutch children, 4036 boys (mean age 8.6 years, SD 2.1) and 3941 girls (mean age 8.6 years, SD 2.1), performed an age-related version of the Athletic Skills Track (AST). The AST is a track consisting of 5-7 fundamental movement skill tasks that should be completed as fast as possible. The children performed the test during a regular physical education (PE) lesson under the supervision of their own PE teacher. For each version of the AST (AST-1: n=917; AST-2: n=3947; AST-3: n=3213) age- and gender-related reference centiles were derived from the gathered data using the Lambda, Mu, Sigma (LMS) method. All children completed the AST within 60s (mean 29.6s, SD 7.7). An independent samples t-test showed that boys were significantly faster in completing the track than girls, except for the 4-year-old boys. Therefore, age- and gender-related reference centiles were derived. The reference curves demonstrate an almost linear decrease in time to complete AST-1 and AST-2 with increasing age. The present study provides age- and gender-related normative values and MQ values for the AST among 4- to 12-year-old Dutch children. With these normative values PE teachers can interpret children's performance on the AST. Copyright © 2018 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  14. Reference values and equations reference of balance for children of 8 to 12 years.

    PubMed

    Libardoni, Thiele de Cássia; Silveira, Carolina Buzzi da; Sinhorim, Larissa Milani Brognoli; Oliveira, Anamaria Siriani de; Santos, Márcio José Dos; Santos, Gilmar Moraes

    2018-02-01

    There are still no normative data in balance sway for school-age children in Brazil. We aimed to establish the reference ranges for balance scores and to develop prediction equations for estimation of balance scores in children aged 8 to 12 years old. The study included 165 healthy children (83 boys and 82 girls; age, 8-12 years) recruited from a public school in the city of Florianópolis, Santa Catarina, Brazil. We used the Sensory Organization Test to assess the balance scores and both a digital scale and a stadiometer to measure the anthropometric variables. We tested a stepwise multiple-regression model with sex, height, weight, and mid-thigh circumference of the dominant leg as predictors of the balance score. For all experimental conditions, girls' age accounted for over 85% of the variability in balance scores; while, boys' age accounted only 55% of the variability in balance scores. Therefore, balance scores increase with age for boys and girls. This study described the ranges of age- and sex-specific normative values for balance scores in children during 6 different testing conditions established by the sensory organization test. We confirmed that age was the predictor that best explained the variability in balance scores in children between 8 and 12 years old. This study stimulates a new and more comprehensive study to estimate balance scores from prediction equations for overall Brazilian pediatric population. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Measuring Thermal Conductivity at LH2 Temperatures

    NASA Technical Reports Server (NTRS)

    Selvidge, Shawn; Watwood, Michael C.

    2004-01-01

    For many years, the National Institute of Standards and Technology (NIST) produced reference materials for materials testing. One such reference material was intended for use with a guarded hot plate apparatus designed to meet the requirements of ASTM C177-97, "Standard Test Method for Steady-State Heat Flux Measurements and Thermal Transmission Properties by Means of the Guarded-Hot-Plate Apparatus." This apparatus can be used to test materials in various gaseous environments from atmospheric pressure to a vacuum. It allows the thermal transmission properties of insulating materials to be measured from just above ambient temperature down to temperatures below liquid hydrogen. However, NIST did not generate data below 77 K temperature for the reference material in question. This paper describes a test method used at NASA's Marshall Space Flight Center (MSFC) to optimize thermal conductivity measurements during the development of thermal protection systems. The test method extends the usability range of this reference material by generating data at temperatures lower than 77 K. Information provided by this test is discussed, as are the capabilities of the MSFC Hydrogen Test Facility, where advanced methods for materials testing are routinely developed and optimized in support of aerospace applications.

  16. Summative assessment of 5th year medical students’ clinical reasoning by script concordance test: requirements and challenges

    PubMed Central

    2012-01-01

    Background The Script Concordance Test (SCT) has not been reported in summative assessment of students across the multiple domains of a medical curriculum. We report the steps used to build a test for summative assessment in a medical curriculum. Methods A 51 case, 158-question, multidisciplinary paper was constructed to assess clinical reasoning in 5th-year. 10–16 experts in each of 7 discipline-based reference panels answered questions on-line. A multidisciplinary group considered reference panel data and data from a volunteer group of 6th Years, who sat the same test, to determine the passing score for the 5th Years. Results The mean (SD) scores were 63.6 (7.6) and 68.6 (4.8) for the 6th Year (n = 23, alpha = 0.78) and and 5th Year (n = 132, alpha =0.62) groups (p < 0.05), respectively. The passing score was set at 4 SD from the expert mean. Four students failed. Conclusions The SCT may be a useful method to assess clinical reasoning in medical students in multidisciplinary summative assessments. Substantial investment in training of faculty and students and in the development of questions is required. PMID:22571351

  17. Reference equations for 6-min walk test in healthy Indian subjects (25-80 years).

    PubMed

    Palaniappan Ramanathan, Ramanathan; Chandrasekaran, Baskaran

    2014-01-01

    Six-min walk test (6MWT), a simple functional capacity evaluation tool used globally to determine the prognosis and effectiveness of any therapeutic/medical intervention. However, variability in reference equations derived from western population (due to racial and ethnicity variations) hinders from adequate use of 6MWT clinically. Further, there are no valid Indian studies that predict reference values for 6-min walk distance (6MWD) in healthy Indian normal. We aimed for framing individualized reference equations for 6MWT in healthy Indian population. Anthropometric variables (age, weight, height, and body mass index (BMI)) and 6-min walk in a 30 m corridor were evaluated in 125 subjects (67 females) in a cross-sectional trial. 6MWD significantly correlated with age (r = -0.29), height (r = 0.393), weight (r = 0.08), and BMI (r = -0.17). The gender specific reference equations for healthy Indian individuals were: (1) Males: 561.022 - (2.507 × age [years]) + (1.505 × weight [kg]) - (0.055 × height [cm]). R (2) = 0.288. (2) Indian females: 30.325 - (0.809 × age [years]) - (2.074 × weight [kg]) + (4.235 × height [cm]). R (2) = 0.272. Though the equations possess a small coefficient of determination and larger standard error estimate, the former applicability to Indian population is justified. These reference equations are probably most appropriate for evaluating the walked capacity of Indian patients with chronic diseases.

  18. 49 CFR 572.142 - Head assembly and test procedure.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Head assembly and test procedure. 572.142 Section...-year-Old Child Crash Test Dummy, Alpha Version § 572.142 Head assembly and test procedure. (a) The head assembly (refer to § 572.140(a)(1)(i)) for this test consists of the head (drawing 210-1000), adapter plate...

  19. 49 CFR 572.142 - Head assembly and test procedure.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Head assembly and test procedure. 572.142 Section...-year-Old Child Crash Test Dummy, Alpha Version § 572.142 Head assembly and test procedure. (a) The head assembly (refer to § 572.140(a)(1)(i)) for this test consists of the head (drawing 210-1000), adapter plate...

  20. 49 CFR 572.142 - Head assembly and test procedure.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Head assembly and test procedure. 572.142 Section...-year-Old Child Crash Test Dummy, Alpha Version § 572.142 Head assembly and test procedure. (a) The head assembly (refer to § 572.140(a)(1)(i)) for this test consists of the head (drawing 210-1000), adapter plate...

  1. 49 CFR 572.142 - Head assembly and test procedure.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 false Head assembly and test procedure. 572.142 Section...-year-Old Child Crash Test Dummy, Alpha Version § 572.142 Head assembly and test procedure. (a) The head assembly (refer to § 572.140(a)(1)(i)) for this test consists of the head (drawing 210-1000), adapter plate...

  2. Development of reference equations for spirometry in Japanese children aged 6-18 years.

    PubMed

    Takase, Masato; Sakata, Hiroshi; Shikada, Masahiro; Tatara, Katsuyoshi; Fukushima, Takayoshi; Miyakawa, Tomoo

    2013-01-01

    Spirometry is the most widely used pulmonary function test and the measured values of spirometric parameters need to be evaluated using reference values predicted for the corresponding race, sex, age, and height. However, none of the existing reference equations for Japanese children covers the entire age range of 6-18 years. The Japanese Society of Pediatric Pulmonology had organized a working group in 2006, in order to develop a new set of national standard reference equations for commonly used spirometric parameters that are applicable through the age range of 6-18 years. Quality assured spirometric data were collected through 2006-2008, from 14 institutions in Japan. We applied multiple regression analysis, using age in years (A), square of age (A(2)), height in meters (H), square of height (H(2)), and the product of age and height (AH) as explanatory variables to predict forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV(1)), peak expiratory flow (PEF), forced expiratory flow between 25% and 75% of the FVC (FEF(25-75%)), instantaneous forced expiratory flow when 50% (FEF(50%)) or 75% (FEF(75%)) of the FVC have been expired. Finally, 1,296 tests (674 boys, 622 girls) formed the reference data set. Distributions of the percent predicted values did not differ by ages, confirming excellent fit of the prediction equations throughout the entire age range from 6 to 18 years. Cut-off values (around 5 percentile points) for the parameters were also determined. We recommend the use of this new set of prediction equations together with suggested cut-off values, for assessment of spirometry in Japanese children and adolescents. Copyright © 2012 Wiley Periodicals, Inc.

  3. Validated age-specific reference values for CSF total protein levels in children.

    PubMed

    Kahlmann, V; Roodbol, J; van Leeuwen, N; Ramakers, C R B; van Pelt, D; Neuteboom, R F; Catsman-Berrevoets, C E; de Wit, M C Y; Jacobs, B C

    2017-07-01

    To define age-specific reference values for cerebrospinal fluid (CSF) total protein levels for children and validate these values in children with Guillain-Barré syndrome (GBS), acute disseminated encephalomyelitis (ADEM) and multiple sclerosis (MS). Reference values for CSF total protein levels were determined in an extensive cohort of diagnostic samples from children (<18 year) evaluated at Erasmus Medical Center/Sophia Children's Hospital. These reference values were confirmed in children diagnosed with disorders unrelated to raised CSF total protein level and validated in children with GBS, ADEM and MS. The test results of 6145 diagnostic CSF samples from 3623 children were used to define reference values. The reference values based on the upper limit of the 95% CI (i.e. upper limit of normal) were for 6 months-2 years 0.25 g/L, 2-6 years 0.25 g/L, 6-12 years 0.28 g/L, 12-18 years 0.34 g/L. These reference values were confirmed in a subgroup of 378 children diagnosed with disorders that are not typically associated with increased CSF total protein. In addition, the CSF total protein levels in these children in the first 6 months after birth were highly variable (median 0.47 g/L, IQR 0.26-0.65). According to these new reference values, CSF total protein level was elevated in 85% of children with GBS, 66% with ADEM and 23% with MS. More accurate age-specific reference values for CSF total protein levels in children were determined. These new reference values are more sensitive than currently used values for diagnosing GBS and ADEM in children. Copyright © 2017 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  4. Reference values of renal tubular function tests are dependent on age and kidney function.

    PubMed

    Bech, Anneke P; Wetzels, Jack F M; Nijenhuis, Tom

    2017-12-01

    Electrolyte disorders due to tubular disorders are rare, and knowledge about validated clinical diagnostic tools such as tubular function tests is sparse. Reference values for tubular function tests are based on studies with small sample size in young healthy volunteers. Patients with tubular disorders, however, frequently are older and can have a compromised renal function. We therefore evaluated four tubular function tests in individuals with different ages and renal function. We performed furosemide, thiazide, furosemide-fludrocortisone, and desmopressin tests in healthy individuals aged 18-50 years, healthy individuals aged more than 50 years and individuals with compromised renal function. For each tubular function test we included 10 individuals per group. The responses in young healthy individuals were in line with previously reported values in literature. The maximal increase in fractional chloride excretion after furosemide was below the lower limit of young healthy individuals in 5/10 older subjects and in 2/10 patients with compromised renal function. The maximal increase in fractional chloride excretion after thiazide was below the lower limit of young healthy individuals in 6/10 older subjects and in 7/10 patients with compromised renal function. Median maximal urine osmolality after desmopressin was 1002 mosmol/kg H 2 O in young healthy individuals, 820 mosmol/kg H 2 O in older subjects and 624 mosmol/kg H 2 O in patients with compromised renal function. Reference values for tubular function tests obtained in young healthy adults thus cannot simply be extrapolated to older patients or patients with compromised kidney function. Larger validation studies are needed to define true reference values in these patient categories. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

  5. A Descriptive Analysis of Exercise Tolerance Test at Seremban Hospital : An Audit for the Year 2001

    PubMed Central

    Mohamed, Abdul Latiff; Nee, Chan Chee; Azzad, Ahmed

    2004-01-01

    Our purpose is to report on the epidemiological variables and their association with the results of the exercise tolerance test (ETT) in the series of patients referred for standard diagnostic ETT at Seremban Hospital during the year 2001. ETT is widely performed, but, in Malaysia, an analysis of the associations between the epidemiological data and the results of the ETT has not been presented. All patients referred for ETT at Seremban Hospital who underwent exercise treadmill tests for the year 2001 were taken as the study population. Demographic details and patients with established heart disease (i.e. prior coronary bypass surgery, myocardial infarction, or congestive heart failure) were noted. Clinical and ETT variables were collected retrospectively from the hospital records. Testing and data management were performed in a standardized fashion with a computer-assisted protocol. This study showed that there was no significant predictive epidemiological variable on the results of the ETT. However, it was found that there was statistically significant difference between the peak exercise time of males and females undergoing the ETT. PMID:22973128

  6. Your Mentor. A Practical Guide for First-Year Teachers in Grades 1-3.

    ERIC Educational Resources Information Center

    Roberts, Mary Presson

    This reference guide was developed by surveying student teachers, substitute teachers, returning teachers, emergency credential teachers, and teacher educators on what they wanted to see in a teaching reference. Samples of lesson units, themes, and communication with parents are provided, along with classroom-tested strategies. The 12 chapters…

  7. Cervical human papilloma virus (HPV) DNA primary screening test: Results of a population-based screening programme in central Italy.

    PubMed

    Passamonti, Basilio; Gustinucci, Daniela; Giorgi Rossi, Paolo; Cesarini, Elena; Bulletti, Simonetta; Carlani, Angela; Martinelli, Nadia; Broccolini, Massimo; D'Angelo, Valentina; D'Amico, Maria Rosaria; Di Dato, Eugenio; Galeazzi, Paola; Malaspina, Morena; Spita, Nicoletta; Tintori, Beatrice; Giaimo, Maria Donata

    2017-09-01

    Objective To present the results of the first and second round human papilloma virus (HPV)-based screening programme in the Umbria region after three years. Methods From August 2010 to November 2011, the entire female population aged 35-64 in a local health district was invited for HPV testing (HPV-DNA cobas4800 on a liquid-based cytology sample). HPV-negative women were re-invited after three years. For HPV-positive women, a slide was prepared and interpreted. Positive cytologies were referred to colposcopy; negatives were referred to repeat HPV after one year. If HPV was persistently positive, women were referred to colposcopy; if negative, to normal screening. Indicators of the first and second round are compared with those of cytology screening in the same area in the preceding three years. Results Participation was 56.5%, the same as cytology (56.6%). HPV-positivity was 6.4% (396/6272), cytology triage positivity was 35.6%; 251 cytology negative women were referred to one-year HPV retesting, 84.1% complied, and 55.5% were positive. Total colposcopy referral was 4.1%, and for cytology 1%. The detection rate for cervical intraepithelial neoplasia grade 2 or more severe was 10‰, compared with 3.7‰ using cytology. After three years, HPV-positivity was 3.4% (129/3831), overall colposcopy referral was 2.3% (most at one-year follow-up), and detection rate was 0.5/1000. Conclusions The first round detection rate was more than twice that of cytology screening, while colposcopy referral increased fourfold. At the second round, the detection rate decreased dramatically, showing that longer interval and more conservative protocols are needed.

  8. Uptake of non-invasive prenatal testing in Chinese women: money matters.

    PubMed

    Han, J; Zhen, L; Pan, M; Yang, X; Ou, Y-M; Liao, C; Li, D-Z

    2015-12-01

    To determine the influence of free invasive prenatal testing on the uptake of non-invasive prenatal testing (NIPT). Over a 2-year period at a Chinese tertiary prenatal diagnostic unit, women at risk of fetal trisomy were given the option of NIPT or invasive prenatal testing. Invasive prenatal testing was offered free of charge to women with a local Hukou (household registration); however, women without a local Hukou were charged for invasive prenatal testing. Both women with and without a local Hukou were charged for NIPT. During the first year, 2647 women with a positive trisomy 21 screening test were referred (474 women with a local Hukou and 2173 women without a local Hukou). Only 1.6% of the women with a local Hukou underwent NIPT, while this proportion was 20.6% in the women without a local Hukou. During the second year, the price of NIPT was reduced. The total number of women referred was 3047 (502 women with a local Hukou and 2545 women without a local Hukou). The uptake of NIPT in women without a local Hukou doubled, but the uptake of NIPT remained stable in women with a local Hukou. The financial impact on the uptake of NIPT should not be underestimated. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Preliminary development of an ultrabrief two-item bedside test for delirium.

    PubMed

    Fick, Donna M; Inouye, Sharon K; Guess, Jamey; Ngo, Long H; Jones, Richard N; Saczynski, Jane S; Marcantonio, Edward R

    2015-10-01

    Delirium is common, morbid, and costly, yet is greatly under-recognized among hospitalized older adults. To identify the best single and pair of mental status test items that predict the presence of delirium. Diagnostic test evaluation study that enrolled medicine inpatients aged 75 years or older at an academic medical center. Patients underwent a clinical reference standard assessment involving a patient interview, medical record review, and interviews with family members and nurses to determine the presence or absence of Diagnostic and Statistical Manual of Mental Disorders, 4th Edition defined delirium. Participants also underwent the three-dimensional Confusion Assessment Method (3D-CAM), a brief, validated assessment for delirium. Individual items and pairs of items from the 3D-CAM were evaluated to determine sensitivity and specificity relative to the reference standard delirium diagnosis. Of the 201 participants (mean age 84 years, 62% female), 42 (21%) had delirium based on the clinical reference standard. The single item with the best test characteristics was "months of the year backwards" with a sensitivity of 83% (95% confidence interval [CI]: 69%-93%) and specificity of 69% (95% CI: 61%-76%). The best 2-item screen was the combination of "months of the year backwards" and "what is the day of the week?" with a sensitivity of 93% (95% CI: 81%-99%) and specificity of 64% (95% CI: 56%-70%). We identified a single item with >80% and pair of items with >90% sensitivity for delirium. If validated prospectively, these items will serve as an initial innovative screening step for delirium identification in hospitalized older adults. © 2015 Society of Hospital Medicine.

  10. USGS reference materials

    USGS Publications Warehouse

    ,

    1995-01-01

    Every year in the United States, millions of measurements are made on the chemical composition of items that affect us on a daily basis. Determining the accuracy of these measurements is based on the analysis of appropriate reference materials whose composition was previously determined through rigorous testing. Today, reference materials help us evaluate the composition of the food we eat, medicine we use, soil we grow our crops in, and hundreds of other products that affect our everyday lives.

  11. Reference Pricing, Consumer Cost-Sharing, and Insurer Spending for Advanced Imaging Tests.

    PubMed

    Robinson, James C; Whaley, Christopher; Brown, Timothy T

    2016-12-01

    Fees charged for similar imaging tests often vary dramatically within the same market, leading to wide variation in insurer spending and consumer cost-sharing. Reference pricing is an insurance design that offers good coverage to patients up to a defined contribution limit but requires the patients who select high-priced facilities to pay the remainder out of pocket. To measure the association between implementation of reference pricing and patient choice of facility, test prices, out-of-pocket spending, and insurer spending for advanced imaging (CT and MRI) procedures. Difference-in-differences multivariable analysis of insurance claims data. Study included 4751 employees of a national grocery chain (treatment group) and 23,428 enrollees in the nation's largest private insurance plan (comparison group) that used CT or MRI tests between 2010 and 2013. Patient choice of facility, price paid per test, patient out-of-pocket cost-sharing, and employer spending. Compared with trends in prices paid by insurance enrollees not subject to reference pricing, and after adjusting for characteristics of tests and patients, implementation of reference pricing was associated with a 12.5% (95% CI, -25.0%, 2.1%) reduction in average price paid per test by the end of the second full year of the program for CT scans and a 10.5% (95% CI, -16.9%, 3.6%) for MRIs. Out-of-pocket cost-sharing by patients declined by $71,508 (13.8%). The savings accruing to employees amounted to 45.5% of total savings from reference pricing, with the remainder accruing to the employer. Implementation of reference pricing led to reductions in payments by both employer and employees.

  12. Prediction of cervical intraepithelial neoplasia grade 2+ (CIN2+) using HPV DNA testing after a diagnosis of atypical squamous cell of undetermined significance (ASC-US) in Catalonia, Spain.

    PubMed

    Ibáñez, Raquel; Moreno-Crespi, Judit; Sardà, Montserrat; Autonell, Josefina; Fibla, Montserrat; Gutiérrez, Cristina; Lloveras, Belen; Alejo, María; Català, Isabel; Alameda, Francesc; Casas, Miquel; Bosch, F Xavier; de Sanjosé, Silvia

    2012-01-26

    A protocol for cervical cancer screening among sexually active women 25 to 65 years of age was introduced in 2006 in Catalonia, Spain to increase coverage and to recommend a 3-year-interval between screening cytology. In addition, Human Papillomavirus (HPV) was offered as a triage test for women with a diagnosis of atypical squamous cells of undetermined significance (ASC-US). HPV testing was recommended within 3 months of ASC-US diagnosis. According to protocol, HPV negative women were referred to regular screening including a cytological exam every 3 years while HPV positive women were referred to colposcopy and closer follow-up. We evaluated the implementation of the protocol and the prediction of HPV testing as a triage tool for cervical intraepithelial lesions grade two or worse (CIN2+) in women with a cytological diagnosis of ASC-US. During 2007-08 a total of 611 women from five reference laboratories in Catalonia with a novel diagnosis of ASC-US were referred for high risk HPV (hrHPV) triage using high risk Hybrid Capture version 2. Using routine record linkage data, women were followed for 3 years to evaluate hrHPV testing efficacy for predicting CIN2+ cases. Logistic regression analysis was used to estimate the odds ratio for CIN2 +. Among the 611 women diagnosed with ASC-US, 493 (80.7%) had at least one follow-up visit during the study period. hrHPV was detected in 48.3% of the women at study entry (mean age 35.2 years). hrHPV positivity decreased with increasing age from 72.6% among women younger than 25 years to 31.6% in women older than 54 years (p < 0.01). At the end of the 3 years follow-up period, 37 women with a diagnosis of CIN2+ (18 CIN2, 16 CIN3, 2 cancers, and 1 with high squamous intraepithelial lesions--HSIL) were identified and all but one had a hrHPV positive test at study entry. Sensitivity to detect CIN2+ of hrHPV was 97.2% (95%confidence interval (CI) = 85.5-99.9) and specificity was 68.3% (95%CI = 63.1-73.2). The odds ratio for CIN2+ was 45.3 (95% CI: 6.2-333.0), when among ASC-US hrHPV positive women were compared to ASC-US hrHPV negative women. Triage of ASC-US with hrHPV testing showed a high sensitivity for the detection of CIN2+ and a high negative predictive value after 3 years of follow-up. The results of this study are in line with the current guidelines for triage of women with ASC-US in the target age range of 25-65. Non adherence to guidelines will lead to unnecessary medical interventions. Further investigation is needed to improve specificity of ASC-US triage.

  13. Diagnostic Performance of a Molecular Test versus Clinician Assessment of Vaginitis

    PubMed Central

    Gaydos, Charlotte A.; Nyirjesy, Paul; Paradis, Sonia; Kodsi, Salma; Cooper, Charles K.

    2018-01-01

    ABSTRACT Vaginitis is a common complaint, diagnosed either empirically or using Amsel's criteria and wet mount microscopy. This study sought to determine characteristics of an investigational test (a molecular test for vaginitis), compared to reference, for detection of bacterial vaginosis, Candida spp., and Trichomonas vaginalis. Vaginal specimens from a cross-sectional study were obtained from 1,740 women (≥18 years old), with vaginitis symptoms, during routine clinic visits (across 10 sites in the United States). Specimens were analyzed using a commercial PCR/fluorogenic probe-based investigational test that detects bacterial vaginosis, Candida spp., and Trichomonas vaginalis. Clinician diagnosis and in-clinic testing (Amsel's test, potassium hydroxide preparation, and wet mount) were also employed to detect the three vaginitis causes. All testing methods were compared to the respective reference methods (Nugent Gram stain for bacterial vaginosis, detection of the Candida gene its2, and Trichomonas vaginalis culture). The investigational test, clinician diagnosis, and in-clinic testing were compared to reference methods for bacterial vaginosis, Candida spp., and Trichomonas vaginalis. The investigational test resulted in significantly higher sensitivity and negative predictive value than clinician diagnosis or in-clinic testing. In addition, the investigational test showed a statistically higher overall percent agreement with each of the three reference methods than did clinician diagnosis or in-clinic testing. The investigational test showed significantly higher sensitivity for detecting vaginitis, involving more than one cause, than did clinician diagnosis. Taken together, these results suggest that a molecular investigational test can facilitate accurate detection of vaginitis. PMID:29643195

  14. 40 CFR Appendix Xiii to Part 86 - State Requirements Incorporated by Reference in Part 86 of the Code of Federal Regulations

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... AND IN-USE HIGHWAY VEHICLES AND ENGINES (CONTINUED) Pt. 86, App. XIII Appendix XIII to Part 86—State...-Line Test Procedures for 1983 Through 1997 Model-Year Passenger Cars, Light-Duty Trucks and Medium-Duty...: California Assembly-Line Test Procedures for 1998 and Subsequent Model-Year Passenger Cars, Light-Duty Trucks...

  15. 40 CFR Appendix Xiii to Part 86 - State Requirements Incorporated by Reference in Part 86 of the Code of Federal Regulations

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... AND IN-USE HIGHWAY VEHICLES AND ENGINES (CONTINUED) Pt. 86, App. XIII Appendix XIII to Part 86—State...-Line Test Procedures for 1983 Through 1997 Model-Year Passenger Cars, Light-Duty Trucks and Medium-Duty...: California Assembly-Line Test Procedures for 1998 and Subsequent Model-Year Passenger Cars, Light-Duty Trucks...

  16. 40 CFR Appendix Xiii to Part 86 - State Requirements Incorporated by Reference in Part 86 of the Code of Federal Regulations

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... AND IN-USE HIGHWAY VEHICLES AND ENGINES (CONTINUED) Pt. 86, App. XIII Appendix XIII to Part 86—State...-Line Test Procedures for 1983 Through 1997 Model-Year Passenger Cars, Light-Duty Trucks and Medium-Duty...: California Assembly-Line Test Procedures for 1998 and Subsequent Model-Year Passenger Cars, Light-Duty Trucks...

  17. Reference values for serum ferritin and percentage of transferrin saturation in Korean children and adolescents.

    PubMed

    Oh, Hea Lin; Lee, Jun Ah; Kim, Dong Ho; Lim, Jung Sub

    2018-03-01

    Ferritin reference values vary by age, gender, and ethnicity. We aimed to determine reference values of serum ferritin (SF) and the percentage of transferrin saturation (TSAT) for Korean children and adolescents. We analyzed data from 2,487 participants (1,311 males and 1,176 females) aged 10-20 years from the Korea National Health and Nutrition Examination Survey (2010-2012). We calculated age- and gender-stratified means and percentile values for SF and TSAT. We first plotted mean SF and TSAT by gender and according to age. In males, mean SF tended to be relatively constant among participants aged 10 to 14 years, with an upward trend thereafter. Mean SF trended downward among female participants until the age of 15 years and remained constant thereafter. Thus, significant gender differences in ferritin exist from the age of 14 years. High levels of SF were associated with obesity, and lower SF levels were associated with anemia and menarche status. We established reference values of SF and TSAT according to age and gender. The reference values for SF calculated in this study can be used to test the association between SF values and other defined diseases in Korean children and adolescents.

  18. Neural Correlates of Self and Its Interaction With Memory in Healthy Adolescents.

    PubMed

    Dégeilh, Fanny; Guillery-Girard, Bérengère; Dayan, Jacques; Gaubert, Malo; Chételat, Gaël; Egler, Pierre-Jean; Baleyte, Jean-Marc; Eustache, Francis; Viard, Armelle

    2015-01-01

    Adolescence is marked by the development of personal identity and is associated with structural and functional changes in brain regions associated with Self processing. Yet, little is known about the neural correlates of self-reference processing and self-reference effect in adolescents. This functional magnetic resonance imaging study consists of a self-reference paradigm followed by a recognition test proposed to 30 healthy adolescents aged 13-18 years old. Results showed that the rostral anterior cingulate cortex is specifically involved in self-reference processing and that this specialization develops gradually from 13 to 18 years old. The self-reference effect is associated with increased brain activation changes during encoding, suggesting that the beneficial effect of Self on memory may occur at encoding of self-referential information, rather than at retrieval. © 2015 The Authors. Child Development © 2015 Society for Research in Child Development, Inc.

  19. HPV DNA testing in population-based cervical screening (VUSA-Screen study): results and implications

    PubMed Central

    Rijkaart, D C; Berkhof, J; van Kemenade, F J; Coupe, V M H; Rozendaal, L; Heideman, D A M; Verheijen, R H M; Bulk, S; Verweij, W; Snijders, P J F; Meijer, C J L M

    2012-01-01

    Background: Human papillomavirus (HPV) testing is more sensitive than cytology for detecting high-grade cervical intraepithelial neoplasia (CIN). We evaluated the performance of high-risk HPV (hrHPV) testing in routine screening. Methods: In all, 25 871 women (29–61) enrolled in our population-based cohort study were offered both cytology and hrHPV testing. High-risk HPV-positive women with normal cytology and an age-matched subcohort of hrHPV-negative women with normal cytology were invited for repeat testing after 1 and/or 2 years and were referred for colposcopy if they presented with abnormal cytology and/or a positive hrHPV test. The hrHPV-positive women with borderline or mild dyskaryosis (BMD) and all women with moderate dyskaryosis or worse (>BMD) were directly referred for colposcopy. Women with BMD and an hrHPV-negative test were advised to repeat cytology at 6 and 18 months and were referred for colposcopy if the repeat cytology test was abnormal. The main outcome measure was CIN grade 3 or worse (CIN3+). Results were adjusted for non-attendance at repeat testing. Results: The hrHPV-positive women with abnormal cytology had a CIN3+ risk of 42.2% (95% confidence interval (CI): 36.4–48.2), whereas the hrHPV-positive women with normal cytology had a much lower risk of 5.22% (95% CI: 3.72–7.91). In hrHPV-positive women with normal cytology, an additional cytology step after 1 year reduced the CIN3+ risk to only 1.6% (95% CI: 0.6–4.9) if the repeat test was normal. The CIN3+ risk in women with hrHPV-positive normal cytology was higher among women invited for the first time (29–33 years of age) (9.1% 95% CI: 5.6–14.3) than among older women (3.0% 95% CI: 1.5–5.5). Conclusion: Primary hrHPV screening with cytology triage in women aged ⩾30 years is an effective way to stratify women on CIN3+ risk and seems a feasible alternative to cytological screening. Repeat cytology after 1 year for hrHPV-positive women with normal cytology is however necessary before returning women to routine screening. PMID:22251922

  20. Transplantation of storm-generated coral fragments to enhance Caribbean coral reefs: A successful method but not a solution

    USGS Publications Warehouse

    Garrison, Virginia H.; Ward, Greg A.

    2012-01-01

    In response to dramatic losses of reef-building corals and ongoing lack of recovery, a small-scale coral transplant project was initiated in the Caribbean (U.S. Virgin Islands) in 1999 and was followed for 12 years. The primary objectives were to (1) identify a source of coral colonies for transplantation that would not result in damage to reefs, (2) test the feasibility of transplanting storm-generated coral fragments, and (3) develop a simple, inexpensive method for transplanting fragments that could be conducted by the local community.  The ultimate goal was to enhance abundance of threatened reef-building species on local reefs.  Storm-produced coral fragments of two threatened reef-building species [Acropora palmata and A. cervicornis (Acroporidae)] and another fast-growing species [Porites porites (Poritidae)] were collected from environments hostile to coral fragment survival and transplanted to degraded reefs.  Inert nylon cable ties were used to attach transplanted coral fragments to dead coral substrate.  Survival of 75 reference colonies and 60 transplants was assessed over 12 years. Only 9% of colonies were alive after 12 years: no A. cervicornis; 3% of A. palmata transplants and 18% of reference colonies; and 13% of P. porites transplants and 7% of reference colonies. Mortality rates for all species were high and were similar for transplant and reference colonies. Physical dislodgement resulted in the loss of 56% of colonies, whereas 35% died in place.  Only A. palmata showed a difference between transplant and reference colony survival and that was in the first year only.  Location was a factor in survival only for A. palmata reference colonies and after year 10.  Even though the tested methods and concepts were proven effective in the field over the 12-year study, they do not present a solution. No coral conservation strategy will be effective until underlying intrinsic and/or extrinsic factors driving high mortality rates are understood and mitigated or eliminated. Rev. Biol. Trop. 60 (Suppl. 1): 59-70. Epub 2012 March 01.

  1. [Unnecessary routine laboratory tests in patients referred for surgical services].

    PubMed

    Mata-Miranda, María del Pilar; Cano-Matus, Norberto; Rodriguez-Murrieta, Margarita; Guarneros-Zapata, Idalia; Ortiz, Mario

    2016-01-01

    To question the usefulness of the lab analysis considered routine testing for the identification of abnormalities in the surgical care. To determine the percentage of unnecessary laboratory tests in the preoperative assessment as well as to estimate the unnecessary expenses. A descriptive, cross-sectional study of patients referred for surgical evaluation between January 1st and March 31st 2013. The database of laboratory testing and electronic files were reviewed. Reference criteria from surgical services were compared with the tests requested by the family doctor. In 65% of the patients (n=175) unnecessary examinations were requested, 25% (n=68) were not requested the tests that they required, and only 10% of the patients were requested laboratory tests in accordance with the reference criteria (n=27). The estimated cost in unnecessary examinations was $1,129,552 in a year. The results were similar to others related to this theme, however, they had not been revised from the perspective of the first level of attention regarding the importance of adherence to the reference criteria which could prevent major expenditures. It is a priority for leaders and operational consultants in medical units to establish strategies and lines of action that ensure compliance with institutional policies so as to contain spending on comprehensive services, and which in turn can improve the medical care. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  2. Body mass index and childhood obesity classification systems: A comparison of the French, International Obesity Task Force (IOTF) and World Health Organization (WHO) references.

    PubMed

    Kêkê, L M; Samouda, H; Jacobs, J; di Pompeo, C; Lemdani, M; Hubert, H; Zitouni, D; Guinhouya, B C

    2015-06-01

    This study aims to compare three body mass index (BMI)-based classification systems of childhood obesity: the French, the International Obesity Task Force (IOTF) and the World Health Organization (WHO) references. The study involved 1382 schoolchildren, recruited from the Lille Academic District in France in May 2009 aged 8.4±1.7 years (4.0-12.0 years). Their mean height and body mass were 131.5±10.9cm and 30.7±9.2kg, respectively, resulting in a BMI of 17.4±3.2kg/m(2). The weight status was defined according to the three systems considered in this study. The agreement between these references was tested using the Cohen's kappa coefficient. The prevalence of overweight was higher with the WHO references (20.0%) in comparison with the French references (13.8%; P<0.0001) and the IOTF (16.2%; P≤0.01). A similar result was found with obesity (WHO: 11.6% vs. IOTF: 6.7%; or French references: 6.7%; P<0.0001). Agreement between the three references ranged from "moderate" to "perfect" (0.43≤κ≤1.00; P<0.0001). Kappa coefficients were higher when the three references were used to classify children as obese (0.63≤κ≤1.00; P<0.0001) as compared to classification in the overweight (obesity excluded) category (0.43≤κ≤0.94; P<0.0001). When sex and age categories (4-6 years vs. 7-12 years) were considered to define the overweight status, the lowest kappa coefficient was found between the French and WHO references in boys aged 7-12 years (κ=0.28; P<0.0001), and the highest one in girls aged 7-12 years between the French references and IOTF (κ=0.97; P<0.0001). As for obesity, agreement between the three references ranged from 0.60 to 1.00 (P<0.0001), with the lowest values obtained in the comparison of the WHO references against French references or IOTF among boys aged 7-12 years (κ=0.60; P<0.0001). Overall, the WHO references yield an overestimation in overweight and/or obesity within this sample of schoolchildren as compared to the French references and the IOTF. The magnitude of agreement coefficients between the three references depends on of both sex and age categories. The French references seem to be in rather close agreement with the IOTF in defining overweight, especially in 7-12-year-old children. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  3. Internet-Based Cervical Cytology Screening Program

    DTIC Science & Technology

    2005-04-01

    and Second Trials of Each Pathologist. * Reference diagnostic category: NEG, ASCUS , LSIL > HSIL Pathologist 1 Interpretation. Negative or LSIL 24 (22...Principal Investigator: David C. Wdlbbur, M.D. Description of Subject Population: Women above the age of l18 years having Pap tests performe PURPOSE We...Subject Population: Women above the age of 18 years having Pay tests performed IRB Protocol Number: 2003P-001658 Sponsor Protocol Number: n/a Consent Form

  4. Age-specific MRI brain and head templates for healthy adults from 20 through 89 years of age

    PubMed Central

    Fillmore, Paul T.; Phillips-Meek, Michelle C.; Richards, John E.

    2015-01-01

    This study created and tested a database of adult, age-specific MRI brain and head templates. The participants included healthy adults from 20 through 89 years of age. The templates were done in five-year, 10-year, and multi-year intervals from 20 through 89 years, and consist of average T1W for the head and brain, and segmenting priors for gray matter (GM), white matter (WM), and cerebrospinal fluid (CSF). It was found that age-appropriate templates provided less biased tissue classification estimates than age-inappropriate reference data and reference data based on young adult templates. This database is available for use by other investigators and clinicians for their MRI studies, as well as other types of neuroimaging and electrophysiological research.1 PMID:25904864

  5. Dental age estimation in Japanese individuals combining permanent teeth and third molars.

    PubMed

    Ramanan, Namratha; Thevissen, Patrick; Fleuws, Steffen; Willems, G

    2012-12-01

    The study aim was, firstly, to verify the Willems et al. model on a Japanese reference sample. Secondly to develop a Japanese reference model based on the Willems et al. method and to verify it. Thirdly to analyze the age prediction performance adding tooth development information of third molars to permanent teeth. Retrospectively 1877 panoramic radiographs were selected in the age range between 1 and 23 years (1248 children, 629 sub-adults). Dental development was registered applying Demirjian 's stages of the mandibular left permanent teeth in children and Köhler stages on the third molars. The children's data were, firstly, used to validate the Willems et al. model (developed a Belgian reference sample), secondly, split ino a training and a test sample. On the training sample a Japanese reference model was developed based on the Willems method. The developed model and the Willems et al; model were verified on the test sample. Regression analysis was used to detect the age prediction performance adding third molar scores to permanent tooth scores. The validated Willems et al. model provided a mean absolute error of 0.85 and 0.75 years in females and males, respectively. The mean absolute error in the verified Willems et al. and the developed Japanese reference model was 0.85, 0.77 and 0.79, 0.75 years in females and males, respectively. On average a negligible change in root mean square error values was detected adding third molar scores to permanent teeth scores. The Belgian sample could be used as a reference model to estimate the age of the Japanese individuals. Combining information from the third molars and permanent teeth was not providing clinically significant improvement of age predictions based on permanent teeth information alone.

  6. Threshold values of physical performance tests for locomotive syndrome.

    PubMed

    Muramoto, Akio; Imagama, Shiro; Ito, Zenya; Hirano, Kenichi; Tauchi, Ryoji; Ishiguro, Naoki; Hasegawa, Yukiharu

    2013-07-01

    Our previous study determined which physical performance tests were the most useful for evaluating locomotive syndrome. Our current study establishes reference values for these major physical performance tests with regards to diagnosing and assessing risk of locomotive syndrome (LS). We measured timed-up-and-go test, one-leg standing time, back muscle strength, grip strength, 10-m gait time and maximum stride in 406 individuals (167 men, 239 women) between the ages of 60-88 years (mean 68.8 ± 6.7 years) during Yakumo Study 2011-12. The LS was defined as having a score of >16 points on the 25-Question Geriatric Locomotive Function Scale (GLFS-25). The reference value of each physical test was determined using receiver operating characteristics analysis. Women had a significantly higher prevalence of LS than men did and also scored significantly higher on the GLFS-25: women, 9.2 ± 10.3 pts; men, 6.7 ± 8.0 pts. Both genders in the non-LS group performed significantly better in all physical performance test gender except for back muscle strength in men and grip strength in both genders than those in the LS group, even after adjusting for age. The results of all the physical performance tests correlated significantly with the GLFS-25 scores of both genders even after adjusting for age except for grip strength. Reference values for TUG, one-leg standing time, back muscle strength, 10-m gait time, maximum stride and grip strength in men were 6.7 s, 21 s, 78 kg, 5.5 s and, 119 cm and 34 kg, respectively, and those for women were 7.5 s, 15 s, 40 kg, 6.2 s, 104 cm, and 22 kg, respectively. We established reference values for major physical performance tests used when assessing locomotive syndrome as defined by the GLFS-25. Our results can be used to characterize physical function and to help tailor an anti-LS training program for each individual.

  7. Establishing the reference value for “timed up-and-go” test in healthy adults of Gujarat, India

    PubMed Central

    Khant, Nency; Dani, Vyoma Bharat; Patel, Purvi; Rathod, Rachana

    2018-01-01

    CONTEXT: Timed up-and-go (TUG) test is a valid, reliable, and an objective test for quantifying functional mobility and assessing the fall risk in all age groups. The analysis of patient scores on TUG test is limited by lack of data, having a wide range of performance scores among people without disabilities. AIM: The objective of the study was to provide the reference value for TUG test in healthy individuals of Gujarat, India. SUBJECTS AND METHODS: It was a cross-sectional observational study. Five hundred and twenty healthy individuals, aged 40–70 years, were recruited from various regions of Gujarat based on convenient sampling. All the participants were made to perform TUG test in a controlled environment in community. Three readings of the actual test were obtained and averaged. RESULTS: Data were analyzed with mean, standard deviation, confidence intervals (CIs 95%) and Pearson's correlation coefficient (r) with α = 0.05 by age groups (40–50, 51–60, and 61–70 years) and gender. The mean (CI 95%) TUG time for healthy adults of Gujarat was 8.46 (8.35–8.57) s and demonstrated age-related decline for both male and female participants. TUG time also demonstrated strong correlation with the height of individuals. CONCLUSION: This preliminary data can be used as a reference only for specific population with specific age groups due to variability in test results among the different population due to age, gender, anthropometric measures such as height, weight, and body mass index, geographical variation, nutritional support, and cognitive status.

  8. Diagnostic Performance of a Molecular Test versus Clinician Assessment of Vaginitis.

    PubMed

    Schwebke, Jane R; Gaydos, Charlotte A; Nyirjesy, Paul; Paradis, Sonia; Kodsi, Salma; Cooper, Charles K

    2018-06-01

    Vaginitis is a common complaint, diagnosed either empirically or using Amsel's criteria and wet mount microscopy. This study sought to determine characteristics of an investigational test (a molecular test for vaginitis), compared to reference, for detection of bacterial vaginosis, Candida spp., and Trichomonas vaginalis Vaginal specimens from a cross-sectional study were obtained from 1,740 women (≥18 years old), with vaginitis symptoms, during routine clinic visits (across 10 sites in the United States). Specimens were analyzed using a commercial PCR/fluorogenic probe-based investigational test that detects bacterial vaginosis, Candida spp., and Trichomonas vaginalis Clinician diagnosis and in-clinic testing (Amsel's test, potassium hydroxide preparation, and wet mount) were also employed to detect the three vaginitis causes. All testing methods were compared to the respective reference methods (Nugent Gram stain for bacterial vaginosis, detection of the Candida gene its2 , and Trichomonas vaginalis culture). The investigational test, clinician diagnosis, and in-clinic testing were compared to reference methods for bacterial vaginosis, Candida spp., and Trichomonas vaginalis The investigational test resulted in significantly higher sensitivity and negative predictive value than clinician diagnosis or in-clinic testing. In addition, the investigational test showed a statistically higher overall percent agreement with each of the three reference methods than did clinician diagnosis or in-clinic testing. The investigational test showed significantly higher sensitivity for detecting vaginitis, involving more than one cause, than did clinician diagnosis. Taken together, these results suggest that a molecular investigational test can facilitate accurate detection of vaginitis. Copyright © 2018 Schwebke et al.

  9. Construction and utilization of a script concordance test as an assessment tool for DCEM3 (5th year) medical students in rheumatology.

    PubMed

    Mathieu, Sylvain; Couderc, Marion; Glace, Baptiste; Tournadre, Anne; Malochet-Guinamand, Sandrine; Pereira, Bruno; Dubost, Jean-Jacques; Soubrier, Martin

    2013-12-13

    The script concordance test (SCT) is a method for assessing clinical reasoning of medical students by placing them in a context of uncertainty such as they will encounter in their future daily practice. Script concordance testing is going to be included as part of the computer-based national ranking examination (iNRE).This study was designed to create a script concordance test in rheumatology and use it for DCEM3 (fifth year) medical students administered via the online platform of the Clermont-Ferrand medical school. Our SCT for rheumatology teaching was constructed by a panel of 19 experts in rheumatology (6 hospital-based and 13 community-based). One hundred seventy-nine DCEM3 (fifth year) medical students were invited to take the test. Scores were computed using the scoring key available on the University of Montreal website. Reliability of the test was estimated by the Cronbach alpha coefficient for internal consistency. The test comprised 60 questions. Among the 26 students who took the test (26/179: 14.5%), 15 completed it in its entirety. The reference panel of rheumatologists obtained a mean score of 76.6 and the 15 students had a mean score of 61.5 (p = 0.001). The Cronbach alpha value was 0.82. An online SCT can be used as an assessment tool for medical students in rheumatology. This study also highlights the active participation of community-based rheumatologists, who accounted for the majority of the 19 experts in the reference panel.A script concordance test in rheumatology for 5th year medical students.

  10. The Stayhealthy bioelectrical impedance analyzer predicts body fat in children and adults.

    PubMed

    Erceg, David N; Dieli-Conwright, Christina M; Rossuello, Amerigo E; Jensky, Nicole E; Sun, Stephanie; Schroeder, E Todd

    2010-05-01

    Bioelectrical impedance analysis (BIA) is a time-efficient and cost-effective method for estimating body composition. We hypothesized that there would be no significant difference between the Stayhealthy BC1 BIA and the selected reference methods when determining body composition. Thus, the purpose of the present study was to determine the validity of estimating percent body fat (%BF) using the Stayhealthy BIA with its most recently updated algorithms compared to the reference methods of dual-energy x-ray absorptiometry for adults and hydrostatic weighing for children. We measured %BF in 245 adults aged 18 to 80 years and 115 children aged 10 to 17 years. Body fat by BIA was determined using a single 50 kHz frequency handheld impedance device and proprietary software. Agreement between BIA and reference methods was assessed by Bland and Altman plots. Bland and Altman analysis for men, women, and children revealed good agreement between the reference methods and BIA. There was no significant difference by t tests between mean %BF by BIA for men, women, or children when compared to the respective reference method. Significant correlation values between BIA, and reference methods for all men, women, and children were 0.85, 0.88, and 0.79, respectively. Reliability (test-retest) was assessed by intraclass correlation coefficient and coefficient of variation. Intraclass correlation coefficient values were greater than 0.99 (P < .001) for men, women, and children with coefficient of variation values 3.3%, 1.8%, and 1.7%, respectively. The Stayhealthy BIA device demonstrated good agreement between reference methods using Bland and Altman analyses. Copyright 2010 Elsevier Inc. All rights reserved.

  11. Combined dietary and exercise intervention for control of serum cholesterol in the workplace

    NASA Technical Reports Server (NTRS)

    Angotti, C. M.; Chan, W. T.; Sample, C. J.; Levine, M. S.

    2000-01-01

    PURPOSE: To elucidate a potential combined dietary and exercise intervention affect on cardiovascular risk reduction of the National Aeronautics and Space Administration Headquarters employees. DESIGN: A nonexperimental, longitudinal, clinical-chart review study (1987 to 1996) of an identified intervention group and a reference (not a control) group. SETTING: The study group worked in an office environment and participated in the annual medical examinations. SUBJECTS: An intervention group of 858 people with initially elevated serum cholesterol, and a reference group of 963 people randomly sampled from 10% of the study group. MEASURES: Serum cholesterol data were obtained for both groups, respectively, from pre- and postintervention and annual examinations. The reference group was adjusted by statistical exclusion of potential intervention participants. Regression equations (cholesterol vs. study years) for the unadjusted/adjusted reference groups were tested for statistical significance. INTERVENTION: An 8-week individualized, combined dietary and exercise program was instituted with annual follow-ups and was repeated where warranted. RESULTS: Only the unadjusted (but not the adjusted) reference group with initial mean total serum cholesterol levels above 200 mg/dL shows a significant 9-year decline trend and significant beta coefficient tests. An intervention effect is suggested. Mean high density lipoprotein cholesterol rose slightly in the intervention group but was maintained in the reference group. CONCLUSION: With potential design limitations, the NASA intervention program focusing on a high risk group may be associated to some degree, if not fully, with an overall cardiovascular risk profile improvement.

  12. Reference Values for Cardiorespiratory Fitness and Incidence of Type 2 Diabetes

    PubMed Central

    Kawakami, Ryoko; Sawada, Susumu S.; Matsushita, Munehiro; Okamoto, Takashi; Tsukamoto, Koji; Higuchi, Mitsuru; Miyachi, Motohiko

    2014-01-01

    Background In “Physical Activity Reference for Health Promotion 2013” the Japan Ministry of Health, Labour and Welfare publication gives reference values for cardiorespiratory fitness (CRF) required for good health. We examined the associations between the CRF reference values and incidence of type 2 diabetes. Methods This prospective cohort study enrolled 4633 nondiabetic Japanese men aged 20 to 39 years at baseline. CRF was measured using the cycle ergometer test, and maximal oxygen uptake was estimated. On the basis of the CRF reference value, participants were classified into 2 groups: those with values less than the reference value (under-RV) and those with values equal to or greater than reference value (over-RV). Hazard ratios (HRs) and 95% CIs for incident type 2 diabetes were estimated using a Cox proportional hazards model. Results A total of 266 participants developed type 2 diabetes during the 14 years of follow-up. As compared with the under-RV group, the over-RV group had a significantly lower multivariable-adjusted HR for type 2 diabetes (HR 0.67; 95% CI, 0.51–0.89). In receiver operating characteristic analysis, the optimal CRF cut-off value for predicting incident type 2 diabetes was 10.8 metabolic equivalents (sensitivity, 0.64; specificity, 0.64), which was close to the CRF reference value of 11.0 metabolic equivalents. Conclusions The reference CRF value appears to be reasonably valid for prevention of type 2 diabetes, especially among Japanese men younger than 40 years. Development of type 2 diabetes can be prevented by maintaining a CRF level above the reference value. PMID:24240630

  13. Commonly used reference values underestimate oxygen uptake in healthy, 50-year-old Swedish women.

    PubMed

    Genberg, M; Andrén, B; Lind, L; Hedenström, H; Malinovschi, A

    2018-01-01

    Cardiopulmonary exercise testing (CPET) is the gold standard among clinical exercise tests. It combines a conventional stress test with measurement of oxygen uptake (V O 2 ) and CO 2 production. No validated Swedish reference values exist, and reference values in women are generally understudied. Moreover, the importance of achieved respiratory exchange ratio (RER) and the significance of breathing reserve (BR) at peak exercise in healthy individuals are poorly understood. We compared V O 2 at maximal load (peakV O 2 ) and anaerobic threshold (V O 2@ AT ) in healthy Swedish individuals with commonly used reference values, taking gender into account. Further, we analysed maximal workload and peakV O 2 with regard to peak RER and BR. In all, 181 healthy, 50-year-old individuals (91 women) performed CPET. PeakV O 2 was best predicted using Jones et al. (100·5%), while SHIP reference values underestimated peakV O 2 most: 112·5%. Furthermore, underestimation of peakV O 2 in women was found for all studied reference values (P<0·001) and was largest for SHIP: women had 128% of predicted peakV O 2 , while men had 104%. PeakV O 2 was similar in subjects with peak RER of 1-1·1 and RER > 1·1 (2 328·7 versus 2 176·7 ml min -1 , P = 0·11). Lower BR (≤30%) related to significantly higher peakV O 2 (P<0·001). In conclusion, peakV O 2 was best predicted by Jones. All studied reference values underestimated oxygen uptake in women. No evidence for demanding RER > 1·1 in healthy individuals was found. A lowered BR is probably a normal response to higher workloads in healthy individuals. © 2016 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  14. Change of reference frame for tactile localization during child development.

    PubMed

    Pagel, Birthe; Heed, Tobias; Röder, Brigitte

    2009-11-01

    Temporal order judgements (TOJ) for two tactile stimuli, one presented to the left and one to the right hand, are less precise when the hands are crossed over the midline than when the hands are uncrossed. This 'crossed hand' effect has been considered as evidence for a remapping of tactile input into an external reference frame. Since late, but not early, blind individuals show such remapping, it has been hypothesized that the use of an external reference frame develops during childhood. Five- to 10-year-old children were therefore tested with the tactile TOJ task, both with uncrossed and crossed hands. Overall performance in the TOJ task improved with age. While children older than 5 1/2 years displayed a crossed hand effect, younger children did not. Therefore the use of an external reference frame for tactile, and possibly multisensory, localization seems to be acquired at age 5.

  15. Toxicity Reference Database

    EPA Pesticide Factsheets

    The Toxicity Reference Database (ToxRefDB) contains approximately 30 years and $2 billion worth of animal studies. ToxRefDB allows scientists and the interested public to search and download thousands of animal toxicity testing results for hundreds of chemicals that were previously found only in paper documents. Currently, there are 474 chemicals in ToxRefDB, primarily the data rich pesticide active ingredients, but the number will continue to expand.

  16. Low agreement between the fitnessgram criterion references for adolescents

    PubMed Central

    Coledam, Diogo Henrique Constantino; Batista, João Pedro; Glaner, Maria Fátima

    2015-01-01

    OBJECTIVE: To analyze the association and agreement of fitnessgram reference criteria (RC) for cardiorespiratory fitness, body mass index (BMI) and strength in youth. METHODS: The study included 781 youth, 386 females, aged 10 to 18 years of Londrina-PR. It were performed cardiorespiratory fitness and muscular strength tests and was calculated body mass index. The association between the tests was analyzed using Poisson regression to obtain prevalence ratio (PR) and confidence intervals of 95%, while agreement of the reference criteria was tested by Kappa index. RESULTS: Significant associations were found between cardiorespiratory fitness and BMI (PR=1,49, 1,27-1,75), muscle strength and BMI (PR=1,55, 1,17-2,08), cardiorespiratory fitness and muscle strength (PR=1,81, 1,47-2,24). The agreement between reference criteria ranged from weak to fair, 48.8% (k=0.05, p=0.10) for cardiorespiratory fitness and BMI, 52.9% (k=0.09, p=0.001) for muscle strength and BMI and 38.4% (k=0.22, p<0.001) for cardiorespiratory fitness and muscle strength. CONCLUSIONS: Although RC for cardiorespiratory fitness, muscle strength and BMI are associated, the agreement between them ranged from weak to fair. To evaluate health related physical fitness it is suggest the execution of all tests, since each test has specific characteristics. PMID:25649383

  17. Nondestructive testing techniques

    NASA Astrophysics Data System (ADS)

    Bray, Don E.; McBride, Don

    A comprehensive reference covering a broad range of techniques in nondestructive testing is presented. Based on years of extensive research and application at NASA and other government research facilities, the book provides practical guidelines for selecting the appropriate testing methods and equipment. Topics discussed include visual inspection, penetrant and chemical testing, nuclear radiation, sonic and ultrasonic, thermal and microwave, magnetic and electromagnetic techniques, and training and human factors. (No individual items are abstracted in this volume)

  18. Evaluation of new technologies for the LISA gravitational reference sensor using the UF torsion pendulum

    NASA Astrophysics Data System (ADS)

    Conklin, John; Chilton, Andrew; Olatunde, Taiwo; Apple, Stephen; Aitken, Michael; Ciani, Giacomo; Mueller, Guido

    2016-01-01

    The Laser Interferometer Space Antenna (LISA) is the most mature concept for detecting gravitational waves from space. The LISA design has been studied for more than 20 years as a joint effort between NASA and the European Space Agency. LISA consists of three Sun-orbiting spacecraft that form an equilateral triangle, with each side measuring 1-5 million kilometers in length. Each spacecraft houses two free-floating test masses, which are protected from all disturbing forces so that they follow pure geodesics. A single test mass together with its protective housing and associated components is referred to as a gravitational reference sensor. A drag-free control system is supplied with measurements of the test mass position from these sensors and commands external micronewton thrusters to force the spacecraft to fly in formation with the test masses. Laser interferometry is used to measure the minute variations in the distance, or light travel time, between these purely free-falling TMs, caused by gravitational waves. We have constructed a new torsion pendulum facility with a force sensitivity in the range of pN/Hz1/2 around 1 mHz for testing new gravitational reference sensor technologies. This experimental facility consists of a vacuum enclosed torsion pendulum that suspends mock-ups of the LISA test masses, surrounded by their electrode housings. With the aid of this facility, we are (a) developing a novel test mass charge control scheme based on ultraviolet LEDs, (b) examining alternate test mass and electrode housing coatings, and (c) evaluating alternate operational modes of the LISA gravitational reference sensor. This presentation will describe this facility and the development status of these new technologies.

  19. Reference values for developing responsive functional outcome measures across the lifespan.

    PubMed

    McKay, Marnee J; Baldwin, Jennifer N; Ferreira, Paulo; Simic, Milena; Vanicek, Natalie; Burns, Joshua

    2017-04-18

    To generate a reference dataset of commonly performed functional outcome measures in 1,000 children and adults and investigate the influence of demographic, anthropometric, strength, and flexibility characteristics. Twelve functional outcome measures were collected from 1,000 healthy individuals aged 3-101 years: 6-minute walk test, 30-second chair stand test, timed stairs test, long jump, vertical jump, choice stepping reaction time, balance (Star Excursion Balance Test, tandem stance eyes open and closed, single-leg stance eyes closed), and dexterity (9-hole peg test, Functional Dexterity Test). Correlation and multiple regression analyses were performed to identify factors independently associated with each measure. Age- and sex-stratified reference values for functional outcome measures were generated. Functional performance increased through childhood and adolescence, plateaued during adulthood, and declined in older adulthood. While balance did not differ between the sexes, male participants generally performed better at gross motor tasks while female participants performed better at dexterous tasks. Height was the most consistent correlate of functional performance in children, while lower limb muscle strength was a major determinant in adolescents and adults. In older adults, age, lower limb strength, and joint flexibility explained up to 63% of the variance in functional measures. These normative reference values provide a framework to accurately track functional decline associated with neuromuscular disorders and assist development and validation of responsive outcome measures for therapeutic trials. © 2017 American Academy of Neurology.

  20. Effects of sarin on the nervous system in rescue team staff members and police officers 3 years after the Tokyo subway sarin attack.

    PubMed

    Nishiwaki, Y; Maekawa, K; Ogawa, Y; Asukai, N; Minami, M; Omae, K

    2001-11-01

    Although the clinical manifestations of acute sarin poisoning have been reported in detail, no comprehensive study of the chronic physical and psychiatric effects of acute sarin poisoning has been carried out. To clarify the chronic effects of sarin on the nervous system, a cross-sectional epidemiologic study was conducted 3 years after the Tokyo subway sarin attack. Subjects consisted of the rescue team staff members and police officers who had worked at the disaster site. Subjects consisted of 56 male exposed subjects and 52 referent subjects matched for age and occupation. A neurobehavioral test, stabilometry, and measurement of vibration perception thresholds were performed, as well as psychometric tests to assess traumatic stress symptoms. The exposed group performed less well in the backward digit span test than the referent group in a dose-effect manner. This result was the same after controlling for possible confounding factors and was independent of traumatic stress symptoms. In other tests of memory function, except for the Benton visual retention test (mean correct answers), effects related to exposure were also suggested, although they were not statistically significant. In contrast, the dose-effect relationships observed in the neurobehavioral tests (psychomotor function) were unclear. None of the stabilometry and vibration perception threshold parameters had any relation to exposure. Our findings suggest the chronic decline of memory function 2 years and 10 months to 3 years and 9 months after exposure to sarin in the Tokyo subway attack, and further study is needed.

  1. Effects of sarin on the nervous system in rescue team staff members and police officers 3 years after the Tokyo subway sarin attack.

    PubMed Central

    Nishiwaki, Y; Maekawa, K; Ogawa, Y; Asukai, N; Minami, M; Omae, K

    2001-01-01

    Although the clinical manifestations of acute sarin poisoning have been reported in detail, no comprehensive study of the chronic physical and psychiatric effects of acute sarin poisoning has been carried out. To clarify the chronic effects of sarin on the nervous system, a cross-sectional epidemiologic study was conducted 3 years after the Tokyo subway sarin attack. Subjects consisted of the rescue team staff members and police officers who had worked at the disaster site. Subjects consisted of 56 male exposed subjects and 52 referent subjects matched for age and occupation. A neurobehavioral test, stabilometry, and measurement of vibration perception thresholds were performed, as well as psychometric tests to assess traumatic stress symptoms. The exposed group performed less well in the backward digit span test than the referent group in a dose-effect manner. This result was the same after controlling for possible confounding factors and was independent of traumatic stress symptoms. In other tests of memory function, except for the Benton visual retention test (mean correct answers), effects related to exposure were also suggested, although they were not statistically significant. In contrast, the dose-effect relationships observed in the neurobehavioral tests (psychomotor function) were unclear. None of the stabilometry and vibration perception threshold parameters had any relation to exposure. Our findings suggest the chronic decline of memory function 2 years and 10 months to 3 years and 9 months after exposure to sarin in the Tokyo subway attack, and further study is needed. PMID:11713003

  2. Detection of Human Papillomavirus among Women with Atypical Squamous Cells of Undetermined Significance Referred to Colposcopy: Implications for Clinical Management in Low and MiddleIncome Countries.

    PubMed

    de Abreu, Andre Lp; Gimenes, Fabricia; Malaguti, Natalia; Pereira, Monalisa W; Uchimura, Nelson S; Consolaro, Marcia El

    2016-01-01

    To determine the prevalence of human papillomavirus (HPV) among women with atypical squamous cells of undetermined significance (ASC-US) referred to colposcopy and the implications for clinical management in low- and middle-income countries (LMIC), the present study was conducted. We included 200 women living in Maringa÷Brazil referred to colposcopy service between August 2012 and March 2013 due to an abnormal cytology from ASC-US until high-grade intraepithelial lesion (HSIL). HPV was detected and genotyped by polymerase chain reaction (PCR). The mean age was 36.8±10.5 years, and women with and without ASC-US had similar mean ages (37.4±11.5 and 36.4±9.96 years, respectively). The highest prevalence of ASC-US occurred at 20-24 years (40%). HPV-DNA was positive in 164 (82.0%) women.Of the 57 women with ASC-US, 30 (52.6%) were HPV-DNA-positive and 21 (70%) were high-risk HPV-positive (HR-HPV); the latter was similar to women without ASC-US (76.9%) but with other abnormal cytological findings present. Our data demonstrated that performing tests for HR-HPV can be used for management of women with ASC-US to support the decision of which women should be referred for an immediate or later colposcopy. The same conclusions can be applied to other LMICs for which HPV testing for primary screening has not been adopted.

  3. A Decline in Numeracy Skills among Bioscience Undergraduates.

    ERIC Educational Resources Information Center

    Tariq, Vicki N.

    2002-01-01

    Provides evidence of a decline in basic numeracy skills among first-year bioscience undergraduate students. Tests conceptualized numeracy skills which form a component of an introductory microbiology module. (Contains 23 references.) (Author/YDS)

  4. Simply Gifted: Their Attributes through the Eyes of College Students

    ERIC Educational Resources Information Center

    Gentry, Ruben; Lackey, Tracy Knight

    2011-01-01

    For years, scores on IQ tests and standardized achievement tests were the principal means for determining whether or not persons were gifted. Early literature often referred to them as fluent, flexible, original, and elaborate thinkers; as persons who were extremely curious, sensitive, attracted to aesthetic values; and as individuals who could…

  5. Forecasting Techniques and Library Circulation Operations: Implications for Management.

    ERIC Educational Resources Information Center

    Ahiakwo, Okechukwu N.

    1988-01-01

    Causal regression and time series models were developed using six years of data for home borrowing, average readership, and books consulted at a university library. The models were tested for efficacy in producing short-term planning and control data. Combined models were tested in establishing evaluation measures. (10 references) (Author/MES)

  6. Effects of ventilation behaviour on indoor heat load based on test reference years.

    PubMed

    Rosenfelder, Madeleine; Koppe, Christina; Pfafferott, Jens; Matzarakis, Andreas

    2016-02-01

    Since 2003, most European countries established heat health warning systems to alert the population to heat load. Heat health warning systems are based on predicted meteorological conditions outdoors. But the majority of the European population spends a substantial amount of time indoors, and indoor thermal conditions can differ substantially from outdoor conditions. The German Meteorological Service (Deutscher Wetterdienst, DWD) extended the existing heat health warning system (HHWS) with a thermal building simulation model to consider heat load indoors. In this study, the thermal building simulation model is used to simulate a standardized building representing a modern nursing home, because elderly and sick people are most sensitive to heat stress. Different types of natural ventilation were simulated. Based on current and future test reference years, changes in the future heat load indoors were analyzed. Results show differences between the various ventilation options and the possibility to minimize the thermal heat stress during summer by using an appropriate ventilation method. Nighttime ventilation for indoor thermal comfort is most important. A fully opened window at nighttime and the 2-h ventilation in the morning and evening are more sufficient to avoid heat stress than a tilted window at nighttime and the 1-h ventilation in the morning and the evening. Especially the ventilation in the morning seems to be effective to keep the heat load indoors low. Comparing the results for the current and the future test reference years, an increase of heat stress on all ventilation types can be recognized.

  7. Effects of ventilation behaviour on indoor heat load based on test reference years

    NASA Astrophysics Data System (ADS)

    Rosenfelder, Madeleine; Koppe, Christina; Pfafferott, Jens; Matzarakis, Andreas

    2016-02-01

    Since 2003, most European countries established heat health warning systems to alert the population to heat load. Heat health warning systems are based on predicted meteorological conditions outdoors. But the majority of the European population spends a substantial amount of time indoors, and indoor thermal conditions can differ substantially from outdoor conditions. The German Meteorological Service (Deutscher Wetterdienst, DWD) extended the existing heat health warning system (HHWS) with a thermal building simulation model to consider heat load indoors. In this study, the thermal building simulation model is used to simulate a standardized building representing a modern nursing home, because elderly and sick people are most sensitive to heat stress. Different types of natural ventilation were simulated. Based on current and future test reference years, changes in the future heat load indoors were analyzed. Results show differences between the various ventilation options and the possibility to minimize the thermal heat stress during summer by using an appropriate ventilation method. Nighttime ventilation for indoor thermal comfort is most important. A fully opened window at nighttime and the 2-h ventilation in the morning and evening are more sufficient to avoid heat stress than a tilted window at nighttime and the 1-h ventilation in the morning and the evening. Especially the ventilation in the morning seems to be effective to keep the heat load indoors low. Comparing the results for the current and the future test reference years, an increase of heat stress on all ventilation types can be recognized.

  8. Long-Term Stability of the NIST Conical Reference Transducer.

    PubMed

    Fick, Steven E; Proctor, Thomas M

    2011-01-01

    The National Institute of Standards and Technology (NIST) Conical Reference Transducer (CRT) is designed for purposes requiring frequency response characteristics much more uniform than those attainable with ultrasonic transducers conventionally used for acoustic emission (AE) nondestructive testing. The high performance of the CRT results from the use of design elements radically different from those of conventional transducers. The CRT was offered for sale for 15 years (1985 to 2000). Each CRT was furnished with data which expressed, as a function of frequency, the transducer sensitivity in volts per micrometer of normal displacement on the test block. Of the 22 transducers constructed, eight were reserved for long term research and were stored undisturbed in a laboratory with well controlled temperature and humidity. In 2009, the sensitivities of these eight units were redetermined. The 2009 data have been compared with data from similar tests conducted in 1985. The results of this comparison verify the claim "Results of tests of the long term stability of CRT characteristics indicate that, if proper care is taken, tens of years of service can reasonably be expected." made in the CRT specifications document furnished to prospective customers.

  9. Who is who: Italian norms for visual recognition and identification of celebrities.

    PubMed

    Bizzozero, I; Ferrari, F; Pozzoli, S; Saetti, M C; Spinnler, H

    2005-06-01

    Age-, education- and sex-adjusted norms are provided for two new neuropsychological tests, namely (i) Face Recognition (guess of familiarity) and (ii) Person Identification (biographical contextualisation). Sixty-three pictures of celebrities and 63 of unknown people were selected following two interwoven criteria(1): the realm of their celebrity (i.e., entertainment, culture and politics) and the period of celebrity acquisition (i.e., pre-war, post-war and contemporary). Both media- and education-dependent knowledge of celebrity were considered. Ninety-eight unpaid healthy participants aged between 50 and 93 years and with at least 8 years of formal education took part in this study. Reference is made to serial models of familiar face/persons processing. Recognition is held to tackle the activity of Personal Identity Nodes (PINs) and identification of the Exemplar Semantics Archives. Given the seriality of the reference model, the Identification Test is embedded in the Recognition test. This entailed that only previously recognised faces were employed to achieve norms for identification.

  10. [Standardisation of a battery of tests to evaluate language comprehension, verbal fluency and naming skills in Brazilian children between 7 and 10 years of age: preliminary findings].

    PubMed

    Malloy-Diniz, L Fernandes; Bentes, R C; Figuereido, P M; Brandao-Bretas, D; da Costa-Abrantes, S; Parizzi, A M; Borges-Leite, W; Salgado, J V

    The neuropsychological assessment of language requires instruments that evaluate its receptive and expressive aspects. Due to cultural discrepancies, the use of neuropsychological tests demands normalization studies to the population in which they will be used. To provide normative data for Brazilian schoolchildren in relation to the Token Test, Semantic Verbal Fluency Test and the Minas Gerais Naming Test (animals, body parts and food categories). 101 children (51 males, 50 females) with ages between 7 to 10 years (mean: 8 years and 8 months), with 2 to 4 years of formal education. Exclusion criteria included score below 25 percentile in the Raven Test. RESULTS. There were no differences between male and female performance. Age was significantly related to performance in all tests. The results are compatible to the literature and, thought preliminary, they may be used as reference in research and clinical settings in our country.

  11. Content or connectedness? Mother-child talk and early social understanding.

    PubMed

    Ensor, Rosie; Hughes, Claire

    2008-01-01

    Despite much research into individual differences in social understanding among preschoolers, little is known about corresponding individual differences within younger children. Likewise, although studies of preschoolers highlight the importance of mental-state references, other aspects of talk have received less attention. The current study involved 120 families with 2-year-olds; video-based transcripts of observations of family interaction were coded for quantity, connectedness, and content of mothers' and children's talk. At 2, 3, and 4 years of age, children completed social understanding and verbal ability tests. Mothers' connected turns and mental-state reference within connected turns showed independent associations with children's social understanding (as did children's mental-state references, both overall and within connected turns). Connected conversations provide a fertile context for children's developing social understanding.

  12. Costs, effectiveness, and workload impact of management strategies for women with an adnexal mass.

    PubMed

    Havrilesky, Laura J; Dinan, Michaela; Sfakianos, Gregory P; Curtis, Lesley H; Barnett, Jason C; Van Gorp, Toon; Myers, Evan R

    2015-01-01

    We compared the estimated clinical outcomes, costs, and physician workload resulting from available strategies for deciding which women with an adnexal mass should be referred to a gynecologic oncologist. We used a microsimulation model to compare five referral strategies: 1) American Congress of Obstetricians and Gynecologists (ACOG) guidelines, 2) Multivariate Index Assay (MIA) algorithm, 3) Risk of Malignancy Algorithm (ROMA), 4) CA125 alone with lowered cutoff values to prioritize test sensitivity over specificity, 5) referral of all women (Refer All). Test characteristics and relative survival were obtained from the literature and data from a biomarker validation study. Medical costs were estimated using Medicare reimbursements. Travel costs were estimated using discharge data from Surveillance, Epidemiology and End Results-Medicare and State Inpatient Databases. Analyses were performed separately for pre- and postmenopausal women (60 000 "subjects" in each), repeated 10 000 times. Refer All was cost-effective compared with less expensive strategies in both postmenopausal (incremental cost-effectiveness ratio [ICER] $9423/year of life saved (LYS) compared with CA125) and premenopausal women (ICER $10 644/YLS compared with CA125), but would result in an additional 73 cases/year/subspecialist. MIA was more expensive and less effective than Refer All in pre- and postmenopausal women. If Refer All is not a viable option, CA125 is an optimal strategy in postmenopausal women. Referral of all women to a subspecialist is an efficient strategy for managing women with adnexal masses requiring surgery, assuming sufficient capacity for additional surgical volume. If a test-based triage strategy is needed, CA125 with lowered cutoff values is a cost-effective strategy. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  13. Sleep Disorders and Their Management in Children With Ehlers-Danlos Syndrome Referred to Sleep Clinics.

    PubMed

    Domany, Keren Armoni; Hantragool, Sumalee; Smith, David F; Xu, Yuanfang; Hossain, Monir; Simakajornboon, Narong

    2018-04-15

    The nature of sleep disorders in children with Ehlers-Danlos syndrome (EDS) is unknown. We aimed to describe the type, the management, and the short-term outcome of sleep disorders in children with EDS referred to sleep clinics. This is a retrospective review of medical records and polysomnography tests of children with EDS younger than 18 years who were referred to the sleep clinic. Demographic information and medical history were collected, and polysomnography tests were reviewed. Questionnaires completed during previous clinic visits, including the Pediatrics Sleep Questionnaire (PSQ), Epworth Sleepiness Scale (ESS), and Pediatric Quality of Life Inventory (PedsQL), were also evaluated. Sixty-five patients with EDS-hypermobility type were included. The mean age was 13.15 ± 3.9 years. There were 68% of patients who were female, and 91% of patients were Caucasian. The mean follow-up period was 1.14 ± 1.55 years. Common sleep diagnoses included insomnia (n = 14, 22%), obstructive sleep apnea (OSA) (n = 17, 26%), periodic limb movement disorder (PLMD) (n = 11, 17%), and hypersomnia (n = 10, 15%). In addition, 65% required pharmacologic treatment and 29% were referred to behavioral sleep medicine. For OSA, two patients required continuous positive airway pressure. A significant improvement was observed in the PSQ, ESS, and PedsQL scores during follow-up visits after treatment (n = 34; P = .0004, 0.03, and 0.01, respectively). There is a high prevalence of sleep disorders, including OSA, insomnia, PLMD, and hypersomnia in children with EDS referred to sleep clinics. Specific management can improve quality of life and questionnaire scores of this patient population. Our study emphasizes the importance of screening for sleep disorders in children with EDS. © 2018 American Academy of Sleep Medicine.

  14. Relationships Between School District Level Inputs and the Output Performance of Students on the Missouri Basic Essential Skills Test.

    ERIC Educational Resources Information Center

    Freeman, Vera E.; Hatley, Richard V.

    Missouri requires the testing of all eighth grade students on their competence in reading and language arts, mathematics, and government and economics. This statewide assessment is referred to as the Missouri Basic Essential Skills Test (BEST) and has been given in the spring of each year since 1978. A study was undertaken to determine which…

  15. The Longitudinal Impact of Cognitive Speed of Processing Training on Driving Mobility

    PubMed Central

    Edwards, Jerri D.; Myers, Charlsie; Ross, Lesley A.; Roenker, Daniel L.; Cissell, Gayla M.; McLaughlin, Alexis M.; Ball, Karlene K.

    2009-01-01

    Purpose: To examine how cognitive speed of processing training affects driving mobility across a 3-year period among older drivers. Design and Methods: Older drivers with poor Useful Field of View (UFOV) test performance (indicating greater risk for subsequent at-fault crashes and mobility declines) were randomly assigned to either a speed of processing training or a social and computer contact control group. Driving mobility of these 2 groups was compared with a group of older adults who did not score poorly on the UFOV test (reference group) across a 3-year period. Results: Older drivers with poor UFOV test scores who did not receive training experienced greater mobility declines as evidenced by decreased driving exposure and space and increased driving difficulty at 3 years. Those at risk for mobility decline who received training did not differ across the 3-year period from older adults in the reference group with regard to driving exposure, space, and most aspects of driving difficulty. Implications: Cognitive speed of processing training can not only improve cognitive performance but also protect against mobility declines among older drivers. Scientifically proven cognitive training regimens have the potential to enhance the everyday lives of older adults. PMID:19491362

  16. Integrated Aeroservoelastic Optimization: Status and Direction

    NASA Technical Reports Server (NTRS)

    Livne, Eli

    1999-01-01

    The interactions of lightweight flexible airframe structures, steady and unsteady aerodynamics, and wide-bandwidth active controls on modern airplanes lead to considerable multidisciplinary design challenges. More than 25 years of mathematical and numerical methods' development, numerous basic research studies, simulations and wind-tunnel tests of simple models, wind-tunnel tests of complex models of real airplanes, as well as flight tests of actively controlled airplanes, have all contributed to the accumulation of a substantial body of knowledge in the area of aeroservoelasticity. A number of analysis codes, with the capabilities to model real airplane systems under the assumptions of linearity, have been developed. Many tests have been conducted, and results were correlated with analytical predictions. A selective sample of references covering aeroservoelastic testing programs from the 1960s to the early 1980s, as well as more recent wind-tunnel test programs of real or realistic configurations, are included in the References section of this paper. An examination of references 20-29 will reveal that in the course of development (or later modification), of almost every modern airplane with a high authority active control system, there arose a need to face aeroservoelastic problems and aeroservoelastic design challenges.

  17. Current strategies for monitoring men with localised prostate cancer lack a strong evidence base: observational longitudinal study.

    PubMed

    Metcalfe, C; Tilling, K; Davis, M; Lane, J A; Martin, R M; Kynaston, H; Powell, P; Neal, D E; Hamdy, F; Donovan, J L

    2009-08-04

    The UK National Institute for Health and Clinical Excellence (NICE) guidance recommends conservative management of men with 'low-risk' localised prostate cancer, monitoring the disease using prostate-specific antigen (PSA) kinetics and re-biopsy. However, there is little evidence of the changes in PSA level that should alert to the need for clinical re-assessment. This study compares the alerts resulting from PSA kinetics and a novel longitudinal reference range approach, which incorporates age-related changes, during the monitoring of 408 men with localised prostate cancer. Men were monitored by regular PSA tests over a mean of 2.9 years, recording when a man's PSA doubling time fell below 2 years, PSA velocity exceeded 2 ng ml(-1) per year, or when his upper 10% reference range was exceeded. Prostate-specific antigen doubling time and PSA velocity alerted a high proportion of men initially but became unresponsive to changes with successive tests. Calculating doubling time using recent PSA measurements reduced the decline in response. The reference range method maintained responsiveness to changes in PSA level throughout the monitoring. The increasing unresponsiveness of PSA kinetics is a consequence of the underlying regression model. Novel methods are needed for evaluation in cohorts currently being managed by monitoring. Meanwhile, the NICE guidance should be cautious.

  18. Geochemical anomalies from bottom ash in a road construction--comparison of the leaching potential between an ash road and the surroundings.

    PubMed

    Lind, Bo B; Norrman, Jenny; Larsson, Lennart B; Ohlsson, Sten-Ake; Bristav, Henrik

    2008-01-01

    A study was performed between June 2001 and December 2004 with the primary objective of assessing long-term leaching from municipal solid waste incineration bottom ash in a test road construction in relation to a reference road made up of conventional materials and the natural geochemical conditions in the surroundings. The metal leaching from the test road and the reference road was compared with the natural weathering in the regional surroundings for three time scales: 16, 80 and 1000 years. The results show that Cu and Zn cause a geochemical anomaly from the test road compared with the surroundings. The leaching of Cu from the test road is initially high but will decline with time and will in the long term be exceeded by natural weathering. Zn on the other hand has low initial leaching, which will increase with time and will in the long term exceed that of the test road and the surroundings by a factor of 100-300. For the other metals studied, Al, Na, K and Mg, there is only very limited leaching over time and the potential accumulation will not exceed the background values in a 1000 years.

  19. Previous radiographic experience of children referred for dental extractions under general anaesthesia in the U.K.

    PubMed

    Young, N L; Rodd, H D; Craig, S A

    2009-03-01

    To determine what proportion of children undergo radiographic assessment prior to referral to a dental hospital for extractions under general anaesthesia. This prospective survey was conducted over a 6-month period. A data sheet was used to record the following information: patient's age; referrer's name and place of work (general dental practice or community dental service); teeth to be extracted (primary dentition and/or permanent dentition) and reported previous radiographic examination. Patients were excluded from the study if, following a clinical examination, radiographs were not actually deemed necessary for diagnosis and treatment planning purposes. Clinical setting A paediatric dentistry clinic within a dental hospital in the North of England. Participants 161 patients with a mean age of six years (SD = 2.2, range = 3-14 years) who were referred to the dental hospital for extractions under general anaesthesia. Overall, 12.4% of children had reportedly undergone a previous radiographic assessment prior to hospital referral. A significantly greater proportion of children referred for permanent tooth extractions had been subject to radiographic examination compared to children referred for primary tooth extractions (46.2% as compared to 6.3%; P = 0.001 chi-squared test). Furthermore, patients referred from the community dental service were significantly more likely to have had previous dental radiographs than children referred from general dental practice (36.9% compared to 9.3%; P = 0.003 chi-squared test). Radiographs do not appear to be routinely employed for caries diagnosis and treatment planning in young children within general dental practice in the U.K.

  20. Establishment of Biological Reference Intervals and Reference Curve for Urea by Exploratory Parametric and Non-Parametric Quantile Regression Models.

    PubMed

    Sarkar, Rajarshi

    2013-07-01

    The validity of the entire renal function tests as a diagnostic tool depends substantially on the Biological Reference Interval (BRI) of urea. Establishment of BRI of urea is difficult partly because exclusion criteria for selection of reference data are quite rigid and partly due to the compartmentalization considerations regarding age and sex of the reference individuals. Moreover, construction of Biological Reference Curve (BRC) of urea is imperative to highlight the partitioning requirements. This a priori study examines the data collected by measuring serum urea of 3202 age and sex matched individuals, aged between 1 and 80 years, by a kinetic UV Urease/GLDH method on a Roche Cobas 6000 auto-analyzer. Mann-Whitney U test of the reference data confirmed the partitioning requirement by both age and sex. Further statistical analysis revealed the incompatibility of the data for a proposed parametric model. Hence the data was non-parametrically analysed. BRI was found to be identical for both sexes till the 2(nd) decade, and the BRI for males increased progressively 6(th) decade onwards. Four non-parametric models were postulated for construction of BRC: Gaussian kernel, double kernel, local mean and local constant, of which the last one generated the best-fitting curves. Clinical decision making should become easier and diagnostic implications of renal function tests should become more meaningful if this BRI is followed and the BRC is used as a desktop tool in conjunction with similar data for serum creatinine.

  1. Bioequivalence of generic lamotrigine 100-mg tablets in healthy Thai male volunteers: a randomized, single-dose, two-period, two-sequence crossover study.

    PubMed

    Srichaiya, Arunee; Longchoopol, Chaowanee; Oo-Puthinan, Sarawut; Sayasathid, Jarun; Sripalakit, Pattana; Viyoch, Jarupa

    2008-10-01

    Lamotrigine is an antiepileptic drug which has been used in the treatment of epilepsy and bipolar disorder. A search of the literature did not find previously published bioequivalence and pharmacokinetic evaluations of lamotrigine in healthy Thai male volunteers. The aim of this study was to compare the pharmacokinetic parameters between 2 brands of lamotrigine in healthy Thai male volunteers. A randomized, single-dose, 2-period, 2-sequence, crossover study design with a 2-week washout period was conducted in healthy Thai males. Subjects were randomized to receive either the test or reference formulation in the first period. All subjects were required to be nonsmokers and without a history of alcohol or drug abuse. Plasma samples were collected over a 120-hour period after 100-mg lamotrigine administration in each period. A validated high-performance liquid chromatography ultraviolet method was used to analyze lamotrigine concentration in plasma. Pharmacokinetic parameters were determined using a noncompartmental method. Bioequivalence between the test and reference products, as defined by the US Food and Drug Administration (FDA), is determined when the ratio for the 90% CIs of the difference in the means of the log-transformed AUC(0-t), AUC(0-infinity), and C(max) of the 2 products are within 0.80 and 1.25. Adverse events were determined by measuring vital signs after dosing. Subjects were also asked if they suffered from undesirable effects such as nausea, vomiting, dizziness, and headache. This bioequivalence study was performed in 24 healthy Thai males (mean [SD] age, 20.5 [1.3] years; range, 19-24 years; weight, 62.5 [7.4] kg; height, 172.8 [6.9] cm; body mass index, 20.9 [2.0] kg/m(2)). The mean (SD) C(max) and T(max) of the test formulation of lamotrigine were 1.7 (0.3) microg/mL and 1.2 (0.9) hours, respectively. The mean (SD) C(max) and T(max) of the reference formulation of lamotrigine were 1.7 (0.3) microg/mL and 1.4 (1.0) hours, respectively. The mean (SD) AUC(0-t) was 67.1 (13.2) microg/mL x h(-1) for the test product and 66.4 (14.6) microg/mL x h(-1) for the reference product. The mean (SD) AUC(0-infinity) was 74.9 (18.3) microg/mL x h(-1) for the test product and 74.3 (20.5) microg/mL x h(-1) for the reference product. The mean (SD) t((1/2)) values were 35.0 (7.6) hours for the test product and 34.7 (7.6) hours for the reference product. The mean test/reference ratios for AUC(0-t), AUC(0-infinity), and Cmax were 1.01, 1.01, and 1.05, respectively. The parametric 90% CIs for AUC(0-t), AUC(0-infinity), and Cmax were 0.98 to 1.05, 0.98 to 1.06, and 0.98 to 1.13, respectively. Following administration, dizziness or headache was reported in 2 subjects in the test group and 1 subject in the reference group. The results of this study suggest that the test product was bioequivalent to the reference product in these healthy Thai male subjects, based on the US FDA's regulatory definition.

  2. Reference equations for the six-minute walk distance in the healthy Chinese population aged 18–59 years

    PubMed Central

    Zou, He; Zhu, Xiuruo; Zhang, Jia; Wang, Yi; Wu, Xiaozhen; Liu, Fang; Xie, Xiaofeng

    2017-01-01

    Background The six-minute walk test (6MWT) is a safe, simple, inexpensive tool for evaluating the functional exercise capacity of patients with chronic respiratory disease. However, there is a lack of standard reference equations for the six-minute walk distance (6MWD) in the healthy Chinese population aged 18–59 years. Aims The purposes of the present study were as follows: 1) to measure the anthropometric data and walking distance of a sample of healthy Chinese Han people aged 18–59 years; 2) to construct reference equations for the 6MWD; 3) to compare the measured 6MWD with previously published equations. Method The anthropometric data, demographic information, lung function, and walking distance of Chinese adults aged 18–59 years were prospectively measured using a standardized protocol. We obtained verbal consent from all the subjects before the test, and the study design was approved by the ethics committee of Wenzhou People's Hospital. The 6MWT was performed twice, and the longer distance was used for further analysis. Results A total of 643 subjects (319 females and 324 males) completed the 6MWT, and average walking distance was 601.6±55.51 m. The walking distance was compared between females and males (578±49.85 m vs. 623±52.53 m; p < 0.0001) and between physically active subjects and sedentary subjects (609.3±56.17 m vs. 592±53.23 m; p < 0.0001). Pearson’s correlation indicated that the 6MWD was significantly correlated with various demographic and the 6MWT variables, such as age, height, weight, body mass index (BMI), heart rate after the test and the difference in the heart rate before and after the test. Stepwise multiple regression analysis showed that age and height were independent predictors associated with the 6MWD. The reference equations from white, Canadian and Chilean populations tended to overestimate the walking distance in our subjects, while Brazilian and Arabian equations tended to underestimate the walking distance. There was no significant difference in the walking distance between Korean reference equations and the results of the current study. Conclusion In summary, age and height were the most significant predictors of the 6MWD, and regression equations could explain approximately 34% and 28% of the distance variance in the female and male groups, respectively. PMID:28910353

  3. How Should We Question Young Children's Understanding of Aspectuality?

    ERIC Educational Resources Information Center

    Waters, Gillian M.; Beck, Sarah R.

    2012-01-01

    In two experiments, we investigated whether 4- to 5-year-old children's ability to demonstrate their understanding of aspectuality was influenced by how the test question was phrased. In Experiment 1, 60 children chose whether to look or feel to gain information about a hidden object (identifiable by sight or touch). Test questions referred either…

  4. Language supports young children’s use of spatial relations to remember locations

    PubMed Central

    Miller, Hilary E.; Patterson, Rebecca; Simmering, Vanessa R.

    2016-01-01

    Two experiments investigated the role of language in children’s spatial recall performance. In particular, we assessed whether selecting an intrinsic reference frame could be improved through verbal encoding. Selecting an intrinsic reference frame requires remembering locations relative to nearby objects independent of one’s body (egocentric) or distal environmental (allocentric) cues, and does not reliably occur in children under 5 years of age (Nardini, Burgess, Breckenridge, & Atkinson, 2006). The current studies tested the relation between spatial language and 4-year-olds’ selection of an intrinsic reference frame in spatial recall. Experiment 1 showed that providing 4-year-olds with location-descriptive cues during (Exp. 1a) or before (Exp. 1b) the recall task improved performance both overall and specifically on trials relying most on an intrinsic reference frame. Additionally, children’s recall performance was predicted by their verbal descriptions of the task space (Exp. 1a control condition). Non-verbally highlighting relations among objects during the recall task (Exp. 2) supported children’s performance relative to the control condition, but significantly less than the location-descriptive cues. These results suggest that the ability to verbally represent relations is a potential mechanism that could account for developmental changes in the selection of an intrinsic reference frame during spatial recall. PMID:26896902

  5. Language supports young children's use of spatial relations to remember locations.

    PubMed

    Miller, Hilary E; Patterson, Rebecca; Simmering, Vanessa R

    2016-05-01

    Two experiments investigated the role of language in children's spatial recall performance. In particular, we assessed whether selecting an intrinsic reference frame could be improved through verbal encoding. Selecting an intrinsic reference frame requires remembering locations relative to nearby objects independent of one's body (egocentric) or distal environmental (allocentric) cues, and does not reliably occur in children under 5 years of age (Nardini, Burgess, Breckenridge, & Atkinson, 2006). The current studies tested the relation between spatial language and 4-year-olds' selection of an intrinsic reference frame in spatial recall. Experiment 1 showed that providing 4-year-olds with location-descriptive cues during (Exp. 1a) or before (Exp. 1b) the recall task improved performance both overall and specifically on trials relying most on an intrinsic reference frame. Additionally, children's recall performance was predicted by their verbal descriptions of the task space (Exp. 1a control condition). Non-verbally highlighting relations among objects during the recall task (Exp. 2) supported children's performance relative to the control condition, but significantly less than the location-descriptive cues. These results suggest that the ability to verbally represent relations is a potential mechanism that could account for developmental changes in the selection of an intrinsic reference frame during spatial recall. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Robust training attenuates TBI-induced deficits in reference and working memory on the radial 8-arm maze

    PubMed Central

    Sebastian, Veronica; Diallo, Aissatou; Ling, Douglas S. F.; Serrano, Peter A.

    2013-01-01

    Globally, it is estimated that nearly 10 million people sustain severe brain injuries leading to hospitalization and/or death every year. Amongst survivors, traumatic brain injury (TBI) results in a wide variety of physical, emotional and cognitive deficits. The most common cognitive deficit associated with TBI is memory loss, involving impairments in spatial reference and working memory. However, the majority of research thus far has characterized the deficits associated with TBI on either reference or working memory systems separately, without investigating how they interact within a single task. Thus, we examined the effects of TBI on short-term working and long-term reference memory using the radial 8-arm maze (RAM) with a sequence of four baited and four unbaited arms. Subjects were given 10 daily trials for 6 days followed by a memory retrieval test 2 weeks after training. Multiple training trials not only provide robust training, but also test the subjects' ability to frequently update short-term memory while learning the reference rules of the task. Our results show that TBI significantly impaired short-term working memory function on previously acquired spatial information but has little effect on long-term reference memory. Additionally, TBI significantly increased working memory errors during acquisition and reference memory errors during retention testing 2 weeks later. With a longer recovery period after TBI, the robust RAM training mitigated the reference memory deficit in retention but not the short-term working memory deficit during acquisition. These results identify the resiliency and vulnerabilities of short-term working and long-term reference memory to TBI in the context of robust training. The data highlight the role of cognitive training and other behavioral remediation strategies implicated in attenuating deficits associated with TBI. PMID:23653600

  7. Standard setting: comparison of two methods.

    PubMed

    George, Sanju; Haque, M Sayeed; Oyebode, Femi

    2006-09-14

    The outcome of assessments is determined by the standard-setting method used. There is a wide range of standard-setting methods and the two used most extensively in undergraduate medical education in the UK are the norm-reference and the criterion-reference methods. The aims of the study were to compare these two standard-setting methods for a multiple-choice question examination and to estimate the test-retest and inter-rater reliability of the modified Angoff method. The norm-reference method of standard-setting (mean minus 1 SD) was applied to the 'raw' scores of 78 4th-year medical students on a multiple-choice examination (MCQ). Two panels of raters also set the standard using the modified Angoff method for the same multiple-choice question paper on two occasions (6 months apart). We compared the pass/fail rates derived from the norm reference and the Angoff methods and also assessed the test-retest and inter-rater reliability of the modified Angoff method. The pass rate with the norm-reference method was 85% (66/78) and that by the Angoff method was 100% (78 out of 78). The percentage agreement between Angoff method and norm-reference was 78% (95% CI 69% - 87%). The modified Angoff method had an inter-rater reliability of 0.81-0.82 and a test-retest reliability of 0.59-0.74. There were significant differences in the outcomes of these two standard-setting methods, as shown by the difference in the proportion of candidates that passed and failed the assessment. The modified Angoff method was found to have good inter-rater reliability and moderate test-retest reliability.

  8. The Comparison of Iranian Normative Reference Data with Five Countries ‎Across Variables in Eight Rorschach Comprehensive System (CS) Clusters

    PubMed Central

    Hosseininasab, Abufazel; Mohammadi, Mohammadreza; Jouzi, Samira; Esmaeilinasab, Maryam; Delavar, Ali

    2016-01-01

    Objective: This study aimed to provide a normative study documenting how 114 five-seven year-old non-‎patient Iranian children respond to the Rorschach test. We compared this especial sample to ‎international normative reference values for the Comprehensive System (CS).‎ Method: One hundred fourteen 5- 7- year-old non-patient Iranian children were recruited from public ‎schools. Using five child and adolescent samples from five countries, we compared Iranian ‎Normative Reference Data- based on reference means and standard deviations for each sample.‎ Results: Findings revealed that how the scores in each sample were distributed and how the samples were ‎compared across variables in eight Rorschach Comprehensive System (CS) clusters. We reported ‎all descriptive statistics such as reference mean and standard deviation for all variables.‎ Conclusion: Iranian clinicians could rely on country specific or “local norms” when assessing children. We ‎discourage Iranian clinicians to use many CS scores to make nomothetic, score-based inferences ‎about psychopathology in children and adolescents.‎ PMID:27928247

  9. Strategies for implementing genomic selection for feed efficiency in dairy cattle breeding schemes.

    PubMed

    Wallén, S E; Lillehammer, M; Meuwissen, T H E

    2017-08-01

    Alternative genomic selection and traditional BLUP breeding schemes were compared for the genetic improvement of feed efficiency in simulated Norwegian Red dairy cattle populations. The change in genetic gain over time and achievable selection accuracy were studied for milk yield and residual feed intake, as a measure of feed efficiency. When including feed efficiency in genomic BLUP schemes, it was possible to achieve high selection accuracies for genomic selection, and all genomic BLUP schemes gave better genetic gain for feed efficiency than BLUP using a pedigree relationship matrix. However, introducing a second trait in the breeding goal caused a reduction in the genetic gain for milk yield. When using contracted test herds with genotyped and feed efficiency recorded cows as a reference population, adding an additional 4,000 new heifers per year to the reference population gave accuracies that were comparable to a male reference population that used progeny testing with 250 daughters per sire. When the test herd consisted of 500 or 1,000 cows, lower genetic gain was found than using progeny test records to update the reference population. It was concluded that to improve difficult to record traits, the use of contracted test herds that had additional recording (e.g., measurements required to calculate feed efficiency) is a viable option, possibly through international collaborations. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  10. Component Identification and Item Difficulty of Raven's Matrices Items.

    ERIC Educational Resources Information Center

    Green, Kathy E.; Kluever, Raymond C.

    Item components that might contribute to the difficulty of items on the Raven Colored Progressive Matrices (CPM) and the Standard Progressive Matrices (SPM) were studied. Subjects providing responses to CPM items were 269 children aged 2 years 9 months to 11 years 8 months, most of whom were referred for testing as potentially gifted. A second…

  11. HIV counselling and testing practices for children seen in an urban emergency department of a tertiary referral hospital in Dar es Salaam, Tanzania: a retrospective cross-sectional study

    PubMed Central

    Sawe, Hendry R; Mfinanga, Juma A; Ringo, Faith H; Mwafongo, Victor; Reynolds, Teri A; Runyon, Michael S

    2016-01-01

    Objectives To describe the HIV counselling and testing practices for children presenting to an emergency department (ED) in a low-income country. Setting The ED of a large east African national referral hospital. Participants This retrospective review of all paediatric (<18 years old) ED visits in 2012 enrolled patients who had an HIV test ordered and excluded those without testing. Files were available for 5540/5774 (96%) eligible patients and 1632 (30%) were tested for HIV, median age 1.3 years (IQR 9 months to 4 years), 58% <18 months old and 61% male. Primary and secondary outcome measures The primary outcome measure was documentation of pretest and post-test counselling, or deferral of counselling, for children tested for HIV in the ED. Secondary measures included the overall rate of HIV testing, rate of counselling documented in the inpatient record when deferred in the ED, rate of counselling documented when testing was initiated by the inpatient service, rate of counselling documented by test result (positive vs negative) and the rate of referral to follow-up HIV care among patients testing positive. Results Of 418 patients tested in the ED, counselling, or deferral of counselling, was documented for 70 (17%). When deferred to the ward, subsequent counselling was documented for 15/42 (36%). Counselling was documented in 33% of patients testing positive versus 1.1% patients testing negative (OR 43 (95% CI 23 to 83). Of 199 patients who tested positive and survived to hospital discharge, 76 (38%) were referred for follow-up at the HIV clinic on discharge. Conclusions Physicians documented the provision, or deferral, of counselling for <20% of children tested for HIV in the ED. Counselling was much more likely to be documented when the test result was positive. Less than 40% of those testing positive were referred for follow-up care. PMID:26880672

  12. Una Ricerca sull'Applicazione del TALB (Test di Attitudine Linguistica per Bambini) nella Scola Elementare [Research on the Application of the TALB (A Test for Linguistic Aptitude for Children) in Elementary School].

    ERIC Educational Resources Information Center

    Acone, Ilario

    1992-01-01

    Discusses the administration of the Test di Attitudine Linguistica per Bambini (TALB) to students 7-9 years of age. Correlations between the TALB and achievement tests administered at the end of the course were very high. It is concluded that aptitude is a main factor in successful learning of a second language. (16 references) (LET)

  13. Trajectories of disposable income among people of working ages diagnosed with multiple sclerosis: a nationwide register-based cohort study in Sweden 7 years before to 4 years after diagnosis with a population-based reference group

    PubMed Central

    Mogard, Olof; Alexanderson, Kristina; Karampampa, Korinna; Friberg, Emilie; Tinghög, Petter

    2018-01-01

    Objectives To describe how disposable income (DI) and three main components changed, and analyse whether DI development differed from working-aged people with multiple sclerosis (MS) to a reference group from 7 years before to 4 years after diagnosis in Sweden. Design Population-based cohort study, 12-year follow-up (7 years before to 4 years after diagnosis). Setting Swedish working-age population with microdata linked from two nationwide registers. Participants Residents diagnosed with MS in 2009 aged 25–59 years (n=785), and references without MS (n=7847) randomly selected with stratified matching (sex, age, education and country of birth). Primary and secondary outcome measures DI was defined as the annual after tax sum of incomes (earnings and benefits) to measure individual economic welfare. Three main components of DI were analysed as annual sums: earnings, sickness absence benefits and disability pension benefits. Results We found no differences in mean annual DI between people with and without MS by independent t-tests (p values between 0.15 and 0.96). Differences were found for all studied components of DI from diagnosis year by independent t-tests, for example, in the final study year (2013): earnings (−64 867 Swedish Krona (SEK); 95% CI−79 203 to −50 528); sickness absence benefits (13 330 SEK; 95% CI 10 042 to 16 500); and disability pension benefits (21 360 SEK; 95% CI 17 380 to 25 350). A generalised estimating equation evaluated DI trajectory development between people with and without MS to find both trajectories developed in parallel, both before (−4039 SEK; 95% CI −10 536 to 2458) and after (−781 SEK; 95% CI −6988 to 5360) diagnosis. Conclusions The key finding of parallel DI trajectory development between working-aged MS and references suggests minimal economic impact within the first 4 years of diagnosis. The Swedish welfare system was responsive to the observed reductions in earnings around MS diagnosis through balancing DI with morbidity-related benefits. Future decreases in economic welfare may be experienced as the disease progresses, although thorough investigation with future studies of modern cohorts are required. PMID:29743325

  14. The applicability of WHO-NCTB in Korea.

    PubMed

    Kang, S K

    2000-10-01

    Neurotoxic chemical substances have been widely used in Korea since 1960. The World Health Organization-recommended Neurobehavioral Core Test Battery (WHO-NCTB) was introduced into Korea early in the 1990s and has been applied to the study of workers exposed to neurotoxic chemicals. Thirteen studies using the WHO-NCTB have been reported in Korean journals, two of which were published in English and the rest in Korean-language journals. Ten studies were reviewed to examine the influence of age, education and other factors on the WHO-NCTB in Korean workers. Pursuit Aiming, Digit Symbol, Digit Span and Benton Visual Retention test are effected by years of education, especially when years of education were less than 12. Santa Ana Dexterity test and Simple Reaction Time test were not effected. Pursuit Aiming, Santa Ana Dexterity test and Digit Symbol were effected by age, but not the Simple Reaction Time test, Benton Visual Retention test, or Digit Span. Some studies had difficulty in finding a proper reference group, because many workers exposed to neurotoxic chemicals were old and less educated than available reference groups. However, daily use of chopsticks by Koreans, especially coupled with work that requires skillful and quick hand movements, might develop psychomotor functions in exposed workers. The cultural and emotional differences between Korean and Caucasian led POMS to be applied only to two studies. In conclusion, the WHO-NCTB has been successfully applied to Korean workers for evaluating the neurobehavioral effects of individual chemicals, although age and education can be confounding factors. It was difficult to apply the WHO-NCTB to workers educated less than 12 years.

  15. Assessment of the swallowing function in older individuals referred to myocardial revascularization surgery.

    PubMed

    Dantas, Mara de Oliveira Rodrigues Luiz; Auler, José Otávio Costa; Andrade, Claudia Regina Furquim de

    2010-01-01

    Swallowing evaluation of older individuals with coronary disease referred to heart surgery. To identify the characteristics of the swallowing function in older individuals referred to myocardial revascularization surgery (MR), using an evaluating protocol composed by a water test, cervical auscultation and pulse oximetry. The Assessment Protocol for Dysphagia Risk through a Combined Swallowing test and Vital Signs monitoring was used (PADTC)--measurements of HR and SpO2 (heart rate and oxygen saturation), water swallowing test with 1, 3, 5, 10, 15 e 20 ml, measurement of respiratory rate and cervical auscultation. The electronic stethoscope was used to analyze the number of swallows, response time and swallowing sound classification. In the Research Group (RG) older individuals with heart disease who were referred to MR were included. In the Control Group (CG) healthy older individuals were included. 38 older individuals were evaluated in the RG (mean age 68 years). In the CG, 30 older individuals were evaluated (mean age 70 years). There was a significant difference for the swallowing response time in older individuals with heart disease who presented HR below 60: swallowing response was shorter for 3 ml, 10 ml, 15 ml e 20 ml. HR was lower for individuals with heart disease. No significant difference was found between the groups for the other analyzed parameters. Older individuals with heart disease presented differences in the swallowing function when compared to healthy older individuals. Older individuals with heart disease presented alterations in the temporal coordination between breathing and swallowing, thus indicating risk for dysphagia.

  16. Assessing the accuracy of TDR-based water leak detection system

    NASA Astrophysics Data System (ADS)

    Fatemi Aghda, S. M.; GanjaliPour, K.; Nabiollahi, K.

    2018-03-01

    The use of TDR system to detect leakage locations in underground pipes has been developed in recent years. In this system, a bi-wire is installed in parallel with the underground pipes and is considered as a TDR sensor. This approach greatly covers the limitations arisen with using the traditional method of acoustic leak positioning. TDR based leak detection method is relatively accurate when the TDR sensor is in contact with water in just one point. Researchers have been working to improve the accuracy of this method in recent years. In this study, the ability of TDR method was evaluated in terms of the appearance of multi leakage points simultaneously. For this purpose, several laboratory tests were conducted. In these tests in order to simulate leakage points, the TDR sensor was put in contact with water at some points, then the number and the dimension of the simulated leakage points were gradually increased. The results showed that with the increase in the number and dimension of the leakage points, the error rate of the TDR-based water leak detection system increases. The authors tried, according to the results obtained from the laboratory tests, to develop a method to improve the accuracy of the TDR-based leak detection systems. To do that, they defined a few reference points on the TDR sensor. These points were created via increasing the distance between two conductors of TDR sensor and were easily identifiable in the TDR waveform. The tests were repeated again using the TDR sensor having reference points. In order to calculate the exact distance of the leakage point, the authors developed an equation in accordance to the reference points. A comparison between the results obtained from both tests (with and without reference points) showed that using the method and equation developed by the authors can significantly improve the accuracy of positioning the leakage points.

  17. Risk factors for respiratory complications after adenotonsillectomy in children with obstructive sleep apnea*

    PubMed Central

    Martins, Renato Oliveira; Castello-Branco, Nuria; de Barros, Jefferson Luis; Weber, Silke Anna Theresa

    2015-01-01

    OBJECTIVE: To identify risk factors for respiratory complications after adenotonsillectomy in children ≤ 12 years of age with obstructive sleep apnea who were referred to the pediatric ICU (PICU). METHODS: A cross-sectional historical cohort study analyzing 53 children after adenotonsillectomy who met predetermined criteria for PICU referral in a tertiary level teaching hospital. The Student's t-test, Mann-Whitney test, and chi-square test were used to identify risk factors. RESULTS: Of the 805 children undergoing adenotonsillectomy between January of 2006 and December of 2012 in the teaching hospital, 53 were referred to the PICU. Twenty-one children (2.6% of all those undergoing adenotonsillectomy and 39.6% of those who were referred to the PICU) had respiratory complications. Of those 21, 12 were male. The mean age was 5.3 ± 2.6 years. A high apnea-hypopnea index (AHI; p = 0.0269), a high oxygen desaturation index (ODI; p = 0.0082), a low SpO2 nadir (p = 0.0055), prolonged orotracheal intubation (p = 0.0011), and rhinitis (p = 0.0426) were found to be independent predictors of respiratory complications. Some of the complications observed were minor (SpO2 90-80%), whereas others were major (SpO2 ≤ 80%, laryngospasm, bronchospasm, acute pulmonary edema, pneumonia, and apnea). CONCLUSIONS: Among children up to 12 years of age with OSA, those who have a high AHI, a high ODI, a low SpO2 nadir, or rhinitis are more likely to develop respiratory complications after adenotonsillectomy than are those without such characteristics. PMID:25909156

  18. Normative Reference of Standing Long Jump for Colombian Schoolchildren Aged 9-17.9 Years: The FUPRECOL Study.

    PubMed

    Ramírez-Vélez, Robinson; Martínez, Martin; Correa-Bautista, Jorge E; Lobelo, Felipe; Izquierdo, Mikel; Rodríguez-Rodríguez, Fernando; Cristi-Montero, Carlos

    2017-08-01

    Ramírez-Vélez, R, Martínez, M, Correa-Bautista, JE, Lobelo, F, Izquierdo, M, Rodríguez-Rodríguez, F, and Cristi-Montero, C. Normative reference of standing long jump for Colombian schoolchildren aged 9-17.9 years: The FUPRECOL study. J Strength Cond Res 31(8): 2083-2090, 2017-The purpose of this study was to generate normative values for the standing long jump (SLJ) test in 9- to 17.9-year olds and to investigate sex and age-group differences. The sample comprised 8,034 healthy Colombian schoolchildren [boys n = 3,488 and girls n = 4,546; mean (SD) age 12.8 (±2.3) years old]. Each participant performed two SLJ. Centile smoothed curves, percentile, and tables for the third, 10th, 25th, 50th, 75th, 90th, and 97th percentiles were calculated using Cole's Lambda-Mu-Sigma method. The 2-way analysis of variance tests and Cohen's d showed that the maximum SLJ (centimeter) was higher in boys than in girls across age groups (p < 0.01), reaching the peak at 13 years. Posthoc analyses within the sexes showed yearly increases in SLJ in all ages. In boys, the 50th percentile SLJ score ranged from 109 to 165 cm. In girls, the 50th percentile jump ranged from 96 to 120 cm. For girls, jump scores increased yearly from age 9 to 12.9 years before reaching a plateau at an age between 13 and 15.9. Our results provide, for the first time, sex- and age-specific SLJ reference values for Colombian schoolchildren aged 9-17.9 years. The normative values presented in this study provide the basis for the determination of the proposed age- and sex-specific standards for the FUPRECOL (Association for Muscular Strength with Early Manifestation of Cardiovascular Disease Risk Factors Among Colombian Children and Adolescents) Study-Physical fitness battery for children and adolescents.

  19. Interlaboratory tests for low-level radioactivity measurements in France

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

    Despres, M.

    In the framework of French national metrological coordination, the Laboratoire de Metrologie des Rayonnements Ionisants (LMRI) organizes every year an interlaboratory test program. The participation in these programs is on a voluntary basis and the results are presented in a nameless way. These tests concern radioactivity, neutron and dosimetry measurements. In this paper, a review of interlaboratory tests for low-level radioactivity measurements proposed by LMRI is given from 1975 to 1986. Every year, three types of tests are proposed: activity tests, multigamma tests, radioanalysis tests. For the last ten years, the number of results has been respectively 90 for activitymore » tests, 570 for multigamma tests and 400 for radioanalysis tests. The user's interest has increased, while the quality of results has improved. The deviations from LMRI's reference values are less than 3% for a restricted number of laboratories, and range between 3 and 10% for the majority of the others. The most urgent tests are for mixtures of {sup 90}Sr and activation and fission products in various matrices such as milk, grass, cereals, and sediments. 16 refs., 3 figs., 3 tabs.« less

  20. One Framework to Unite Them All? Use of the CEFR in European University Entrance Policies

    ERIC Educational Resources Information Center

    Deygers, Bart; Zeidler, Beate; Vilcu, Dina; Carlsen, Cecilie Hamnes

    2018-01-01

    Fifteen years after its publication, the Common European Framework of Reference for Languages is a commonly used document in language tests and policies across Europe. This article considers the CEFR's impact on university entrance language tests and policies that are used to regulate the entrance of international L2 students who wish to study in…

  1. Redistributive Fee Increases, Net Attendance Costs, and the Distribution of Students at the Public University.

    ERIC Educational Resources Information Center

    Hilmer, Michael J.

    2001-01-01

    Studies the effect of net attendance costs on student-enrollment patterns at in-state public 4-year colleges. Findings suggest that when net attendance costs increase, students without financial aid, especially high-test, black, and Hispanic students, may be less likely to attend in-state public 4-year colleges. (Contains 28 references.) (PKP)

  2. Two-Year-Olds Interpret Novel Phonological Neighbors as Familiar Words

    ERIC Educational Resources Information Center

    Swingley, Daniel

    2016-01-01

    When children hear a novel word in a context presenting a novel object and a familiar one, they usually assume that the novel word refers to the novel object. In a series of experiments, we tested whether this behavior would be found when 2-year-olds interpreted novel words that differed phonologically from familiar words in only 1 sound, either a…

  3. Development of a pilot-scale kinetic extruder feeder system and test program. Phase II. Verification testing. Final report

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

    Not Available

    1984-01-12

    This report describes the work done under Phase II, the verification testing of the Kinetic Extruder. The main objective of the test program was to determine failure modes and wear rates. Only minor auxiliary equipment malfunctions were encountered. Wear rates indicate useful life expectancy of from 1 to 5 years for wear-exposed components. Recommendations are made for adapting the equipment for pilot plant and commercial applications. 3 references, 20 figures, 12 tables.

  4. A prospective cohort study among new Chinese coal miners: the early pattern of lung function change.

    PubMed

    Wang, M-L; Wu, Z-E; Du, Q-G; Petsonk, E L; Peng, K-L; Li, Y-D; Li, S-K; Han, G-H; Atffield, M D

    2005-11-01

    To investigate the early pattern of longitudinal change in forced expiratory volume in 1 second (FEV1) among new Chinese coal miners, and the relation between coal mine dust exposure and the decline of lung function. The early pattern of lung function changes in 317 newly hired Chinese underground coal miners was compared to 132 referents. This three year prospective cohort study involved a pre-employment and 15 follow up health surveys, including a questionnaire and spirometry tests. Twice a month, total and respirable dust area sampling was done. The authors used a two stage analysis and a linear mixed effects model approach to analyse the longitudinal spirometry data, and to investigate the changes in FEV1 over time, controlling for age, height, pack years of smoking, mean respirable dust concentration, the room temperature during testing, and the groupxtime interaction terms. FEV1 change over time in new miners is non-linear. New miners experience initial rapid FEV1 declines, primarily during the first year of mining, little change during the second year, and partial recovery during the third year. Both linear and quadratic time trends in FEV1 change are highly significant. Smoking miners lost more FEV1 than non-smokers. Referents, all age less than 20 years, showed continued lung growth, whereas the miners who were under age 20 exhibited a decline in FEV1. Dust and smoking affect lung function in young, newly hired Chinese coal miners. FEV1 change over the first three years of employment is non-linear. The findings have implications for both methods and interpretation of medical screening in coal mining and other dusty work: during the first several years of employment more frequent testing may be desirable, and caution is required in interpreting early FEV1 declines.

  5. Bayesian Latent Class Models in Malaria Diagnosis

    PubMed Central

    Gonçalves, Luzia; Subtil, Ana; de Oliveira, M. Rosário; do Rosário, Virgílio; Lee, Pei-Wen; Shaio, Men-Fang

    2012-01-01

    Aims The main focus of this study is to illustrate the importance of the statistical analysis in the evaluation of the accuracy of malaria diagnostic tests, without admitting a reference test, exploring a dataset (3317) collected in São Tomé and Príncipe. Methods Bayesian Latent Class Models (without and with constraints) are used to estimate the malaria infection prevalence, together with sensitivities, specificities, and predictive values of three diagnostic tests (RDT, Microscopy and PCR), in four subpopulations simultaneously based on a stratified analysis by age groups (, 5 years old) and fever status (febrile, afebrile). Results In the afebrile individuals with at least five years old, the posterior mean of the malaria infection prevalence is 3.2% with a highest posterior density interval of [2.3–4.1]. The other three subpopulations (febrile 5 years, afebrile or febrile children less than 5 years) present a higher prevalence around 10.3% [8.8–11.7]. In afebrile children under-five years old, the sensitivity of microscopy is 50.5% [37.7–63.2]. In children under-five, the estimated sensitivities/specificities of RDT are 95.4% [90.3–99.5]/93.8% [91.6–96.0] – afebrile – and 94.1% [87.5–99.4]/97.5% [95.5–99.3] – febrile. In individuals with at least five years old are 96.0% [91.5–99.7]/98.7% [98.1–99.2] – afebrile – and 97.9% [95.3–99.8]/97.7% [96.6–98.6] – febrile. The PCR yields the most reliable results in four subpopulations. Conclusions The utility of this RDT in the field seems to be relevant. However, in all subpopulations, data provide enough evidence to suggest caution with the positive predictive values of the RDT. Microscopy has poor sensitivity compared to the other tests, particularly, in the afebrile children less than 5 years. This type of findings reveals the danger of statistical analysis based on microscopy as a reference test. Bayesian Latent Class Models provide a powerful tool to evaluate malaria diagnostic tests, taking into account different groups of interest. PMID:22844405

  6. Aquatic information and retrieval (AQUIRE) database system

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

    Hunter, R.; Niemi, G.; Pilli, A.

    The AQUIRE database system is one of the foremost international resources for finding aquatic toxicity information. Information in the system is organized around the concept of an 'aquatic toxicity test.' A toxicity test record contains information about the chemical, species, endpoint, endpoint concentrations, and test conditions under which the toxicity test was conducted. For the past 10 years aquatic literature has been reviewed and entered into the system. Currently, the AQUIRE database system contains data on more than 2,400 species, 160 endpoints, 5,000 chemicals, 6,000 references, and 104,000 toxicity tests.

  7. SSIART: Opening the Way to Wireless Sensor Networks On-Board Spacecraft with an Inter-Agency Research Environment

    NASA Astrophysics Data System (ADS)

    Gunes-Lasnet, Sev; Dufour, Jean-Francois

    2012-08-01

    The potential uses and benefits of wireless technologies in space are very broad. Since many years the CCSDS SOIS wireless working group has worked at the identification of key applications for which wireless would bring benefits, and at supporting the deployment of wireless in space thanks to documents, in particular a Green informative book and magenta books presenting recommended practices.The Smart Sensor Inter-Agency Research Test bench (SSIART) is being designed to provide the space Agencies and the Industry with a reference smart sensor platform to test wireless sensor technologies in reference representative applications and RF propagation environments, while promoting these technologies at the same time.

  8. Citation success of different publication types: a case study on all references in psychology publications from the German-speaking countries (D-A-CH-L-L) in 2009, 2010, and 2011.

    PubMed

    Krampen, Günter; Weiland, Peter; Wiesenhütter, Jürgen

    Scientometric data on the citation success of different publication types and publication genres in psychology publications are presented. Data refer to references that are cited in these scientific publications and that are documented in PSYNDEX, the exhaustive database of psychology publications from the German-speaking countries either published in German or in English language. Firstly, data analyses refer to the references that are cited in publications of 2009 versus 2010 versus 2011. With reference to all cited references, the portion of journal articles ranges from 57 to 61 %, of books from 22 to 24 %, and of book chapters from 14 to 15 %, with a rather high stability across the three publication years analysed. Secondly, data analyses refer to the numbers of cited references from the German-speaking countries, which are also documented in PSYNDEX. These compose about 11 % of all cited references indicating that nearly 90 % of the references cited are of international and/or interdisciplinary publications not stemming from the German-speaking countries. The subsample shows the proportion of journal articles, books, and chapters, and these are very similar to the percentages identified for all references that are cited. Thirdly, analyses refer to document type, scientific genre, and psychological sub-discipline of the most frequently cited references in the psychology publications. The frequency of top-cited references of books and book chapters is almost equal to that of journal articles; two-thirds of the top-cited references are non-empirical publications, only one-third are empirical publications. Top-cited references stem particularly from clinical psychology, experimental psychology, as well as tests, testing and psychometrics. In summary, the results point to the fact that citation analyses, which are limited to journal papers, tend to neglect very high portions of references that are cited in scientific publications.

  9. Reference values for blood pressure response to cycle ergometry in the first two decades of life: comparison with patients with a repaired coarctation of the aorta.

    PubMed

    Kaafarani, Mirna; Schroer, Christian; Takken, Tim

    2017-12-01

    Hemodynamic responses to exercise are used as markers of diagnosis for cardiac diseases, systolic blood pressure (SBP) especially. However, the reference values for SBP in children at peak exertion level are outdated. This study aimed to establish current reference values for SBP, rate pressure product (RPP), and circulatory power (CircP). Data from children who previously underwent cardiopulmonary exercise testing were categorized as healthy (N = 184; age 12.6 ± 2.9 years), and CoA patients (N = 25; age 13.0 ± 3.2 years). With the Lambda-Mu-Sigma (LMS) method, percentile curves were made for SBP, CircP, and RPP in function of peak work rate (Wpeak). Data of CoA patients were used to validate the reference values. Wpeak was the best predictor of peak SBP during exercise. The prediction equations for SBP, CircP and RPP were: (0.2853 x Wpeak) + 111.46; (10.56 x Wpeak) + 2550.2 and (61.879 x Wpeak) + 19.887, respectively. CoA patients showed significantly increased values for peak SBP (Z-score 1.063 ± 1.347). This study provides reference values for SBP, RPP, and CircP at peak exercise. These values can be used for objective evaluation of participants 6-18 years of age in a Dutch population.

  10. Talking about others facilitates theory of mind in Chinese preschoolers.

    PubMed

    Lu, Huijing; Su, Yanjie; Wang, Qi

    2008-11-01

    A longitudinal study and a training study were conducted to show that simply referring to others facilitated theory of mind (ToM) development in Chinese children. In Study 1, 3- to 4-year-old Chinese children (N = 52) were tested on ToM and autobiographical memory (AM). One year later, in the group of children who initially failed the false belief tasks, only those who increased their references to others in AM recall passed the tasks. In Study 2, Chinese preschoolers who were trained to talk about others through storytelling showed improvement in their ToM performance. These findings suggest alternative pathways for ToM development in non-Euro-American context.

  11. Recognition of iconicity doesn't come for free.

    PubMed

    Namy, Laura L

    2008-11-01

    Iconicity--resemblance between a symbol and its referent--has long been presumed to facilitate symbolic insight and symbol use in infancy. These two experiments test children's ability to recognize iconic gestures at ages 14 through 26 months. The results indicate a clear ability to recognize how a gesture resembles its referent by 26 months, but little evidence of recognition of iconicity at the onset of symbolic development. These findings imply that iconicity is not available as an aid at the onset of symbolic development but rather that the ability to apprehend the relation between a symbol and its referent develops over the course of the second year.

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

    Chaudhuri, T.K.; Fink, S.

    The records of 18 consecutive patients referred to a Veterans Administration Hospital nuclear medicine service for renal scintigraphic tests to rule out renovascular hypertension were reviewed. The men were elderly (mean age, 62 years), and risk factors for untoward reactions, including long-standing hypertension, severe peripheral vascular disease, diabetes, chronic renal failure, and recent diuretic use were present. Despite these risks, there was no test morbidity, and the authors conclude that the renal scintigraphic test with captopril enhancement is well tolerated and deserves continued application and evaluation.

  13. Between-Day Reliability and Usefulness of a Fitness Testing Battery in Youth Sport Athletes: Reference Data for Practitioners

    ERIC Educational Resources Information Center

    Sawczuk, Thomas; Jones, Ben; Scantlebury, Sean; Weakley, Jonathan; Read, Dale; Costello, Nessan; Darrall-Jones, Joshua David; Stokes, Keith; Till, Kevin

    2018-01-01

    This study aimed to evaluate the between-day reliability and usefulness of a fitness testing battery in a group of youth sport athletes. Fifty-nine youth sport athletes (age = 17.3 ± 0.7 years) undertook a fitness testing battery including the isometric mid-thigh pull, counter-movement jump, 5-40 m sprint splits, and the 5-0-5 change of direction…

  14. 78 FR 69943 - Anthropomorphic Test Devices; Q3s 3-Year-Old Child Side Impact Test Dummy, Incorporation by...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-21

    ... design and by July 2007 Build Level C was released. b. Developments In 2007, the Occupant Safety Research... reference a parts list, a set of design drawings, and a ``Procedures for Assembly, Disassembly and Inspection (PADI)'' document, to ensure that all Q3s dummies are the same in their design and construction.\\2...

  15. The Displacement of Water from a Steel Surface.

    DTIC Science & Technology

    1982-11-08

    example Report No. NADC-78015-20 indicates the fifteeth Center report for the year 1978, and prepared by the Systems. Directorate. The numerical ...50 Software Computer Directorate 60 Aircraft & Crew Systems Technology Directorate 70 Planning Assessment Resources 80 Eneing.Support Group . PRODUCT...Table I.- Water Displacement Tests TEST METHD Continuous water layer, A thin continuous layer of water is references (a) and (d) placed onto a steel

  16. Advancements in Chinese Geomagnetism and Aeronomy during the Last Thirty Years,

    DTIC Science & Technology

    1981-02-09

    movements of charged particles in geomagnetic fields and neutral line magnetic fields and they vigorously initiated simulated tests. References (120-121... telluric prospecting and related probems; (6) Magnetic prospecting and interpretation of data; (7) Some research on geomagnetic instruments; (8

  17. Reducing measurement errors during functional capacity tests in elders.

    PubMed

    da Silva, Mariane Eichendorf; Orssatto, Lucas Bet da Rosa; Bezerra, Ewertton de Souza; Silva, Diego Augusto Santos; Moura, Bruno Monteiro de; Diefenthaeler, Fernando; Freitas, Cíntia de la Rocha

    2018-06-01

    Accuracy is essential to the validity of functional capacity measurements. To evaluate the error of measurement of functional capacity tests for elders and suggest the use of the technical error of measurement and credibility coefficient. Twenty elders (65.8 ± 4.5 years) completed six functional capacity tests that were simultaneously filmed and timed by four evaluators by means of a chronometer. A fifth evaluator timed the tests by analyzing the videos (reference data). The means of most evaluators for most tests were different from the reference (p < 0.05), except for two evaluators for two different tests. There were different technical error of measurement between tests and evaluators. The Bland-Altman test showed difference in the concordance of the results between methods. Short duration tests showed higher technical error of measurement than longer tests. In summary, tests timed by a chronometer underestimate the real results of the functional capacity. Difference between evaluators' reaction time and perception to determine the start and the end of the tests would justify the errors of measurement. Calculation of the technical error of measurement or the use of the camera can increase data validity.

  18. The Magic Shrinking Machine Revisited: The Presence of Props at Recall Facilitates Memory in 3-Year-Olds

    ERIC Educational Resources Information Center

    Dahl, Jonna J.; Kingo, Osman S.; Krøjgaard, Peter

    2015-01-01

    In a seminal study Simcock and Hayne (2002) showed that 3-year-olds were unable to use newly acquired words to describe a "magic" event experienced 6 or 12 months earlier. In the reference study the children's verbal recall was tested without props being present. Inspired by recent evidence, the original design was replicated, testing…

  19. Increased risk of obstructive pulmonary disease in tunnel workers

    PubMed Central

    Ulvestad, B.; Bakke, B.; Melbostad, E.; Fuglerud, P.; Kongerud, J.; Lund, M. B.

    2000-01-01

    BACKGROUND—Tunnel workers are exposed to gases and particles from blasting and diesel exhausts. The aim of this study was to assess the occurrence of respiratory symptoms and airflow limitation in tunnel workers and to relate these findings to years of exposure.
METHODS—Two hundred and twelve tunnel workers and a reference group of 205 other heavy construction workers participated in a cross sectional investigation. Exposure measurements were carried out to demonstrate the difference in exposure between the two occupational groups. Spirometric tests and a questionnaire on respiratory symptoms and smoking habits were applied. Atopy was determined by a multiple radioallergosorbent test (RAST). Radiological signs of silicosis were evaluated. Respiratory symptoms and lung function were studied in relation to years of exposure and adjusted for smoking habits and atopy.
RESULTS—Compared with the reference subjects the tunnel workers had a significant decrease in forced vital capacity (FVC) % predicted and forced expiratory volume in one second (FEV1) % predicted when related to years of exposure. Adjusted FEV1 decreased by 17 ml for each year of tunnel work exposure compared with 0.5 ml in outdoor heavy construction workers. The tunnel workers also reported significantly higher occurrence of respiratory symptoms. The prevalence of chronic obstructive pulmonary disease (COPD) was 14% in the tunnel workers compared with 8% in the reference subjects.
CONCLUSION—Exposure to dust and gases from diesel exhaust, blasting, drilling and rock transport in tunnel work enhances the risk for accelerated decline in FEV1, respiratory symptoms, and COPD in tunnel workers compared with other heavy construction workers.

 PMID:10722766

  20. Increased risk of obstructive pulmonary disease in tunnel workers.

    PubMed

    Ulvestad, B; Bakke, B; Melbostad, E; Fuglerud, P; Kongerud, J; Lund, M B

    2000-04-01

    Tunnel workers are exposed to gases and particles from blasting and diesel exhausts. The aim of this study was to assess the occurrence of respiratory symptoms and airflow limitation in tunnel workers and to relate these findings to years of exposure. Two hundred and twelve tunnel workers and a reference group of 205 other heavy construction workers participated in a cross sectional investigation. Exposure measurements were carried out to demonstrate the difference in exposure between the two occupational groups. Spirometric tests and a questionnaire on respiratory symptoms and smoking habits were applied. Atopy was determined by a multiple radioallergosorbent test (RAST). Radiological signs of silicosis were evaluated. Respiratory symptoms and lung function were studied in relation to years of exposure and adjusted for smoking habits and atopy. Compared with the reference subjects the tunnel workers had a significant decrease in forced vital capacity (FVC) % predicted and forced expiratory volume in one second (FEV(1)) % predicted when related to years of exposure. Adjusted FEV(1) decreased by 17 ml for each year of tunnel work exposure compared with 0.5 ml in outdoor heavy construction workers. The tunnel workers also reported significantly higher occurrence of respiratory symptoms. The prevalence of chronic obstructive pulmonary disease (COPD) was 14% in the tunnel workers compared with 8% in the reference subjects. Exposure to dust and gases from diesel exhaust, blasting, drilling and rock transport in tunnel work enhances the risk for accelerated decline in FEV(1), respiratory symptoms, and COPD in tunnel workers compared with other heavy construction workers.

  1. Association of a culturally defined syndrome (nervios) with chest pain and DSM-IV affective disorders in Hispanic patients referred for cardiac stress testing.

    PubMed

    Pavlik, Valory N; Hyman, David J; Wendt, Juliet A; Orengo, Claudia

    2004-01-01

    Hispanics have a high prevalence of cardiovascular risk factors, most notably type 2 diabetes. However, in a large public hospital in Houston, Texas, Hispanic patients referred for cardiac stress testing were significantly more likely to have normal test results than were Whites or non-Hispanic Blacks. We undertook an exploratory study to determine if nervios, a culturally based syndrome that shares similarities with both panic disorder and anginal symptoms, is sufficiently prevalent among Hispanics referred for cardiac testing to be considered as a possible explanation for the high probability of a normal test result. Hispanic patients were recruited consecutively when they presented for a cardiac stress test. A bilingual interviewer administered a brief medical history, the Rose Angina Questionnaire (RAQ), a questionnaire to assess a history of nervios and associated symptoms, and the PRIME-MD, a validated brief questionnaire to diagnose DSM-IV defined affective disorders. The average age of the 114 participants (38 men and 76 women) was 57 years, and the average educational attainment was 7 years. Overall, 50% of participants reported a history of chronic nervios, and 14% reported an acute subtype known as ataque de nervios. Only 2% of patients had DSM-IV defined panic disorder, and 59% of patients had a positive RAQ score (ie, Rose questionnaire angina). The acute subtype, ataque de nervios, but not chronic nervios, was related to an increased probability of having Rose questionnaire angina (P=.006). Adjusted for covariates, a positive history of chronic nervios, but not Rose questionnaire angina, was significantly associated with a normal cardiac test result (OR=2.97, P=.04). Nervios is common among Hispanics with symptoms of cardiac disease. Additional research is needed to understand how nervios symptoms differ from chest pain in Hispanics and the role of nervios in referral for cardiac workup by primary care providers and emergency room personnel.

  2. Abdominal symptoms during physical exercise and the role of gastrointestinal ischaemia: a study in 12 symptomatic athletes.

    PubMed

    ter Steege, Rinze W F; Geelkerken, Robert H; Huisman, Ad B; Kolkman, Jeroen J

    2012-10-01

    Gastrointestinal (GI) symptoms during exercise may be caused by GI ischaemia. The authors report their experience with the diagnostic protocol and management of athletes with symptomatic exercise-induced GI ischaemia. The value of prolonged exercise tonometry in the diagnostic protocol of these patients was evaluated. Patients referred for GI symptoms during physical exercise underwent a standardised diagnostic protocol, including prolonged exercise tonometry. Indicators of GI ischaemia, as measured by tonometry, were related to the presence of symptoms during the exercise test (S+ and S- tests) and exercise intensity. 12 athletes were specifically referred for GI symptoms during exercise (five males and seven females; median age 29 years (range 15-46 years)). Type of sport was cycling, long-distance running and triathlon. Median duration of symptoms was 32 months (range 7-240 months). Splanchnic artery stenosis was found in one athlete. GI ischaemia was found in six athletes during submaximal exercise. All athletes had gastric and jejunal ischaemia during maximum intensity exercise. No significant difference was found in gastric and jejunal Pco(2) or gradients between S+ and S- tests during any phase of the exercise protocol. In S+ tests, but not in S- tests, a significant correlation between lactate and gastric gradient was found. In S+ tests, the regression coefficients of gradients were higher than those in S- tests. Treatment advice aimed at limiting GI ischaemia were successful in reducing complaints in the majority of the athletes. GI ischaemia was present in all athletes during maximum intensity exercise and in 50% during submaximal exercise. Athletes with GI symptoms had higher gastric gradients per mmol/l increase in lactate, suggesting an increased susceptibility for the development of ischaemia during exercise. Treatment advice aimed at limiting GI ischaemia helped the majority of the referred athletes to reduce their complaints. Our results suggest an important role for GI ischaemia in the pathophysiology of their complaints.

  3. Implications of false positive serology of Toxoplasma gondii in a pre-transplant patient.

    PubMed

    Beal, Stacy; Racsa, Lori; Alatoom, Adnan

    2014-01-01

    A 21-year-old white male with cystic fibrosis. Pre-transplant workup in preparation for bilateral lung transplant. Cystic fibrosis diagnosed at age 3, onset of insulin-dependent diabetes around age 20, and multiple hospitalizations for pulmonary and gastrointestinal complications. FAMILY AND SOCIAL HISTORY: The patient lives with his father and stepmother, has a pet bearded dragon, and has multiple tattoos and piercings. His stepmother has a cat, but he does not clean the litter box. The pre-transplant workup included several tests for infectious diseases, tests of organ function, radiology studies, and markers of malignancy. The only significant finding was a positive Toxoplasma gondii (T. gondii) IgM titer (> or = 1:40) (reference values for IgM: negative; < 1:40, positive; > or = 1:40) and IgG (1:2048) (reference values for IgG: negative; < 1:16, equivocal; > or = 1:16 - < 1:256, positive; > or = 1:256). Testing was done by indirect immunofluorescence assay (IFA) in April 2012 in our hospital laboratory. The patient was treated with sulfadiazine, leucovorin, and pyrimethamine. Three months later (July), he returned for follow-up testing. Real-time polymerase chain reaction (PCR) for T. gondii DNA performed by a reference laboratory was negative. One month later (August), Toxoplasma serology was performed by enzyme-linked immunosorbent assay (ELISA) by a different reference laboratory and showed an elevated IgM of 0.95 IU/mL (reference values: negative; < 0.55 IU/mL, equivocal; > or = 0.55- < 0.65 IU/mL, positive; > or = 0.65 IU/mL) and a normal level of IgG (< 4 IU/mL). At this time, PCR was repeated and was negative. An additional month later (September), the patient's serology studies were performed at a third reference laboratory and showed an elevated IgM of 1.32 IU/mL (reference values: negative; 0.89, equivocal; 0.90 - 1.09, positive; > 1.10) and a normal IgG.

  4. Sustaining quality in the community: trends in the performance of a structured diabetes care programme in primary care over 16 years.

    PubMed

    Riordan, F; McHugh, S M; Harkins, V; Marsden, P; Kearney, P M

    2018-04-29

    To examine the quality of care delivered by a structured primary care-led programme for people with Type 2 diabetes mellitus in 1999-2016. The Midland Diabetes Structured Care Programme provides structured primary care-led management. Trends over time in care processes were examined (using a chi-squared trend test and age- and gender-adjusted logistic regression). Screening and annual review attendance were reviewed. A composite of eight National Institute for Health and Care Excellence-recommended processes was used as a quality indicator. Participants who were referred to diabetes nurse specialists were compared with those not referred (Student's t-test, Pearson's chi-squared test, Wilcoxon-Mann-Whitney test). Proportions achieving outcome targets [HbA 1c ≤58 mmol/mol (7.5%), blood pressure ≤140/80 mmHg, cholesterol <5.0 mmol/l] were calculated. Data were available for people with diabetes aged ≥18 years: 1998/1999 (n=336); 2003 (n=843); 2008 (n=988); and 2016 (n=1029). Recording of some processes improved significantly over time (HbA 1c , cholesterol, blood pressure, creatinine), and in 2016 exceeded 97%. Foot assessment and annual review attendance declined. In 2016, only 29% of participants had all eight National Institute for Health and Care Excellence processes recorded. A higher proportion of people with diabetes who were referred to a diabetes nurse specialist had poor glycaemic control compared with those not referred. The proportions meeting blood pressure and lipid targets increased over time. Structured primary care led to improvements in the quality of care over time. Poorer recording of some processes, a decline in annual review attendance, and participants remaining at high risk suggest limits to what structured care alone can achieve. Engagement in continuous quality improvement to target other factors, including attendance and self-management, may deliver further improvements. © 2018 Diabetes UK.

  5. The distribution of the indicator height for age of Mexican children and adolescents with Down syndrome according to different reference standards.

    PubMed

    Peña Rivera, Adriana Graciela; Vásquez Garibay, Edgar Manuel; Troyo Sanromán, Rogelio; Romero Velarde, Enrique; Caro Sabido, Erika; Ramírez Díaz, Joanie

    2015-06-01

    To compare the indicator height for age in Mexican children with Down Syndrome (DS) with two different reference patterns of growth (American and Spanish) that might be suitable for the Mexican population. A cross-sectional study was performed including 235 Mexican children and adolescents of both sexes with DS aged 45 days to 16 years enrolled in two specialized schools in the metropolitan area of Guadalajara. The dependent variables were weight/age; height/age; weight/ height and BMI. The data expressed was percentiles and the chi-square test was used to compare the distribution of the height/age index with American and Spanish reference patterns. In addition, a chi-square test was performed for the goodness of fit of the height/age index, with breakpoints lower and greater than the 50th percentile. The percentage of participants who were below the 50th percentile in the height/age index was significantly higher with the Spanish vs. the American reference pattern. The chi-square test for goodness of fit showed that the frequency of cases located below the 50th percentile in the height/age index was significantly higher with the American pattern in the age groups of 0 to 36 months (p = 0.022) and 37 to 72 months (p <0.001), but it was not significant (p = 0.225) in the older than 72 months age group. The American reference pattern is a better fit for the growth of Mexican children with DS compared with the Spanish reference pattern, and the distribution profile obtained with the standard growth and WHO reference was not suitable for the assessment of children with Down syndrome. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  6. Evaluation of continuing education of family health strategy teams for the early identification of suspected cases of cancer in children.

    PubMed

    Costa, Ana Maria Aranha Magalhaes; Magluta, Cynthia; Gomes Junior, Saint Clair

    2017-09-07

    This study evaluated the influence of continuing education of family health strategy teams by the Ronald McDonald Institute program on the early diagnosis of cancer in children and adolescents. The study applied Habicht's model to evaluate the adequacy and plausibility of continuing education by using as outcome the number of children with suspected cancer who were referred to the hospital of references in the 1 year before and 1 year after intervention and the number of patients referred by intervention group and control group family health strategy teams. Medical records from each hospital of reference were used to collect information of suspect cases of cancer. Descriptive analyses were performed using frequencies and mean values. Chi-square tests were used to assess statistically significant differences between the groups and periods by using p-values < 0.05. The results showed a 30.6% increase in the number of children referred to the hospital of reference for suspected cancer in the post-intervention period; in addition, the family health strategy teams that underwent the intervention referred 3.6 times more number of children to hospital of references than did the control group. Only the intervention group showed an increase in the number of confirmed cases. This evaluation of a continuing education program for early identification of pediatric cancer showed that the program was adequate in achieving the established goals and that the results could be attributed to the program.

  7. Trajectories of disposable income among people of working ages diagnosed with multiple sclerosis: a nationwide register-based cohort study in Sweden 7 years before to 4 years after diagnosis with a population-based reference group.

    PubMed

    Murley, Chantelle; Mogard, Olof; Wiberg, Michael; Alexanderson, Kristina; Karampampa, Korinna; Friberg, Emilie; Tinghög, Petter

    2018-05-09

    To describe how disposable income (DI) and three main components changed, and analyse whether DI development differed from working-aged people with multiple sclerosis (MS) to a reference group from 7 years before to 4 years after diagnosis in Sweden. Population-based cohort study, 12-year follow-up (7 years before to 4 years after diagnosis). Swedish working-age population with microdata linked from two nationwide registers. Residents diagnosed with MS in 2009 aged 25-59 years (n=785), and references without MS (n=7847) randomly selected with stratified matching (sex, age, education and country of birth). DI was defined as the annual after tax sum of incomes (earnings and benefits) to measure individual economic welfare. Three main components of DI were analysed as annual sums: earnings, sickness absence benefits and disability pension benefits. We found no differences in mean annual DI between people with and without MS by independent t-tests (p values between 0.15 and 0.96). Differences were found for all studied components of DI from diagnosis year by independent t-tests, for example, in the final study year (2013): earnings (-64 867 Swedish Krona (SEK); 95% CI-79 203 to -50 528); sickness absence benefits (13 330 SEK; 95% CI 10 042 to 16 500); and disability pension benefits (21 360 SEK; 95% CI 17 380 to 25 350). A generalised estimating equation evaluated DI trajectory development between people with and without MS to find both trajectories developed in parallel, both before (-4039 SEK; 95% CI -10 536 to 2458) and after (-781 SEK; 95% CI -6988 to 5360) diagnosis. The key finding of parallel DI trajectory development between working-aged MS and references suggests minimal economic impact within the first 4 years of diagnosis. The Swedish welfare system was responsive to the observed reductions in earnings around MS diagnosis through balancing DI with morbidity-related benefits. Future decreases in economic welfare may be experienced as the disease progresses, although thorough investigation with future studies of modern cohorts are required. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. Randomized, investigator-blinded, controlled clinical study with lice shampoo (Licener®) versus dimethicone (Jacutin® Pedicul Fluid) for the treatment of infestations with head lice.

    PubMed

    Semmler, Margit; Abdel-Ghaffar, Fathy; Gestmann, Falk; Abdel-Aty, Mohammed; Rizk, Ibrahim; Al-Quraishy, Saleh; Lehmacher, Walter; Hoff, Norman-Philipp

    2017-07-01

    The present clinical trial was conducted to obtain additional data for the safety and efficacy of a head lice shampoo that is free of silicone compared with an anti-head lice product containing dimethicone. Both products act by a physical mode of action. This randomized, investigator-blinded, controlled clinical study was conducted between July and November 2016 in households of two villages (Abou Rawash and Shandalat) in Egypt. Children older than 2 years with an active head lice infestation were treated with either a shampoo-based head lice treatment containing neem extract (Licener®) or dimethicone (Jacutin® Pedicul Fluid) on day 1 and additionally on day 9. Assessment for living lice by combing was conducted before and 1-2 h after treatment and on days 5 and 13. The main objective was to demonstrate a cure rate of the test product of at least 85% after a single application (day 5 and 9). Secondary objectives were to scrutinize patient safety and satisfaction as well as cure rates on day 13 after two treatments and the evaluation of ovicidal and licicidal efficacies of the products. Sixty-one children in the test-group (Licener®) and 58 children in the reference group (Jacutin® Pedicul Fluid) were included in this study. The test product and the reference product were very well tolerated. Both products exceeded the objective of cure rates of over 85% after single treatment (test group 60/60 = 100%; 95% CI = 94.04-100.00%; reference group 54/57 = 94.74%; 95% CI = 85.38-98.90%; p = 0.112; CI by Clopper-Pearson) and after two treatments (test group 58/58 = 100%; 95% CI = 93.84-100.00%; reference group 52/54 = 96.30%; 95% CI = 87.25-99.55%; p = 0.230) with higher cure rates and non-inferiority for the test product. The combined success rate shows significant superiority of the test product against the reference product (test group 58/58 = 100%; 95% CI = 93.84-100.00%; reference group 49/54 = 90.7%; 95% CI = 79.70-96.92%; p = 0.024). The test product showed higher ovicidal efficacy than the reference product. Thus, the present study demonstrates that a single treatment with a head lice product like Licener® can be sufficient to eliminate a head lice infestation.

  9. HIV counselling and testing practices for children seen in an urban emergency department of a tertiary referral hospital in Dar es Salaam, Tanzania: a retrospective cross-sectional study.

    PubMed

    Sawe, Hendry R; Mfinanga, Juma A; Ringo, Faith H; Mwafongo, Victor; Reynolds, Teri A; Runyon, Michael S

    2016-02-15

    To describe the HIV counselling and testing practices for children presenting to an emergency department (ED) in a low-income country. The ED of a large east African national referral hospital. This retrospective review of all paediatric (<18 years old) ED visits in 2012 enrolled patients who had an HIV test ordered and excluded those without testing. Files were available for 5540/5774 (96%) eligible patients and 1632 (30%) were tested for HIV, median age 1.3 years (IQR 9 months to 4 years), 58% <18 months old and 61% male. The primary outcome measure was documentation of pretest and post-test counselling, or deferral of counselling, for children tested for HIV in the ED. Secondary measures included the overall rate of HIV testing, rate of counselling documented in the inpatient record when deferred in the ED, rate of counselling documented when testing was initiated by the inpatient service, rate of counselling documented by test result (positive vs negative) and the rate of referral to follow-up HIV care among patients testing positive. Of 418 patients tested in the ED, counselling, or deferral of counselling, was documented for 70 (17%). When deferred to the ward, subsequent counselling was documented for 15/42 (36%). Counselling was documented in 33% of patients testing positive versus 1.1% patients testing negative (OR 43 (95% CI 23 to 83). Of 199 patients who tested positive and survived to hospital discharge, 76 (38%) were referred for follow-up at the HIV clinic on discharge. Physicians documented the provision, or deferral, of counselling for <20% of children tested for HIV in the ED. Counselling was much more likely to be documented when the test result was positive. Less than 40% of those testing positive were referred for follow-up care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  10. Association of Reference Payment for Colonoscopy With Consumer Choices, Insurer Spending, and Procedural Complications.

    PubMed

    Robinson, James C; Brown, Timothy T; Whaley, Christopher; Finlayson, Emily

    2015-11-01

    Regulatory limits on consumer cost sharing permit wide variation in the prices charged for screening and diagnostic tests such as colonoscopy. Employers are experimenting with reference payment initiatives that offer full insurance coverage at low-priced facilities but require substantial cost sharing if patients select high-priced alternatives. To ascertain the effect of reference payment on facility choice, insurer spending, consumer cost sharing, and procedural complications for colonoscopy. The California Public Employees' Retirement System (CalPERS) implemented reference payment in January 2012. We obtained data on 21 644 CalPERS enrollees who underwent colonoscopy in the 3 years prior to implementation and on 13 551 patients in the 2 years after implementation. Control group data were obtained on 258 616 Anthem Blue Cross enrollees who underwent colonoscopy and who were not subject to reference payment initiatives during this 5-year period. Consumer choice of facility, price paid per procedure, total insurer spending, consumer cost sharing, and procedural complications. Choices, prices, and complications were compared for CalPERS and Anthem patients before and after implementation of reference payments, using difference-in-difference multivariable regressions to adjust for patient demographic characteristics and comorbidities, procedure indications, and geographic location. Utilization of low-priced facilities for CalPERS members increased from 68.6% in 2009 to 90.5% in 2013. After adjusting for patient demographic characteristics, comorbidities, and other factors, the implementation of reference payment increased use of low-priced facilities by 17.6 percentage points (95% CI, 11.8 to 23.4; P < .001). The mean price paid for colonoscopy for the CalPERS population increased from $1587 (95% CI, $1555-$1618) in 2009 to $1716 (95% CI, $1678-$1753) in 2011 and then decreased to $1508 (95% CI, $1469-$1548) in 2013 for patients subject to reference payment. After adjustment for other relevant factors, reference payment was responsible for a 21.0% (95% CI, -26.0% to -15.6%, P < .001) reduction in the price. Reference payment was associated with a small but statistically insignificant decline in procedural complications, from 2.1% in 2009 to 2.0% in 2013 (P = .47). In the first 2 years after implementation, CalPERS saved $7.0 million (28%) on spending for the procedure. Implementation of reference payment for colonoscopy was associated with reduced spending and no change in complications.

  11. Benchmarks for the Dichotic Sentence Identification test in Brazilian Portuguese for ear and age.

    PubMed

    Andrade, Adriana Neves de; Gil, Daniela; Iorio, Maria Cecilia Martinelli

    2015-01-01

    Dichotic listening tests should be used in local languages and adapted for the population. Standardize the Brazilian Portuguese version of the Dichotic Sentence Identification test in normal listeners, comparing the performance for age and ear. This prospective study included 200 normal listeners divided into four groups according to age: 13-19 years (GI), 20-29 years (GII), 30-39 years (GIII), and 40-49 years (GIV). The Dichotic Sentence Identification was applied in four stages: training, binaural integration and directed sound from right and left. Better results for the right ear were observed in the stages of binaural integration in all assessed groups. There was a negative correlation between age and percentage of correct responses in both ears for free report and training. The worst performance in all stages of the test was observed for the age group 40-49 years old. Reference values for the Brazilian Portuguese version of the Dichotic Sentence Identification test in normal listeners aged 13-49 years were established according to age, ear, and test stage; they should be used as benchmarks when evaluating individuals with these characteristics. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  12. Nuclear Cryogenic Propulsion Stage (NCPS) Fuel Element Testing in the Nuclear Thermal Rocket Element Environmental Simulator (NTREES)

    NASA Technical Reports Server (NTRS)

    Emrich, William J., Jr.

    2017-01-01

    To support the on-going nuclear thermal propulsion effort, a state-of-the-art non nuclear experimental test setup has been constructed to evaluate the performance characteristics of candidate fuel element materials and geometries in representative environments. The facility to perform this testing is referred to as the Nuclear Thermal Rocket Element Environment Simulator (NTREES). Last year NTREES was successfully used to satisfy a testing milestone for the Nuclear Cryogenic Propulsion Stage (NCPS) project and met or exceeded all required objectives.

  13. Application of a Brazilian test of expressive vocabulary in European Portuguese children.

    PubMed

    Cáceres-Assenço, Ana Manhani; Ferreira, Sandra Cristina Araújo; Santos, Anabela Cruz; Befi-Lopes, Debora Maria

    2018-01-01

    Objective to investigate the performance of European Portuguese children in a Brazilian test of expressive vocabulary, seeking to identify differences between age groups and gender, and to verify its applicability in this population. Methods the sample consisted of 150 typical developed children, of both genders, between the ages of 5 and 6. All children attended public schools in the north area of Portugal. To assess the semantic performance, the expressive vocabulary sub-test of the language test (ABFW) was used, considering the percentage of usual verbal assignments and the classification (adequate/inadequate) according to the Brazilian reference values. Results the performance of the European Portuguese children indicated that at age 6 they have a higher percentage of correct answers in expressive vocabulary. As for the gender, there were only occasional differences: the girls showed a greater dominance in the semantic fields of clothing (both ages) and furniture and utensils (at age 5), whereas the boys showed more dominance in the semantic field means of transportation (6 years). Regarding classification, there was no difference between age groups in overall performance. Only the semantic field shapes and colors had more individuals of 6 years with inadequate performance. Conclusion the reference values adopted in the Brazilian population for semantic performance indicated that more than 80% of the children of each age group could have their performance classified as adequate. Such evidence suggests that this tool shows potential as an instrument of quantitative vocabulary's assessment of 5 and 6-years old children in European Portuguese.

  14. Cardiopulmonary Exercise Testing in Patients with Asymptomatic or Equivocal Symptomatic Aortic Stenosis: Feasibility, Reproducibility, Safety and Information Obtained on Exercise Physiology.

    PubMed

    van Le, Douet; Jensen, Gunnar Vagn Hagemann; Carstensen, Steen; Kjøller-Hansen, Lars

    2016-01-01

    The aim of this study was to determine the feasibility, reproducibility, safety and information obtained on exercise physiology from cardiopulmonary exercise testing (CPX) in patients with aortic stenosis. Patients with an aortic valve area (AVA) <1.3 cm2 who were judged asymptomatic or equivocal symptomatic underwent CPX and an inert gas rebreathing test. Only those where comprehensive evaluation of CPX results indicated haemodynamic compromise from aortic stenosis were referred for valve replacement. The mean patient age was 72 (±9) years; an AVA index <0.6 cm2/m2 and equivocal symptomatic status were found in 90 and 70%, respectively. CPX was feasible in 130 of the 131 patients. The coefficients of repeatability by test-retest were 5.4% (pVO2) and 4.6% (peak O2 pulse). A pVO2 <83% of the expected was predicted by a lower stroke volume at exercise, lower peak heart rate and FEV1, and higher VE/VCO2, but not by AVA index. Equivocal symptomatic status and a low gradient but high valvulo-arterial impedance were associated with a lower pVO2, but not with an inability to increase stroke volume. In total, 18 patients were referred for valve replacement. At 1 year, no cardiovascular deaths had occurred. CPX was feasible and reproducible and provided comprehensive data on exercise physiology. A CPX-guided treatment strategy was safe up to 1 year. © 2015 S. Karger AG, Basel.

  15. Reference Curves for Field Tests of Musculoskeletal Fitness in U.S. Children and Adolescents: The 2012 NHANES National Youth Fitness Survey.

    PubMed

    Laurson, Kelly R; Saint-Maurice, Pedro F; Welk, Gregory J; Eisenmann, Joey C

    2017-08-01

    Laurson, KR, Saint-Maurice, PF, Welk, GJ, and Eisenmann, JC. Reference curves for field tests of musculoskeletal fitness in U.S. children and adolescents: The 2012 NHANES National Youth Fitness Survey. J Strength Cond Res 31(8): 2075-2082, 2017-The purpose of the study was to describe current levels of musculoskeletal fitness (MSF) in U.S. youth by creating nationally representative age-specific and sex-specific growth curves for handgrip strength (including relative and allometrically scaled handgrip), modified pull-ups, and the plank test. Participants in the National Youth Fitness Survey (n = 1,453) were tested on MSF, aerobic capacity (via submaximal treadmill test), and body composition (body mass index [BMI], waist circumference, and skinfolds). Using LMS regression, age-specific and sex-specific smoothed percentile curves of MSF were created and existing percentiles were used to assign age-specific and sex-specific z-scores for aerobic capacity and body composition. Correlation matrices were created to assess the relationships between z-scores on MSF, aerobic capacity, and body composition. At younger ages (3-10 years), boys scored higher than girls for handgrip strength and modified pull-ups, but not for the plank. By ages 13-15, differences between the boys and girls curves were more pronounced, with boys scoring higher on all tests. Correlations between tests of MSF and aerobic capacity were positive and low-to-moderate in strength. Correlations between tests of MSF and body composition were negative, excluding absolute handgrip strength, which was inversely related to other MSF tests and aerobic capacity but positively associated with body composition. The growth curves herein can be used as normative reference values or a starting point for creating health-related criterion reference standards for these tests. Comparisons with prior national surveys of physical fitness indicate that some components of MSF have likely decreased in the United States over time.

  16. Prevalence of acquired undescended testis in 6‐year, 9‐year and 13‐year‐old Dutch schoolboys

    PubMed Central

    Hack, W W M; Sijstermans, K; van Dijk, J; van der Voort‐Doedens, L M; de Kok, M E; Hobbelt‐Stoker, M J

    2007-01-01

    Objective To investigate the prevalence of acquired undescended testis (UDT) in Dutch schoolboys. Design and participants As a part of routine school medical examinations, during a 2‐year period (2001–3), testis position was determined in 6‐year, 9‐year and 13‐year‐old schoolboys. Before the examination, a parent questionnaire was sent inquiring both about the position of the testes and whether the child had been admitted earlier to hospital for orchidopexy. In 6‐year and 13‐year olds, a physical examination was performed by the school medical officer; in 9‐year olds, a school nurse interview was held. Each boy for whom there was any doubt of the scrotal position was referred to the hospital for examination of both testes. Setting Institution for Youth Health Care “Noordkennemerland” and Medical Centre Alkmaar, Alkmaar, the Netherlands. Results Testis position was determined in 2042 boys aged 6, 1038 aged 9 and 353 aged 13. Of these, 47, 53 and 8 boys, respectively, were referred to the hospital and seen for further evaluation. The diagnosis of acquired UDT was made in 25 boys aged 6, 23 aged 9 and four aged 13. In 33 boys, a congenital UDT was diagnosed; 32 (97%) had already been diagnosed and treated at an early age. Conclusions The prevalence of acquired UDT for 6‐year, 9‐year and 13‐year olds was, respectively, 1.2% (25/2042), 2.2% (23/1038) and 1.1% (4/353). In addition, congenital UDT is treated during the early years of life and, in contrast with popular belief, screening programmes for detecting UDT in the early years are successful. PMID:16905567

  17. The Howard University Hospital Experience with Routineized HIV Screening: A Progress Report*

    PubMed Central

    Scott, Victor F.; Sitapati, Amy; Martin, Sayyida; Summers, Pamela; Washington, Michael; Daniels, Fernando; Mouton, Charles; Bonney, George; Apprey, Victor; Webster, Virginia; Smith, Avemaria; Mountvarner, Geoffrey; Daftary, Monica; Maxwell, Celia J.

    2009-01-01

    Background: Howard University Hospital (HUH) is the first hospital in the nation to have instituted a hospital-wide routine rapid HIV screening campaign as recommended by the CDC for healthcare settings. Methods: HUH developed a protocol and implemented a hospital-wide routine HIV screening in October 2006. Rapid oral fluid-based HIV testing was conducted throughout the hospital using the OraSure OraQuick Advance Rapid HIV-1/2 Antibody Test. Patients with a preliminarily reactive test result were either referred for confirmatory testing or offered a Western Blot confirmatory test on-site and referred for follow-up care. This is a report on the progress of this program for the first eight months. Results: Of the 9,817 patients offered HIV testing, 5,642 consented. The mean age of the screened population was 40.7 years. Ninety percent of the patients screened were black and 55% were female. A preliminarily reactive test result was identified in 139 patients for a seroprevalence rate of 2.46%. Of these patients, 136, or 98% were black; 63% were male and 37% were female. HIV prevalence in the overall sample, among blacks, and among both black males and females peaked in the 40–54 year old age group. Challenges were experienced initially in securing confirmatory tests. Conclusions: Hospital-wide routine HIV screening is both possible and productive. The routine HIV screening campaign instituted at Howard University Hospital has identified a significant number of previously unidentified HIV positive persons. Success in assuring confirmatory testing and transition to care improved as time progressed. PMID:19768195

  18. The Howard University Hospital experience with routineized HIV screening: a progress report.

    PubMed

    Scott, Victor F; Sitapati, Amy; Martin, Sayyida; Summers, Pamela; Washington, Michael; Daniels, Fernando; Mouton, Charles; Bonney, George; Apprey, Victor; Webster, Virginia; Smith, Avemaria; Mountvarner, Geoffrey; Daftary, Monica; Maxwell, Celia J

    2009-01-01

    Howard University Hospital (HUH) is the first hospital in the nation to have instituted a hospital-wide routine rapid HIV screening campaign as recommended by the CDC for healthcare settings. HUH developed a protocol and implemented a hospital-wide routine HIV screening in October 2006. Rapid oral fluid-based HIV testing was conducted throughout the hospital using the OraSure OraQuick Advance Rapid HIV-1/2 Antibody Test. Patients with a preliminarily reactive test result were either referred for confirmatory testing or offered a Western Blot confirmatory test on-site and referred for follow-up care. This is a report on the progress of this program for the first eight months. Of the 9,817 patients offered HIV testing, 5,642 consented. The mean age of the screened population was 40.7 years. Ninety percent of the patients screened were black and 55% were female. A preliminarily reactive test result was identified in 139 patients for a seroprevalence rate of 2.46%. Of these patients, 136, or 98% were black; 63% were male and 37% were female. HIV prevalence in the overall sample, among blacks, and among both black males and females peaked in the 40-54 year old age group. Challenges were experienced initially in securing confirmatory tests. Hospital-wide routine HIV screening is both possible and productive. The routine HIV screening campaign instituted at Howard University Hospital has identified a significant number of previously unidentified HIV positive persons. Success in assuring confirmatory testing and transition to care improved as time progressed.

  19. Acceptability of HIV/AIDS testing among pre-marital couples in Iran (2012)

    PubMed Central

    Ayatollahi, Jamshid; Nasab Sarab, Mohammad Ali Bagheri; Sharifi, Mohammad Reza; Shahcheraghi, Seyed Hossein

    2014-01-01

    Background: Human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) is a lifestyle-related disease. This disease is transmitted through unprotected sex, contaminated needles, infected blood transfusion and from mother to child during pregnancy and delivery. Prevention of infection with HIV, mainly through safe sex and needle exchange programmes is a solution to prevent the spread of the disease. Knowledge about HIV state helps to prevent and subsequently reduce the harm to the later generation. The purpose of this study was to assess the willingness rate of couples referred to the family regulation pre-marital counselling centre for performing HIV test before marriage in Yazd. Patients and Methods: In this descriptive study, a simple random sampling was done among people referred to Akbari clinic. The couples were 1000 men and 1000 women referred to the premarital counselling centre for pre-marital HIV testing in Yazd in the year 2012. They were in situations of pregnancy, delivery or nursing and milking. The data were analyzed using Statistical Package for the Social Sciences (SPSS) software and chi-square statistical test. Results: There was a significant statistical difference between the age groups about willingness for HIV testing before marriage (P < 0.001) and also positive comments about HIV testing in asymptomatic individuals (P < 0.001). This study also proved a significant statistical difference between the two gender groups about willingness to marry after HIV positive test of their wives. Conclusion: The willingness rate of couples to undergo HIV testing before marriage was significant. Therefore, HIV testing before marriage as a routine test was suggested. PMID:25114363

  20. Acceptability of HIV/AIDS testing among pre-marital couples in Iran (2012).

    PubMed

    Ayatollahi, Jamshid; Nasab Sarab, Mohammad Ali Bagheri; Sharifi, Mohammad Reza; Shahcheraghi, Seyed Hossein

    2014-07-01

    Human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) is a lifestyle-related disease. This disease is transmitted through unprotected sex, contaminated needles, infected blood transfusion and from mother to child during pregnancy and delivery. Prevention of infection with HIV, mainly through safe sex and needle exchange programmes is a solution to prevent the spread of the disease. Knowledge about HIV state helps to prevent and subsequently reduce the harm to the later generation. The purpose of this study was to assess the willingness rate of couples referred to the family regulation pre-marital counselling centre for performing HIV test before marriage in Yazd. In this descriptive study, a simple random sampling was done among people referred to Akbari clinic. The couples were 1000 men and 1000 women referred to the premarital counselling centre for pre-marital HIV testing in Yazd in the year 2012. They were in situations of pregnancy, delivery or nursing and milking. The data were analyzed using Statistical Package for the Social Sciences (SPSS) software and chi-square statistical test. There was a significant statistical difference between the age groups about willingness for HIV testing before marriage (P < 0.001) and also positive comments about HIV testing in asymptomatic individuals (P < 0.001). This study also proved a significant statistical difference between the two gender groups about willingness to marry after HIV positive test of their wives. The willingness rate of couples to undergo HIV testing before marriage was significant. Therefore, HIV testing before marriage as a routine test was suggested.

  1. Attention Problems and Stability of WISC-IV Scores Among Clinically Referred Children.

    PubMed

    Green Bartoi, Marla; Issner, Jaclyn Beth; Hetterscheidt, Lesley; January, Alicia M; Kuentzel, Jeffrey Garth; Barnett, Douglas

    2015-01-01

    We examined the stability of Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) scores among 51 diverse, clinically referred 8- to 16-year-olds (M(age) = 11.24 years, SD = 2.36). Children were referred to and tested at an urban, university-based training clinic; 70% of eligible children completed follow-up testing 12 months to 40 months later (M = 22.05, SD = 5.94). Stability for index scores ranged from .58 (Processing Speed) to .81 (Verbal Comprehension), with a stability of .86 for Full-Scale IQ. Subtest score stability ranged from .35 (Letter-Number Sequencing) to .81 (Vocabulary). Indexes believed to be more susceptible to concentration (Processing Speed and Working Memory) had lower stability. We also examined attention problems as a potential moderating factor of WISC-IV index and subtest score stability. Children with attention problems had significantly lower stability for Digit Span and Matrix Reasoning subtests compared with children without attention problems. These results provide support for the temporal stability of the WISC-IV and also provide some support for the idea that attention problems contribute to children producing less stable IQ estimates when completing the WISC-IV. We hope our report encourages further examination of this hypothesis and its implications.

  2. Identification of trend in long term precipitation and reference evapotranspiration over Narmada river basin (India)

    NASA Astrophysics Data System (ADS)

    Pandey, Brij Kishor; Khare, Deepak

    2018-02-01

    Precipitation and reference evapotranspiration are key parameters in hydro-meteorological studies and used for agricultural planning, irrigation system design and management. Precipitation and evaporative demand are expected to be alter under climate change and affect the sustainable development. In this article, spatial variability and temporal trend of precipitation and reference evapotranspiration (ETo) were investigated over Narmada river basin (India), a humid tropical climatic region. In the present study, 12 and 28 observatory stations were selected for precipitation and ETo, respectively of 102-years period (1901-2002). A rigorous analysis for trend detection was carried out using non parametric tests such as Mann-Kendall (MK) and Spearman Rho (SR). Sen's slope estimator was used to analyze the rate of change in long term series. Moreover, all the stations of basin exhibit positive trend for annual ETo, while 8% stations indicate significant negative trend for mean annual precipitation, respectively. Change points of annual precipitation were identified around the year 1962 applying Buishand's and Pettit's test. Annual mean precipitation reduced by 9% in upper part while increased maximum by 5% in lower part of the basin due temporal changes. Although annual mean ETo increase by 4-12% in most of the region. Moreover, results of the study are very helpful in planning and development of agricultural water resources.

  3. The eGFR-C study: accuracy of glomerular filtration rate (GFR) estimation using creatinine and cystatin C and albuminuria for monitoring disease progression in patients with stage 3 chronic kidney disease--prospective longitudinal study in a multiethnic population.

    PubMed

    Lamb, Edmund J; Brettell, Elizabeth A; Cockwell, Paul; Dalton, Neil; Deeks, Jon J; Harris, Kevin; Higgins, Tracy; Kalra, Philip A; Khunti, Kamlesh; Loud, Fiona; Ottridge, Ryan S; Sharpe, Claire C; Sitch, Alice J; Stevens, Paul E; Sutton, Andrew J; Taal, Maarten W

    2014-01-14

    Uncertainty exists regarding the optimal method to estimate glomerular filtration rate (GFR) for disease detection and monitoring. Widely used GFR estimates have not been validated in British ethnic minority populations. Iohexol measured GFR will be the reference against which each estimating equation will be compared. The estimating equations will be based upon serum creatinine and/or cystatin C. The eGFR-C study has 5 components: 1) A prospective longitudinal cohort study of 1300 adults with stage 3 chronic kidney disease followed for 3 years with reference (measured) GFR and test (estimated GFR [eGFR] and urinary albumin-to-creatinine ratio) measurements at baseline and 3 years. Test measurements will also be undertaken every 6 months. The study population will include a representative sample of South-Asians and African-Caribbeans. People with diabetes and proteinuria (ACR ≥30 mg/mmol) will comprise 20-30% of the study cohort.2) A sub-study of patterns of disease progression of 375 people (125 each of Caucasian, Asian and African-Caribbean origin; in each case containing subjects at high and low risk of renal progression). Additional reference GFR measurements will be undertaken after 1 and 2 years to enable a model of disease progression and error to be built.3) A biological variability study to establish reference change values for reference and test measures.4) A modelling study of the performance of monitoring strategies on detecting progression, utilising estimates of accuracy, patterns of disease progression and estimates of measurement error from studies 1), 2) and 3).5) A comprehensive cost database for each diagnostic approach will be developed to enable cost-effectiveness modelling of the optimal strategy.The performance of the estimating equations will be evaluated by assessing bias, precision and accuracy. Data will be modelled as a linear function of time utilising all available (maximum 7) time points compared with the difference between baseline and final reference values. The percentage of participants demonstrating large error with the respective estimating equations will be compared. Predictive value of GFR estimates and albumin-to-creatinine ratio will be compared amongst subjects that do or do not show progressive kidney function decline. The eGFR-C study will provide evidence to inform the optimal GFR estimate to be used in clinical practice. ISRCTN42955626.

  4. The Measurement of Translation Ability.

    ERIC Educational Resources Information Center

    Stansfield, Charles W.; And Others

    1992-01-01

    Variables that constitute translation ability are discussed, based on a two-year development and validation study of job-related tests of translation ability for the Federal Bureau of Investigation. The project involved the development of two parallel forms of the Spanish into English Verbatim Translation Exam (SEVTE). (five references) (LB)

  5. Novel retinopathy in related Gordon setters: a clinical, behavioral, electrophysiological, and genetic investigation.

    PubMed

    Good, Kathryn L; Komáromy, András M; Kass, Philip H; Ofri, Ron

    2016-09-01

    To conduct ophthalmic, behavioral, electrophysiological, and genetic testing on two related Gordon setters presented for day blindness and compare findings with those of nine related and unrelated Gordon setters. All dogs underwent comprehensive ophthalmic examination. Maze testing was conducted under different light intensities. Rod and cone function was assessed electroretinographically. DNA samples were screened for five canine retinal disease gene mutations. Ophthalmic examination was unremarkable in all dogs. There was no notable difference between day blind dogs and the reference population in scotopic and mesopic maze tests. Day blind dogs performed worse in the photopic maze with slower course completion time and more obstacle collisions. Electroretinography revealed extinguished cone function in day blind dogs and depressed rod responses in all but two reference dogs. One reference population dog presented with day blindness 1 year after initial examination. Mutations that cause achromatopsia (in CNGB3) and cone-rod dystrophies (in ADAM9 and IQCB1) were not detected in any dog tested, although five reference dogs were carriers of the mutation in C2orf71 that causes rod-cone degeneration 4 (rcd4) in Gordon setters and in polski owczarek nizinny dogs. This report describes a novel retinopathy in related Gordon setters that has clinical signs and vision testing results consistent with achromatopsia but electroretinographic results suggestive of cone-rod dystrophy. The majority of Gordon setters in this study had low rod responses on electroretinography but it is unclear whether this was indicative of rod dysfunction or normal for the breed. Longer-term observation of affected individuals is warranted. © 2015 American College of Veterinary Ophthalmologists.

  6. In vitro testing of Nd:YAG laser processed calcium phosphate coatings.

    PubMed

    De Carlos, A; Lusquiños, F; Pou, J; León, B; Pérez-Amor, M; Driessens, F C M; Hing, K; Best, S; Bonfield, W

    2006-11-01

    Nd:YAG laser cladding is a new method for deposition of a calcium phosphate onto metallic surfaces of interest in implantology. The aim of this study was to compare the biologic response of MG-63 human osteoblast-like cells grown on Ti-6Al-4V substrates coated with a calcium phosphate layer applied using different methods: plasma spraying as reference material and Nd:YAG laser cladding as test material. Tissue culture polystyrene was used as negative control. The Nd:YAG laser clad material showed a behaviour similar to the reference material, plasma spray, respective to cell morphology (SEM observations), cell proliferation (AlamarBlue assay) and cytotoxicity of extracts (MTT assay). Proliferation, as measured by the AlamarBlue assay, showed little difference in the metabolic activity of the cells on the materials over an 18 day culture period. There were no significant differences in the cellular growth response on the test material when compared to the ones exhibited by the reference material. In the solvent extraction test all the extracts had some detrimental effect on cellular activity at 100% concentration, although cells incubated in the test material extract showed a proliferation rate similar to that of the reference material. To better understand the scope of these results it should be taken into account that the Nd:YAG clad coating has recently been developed. The fact that its in vitro performance is comparable to that produced by plasma spray, a material commercially available for more than ten years, indicates that this new laser based method could be of commercial interest in the near future.

  7. Celiac disease: management of persistent symptoms in patients on a gluten-free diet.

    PubMed

    Dewar, David H; Donnelly, Suzanne C; McLaughlin, Simon D; Johnson, Matthew W; Ellis, H Julia; Ciclitira, Paul J

    2012-03-28

    To investigate all patients referred to our center with non-responsive celiac disease (NRCD), to establish a cause for their continued symptoms. We assessed all patients referred to our center with non-responsive celiac disease over an 18-mo period. These individuals were investigated to establish the eitiology of their continued symptoms. The patients were first seen in clinic where a thorough history and examination were performed with routine blood work including tissue transglutaminase antibody measurement. They were also referred to a specialist gastroenterology dietician to try to identift any lapses in the diet and sources of hidden gluten ingestion. A repeat small intestinal biopsy was also performed and compared to biopsies from the referring hospital where possible. Colonoscopy, lactulose hydrogen breath testing, pancreolauryl testing and computed tomography scan of the abdomen were undertaken if the symptoms persisted. Their clinical progress was followed over a minimum of 2 years. One hundred and twelve consecutive patients were referred with NRCD. Twelve were found not to have celiac disease (CD). Of the remaining 100 patients, 45% were not adequately adhering to a strict gluten-free diet, with 24 (53%) found to be inadvertently ingesting gluten, and 21 (47%) admitting non-compliance. Microscopic colitis was diagnosed in 12% and small bowel bacterial overgrowth in 9%. Refractory CD was diagnosed in 9%. Three of these were diagnosed with intestinal lymphoma. After 2 years, 78 patients remained well, eight had continuing symptoms, and four had died. In individuals with NRCD, a remediable cause can be found in 90%: with continued gluten ingestion as the leading cause. We propose an algorithm for investigation.

  8. Complex reference values for endocrine and special chemistry biomarkers across pediatric, adult, and geriatric ages: establishment of robust pediatric and adult reference intervals on the basis of the Canadian Health Measures Survey.

    PubMed

    Adeli, Khosrow; Higgins, Victoria; Nieuwesteeg, Michelle; Raizman, Joshua E; Chen, Yunqi; Wong, Suzy L; Blais, David

    2015-08-01

    Defining laboratory biomarker reference values in a healthy population and understanding the fluctuations in biomarker concentrations throughout life and between sexes are critical to clinical interpretation of laboratory test results in different disease states. The Canadian Health Measures Survey (CHMS) has collected blood samples and health information from the Canadian household population. In collaboration with the Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER), the data have been analyzed to determine reference value distributions and reference intervals for several endocrine and special chemistry biomarkers in pediatric, adult, and geriatric age groups. CHMS collected data and blood samples from thousands of community participants aged 3 to 79 years. We used serum samples to measure 13 immunoassay-based special chemistry and endocrine markers. We assessed reference value distributions and, after excluding outliers, calculated age- and sex-specific reference intervals, along with corresponding 90% CIs, according to CLSI C28-A3 guidelines. We observed fluctuations in biomarker reference values across the pediatric, adult, and geriatric age range, with stratification required on the basis of age for all analytes. Additional sex partitions were required for apolipoprotein AI, homocysteine, ferritin, and high sensitivity C-reactive protein. The unique collaboration between CALIPER and CHMS has enabled, for the first time, a detailed examination of the changes in various immunochemical markers that occur in healthy individuals of different ages. The robust age- and sex-specific reference intervals established in this study provide insight into the complex biological changes that take place throughout development and aging and will contribute to improved clinical test interpretation. © 2015 American Association for Clinical Chemistry.

  9. Cardiac Channel Molecular Autopsy: Insights From 173 Consecutive Cases of Autopsy-Negative Sudden Unexplained Death Referred for Postmortem Genetic Testing

    PubMed Central

    Tester, David J.; Medeiros-Domingo, Argelia; Will, Melissa L.; Haglund, Carla M.; Ackerman, Michael J.

    2012-01-01

    Objective To perform long QT syndrome and catecholaminergic polymorphic ventricular tachycardia cardiac channel postmortem genetic testing (molecular autopsy) for a large cohort of cases of autopsy-negative sudden unexplained death (SUD). Methods From September 1, 1998, through October 31, 2010, 173 cases of SUD (106 males; mean ± SD age, 18.4±12.9 years; age range, 1-69 years; 89% white) were referred by medical examiners or coroners for a cardiac channel molecular autopsy. Using polymerase chain reaction, denaturing high-performance liquid chromatography, and DNA sequencing, a comprehensive mutational analysis of the long QT syndrome susceptibility genes (KCNQ1, KCNH2, SCN5A, KCNE1, and KCNE2) and a targeted analysis of the catecholaminergic polymorphic ventricular tachycardia type 1–associated gene (RYR2) were conducted. Results Overall, 45 putative pathogenic mutations absent in 400 to 700 controls were identified in 45 autopsy-negative SUD cases (26.0%). Females had a higher yield (26/67 [38.8%]) than males (19/106 [17.9%]; P<.005). Among SUD cases with exercise-induced death, the yield trended higher among the 1- to 10-year-olds (8/12 [66.7%]) compared with the 11- to 20-year-olds (4/27 [14.8%]; P=.002). In contrast, for those who died during a period of sleep, the 11- to 20-year-olds had a higher yield (9/25 [36.0%]) than the 1- to 10-year-olds (1/24 [4.2%]; P=.01). Conclusion Cardiac channel molecular autopsy should be considered in the evaluation of autopsy-negative SUD. Several interesting genotype-phenotype observations may provide insight into the expected yields of postmortem genetic testing for SUD and assist in selecting cases with the greatest potential for mutation discovery and directing genetic testing efforts. PMID:22677073

  10. [Audiological characteristics of young children with otitis media with effusion].

    PubMed

    Wang, Qiu-ju; Shi, Wei; Lan, Lan; Wang, Da-yong; Zhang, Ya-mei

    2008-12-01

    To characterize the audiological features in the infants with otitis media with effusion (OME) and to investigate the utility of variety of objective audiometry methods in diagnosis and intervention on OME. Fifty six infants (40 males and 16 females) were investigated, who were referred to our clinic at the General Hospital of Chinese People's Liberation Army by the other hospitals from December 2004 to June 2007 when the infants were diagnosed or highly suspected of OME. The ages at the initial diagnosis ranged from 42 days to three years, with an average of five months. The infants, after receiving the conventional otolaryngological exams, were subjected to the tests of auditory brainstem response (ABR), otoacoustic emission (OAE), tympanometry (226 Hz and 1000 Hz) and behaviors audiometry. Among 56 affected infants, 87 ears were diagnosed with OME, of which 31 infants were affected bilateral and 25 with monaural. For the 49 infants who received hearing screening at birth, 36 infants were referred at the initial screening. For the 52 infants who received repeated screening, all subjects were referred. Six infants without receiving hearing screening came to clinic when their parents observed their kids' hearing impairment. Among the 52 cases (104 ears) who received tympanometry test, 20 subjects (28 ears) showed B or C type tympanometry curve. Thirty-nine cases (78 ears) were given tympanometry test at 1000 Hz, of which 38 cases (55 ears) showed abnormal hearing. Among 56 infants (112 ears) with ABR test, 49 subjects (74 ears) exhibited prolonged ABR type I curve. All 56 infants (112 ears) received OAE test, of which 55 subjects (81 ears) were referred. Four infants (8 ears) accepted the behavior test and all of them showed A-B Gap. The combined tympanometry test at both 226 Hz and 1000 Hz, ABR latency or threshold test, infant's behavior test and OAE, used jointly, enable characterizing better OME in infants, thus helping early diagnosis of this hearing disorder.

  11. The association of clinical indication for exercise stress testing with all-cause mortality: the FIT Project

    PubMed Central

    Kim, Joonseok; Al-Mallah, Mouaz; Juraschek, Stephen P.; Brawner, Clinton; Keteyian, Steve J.; Nasir, Khurram; Dardari, Zeina A.; Blumenthal, Roger S.

    2016-01-01

    Introduction We hypothesized that the indication for stress testing provided by the referring physician would be an independent predictor of all-cause mortality. Material and methods We studied 48,914 patients from The Henry Ford Exercise Testing Project (The FIT Project) without known congestive heart failure who were referred for a clinical treadmill stress test and followed for 11 ±4.7 years. The reason for stress test referral was abstracted from the clinical test order, and should be considered the primary concerning symptom or indication as stated by the ordering clinician. Hierarchical multivariable Cox proportional hazards regression was performed, after controlling for potential confounders including demographics, risk factors, and medication use as well as additional adjustment for exercise capacity in the final model. Results A total of 67% of the patients were referred for chest pain, 12% for shortness of breath (SOB), 4% for palpitations, 3% for pre-operative evaluation, 6% for abnormal prior testing, and 7% for risk factors only. There were 6,211 total deaths during follow-up. Compared to chest pain, those referred for palpitations (HR = 0.72, 95% CI: 0.60–0.86) and risk factors only (HR = 0.72, 95% CI: 0.63–0.82) had a lower risk of all-cause mortality, whereas those referred for SOB (HR = 1.15, 95% CI: 1.07–1.23) and pre-operative evaluation (HR = 2.11, 95% CI: 1.94–2.30) had an increased risk. In subgroup analysis, referral for palpitations was protective only in those without coronary artery disease (CAD) (HR = 0.75, 95% CI: 0.62–0.90), while SOB increased mortality risk only in those with established CAD (HR = 1.25, 95% CI: 1.10–1.44). Conclusions The indication for stress testing is an independent predictor of mortality, showing an interaction with CAD status. Importantly, SOB may be associated with higher mortality risk than chest pain, particularly in patients with CAD. PMID:27186173

  12. The relative bioavailability and fasting pharmacokinetics of three formulations of olmesartan medoxomil 20-mg capsules and tablets in healthy Chinese male volunteers: An open-label, randomized-sequence, single-dose, three-way crossover study.

    PubMed

    Li, Kun-Yan; Liang, Jian-Ping; Hu, Bing-Qiang; Qiu, Yu; Luo, Chen-Hui; Jiang, Yun; Lin, Xiao-Ping; Yang, Nong

    2010-08-01

    Olmesartan medoxomil is an angiotensin II-receptor antagonist used in the treatment of hypertension. It is a prodrug and is converted to the pharmacologically active compound on de-esterification by arylesterase in the gastrointestinal tract. This study investigated the relative bioavailability and fasting pharmacokinetic properties of olmesartan after single doses of a 20-mg test tablet, a 20-mg test capsule, and a commercially available 20-mg reference tablet in healthy Chinese male volunteers. The study was conducted to satisfy Chinese State Food and Drug Administration regulatory requirements for approval of a generic formulation of olmesartan medoxomil. This study had an open-label, randomized-sequence, single-dose, 3-treatment, 3-period crossover design. Healthy volunteers were randomly assigned in a 1:1:1 ratio to receive a single 20-mg dose of the test tablet, test capsule, or reference tablet, each administered after a 12-hour overnight fast, followed by a 1-week washout period and administration of the alternate formulation. Blood samples were obtained at baseline and at 0.5, 1, 1.5,2,2.5,3,4,6,8,12,24,36, and 48 hours after dosing. Tolerability was assessed based on vital signs and laboratory values obtained before and after administration of study drug. The formulations were assumed to be bioequivalent if the 90% CIs for the log-transformed ratios of C(max), AUC(0-t), and AUC(0-∞) were within the predetermined equivalence range (70%-143% for C(max); 80%-125% for AUC(0-t) and AUC(0-∞)), as established by the Chinese State Food and Drug Administration. Twenty-one healthy male subjects (mean age, 21 years [range, 18-25 years]; weight, 62.1 kg [range, 54.0-80.0 kg]) were enrolled in and completed the study. No period or sequence effect was observed. The mean AUC(0-∞) values for the test tablet, test capsule, and reference tablet were 3993 (1070), 3567 (850), and 3849 (872) ng/mL/h, respectively. The 90% CIs for the log-transformed ratios of test tablet to reference tablet for C(max), AUC(0-48), and AUC(0-∞) were 103.9 to 124.9, 94.0 to 111.5, and 94.4 to 111.7, respectively (all, P = NS). The corresponding 90% CIs for the log-transformed ratios of test capsule to reference tablet were 90.8 to 109.2, 84.9 to 107.9, and 85.1 to 100.7 (all, P = NS). Ten adverse events were reported during the study; 7 subjects complained of pain during blood sampling, and 3 had a blocked venous catheter. No treatment-related adverse events were reported or observed. In this single-dose crossover study in healthy Chinese male volunteers, the test and reference formulations of olmesartan medoxomil 20-mg capsules and tablets met the regulatory criteria for assuming bioequivalence. The 3 formulations were well tolerated. Copyright © 2010 Excerpta Medica Inc. All rights reserved.

  13. Physical fitness percentile charts for children aged 6-10 from Portugal.

    PubMed

    Roriz De Oliveira, M S; Seabra, A; Freitas, D; Eisenmann, J C; Maia, J

    2014-12-01

    The present study aims (1) to provide reference percentile charts for the following measures of Physical Fitness (PF): the sit-and-reach, handgrip, standing long jump, 50 yards' dash, 4x10m shuttle run and 1-mile run/walk tests in children aged 6 to 10 years, and (2) to compare the performance of the Portuguese children with their age- and sex peers. A total of 3804 Portuguese children (1985 boys and 1819 girls) aged 6-10 years old participated in this study. The sample was stratified from 20 public elementary schools and children were randomly selected in each school. Charts were separately built for each sex using the LMS method. Boys showed better results than girls in handgrip, standing long jump, 50 yards' dash, 4x10 m shuttle run and 1-mile run/walk, while girls are better performers than boys in sit-and-reach. Age- and gender- percentiles for a set of physical fitness tests for 6-10 year old (primary school) Portuguese children have been established. Boys showed greater overall PF than girls, except in the flexibility test, in which girls performed better. The reported normative values provide ample opportunities to accurately detect individual changes during childhood. These reference values are especially important in healthcare and educational settings, and can be added to the worldwide literature on physical fitness values in children.

  14. Routine development of objectively derived search strategies.

    PubMed

    Hausner, Elke; Waffenschmidt, Siw; Kaiser, Thomas; Simon, Michael

    2012-02-29

    Over the past few years, information retrieval has become more and more professionalized, and information specialists are considered full members of a research team conducting systematic reviews. Research groups preparing systematic reviews and clinical practice guidelines have been the driving force in the development of search strategies, but open questions remain regarding the transparency of the development process and the available resources. An empirically guided approach to the development of a search strategy provides a way to increase transparency and efficiency. Our aim in this paper is to describe the empirically guided development process for search strategies as applied by the German Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, or "IQWiG"). This strategy consists of the following steps: generation of a test set, as well as the development, validation and standardized documentation of the search strategy. We illustrate our approach by means of an example, that is, a search for literature on brachytherapy in patients with prostate cancer. For this purpose, a test set was generated, including a total of 38 references from 3 systematic reviews. The development set for the generation of the strategy included 25 references. After application of textual analytic procedures, a strategy was developed that included all references in the development set. To test the search strategy on an independent set of references, the remaining 13 references in the test set (the validation set) were used. The validation set was also completely identified. Our conclusion is that an objectively derived approach similar to that used in search filter development is a feasible way to develop and validate reliable search strategies. Besides creating high-quality strategies, the widespread application of this approach will result in a substantial increase in the transparency of the development process of search strategies.

  15. Frequency of Unnecessarily Biopsies among Patients with Suspicion of Prostate Cancer in Syrian Men.

    PubMed

    Bachour, Dala-Maria; Chahin, Emil; Al-Fahoum, Sahar

    2015-01-01

    The prevalence of prostate cancer is considered high in many countries, and screening tests are very important in order to detect prostate cancer in its early stages; however false positivity with these screening tests means that a lot of patients undergo unnecessary biopsy, which is an invasive procedure, for the confirmatory test. The purpose of this study was to estimate the frequency of unnecessary biopsy cases in patients referred for prostate biopsy in one of the most important and overload cancer centers in Syria. Retrospective data for a period of four years between January 2009 and December 2012 were collected in Al- Bayrouni University Medical hospital in Damascus, Syria. The patients from whom data were collected were referred to our histopathological department because of elevated prostate specific antigen (PSA) serum or an abnormal digital rectal examination (DRE). All patients underwent prostatic TRUS-guided biopsies. Diagnosis of prostate cancer (PCa) or benign prostatic hyperplasia (BPH) was based on histopathological examination and prostate cancers cases were graded and scored according to the Gleason score system. For the 406 patients referred to biopsy, the mean±SD age was 58.4 ±23.3 years. The mean ± SD PSA level was 49.2±21.5 ng/ ml. Of the total we found 237 patients diagnosed with PCa (58. 4%), 166 patients with BPH (40.9%) and 3 cases were unable to be diagnosed (0.7%) because of biopsy collection errors. Our study shows that a high percentage of patients are undergoing unnecessary biopsy, which suggests that the performed screening tests had a high level of false positive and may need re-evaluation.

  16. How fit are children and adolescents with haemophilia in Germany? Results of a prospective study assessing the sport-specific motor performance by means of modern test procedures of sports science.

    PubMed

    Seuser, A; Boehm, P; Ochs, S; Trunz-Carlisi, E; Halimeh, S; Klamroth, R

    2015-07-01

    There are a lot of publications on the physical fitness of patients with haemophilia (PWH), however, most studies only reflect individual sport-specific motor capacities or focus on a single fitness ability. They involve small patient populations. In this respect principal objective of this study was to compare the physical fitness in all respects and the body composition of young PWH to healthy peers based on the most valid data we could get. Twenty-one German haemophilia treatment centres were visited from 2002 to 2009. PWH between 8 and 25 years were included. They performed a five-stage fitness test covering the sport-specific motor capacities for coordination, measured by one leg stand, strength, aerobic fitness and mobility as well as body composition. The patients' results were compared with age- and gender-specific reference values of healthy subjects. Two hundred and eighty-five PWH (mean age 13.2 ± 4.5 years, 164 PWH with severe disease) were included prospectively in the study. PWH are significantly below the reference values of healthy subjects in the one-leg stand test, the mobility of the lower extremity, the strength ratio of chest and back muscles and the endurance test. In body composition, the back strength and the mobility of the upper extremity PWH are significantly above the reference values. There are no significant differences in abdominal strength. In conclusion we found specific differences in different fitness abilities between PWH and healthy subjects. Knowing this, we are able to work out exercise programmes to compensate the diminished fitness abilities for our PWH. © 2015 John Wiley & Sons Ltd.

  17. Physical fitness and anthropometric normative values among Colombian-Indian schoolchildren.

    PubMed

    Ramos-Sepúlveda, Jeison Alexander; Ramírez-Vélez, Robinson; Correa-Bautista, Jorge Enrique; Izquierdo, Mikel; García-Hermoso, Antonio

    2016-09-13

    Substantial evidence indicates that children's physical fitness levels are markers of their lifestyles and their cardio-metabolic health profile and are predictors of the future risk of chronic diseases such as obesity, cardiometabolic disease, skeletal health and mental health. However, fitness reference values for ethnic children and adolescents have not been published in a Latin-American population. Therefore, the aim of the study was to provide sex- and age-specific physical fitness and anthropometric reference standards among Colombian-Indian schoolchildren. A sample of 576 participants (319 boys and 257 girls) aged 10 to 17 years old was assessed using the FUPRECOL test battery. Four components of physical fitness were measured: 1) morphological component: height, weight, body mass index (BMI), waist circumference (WC), triceps skinfold, subscapular skinfold, and body fat (%); 2) musculoskeletal component: handgrip and standing long jump test; 3) motor component: speed/agility test (4 × 10 m shuttle run); and 4) cardiorespiratory component: course-navette 20 m, shuttle run test and estimation of maximal oxygen consumption by VO2max indirect. Centile smoothed curves for the 3(rd), 10(th), 25(th), 50(th), 75(th), 90(th) and 97(th) percentiles were calculated using Cole's LMS method. Our results show that weight, height and BMI in each age group were higher in boys than in girls. In each groups, age showed a significant effect for BMI and WC. Boys showed better than girls in cardiorespiratory fitness, lower- and upper-limb strength and speed/agility and girls performed better in low back flexibility. Our results provide for the first time sex- and age-specific physical fitness and anthropometric reference values for Colombian Nasa Indian children and adolescents aged 10-17.9 years.

  18. 40 CFR 86.1 - Reference materials.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Passenger Cars, Light-Duty Trucks, and Medium-Duty Vehicles and Engines (OBD-II), IBR approved for § 86.1806... Requirements for 2004 and Subsequent Model-Year Passenger Cars, Light-Duty Trucks, and Medium-Duty Vehicles and....1311-94. (2) SAE J1634, Electric Vehicle Energy Consumption and Range Test Procedure, Cancelled October...

  19. Getting Value out of Value-Added: Report of a Workshop

    ERIC Educational Resources Information Center

    Braun, Henry, Ed.; Chudowsky, Naomi, Ed.; Koenig, Judith, Ed.

    2010-01-01

    Value-added methods refer to efforts to estimate the relative contributions of specific teachers, schools, or programs to student test performance. In recent years, these methods have attracted considerable attention because of their potential applicability for educational accountability, teacher pay-for-performance systems, school and teacher…

  20. 75 FR 57253 - Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-20

    ....S. Census Bureau. Title: 2011 Field Test of the Re-Engineered Survey of Income and Program...-engineered Survey of Income and Program Participation (SIPP). The Census Bureau's SIPP CAPI interview will use an event history calendar (EHC) interviewing method and a 12-month, calendar-year reference period...

  1. 76 FR 51939 - Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-19

    ....S. Census Bureau. Title: 2012 Survey of Income and Program Participation Event History Calendar... conduct the 2012 Survey of Income and Program Participation Event History Calendar (SIPP-EHC) Field Test... Calendar (EHC) interviewing method and a 12-month, calendar-year reference period in place of the current...

  2. EPAs ToxCast Program: From Research to Application

    EPA Science Inventory

    A New Paradigm for Toxicity Testing in the 21st Century. In FY 2009, EPA published the toxicity reference database ToxRefDB, which contains results of over 30 years and $2B worth of animal studies for over 400 chemicals. This database is available on EPA’s website, and increases...

  3. 40 CFR 791.3 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... been required to develop that data or after 5 years, whichever is later. (i) Small business refers to a...) DATA REIMBURSEMENT General Provisions § 791.3 Definitions. Terms defined in the Act, and not explicitly... reimbursement for the cost of developing health and environmental data on the test chemical. (e) Exemption...

  4. 40 CFR 791.3 - Definitions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... been required to develop that data or after 5 years, whichever is later. (i) Small business refers to a...) DATA REIMBURSEMENT General Provisions § 791.3 Definitions. Terms defined in the Act, and not explicitly... reimbursement for the cost of developing health and environmental data on the test chemical. (e) Exemption...

  5. Do women with pelvic floor dysfunction referred by gynaecologists and urologists at hospitals complete a pelvic floor muscle training programme? A retrospective study, 1992-2008.

    PubMed

    Tibaek, Sigrid; Dehlendorff, Christian

    2013-08-01

    For decades women with pelvic floor dysfunction (PFD) have been referred to pelvic floor muscle training (PFMT), but there is only little information on whether the women complete the programmes and why. The objectives of this study were to investigate to which extent women completed a PFMT programme to which they were referred by gynaecologists and urologists and to identify associated factors for completion. In a hospital-based, retrospective clinical design women with PFD referred to a free PFMT programme as outpatients were included. The PFMT programme consisted of: (a) vaginal digital palpation test of PFM, (b) individual instructions, (c) introduction (theory), (d) weekly supervised PFMT in groups for 3 months (12 sessions) and (e) progressive home exercises (10 sets). Data were analysed in 1,544 women, mean age 54 (SD 13) years, with PFD (urinary incontinence, n = 1,214; anal incontinence, n = 41; pelvic organ prolapse, n = 162; other PFD, n = 127). In total 747 (48 %) subjects completed (attended ≥8 sessions) the PFMT programme, 466 (30 %) dropped out and 331 (22 %) cancelled or stayed away. Age, year of referral and nationality were significantly different (p < 0.01) between completers and non-completers. Likewise, year of referral, distance from home to hospital, waiting list times and diagnosis were significantly different (p < 0.01) between dropouts and subjects who cancelled or stayed away. The results showed that less than half of the women with PFD completed a PFMT programme to which they were referred by gynaecologists and urologists. The most important associated factors for completion were age, year of referral and nationality.

  6. [Determination of normal reference value of pyrrole adducts in urine in young people in a university in Shandong, China].

    PubMed

    Wang, Hui; Wang, Yiping; Zhou, Zhenwei; Wang, Shuo; Yin, Hongyin; Xie, Keqin

    2015-06-01

    To determine the normal reference value of pyrrole adducts in urine in young people in a university in Shandong, China, and to provide a reliable basis for the clinical diagnosis of n-hexane poisoning. A total of 240 college students were randomly selected. After excluding 32 ineligible students, 208 subjects were included in this study, consisting of 104 males and 104 females, with a mean age of 21?3 years (range: 18 to 24 years). Morning urine was collected from each subject. The content of pyrrole adducts was determined by chromatometry. The content of pyrrole adducts in both male and female obeyed a positively skewed distribution. The median level of pyrrole adducts in male subjects was 0.88 nmol/ml, and the reference value was 0.14-3.92 nmol/ml. The median level of pyrrole adducts in female subjects was 0.93 nmol/ ml, and the reference value was 0.09-3.27 nmol/ml. Student's t test identified no statistical difference in pyrrole adduct level between male and female subjects (t=0.15, P>0.05). The median level of pyrrole adducts in normal young people is 0.91 nmol/ml, and the reference value is 0.11-3.95 nmol/ml.

  7. Revisiting Statistical Aspects of Nuclear Material Accounting

    DOE PAGES

    Burr, T.; Hamada, M. S.

    2013-01-01

    Nuclear material accounting (NMA) is the only safeguards system whose benefits are routinely quantified. Process monitoring (PM) is another safeguards system that is increasingly used, and one challenge is how to quantify its benefit. This paper considers PM in the role of enabling frequent NMA, which is referred to as near-real-time accounting (NRTA). We quantify NRTA benefits using period-driven and data-driven testing. Period-driven testing makes a decision to alarm or not at fixed periods. Data-driven testing decides as the data arrives whether to alarm or continue testing. The difference between period-driven and datad-riven viewpoints is illustrated by using one-year andmore » two-year periods. For both one-year and two-year periods, period-driven NMA using once-per-year cumulative material unaccounted for (CUMUF) testing is compared to more frequent Shewhart and joint sequential cusum testing using either MUF or standardized, independently transformed MUF (SITMUF) data. We show that the data-driven viewpoint is appropriate for NRTA and that it can be used to compare safeguards effectiveness. In addition to providing period-driven and data-driven viewpoints, new features include assessing the impact of uncertainty in the estimated covariance matrix of the MUF sequence and the impact of both random and systematic measurement errors.« less

  8. Anthropometry, Physical Fitness and Coordination of Young Figure Skaters of Different Levels.

    PubMed

    Mostaert, M; Deconinck, F; Pion, J; Lenoir, M

    2016-06-01

    The aim of the present study was to identify anthropometric, physical, coordinative and ice-skating specific characteristics that discriminate young elite ice skaters from non-elite skaters and their non-skating peers. 32 skaters aged 9-12 years old (11 elites and 21 non-elites) voluntarily participated in the study. They were submitted to 5 anthropometric, 7 physical, 3 coordination and 5 ice-skating specific tests. Reference values of a representative healthy non-skating sample were taken from the Flemish Sports Compass dataset. Figure skaters appeared to be predominantly average mature (93.8%), were lighter and leaner than the reference sample, and demonstrated better physical characteristics and motor coordination. There was no difference between the elite and non-elite group regarding maturity status and anthropometric or physical parameters. Still, elite skaters scored better than non-elites on the coordination tests jumping sideways and tended to do so on the moving sideways test. Profiles of figure skaters differ clearly from a reference population, while non-sport-specific motor coordination tests allow discrimination between elite and non-elite skaters. The relevance of these findings with respect to talent detection and identification in young ice skaters are discussed. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Thyroid function tests in patients taking thyroid medication in Germany: Results from the population-based Study of Health in Pomerania (SHIP).

    PubMed

    Hannemann, Anke; Friedrich, Nele; Haring, Robin; Krebs, Alexander; Völzke, Henry; Alte, Dietrich; Nauck, Matthias; Kohlmann, Thomas; Schober, Hans-Christof; Hoffmann, Wolfgang; Wallaschofski, Henri

    2010-08-16

    Studies from iodine-sufficient areas have shown that a high proportion of patients taking medication for thyroid diseases have thyroid stimulating hormone (TSH) levels outside the reference range. Next to patient compliance, inadequate dosing adjustment resulting in under- and over-treatment of thyroid disease is a major cause of poor therapy outcomes. Using thyroid function tests, we aim to measure the proportions of subjects, who are under- or over-treated with thyroid medication in a previously iodine-deficient area. Data from 266 subjects participating in the population-based Study of Health in Pomerania (SHIP) were analysed. All subjects were taking thyroid medication. Serum TSH levels were measured using immunochemiluminescent procedures. TSH levels of < 0.27 or > 2.15 mIU/L in subjects younger than 50 years and < 0.19 or > 2.09 mIU/L in subjects 50 years and older, were defined as decreased or elevated, according to the established reference range for the specific study area. Our analysis revealed that 56 of 190 (29.5%) subjects treated with thyroxine had TSH levels outside the reference range (10.0% elevated, 19.5% decreased). Of the 31 subjects taking antithyroid drugs, 12 (38.7%) had TSH levels outside the reference range (9.7% elevated, 29.0% decreased). These proportions were lower in the 45 subjects receiving iodine supplementation (2.2% elevated, 8.9% decreased). Among the 3,974 SHIP participants not taking thyroid medication, TSH levels outside the reference range (2.8% elevated, 5.9% decreased) were less frequent. In concordance with previous studies in iodine-sufficient areas, our results indicate that a considerable number of patients taking thyroid medication are either under- or over-treated. Improved monitoring of these patients' TSH levels, compared to the local reference range, is recommended.

  10. Polycystic Ovary Syndrome

    PubMed Central

    McCartney, Christopher R.; Marshall, John C.

    2017-01-01

    A 22-year-old woman reports having hirsutism and irregular menses. She describes unpredictable and infrequent menses (five or six per year) since menarche at 11 years of age. Dark, coarse facial hair began to develop at 13 years of age. The symptoms worsened after she gained weight in college. The physical examination includes a body-mass index (BMI; the weight in kilograms divided by the square of the height in meters) of 29, blood pressure of 135/85 mm Hg, and moderate hirsutism without virilization. Laboratory tests reveal a total testosterone level of 65 ng per deciliter (2.3 nmol per liter) (assay reference range, 14 to 53 ng per deciliter [0.5 to 1.8 nmol per liter]), calculated free testosterone level of 15.3 pg per milliliter (53.1 pmol per liter) (assay reference range, 0.6 to 6.8 pg per milliliter [2.1 to 23.6 pmol per liter]), and glycated hemoglobin level of 5.7% (normal value, ≤5.6%). How should this case be evaluated and managed? PMID:27406348

  11. Adjective semantics, world knowledge and visual context: comprehension of size terms by 2- to 7-year-old Dutch-speaking children.

    PubMed

    Tribushinina, Elena

    2013-06-01

    The interpretation of size terms involves constructing contextually-relevant reference points by combining visual cues with knowledge of typical object sizes. This study aims to establish at what age children learn to integrate these two sources of information in the interpretation process and tests comprehension of the Dutch adjectives groot 'big' and klein 'small' by 2- to 7-year-old children. The results demonstrate that there is a gradual increase in the ability to inhibit visual cues and to use world knowledge for interpreting size terms. 2- and 3-year-old children only used the extremes of the perceptual range as reference points. From age four onwards children, like adults, used a cut-off point in the mid-zone of a series. From age five on, children were able to integrate world knowledge and perceptual context. Although 7-year-olds could make subtle distinctions between sizes of various object classes, their performance on incongruent items was not yet adult-like.

  12. KRAS and BRAF mutation analysis in metastatic colorectal cancer: a cost-effectiveness analysis from a Swiss perspective.

    PubMed

    Blank, Patricia R; Moch, Holger; Szucs, Thomas D; Schwenkglenks, Matthias

    2011-10-01

    Monoclonal antibodies against the epidermal growth factor receptor (EGFR), such as cetuximab, have led to significant clinical benefits for metastatic colorectal cancer (mCRC) patients but have also increased treatment costs considerably. Recent evidence associates KRAS and BRAF mutations with resistance to EGFR antibodies. We assessed the cost-effectiveness of predictive testing for KRAS and BRAF mutations, prior to cetuximab treatment of chemorefractory mCRC patients. A life-long Markov simulation model was used to estimate direct medical costs (€) and clinical effectiveness [quality-adjusted life-years (QALY)] of the following strategies: KRAS testing, KRAS testing with subsequent BRAF testing of KRAS wild-types (KRAS/BRAF), cetuximab treatment without testing. Comparison was against no cetuximab treatment (reference strategy). In the testing strategies, cetuximab treatment was initiated if no mutations were detected. Best supportive care was given to all patients. Survival times/utilities were derived from published randomized clinical trials. Costs were assessed from the perspective of the Swiss health system. Average remaining lifetime costs ranged from €3,983 (no cetuximab) to €38,662 (no testing). Cetuximab treatment guided by KRAS/BRAF achieved gains of 0.491 QALYs compared with the reference strategy. The KRAS testing strategy achieved an additional gain of 0.002 QALYs compared with KRAS/BRAF. KRAS/BRAF testing was the most cost-effective approach when compared with the reference strategy (incremental cost-effectiveness ratio: €62,653/QALY). New predictive tests for KRAS and BRAF status are currently being introduced in pathology. Despite substantial costs of predictive testing, it is economically favorable to identify patients with KRAS and BRAF wild-type status. ©2011 AACR

  13. Assessment of Fundamental Movement Skills in Childhood Cancer Patients.

    PubMed

    Naumann, Fiona L; Hunt, Mitchell; Hunt, Mitchel; Ali, Dulfikar; Wakefield, Claire E; Moultrie, Kevin; Cohn, Richard J

    2015-12-01

    The improved treatment protocols and subsequent improved survival rates among childhood cancer patients have shifted the focus toward the long-term consequences arising from cancer treatment. Children who have completed cancer treatment are at a greater risk of delayed development, diminished functioning, disability, compromised fundamental movement skill (FMS) attainment, and long-term chronic health conditions. The aim of the study was to compare FMS of childhood cancer patients with an aged matched healthy reference group. Pediatric cancer patients aged 5-8 years (n = 26; median age 6.91 years), who completed cancer treatment (<5 years) at the Sydney Children's Hospital, were assessed performing seven key FMS: sprint, side gallop, vertical jump, catch, over-arm throw, kick, and leap. Results were compared to the reference group (n = 430; 6.56 years). Childhood cancer patients scored significantly lower on three out of seven FMS tests when compared to the reference group. These results equated to a significantly lower overall score for FMS. This study highlighted the significant deficits in FMS within pediatric patients having completed cancer treatment. In order to reduce the occurrence of significant FMS deficits in this population, FMS interventions may be warranted to assist in recovery from childhood cancer, prevent late effects, and improve the quality of life in survivors of childhood cancer. © 2015 Wiley Periodicals, Inc.

  14. Reference Values for Cardiac and Aortic Magnetic Resonance Imaging in Healthy, Young Caucasian Adults.

    PubMed

    Eikendal, Anouk L M; Bots, Michiel L; Haaring, Cees; Saam, Tobias; van der Geest, Rob J; Westenberg, Jos J M; den Ruijter, Hester M; Hoefer, Imo E; Leiner, Tim

    2016-01-01

    Reference values for morphological and functional parameters of the cardiovascular system in early life are relevant since they may help to identify young adults who fall outside the physiological range of arterial and cardiac ageing. This study provides age and sex specific reference values for aortic wall characteristics, cardiac function parameters and aortic pulse wave velocity (PWV) in a population-based sample of healthy, young adults using magnetic resonance (MR) imaging. In 131 randomly selected healthy, young adults aged between 25 and 35 years (mean age 31.8 years, 63 men) of the general-population based Atherosclerosis-Monitoring-and-Biomarker-measurements-In-The-YOuNg (AMBITYON) study, descending thoracic aortic dimensions and wall thickness, thoracic aortic PWV and cardiac function parameters were measured using a 3.0T MR-system. Age and sex specific reference values were generated using dedicated software. Differences in reference values between two age groups (25-30 and 30-35 years) and both sexes were tested. Aortic diameters and areas were higher in the older age group (all p<0.007). Moreover, aortic dimensions, left ventricular mass, left and right ventricular volumes and cardiac output were lower in women than in men (all p<0.001). For mean and maximum aortic wall thickness, left and right ejection fraction and aortic PWV we did not observe a significant age or sex effect. This study provides age and sex specific reference values for cardiovascular MR parameters in healthy, young Caucasian adults. These may aid in MR guided pre-clinical identification of young adults who fall outside the physiological range of arterial and cardiac ageing.

  15. Selection of Atypia/Follicular Lesion of Unknown Significance Patients for Surgery Versus Active Surveillance, Without Using Genetic Testing: A Single Institute Experience, Prospective Analysis, and Recommendations.

    PubMed

    Cohen, Oded; Tzelnick, Sharon; Lahav, Yonatan; Schindel, Doron; Halperin, Doron; Yehuda, Moshe

    2017-07-01

    Atypia/follicular lesion of unknown significance (AUS/FLUS) has variable rates of malignancy. The recommended management includes active surveillance (AS), repeated fine-needle aspiration (RFNA), diagnostic surgery, or genetic testing for malignancy. The objective of this study was to assess the management of AUS/FLUS patients in a dedicated thyroid clinic without implementing genetic testing. This was a single institute cohort study of all patients aged ≥18 years who underwent ultrasound-guided FNA thyroid biopsies between January 2009 and January 2013 and were followed until January 2016. The median follow-up time was 4.6 years (range 3.2-6.8 years). Forty-eight (57%) patients were referred to AS, and 36 (43%) patients were referred for diagnostic surgery. Thirty-six (75%) patients from the AS group underwent RFNA. An additional eight patients from the AS group subsequently underwent diagnostic surgery. Malignancies were found in 15/44 (34%) diagnostic surgical samples, and benign cytologies were found in 61.1% of the RFNAs. Analysis of adherence to follow-up in the 36 AS patients showed an adherence rate of only 53%, with males tending to comply better than females did (31.6% vs. 5.8%, respectively; p = 0.052), especially males in their sixth decade of life. Genetic tests for AUS/FLUS patients are accepted today as complementary evaluations in many well-developed health systems. Yet, when these tests are not feasible due to financial or availability issues, careful management of AUS/FLUS patients may still offer good results in the selection of patients for surgery or AS. The present results also indicate that compliance to follow-up schedules is a major consideration when selecting patients for AS.

  16. Psychological and Physiological Processes in Figure-Tracing Abilities Measured Using a Tablet Computer: A Study with 7 and 9 Years Old Children

    PubMed Central

    Giammarco, Enrico; Di Sano, Sergio; Aureli, Tiziana; Cerratti, Paola; Fanò-Illic, Giorgio; Pietrangelo, Tiziana

    2016-01-01

    The present study investigated the use of a tablet computer to assess figure-tracing skills and their relationships with psychological (visual–perceptual processes, cognitive processes, handwriting skills) and physiological (body mass index, isometric strength of arms) parameters with school-children of second (7–8-year-olds) and fourth (9–10-year-olds) grades. We were also interested in gender differences. The task required tracing of geometric figures on a template, shown on a tablet screen in light gray, for the segments that make up the target figure, one at a time. This figure-tracing tablet test allows acquisition and automated analysis of four parameters: number of strokes (pen lift) for each segment; oscillations of lines drawn with respect to reference lines; pressure of pen on tablet; and average speed of tracing. The results show a trade-off between speed and quality for the tablet parameters, with higher speed associated with more oscillations with respect to the reference lines, and lower number of strokes for each segment, in both male and female children. The involvement of visual–motor integration on the ability to reduce the oscillations in this tablet test was only seen for the male children, while both the male and female children showed a relationship between oscillations and more general/abstract visual–spatial processes. These data confirm the role of visual–motor processes in this figure-tracing tablet test only for male children, while more general visual–spatial processes influence the performance in the tablet test for both sexes. We conclude that the test proposed is useful to screen for grapho-motor difficulties. PMID:27803678

  17. Phase-shifting point diffraction interferometer

    DOEpatents

    Medecki, H.

    1998-11-10

    Disclosed is a point diffraction interferometer for evaluating the quality of a test optic. In operation, the point diffraction interferometer includes a source of radiation, the test optic, a beam divider, a reference wave pinhole located at an image plane downstream from the test optic, and a detector for detecting an interference pattern produced between a reference wave emitted by the pinhole and a test wave emitted from the test optic. The beam divider produces separate reference and test beams which focus at different laterally separated positions on the image plane. The reference wave pinhole is placed at a region of high intensity (e.g., the focal point) for the reference beam. This allows reference wave to be produced at a relatively high intensity. Also, the beam divider may include elements for phase shifting one or both of the reference and test beams. 8 figs.

  18. Phase-shifting point diffraction interferometer

    DOEpatents

    Medecki, Hector

    1998-01-01

    Disclosed is a point diffraction interferometer for evaluating the quality of a test optic. In operation, the point diffraction interferometer includes a source of radiation, the test optic, a beam divider, a reference wave pinhole located at an image plane downstream from the test optic, and a detector for detecting an interference pattern produced between a reference wave emitted by the pinhole and a test wave emitted from the test optic. The beam divider produces separate reference and test beams which focus at different laterally separated positions on the image plane. The reference wave pinhole is placed at a region of high intensity (e.g., the focal point) for the reference beam. This allows reference wave to be produced at a relatively high intensity. Also, the beam divider may include elements for phase shifting one or both of the reference and test beams.

  19. DAT positivity in blood donors: a perplexing scenario.

    PubMed

    Bedi, Ravneet Kaur; Mittal, Kshitija; Sood, Tanvi; Kumar, Rakesh; Praveen, Ajay S

    2014-04-01

    A blood request was received for 70 year male patient suffering from Chronic Obstructive Pulmonary Disease with anemia. One unit was found incompatible in AHG phase. Patient's antibody screen, indirect antiglobulin test (IAT), direct antiglobulin test (DAT) and auto control was negative. DAT of donor unit was positive with anti IgG gel card and negative with C3d reagent along with positive auto control. Donor was 30 year male with no history of blood transfusion and medication and had no evidence of hemolysis. Donors with positive DAT should be deferred, notified and referred to physician but further studies are required. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Life satisfaction and its correlates among college students in China: a test of social reference theory.

    PubMed

    Zhang, Jie; Zhao, Sibo; Lester, David; Zhou, Chengchao

    2014-08-01

    To study life satisfaction and to test the role of social reference in determining the degree of life satisfaction, we examined a large sample of undergraduate students in China for the correlates of campus life satisfaction. A questionnaire survey was administered at a university and the final sample consisted of 439 respondents aged between 17 and 24 years, from all over the country, and studying different subjects. It was found that freshman students tended to score higher on their life satisfaction than students in other grades and the college students' life satisfaction was positively related to female gender, self-esteem, social support, and the liberal attitudes on female gender roles, but negatively correlated with depression and suicidal ideation. Contrary to common beliefs, students from an urban area or from better-off families were not necessarily more satisfied with current life than those students coming from the countryside or low income families. The findings were accounted for by the social reference theory and in this case college students' campus life satisfaction is basically affected by their pre-college life quality as a reference. Copyright © 2013 Elsevier B.V. All rights reserved.

  1. Development of Visuospatial Attention in Typically Developing Children

    PubMed Central

    Ickx, Gaétan; Bleyenheuft, Yannick; Hatem, Samar M.

    2017-01-01

    The aim of the present study is to investigate the development of visuospatial attention in typically developing children and to propose reference values for children for the following six visuospatial attention tests: star cancellation, Ogden figure, reading test, line bisection, proprioceptive pointing and visuo-proprioceptive pointing. Data of 159 children attending primary or secondary school in the Fédération Wallonie Bruxelles (Belgium) were analyzed. Results showed that the children's performance on star cancellation, Ogden figure and reading test improved until the age of 13 years, whereas their performance on proprioceptive pointing, visuo-proprioceptive pointing and line bisection was stable with increasing age. These results suggest that the execution of different types of visuospatial attention tasks are not following the same developmental trajectories. This dissociation is strengthened by the lack of correlation observed between tests assessing egocentric and allocentric visuospatial attention, except for the star cancellation test (egocentric) and the Ogden figure copy (ego- and allocentric). Reference values are proposed that may be useful to examine children with clinical disorders of visuospatial attention. PMID:29270138

  2. 75 FR 33391 - Amendments to the Protocol Gas Verification Program and Minimum Competency Requirements for Air...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-11

    ...Recent EPA gas audit results indicate that some gas cylinders used to calibrate continuous emission monitoring systems on stationary sources do not meet EPA's performance specification. Reviews of stack test reports in recent years indicate that some stack testers do not properly follow EPA test methods or do not correctly calculate test method results. Therefore, EPA is proposing to amend its Protocol Gas Verification Program (PGVP) and the minimum competency requirements for air emission testing (formerly air emission testing body requirements) to improve the accuracy of emissions data. EPA is also proposing to amend other sections of the Acid Rain Program continuous emission monitoring system regulations by adding and clarifying certain recordkeeping and reporting requirements, removing the provisions pertaining to mercury monitoring and reporting, removing certain requirements associated with a class-approved alternative monitoring system, disallowing the use of a particular quality assurance option in EPA Reference Method 7E, adding an incorporation by reference that was inadvertently left out of the January 24, 2008 final rule, and clarifying the language and applicability of certain provisions.

  3. Evaluation of ZY-3 for Dsm and Ortho Image Generation

    NASA Astrophysics Data System (ADS)

    d'Angelo, P.

    2013-04-01

    DSM generation using stereo satellites is an important topic for many applications. China has launched the three line ZY-3 stereo mapping satellite last year. This paper evaluates the ZY-3 performance for DSM and orthophoto generation on two scenes east of Munich. The direct georeferencing performance is tested using survey points, and the 3D RMSE is 4.5 m for the scene evaluated in this paper. After image orientation with GCPs and tie points, a DSM is generated using the Semi-Global Matching algorithm. For two 5 × 5 km2 test areas, a LIDAR reference DTM was available. After masking out forest areas, the overall RMSE between ZY-3 DSM and LIDAR reference is 2.0 m (RMSE). Additionally, qualitative comparison between ZY-3 and Cartosat-1 DSMs is performed.

  4. Normative data for hand grip strength and key pinch strength, stratified by age and gender for a multiethnic Asian population.

    PubMed

    Lam, Ngee Wei; Goh, Hui Ting; Kamaruzzaman, Shahrul Bahyah; Chin, Ai-Vyrn; Poi, Philip Jun Hua; Tan, Maw Pin

    2016-10-01

    Hand strength is a good indicator of physical fitness and frailty among the elderly. However, there are no published hand strength references for Malaysians aged > 65 years. This study aimed to establish normative data for hand grip strength (HGS) and key pinch strength (KPS) for Malaysians aged ≥ 60 years, and explore the relationship between hand strength and physical ability. Healthy participants aged ≥ 60 years with no neurological conditions were recruited from rural and urban locations in Malaysia. HGS and KPS were measured using hand grip and key pinch dynamometers. Basic demographic data, anthropometric measures, modified Barthel Index scores and results of the Functional Reach Test (FRT), Timed Up and Go (TUG) test and Jebsen-Taylor Hand Function Test (JTHFT) were recorded. 362 subjects aged 60-93 years were recruited. The men were significantly stronger than the women in both HGS and KPS (p < 0.001). The hand strength of the study cohort was lower than that of elderly Western populations. Significant correlations were observed between hand strength, and residential area (p < 0.001), FRT (r = 0.236, p = 0.028), TUG (r = -0.227, p = 0.009) and JTHFT (r = -0.927, p < 0.001). This study established reference ranges for the HGS and KPS of rural and urban elderly Malaysian subpopulations. These will aid the use of hand strength as a screening tool for frailty among elderly persons in Malaysia. Future studies are required to determine the modifiable factors for poor hand strength. Copyright: © Singapore Medical Association

  5. Customizing Perimetric Locations Based on En Face Images of Retinal Nerve Fiber Bundles With Glaucomatous Damage

    PubMed Central

    Alluwimi, Muhammed S.; Swanson, William H.; Malinovsky, Victor E.; King, Brett J.

    2018-01-01

    Purpose Prior studies suggested the use of customized perimetric locations in glaucoma; these studies were limited by imaging only the superficial depths of the retinal nerve fiber layer (RNFL) and by prolonged perimetric testing. We aimed to develop a rapid perimetric test guided by high-resolution images of RNFL bundles. Methods We recruited 10 patients with glaucoma, ages 56 to 80 years, median 68 years, and 10 controls, ages 55 to 77 years, median 68 years. The patients were selected based on discrepancies between locations of glaucomatous damage for perimetric and structural measures. Montaging was used to produce optical coherence tomography en face images of the RNFL covering much of the 24-2 grid locations. In experiment 1, we presented the Goldmann size III stimulus at preselected retinal locations of glaucomatous damage, using just two contrasts. In experiment 2, we developed an elongated sinusoidal stimulus, aligned within the defect, to measure contrast sensitivities; abnormalities were defined based on lower 95% reference limits derived from the controls. Results The percentage of predicted locations where size III was not seen at 28 dB ranged from 16% to 80%, with a median of 48%. Contrast sensitivity for the sinusoidal stimulus was below the 95% reference range for 37 of 44 stimuli aligned within the defects. Conclusions We developed methods for rapid perimetric testing guided by en face images of the RNFL bundles in patients with glaucoma. Results indicated ganglion cell damage under all of the visible RNFL defects. Translational Relevance Customized perimetric locations have potential to improve clinical assessment of glaucoma. PMID:29576929

  6. Normative data for hand grip strength and key pinch strength, stratified by age and gender for a multiethnic Asian population

    PubMed Central

    Lam, Ngee Wei; Goh, Hui Ting; Kamaruzzaman, Shahrul Bahyah; Chin, Ai-Vyrn; Poi, Philip Jun Hua; Tan, Maw Pin

    2016-01-01

    INTRODUCTION Hand strength is a good indicator of physical fitness and frailty among the elderly. However, there are no published hand strength references for Malaysians aged > 65 years. This study aimed to establish normative data for hand grip strength (HGS) and key pinch strength (KPS) for Malaysians aged ≥ 60 years, and explore the relationship between hand strength and physical ability. METHODS Healthy participants aged ≥ 60 years with no neurological conditions were recruited from rural and urban locations in Malaysia. HGS and KPS were measured using hand grip and key pinch dynamometers. Basic demographic data, anthropometric measures, modified Barthel Index scores and results of the Functional Reach Test (FRT), Timed Up and Go (TUG) test and Jebsen-Taylor Hand Function Test (JTHFT) were recorded. RESULTS 362 subjects aged 60–93 years were recruited. The men were significantly stronger than the women in both HGS and KPS (p < 0.001). The hand strength of the study cohort was lower than that of elderly Western populations. Significant correlations were observed between hand strength, and residential area (p < 0.001), FRT (r = 0.236, p = 0.028), TUG (r = −0.227, p = 0.009) and JTHFT (r = −0.927, p < 0.001). CONCLUSION This study established reference ranges for the HGS and KPS of rural and urban elderly Malaysian subpopulations. These will aid the use of hand strength as a screening tool for frailty among elderly persons in Malaysia. Future studies are required to determine the modifiable factors for poor hand strength. PMID:26768064

  7. USA hCG reference service, 10-year report.

    PubMed

    Cole, Laurence A; Laidler, Laura L; Muller, Carolyn Y

    2010-08-01

    The USA hCG Reference Service has been dealing with cases of persistent low levels of hCG and gestational trophoblastic diseases for 10years. Here we present the complete experience. Total hCG in serum and urine was measured using the Siemen's Immulite 1000 assay. Hyperglycosylated hCG, nicked hCG, free ss-subunit and ss-core fragment were measured using microtiterplate assays with antibodies B152, B151, FBT11 and B210, respectively. The USA hCG Reference Service has identified 83 cases of false-positive hCG, 71 cases of aggressive gestational trophoblastic disease (GTD), 52 cases of minimally invasive GTD, 168 cases of quiescent GTD and 22 cases of placenta site trophoblastic tumor (PSTT). In addition, 103 cases of pituitary hCG have been identified, 60 cases of nontrophoblastic tumor, 4 cases of inherited hCG and 2 cases of Munchausen's syndrome. This is 565 cases total. Multiple new methods are described and tested for diagnosing all of these disorders. The USA hCG Reference Service experience shows new methods for detecting multiple hCG-related disorders and recommends new approaches for detecting these hCG-related disorders. 2010 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  8. Added value of cost-utility analysis in simple diagnostic studies of accuracy: (18)F-fluoromethylcholine PET/CT in prostate cancer staging.

    PubMed

    Gerke, Oke; Poulsen, Mads H; Høilund-Carlsen, Poul Flemming

    2015-01-01

    Diagnostic studies of accuracy targeting sensitivity and specificity are commonly done in a paired design in which all modalities are applied in each patient, whereas cost-effectiveness and cost-utility analyses are usually assessed either directly alongside to or indirectly by means of stochastic modeling based on larger randomized controlled trials (RCTs). However the conduct of RCTs is hampered in an environment such as ours, in which technology is rapidly evolving. As such, there is a relatively limited number of RCTs. Therefore, we investigated as to which extent paired diagnostic studies of accuracy can be also used to shed light on economic implications when considering a new diagnostic test. We propose a simple decision tree model-based cost-utility analysis of a diagnostic test when compared to the current standard procedure and exemplify this approach with published data from lymph node staging of prostate cancer. Average procedure costs were taken from the Danish Diagnosis Related Groups Tariff in 2013 and life expectancy was estimated for an ideal 60 year old patient based on prostate cancer stage and prostatectomy or radiation and chemotherapy. Quality-adjusted life-years (QALYs) were deduced from the literature, and an incremental cost-effectiveness ratio (ICER) was used to compare lymph node dissection with respective histopathological examination (reference standard) and (18)F-fluoromethylcholine positron emission tomography/computed tomography (FCH-PET/CT). Lower bounds of sensitivity and specificity of FCH-PET/CT were established at which the replacement of the reference standard by FCH-PET/CT comes with a trade-off between worse effectiveness and lower costs. Compared to the reference standard in a diagnostic accuracy study, any imperfections in accuracy of a diagnostic test imply that replacing the reference standard generates a loss in effectiveness and utility. We conclude that diagnostic studies of accuracy can be put to a more extensive use, over and above a mere indication of sensitivity and specificity of an imaging test, and that health economic considerations should be undertaken when planning a prospective diagnostic accuracy study. These endeavors will prove especially fruitful when comparing several imaging techniques with one another, or the same imaging technique using different tracers, with an independent reference standard for the evaluation of results.

  9. [Anthropometric measures in urban child population from 6 to 12 years from the northwest of México].

    PubMed

    Brito-Zurita, Olga Rosa; López-Leal, Josefa; Exiga-González, Emma Beatriz; Armenta-Llanes, Oscar; Jorge-Plascencia, Blanca; Domínguez-Banda, Alberto; López-Morales, Mónica; Ornelas-Aguirre, José Manuel; Sabag-Ruiz, Enrique

    2014-01-01

    The degree of overweight-obesity varies according to the conditions of each population and depending on geographical area, race or ethnicity, socioeconomic status, and susceptibility of each individual. The aim of this study was to determine anthropometric measures in urban child population from 6 to 12 years of Ciudad Obregón, Sonora. We studied 684 schoolchildren from 6 to 12 years of age, of both genders in the urban area of Ciudad Obregón, Sonora. We measured weight, height, arm circumference (AC), waist, and body mass index (BMI). We used descriptive statistics (frequencies, percentages), and to compare the growth charts of this study vs. the reference standards (CDC and Ramos-Galván), we employed statistical inference (Student t test). On average, weight, height, AC, BMI for age by gender were higher than the reference standards at all ages. Seventy-four boys (22 %) and 51 girls (14.5 %) were above 95th percentile. With regards to size, 42 children (12.6 %) were below the 5th percentile and 37 (10.5 %) above the 95th percentile. Schoolchildren in the southern zone of Sonora showed a higher anthropometric pattern than the reference standards.

  10. Two-year-olds can begin to acquire verb meanings in socially impoverished contexts.

    PubMed

    Arunachalam, Sudha

    2013-12-01

    By two years of age, toddlers are adept at recruiting social, observational, and linguistic cues to discover the meanings of words. Here, we ask how they fare in impoverished contexts in which linguistic cues are provided, but no social or visual information is available. Novel verbs are presented in a stream of syntactically informative sentences, but the sentences are not embedded in a social context, and no visual access to the verb's referent is provided until the test phase. The results provide insight into how toddlers may benefit from overhearing contexts in which they are not directly attending to the ambient speech, and in which no conversational context, visual referent, or child-directed conversation is available. Copyright © 2013 Elsevier B.V. All rights reserved.

  11. Exact test-based approach for equivalence test with parameter margin.

    PubMed

    Cassie Dong, Xiaoyu; Bian, Yuanyuan; Tsong, Yi; Wang, Tianhua

    2017-01-01

    The equivalence test has a wide range of applications in pharmaceutical statistics which we need to test for the similarity between two groups. In recent years, the equivalence test has been used in assessing the analytical similarity between a proposed biosimilar product and a reference product. More specifically, the mean values of the two products for a given quality attribute are compared against an equivalence margin in the form of ±f × σ R , where ± f × σ R is a function of the reference variability. In practice, this margin is unknown and is estimated from the sample as ±f × S R . If we use this estimated margin with the classic t-test statistic on the equivalence test for the means, both Type I and Type II error rates may inflate. To resolve this issue, we develop an exact-based test method and compare this method with other proposed methods, such as the Wald test, the constrained Wald test, and the Generalized Pivotal Quantity (GPQ) in terms of Type I error rate and power. Application of those methods on data analysis is also provided in this paper. This work focuses on the development and discussion of the general statistical methodology and is not limited to the application of analytical similarity.

  12. First-year university Physics students’ knowledge about direct current circuits: probing improvement in understanding as a function of teaching and learning interventions

    NASA Astrophysics Data System (ADS)

    Newman, Richard; van der Ventel, Brandon; Hanekom, Crischelle

    2017-07-01

    Probing university students’ understanding of direct-current (DC) resistive circuits is still a field of active physics education research. We report here on a study we conducted of this understanding, where the cohort consisted of students in a large-enrollment first-year physics module. This is a non-calculus based physics module for students in the life sciences stream. The study involved 366 students enrolled in the physics (bio) 154 module at Stellenbosch University in 2015. Students’ understanding of DC resistive circuits was probed by means of a standardized test instrument. The instrument comprises 29 multiple choice questions that students have to answer in ~40 min. Students were required to first complete the standardized test at the start of semester (July 2015). For ease of reference we call this test the pre-test. Students answered the pre-test having no university-level formal exposure to DC circuits in theory or practice. The pre-test therefore served to probe students’ school level knowledge of DC circuits. As the semester progressed students were exposed to a practical (E1), lectures, a prescribed textbook, a tutorial and online videos focusing on DC circuits. The E1 practical required students to solve DC circuit problems by means of physically constructing circuits, algebraically using Kirchhoff's Rules and Ohm’s Law, and by means of simulating circuits using the app iCircuit running on iPads (iOS platform). Each E1 practical involved ~50 students in a three hour session. The practical was repeated three afternoons per week over an eight week period. Twenty three iPads were distributed among students on a practical afternoon in order for them to do the circuit simulations in groups (of 4-5 students). At the end of the practical students were again required to do the standardized test on circuits and complete a survey on their experience of the use of the iPad and iCircuit app. For ease of reference we refer to this second test as the post-test. The students’ average score on the post-test was found to be ~25% higher than their pre-test score. The results of the iPad use survey show that the majority of students felt that the iCircuit app enhanced their learning of DC circuits.

  13. Feasibility of an Assessment Tool for Children's Competence to Consent to Predictive Genetic Testing: a Pilot Study.

    PubMed

    Hein, Irma M; Troost, Pieter W; Lindeboom, Robert; Christiaans, Imke; Grisso, Thomas; van Goudoever, Johannes B; Lindauer, Ramón J L

    2015-12-01

    Knowledge on children's capacities to consent to medical treatment is limited. Also, age limits for asking children's consent vary considerably between countries. Decision-making on predictive genetic testing (PGT) is especially complicated, considering the ongoing ethical debate. In order to examine just age limits for alleged competence to consent in children, we evaluated feasibility of a standardized assessment tool, and investigated cutoff ages for children's competence to consent to PGT. We performed a pilot study, including 17 pediatric outpatients between 6 and 18 years at risk for an autosomal dominantly inherited cardiac disease, eligible for predictive genetic testing. The reference standard for competence was established by experts trained in the relevant criteria for competent decision-making. The MacArthur Competence Assessment Tool for Treatment (MacCAT-T) served as index test. Data analysis included raw agreement between competence classifications, difference in mean ages between children judged competent and judged incompetent, and estimation of cutoff ages for judgments of competence. Twelve (71 %) children were considered competent by the reference standard, and 16 (94 %) by the MacCAT-T, with an overall agreement of 76 %. The expert judgments disagreed in most cases, while the MacCAT-T judgments agreed in 65 %. Mean age of children judged incompetent was 9.3 years and of children judged competent 12.1 years (p = .035). With 90 % sensitivity, children younger than 10.0 years were judged incompetent, with 90 % specificity children older than 11.8 years were judged competent. Feasibility of the MacCAT-T in children is confirmed. Initial findings on age cutoffs are indicative for children between the age of 12 and 18 to be judged competent for involvement in the informed consent process. Future research on appropriate age-limits for children's alleged competence to consent is needed.

  14. A 4-year-old boy presenting with persistent urinary incontinence: Questions.

    PubMed

    Keenswijk, Werner; Walle, Johan Vande

    2017-05-01

    A 4-year-old boy was referred to the nephrologist with daytime urinary incontinence and suspicion of an overactive bladder. At the age of 17 months he had been referred to the pediatric endocrinologist because of polyuria and polydipsia in order to exclude diabetes insipidus. Repeated water deprivation tests and a magnetic resonance imaging scan of the brain were normal. Diabetes insipidus was excluded, and primary polydipsia was thought to be most likely since diabetes mellitus also had been excluded. At the current presentation, he drank up to 3 L a day and quite often had wet diapers. He also seemed to pass stools infrequently and with difficulty. Curiously his grandmother had similar symptoms of polyuria and polydipsia since childhood and had been diagnosed with primary polydipsia. The physical examination of our pediatric patient was normal. In the differential diagnosis we included diabetes insipidus but also contemplated other possibilities, such as nephronophthisis, tubulopathies and hypercalciuria. Laboratory results including urinalysis and an ultrasound of the kidney did not show any abnormalities, making a tubulopathy or hypercalciuria unlikely. A desmopressin test by the intravenous route came back completely normal, pointing to another cause than diabetes insipidus. Genetic testing for the nephronophthisis came back negative but was positive for a missense mutation in the AVPR2 gene (p.Arg104Cys) associated with partial nephrogenic diabetes insipidus. He was started on daily desmopressin. Within 3 days the urinary incontinence resolved as did the polyuria and faecal incontinence. His grandmother was referred to the geneticist and eventually the adult nephrologist. This case highlights the importance of being thorough when confronted with a difficult diagnosis. It also emphasizes that a test result does not necessarily equate to the presence or absence of a condition since the test with 100 % sensitivity and specificity has yet to be discovered.

  15. Monitoring on-orbit calibration stability of the Terra MODIS and Landsat 7 ETM+ sensors using pseudo-invariant test sites

    USGS Publications Warehouse

    Chander, G.; Xiong, X.(J.); Choi, T.(J.); Angal, A.

    2010-01-01

    The ability to detect and quantify changes in the Earth's environment depends on sensors that can provide calibrated, consistent measurements of the Earth's surface features through time. A critical step in this process is to put image data from different sensors onto a common radiometric scale. This work focuses on monitoring the long-term on-orbit calibration stability of the Terra Moderate Resolution Imaging Spectroradiometer (MODIS) and the Landsat 7 (L7) Enhanced Thematic Mapper Plus (ETM+) sensors using the Committee on Earth Observation Satellites (CEOS) reference standard pseudo-invariant test sites (Libya 4, Mauritania 1/2, Algeria 3, Libya 1, and Algeria 5). These sites have been frequently used as radiometric targets because of their relatively stable surface conditions temporally. This study was performed using all cloud-free calibrated images from the Terra MODIS and the L7 ETM+ sensors, acquired from launch to December 2008. Homogeneous regions of interest (ROI) were selected in the calibrated images and the mean target statistics were derived from sensor measurements in terms of top-of-atmosphere (TOA) reflectance. For each band pair, a set of fitted coefficients (slope and offset) is provided to monitor the long-term stability over very stable pseudo-invariant test sites. The average percent differences in intercept from the long-term trends obtained from the ETM + TOA reflectance estimates relative to the MODIS for all the CEOS reference standard test sites range from 2.5% to 15%. This gives an estimate of the collective differences due to the Relative Spectral Response (RSR) characteristics of each sensor, bi-directional reflectance distribution function (BRDF), spectral signature of the ground target, and atmospheric composition. The lifetime TOA reflectance trends from both sensors over 10 years are extremely stable, changing by no more than 0.4% per year in its TOA reflectance over the CEOS reference standard test sites.

  16. Possible Rickettsia massiliae Infection in Greece: an Imported Case.

    PubMed

    Chochlakis, Dimosthenis; Bongiorni, Christine; Partalis, Nikolaos; Tselentis, Yannis; Psaroulaki, Anna

    2016-07-22

    Tick-borne rickettsioses are endemic in Greece; however, until recently, only Rickettsia typhi and R. conorii were tested routinely in human samples arriving at the National Reference Center. During the last few years, the identification of different rickettsia species in ticks led to the introduction of other spotted fever group rickettsiae in routine analysis. Under the new scheme, R. massiliae is now tested routinely in human samples; herein, we describe a human case of this infection.

  17. Reference values for body composition and associations with blood pressure in Kenyan adults aged ≥50 years old.

    PubMed

    Bastawrous, Madeleine C; Piernas, Carmen; Bastawrous, Andrew; Oke, Jason; Lasserson, Daniel; Mathenge, Wanjiku; Burton, Matthew J; Jebb, Susan A; Kuper, Hannah

    2018-05-15

    To develop age- and sex-specific centile reference curves for fat-free mass (FFM) and fat mass (FM) adjusted for height in an adult Kenyan population and to investigate the association between FM, FFM and blood pressure (BP). Measures of body composition from bioimpedance analyses and BP were collected in 1995 participants aged ≥50 years in Nakuru County, Kenya. Reference curves were produced using the LMS method. Multivariable linear regression models were used to test the cross-sectional association between body composition indexes and BP. The age- and sex-specific reference curves for body composition (FMI and FFMI) confirmed that FFMI is lower in both men and women with increasing age. FMI declines with age in women while among men the decline starts after 70 years. FFM was higher in men (47.4 ± 7.2 kg) than in women (38.8 ± 5.5 kg), while FM was lower in men (17.3 ± 8.1 kg) than in women (24.4 ± 10.2 kg). FMI, FFMI and BMI were all positively associated with systolic and diastolic BP, and after adjusting for body weight, FFMI remained positively associated with systolic BP and the FMI remained positively associated with diastolic BP. There was no evidence to suggest that FMI and FFMI were superior to measurement of BMI alone. These body composition reference curves provide normative data on body composition for older adults in Kenya. Further research should consider the prospective associations with health, including frailty-related outcomes.

  18. An Experimental Test of Buffer Utility as a Technique for Managing Pool-Breeding Amphibians

    PubMed Central

    Veysey Powell, Jessica S.; Babbitt, Kimberly J.

    2015-01-01

    Vegetated buffers are used extensively to manage wetland-dependent wildlife. Despite widespread application, buffer utility has not been experimentally validated for most species. To address this gap, we conducted a six-year, landscape-scale experiment, testing how buffers of different widths affect the demographic structure of two amphibian species at 11 ephemeral pools in a working forest of the northeastern U.S. We randomly assigned each pool to one of three treatments (i.e., reference, 100m buffer, 30m buffer) and clearcut to create buffers. We captured all spotted salamanders and wood frogs breeding in each pool and examined the impacts of treatment and hydroperiod on breeding-population abundance, sex ratio, and recapture rate. The negative effects of clearcutting tended to increase as forest-buffer width decreased and be strongest for salamanders and when other stressors were present (e.g., at short-hydroperiod pools). Recapture rates were reduced in the 30m, but not 100m, treatment. Throughout the experiment for frogs, and during the first year post-cut for salamanders, the predicted mean proportion of recaptured adults in the 30m treatment was only 62% and 40%, respectively, of that in the reference treatment. Frog sex ratio and abundance did not differ across treatments, but salamander sex ratios were increasingly male-biased in both cut treatments. By the final year, there were on average, only about 40% and 65% as many females predicted in the 100m and 30m treatments, respectively, compared to the first year. Breeding salamanders at short-hydroperiod pools were about 10% as abundant in the 100m versus reference treatment. Our study demonstrates that buffers partially mitigate the impacts of habitat disturbance on wetland-dependent amphibians, but buffer width and hydroperiod critically mediate that process. We provide the first experimental evidence showing that 30-m-wide buffers may be insufficient for maintaining resilient breeding populations of pool-dependent amphibians, at least during the first six years post-disturbance. PMID:26196129

  19. Guide for Teaching Chemistry-Physics Combined 1-2, 3-4 (PSSC - CHEMS).

    ERIC Educational Resources Information Center

    Millstone, H. George

    This guide is written for a combined physics-chemistry course taught over a two-year period. The subject matter contains the major ideas in Chemical Education Materials Study (CHEMS) Chemistry and Physical Science Study Committee (PSSC) Physics. The guide includes discussion of text references, laboratory experiments, films, testing and evaluation…

  20. A Teaching-Learning Method Enhancing Problem Solving and Motivation in Secondary Schools.

    ERIC Educational Resources Information Center

    Markoczi-Revak, Ibolya

    2003-01-01

    Presents a teaching-learning method for enhancing problem solving and motivation for studying science in secondary schools. Emerges from a former survey which, found that the motivation of 14-18-year-olds as measured by the Kozekik-Entwistle test was at a rather low level. (Contains 16 references.) (Author/YDS)

  1. Relative Efficacy of Behavioral Interventions in Preschool Children Attending Head Start

    ERIC Educational Resources Information Center

    Bellone, Katherine M.; Dufrene, Brad A.; Tingstrom, Daniel H.; Olmi, D. Joe; Barry, Christopher

    2014-01-01

    This study tested the relative efficacy of two interventions for children referred for consultation services due to problem behavior in the classroom. Teachers nominated children for participation due to frequent disruptive behaviors, such as inappropriate vocalizations and off-task behavior. Four Black males from 3 to 4 years old who attended…

  2. Effects of Recurrent Otitis Media on Language, Speech, and Educational Achievement in Menominee Indian Children.

    ERIC Educational Resources Information Center

    Thielke, Helen M.; Shriberg, Lawrence D.

    1990-01-01

    Among 28 monolingual English-speaking Menominee Indian children, a history of otitis media was associated with significantly lower scores on measures of language comprehension and speech perception and production at ages 3-5, and on school standardized tests 2 years later. Contains 38 references. (SV)

  3. Do Treatment Manuals Undermine Youth-Therapist Alliance in Community Clinical Practice?

    ERIC Educational Resources Information Center

    Langer, David A.; McLeod, Bryce D.; Weisz, John R.

    2011-01-01

    Objective: Some critics of treatment manuals have argued that their use may undermine the quality of the client-therapist alliance. This notion was tested in the context of youth psychotherapy delivered by therapists in community clinics. Method: Seventy-six clinically referred youths (57% female, age 8-15 years, 34% Caucasian) were randomly…

  4. Proficiency testing to detect Trichinella larvae in meat in the European Union.

    PubMed

    Marucci, G; Tonanzi, D; Cherchi, S; Galati, F; Bella, A; Interisano, M; Ludovisi, A; Amati, A; Pozio, E

    2016-11-15

    According to the Commission Implementing Regulation (EU) 2015/1375 (replacing the Commission Regulation (EC) No 2075/2005), all animals, which are potential carriers of Trichinella spp. larvae, should be tested at the slaughterhouse or game-handling establishments according to one of the approved tests. One of the core duties of the European Union Reference Laboratory for Parasites is to organize proficiency testing (PT), as stated in the Commission Regulation (EC) No. 882/2004 of the European Parliament and of the Council. The aim of this work was to evaluate the results of PTs of the digestion method carried out by the National Reference Laboratories for Parasites (NRLPs) over a nine year period (2007-2015). Participating laboratories received a panel of samples consisting in 35g or 100g of minced pork or horse meat spiked with Trichinella spiralis live larvae. The number of spiked samples varied from 2 to 9 over the years. A negative control was also included in the panel, except during the 2015 PT, when only positive samples were used. The percentage of NRLPs, which passed the PT, increased from 83.3% in 2007 to 100% in 2014. Considering the number of recovered larvae, the heterogeneity in participant's results reduced overtime. The values of the overall mean difference between spiked and recovered larvae decreased during the study period, witnessing a general improvement of NRLPs performance and confirming the effectiveness of PT for a good performance of this test. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Frontal and oblique crash tests of HIII 6-year-old child ATD using real-world, observed child passenger postures.

    PubMed

    Bohman, Katarina; Arbogast, Kristy B; Loeb, Helen; Charlton, Judith L; Koppel, Sjaan; Cross, Suzanne L

    2018-02-28

    The aim of this study was to evaluate the consequences of frontal and oblique crashes when positioning a Hybrid III (HIII) 6-year-old child anthropometric test device (ATD) using observed child passenger postures from a naturalistic driving study (NDS). Five positions for booster-seated children aged 4-7 years were selected, including one reference position according to the FMVSS 213 ATD seating protocol and 4 based on real-world observed child passenger postures from an NDS including 2 user positions with forward tilting torso and 2 that combined both forward and lateral inboard tilting of the torso. Seventeen sled tests were conducted in a mid-sized vehicle body at 64 km/h (European New Car Assessment Programme [Euro NCAP] Offset Deformable Barrier [ODB] pulse), in full frontal and oblique (15°) crash directions. The rear-seated HIII 6-year-old child ATD was restrained on a high-back booster seat. In 10 tests, the booster seat was also attached with a top tether. In the oblique tests, the ATD was positioned on the far side. Three camera views and ATD responses (head, neck, and chest) were analyzed. The shoulder belt slipped off the shoulder in all ATD positions in the oblique test configuration. In full frontal tests, the shoulder belt stayed on the shoulder in 3 out of 9 tests. Head acceleration and neck tension were decreased in the forward leaning positions; however, the total head excursion increased up to 210 mm compared to te reference position, due to belt slip-off and initial forward leaning position. These results suggest that real-world child passenger postures may contribute to shoulder belt slip-off and increased head excursion, thus increasing the risk of head injury. Restraint system development needs to include a wider range of sitting postures that children may choose, in addition to the specified postures of ATDs in seating test protocols, to ensure robust performance across diverse use cases. In addition, these tests revealed that the child ATD is limited in its ability to mimic real-world child passenger postures. There is a need to develop child human body models that may offer greater flexibility for these types of crash evaluations.

  6. Insufficient filling of vacuum tubes as a cause of microhemolysis and elevated serum lactate dehydrogenase levels. Use of a data-mining technique in evaluation of questionable laboratory test results.

    PubMed

    Tamechika, Yoshie; Iwatani, Yoshinori; Tohyama, Kaoru; Ichihara, Kiyoshi

    2006-01-01

    Experienced physicians noted unexpectedly elevated concentrations of lactate dehydrogenase in some patient samples, but quality control specimens showed no bias. To evaluate this problem, we used a "latent reference individual extraction method", designed to obtain reference intervals from a laboratory database by excluding individuals who have abnormal results for basic analytes other than the analyte in question, in this case lactate dehydrogenase. The reference interval derived for the suspected year was 264-530 U/L, while that of the previous year was 248-495 U/L. The only change we found was the introduction of an order entry system, which requests precise sampling volumes rather than complete filling of vacuum tubes. The effect of vacuum persistence was tested using ten freshly drawn blood samples. Compared with complete filling, 1/5 filling resulted in average elevations of lactate dehydrogenase, aspartic aminotransferase, and potassium levels of 8.0%, 3.8%, and 3.4%, respectively (all p<0.01). Microhemolysis was confirmed using a urine stick method. The length of time before centrifugation determined the degree of hemolysis, while vacuum during centrifugation did not affect it. Microhemolysis is the probable cause of the suspected pseudo-elevation noted by the physicians. Data-mining methodology represents a valuable tool for monitoring long-term bias in laboratory results.

  7. The knowledge-attitude dissociation in geriatric education: can it be overcome?

    PubMed

    Koh, Gerald C H; Merchant, Reshma A; Lim, Wee Shiong; Amin, Zubair

    2012-09-01

    A knowledge-attitude dissociation often exists in geriatrics where knowledge but not attitudes towards elderly patients improve with education. This study aims to determine whether a holistic education programme incorporating multiple educational strategies such as early exposure, ageing simulation and small group teaching results in improving geriatrics knowledge and attitudes among medical students. We administered the 18-item University of California Los Angeles (UCLA) Geriatric Knowledge Test (GKT) and the Singapore-modified 16-item UCLA Geriatric Attitudes Test (GAT) to 2nd year students of the old curriculum in 2009 (baseline reference cohort, n = 254), and before and after the new module to students of the new curriculum in 2010 (intervention cohort, n = 261), both at the same time of the year. At baseline, between the baseline reference and intervention cohort, there was no difference in knowledge (UCLA-GKT Score: 31.6 vs 33.5, P = 0.207) but attitudes of the intervention group were worse than the baseline reference group (UCLA-GAT Score: 3.53 vs 3.43, P = 0.003). The new module improved both the geriatric knowledge (UCLA-GKT Score: 34.0 vs 46.0, P <0.001) and attitudes (UCLA-GAT Score: 3.43 vs 3.50, P <0.001) of the intervention cohort. A geriatric education module incorporating sound educational strategies improved both geriatric knowledge and attitudes among medical students.

  8. Results of patch testing in 10 patients with peristomal dermatitis.

    PubMed

    Landis, Megan N; Keeling, James H; Yiannias, James A; Richardson, Donna M; Nordberg Linehan, Diane L; Davis, Mark D P

    2012-09-01

    Peristomal dermatitis is a common problem in patients with ostomies that is a source of considerable morbidity. Irritant contact dermatitis is most common, but allergic contact dermatitis can also occur. Because of the lack of published reports on patch testing for this indication, we undertook a retrospective study of patch testing results in patients with suspected peristomal allergic contact dermatitis. We sought to describe our patch testing experience with patients referred with peristomal dermatitis. This was a retrospective review of medical records of patients with ostomies and peristomal dermatitis who underwent patch testing in the Mayo Clinic Departments of Dermatology in Jacksonville, FL; Rochester, MN; and Scottsdale, AZ, during a 10-year period (2000-2010). Ten patients with peristomal dermatitis were referred for patch testing (6 in Minnesota, 2 in Florida, and 2 in Arizona). Patients were patch tested to the materials used in their stoma devices, to the standard series, and in some cases to supplemental series. All 10 had at least one allergic patch test reaction, most commonly to stoma paste (3 of 10 patients). Retrospective nature of study via chart review is a limitation. Patch testing is a useful tool for identification of allergens in patients with peristomal dermatitis. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  9. Argentine references for the assessment of body proportions from birth to 17 years of age.

    PubMed

    Del Pino, Mariana; Orden, Alicia B; Arenas, María A; Fano, Virginia

    2017-06-01

    Abnormal body proportions may indicate skeletal disorders; therefore, their detection has great clinical significance. To estimate centiles for head circumference/height (HC/H) and sitting height/height (SH/H) ratios, and assess their diagnostic usefulness among a group of children with skeletal dysplasia. Centiles 3, 10, 25, 50, 75, 90 and 97 for HC/H and SH/H ratios were estimated with the LMS method using Box-Cox transformation to normalize data distribution for each age. Q-Q plot tests were applied to evaluate normality of residuals and the Q test to calculate goodness-of-fit. The sample included 4818 girls and4803 boys, all healthy, between 0-17 years old. The median of the SH/H ratio for each age decreased from 0.67 at birth to 0.57 at age 4. At 12 years of age, values reached 0.52 and 0.53 for males and females, respectively, remaining unchanged until age 17. The median of the HC/H ratio decreased from 0.45 at 6 years old to 0.34 at 17 years old for both sexes. Z-scores for SH/H among 20 children diagnosed with hypochondroplasia were better at showing abnormal proportions than the SH/H ratio not adjusted by age. Estimated centiles for HC/H and SH/H ratios show that the most dramatic changes in body proportions occur in the prepubertal period. These references allow an earlier detection of abnormal body proportions in children with skeletal dysplasia.

  10. Chemical and textural characteristics of sediments at an EPA reference site for dredged material on the continental slope SW of the Farallon Islands

    USGS Publications Warehouse

    Bothner, Michael H.; Gill, P.W.; Boothman, W.S.; Taylor, B.B.; Karl, Herman A.

    1997-01-01

    A U.S. Environmental Protection Agency (EPA) reference site for dredged material has been established on the Continental Slope off San Francisco in water depths of 800-1500 m. This site, 35 km southwest of the Farallon Islands, serves as a reference for sediment testing in support of dredging and disposal at the San Francisco Deep Ocean Disposal Site (SF-DODS). An estimated 300 million cubic yards of dredged material from San Francisco Bay are expected to be discharged at this site during the next 50 years. Information from the reference site provides an additional baseline for monitoring environmental changes at the SF-DODS. This study provides sediment data on a suite of heavy metals and organic compounds which make up the EPA list of "chemicals of concern" because of their potential toxicity to marine organisms.

  11. Occupational Contact Dermatitis in the Canadian Aircraft Industry: A 25-Year Retrospective Study.

    PubMed

    Loranger, Camille; Moreau, Linda; Sasseville, Denis

    2018-03-24

    Aircraft building exposes workers to irritant and sensitizing products. The aim of this article was to study occupational dermatoses among aircraft workers over 25 years. The files of aerospace workers referred between 1990 and 2015 were extracted from the database of the McGill University Health Centre contact dermatitis clinic. These were subdivided according to demographics, type of work, patch testing results, and final diagnosis. Of 305 workers, 58% were 40 years or younger; one third were women. Onset of dermatitis varied from 2 months to 25 years, but 120 cases (39%) occurred during the first 3 years. Fifty-one percent of the cases involved assemblers, and 27% were composite material technicians, which were overrepresented as they constitute 10% of the workforce. Of the 305 workers, 152 suffered from allergic contact dermatitis, and 96 had irritant contact dermatitis. Of those with allergic contact dermatitis, 124 reacted to epoxy-based workplace products, but only 48 had positive patch tests to commercially available epoxy allergens. More than 60% of the cases of epoxy allergy would have been missed without testing with workplace products.

  12. The risk of coronary heart disease of seafarers on vessels sailing under a German flag.

    PubMed

    Oldenburg, Marcus; Jensen, Hans-Joachim; Latza, Ute; Baur, Xaver

    2010-01-01

    This study aimed to predict the risk of coronary heart disease (CHD) among seafarers on German-flagged vessels and to assess the association of shipboard job duration at sea with the risk of CHD. During the legally required medical fitness test for nautical service, 161 seafarers in Hamburg participated in a cross-sectional study which included an interview, blood sampling, and blood pressure measurements (response 84.9%). The predicted 10-year risk of an acute coronary event of the examined German seafarers aged 35 to 64 years (n = 46) was assessed in comparison with a sample of male German employees of the same age working ashore (PROCAM study). The number of independent CHD risk factors (according to the PROCAM study) was compared in the groups with 'shorter' and 'longer' median shipboard job duration at sea (15.0 years). The examined German seafarers had a similar age-standardized predicted 10-year CHD risk as the German reference population. Nearly all independent CHD risk factors were significantly more frequent in seamen with job duration at sea of ≥ 15 years than in those with 〈 15 years. After adjusting for age, the number of CHD risk factors was associated with job duration (OR 1.08 [95% CI 1.02-1.14] per year). Seafarers on German-flagged ships have to attend a medical fitness test for nautical service every 2 years. Thus, it can be assumed that seafarers present a healthier population than employees ashore. In this study, however, CHD risk of seafarers was similar to that of the reference population. This may indicate that working onboard implies a high coronary risk. Furthermore, the study results suggest a tendency of increased risk of CHD among seafarers with longer job duration at sea.

  13. Advanced Turbine Technology Applications Project (ATTAP)

    NASA Technical Reports Server (NTRS)

    1993-01-01

    The Advanced Turbine Technologies Application Project (ATTAP) is in the fifth year of a multiyear development program to bring the automotive gas turbine engine to a state at which industry can make commercialization decisions. Activities during the past year included reference powertrain design updates, test-bed engine design and development, ceramic component design, materials and component characterization, ceramic component process development and fabrication, ceramic component rig testing, and test-bed engine fabrication and testing. Engine design and development included mechanical design, combustion system development, alternate aerodynamic flow testing, and controls development. Design activities included development of the ceramic gasifier turbine static structure, the ceramic gasifier rotor, and the ceramic power turbine rotor. Material characterization efforts included the testing and evaluation of five candidate high temperature ceramic materials. Ceramic component process development and fabrication, with the objective of approaching automotive volumes and costs, continued for the gasifier turbine rotor, gasifier turbine scroll, extruded regenerator disks, and thermal insulation. Engine and rig fabrication, testing, and development supported improvements in ceramic component technology. Total test time in 1992 amounted to 599 hours, of which 147 hours were engine testing and 452 were hot rig testing.

  14. Polish universal neonatal hearing screening program-4-year experience (2003-2006).

    PubMed

    Szyfter, Witold; Wróbel, Maciej; Radziszewska-Konopka, Marzanna; Szyfter-Harris, Joanna; Karlik, Michał

    2008-12-01

    The aim of this paper is to share our experience and observations in running the Universal Neonatal Hearing Screening Program on a national level, present results and indicate some problems that have arisen during these 4 years. Polish Universal Neonatal Hearing Screening Program started back in 2002 in all neonatal units in Poland. Implemented testing methods consisted of test of transient evoked otoacoustic emission (TEOAE) performed in all new born children in their first 2-3 days of life and auditory brainstem response testing (ABR) conducted on children, who did not meet the TEOAE pass criteria. Additional questionnaire registered information on ototoxic drugs and family history of hearing impairment in every newborn. Diagnosed children were further referred for treatment and rehabilitation. After 4 years of running the program (between 2003 and 2006) a total number of 1,392,427 children were screened for hearing impairment, what stands for 96.3% of all delivered babies, registered in Poland. The screening program enabled to identify and refer for further treatment 2485 children with various types of hearing loss, 312 with profound (0.02% of population) and 145 with severe sensorineural hearing loss (0.11% of population). Our results indicate the accuracy of newborn hearing screening which remain an issue. Although improvement is needed in both intervention systems and diagnostic follow-up of hospitals, the Polish Universal Neonatal Hearing Program fully has achieved the main goal, the identification and treatment of hearing impaired children.

  15. Women's attitude toward smoking: effect of a community-based intervention on smoking-related social norms.

    PubMed

    Toghianifar, Nafiseh; Sarrafzadegan, Nizal; Gharipour, Mojgan

    2014-12-01

    Smoking has long been discouraged in Iranian women. However, in recent years, more women have started smoking. This study aimed to investigate the role of women's attitude towards smoking on smoking prevalence in women in the context of a community-based intervention program. Participants were samples of the third and fifth evaluation stages of the 'Isfahan Healthy Heart Program', which is a comprehensive community-based intervention program for noncommunicable disease prevention and control. A total of 3112 and 4794 women were investigated in 2004 and 2007, respectively. Intervention and reference groups were assessed for smoking habits and attitude towards smoking. T test and chi-square test were used to compare the parameters between the intervention and the reference groups. Negative attitude towards smoking increased significantly in the intervention and the reference groups from 2004 to 2007 (P = 0.0001). Negative attitude towards smoking in women decreased significantly in the intervention group (P = 0.0001), whereas it increased significantly in the reference group (P = 0.0001). However, smoking prevalence showed a significant decrease in women in the intervention group, from 2.5 to 1% (P < 0.0001) and a nonsignificant decrease in the reference group. A change in social norms towards acceptability of smoking for women can be overcome by effective strategies that discourage the population from smoking.

  16. Prevalence and causes of abnormal liver function in patients with coeliac disease.

    PubMed

    Casella, Giovanni; Antonelli, Elisabetta; Di Bella, Camillo; Villanacci, Vincenzo; Fanini, Lucia; Baldini, Vittorio; Bassotti, Gabrio

    2013-08-01

    Coeliac disease patients frequently display mild elevation of liver enzymes and this abnormality usually normalizes after gluten-free diet. To investigate the cause and prevalence of altered liver function tests in coeliac patients, basally and after 1 year of gluten-free diet. Data from 245 untreated CD patients (196 women and 49 men, age range 15-80 years) were retrospectively analysed and the liver function tests before and after diet, as well as associated liver pathologies, were assessed. Overall, 43/245 (17.5%) patients had elevated values of one or both aminotransferases; the elevation was mild (<5 times the upper reference limit) in 41 (95%) and marked (>10 times the upper reference limit) in the remaining 2 (5%) patients. After 1 year of gluten-free diet, aminotransferase levels normalized in all but four patients with HCV infection or primary biliary cirrhosis. In coeliac patients, hypertransaminaseaemia at diagnosis and the lack of normalization of liver enzymes after 12 months of diet suggest coexisting liver disease. In such instance, further evaluation is recommended to exclude the liver disease. Early recognition and treatment of coeliac disease in patients affected by liver disease are important to improve the liver function and prevent complications. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. [The effects of moderate physical exercise on cognition in adults over 60 years of age].

    PubMed

    Sanchez-Gonzalez, J L; Calvo-Arenillas, J I; Sanchez-Rodriguez, J L

    2018-04-01

    Clinical evidence gathered in recent years indicates that elderly individuals more frequently display cognitive changes. These age-related changes refer, above all, to memory functions and to the speed of thinking and reasoning. A number of studies have shown that physical activity can be used as an important mechanism for protecting the cognitive functions. To test the hypothesis that physical exercise is able to bring about changes in the cognitive functions of healthy elderly adults without cognitive impairment, thereby improving their quality of life. The study population included participants in the University of Salamanca geriatric revitalisation programme. The sample initially consisted of a total of 44 subjects of both sexes, with a mean age of 74.93 years. The neuropsychological evaluation of the subjects included a series of validated neuropsychological tests: Mini-Mental State Examination, Benton Visual Retention Test, Rey Auditory Verbal Learning Test, Stroop Test and Trail Making Test. The results show that more physical activity is related to better performance in the cognitive functions of the subjects included in this study, after applying the geriatric revitalisation programme. The geriatric revitalisation programme can be a valuable tool for improving cognition in adults over 60 years of age, resulting in enhanced well-being in their quality of life.

  18. Electrostatic Discharge Test of Multi-Junction Solar Array Coupons After Combined Space Environmental Exposures

    NASA Technical Reports Server (NTRS)

    Wright, Kenneth H.; Schneider, Todd; Vaughn, Jason; Hoang, Bao; Funderburk, Victor V.; Wong, Frankie; Gardiner, George

    2010-01-01

    A set of multi-junction GaAs/Ge solar array test coupons were subjected to a sequence of 5-year increments of combined environmental exposure tests. The test coupons capture an integrated design intended for use in a geosynchronous (GEO) space environment. A key component of this test campaign is conducting electrostatic discharge (ESD) tests in the inverted gradient mode. The protocol of the ESD tests is based on the ISO/CD 11221, the ISO standard for ESD testing on solar array panels. This standard is currently in its final review with expected approval in 2010. The test schematic in the ISO reference has been modified with Space System/Loral designed circuitry to better simulate the on-orbit operational conditions of its solar array design. Part of the modified circuitry is to simulate a solar array panel coverglass flashover discharge. All solar array coupons used in the test campaign consist of 4 cells. The ESD tests are performed at the beginning of life (BOL) and at each 5-year environment exposure point. The environmental exposure sequence consists of UV radiation, electron/proton particle radiation, thermal cycling, and ion thruster plume. This paper discusses the coverglass flashover simulation, ESD test setup, and the importance of the electrical test design in simulating the on-orbit operational conditions. Results from 5th-year testing are compared to the baseline ESD characteristics determined at the BOL condition.

  19. Electrocardiogram reference intervals for clinically normal wild-born chimpanzees (Pan troglodytes).

    PubMed

    Atencia, Rebeca; Revuelta, Luis; Somauroo, John D; Shave, Robert E

    2015-08-01

    To generate reference intervals for ECG variables in clinically normal chimpanzees (Pan troglodytes). 100 clinically normal (51 young [< 10 years old] and 49 adult [≥ 10 years old]) wild-born chimpanzees. Electrocardiograms collected between 2009 and 2013 at the Tchimpounga Chimpanzee Rehabilitation Centre were assessed to determine heart rate, PR interval, QRS duration, QT interval, QRS axis, P axis, and T axis. Electrocardiographic characteristics for left ventricular hypertrophy (LVH) and morphology of the ST segment, T wave, and QRS complex were identified. Reference intervals for young and old animals were calculated as mean ± 1.96•SD for normally distributed data and as 5th to 95th percentiles for data not normally distributed. Differences between age groups were assessed by use of unpaired Student t tests. RESULTS Reference intervals were generated for young and adult wild-born chimpanzees. Most animals had sinus rhythm with small or normal P wave morphology; 24 of 51 (47%) young chimpanzees and 30 of 49 (61%) adult chimpanzees had evidence of LVH as determined on the basis of criteria for humans. Cardiac disease has been implicated as the major cause of death in captive chimpanzees. Species-specific ECG reference intervals for chimpanzees may aid in the diagnosis and treatment of animals with, or at risk of developing, heart disease. Chimpanzees with ECG characteristics outside of these intervals should be considered for follow-up assessment and regular cardiac monitoring.

  20. Early language screening in city and Hackney: the concurrent validity of a measure designed for use with 2 1/2-year-olds.

    PubMed

    Law, J

    1994-01-01

    This paper reports data relating to the development of a screening test for language impairment in 2 1/2-year-old children. The screening test itself has previously been described. The results of a pilot study and a larger community study are reported. In all, 34 children were included in the pilot study and 1015 in the community study. The reference test selected was the Reynell Developmental Language Scales and the cut-off adopted 1.5 standard deviations below the mean for either the expressive or the receptive scale of the test concerned. The pass mark on the screening test was ascertained using receiver operating characteristics (ROC). The validity is reported given the cut-off identified. The specificity, sensitivity and both positive and negative predictive abilities are reported for both the pilot and the subsequent study. The application of the test is discussed in the context of the current debate about early identification.

  1. PV industry growth and module reliability in Thailand

    NASA Astrophysics Data System (ADS)

    Chenvidhya, Dhirayut; Seapan, Manit; Sangpongsanont, Yaowanee; Chenvidhya, Tanokkorn; Limsakul, Chamnan; Songprakorp, Roongrojana

    2015-09-01

    The PV applications in Thailand are now installed more than 1.2 GWp cumulatively. It is due to the National Renewable Energy Program and its targets. In the latest Alternative Energy Development Plan (AEDP), the PV electricity production target has increased from 2 GWp to 3 GWp. With this rapid growth, customers and manufacturers seek for module standard testing. So far over one thousands of PV modules per annum have been tested since 2012. The normal tests include type approval test according to TIS standard, acceptance test and testing for local standard development. For type test, the most module failure was found during damp heat test. For annual evaluation test, the power degradation and delamination of power was found between 0 to 6 percent from its nameplate after deployment of 0 to 5 years in the field. For thin-film module, the degradation and delamination was found in range of 0 to 13 percent (about 5 percent on average) from its nameplate for the modules in operation with less than 5 years. However, for the PV modules at the reference site on campus operated for 12 years, the power degradation was ranging from 10 to 15 percent. Therefore, a long term performance assessment needs to be considered to ensure the system reliability.

  2. Reference values for rotational thromboelastometry (ROTEM) in clinically healthy cats.

    PubMed

    Marly-Voquer, Charlotte; Riond, Barbara; Jud Schefer, Rahel; Kutter, Annette P N

    2017-03-01

    To establish reference intervals for rotational thromboelastometry (ROTEM) using feline blood. Prospective study. University teaching hospital. Twenty-three clinically healthy cats between 1 and 15 years. For each cat, whole blood was collected via jugular or medial saphenous venipuncture, and blood was placed into a serum tube, a tube containing potassium-EDTA, and tubes containing 3.2% sodium citrate. The tubes were maintained at 37°C for a maximum of 30 minutes before coagulation testing. ROTEM tests included the EXTEM, INTEM, FIBTEM, and APTEM assays. In addition, prothrombin time, activated partial thromboplastin time, thrombin time, and fibrinogen concentration (Clauss method) were analyzed for each cat. Reference intervals for ROTEM were calculated using the 2.5-97.5 th percentile for each parameter, and correlation with the standard coagulation profile was performed. Compared to people, clinically healthy cats had similar values for the EXTEM and INTEM assays, but had lower plasma fibrinogen concentrations (0.9-2.2 g/L), resulting in weaker maximum clot firmness (MCF, 3-10 mm) in the FIBTEM test. In 18 cats, maximum lysis (ML) values in the APTEM test were higher than in the EXTEM test, which seems unlikely to have occurred in the presence of aprotinin. It is possible that the observed high maximum lysis values were due to clot retraction rather than true clot lysis. Further studies will be required to test this hypothesis. Cats have a weaker clot in the FIBTEM test, but have a similar clot strength to human blood in the other ROTEM assays, which may be due to a stronger contribution of platelets compared to that found in people. In cats, careful interpretation of the results to diagnose hyperfibrinolysis is advised, especially with the APTEM test, until further data are available. © Veterinary Emergency and Critical Care Society 2017.

  3. Influencing Factors of Intention to Receive Pap Tests in Vietnamese Women who Immigrated to Taiwan for Marriage.

    PubMed

    Lee, Fang-Hsin; Wang, Hsiu-Hung; Yang, Yung-Mei; Huang, Joh-Jong; Tsai, Hsiu-Min

    2016-09-01

    This study aimed to explore the factors associated with the intention to receive a Pap test among married immigrant women of Vietnamese origin living in Taiwan. This was a cross-sectional community-based study. We enrolled 281 women aged 30 years and over in the study, from July 2013 to January 2014. The participants' characteristics, cervical cancer knowledge, Pap test knowledge, attitudes toward cervical cancer, barriers to receiving a Pap test, fatalism, and intention to receive a Pap test, were measured using self-report questionnaires. Hierarchical multiple regression analyses were performed to examine the variables associated with participants' intentions to receive a Pap test. Vietnamese women with low scores on the measures of cervical cancer knowledge and perceived barriers to receiving a Pap test were more willing to receive the test, as were those with high scores on the measures of Pap test knowledge and fatalism. Women who received a Pap test in the previous year were more willing to receive a Pap test within the next 3 years. Preventive healthcare for immigrant women should be a focus of nurses. The development of culturally appropriate health education and strategies should enhance their knowledge of Pap tests and reduce perceived barriers to Pap test participation. This study's results can be a reference for nurses who work with immigrant women. Copyright © 2016. Published by Elsevier B.V.

  4. Quality-assurance results for routine water analyses in U.S. Geological Survey laboratories, water year 1998

    USGS Publications Warehouse

    Ludtke, Amy S.; Woodworth, Mark T.; Marsh, Philip S.

    2000-01-01

    The U.S. Geological Survey operates a quality-assurance program based on the analyses of reference samples for two laboratories: the National Water Quality Laboratory and the Quality of Water Service Unit. Reference samples that contain selected inorganic, nutrient, and low-level constituents are prepared and submitted to the laboratory as disguised routine samples. The program goal is to estimate precision and bias for as many analytical methods offered by the participating laboratories as possible. Blind reference samples typically are submitted at a rate of 2 to 5 percent of the annual environmental-sample load for each constituent. The samples are distributed to the laboratories throughout the year. The reference samples are subject to the identical laboratory handling, processing, and analytical procedures as those applied to environmental samples and, therefore, have been used as an independent source to verify bias and precision of laboratory analytical methods and ambient water-quality measurements. The results are stored permanently in the National Water Information System and the Blind Sample Project's data base. During water year 1998, 95 analytical procedures were evaluated at the National Water Quality Laboratory and 63 analytical procedures were evaluated at the Quality of Water Service Unit. An overall evaluation of the inorganic and low-level constituent data for water year 1998 indicated 77 of 78 analytical procedures at the National Water Quality Laboratory met the criteria for precision. Silver (dissolved, inductively coupled plasma-mass spectrometry) was determined to be imprecise. Five of 78 analytical procedures showed bias throughout the range of reference samples: chromium (dissolved, inductively coupled plasma-atomic emission spectrometry), dissolved solids (dissolved, gravimetric), lithium (dissolved, inductively coupled plasma-atomic emission spectrometry), silver (dissolved, inductively coupled plasma-mass spectrometry), and zinc (dissolved, inductively coupled plasma-mass spectrometry). At the National Water Quality Laboratory during water year 1998, lack of precision was indicated for 2 of 17 nutrient procedures: ammonia as nitrogen (dissolved, colorimetric) and orthophosphate as phosphorus (dissolved, colorimetric). Bias was indicated throughout the reference sample range for ammonia as nitrogen (dissolved, colorimetric, low level) and nitrate plus nitrite as nitrogen (dissolved, colorimetric, low level). All analytical procedures tested at the Quality of Water Service Unit during water year 1998 met the criteria for precision. One of the 63 analytical procedures indicated a bias throughout the range of reference samples: aluminum (whole-water recoverable, inductively coupled plasma-atomic emission spectrometry, trace).

  5. A Case of Human Infection by Rickettsia slovaca in Greece.

    PubMed

    Kostopoulou, Vasiliki; Chochlakis, Dimosthenis; Kanta, Chrysoula; Katsanou, Andromachi; Rossiou, Konstantina; Rammos, Aidonis; Papadopoulos, Spyridon-Filippos; Katsarou, Theodora; Tselentis, Yannis; Psaroulaki, Anna; Boukas, Chrysostomos

    2016-07-22

    Although tick-borne rickettsiosis is endemic in Greece, until recently, human samples arriving at the National Reference Centre under suspicion of rickettsial infection were routinely tested only for Rickettsia typhi and R. conorii. However, identification of additional rickettsia species in ticks prompted revision of the protocol in 2010. Until that year, all human samples received by the laboratory were tested for antibodies against R. conorii and R. typhi only. Now, tests for R. slovaca, R. felis, and R. mongolotimonae are all included in routine analysis. The current description of a human R. slovaca case is possible as a result of these changes in routine testing.

  6. The retest reliability of the six-minute walk test in patients referred to a cardiac rehabilitation programme.

    PubMed

    Hanson, Lisa C; McBurney, Helen; Taylor, Nicholas F

    2012-03-01

    The purpose of this paper was to determine if the Six-minute Walk Test (6MWT) was a reliable exercise test for patients referred to cardiac rehabilitation when up to three tests were performed and to determine if test scores differed according to between-test time interval. Thirty adults aged 63 ± 7.9 years referred to cardiac rehabilitation participated in a repeated measures reliability trial. Participants completed three 6MWTs within a one-week period. Participants were randomly allocated to one of three groups: on the first day, Group A completed three walks, Group B completed two walks and Group C completed one walk. Relative reliability was expressed in a ratio (ICC(2,1) ), and absolute reliability was expressed in metres (95% confidence intervals) for group and individuals. The 6MWT demonstrated a high level of relative reliability (intraclass correlation coefficients [ICC] = 0.94) across the three walks. There was no statistically significant difference between the test scores of the three groups. However, there was an increase in distance walked from the first to the second to the third 6MWT. Absolute reliability indicated that a change of at least 44 m would be required to be interpreted as true change in a group, and at least 95 m to be interpreted as true change in an individual with 95% confidence. Three 6MWTs completed in relatively short timeframes were not sufficient for reliable results as there was an increase in the distance walked, and relatively large increases in distances would be required to be interpreted as change. It did not make any difference whether the tests were all completed on one day or over one week. This study highlighted problems that may arise when relying on reliability coefficients alone to interpret reliability. These results suggest that the 6MWT may not have sufficient reliability to be a suitable test to evaluate exercise tolerance in patients referred to cardiac rehabilitation. Copyright © 2011 John Wiley & Sons, Ltd.

  7. Hypokalaemia and dysmorphia, is there a link?

    PubMed

    Burtey, Stéphane; Sternberg, Damien; Nguyen, Karine; Philip, Nicole; Berland, Yvon; Dussol, Bertrand

    2009-06-01

    A 15-year-old boy with quadriplegia and facial dysmorphia was referred to the emergency room. This was his first episode of tetraplegia. One maternal uncle had exhibited the same manifestation 20 years before. Blood test revealed severe hypokalaemia and mild hypocalcaemia. The clinical diagnosis revealed an Andersen-Tawil syndrome. Molecular tools allowed us to make the diagnosis of familial hypokalaemic periodic paralysis type 1 associated with a de novo 22q11.2 microdeletion syndrome. Our case report emphasizes the importance of molecular diagnosis in genetic diseases.

  8. Rapid corn and soybean mapping in US Corn Belt and neighboring areas

    PubMed Central

    Zhong, Liheng; Yu, Le; Li, Xuecao; Hu, Lina; Gong, Peng

    2016-01-01

    The goal of this study was to promptly map the extent of corn and soybeans early in the growing season. A classification experiment was conducted for the US Corn Belt and neighboring states, which is the most important production area of corn and soybeans in the world. To improve the timeliness of the classification algorithm, training was completely based on reference data and images from other years, circumventing the need to finish reference data collection in the current season. To account for interannual variability in crop development in the cross-year classification scenario, several innovative strategies were used. A random forest classifier was used in all tests, and MODIS surface reflectance products from the years 2008–2014 were used for training and cross-year validation. It is concluded that the fuzzy classification approach is necessary to achieve satisfactory results with R-squared ~0.9 (compared with the USDA Cropland Data Layer). The year of training data is an important factor, and it is recommended to select a year with similar crop phenology as the mapping year. With this phenology-based and cross-year-training method, in 2015 we mapped the cropping proportion of corn and soybeans around mid-August, when the two crops just reached peak growth. PMID:27811989

  9. Rapid corn and soybean mapping in US Corn Belt and neighboring areas

    NASA Astrophysics Data System (ADS)

    Zhong, Liheng; Yu, Le; Li, Xuecao; Hu, Lina; Gong, Peng

    2016-11-01

    The goal of this study was to promptly map the extent of corn and soybeans early in the growing season. A classification experiment was conducted for the US Corn Belt and neighboring states, which is the most important production area of corn and soybeans in the world. To improve the timeliness of the classification algorithm, training was completely based on reference data and images from other years, circumventing the need to finish reference data collection in the current season. To account for interannual variability in crop development in the cross-year classification scenario, several innovative strategies were used. A random forest classifier was used in all tests, and MODIS surface reflectance products from the years 2008-2014 were used for training and cross-year validation. It is concluded that the fuzzy classification approach is necessary to achieve satisfactory results with R-squared ~0.9 (compared with the USDA Cropland Data Layer). The year of training data is an important factor, and it is recommended to select a year with similar crop phenology as the mapping year. With this phenology-based and cross-year-training method, in 2015 we mapped the cropping proportion of corn and soybeans around mid-August, when the two crops just reached peak growth.

  10. Application of the Undifferenced GNSS Precise Positioning in Determining Coordinates in National Reference Frames

    NASA Astrophysics Data System (ADS)

    Krzan, Grzegorz; Stępniak, Katarzyna

    2017-09-01

    In high-accuracy positioning using GNSS, the most common solution is still relative positioning using double-difference observations of dual-frequency measurements. An increasingly popular alternative to relative positioning are undifferenced approaches, which are designed to make full use of modern satellite systems and signals. Positions referenced to global International Terrestrial Reference Frame (ITRF2008) obtained from Precise Point Positioning (PPP) or Undifferenced (UD) network solutions have to be transformed to national (regional) reference frame, which introduces additional bases related to the transformation process. In this paper, satellite observations from two test networks using different observation time series were processed. The first test concerns the positioning accuracy from processing one year of dual-frequency GPS observations from 14 EUREF Permanent Network (EPN) stations using NAPEOS 3.3.1 software. The results were transformed into a national reference frame (PL-ETRF2000) and compared to positions from an EPN cumulative solution, which was adopted as the true coordinates. Daily observations were processed using PPP and UD multi-station solutions to determine the final accuracy resulting from satellite positioning, the transformation to national coordinate systems and Eurasian intraplate plate velocities. The second numerical test involved similar processing strategies of post-processing carried out using different observation time series (30 min., 1 hour, 2 hours, daily) and different classes of GNSS receivers. The centimeter accuracy of results presented in the national coordinate system satisfies the requirements of many surveying and engineering applications.

  11. Breast Reference Set Application: Chris Li-FHCRC (2015) — EDRN Public Portal

    Cancer.gov

    We propose to evaluate nine candidate biomarkers for ER+ breast cancer in samples from the EDRN Breast Cancer Reference Set. These biomarkers have been preliminarily validated in preclinical samples. The intended clinical applications of these markers are to: 1. Inform timing of a subsequent mammogram in women with a negative screening mammogram; 2. Inform continuation of mammographic screening among women 75-79 years; 3. Prioritize women who should be screened with mammography in areas with limited resources. Testing the reference samples would further expedite addressing these intended clinical applications by providing further validation data to support requests for samples from other sources for further Phase 3 evaluation (e.g., WHI, PLCO, and samples collected at the time of mammographic screening from the University of Toronto and UCSF).

  12. Image sharpness assessment based on wavelet energy of edge area

    NASA Astrophysics Data System (ADS)

    Li, Jin; Zhang, Hong; Zhang, Lei; Yang, Yifan; He, Lei; Sun, Mingui

    2018-04-01

    Image quality assessment is needed in multiple image processing areas and blur is one of the key reasons of image deterioration. Although great full-reference image quality assessment metrics have been proposed in the past few years, no-reference method is still an area of current research. Facing this problem, this paper proposes a no-reference sharpness assessment method based on wavelet transformation which focuses on the edge area of image. Based on two simple characteristics of human vision system, weights are introduced to calculate weighted log-energy of each wavelet sub band. The final score is given by the ratio of high-frequency energy to the total energy. The algorithm is tested on multiple databases. Comparing with several state-of-the-art metrics, proposed algorithm has better performance and less runtime consumption.

  13. Comparison of results of fluconazole disk diffusion testing for Candida species with results from a central reference laboratory in the ARTEMIS global antifungal surveillance program.

    PubMed

    Pfaller, M A; Hazen, K C; Messer, S A; Boyken, L; Tendolkar, S; Hollis, R J; Diekema, D J

    2004-08-01

    The accuracy of antifungal susceptibility tests is important for accurate resistance surveillance and for the clinical management of patients with serious infections. Our main objective was to compare the results of fluconazole disk diffusion testing of Candida spp. performed by ARTEMIS participating centers with disk diffusion and MIC results obtained by the central reference laboratory. A total of 2,949 isolates of Candida spp. were tested by NCCLS disk diffusion and reference broth microdilution methods in the central reference laboratory. These results were compared to the results of disk diffusion testing performed in the 54 participating centers. All tests were performed and interpreted following NCCLS recommendations. Overall categorical agreement between participant disk diffusion test results and reference laboratory MIC results was 87.4%, with 0.2% very major errors (VME) and 3.3% major errors (ME). The categorical agreement between the disk diffusion test results obtained in the reference laboratory with the MIC test results was similar: 92.8%. Likewise, good agreement was observed between participant disk diffusion test results and reference laboratory disk diffusion test results: 90.4%, 0.4% VME, and 3.4% ME. The disk diffusion test was especially reliable in detecting those isolates of Candida spp. that were characterized as resistant by reference MIC testing. External quality assurance data obtained by surveillance programs such as the ARTEMIS Global Antifungal Surveillance Program ensure the generation of useful surveillance data and result in the continued improvement of antifungal susceptibility testing practices.

  14. BRCA1 and BRCA2 mutations in women of different ethnicities undergoing testing for hereditary breast-ovarian cancer.

    PubMed

    Hall, Michael J; Reid, Julia E; Burbidge, Lynn A; Pruss, Dmitry; Deffenbaugh, Amie M; Frye, Cynthia; Wenstrup, Richard J; Ward, Brian E; Scholl, Thomas A; Noll, Walter W

    2009-05-15

    In women at increased risk for breast and ovarian cancer, the identification of a mutation in breast cancer gene 1 (BRCA1) and BRCA2 has important implications for screening and prevention counseling. Uncertainty regarding the role of BRCA1 and BRCA2 testing in high-risk women from diverse ancestral backgrounds exists because of variability in prevalence estimates of deleterious (disease-associated) mutations in non-white populations. In this study, the authors examined the prevalence of BRCA1 and BRCA2 mutations in an ethnically diverse group of women who were referred for genetic testing. In this cross-sectional analysis, the prevalence of BRCA1 and BRCA2 mutations was assessed in a group of non-Ashkenazi Jewish women who underwent genetic testing. From 1996 to 2006, 46,276 women who met study criteria underwent DNA full-sequence analysis of the BRCA1 and BRCA2 genes. Deleterious mutations were identified in 12.5% of women, and recurrent deleterious mutations (prevalence >2%) were identified in all ancestral groups. Women of non-European descent were younger (mean age, 45.9 years; standard deviation [SD], 11.6 years) than European women (mean age, 50 years; SD, 11.9 years; P < .001). Women of African (15.6%; odds ratio [OR], 1.3 [95% confidence interval (95% CI), 1.1-1.5]) and Latin American (14.8%; OR, 1.2 [95% CI, 1.1-1.4]) ancestries had a significantly higher prevalence of deleterious BRCA1 and BRCA2 mutations compared with women of Western European ancestry (12.1%), primarily because of an increased prevalence of BRCA1 mutations in those 2 groups. Non-European ethnicity was associated strongly with having a variant of uncertain significance; however, reclassification decreased variant reporting (from 12.8%-->5.9%), and women of African ancestry experienced the largest decline (58%). Mutation prevalence was found to be high among women who were referred for clinical BRCA1 and BRCA2 testing, and the risk was similar across diverse ethnicities. BRCA1 and BRCA2 testing is integral to cancer risk assessment in all high-risk women.

  15. Spatial Standard Observer

    NASA Technical Reports Server (NTRS)

    Watson, Andrw B. (Inventor)

    2010-01-01

    The present invention relates to devices and methods for the measurement and/or for the specification of the perceptual intensity of a visual image. or the perceptual distance between a pair of images. Grayscale test and reference images are processed to produce test and reference luminance images. A luminance filter function is convolved with the reference luminance image to produce a local mean luminance reference image . Test and reference contrast images are produced from the local mean luminance reference image and the test and reference luminance images respectively, followed by application of a contrast sensitivity filter. The resulting images are combined according to mathematical prescriptions to produce a Just Noticeable Difference, JND value, indicative of a Spatial Standard Observer. SSO. Some embodiments include masking functions. window functions. special treatment for images lying on or near border and pre-processing of test images.

  16. Spatial Standard Observer

    NASA Technical Reports Server (NTRS)

    Watson, Andrew B. (Inventor)

    2012-01-01

    The present invention relates to devices and methods for the measurement and/or for the specification of the perceptual intensity of a visual image, or the perceptual distance between a pair of images. Grayscale test and reference images are processed to produce test and reference luminance images. A luminance filter function is convolved with the reference luminance image to produce a local mean luminance reference image. Test and reference contrast images are produced from the local mean luminance reference image and the test and reference luminance images respectively, followed by application of a contrast sensitivity filter. The resulting images are combined according to mathematical prescriptions to produce a Just Noticeable Difference, JND value, indicative of a Spatial Standard Observer, SSO. Some embodiments include masking functions, window functions, special treatment for images lying on or near borders and pre-processing of test images.

  17. Thermal-dissipation sap flow sensors may not yield consistent sap-flux estimates over multiple years

    Treesearch

    Georgianne W. Moore; Barbara J. Bond; Julia A. Jones; Frederick C. Meinzer

    2010-01-01

    Sap flow techniques, such as thermal dissipation, involve an empirically derived relationship between sap flux and the temperature differential between a heated thermocouple and a nearby reference thermocouple inserted into the sapwood. This relationship has been widely tested but mostly with newly installed sensors. Increasingly, sensors are used for extended periods...

  18. "It's Harder Than We Thought It Would Be": A Comparative Case Study of Expert-Novice Experimentation Strategies.

    ERIC Educational Resources Information Center

    Hmelo-Silver, Cindy E.; Nagarajan, Anandi; Day, Roger S.

    2002-01-01

    Compares a group of expert cancer researchers with four groups of fourth year medical students (the "novice" groups) engaged in the task of designing a clinical trial to test a new cancer drug using a computer-based modeling tool, the Oncology Thinking Cap. (Contains 24 references.) (Author/YDS)

  19. Solar Energy: Instructor Guides, Labs and Tests. First Edition.

    ERIC Educational Resources Information Center

    Orsak, Charles G., Jr.; And Others

    Instructor guides are provided for each of 11 courses in a 2-year associate degree program in solar technology. The semester-length solar courses are broken down into modules which correspond roughly to a 1- to 2-week block of instruction. Each guide presents a course description, course objectives, references for further information, and a…

  20. The WISC-III and Raven Coloured Progressive Matrices Test: A Pilot Study of Relationships.

    ERIC Educational Resources Information Center

    Kluever, Raymond C.; And Others

    The relationship between scores on Raven's Coloured Progressive Matrices (CPM) scores and subtest scores and IQs from the Wechsler Intelligence Scale for Children-III (WISC-III) was studied for 28 children aged 6 to 11 years. Subjects had been referred to a university assessment center because they were believed to have exceptional learning…

  1. Validity of the WISC-IV Spanish for a Clinically Referred Sample of Hispanic Children

    ERIC Educational Resources Information Center

    San Miguel Montes, Liza E.; Allen, Daniel N.; Puente, Antonio E.; Neblina, Cris

    2010-01-01

    The Wechsler Intelligence Scale for Children (WISC) is the most commonly used intelligence test for children. Five years ago, a Spanish version of the WISC-IV was published (WISC-IV Spanish; Wechsler, 2005), but a limited amount of published information is available regarding its utility when assessing clinical samples. The current study included…

  2. Family Pedigrees of Children with Suspected Childhood Apraxia of Speech

    ERIC Educational Resources Information Center

    Lewis, Barbara A.; Freebairn, Lisa A.; Hansen, Amy; Taylor, H. Gerry; Iyengar, Sudha; Shriberg, Lawrence D.

    2004-01-01

    Forty-two children (29 boys and 13 girls), ages 3-10 years, were referred from the caseloads of clinical speech-language pathologists for suspected childhood apraxia of speech (CAS). According to results from tests of speech and oral motor skills, 22 children met criteria for CAS, including a severely limited consonant and vowel repertoire,…

  3. The Pictorial Fire Stroop: A Measure of Processing Bias for Fire-Related Stimuli

    ERIC Educational Resources Information Center

    Gallagher-Duffy, Joanne; MacKay, Sherri; Duffy, Jim; Sullivan-Thomas, Meara; Peterson-Badali, Michele

    2009-01-01

    Fire interest is a risk factor for firesetting. This study tested whether a fire-specific emotional Stroop task can effectively measure an information-processing bias for fire-related stimuli. Clinic-referred and nonreferred adolescents (aged 13-16 years) completed a pictorial "Fire Stroop," as well as a self-report fire interest questionnaire and…

  4. Reference equation for prediction of a total distance during six-minute walk test using Indonesian anthropometrics.

    PubMed

    Nusdwinuringtyas, Nury; Widjajalaksmi; Yunus, Faisal; Alwi, Idrus

    2014-04-01

    to develop a reference equation for prediction of the total distance walk using Indonesian anthropometrics of sedentary healthy subjects. Subsequently, the prediction obtained was compared to those calculated by the Caucasian-based Enright prediction equation. the cross-sectional study was conducted among 123 healthy Indonesian adults with sedentary life style (58 male and 65 female subjects in an age range between 18 and 50 years). Heart rate was recorded using Polar with expectation in the sub-maximal zone (120-170 beats per minute). The subjects performed two six-minute walk tests, the first one on a 15-meter track according to the protocol developed by the investigator. The second walk was carried out on Biodex®gait trainer as gold standard. an average total distance of 547±54.24 m was found, not significantly different from the gold standard of 544.72±54.11 m (p>0.05). Multiple regression analysis was performed to develop the new equation. the reference equation for prediction of the total distance using Indonesian anthropometrics is more applicable in Indonesia.

  5. Safety assessment of plant varieties using transcriptomics profiling and a one-class classifier.

    PubMed

    van Dijk, Jeroen P; de Mello, Carla Souza; Voorhuijzen, Marleen M; Hutten, Ronald C B; Arisi, Ana Carolina Maisonnave; Jansen, Jeroen J; Buydens, Lutgarde M C; van der Voet, Hilko; Kok, Esther J

    2014-10-01

    An important part of the current hazard identification of novel plant varieties is comparative targeted analysis of the novel and reference varieties. Comparative analysis will become much more informative with unbiased analytical approaches, e.g. omics profiling. Data analysis estimating the similarity of new varieties to a reference baseline class of known safe varieties would subsequently greatly facilitate hazard identification. Further biological and eventually toxicological analysis would then only be necessary for varieties that fall outside this reference class. For this purpose, a one-class classifier tool was explored to assess and classify transcriptome profiles of potato (Solanum tuberosum) varieties in a model study. Profiles of six different varieties, two locations of growth, two year of harvest and including biological and technical replication were used to build the model. Two scenarios were applied representing evaluation of a 'different' variety and a 'similar' variety. Within the model higher class distances resulted for the 'different' test set compared with the 'similar' test set. The present study may contribute to a more global hazard identification of novel plant varieties. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Clinical history as a predictor of penicillin skin test outcome.

    PubMed

    Wong, Benjamin B L; Keith, Paul K; Waserman, Susan

    2006-08-01

    Up to 10% of the population reports an "allergy" to penicillin, whereas approximately 1.1% has positive penicillin skin test results. Where penicillin skin tests are unavailable, some have advocated using history to decide whether to use a penicillin-related antibiotic. To determine if clinical history predicts penicillin skin test results. Retrospective medical record review of 94 consecutive patients who had previously taken penicillin referred for penicillin allergy. Case histories were taken, penicillin skin tests performed, and an oral challenge recommended if skin test results were negative. Of 91 cases studied, the average patient age was 27 years (range, 6 months to 82 years; 36% female). Fifty-two (57%) experienced hives as their main adverse reaction. Sixteen (18%) had at least 1 positive test result. Of this group, 9 had hives as their main symptom, whereas 1 had respiratory problems and 1 had angioedema. Most patients with positive skin test results had experienced their reaction at least 3 years ago. Regression analysis showed that age, sex, and clinical history, including type of reaction, time of reaction after penicillin ingestion, or time since the last reaction, were not associated with skin test positivity. Seventy-two (96%) of the 75 patients who had negative skin test results underwent oral challenge. Seventy had negative challenge results. The negative predictive value of a negative penicillin skin test result was 97%. Clinical history was not predictive of subsequent penicillin skin test results.

  7. Evaluation of ability of reference toxicity tests to identify stress in laboratory populations of the amphipod Hyalella azteca

    USGS Publications Warehouse

    McNulty, E.W.; Dwyer, F.J.; Ellersieck, Mark R.; Greer, E.I.; Ingersoll, C.G.; Rabeni, C.F.

    1999-01-01

    Standard methods for conducting toxicity tests imply that the condition of test organisms can be established using reference toxicity tests. However, only a limited number of studies have evaluated whether reference toxicity tests can actually be used to determine if organisms are in good condition at the start of a test. We evaluated the ability of reference toxicants to identify stress associated with starvation in laboratory populations of the amphipod Hyalella azteca using acute toxicity tests and four reference toxicants: KCl, CdCl2, sodium pentachlorophenate (NaPCP), and carbaryl. Stress associated with severe starvation was observed with exposure of amphipods to carbaryl or NaPCP but not with exposure to KCl or CdCl2 (i.e., lower LC50 with severe starvation). Although the LC50s for NaPCP and carbaryl were statistically different between starved and fed amphipods, this difference may not be biologically significant given the variability expected in acute lethality tests. Stress associated with sieving, heat shock, or cold shock of amphipods before the start of a test was not evident with exposure to carbaryl or KCl as reference toxicants. The chemicals evaluated in this study provided minimal information about the condition of the organisms used to start a toxicity test. Laboratories should periodically perform reference toxicity tests to assess the sensitivity of life stages or strains of test organisms. However, use of other test acceptability criteria required in standard methods such as minimum survival, growth, or reproduction of organisms in the control treatment at the end of a test, provides more useful information about the condition of organisms used to start a test compared to data generated from reference toxicity tests.

  8. The Effect of Cochlear Implantation on the Improvement of the Auditory Performance in 2-7 Years old Children, Shiraz 2004-2008.

    PubMed

    Hashemi, Sayed Basir; Rajaeefard, Abdolreza; Norouzpour, Hasan; Tabatabaee, Hamid Reza; Monshizadeh, Leila

    2013-03-01

    Hearing loss is the most common sensorineural deficiency in human beings. Cochlear implantation is introduced worldwide to treat the severe to profound sensorineural hearing loss, and can result in both speech comprehension and production. The present study aims to determine the effect of cochlear implantation on the improvement of the auditory performance in 2-7 years old children. The present follow-up study is a kind of cohort study which was conducted on 98 children between 2-7 years old who had referred to Fars Cochlear Implantation Center. The patients' information was gathered from their profiles both before and after the operation. The auditory performance score was obtained in 3 stages; 6 months, 1 year, and 2 years after the cochlear implantation through the Cap test. The data was analyzed using the nonparametric Friedman test as well as Mann-Withney, Kruskal-Wallis, and Spearman's Ranks Correlation coefficients. The mean and the median of the auditory performance score of the children who had undergone the cochlear implantation revealed a significant improvement from 6 months to 1 year, and 2 years after the implantation. It showed a significant statistical association between implantation age, type of hearing loss, regular reference, and the length of being present in the rehabilitation program with the auditory performance. It showed no significant association between sex, mother's level of education, being monolingual or bilingual, and family size with the auditory performance. This study revealed that the type of hearing loss, Presence in the rehabilitation program, and the age of cochlear implantation can be major prognostic factors of the response to the treatment, then the country's health policy makers and health planners must executively take into account the infants' hearing screening program during the first 6 month of age.

  9. An assessment of oil-spill effects on pink salmon populations following the Exxon Valdez oil spill. Part 2: Adults and escapement

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

    Maki, A.W.; Brannon, E.J.; Gilbertson, L.G.

    1995-12-31

    This paper presents results of a field program designed to monitor the status of wildstock pink salmon populations in Prince William Sound following the Exxon Valdez oil spill. Field counts of spawning salmon were conducted each year from 1989 through 1992 to test for spill effects o the distribution nd abundance of pink salmon adults spawning in selected streams in the southwestern portion of Prince William Sound, including streams from the most heavily oiled areas. Counts of whole-stream and intertidal escapement density were statistically compared for 40 study streams in 1989 and for a subset of those streams in successivemore » years. Measurements of residual hydrocarbons were made from stream-bed sediments to test for correlations with spawning behavior. Adult pink salmon in the postspill years of 1990 and 1991, progeny of the year classes considered most vulnerable to the oil spill, returned in high numbers, with the wildstock spawners exceeding their parent year returns. In 1989, adult returns reflected the relatively weak run for that year with a mean spawner density of 0.68 fish/m{sup 2} in reference streams and 0.69 fish/m{sup 2} in oiled streams. In 1990, mean escapement density for reference streams was 1.40 fish/m{sup 2} and 1.55 fish/m{sup 2} for oiled streams, indicating the strongest run of the four study years. Trends in polycyclic aromatic hydrocarbon (PAH) concentrations for the majority of oiled streams show a general decline from 1989 to background levels by 1990. 45 refs., 14 figs., 5 tabs.« less

  10. Thyroid Function Variations Within the Reference Range Do Not Affect Quality of Life, Mood, or Cognitive Function in Community-Dwelling Older Men.

    PubMed

    Samuels, Mary H; Kaimal, Rajani; Waring, Avantika; Fink, Howard A; Yaffe, Kristine; Hoffman, Andrew R; Orwoll, Eric; Bauer, Douglas

    2016-09-01

    Variations in thyroid function within the laboratory reference range have been associated with a number of clinical outcomes. However, quality of life, mood, and cognitive function have not been extensively studied, and it is not clear whether mild variations in thyroid function have major effects on these neurocognitive outcomes. Data were analyzed from the Osteoporotic Fractures in Men (MrOS) Study, a cohort of community-dwelling men aged 65 years and older in the United States. A total of 539 participants who were not taking thyroid medications and had age-adjusted TSH levels within the reference range underwent detailed testing of quality of life, mood, and cognitive function at baseline. The same quality of life, mood, and cognitive outcomes were measured again in 193 of the men after a mean follow-up of 6 years. Outcomes were analyzed using thyrotropin (TSH) and free thyroxine (FT4) levels as continuous independent variables, adjusting for relevant covariates. At baseline, there were no associations between TSH or FT4 levels and measures of quality of life, mood, or cognition in the 539 euthyroid men. Baseline thyroid function did not predict changes in these outcomes over a mean of 6 years in the 193 men in the longitudinal analysis. Variations in thyroid function within the age-adjusted laboratory reference range are not associated with variations in quality of life, mood, or cognitive function in community-dwelling older men.

  11. Estimated age and gender profile of individuals missed by a home-based HIV testing and counselling campaign in a Botswana community.

    PubMed

    Novitsky, Vlad; Bussmann, Hermann; Okui, Lillian; Logan, Andrew; Moyo, Sikhulile; van Widenfelt, Erik; Mmalane, Mompati; Lei, Quanhong; Holme, Molly P; Makhema, Joseph; Lockman, Shahin; Degruttola, Victor; Essex, M

    2015-01-01

    It would be useful to understand which populations are not reached by home-based HIV-1 testing and counselling (HTC) to improve strategies aimed at linking these individuals to care and reducing rates of onward HIV transmission. We present the results of a baseline home-based HTC (HBHTC) campaign aimed at counselling and testing residents aged 16 to 64 for HIV in the north-eastern sector of Mochudi, a community in Botswana with about 44,000 inhabitants. Collected data were compared with population references for Botswana, the United Nations (UN) estimates based on the National Census data and the Botswana AIDS Impact Survey IV (BAIS-IV). Analyzed data and references were stratified by age and gender. A total of 6238 age-eligible residents were tested for HIV-1; 1247 (20.0%; 95% CI 19.0 to 21.0%) were found to be HIV positive (23.7% of women vs. 13.4% of men). HIV-1 prevalence peaked at 44% in 35- to 39-year-old women and 32% in 40- to 44-year-old men. A lower HIV prevalence rate, 10.9% (95% CI 9.5 to 12.5%), was found among individuals tested for the first time. A significant gender gap was evident in all analyzed subsets. The existing HIV transmission network was analyzed by combining phylogenetic mapping and household structure. Between 62.4 and 71.8% of all HIV-positive individuals had detectable virus. When compared with the UN and BAIS-IV estimates, the proportion of men missed by the testing campaign (48.5%; 95% CI 47.0 to 50.0%) was significantly higher than the proportion of missed women (14.2%; 95% CI 13.2 to 15.3%; p<0.0001). The estimated proportion of missed men peaked at about 60% in the age group 30 to 39 years old. The proportions of missed women were substantially smaller, at approximately 28% within the age groups 30 to 34 and 45 to 49 years old. The HBHTC campaign seems to be an efficient tool for reaching individuals who have never been tested previously in southern African communities. However, about half of men from 16 to 64 years old were not reached by the HBHTC, including about 60% of men between 30 and 40 years old. Alternative HTC strategies should be developed to bring these men to care, which will contribute to reduction of HIV incidence in communities.

  12. Cardiorespiratory Fitness and Reclassification of Risk for Incidence of Heart Failure: The Veterans Exercise Testing Study.

    PubMed

    Myers, Jonathan; Kokkinos, Peter; Chan, Khin; Dandekar, Eshan; Yilmaz, Bilge; Nagare, Atul; Faselis, Charles; Soofi, Muhammad

    2017-06-01

    It is well established that cardiorespiratory fitness (CRF) is inversely associated with cardiovascular and all-cause mortality. However, little is known regarding the association between CRF and incidence of heart failure (HF). Between 1987 and 2014, we assessed CRF in 21 080 HF-free subjects (58.3±11 years) at the Veterans Affairs Medical Centers in Washington, DC, and Palo Alto, CA. Subjects were classified by age-specific quintiles of CRF. Multivariable Cox models were used to determine the association between HF incidence and clinical and exercise test variables. Reclassification characteristics of fitness relative to standard clinical risk factors were determined using the category-free net reclassification improvement and integrated discrimination improvement indices. During the follow-up (mean 12.3±7.4 years), 1902 subjects developed HF (9.0%; average annual incidence rate, 7.4 events per 1000 person-years). When CRF was considered as a binary variable (unfit/fit), low fitness was the strongest predictor of risk for HF among clinical and exercise test variables (hazard ratio, 1.91; 95% confidence interval, 1.74-2.09; P <0.001). In a fully adjusted model with the least-fit group as the reference, there was a graded and progressive reduction in risk for HF as fitness level was higher. Risks for developing HF were 36%, 41%, 67%, and 76% lower among increasing quintiles of fitness compared with the least-fit subjects ( P <0.001). Adding CRF to standard risk factors resulted in a net reclassification improvement of 0.37 ( P <0.001). CRF is strongly, inversely, and independently associated with the incidence of HF in veterans referred for exercise testing. © 2017 American Heart Association, Inc.

  13. Gastric emptying of solids in children: reference values for the (13) C-octanoic acid breath test.

    PubMed

    Hauser, B; Roelants, M; De Schepper, J; Veereman, G; Caveliers, V; Devreker, T; De Greef, E; Vandenplas, Y

    2016-10-01

    (99m) Technetium scintigraphy ((99m) TS) is the 'gold standard' for measuring gastric emptying (GE), but it is associated with a radiation exposure. For this reason, the (13) C-octanoic acid breath test ((13) C-OBT) was developed for measuring GE of solids. The objective of this study was to determine normal values for gastric half-emptying time (t1/2 GE) of solids in healthy children. Gastric emptying of a standardized solid test meal consisting of a pancake evaluated with (99m) TS and (13) C-OBT was compared in 22 children aged between 1 and 15 years with upper gastrointestinal symptoms. Subsequently, the (13) C-OBT was used to determine normal values for GE of the same solid test meal in 120 healthy children aged between 1 and 17 years. The results showed a significant correlation (r = 0.748, p = 0.0001) between t1/2 GE measured with both techniques in the group of children with upper gastrointestinal symptoms. In the group of healthy children, mean t1/2 GE was 157.7 ± 54.0 min (range 71-415 min), but t1/2 GE decreased with age between 1 and 10 years and remained stable afterward. There was no influence of gender, weight, height, body mass index, and body surface area on t1/2 GE. Normal values for GE of solids measured with the (13) C-OBT using a standardized methodology were determined in healthy children. We propose to use this method and corresponding reference ranges to study GE of solids in children with gastrointestinal problems. © 2016 John Wiley & Sons Ltd.

  14. High frequency of discordance between antimüllerian hormone and follicle-stimulating hormone levels in serum from estradiol-confirmed days 2 to 4 of the menstrual cycle from 5,354 women in U.S. fertility centers.

    PubMed

    Leader, Benjamin; Hegde, Aparna; Baca, Quentin; Stone, Kimberly; Lannon, Benjamin; Seifer, David B; Broekmans, Frank; Baker, Valerie L

    2012-10-01

    To determine the frequency of clinical discordance between antimüllerian hormone (AMH, ng/mL) and follicle-stimulating hormone (FSH, IU/L) by use of cut points defined by response to controlled ovarian stimulation in the same serum samples drawn on estradiol-confirmed, menstrual cycle days 2 to 4. Retrospective analysis. Fertility centers in 30 U.S. states and a single reference laboratory with uniform testing protocols. 5,354 women, 20 to 45 years of age. None. Frequency of discordance between serum AMH and FSH values. Of the 5,354 women tested, 1 in 5 had discordant AMH and FSH values defined as AMH <0.8 (concerning) with FSH <10 (reassuring) or AMH ≥ 0.8 (reassuring) with FSH ≥ 10 (concerning). Of the women with reassuring FSH values (n = 4,469), the concerning AMH values were found in 1 in 5 women in a highly age-dependent fashion, ranging from 1 in 11 women under 35 years of age to 1 in 3 women above 40 years of age. On the other hand, of the women with reassuring AMH values (n = 3,742), 1 in 18 had concerning FSH values, a frequency that did not vary in a statistically significant fashion by age. Clinical discordance in serum AMH and FSH values was frequent and age dependent using common clinical cut points, a large patient population, one reference laboratory, and uniform testing methodology. This conclusion is generalizable to women undergoing fertility evaluation, although AMH testing has not been standardized among laboratories, and the cut points presented are specific to the laboratory in this study. Copyright © 2012. Published by Elsevier Inc.

  15. Spirometric reference values for Hopi Native American children ages 4-13 years.

    PubMed

    Arnall, David A; Nelson, Arnold G; Hearon, Christopher M; Interpreter, Christina; Kanuho, Verdell

    2016-04-01

    Spirometry is the most important tool in diagnosing pulmonary disease and is the most frequently performed pulmonary function test. Respiratory disease is also one of the greatest causes for morbidity and mortality on the Hopi Nation, but no specific reference equations exist for this unique population. The purpose of this study was to determine if population reference equations were necessary for these children and, if needed, to create new age and race-specific pulmonary nomograms for Hopi children. Two hundred and ninety-two healthy children, ages 4-13 years, attending Hopi Nation elementary schools in Arizona, were asked to perform spirometry for a full battery of pulmonary volumes and capacities of which the following were analyzed: forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1 ), FEV1 % (FEV1 /FVC), FEF25-75% and peak expiratory flow rate (PEFR). Spirometric data from Navajo children living in the same geographical region as the Hopi children were compared as well as spirometric data from common reference values used for other ethnic groups in the USA. Spirometry tests from 165 girls and 127 boys met American Thoracic Society quality control standards. We found that the natural log of height, body mass and age were significant predictors of FEV1 , FVC, and FEF25-75% in the gender-specific models and that lung function values all increased with height and age as expected. The predictions using the equations derived for Navajo, Caucasian, Mexican-American, African-American youth were significantly different (P ≤ 0.05) from the predictions derived from the Hopi equations for all of the variables across both genders, with the exceptions of Hopi versus Navajo FEV1 /FVC in the males and Hopi versus Caucasians FEF25-75% in the females. Thus it would appear for this population important to have specific formulae to provide more accurate reference values. © 2015 Wiley Periodicals, Inc.

  16. Characterization of thyroid function and antithyroid antibody tests among Saudis

    PubMed Central

    Jammah, Anwar A.; Alshehri, Anwar S.; Alrakhis, Afaf A.; Alhedaithy, Asma S.; Almadhi, Asma M.; Alkwai, Hala M.; Alhamad, Maram M.; Alzahrani, Saad H.

    2015-01-01

    Objective: To determine the reference intervals for thyroid function tests and the prevalence of thyroid autoimmunity in the Saudi population. Methods: A cross-sectional prospective study was conducted in King Khalid University Hospital, Riyadh, Saudi Arabia from January to June 2013. History and physical examination were obtained. Thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) were measured by Electro-chemiluminescence Immunoassay system-assay. Anti-thyroperoxidase, and anti-thyroglobulin antibodies were measured using enzyme-linked immunosorbent-assay. Subjects with previous or a family history of thyroid disorders, those taking medications affecting thyroid function, pregnant or lactating women, and those with goiter were excluded. Individuals with positive antibodies were excluded from the final analysis of the TSH reference range, but were used to determine the prevalence of thyroid autoimmunity. Results: Out of 337 Saudi subjects initially screened, 132 (aged 13-60 years) were candidates for reference calculation, the mean±standard deviation, and (2.5th-97.5th) percentile of TSH (mIU/L) was 1.96±0.9 (0.59-4.37), for FT4 (pmol/L) was 15.47±1.83 (12.04-19.13), and for FT3 (pmol/L) was 5.22±0.7 (4.07-6.76). The TSH was higher in the antibodies positive group (2.5±1.17 mIU/L) compared with the negative one (1.96±0.9 mIU/L) (p<0.05). Finally, 26% of subjects were tested positive for antithyroid antibodies. Conclusion: The TSH reference range was similar to laboratory references. Thyroid antibodies were prevalent in Saudis, necessitating further work in larger scale studies. PMID:25987111

  17. Characterization of thyroid function and antithyroid antibody tests among Saudis.

    PubMed

    Jammah, Anwar A; Alshehri, Anwar S; Alrakhis, Afaf A; Alhedaithy, Asma S; Almadhi, Asma M; Alkwai, Hala M; Alhamad, Maram M; Alzahrani, Saad H

    2015-06-01

    To determine the reference intervals for thyroid function tests and the prevalence of thyroid autoimmunity in the Saudi population.   A cross-sectional prospective study was conducted in King Khalid University Hospital, Riyadh, Saudi Arabia from January to June 2013. History and physical examination were obtained. Thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) were measured by Electro-chemiluminescence Immunoassay system-assay. Anti-thyroperoxidase, and anti-thyroglobulin antibodies were measured using enzyme-linked immunosorbent-assay. Subjects with previous or a family history of thyroid disorders, those taking medications affecting thyroid function, pregnant or lactating women, and those with goiter were excluded. Individuals with positive antibodies were excluded from the final analysis of the TSH reference range, but were used to determine the prevalence of thyroid autoimmunity.   Out of 337 Saudi subjects initially screened, 132 (aged 13-60 years) were candidates for reference calculation, the mean±standard deviation, and (2.5th-97.5th) percentile of TSH (mIU/L) was 1.96±0.9 (0.59-4.37), for FT4 (pmol/L) was 15.47±1.83 (12.04-19.13), and for FT3 (pmol/L) was 5.22±0.7 (4.07-6.76). The TSH was higher in the antibodies positive group (2.5±1.17 mIU/L) compared with the negative one (1.96±0.9 mIU/L) (p less than 0.05). Finally, 26% of subjects were tested positive for antithyroid antibodies.   The TSH reference range was similar to laboratory references. Thyroid antibodies were prevalent in Saudis, necessitating further work in larger scale studies.

  18. Simplified risk assessment of noise induced hearing loss by means of 2 spreadsheet models.

    PubMed

    Lie, Arve; Engdahl, Bo; Tambs, Kristian

    2016-11-18

    The objective of this study has been to test 2 spreadsheet models to compare the observed with the expected hearing loss for a Norwegian reference population. The prevalence rates of the Norwegian and the National Institute for Occupational Safety and Health (NIOSH) definitions of hearing outcomes were calculated in terms of sex and age, 20-64 years old, for a screened (with no occupational noise exposure) (N = 18 858) and unscreened (N = 38 333) Norwegian reference population from the Nord-Trøndelag Hearing Loss Study (NTHLS). Based on the prevalence rates, 2 different spreadsheet models were constructed in order to compare the prevalence rates of various groups of workers with the expected rates. The spreadsheets were then tested on 10 different occupational groups with varying degrees of hearing loss as compared to a reference population. Hearing of office workers, train drivers, conductors and teachers differed little from the screened reference values based on the Norwegian and the NIOSH criterion. The construction workers, miners, farmers and military had an impaired hearing and railway maintenance workers and bus drivers had a mildly impaired hearing. The spreadsheet models give a valid assessment of the hearing loss. The use of spreadsheet models to compare hearing in occupational groups with that of a reference population is a simple and quick method. The results are in line with comparable hearing thresholds, and allow for significance testing. The method is believed to be useful for occupational health services in the assessment of risk of noise induced hearing loss (NIHL) and the preventive potential in groups of noise-exposed workers. Int J Occup Med Environ Health 2016;29(6):991-999. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  19. Evaluation of a follow-up protocol for patients on chloroquine and hydroxychloroquine treatment.

    PubMed

    Sanabria, M R; Toledo-Lucho, S C

    2016-01-01

    To review the problems found after a new follow-up protocol for patients on chloroquine and hydroxychloroquine treatment. Retrospective study was conducted between May 2012 and January 2013 on the clinical files, retinographies, fundus auto-fluorescence (FAF) images, and central-10 degree visual fields (VF) of patients who were referred to the Ophthalmology Department as they had started treatment with hydroxychloroquine. One hundred twenty-six patients were included; 94.4% were referred from the Rheumatology Department and 5.6% from Dermatology. Mean age was 59.7 years, and 73.8% were women. All of them were on hydroxychloroquine treatment, and 300mg was the most frequent daily dose. Rheumatoid arthritis was the most common diagnosis (40.5%), followed by systemic lupus erythematosus (15.9%). The mean Snellen visual acuity was 0.76, and 26 patients had lens opacities. The VF were normal in 97 patients, 8 had mild to moderate defects with no definite pattern, and in 9 the results were unreliable. Of the 51 patients older than 65years, 16 (31.4%) had altered or unreliable VF. The FAF was normal in 104 patients (82.5%), and abnormal, but consistent with ophthalmoscopic features, in 12 patients (pathological myopia, age related changes, early, middle or late age-related macular degeneration). Visual fields as a reference test for the diagnosis of AP toxicity are not quite reliable for patients over 65. Therefore, the FAF is recommended as primary test, perhaps combined with another objective test, such as SD-OCT instead of VF. Copyright © 2015 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  20. Development of a Reference Data Set (RDS) for dental age estimation (DAE) and testing of this with a separate Validation Set (VS) in a southern Chinese population.

    PubMed

    Jayaraman, Jayakumar; Wong, Hai Ming; King, Nigel M; Roberts, Graham J

    2016-10-01

    Many countries have recently experienced a rapid increase in the demand for forensic age estimates of unaccompanied minors. Hong Kong is a major tourist and business center where there has been an increase in the number of people intercepted with false travel documents. An accurate estimation of age is only possible when a dataset for age estimation that has been derived from the corresponding ethnic population. Thus, the aim of this study was to develop and validate a Reference Data Set (RDS) for dental age estimation for southern Chinese. A total of 2306 subjects were selected from the patient archives of a large dental hospital and the chronological age for each subject was recorded. This age was assigned to each specific stage of dental development for each tooth to create a RDS. To validate this RDS, a further 484 subjects were randomly chosen from the patient archives and their dental age was assessed based on the scores from the RDS. Dental age was estimated using meta-analysis command corresponding to random effects statistical model. Chronological age (CA) and Dental Age (DA) were compared using the paired t-test. The overall difference between the chronological and dental age (CA-DA) was 0.05 years (2.6 weeks) for males and 0.03 years (1.6 weeks) for females. The paired t-test indicated that there was no statistically significant difference between the chronological and dental age (p > 0.05). The validated southern Chinese reference dataset based on dental maturation accurately estimated the chronological age. Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  1. Quality-assurance results for routine water analysis in US Geological Survey laboratories, water year 1991

    USGS Publications Warehouse

    Maloney, T.J.; Ludtke, A.S.; Krizman, T.L.

    1994-01-01

    The US. Geological Survey operates a quality- assurance program based on the analyses of reference samples for the National Water Quality Laboratory in Arvada, Colorado, and the Quality of Water Service Unit in Ocala, Florida. Reference samples containing selected inorganic, nutrient, and low ionic-strength constituents are prepared and disguised as routine samples. The program goal is to determine precision and bias for as many analytical methods offered by the participating laboratories as possible. The samples typically are submitted at a rate of approximately 5 percent of the annual environmental sample load for each constituent. The samples are distributed to the laboratories throughout the year. Analytical data for these reference samples reflect the quality of environmental sample data produced by the laboratories because the samples are processed in the same manner for all steps from sample login through data release. The results are stored permanently in the National Water Data Storage and Retrieval System. During water year 1991, 86 analytical procedures were evaluated at the National Water Quality Laboratory and 37 analytical procedures were evaluated at the Quality of Water Service Unit. An overall evaluation of the inorganic (major ion and trace metal) constituent data for water year 1991 indicated analytical imprecision in the National Water Quality Laboratory for 5 of 67 analytical procedures: aluminum (whole-water recoverable, atomic emission spectrometric, direct-current plasma); calcium (atomic emission spectrometric, direct); fluoride (ion-exchange chromatographic); iron (whole-water recoverable, atomic absorption spectrometric, direct); and sulfate (ion-exchange chromatographic). The results for 11 of 67 analytical procedures had positive or negative bias during water year 1991. Analytical imprecision was indicated in the determination of two of the five National Water Quality Laboratory nutrient constituents: orthophosphate as phosphorus and phosphorus. A negative or positive bias condition was indicated in three of five nutrient constituents. There was acceptable precision and no indication of bias for the 14 low ionic-strength analytical procedures tested in the National Water Quality Laboratory program and for the 32 inorganic and 5 nutrient analytical procedures tested in the Quality of Water Service Unit during water year 1991.

  2. Slow recovery of tropical old-field rainforest regrowth and the value and limitations of active restoration.

    PubMed

    Shoo, Luke P; Freebody, Kylie; Kanowski, John; Catterall, Carla P

    2016-02-01

    There is current debate about the potential for secondary regrowth to rescue tropical forests from an otherwise inevitable cascade of biodiversity loss due to land clearing and scant evidence to test how well active restoration may accelerate recovery. We used site chronosequences to compare developmental trajectories of vegetation between self-organized (i.e., spontaneous) forest regrowth and biodiversity plantings (established for ecological restoration, with many locally native tree species at high density) in the Australian wet tropics uplands. Across 28 regrowth sites aged 1-59 years, some structural attributes reached reference rainforest levels within 40 years, whereas wood volume and most tested components of native plant species richness (classified by species' origins, family, and ecological functions) reached less than 50% of reference rainforest values. Development of native tree and shrub richness was particularly slow among species that were wind dispersed or animal dispersed with large (>10 mm) seeds. Many species with animal-dispersed seeds were from near-basal evolutionary lineages that contribute to recognized World Heritage values of the study region. Faster recovery was recorded in 25 biodiversity plantings of 1-25 years in which wood volume developed more rapidly; native woody plant species richness reached values similar to reference rainforest and was better represented across all dispersal modes; and species from near-basal plant families were better (although incompletely) represented. Plantings and regrowth showed slow recovery in species richness of vines and epiphytes and in overall resemblance to forest in species composition. Our results can inform decision making about when and where to invest in active restoration and provide strong evidence that protecting old-growth forest is crucially important for sustaining tropical biodiversity. © 2015 Society for Conservation Biology.

  3. Establishing the traceability of a uranyl nitrate solution to a standard reference material

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

    Jackson, C.H.; Clark, J.P.

    1978-01-01

    A uranyl nitrate solution for use as a Working Calibration and Test Material (WCTM) was characterized, using a statistically designed procedure to document traceability to National Bureau of Standards Reference Material (SPM-960). A Reference Calibration and Test Material (PCTM) was prepared from SRM-960 uranium metal to approximate the acid and uranium concentration of the WCTM. This solution was used in the characterization procedure. Details of preparing, handling, and packaging these solutions are covered. Two outside laboratories, each having measurement expertise using a different analytical method, were selected to measure both solutions according to the procedure for characterizing the WCTM. Twomore » different methods were also used for the in-house characterization work. All analytical results were tested for statistical agreement before the WCTM concentration and limit of error values were calculated. A concentration value was determined with a relative limit of error (RLE) of approximately 0.03% which was better than the target RLE of 0.08%. The use of this working material eliminates the expense of using SRMs to fulfill traceability requirements for uranium measurements on this type material. Several years' supply of uranyl nitrate solution with NBS traceability was produced. The cost of this material was less than 10% of an equal quantity of SRM-960 uranium metal.« less

  4. An IMU Evaluation Method Using a Signal Grafting Scheme

    PubMed Central

    Niu, Xiaoji; Wang, Qiang; Li, You; Zhang, Quan; Jiang, Peng

    2016-01-01

    As various inertial measurement units (IMUs) from different manufacturers appear every year, it is not affordable to evaluate every IMU through tests. Therefore, this paper presents an IMU evaluation method by grafting data from the tested IMU to the reference data from a higher-grade IMU. The signal grafting (SG) method has several benefits: (a) only one set of field tests with a higher-grade IMU is needed, and can be used to evaluate numerous IMUs. Thus, SG is effective and economic because all data from the tested IMU is collected in the lab; (b) it is a general approach to compare navigation performances of various IMUs by using the same reference data; and, finally, (c) through SG, one can first evaluate an IMU in the lab, and then decide whether to further test it. Moreover, this paper verified the validity of SG to both medium- and low-grade IMUs, and presents and compared two SG strategies, i.e., the basic-error strategy and the full-error strategy. SG provided results similar to field tests, with a difference of under 5% and 19.4%–26.7% for tested tactical-grade and MEMS IMUs. Meanwhile, it was found that dynamic IMU errors were essential to guarantee the effect of the SG method. PMID:27294932

  5. Hearing Tests on Mobile Devices: Evaluation of the Reference Sound Level by Means of Biological Calibration.

    PubMed

    Masalski, Marcin; Kipiński, Lech; Grysiński, Tomasz; Kręcicki, Tomasz

    2016-05-30

    Hearing tests carried out in home setting by means of mobile devices require previous calibration of the reference sound level. Mobile devices with bundled headphones create a possibility of applying the predefined level for a particular model as an alternative to calibrating each device separately. The objective of this study was to determine the reference sound level for sets composed of a mobile device and bundled headphones. Reference sound levels for Android-based mobile devices were determined using an open access mobile phone app by means of biological calibration, that is, in relation to the normal-hearing threshold. The examinations were conducted in 2 groups: an uncontrolled and a controlled one. In the uncontrolled group, the fully automated self-measurements were carried out in home conditions by 18- to 35-year-old subjects, without prior hearing problems, recruited online. Calibration was conducted as a preliminary step in preparation for further examination. In the controlled group, audiologist-assisted examinations were performed in a sound booth, on normal-hearing subjects verified through pure-tone audiometry, recruited offline from among the workers and patients of the clinic. In both the groups, the reference sound levels were determined on a subject's mobile device using the Bekesy audiometry. The reference sound levels were compared between the groups. Intramodel and intermodel analyses were carried out as well. In the uncontrolled group, 8988 calibrations were conducted on 8620 different devices representing 2040 models. In the controlled group, 158 calibrations (test and retest) were conducted on 79 devices representing 50 models. Result analysis was performed for 10 most frequently used models in both the groups. The difference in reference sound levels between uncontrolled and controlled groups was 1.50 dB (SD 4.42). The mean SD of the reference sound level determined for devices within the same model was 4.03 dB (95% CI 3.93-4.11). Statistically significant differences were found across models. Reference sound levels determined in the uncontrolled group are comparable to the values obtained in the controlled group. This validates the use of biological calibration in the uncontrolled group for determining the predefined reference sound level for new devices. Moreover, due to a relatively small deviation of the reference sound level for devices of the same model, it is feasible to conduct hearing screening on devices calibrated with the predefined reference sound level.

  6. Assessment of the Potential Impact and Cost-effectiveness of Self-Testing for HIV in Low-Income Countries

    PubMed Central

    Cambiano, Valentina; Ford, Deborah; Mabugu, Travor; Napierala Mavedzenge, Sue; Miners, Alec; Mugurungi, Owen; Nakagawa, Fumiyo; Revill, Paul; Phillips, Andrew

    2015-01-01

    Background Studies have demonstrated that self-testing for human immunodeficiency virus (HIV) is highly acceptable among individuals and could allow cost savings, compared with provider-delivered HIV testing and counseling (PHTC), although the longer-term population-level effects are uncertain. We evaluated the cost-effectiveness of introducing self-testing in 2015 over a 20-year time frame in a country such as Zimbabwe. Methods The HIV synthesis model was used. Two scenarios were considered. In the reference scenario, self-testing is not available, and the rate of first-time and repeat PHTC is assumed to increase from 2015 onward, in line with past trends. In the intervention scenario, self-testing is introduced at a unit cost of $3. Results We predict that the introduction of self-testing would lead to modest savings in healthcare costs of $75 million, while averting around 7000 disability-adjusted life-years over 20 years. Findings were robust to most variations in assumptions; however, higher cost of self-testing, lower linkage to care for people whose diagnosis is a consequence of a positive self-test result, and lower threshold for antiretroviral therapy eligibility criteria could lead to situations in which self-testing is not cost-effective. Conclusions This analysis suggests that introducing self-testing offers some health benefits and may well save costs. PMID:25767214

  7. Evaluating ecological equivalence of created marshes: comparing structural indicators with stable isotope indicators of blue crab trophic support

    USGS Publications Warehouse

    Llewellyn, Chris; LaPeyre, Megan K.

    2010-01-01

    This study sought to examine ecological equivalence of created marshes of different ages using traditional structural measures of equivalence, and tested a relatively novel approach using stable isotopes as a measure of functional equivalence. We compared soil properties, vegetation, nekton communities, and δ13C and δ15N isotope values of blue crab muscle and hepatopancreas tissue and primary producers at created (5-24 years old) and paired reference marshes in SW Louisiana. Paired contrasts indicated that created and reference marshes supported equivalent plant and nekton communities, but differed in soil characteristics. Stable isotope indicators examining blue crab food web support found that the older marshes (8 years+) were characterized by comparable trophic diversity and breadth compared to their reference marshes. Interpretation of results for the youngest site was confounded by the fact that the paired reference, which represented the desired end goal of restoration, contained a greater diversity of basal resources. Stable isotope techniques may give coastal managers an additional tool to assess functional equivalency of created marshes, as measured by trophic support, but may be limited to comparisons of marshes with similar vegetative communities and basal resources, or require the development of robust standardization techniques.

  8. Effects of vehicle front-end stiffness on rear seat dummies in NCAP and FMVSS208 tests.

    PubMed

    Sahraei, Elham; Digges, Kennerly; Marzougui, Dhafer

    2013-01-01

    This study is devoted to quantifying changes in mass and stiffness of vehicles tested by the National Highway Traffic Safety Administration (NHTSA) over the past 3 decades (model years 1982 to 2010) and understanding the effect of those changes on protection of rear seat occupants. A total of 1179 tests were used, and the changes in their mass and stiffness versus their model year was quantified. Additionally, data from 439 dummies tested in rear seats of NHTSA's full frontal crashes were analyzed. Dummies were divided into 3 groups based on their reference injury criteria. Multiple regressions were performed with speed, stiffness, and mass as predicting variables for head, neck, and chest injury criteria. A significant increase in mass and stiffness over model year of vehicles was observed, for passenger cars as well as large platform vehicles. The result showed a significant correlation (P-value < .05) between the increase in stiffness of the vehicles and increase in head and chest injury criteria for all dummy sizes. These results explain that stiffness is a significant contributor to previously reported decreases in protection of rear seat occupants over model years of vehicles.

  9. Comparative bioavailability and tolerability of a single 20-mg dose of two fluoxetine hydrochloride dispersible tablet formulations in fasting, healthy Chinese male volunteers: an open-label, randomized-sequence, two-period crossover study.

    PubMed

    Shi, Shaojun; Liu, Yani; Wu, Jianhong; Li, Zhongfang; Zhao, Yan; Zhong, Dafang; Zeng, Fandian

    2010-10-01

    The proprietary formulation of fluoxetine hydrochloride is an antidepressant of the selective serotonin reuptake inhibitor class. Pharmacokinetic studies investigating the bioequivalence of generic and branded formulations are needed to market generic fluoxetine in China. The aim of this study was to compare the bioavailability and tolerability of the proposed generic formulation with the established reference formulation of fluoxetine hydrochloride 20 mg in a fasting, healthy Chinese male population. This 10-week, open-label, randomized-sequence, single-dose, 2-period crossover study was conducted in healthy native Han Chinese male volunteers. Eligible subjects were randomly assigned in a 1:1 ratio to receive a single 20-mg dose of the test or reference formulation, followed by a 35-day washout period and administration of the alternate formulation. Doses were administered after a 12-hour overnight fast. For analysis of pharmacokinetic properties (including C(max), T(max), AUC(0-t), AUC(0-∞), and t(½)), blood samples were obtained over a 672-hour period after dosing. Plasma concentrations of fluoxetine and its active metabolite, norfluoxetine, were analyzed using a validated LC-MS/MS method. The formulations were to be considered bioequivalent if the ln-transformed ratios (test/ reference) of C(max) and AUC were within the predetermined bioequivalence range of 80% to 125%, as established by the US Food and Drug Administration, and if the P values were <0.05 for the 90% CIs. Signs and symptoms of adverse effects of fluoxetine hydrochloride such as nausea, vomiting, insomnia, somnolence, anxiety, and nervousness, as well as any untoward effects, were collected using a daily written questionnaire and recorded by the study physicians. Tolerability was assessed using monitoring of vital signs, physical ex- amination, ECG, and routine blood and urine tests, along with blood biochemical tests, at the start as well as at the end of the study. Twenty-four subjects were enrolled and completed the study (mean [SD] age, 24.4 [2.3] years [range, 20-30 years]; weight, 63.6 [8.5] kg [range, 51.2-86.8 kg]; height, 1.72 [0.07] m [range, 1.57-1.91 m]). The AUC values for fluoxetine were not consistent with a normal distribution, reflecting the existence of 2 different populations (poor and extensive metabolizers). Data from the one poor metabolizer were excluded from the pharmacokinetics data summarized. In extensive metabolizers, the mean (SD) C(max) for fluoxetine with the test formulation was 11.786 (3.459) ng/mL and T(max) was 5.48 (2.06) hours. With the reference formulation, the corresponding values were 11.754 (3.292) ng/mL and 6.26 (5.77) hours, respectively. The t(½) values with the test and reference formulations were 30.86 (7.61) and 30.96 (6.91) hours, respectively. For norfluoxetine, mean C(max) with the test formulation was 14.177 (4.957) ng/mL and T(max) was 58.48 (31.67) hours; the corresponding values for the reference formulation were 13.828 (4.838) ng/mL and 57.91 (25.75) hours. The t(½) values with the test and reference formulations were 130.91 (42.04) and 128.79 (52.72) hours, respectively. For fluoxetine, the 90% CIs (in extensive metabolizers only) for the In-transformed C(max), AUC(0-168), and AUC(0-∞) were 92.0% to 108.4%, 95.7% to 110.3%, and 97.4% to 111.3%, respectively (all, P < 0.001). For norfluoxetine, the 90% CIs for the ln-transformed C(max), AUC(0-672), and AUC(0-∞) were 93.7% to 110.7%, 98.9% to 111.4%, and 98.8% to 110.9% (all, P < 0.001). No period or sequence effects were observed for any pharmacokinetic variable in the extensive metabolizers. No adverse events were reported by the volunteers or found with results of clinical laboratory testing. This single-dose study found that the test and reference formulations of fluoxetine hydro- chloride met the regulatory criteria for bioequivalence in these fasting, healthy Chinese male volunteers. Both formulations appeared to be well tolerated. Copyright © 2010 Excerpta Medica Inc. All rights reserved.

  10. Family influences on the cognitive development of profoundly deaf children: exploring the effects of socioeconomic status and siblings.

    PubMed

    Macaulay, Catrin E; Ford, Ruth M

    2013-10-01

    We evaluated the cognitive development of 48 profoundly deaf children from hearing families (born 1994-2002, mean age M = 8.0 years at time of test, none of whom had received early auditory-verbal therapy) as a function of family socioeconomic status and number of siblings. Overall, the deaf children matched a younger group of 47 hearing controls (M = 4.6 years) on verbal ability, theory of mind, and cognitive inhibition. Partial correlations (controlling for age) revealed positive relations in the hearing group between maternal education and inhibition, between number of younger siblings and references to emotions, and between number of close-in-age siblings and references to desires and false beliefs. In the deaf group, there were positive relations between household income and memory span, between maternal education and references to false beliefs, and between number of younger siblings and nonverbal ability. In contrast, deaf children with a greater number of older siblings aged ≤12 years showed inferior memory span, inhibition, belief understanding, picture-sequencing accuracy, and mental-state language, suggesting that they failed to compete successfully with older siblings for their parents' attention and material resources. We consider the implications of the findings for understanding birth-order effects on deaf and language-impaired children.

  11. German translation, cross-cultural adaptation and diagnostic test accuracy of three frailty screening tools : PRISMA-7, FRAIL scale and Groningen Frailty Indicator.

    PubMed

    Braun, Tobias; Grüneberg, Christian; Thiel, Christian

    2018-04-01

    Routine screening for frailty could be used to timely identify older people with increased vulnerability und corresponding medical needs. The aim of this study was the translation and cross-cultural adaptation of the PRISMA-7 questionnaire, the FRAIL scale and the Groningen Frailty Indicator (GFI) into the German language as well as a preliminary analysis of the diagnostic test accuracy of these instruments used to screen for frailty. A diagnostic cross-sectional study was performed. The instrument translation into German followed a standardized process. Prefinal versions were clinically tested on older adults who gave structured in-depth feedback on the scales in order to compile a final revision of the German language scale versions. For the analysis of diagnostic test accuracy (criterion validity), PRISMA-7, FRAIL scale and GFI were considered the index tests. Two reference tests were applied to assess frailty, either based on Fried's model of a Physical Frailty Phenotype or on the model of deficit accumulation, expressed in a Frailty Index. Prefinal versions of the German translations of each instrument were produced and completed by 52 older participants (mean age: 73 ± 6 years). Some minor issues concerning comprehensibility and semantics of the scales were identified and resolved. Using the Physical Frailty Phenotype (frailty prevalence: 4%) criteria as a reference standard, the accuracy of the instruments was excellent (area under the curve AUC >0.90). Taking the Frailty Index (frailty prevalence: 23%) as the reference standard, the accuracy was good (AUC between 0.73 and 0.88). German language versions of PRISMA-7, FRAIL scale and GFI have been established and preliminary results indicate sufficient diagnostic test accuracy that needs to be further established.

  12. 40 CFR 160.107 - Test, control, and reference substance handling.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Test, control, and reference substance handling. 160.107 Section 160.107 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS GOOD LABORATORY PRACTICE STANDARDS Test, Control, and Reference Substances § 160.107 Test...

  13. Safety Assurances at Space Test Centres: Lessons Learned

    NASA Astrophysics Data System (ADS)

    Alarcon Ruiz, Raul; O'Neil, Sean; Valls, Rafel Prades

    2010-09-01

    The European Space Agency’s(ESA) experts in quality, cleanliness and contamination control, safety, test facilities and test methods have accumulated valuable experience during the performance of dedicated audits of space test centres in Europe over a period of 10 years. This paper is limited to a summary of the safety findings and provides a valuable reference to the lessons learned, identifying opportunities for improvement in the areas of risk prevention measures associated to the safety of all test centre personnel, the test specimen, the test facilities and associated infrastructure. Through the analysis of the audit results the authors present what are the main lessons learned, and conclude how an effective safety management system will contribute to successful test campaigns and have a positive impact on the cost and schedule of space projects.

  14. Evaluation of Altona Diagnostics RealStar Zika Virus Reverse Transcription-PCR Test Kit for Zika Virus PCR Testing

    PubMed Central

    Lombos, Ernesto; Tang, Elaine; Perusini, Stephen; Eshaghi, Alireza; Nagra, Sandeep; Frantz, Christine; Olsha, Romy; Kristjanson, Erik; Dimitrova, Kristina; Safronetz, David; Drebot, Mike

    2017-01-01

    ABSTRACT With the emerging Zika virus (ZIKV) epidemic, accessible real-time reverse transcription-PCR (rRT-PCR) assays are needed to streamline testing. The commercial Altona Diagnostics RealStar ZIKV rRT-PCR test kit (Altona PCR) has been approved for emergency use authorization by the U.S. FDA. Our aim was to verify the Altona PCR by comparing it to the CDC-designed dual-target ZIKV rRT-PCR reference assay (reference PCR) and describe the demographics of patients tested for ZIKV by rRT-PCR in Ontario, Canada. A large set of clinical specimens was tested for ZIKV by the Altona PCR and the reference PCR. Positive or equivocal specimens underwent PCR and Sanger sequencing targeting the ZIKV NS5 gene. A total of 671 serum specimens were tested by the reference PCR: 58 (8.6%) were positive, 193 (28.8%) were equivocal, and 420 (62.6%) were negative. Ninety percent of the reference PCR-positive patients were tested in the first 5 days after symptom onset. The Altona PCR was performed on 284/671 specimens tested by the reference PCR. The Altona PCR was positive for 53/58 (91%) reference PCR-positive specimens and 16/193 (8%) reference PCR-equivocal specimens; the ZIKV NS5 PCR was positive for all 68 Altona PCR-positive specimens and negative for all 181 Altona PCR-negative specimens that underwent the NS5 PCR. The Altona PCR has very good sensitivity (91%) and specificity (97%) compared to the reference PCR. The Altona PCR can be used for ZIKV diagnostic testing and has less extensive verification requirements than a laboratory-developed test. PMID:28298448

  15. Bone turnover marker reference intervals in young females.

    PubMed

    Callegari, Emma T; Gorelik, Alexandra; Garland, Suzanne M; Chiang, Cherie Y; Wark, John D

    2017-07-01

    Background The use of bone turnover markers in clinical practice and research in younger people is limited by the lack of normative data and understanding of common causes of variation in bone turnover marker values in this demographic. To appropriately interpret bone turnover markers, robust reference intervals specific to age, development and sex are necessary. This study aimed to determine reference intervals of bone turnover markers in females aged 16-25 years participating in the Safe-D study. Methods Participants were recruited through social networking site Facebook and were asked to complete an extensive, online questionnaire and attend a site visit. Participants were tested for serum carboxy-terminal cross-linking telopeptide of type 1 collagen and total procollagen type 1 N-propeptide using the Roche Elecsys automated analyser. Reference intervals were determined using the 2.5th to 97.5th percentiles of normalized bone turnover marker values. Results Of 406 participants, 149 were excluded due to medical conditions or medication use (except hormonal contraception) which may affect bone metabolism. In the remaining 257 participants, the reference interval was 230-1000 ng/L for serum carboxy-terminal cross-linking telopeptide of type 1 collagen and 27-131  µg/L for procollagen type 1 N-propeptide. Both marker concentrations were inversely correlated with age and oral contraceptive pill use. Therefore, intervals specific to these variables were calculated. Conclusions We defined robust reference intervals for cross-linking telopeptide of type 1 collagen and procollagen type 1 N-propeptide in young females grouped by age and contraceptive pill use. We examined bone turnover markers' relationship with several lifestyle, clinical and demographic factors. Our normative intervals should aid interpretation of bone turnover markers in young females particularly in those aged 16 to 19 years where reference intervals are currently provisional.

  16. Diagnostic accuracy of a pocket screening spirometer in diagnosing chronic obstructive pulmonary disease in general practice: a cross sectional validation study using tertiary care as a reference.

    PubMed

    Labor, Marina; Vrbica, Žarko; Gudelj, Ivan; Labor, Slavica; Plavec, Davor

    2016-08-19

    COPD-6™ is a lung function testing device for a rapid pre-spirometry testing to screen-out at-risk individuals not having COPD and indicating those at risk. The aim of this study was to validate COPD-6™ lung function testing (index test) in general practice in discriminating patients with COPD out of the population at risk - smokers/ex-smokers with no previous diagnosis of COPD, using measurements at tertiary care as reference standard. Consecutive 227 subjects (115 women, 185 smokers/42 ex-smokers, ≥20 pack-years) with no previous diagnosis of COPD, aged 52.5 (SD 6.8) years from 26 general practitioners (GPs) were recruited, lung function tested with COPD-6™, referred to the tertiary institution for repeated COPD-6™ testing followed by spirometry with a bronchodilator (salbutamol), examination, and pulmonologist consultation for the diagnosis and severity of COPD. COPD was diagnosed in 43 subjects (18.9 %), with an AUC of 0.827 (95 % CI 0.769-0.875, P < 0.001) for the diagnosis of COPD when lung function was measured using COPD-6™ in GP's office with a specificity of 100 % (95 % CI, 97.95-100 %) but a very low sensitivity of 32.56 % (95 % CI, 20.49-47.48 %). Significant agreement for forced expiratory volume in 1 s measured at GP's office and at lung function lab was found (mean difference 0.01 L, p = 0.667) but not for other measured parameters (p < 0.001 for all). Our study results point out that active case finding in a population at risk for COPD should be instituted (almost 20 % of undiagnosed COPD). Based on our results lung function testing with COPD-6™ can substitute spirometry testing in cases where it is not readily available to the patient/physician taken into account that the traditional FEV1/FEV6 cutoff value of <0.7 is not the only criterion for diagnosis and/or further referral. ClinicalTrials.gov Identifier NCT01550679 Registered 28 September 2014, retrospectively registered.

  17. Reference intervals: current status, recent developments and future considerations.

    PubMed

    Ozarda, Yesim

    2016-01-01

    Reliable and accurate reference intervals (RIs) for laboratory analyses are an integral part of the process of correct interpretation of clinical laboratory test results. RIs given in laboratory reports have an important role in aiding the clinician in interpreting test results in reference to values for healthy populations. Since the 1980s, the International Federation of Clinical Chemistry (IFCC) has been proactive in establishing recommendations to clarify the true significance of the term 'RIs, to select the appropriate reference population and statistically analyse the data. The C28-A3 guideline published by the Clinical and Laboratory Standards Institute (CLSI) and IFCC is still the most widely-used source of reference in this area. In recent years, protocols additional to the Guideline have been published by the IFCC, Committee on Reference Intervals and Decision Limits (C-RIDL), including all details of multicenter studies on RIs to meet the requirements in this area. Multicentric RIs studies are the most important development in the area of RIs. Recently, the C-RIDL has performed many multicentric studies to obtain common RIs. Confusion of RIs and clinical decision limits (CDLs) remains an issue and pediatric and geriatric age groups are a significant problem. For future studies of RIs, the genetic effect would seem to be the most challenging area. 
The aim of the review is to present the current theory and practice of RIs, with special emphasis given to multicenter RIs studies, RIs studies for pediatric and geriatric age groups, clinical decision limits and partitioning by genetic effects on RIs.

  18. Reference intervals: current status, recent developments and future considerations

    PubMed Central

    Ozarda, Yesim

    2016-01-01

    Reliable and accurate reference intervals (RIs) for laboratory analyses are an integral part of the process of correct interpretation of clinical laboratory test results. RIs given in laboratory reports have an important role in aiding the clinician in interpreting test results in reference to values for healthy populations. Since the 1980s, the International Federation of Clinical Chemistry (IFCC) has been proactive in establishing recommendations to clarify the true significance of the term ‘RIs, to select the appropriate reference population and statistically analyse the data. The C28-A3 guideline published by the Clinical and Laboratory Standards Institute (CLSI) and IFCC is still the most widely-used source of reference in this area. In recent years, protocols additional to the Guideline have been published by the IFCC, Committee on Reference Intervals and Decision Limits (C-RIDL), including all details of multicenter studies on RIs to meet the requirements in this area. Multicentric RIs studies are the most important development in the area of RIs. Recently, the C-RIDL has performed many multicentric studies to obtain common RIs. Confusion of RIs and clinical decision limits (CDLs) remains an issue and pediatric and geriatric age groups are a significant problem. For future studies of RIs, the genetic effect would seem to be the most challenging area.
The aim of the review is to present the current theory and practice of RIs, with special emphasis given to multicenter RIs studies, RIs studies for pediatric and geriatric age groups, clinical decision limits and partitioning by genetic effects on RIs. PMID:26981015

  19. A case of misdiagnosis of mild cognitive impairment: The utility of symptom validity testing in an outpatient memory clinic.

    PubMed

    Roor, Jeroen J; Dandachi-FitzGerald, Brechje; Ponds, Rudolf W H M

    2016-01-01

    Noncredible symptom reports hinder the diagnostic process. This fact is especially the case for medical conditions that rely on subjective report of symptoms instead of objective measures. Mild cognitive impairment (MCI) primarily relies on subjective report, which makes it potentially susceptible to erroneous diagnosis. In this case report, we describe a 59-year-old female patient diagnosed with MCI 10 years previously. The patient was referred to the neurology department for reexamination by her general practitioner because of cognitive complaints and persistent fatigue. This case study used information from the medical file, a new magnetic resonance imaging brain scan, and neuropsychological assessment. Current neuropsychological assessment, including symptom validity tests, clearly indicated noncredible test performance, thereby invalidating the obtained neuropsychological test data. We conclude that a blind spot for noncredible symptom reports existed in the previous diagnostic assessments. This case highlights the usefulness of formal symptom validity testing in the diagnostic assessment of MCI.

  20. In vitro vaccine potency testing: a proposal for reducing animal use for requalification testing.

    PubMed

    Brown, K; Stokes, W

    2012-01-01

    This paper proposes a program under which the use of animals for requalification of in vitro potency tests could be eliminated. Standard References (USDA/CVB nomenclature) would be developed, characterized, stored and monitored by selected reference laboratories worldwide. These laboratories would employ scientists skilled in protein and glycoprotein chemistry and equipped with state-of-the-art instruments for required analyses. After Standard References are established, the reference laboratories would provide them to the animal health industry as "gold standards". Companies would then establish and validate a correlation between the Standard Reference and the company Master Reference (USDA/CVB nomenclature) using an internal in vitro assay. After this correlation is established, the company could use the Standard References for qualifying, monitoring and requalifying company Master References without the use of animals. Such a program would eliminate the need for animals for requalification of Master References and the need for each company to develop and validate a battery of Master Reference Monitoring assays. It would also provide advantages in terms of reduced costs and reduced time for requalification testing. As such it would provide a strong incentive for companies to develop and use in vitro assays for potency testing.

  1. Dental age assessment of southern Chinese using the United Kingdom Caucasian reference dataset.

    PubMed

    Jayaraman, Jayakumar; Roberts, Graham J; King, Nigel M; Wong, Hai Ming

    2012-03-10

    Dental age assessment is one the most accurate methods for estimating the age of an unknown person. Demirjian's dataset on a French-Canadian population has been widely tested for its applicability on various ethnic groups including southern Chinese. Following inaccurate results from these studies, investigators are now confronted with using alternate datasets for comparison. Testing the applicability of other reliable datasets which result in accurate findings might limit the need to develop population specific standards. Recently, a Reference Data Set (RDS) similar to the Demirjian was prepared in the United Kingdom (UK) and has been subsequently validated. The advantages of the UK Caucasian RDS includes versatility from including both the maxillary and mandibular dentitions, involvement of a wide age group of subjects for evaluation and the possibility of precise age estimation with the mathematical technique of meta-analysis. The aim of this study was to evaluate the applicability of the United Kingdom Caucasian RDS on southern Chinese subjects. Dental panoramic tomographs (DPT) of 266 subjects (133 males and 133 females) aged 2-21 years that were previously taken for clinical diagnostic purposes were selected and scored by a single calibrated examiner based on Demirjian's classification of tooth developmental stages (A-H). The ages corresponding to each stage of tooth developmental stage were obtained from the UK dataset. Intra-examiner reproducibility was tested and the Cohen kappa (0.88) showed that the level of agreement was 'almost perfect'. The estimated dental age was then compared with the chronological age using a paired t-test, with statistical significance set at p<0.01. The results showed that the UK dataset, underestimated the age of southern Chinese subjects by 0.24 years but the results were not statistically significant. In conclusion, the UK Caucasian RDS may not be suitable for estimating the age of southern Chinese subjects and there is a need for an ethnic specific reference dataset for southern Chinese. Copyright © 2011. Published by Elsevier Ireland Ltd.

  2. Preschool vision screening in a Swedish city region: results after alteration of criteria for referral to eye clinics.

    PubMed

    Hård, Anna-Lena; Sjödell, Lena; Borres, Magnus P; Zetterberg, Ingrid; Sjöstrand, Johan

    2002-12-01

    To investigate the results of preschool vision screening and to evaluate new referral criteria in a Swedish city region. Prior to 1992, all children with visual acuity (VA) of less than 0.8 at the age of 4 years were referred to an eye clinic. Since 1992, those with slightly reduced VA (0.65 in each eye or 0.65 in one eye and 0.8 in the other) have been retested at 5.5 years of age and referred if their VA is less than 0.8. In a prospective study, the results of vision testing were collected for all children (n = 483) born in 1989-92 inclusive and registered at one child health centre at 4 years of age. The study also involved 123 other children scheduled for retesting at the age of 5.5 years. The results of the examinations and treatments at the eye clinic are evaluated. Few of the children with slightly reduced VA who were retested at the age of 5.5 years had visual defects that required treatment. In those who were treated, the results of treatment were good. The new screening criteria appear to be appropriate and are recommended.

  3. Changes in lung function of granite crushers exposed to moderately high silica concentrations: a 12 year follow up.

    PubMed Central

    Malmberg, P; Hedenström, H; Sundblad, B M

    1993-01-01

    45 granite crushers and 45 age and smoking matched referents underwent pulmonary function tests in 1976 and 1988. On average, the granite crushers at follow up had worked for 22 years, were 52 (range 36-78) years old, and had inhaled a cumulated amount of 7 mg of silica in the respirable dust fraction. Between 1976 and 1988 the average concentration of respirable quartz in air was 0.16 mg/m3 (threshold limit value (TLV) = 0.10 mg/m3). In 1988 the granite crushers had somewhat lower forced expiratory flows (forced expiratory volume in one second/vital capacity (FEV1/VC) -4.5% and forced midexpiratory flow FEF50 -15%) compared with the referents and a more uneven ventilation distribution (17% higher slope of phase III in the nitrogen single breath curve). Five smoking granite crushers, but none of the referents, had an FEV1 < 80% of the predicted. During the 12 year interval the granite crushers had--compared with the matched referents--a greater decrease in FEV1 (-4.6%), FEV1/VC (-5.4%), maximal expiratory flow, (-8%) and FEF50 (-14%), and a larger increase in phase III and static compliance (p < 0.02 in all variables). The functional changes suggest the presence of airways obstruction and increased compliance of the lungs. Exposure to silica at concentrations of about twice the present TLV was thus associated with airways obstruction and loss of elastic recoil rather than fibrosis and a restrictive function loss as seen in silicosis. The changes were on average small, but in some tobacco smokers more pronounced changes were found. PMID:8398859

  4. Screening women for cervical cancer carcinoma with a HPV mRNA test: first results from the Venice pilot program.

    PubMed

    Maggino, Tiziano; Sciarrone, Rocco; Murer, Bruno; Dei Rossi, Maria Rosa; Fedato, Chiara; Maran, Michela; Lorio, Melania; Soldà, Marika; Zago, Fiorella; Giorgi Rossi, Paolo; Zorzi, Manuel

    2016-08-23

    HPV DNA-based screening is more effective than a Pap test in preventing cervical cancer, but the test is less specific. New HPV tests have been proposed for primary screening. The HPV mRNA test showed a similar or slightly lower sensitivity than the HPV DNA tests but with a higher specificity. We report the results of an organised HPV mRNA-based screening pilot program in Venice, Italy. From October 2011 to May 2014, women aged 25-64 years were invited to undergo a HPV mRNA test (Aptima). Those testing positive underwent cytological triage. Women with positive cytology were referred to colposcopy, whereas those with negative cytology were referred to repeat the HPV mRNA test 1 year later. The results of the HPV mRNA test program were compared with both the local historical cytology-based program and with four neighbouring DNA HPV-based pilot projects. Overall, 23 211 women underwent a HPV mRNA test. The age-standardised positivity rate was 7.0%, higher than in HPV DNA programs (6.8%; relative rate (RR) 1.11, 95% confidence interval (CI) 1.05-1.17). The total colposcopy referral was 5.1%, double than with cytology (2.6%; RR 2.02, 95% CI 1.82-2.25) but similar to the HPV DNA programs (4.8%; RR 1.02; 95% CI 0.96-1.08). The cervical intraepithelial neoplasia grade 2+ detection rate with HPV mRNA was greater than in the HPV DNA programs at baseline (RR 1.50; 95% CI 1.19-1.88) and not significantly lower at the 1-year repeat (RR 0.70; 95% CI 0.40-1.16). The overall RR was 1.29 (95% CI 1.05-1.59), which was much higher than with cytology (detection rate 5.5‰ vs 2.1‰; RR 2.50, 95% CI 1.76-3.62). A screening programme based on the HPV mRNA obtained results similar to those observed with the HPV DNA test. In routine screening programmes, even a limited increase in HPV prevalence may conceal the advantage represented by the higher specificity of HPV mRNA.

  5. 40 CFR 792.105 - Test, control, and reference substance characterization.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Test, control, and reference substance... shall be determined by the testing facility or the sponsor before the experimental start date. The stability of the test, control or reference substance shall be determined before the experimental start date...

  6. Occupational Contact Dermatitis in the Canadian Aircraft Industry.

    PubMed

    Loranger, Camille; Moreau, Linda; Sasseville, Denis

    Aircraft building exposes workers to irritant and sensitizing products. The aim of this article was to study occupational dermatoses among aircraft workers over 25 years. The files of aerospace workers referred between 1990 and 2015 were extracted from the database of the McGill University Health Centre contact dermatitis clinic. These were subdivided according to demographics, type of work, patch testing results, and final diagnosis. Of 305 workers, 58% were 40 years or younger; one third were women. Onset of dermatitis varied from 2 months to 25 years, but 120 cases (39%) occurred during the first 3 years. Fifty-one percent of the cases involved assemblers, and 27% were composite material technicians, which were overrepresented as they constitute 10% of the workforce. Of the 305 workers, 152 suffered from allergic contact dermatitis, and 96 had irritant contact dermatitis. Of those with allergic contact dermatitis, 124 reacted to epoxy-based workplace products, but only 48 had positive patch tests to commercially available epoxy allergens. More than 60% of the cases of epoxy allergy would have been missed without testing with workplace products.

  7. Race/ethnicity and the socioeconomic status gradient in women's cancer screening utilization: a case of diminishing returns?

    PubMed

    Monnat, Shannon M

    2014-02-01

    Using three years (2006, 2008, 2010) of nationally representative data from the Behavioral Risk Factor Surveillance System, I assessed the socioeconomic status (SES) gradient for odds of receiving a mammogram in the past two years and a Pap test in the past three years among White, Black, Hispanic, and Asian women living in the U.S. Mammogram and Pap test utilization were less likely among low-SES women. However, women of color experience less benefit than Whites from increasing SES for both screenings; as income and education increased, White women experienced more pronounced increases in the likelihood of being screened than did women of color. In what might be referred to as paradoxical returns, Asian women actually experienced a decline in the likelihood of obtaining a recent Pap test at higher levels of education. My findings suggest that women of color differ from Whites in the extent to which increasing socioeconomic resources is associated with increasing cancer screening utilization.

  8. Free-breathing Sparse Sampling Cine MR Imaging with Iterative Reconstruction for the Assessment of Left Ventricular Function and Mass at 3.0 T.

    PubMed

    Sudarski, Sonja; Henzler, Thomas; Haubenreisser, Holger; Dösch, Christina; Zenge, Michael O; Schmidt, Michaela; Nadar, Mariappan S; Borggrefe, Martin; Schoenberg, Stefan O; Papavassiliu, Theano

    2017-01-01

    Purpose To prospectively evaluate the accuracy of left ventricle (LV) analysis with a two-dimensional real-time cine true fast imaging with steady-state precession (trueFISP) magnetic resonance (MR) imaging sequence featuring sparse data sampling with iterative reconstruction (SSIR) performed with and without breath-hold (BH) commands at 3.0 T. Materials and Methods Ten control subjects (mean age, 35 years; range, 25-56 years) and 60 patients scheduled to undergo a routine cardiac examination that included LV analysis (mean age, 58 years; range, 20-86 years) underwent a fully sampled segmented multiple BH cine sequence (standard of reference) and a prototype undersampled SSIR sequence performed during a single BH and during free breathing (non-BH imaging). Quantitative analysis of LV function and mass was performed. Linear regression, Bland-Altman analysis, and paired t testing were performed. Results Similar to the results in control subjects, analysis of the 60 patients showed excellent correlation with the standard of reference for single-BH SSIR (r = 0.93-0.99) and non-BH SSIR (r = 0.92-0.98) for LV ejection fraction (EF), volume, and mass (P < .0001 for all). Irrespective of breath holding, LV end-diastolic mass was overestimated with SSIR (standard of reference: 163.9 g ± 58.9, single-BH SSIR: 178.5 g ± 62.0 [P < .0001], non-BH SSIR: 175.3 g ± 63.7 [P < .0001]); the other parameters were not significantly different (EF: 49.3% ± 11.9 with standard of reference, 48.8% ± 11.8 with single-BH SSIR, 48.8% ± 11 with non-BH SSIR; P = .03 and P = .12, respectively). Bland-Altman analysis showed similar measurement errors for single-BH SSIR and non-BH SSIR when compared with standard of reference measurements for EF, volume, and mass. Conclusion Assessment of LV function with SSIR at 3.0 T is noninferior to the standard of reference irrespective of BH commands. LV mass, however, is overestimated with SSIR. © RSNA, 2016 Online supplemental material is available for this article.

  9. [Full blood count reference values in children of 8 to 12 years old residing at 2,760 m above sea level].

    PubMed

    Armando García-Miranda, L; Contreras, I; Estrada, J A

    2014-04-01

    To determine reference values for full blood count parameters in a population of children 8 to 12 years old, living at an altitude of 2760 m above sea level. Our sample consisted of 102 individuals on whom a full blood count was performed. The parameters included: total number of red blood cells, platelets, white cells, and a differential count (millions/μl and %) of neutrophils, lymphocytes, monocytes, eosinophils and basophils. Additionally, we obtained values for hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, concentration of corpuscular hemoglobin and red blood cell distribution width. The results were statistically analyzed with a non-parametric test, to divide the sample in quartiles and obtain the lower and upper limits for our intervals. Moreover, the values for the intervals obtained from this analysis were compared to intervals obtained estimating+- 2 standard deviations above and below from our mean values. Our results showed significant differences compared to normal interval values reported for the adult Mexican population in most of the parameters studied. The full blood count is an important laboratory test used routinely for the initial assessment of a patient. Values of full blood counts in healthy individuals vary according to gender, age and geographic location; therefore, each population should have its own reference values. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  10. Balance ability of 7 and 10 year old children in the population: results from a large UK birth cohort study.

    PubMed

    Humphriss, Rachel; Hall, Amanda; May, Margaret; Macleod, John

    2011-01-01

    The literature contains many reports of balance function in children, but these are often on atypical samples taken from hospital-based clinics and may not be generalisable to the population as a whole. The purpose of the present study is to describe balance test results from a large UK-based birth cohort study. Data from the Avon Longitudinal Study of Parents and Children (ALSPAC) were analysed. A total of 5402 children completed the heel-to-toe walking test at age 7 years. At age 10 years, 6915 children underwent clinical tests of balance including beam-walking, standing heel-to-toe on a beam and standing on one leg. A proportion of the children returned to the clinic for retesting within 3 months allowing test-retest agreement to be measured. Frequency distributions for each of the balance tests are given. Correlations between measures of dynamic balance at ages 7 and 10 years were weak. The static balance of 10 year old children was found to be poorer with eyes closed than with eyes open, and poorer in boys than in girls for all measures. Balance on one leg was poorer than heel-to-toe balance on a beam. A significant learning effect was found when first and second attempts of the tests were compared. Measures of static and dynamic balance appeared independent. Consistent with previous reports in the literature, test-retest reliability was found to be low. This study provides information about the balance ability of children aged 7 and 10 years and provides clinicians with reference data for balance tests commonly used in the paediatric clinic. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  11. Comparison of Performance Predictions for New Low-Thrust Trajectory Tools

    NASA Technical Reports Server (NTRS)

    Polsgrove, Tara; Kos, Larry; Hopkins, Randall; Crane, Tracie

    2006-01-01

    Several low thrust trajectory optimization tools have been developed over the last 3% years by the Low Thrust Trajectory Tools development team. This toolset includes both low-medium fidelity and high fidelity tools which allow the analyst to quickly research a wide mission trade space and perform advanced mission design. These tools were tested using a set of reference trajectories that exercised each tool s unique capabilities. This paper compares the performance predictions of the various tools against several of the reference trajectories. The intent is to verify agreement between the high fidelity tools and to quantify the performance prediction differences between tools of different fidelity levels.

  12. United States Department of Energy, Nevada Operations Office, completion report Operation KLAXON, Fiscal Year 1993

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

    Not Available

    1994-06-01

    The U.S. Department of Energy, Nevada Operations Office (DOE/NV), Completion Report provides a summary of activities conducted at the Nevada Test Site (NTS) between October 1, 1992, and September 30, 1993, associated with Operation KLAXON. (In the past, each annual Completion Report dealt with a series of underground nuclear detonations; however, because no nuclear tests were conducted during FY 1993, this Report summarizes continuing nonnuclear and nuclear test readiness activities at the NTS sponsored by DOE/NV.) The report serves as a reference for those involved with the planning and execution of Operation KLAXON and also serves as a planning guidemore » for future operations. Information in the report covers the logistics and management of activities. Scientific information and data associated with NTS activities are presented in technical documents published by participating agencies. In September 1992, Congress legislated a nine-month moratorium on the testing of nuclear weapons. The bill also provided for a resumption of testing (with no more than five tests per year, or a total of 15 during the next three years) in July 1993, and mandated an end to nuclear testing, entirely, by 1996. President Bush signed the bill into law in October 1992.« less

  13. Results of delayed triage by HPV testing and cytology in the Norwegian Cervical Cancer Screening Programme.

    PubMed

    Haldorsen, Tor; Skare, Gry Baadstrand; Ursin, Giske; Bjørge, Tone

    2015-02-01

    High-risk human papilloma virus (hrHPV) testing was added to the cytology triage of women with equivocal screening smears in the Norwegian programme for cervical cancer screening in 2005. In this population-based observational before and after study we assessed the effect of changing the screening algorithm. In periods before and after the change 75 852 and 66 616 women, respectively, were eligible for triage, i.e. they had smear results of unsatisfactory, atypical squamous cells of undetermined significance (ASC-US), or low-grade squamous intraepithelial lesion (LSIL) at routine screening. The triage was delayed as supplementary testing started six months after the initial screening. The groups were compared with respect to results of triage and later three-year cumulative incidence of cervical intraepithelial neoplasia grade 2 or worse (CIN2+). Before and after the change in the screening algorithm 5.2% (3964/75 852) and 8.1% (5417/66 616) of women, respectively, were referred to colposcopy. Among women referred to colposcopy cumulative incidence of CIN2+ (positive predictive value of referral) increased from 42.0% [95% confidence interval (CI): 40.3 - 43.7%] in the period with cytology only to 48.0% (95% CI 46.6 - 49.4%) after the start of HPV testing. For women recalled to ordinary screening the three-year cumulative incidence decreased from 2.7% (95% CI 2.5 - 2.9%) to 1.0% (95% CI 0.9 - 1.2%) during the same period. Among women with LSIL at routine screening and HPV testing in triage, 52.5% (1976/3766) were HPV positive. The new algorithm with HPV testing implemented in 2005 resulted in an increased rate of referral to colposcopy, but in a better risk stratification with respect to precancerous disease.

  14. Age Induced Effects on ESD Characteristics of Solar Array Coupons After Combined Space Environmental Exposures

    NASA Technical Reports Server (NTRS)

    Wright, Kenneth H.; Schneider, Todd A.; Vaughn, Jason A.; Hoang, Bao; Funderburk, Victor V.; Wong, Frankie; Gardiner, George

    2012-01-01

    A set of multi-junction GaAs/Ge solar array test coupons provided by Space Systems/Loral were subjected to a sequence of 5-year increments of combined space environment exposure tests. The test coupons capture an integrated design intended for use in a geosynchronous (GEO) space environment. A key component of this test campaign is performing electrostatic discharge (ESD) tests in the inverted gradient mode. The protocol of the ESD tests is based on the ISO standard for ESD testing on solar array panels [ISO-11221]. The test schematic in the ISO reference has been modified with Space System/Loral designed circuitry to better simulate the on-orbit operational conditions of its solar array design. Part of the modified circuitry is to simulate a solar array panel coverglass flashover discharge. All solar array coupons used in the test campaign consist of four cells constructed to form two strings. The ESD tests were performed at the beginning-of-life (BOL) and at each 5-year environment exposure point until end-of-life (EOL) at 15 years. The space environmental exposure sequence consisted of ultra-violet radiation, electron/proton particle radiation, thermal cycling, and Xenon ion thruster plume erosion. This paper describes the ESD test setup and the importance of the electrical test design in simulating the on-orbit operational conditions. Arc inception voltage results along with ESD test behavior from the BOL condition through the 15th year age condition are discussed. In addition, results from a Xenon plasma plume exposure test with an EOL coupon under the full ESD test condition will be discussed.

  15. Ethnic differences in cognitive development in the first 7 years: does maternal generational status matter?

    PubMed

    Smith, Neil R; Kelly, Yvonne J; Nazroo, James Y

    2016-05-01

    Differences in cognitive development have been observed across a variety of ethnic minority groups but relatively little is known about the persistence of these developmental inequalities over time or generations. A repeat cross-sectional analysis assessed cognitive ability scores of children aged 3, 5 and 7 years from the longitudinal UK Millennium Cohort Study (white UK born n=7630; Indian n=248; Pakistani n=328; Bangladeshi n=87; black Caribbean n=172; and black African n=136). Linear regression estimated ethnic differences in age normed scores at each time point. Multivariable logistic regression estimated within-group generational differences in test scores at each age adjusting stepwise for sociodemographic factors, maternal health behaviours, indicators of the home learning environment and parenting styles. The majority of ethnic minority groups scored lower than the white UK born reference group at 3 years with these differences narrowing incrementally at ages 5 and 7 years. However, the black Caribbean group scored significantly lower than the white UK born reference group throughout early childhood. At 3 years, Pakistani, black Caribbean and black African children with UK born mothers had significantly higher test scores than those with foreign born mothers after baseline adjustment for maternal age and child gender. Controlling for social, behavioural and parenting factors attenuated this generational advantage. By 7 years there were no significant generational differences in baseline models. Ethnic differences in cognitive development diminish throughout childhood for the majority of groups. Cumulative exposure to the UK environment may be associated with higher cognitive development scores. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  16. Evolution of activities in international biological standardization since the early days of the Health Organisation of the League of Nations.

    PubMed

    Sizaret, P

    1988-01-01

    The main activities in international biological standardization during the 18 years that followed the first international biological standardization meeting in London in 1921 were concerned with expressing the potencies of test preparations in comparison with reference materials. After the Second World War, however, it became clear that the testing of biological substances against international reference materials was only one among several measures for obtaining safe and potent products. The activities in international biological standardization were therefore widened so that, by the strict observance of specific manufacturing and control requirements, it was possible to gain further in safety and efficacy. At the end of 1987, 42 international requirements for biological substances were available and were being used as national requirements, sometimes after minor modification, by the majority of WHO's Member States. This is of utmost importance for the worldwide use of safe and potent biological products, including vaccines.

  17. [Validation of BREV: comparison with reference battery in 173 children with learning disorders].

    PubMed

    Billard, C; Ducot, B; Pinton, F; Coste-Zeitoun, D; Picard, S; Warszawski, J

    2006-01-01

    The BREV battery (Battery for rapid evaluation of cognitive functions) is a tool which can be used for the rapid neuropsychological evaluation of children aged between 4 and 9 years. After standardization (700 unaffected children) and validation by comparison with a reference battery (202 children with epilepsy), the aim of this study was further validation in 173 children with learning disorders. The study protocol included administration of the BREV, precise neuropsychological examination and evaluation of oral and written language. Statistical analysis was used to compare the findings of the BREV with those of the reference method, and the recommendations indicated by the BREV with the final diagnoses, and to define the sensitivity and the specificity of the BREV battery. All the correlations between BREV tests and reference tests were significant. Recommendations after the BREV were in agreement with the conclusions of the reference evaluation in 168/172 children for language, 145/173 for the psychometric evaluation. For only 4 chidren, the results of the BREV were false negative. Diagnoses corresponded in 168/173 children for oral language, in 102/110 for written language, 166/173 for praxis disorders and 157/173 for intellectual deficit. The most predictive subtests of the BREV and sensitivity and specificity of verbal and non-verbal scores were calculated. The BREV is a reliable examination, in learning disorders, to determine the most complementary investigations both in terms of language disorders and for non-verbal or global learning disabilities.

  18. "The Red Zone": Temporal Risk for Unwanted Sex among College Students

    ERIC Educational Resources Information Center

    Flack, William F., Jr.; Caron, Marcia L.; Leinen, Sarah J.; Breitenbach, Katherine G.; Barber, Ann M.; Brown, Elaine N.; Gilbert, Caitlin T.; Harchak, Taylor F.; Hendricks, Melissa M.; Rector, Catherine E.; Schatten, Heather T.; Stein, Heather C.

    2008-01-01

    The "red zone" usually refers to the first few weeks of the first semester at college, when female students are believed to be at greatest risk for experiencing unwanted sex. We tested this notion using data from a survey study of 207 first-and second-year students (121 women, 84 men) at a small, liberal arts university. Results demonstrated only…

  19. Organization and evolution of organized cervical cytology screening in Thailand.

    PubMed

    Khuhaprema, Thiravud; Attasara, Pattarawin; Srivatanakul, Petcharin; Sangrajrang, Suleeporn; Muwonge, Richard; Sauvaget, Catherine; Sankaranarayanan, Rengaswamy

    2012-08-01

    To describe phase 1 of an organized cytology screening project initiated in Thailand by the Ministry of Public Health and the National Health Security Office. Women aged 35-60 years were encouraged to undergo cervical screening in primary care units and hospitals through awareness programs. Papanicolaou smears were processed and reported at district or provincial cytology laboratories. Women with normal test results were advised to undergo repeat screening after 5 years, while those with precancerous and cancerous lesions were referred for colposcopy, biopsy, and treatment. Information on screening, referral, investigations, and therapy were logged in a computer database. Between 2005 and 2009, 69.2% of the 4030833 targeted women were screened. In all, 20991 women had inadequate smears; 27253 had low-grade squamous intraepithelial lesions; 15706 had high-grade squamous intraepithelial lesions; and 2920 had invasive cancers. Information on the management of precancerous lesions was available for only 17.4% of women referred for colposcopy. Although follow-up data on women with positive test results were inadequately documented, the present findings indicate that provision of cytology services through the existing healthcare system is feasible. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  20. Capillary reference half-cell

    DOEpatents

    Hall, Stephen H.

    1996-01-01

    The present invention is a reference half-cell electrode wherein intermingling of test fluid with reference fluid does not affect the performance of the reference half-cell over a long time. This intermingling reference half-cell may be used as a single or double junction submersible or surface reference electrode. The intermingling reference half-cell relies on a capillary tube having a first end open to reference fluid and a second end open to test fluid wherein the small diameter of the capillary tube limits free motion of fluid within the capillary to diffusion. The electrode is placed near the first end of the capillary in contact with the reference fluid. The method of operation of the present invention begins with filling the capillary tube with a reference solution. After closing the first end of the capillary, the capillary tube may be fully submerged or partially submerged with the second open end inserted into test fluid. Since the electrode is placed near the first end of the capillary, and since the test fluid may intermingle with the reference fluid through the second open end only by diffusion, this intermingling capillary reference half-cell provides a stable voltage potential for long time periods.

  1. Capillary reference half-cell

    DOEpatents

    Hall, S.H.

    1996-02-13

    The present invention is a reference half-cell electrode wherein intermingling of test fluid with reference fluid does not affect the performance of the reference half-cell over a long time. This intermingling reference half-cell may be used as a single or double junction submersible or surface reference electrode. The intermingling reference half-cell relies on a capillary tube having a first end open to reference fluid and a second end open to test fluid wherein the small diameter of the capillary tube limits free motion of fluid within the capillary to diffusion. The electrode is placed near the first end of the capillary in contact with the reference fluid. The method of operation of the present invention begins with filling the capillary tube with a reference solution. After closing the first end of the capillary, the capillary tube may be fully submerged or partially submerged with the second open end inserted into test fluid. Since the electrode is placed near the first end of the capillary, and since the test fluid may intermingle with the reference fluid through the second open end only by diffusion, this intermingling capillary reference half-cell provides a stable voltage potential for long time periods. 11 figs.

  2. A Sediment Testing Reference Area Database for the San Francisco Deep Ocean Disposal Site (SF-DODS)

    EPA Pesticide Factsheets

    EPA established and maintains a SF-DODS reference area database of previously-collected sediment test data. Several sets of sediment test data have been successfully collected from the SF-DODS reference area.

  3. Measurement accuracy of weighing and tipping-bucket rainfall intensity gauges under dynamic laboratory testing

    NASA Astrophysics Data System (ADS)

    Colli, M.; Lanza, L. G.; La Barbera, P.; Chan, P. W.

    2014-07-01

    The contribution of any single uncertainty factor in the resulting performance of infield rain gauge measurements still has to be comprehensively assessed due to the high number of real world error sources involved, such as the intrinsic variability of rainfall intensity (RI), wind effects, wetting losses, the ambient temperature, etc. In recent years the World Meteorological Organization (WMO) addressed these issues by fostering dedicated investigations, which revealed further difficulties in assessing the actual reference rainfall intensity in the field. This work reports on an extensive assessment of the OTT Pluvio2 weighing gauge accuracy when measuring rainfall intensity under laboratory dynamic conditions (time varying reference flow rates). The results obtained from the weighing rain gauge (WG) were also compared with a MTX tipping-bucket rain gauge (TBR) under the same test conditions. Tests were carried out by simulating various artificial precipitation events, with unsteady rainfall intensity, using a suitable dynamic rainfall generator. Real world rainfall data measured by an Ogawa catching-type drop counter at a field test site located within the Hong Kong International Airport (HKIA) were used as a reference for the artificial rain generation system. Results demonstrate that the differences observed between the laboratory and field performance of catching-type gauges are only partially attributable to the weather and operational conditions in the field. The dynamics of real world precipitation events is responsible for a large part of the measurement errors, which can be accurately assessed in the laboratory under controlled environmental conditions. This allows for new testing methodologies and the development of instruments with enhanced performance in the field.

  4. Impact of Gene Patents and Licensing Practices on Access to Genetic Testing for Long QT Syndrome

    PubMed Central

    Angrist, Misha; Chandrasekharan, Subhashini; Heaney, Christopher; Cook-Deegan, Robert

    2010-01-01

    Genetic testing for Long QT syndrome (LQTS) exemplifies patenting and exclusive licensing with different outcomes at different times. Exclusive licensing from the University of Utah changed the business model from sole provider to two US providers of LQTS testing. LQTS is associated with mutations in many genes, ten of which are now tested by two competing firms in the United States, PGxHealth and GeneDx. Until 2009, PGxHealth was sole provider, based largely on exclusive rights to patents from the University of Utah and other academic institutions. University of Utah patents were initially licensed to DNA Sciences, whose patent rights were acquired by Gennaissance, and then by Clinical Data, Inc., which owns PGxHealth. In 2002, DNA Sciences “cleared the market” by sending cease and desist patent enforcement letters to university and reference laboratories offering LQTS genetic testing. There was no test on the market for a one- to two-year period. From 2005-2008, most LQTS-related patents were controlled by Clinical Data, Inc., and its subsidiary PGxHealth. BioReference Laboratories, Inc., secured countervailing exclusive patent rights starting in 2006, also from the University of Utah, and broke the PGxHealth monopoly in early 2009, creating a duopoly for genetic testing in the United States, and expanding the number of genes for which commercial testing is available from five to ten. PMID:20393304

  5. Seroprevalence of HCV and HIV Infections by Year of Birth in Spain: Impact of US CDC and USPSTF Recommendations for HCV and HIV Testing

    PubMed Central

    Meijide, Héctor; Cañizares, Angelina; Castro-Iglesias, Ángeles; Delgado, Manuel; Pértega, Sonia; Pedreira, José; Bou, Germán; Poveda, Eva

    2014-01-01

    Background The US Centers for Disease Control and Prevention (CDC) recently add the advice of one-time testing of HCV infection in persons born during 1945–1965. Moreover, the US Preventive Services Task Force (USPSTF) newly recommended one-time HIV testing for persons aged 15–65. Herein, we evaluate the potential impact of these recommendations in a reference medical area of Spain. Methods All assays results entries for HCV and HIV serological markers ordered at a reference lab from primary care and specialized physicians between 2008 and 2012 were recorded in a medical area which covers 501,526 citizens in Northern Spain. The year of birth were also documented. Results A total of 108,159 anti-HCV-Ab results were generated during the study period. The global rate of anti-HCV-Ab+ was 7.7% (95% CI: 7.6%–7.9%), being more prevalent in men than women (8.6% vs. 4.5%). By year of birth, the highest prevalence was found in persons born between 1955 and 1970. HCV genotype 1 was the most prevalent (59.7%) followed by genotype 3 (22.7%). Regard HIV infection, among 65,279 anti-HIV results generated the prevalence of anti-HIV+ was 1.1% (95% CI: 1.0%–1.2%), being more frequent in men (2% vs 0.5%). The years of birth with highest rates of HIV infection exactly match with those for HCV infection. Conclusions The highest rates of HCV and HIV infections are found between 1960 and 1965. Different historical and social circumstances such as the huge intravenous drug use epidemic in the eighties in Spain, might explain it. Therefore, each country needs to determine its own HCV and HIV seroprevalences by year of birth to establish the proper recommendations for the screening of both infections. PMID:25436642

  6. [Waist circumference reference values in Beijing versus the national values in detecting cardiovascular risk factors in 7-18 years old children].

    PubMed

    Meng, Ling-hui; Luo, Na; Cheng, Hong; Hou, Dong-qing; Zhao, Xiao-yuan; Mi, Jie

    2011-08-01

    To compare the optimal references of waist circumference (WC) between Beijing and China in detecting cardiovascular risk factors in school-age children. Percentile curves for WC were drawn by sex using LMS method based on 21 787 children and adolescents aged 7 - 18 from Beijing Child and Adolescent Metabolic Syndrome Study. The 75(th) and the 90(th) percentiles by age and by gender of WC percentile curves were chosen as the optimal WC reference for 3 - 18 years old children and adolescents in Beijing. The sensitivities (Se) and specificities (Sp) were compared between Beijing and China WC references based on the evaluation of cardiovascular risk factors including hypertension, dyslipidemia, impaired fasting glucose and non-alcoholic fatty liver disease (NAFLD) in the test population being composed of 4927 school children aged 7 - 18 years. The predictive values for those cardiovascular risk factors were compared between the two optimal thresholds through comparison of the odds ratio (OR) in regression analysis. The optimal reference for Beijing children and adolescents aged 3 - 18 years ranged from 51.8 to 78.2 cm for the 75(th) percentile in boys and 50.8 to 72.1 cm in girls, and the 90(th) percentile increased from 54.0 to 86.0 cm in boys and 53.3 to 77.3 cm in girls. The Ses of Beijing and China WC references in detecting hypertension were 0.74 and 0.82 in boys and 0.68 and 0.73 in girls; the Ses were 0.69 and 0.80 in detecting low-high density lipoprotein in boys and 0.64 and 0.71 in girls; and they were 0.98 and 1.00 in boys and both were 0.93 in girls for NAFLD. The Sps of Beijing and China WC references in screening hypertension were 0.62 and 0.53 in boys and 0.68 and 0.63 in girls, respectively. In predicting low-high density lipoprotein, the Sps were 0.59 and 0.50 in boys and 0.66 and 0.61 in girls, the Sps were 0.60 and 0.50 in boys and 0.56 and 0.51 in girls for predicting NAFLD. After adjustment for age and gender, ORs and their 95% credibility intervals (CI) of the 90(th) WC percentiles of Beijing and China school children were 6.3 (5.2 - 7.7) and 6.0 (4.9 - 7.4) in predicting hypertension. Both predictive ORs and their 95%CIs were 1.3 (1.1 - 1.5) in predicting impaired fasting glucose and the both were 2.9 (2.5 - 3.4) for dyslipidemia. In predicting NAFLD the ORs and their 95%CIs were 49.1 (12.0 - 201.6) and 69.8 (9.7 - 504.2) for Beijing and China WC optimal references, separately. Compared with Chinese WC reference, WC reference of Beijing had high Sps in screening cardiovascular risk factors in 7 - 18 years old children. The predictive values were not significant different between Beijing and China WC references for almost all cardiovascular risk factors except NAFLD. The WC reference in Beijing was more practical and handy for reference in Beijing and other north developed metropolises.

  7. 21 CFR 660.25 - Potency tests without reference preparations.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... manufacturer's package insert using red blood cells showing heterozygous or diminished expression of the... SERVICES (CONTINUED) BIOLOGICS ADDITIONAL STANDARDS FOR DIAGNOSTIC SUBSTANCES FOR LABORATORY TESTS Blood Grouping Reagent § 660.25 Potency tests without reference preparations. Products for which Reference Blood...

  8. 21 CFR 660.25 - Potency tests without reference preparations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... manufacturer's package insert using red blood cells showing heterozygous or diminished expression of the... SERVICES (CONTINUED) BIOLOGICS ADDITIONAL STANDARDS FOR DIAGNOSTIC SUBSTANCES FOR LABORATORY TESTS Blood Grouping Reagent § 660.25 Potency tests without reference preparations. Products for which Reference Blood...

  9. 21 CFR 660.25 - Potency tests without reference preparations.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... manufacturer's package insert using red blood cells showing heterozygous or diminished expression of the... SERVICES (CONTINUED) BIOLOGICS ADDITIONAL STANDARDS FOR DIAGNOSTIC SUBSTANCES FOR LABORATORY TESTS Blood Grouping Reagent § 660.25 Potency tests without reference preparations. Products for which Reference Blood...

  10. 21 CFR 660.25 - Potency tests without reference preparations.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... manufacturer's package insert using red blood cells showing heterozygous or diminished expression of the... SERVICES (CONTINUED) BIOLOGICS ADDITIONAL STANDARDS FOR DIAGNOSTIC SUBSTANCES FOR LABORATORY TESTS Blood Grouping Reagent § 660.25 Potency tests without reference preparations. Products for which Reference Blood...

  11. 21 CFR 660.25 - Potency tests without reference preparations.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... manufacturer's package insert using red blood cells showing heterozygous or diminished expression of the... SERVICES (CONTINUED) BIOLOGICS ADDITIONAL STANDARDS FOR DIAGNOSTIC SUBSTANCES FOR LABORATORY TESTS Blood Grouping Reagent § 660.25 Potency tests without reference preparations. Products for which Reference Blood...

  12. The Steep Ramp Test in Dutch white children and adolescents: age- and sex-related normative values.

    PubMed

    Bongers, Bart C; de Vries, Sanne I; Obeid, Joyce; van Buuren, Stef; Helders, Paul J M; Takken, Tim

    2013-11-01

    The Steep Ramp Test (SRT), a feasible, reliable, and valid exercise test on a cycle ergometer, may be more appealing for use in children in daily clinical practice than the traditional cardiopulmonary exercise test because of its short duration, its resemblance to children's daily activity patterns, and the fact that it does not require respiratory gas analysis. The aim of the present study was to provide sex- and age-related normative values for SRT performance in Dutch white children and adolescents who were healthy and 8 to 19 years old. This was a cross-sectional, observational study. A total of 252 Dutch white children and adolescents, 118 boys (mean age=13.4 years, SD=3.0) and 134 girls (mean age=13.4 years, SD=2.9), performed the SRT (work rate increment of 10, 15, or 20 W·10 s(-1), depending on body height) to voluntary exhaustion to assess peak work rate (WRpeak). Normative values are presented as reference centiles developed by use of generalized additive models for location, scale, and shape. Peak work rate correlated highly with age (r=.915 and r=.811), body mass (r=.870 and r=.850), body height (r=.922 and r=.896), body surface area (r=.906 and r=.885), and fat free mass (r=.930 and r=.902) in boys and girls, respectively. The reference curves demonstrated an almost linear increase in WRpeak with age in boys, even when WRpeak was normalized for body mass. In contrast, absolute WRpeak in girls increased constantly until the age of approximately 13 years, when it started to level off. Peak work rate normalized for body mass in girls showed only a slight increase with age until 14 years of age, when a slight decrease in relative WRpeak was observed. The sample may not have been entirely representative of the Dutch population. The present study provides sex- and age-related normative values for SRT performance in terms of both absolute WRpeak and relative WRpeak, thereby facilitating the interpretation of SRT results by clinicians and researchers.

  13. Ares I-X Test Flight Reference Trajectory Development

    NASA Technical Reports Server (NTRS)

    Starr, Brett R.; Gumbert, Clyde R.; Tartabini, Paul V.

    2011-01-01

    Ares I-X was the first test flight of NASA's Constellation Program's Ares I crew launch vehicle. Ares I is a two stage to orbit launch vehicle that provides crew access to low Earth orbit for NASA's future manned exploration missions. The Ares I first stage consists of a Shuttle solid rocket motor (SRM) modified to include an additional propellant segment and a liquid propellant upper stage with an Apollo J2X engine modified to increase its thrust capability. The modified propulsion systems were not available for the first test flight, thus the test had to be conducted with an existing Shuttle 4 segment reusable solid rocket motor (RSRM) and an inert Upper Stage. The test flight's primary objective was to demonstrate controllability of an Ares I vehicle during first stage boost and the ability to perform a successful separation. In order to demonstrate controllability, the Ares I-X ascent control algorithms had to maintain stable flight throughout a flight environment equivalent to Ares I. The goal of the test flight reference trajectory development was to design a boost trajectory using the existing RSRM that results in a flight environment equivalent to Ares I. A trajectory similarity metric was defined as the integrated difference between the Ares I and Ares I-X Mach versus dynamic pressure relationships. Optimization analyses were performed that minimized the metric by adjusting the inert upper stage weight and the ascent steering profile. The sensitivity of the optimal upper stage weight and steering profile to launch month was also investigated. A response surface approach was used to verify the optimization results. The analyses successfully defined monthly ascent trajectories that matched the Ares I reference trajectory dynamic pressure versus Mach number relationship to within 10% through Mach 3.5. The upper stage weight required to achieve the match was found to be feasible and varied less than 5% throughout the year. The paper will discuss the flight test requirements, provide Ares I-X vehicle background, discuss the optimization analyses used to meet the requirements, present analysis results, and compare the reference trajectory to the reconstructed flight trajectory.

  14. Strength performance in youth: trainability of adolescents and children in the back and front squats.

    PubMed

    Keiner, Michael; Sander, Andre; Wirth, Klaus; Caruso, Oliver; Immesberger, Peter; Zawieja, Martin

    2013-02-01

    A basic question for many athletic coaches pertains to the maximum attainable strength level for youth athletes. The aim of this investigation was to establish reference values for the strength performance in the front and back squats in youth athletes. The strength performance in front and back squats of 141 elite youth soccer players was tested by a 1 repetition maximum (1RM) and 1RM related to bodyweight (SREL). The subjects aged between 11 and 19 years and were divided into 2 groups and 4 subgroups (A = younger than 19 years, B = younger than 17 years, C = younger than 15 years, and D = younger than 13 years). For approximately 2 years, one group (control group [CG]) only participated in routine soccer training and the other group (strength training group [STG]) participated in an additional strength training program along with the routine soccer training. Additionally, the strength performance in a 5RM in both squat variants of 105 young elite weightlifters (National Weightlifting Organization Baden Württemberg, [BWG]) was examined to show the high level of trainability of children and adolescents and to determine the reference strength values for young athletes. The STG performed in the parallel front squat SREL in the subgroups A 1.7 +/- 0.2, B 1.6 +/- 0.2, C 1.4 +/-0.2 and D 0.9 +/- 0.3. The STG had significantly (p < 0.001) higher strength values in 1RM and SREL than CG. The BWG had higher strength values than STG, but the BWG was not part of the statistical analysis because of the different test protocols (1RM vs. 5RM). Our data show that the SREL in parallel squat for young elite athletes with long-term training experience should be a minimum of 2.0 for 16- to 19-year-olds, 1.5 for 13- to 15-year-olds, and 0.7 for 11- to 12-year-olds.

  15. First Nine Cases of Candida auris Infection Reported in Central America: Importance of Acurate Diagnosis and Susceptibility Testing

    PubMed Central

    Rodriguez, Ana Belen Arauz; Caceres, Diego H; Santiago, Erika; Armstrong, Paige; French, Amalia Rodriguez; Arosemena, Susan; Ramos, Carolina; Espinosa-Bode, Andres; Borace, Jovanna; Hayer, Lizbeth; Cedeño, Israel; Sosa, Nestor; Berkow, Elizabeth L; Lockhart, Shawn R; Jackson, Brendan R; Chiller, Tom

    2017-01-01

    Abstract Background Candida auris is an emerging multidrug-resistant pathogen associated with invasive infections and high mortality. This report describes the first 9 cases of C. auris in Central America in a hospital in Panama City, Panama, and highlights the challenges of accurate identification and methods for susceptibility testing. Methods Isolates initially identified at a Panama City acute care hospital during July–October 2016 as Candida haemulonii (a common misidentification for C. auris) or Candida species by Vitek® 2 automated system (bioMérieux) were further characterized by molecular methods. Antifungal susceptibility testing was performed and results were compared between standard and reference methodologies. Patient demographic, clinical, and laboratory data were collected from the medical record. Results A total of 14 isolates from 9 hospitalized patients were confirmed as C. auris. Isolates were from urine (11), blood (1), catheter tip (1) and pleural fluid (1). Results of susceptibility testing were highly discrepant between automated and reference techniques for fluconazole (92% resistant vs. 77%, respectively) and amphotericin B (100% vs. 8%). Six (67%) patients were male, and the mean age was 53 years (range 42–78). All patients were admitted to the intensive care unit and were mechanically ventilated. Seven (78%) patients died. Conclusion C. auris is present in Central America. Healthcare facilities in the region should be vigilant for this concerning pathogen, particularly given challenges in its identification and need for infection control precautions. Although automated testing overestimated amphotericin B resistance, most initial isolates were susceptible by reference testing. Disclosures All authors: No reported disclosures.

  16. Behavioral and cognitive outcomes for clinical trials in children with neurofibromatosis type 1.

    PubMed

    van der Vaart, Thijs; Rietman, André B; Plasschaert, Ellen; Legius, Eric; Elgersma, Ype; Moll, Henriëtte A

    2016-01-12

    To evaluate the appropriateness of cognitive and behavioral outcome measures in clinical trials in neurofibromatosis type 1 (NF1) by analyzing the degree of deficits compared to reference groups, test-retest reliability, and how scores correlate between outcome measures. Data were analyzed from the Simvastatin for cognitive deficits and behavioral problems in patients with neurofibromatosis type 1 (NF1-SIMCODA) trial, a randomized placebo-controlled trial of simvastatin for cognitive deficits and behavioral problems in children with NF1. Outcome measures were compared with age-specific reference groups to identify domains of dysfunction. Pearson r was computed for before and after measurements within the placebo group to assess test-retest reliability. Principal component analysis was used to identify the internal structure in the outcome data. Strongest mean score deviations from the reference groups were observed for full-scale intelligence (-1.1 SD), Rey Complex Figure Test delayed recall (-2.0 SD), attention problems (-1.2 SD), and social problems (-1.1 SD). Long-term test-retest reliability were excellent for Wechsler scales (r > 0.88), but poor to moderate for other neuropsychological tests (r range 0.52-0.81) and Child Behavioral Checklist subscales (r range 0.40-0.79). The correlation structure revealed 2 strong components in the outcome measures behavior and cognition, with no correlation between these components. Scores on psychosocial quality of life correlate strongly with behavioral problems and less with cognitive deficits. Children with NF1 show distinct deficits in multiple domains. Many outcome measures showed weak test-retest correlations over the 1-year trial period. Cognitive and behavioral outcomes are complementary. This analysis demonstrates the need to include reliable outcome measures on a variety of cognitive and behavioral domains in clinical trials for NF1. © 2015 American Academy of Neurology.

  17. Exotic-Dominated Grasslands Show Signs of Recovery with Cattle Grazing and Fire.

    PubMed

    Delaney, John T; Moranz, Raymond A; Debinski, Diane M; Engle, David M; Miller, James R

    2016-01-01

    In grasslands, overgrazing by domestic livestock, fertilization, and introduction of exotic forage species leads to plant communities consisting of a mixture of native and exotic species. These degraded grasslands present a problem for land managers, farmers, and restoration ecologists concerned with improving biodiversity while continuing to use the land for livestock production. Here we assessed the response of butterfly and plant community composition to the use of fire and moderate grazing by domestic cattle on degraded grasslands dominated by exotic plants. We evaluated change by comparing experimental pastures to two reference sites that were grasslands dominated by native plants. We used two burning and grazing treatments: 1) patch-burn graze, a heterogeneously managed treatment, where one third of the pasture is burned each year and cattle have free access to the entire pasture, and 2) graze-and-burn, a homogenously managed treatment, where the entire pasture is grazed each year and burned in its entirety every three years. We tested for change in the butterfly and plant community composition over seven years using Bray-Curtis dissimilarity measures. Over the course of seven years, degraded pastures in both treatments became more similar to reference sites with respect to the butterfly and plant communities. Only two butterfly species and two plant functional guilds exhibited significant linear trends over time, with varying responses. Compositional changes in both the butterfly and plant communities indicate that the use of moderate grazing and fire may shift butterfly and plant communities of exotic-dominated grasslands to be more similar to reference tallgrass prairies over time.

  18. Direct Reading Particle Counters: Calibration Verification and Multiple Instrument Agreement via Bump Testing

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

    Jankovic, John; Zontek, Tracy L.; Ogle, Burton R.

    We examined the calibration records of two direct reading instruments designated as condensation particle counters in order to determine the number of times they were found to be out of tolerance at annual manufacturer's recalibration. For both instruments were found to be out of tolerance more times than within tolerance. And, it was concluded that annual calibration alone was insufficient to provide operational confidence in an instrument's response. Thus, a method based on subsequent agreement with data gathered from a newly calibrated instrument was developed to confirm operational readiness between annual calibrations, hereafter referred to as bump testing. The methodmore » consists of measuring source particles produced by a gas grille spark igniter in a gallon-size jar. Sampling from this chamber with a newly calibrated instrument to determine the calibrated response over the particle concentration range of interest serves as a reference. Agreement between this reference response and subsequent responses at later dates implies that the instrument is performing as it was at the time of calibration. Side-by-side sampling allows the level of agreement between two or more instruments to be determined. This is useful when simultaneously collected data are compared for differences, i.e., background with process aerosol concentrations. A reference set of data was obtained using the spark igniter. The generation system was found to be reproducible and suitable to form the basis of calibration verification. Finally, the bump test is simple enough to be performed periodically throughout the calibration year or prior to field monitoring.« less

  19. Direct Reading Particle Counters: Calibration Verification and Multiple Instrument Agreement via Bump Testing

    DOE PAGES

    Jankovic, John; Zontek, Tracy L.; Ogle, Burton R.; ...

    2015-01-27

    We examined the calibration records of two direct reading instruments designated as condensation particle counters in order to determine the number of times they were found to be out of tolerance at annual manufacturer's recalibration. For both instruments were found to be out of tolerance more times than within tolerance. And, it was concluded that annual calibration alone was insufficient to provide operational confidence in an instrument's response. Thus, a method based on subsequent agreement with data gathered from a newly calibrated instrument was developed to confirm operational readiness between annual calibrations, hereafter referred to as bump testing. The methodmore » consists of measuring source particles produced by a gas grille spark igniter in a gallon-size jar. Sampling from this chamber with a newly calibrated instrument to determine the calibrated response over the particle concentration range of interest serves as a reference. Agreement between this reference response and subsequent responses at later dates implies that the instrument is performing as it was at the time of calibration. Side-by-side sampling allows the level of agreement between two or more instruments to be determined. This is useful when simultaneously collected data are compared for differences, i.e., background with process aerosol concentrations. A reference set of data was obtained using the spark igniter. The generation system was found to be reproducible and suitable to form the basis of calibration verification. Finally, the bump test is simple enough to be performed periodically throughout the calibration year or prior to field monitoring.« less

  20. Comparison of Scores on Two Visual-Motor Tests for Children Referred for Learning or Adjustment Difficulties.

    ERIC Educational Resources Information Center

    DeMers, Stephen T.; And Others

    1981-01-01

    This study compared the performance of school-aged children referred for learning or adjustment difficulties on Beery's Developmental Test of Visual-Motor Integration and Koppitz's version of the Bender-Gestalt test. Results indicated that the tests are related but not equivalent when administered to referred populations. (Author/AL)

  1. 10 CFR 32.102 - Schedule C-prototype tests for calibration or reference sources containing americium-241 or...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Schedule C-prototype tests for calibration or reference... Licensed Items § 32.102 Schedule C—prototype tests for calibration or reference sources containing..., conduct prototype tests, in the order listed, on each of five prototypes of the source, which contains...

  2. Hypokalaemia and dysmorphia, is there a link?

    PubMed Central

    Burtey, Stéphane; Sternberg, Damien; Nguyen, Karine; Philip, Nicole; Berland, Yvon; Dussol, Bertrand

    2009-01-01

    A 15-year-old boy with quadriplegia and facial dysmorphia was referred to the emergency room. This was his first episode of tetraplegia. One maternal uncle had exhibited the same manifestation 20 years before. Blood test revealed severe hypokalaemia and mild hypocalcaemia. The clinical diagnosis revealed an Andersen–Tawil syndrome. Molecular tools allowed us to make the diagnosis of familial hypokalaemic periodic paralysis type 1 associated with a de novo 22q11.2 microdeletion syndrome. Our case report emphasizes the importance of molecular diagnosis in genetic diseases. PMID:25983995

  3. Validation of test-day models for genetic evaluation of dairy goats in Norway.

    PubMed

    Andonov, S; Ødegård, J; Boman, I A; Svendsen, M; Holme, I J; Adnøy, T; Vukovic, V; Klemetsdal, G

    2007-10-01

    Test-day data for daily milk yield and fat, protein, and lactose content were sampled from the years 1988 to 2003 in 17 flocks belonging to 2 genetically well-tied buck circles. In total, records from 2,111 to 2,215 goats for content traits and 2,371 goats for daily milk yield were included in the analysis, averaging 2.6 and 4.8 observations per goat for the 2 groups of traits, respectively. The data were analyzed by using 4 test-day models with different modeling of fixed effects. Model [0] (the reference model) contained a fixed effect of year-season of kidding with regression on Ali-Schaeffer polynomials nested within the year-season classes, and a random effect of flock test-day. In model [1], the lactation curve effect from model [0] was replaced by a fixed effect of days in milk (in 3-d periods), the same for all year-seasons of kidding. Models [2] and [3] were obtained from model [1] by removing the fixed year-season of kidding effect and considering the flock test-day effect as either fixed or random, respectively. The models were compared by using 2 criteria: mean-squared error of prediction and a test of bias affecting the genetic trend. The first criterion indicated a preference for model [3], whereas the second criterion preferred model [1]. Mean-squared error of prediction is based on model fit, whereas the second criterion tests the ability of the model to produce unbiased genetic evaluation (i.e., its capability of separating environmental and genetic time trends). Thus, a fixed structure with year (year, year-season, or possibly flock-year) was indicated to appropriately separate time trends. Heritability estimates for daily milk yield and milk content were 0.26 and 0.24 to 0.27, respectively.

  4. 40 CFR 792.107 - Test, control, and reference substance handling.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Test, control, and reference substance handling. 792.107 Section 792.107 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS Test, Control, and Reference...

  5. An Overview of the Smart Sensor Inter-Agency Reference Testbench (SSIART)

    NASA Technical Reports Server (NTRS)

    Wagner, Raymond S.; Braham, Stephen P.; Dufour, Jean-Francois; Barton, Richard J.

    2012-01-01

    In this paper, we present an overview of a proposed collaboration between the National Aeronautics and Space Administration (NASA) and the European Space Agency (ESA), which is designed to facilitate the introduction of commercial-off-the-shelf (COTS) radios for smart-sensing applications into international spaceflight programs and projects. The proposed work will produce test hardware reference designs, test software reference architectures and example implementations, test plans in reference test environments, and test results, all of which will be shared between the agencies and documented for future use by mission planners. The proposed collaborative structure together with all of the anticipated tools and results produced under the effort is collectively referred to as the Smart Sensor Inter-agency Reference Testbench or SSIART. It is intended to provide guidance in technology selection and in increasing the related readiness levels of projects and missions as well as the space industry.

  6. Evaluation of the methodological quality of studies of the performance of diagnostic tests for bovine tuberculosis using QUADAS.

    PubMed

    Downs, Sara H; More, Simon J; Goodchild, Anthony V; Whelan, Adam O; Abernethy, Darrell A; Broughan, Jennifer M; Cameron, Angus; Cook, Alasdair J; Ricardo de la Rua-Domenech, R; Greiner, Matthias; Gunn, Jane; Nuñez-Garcia, Javier; Rhodes, Shelley; Rolfe, Simon; Sharp, Michael; Upton, Paul; Watson, Eamon; Welsh, Michael; Woolliams, John A; Clifton-Hadley, Richard S; Parry, Jessica E

    2018-05-01

    There has been little assessment of the methodological quality of studies measuring the performance (sensitivity and/or specificity) of diagnostic tests for animal diseases. In a systematic review, 190 studies of tests for bovine tuberculosis (bTB) in cattle (published 1934-2009) were assessed by at least one of 18 reviewers using the QUADAS (Quality Assessment of Diagnostic Accuracy Studies) checklist adapted for animal disease tests. VETQUADAS (VQ) included items measuring clarity in reporting (n = 3), internal validity (n = 9) and external validity (n = 2). A similar pattern for compliance was observed in studies of different diagnostic test types. Compliance significantly improved with year of publication for all items measuring clarity in reporting and external validity but only improved in four of the nine items measuring internal validity (p < 0.05). 107 references, of which 83 had performance data eligible for inclusion in a meta-analysis were reviewed by two reviewers. In these references, agreement between reviewers' responses was 71% for compliance, 32% for unsure and 29% for non-compliance. Mean compliance with reporting items was 2, 5.2 for internal validity and 1.5 for external validity. The index test result was described in sufficient detail in 80.1% of studies and was interpreted without knowledge of the reference standard test result in only 33.1%. Loss to follow-up was adequately explained in only 31.1% of studies. The prevalence of deficiencies observed may be due to inadequate reporting but may also reflect lack of attention to methodological issues that could bias the results of diagnostic test performance estimates. QUADAS was a useful tool for assessing and comparing the quality of studies measuring the performance of diagnostic tests but might be improved further by including explicit assessment of population sampling strategy. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

  7. Relationship Among Body Fat Percentage, Body Mass Index, and All-Cause Mortality: A Cohort Study.

    PubMed

    Padwal, Raj; Leslie, William D; Lix, Lisa M; Majumdar, Sumit R

    2016-04-19

    Prior mortality studies have concluded that elevated body mass index (BMI) may improve survival. These studies were limited because they did not measure adiposity directly. To examine associations of BMI and body fat percentage (separately and together) with mortality. Observational study. Manitoba, Canada. Adults aged 40 years or older referred for bone mineral density (BMD) testing. Participants had dual-energy x-ray absorptiometry (DXA), entered a clinical BMD registry, and were followed using linked administrative databases. Adjusted, sex-stratified Cox models were constructed. Body mass index and DXA-derived body fat percentage were divided into quintiles, with quintile 1 as the lowest, quintile 5 as the highest, and quintile 3 as the reference. The final cohort included 49 476 women (mean age, 63.5 years; mean BMI, 27.0 kg/m2; mean body fat, 32.1%) and 4944 men (mean age, 65.5 years; mean BMI, 27.4 kg/m2; mean body fat, 29.5%). Death occurred in 4965 women over a median of 6.7 years and 984 men over a median of 4.5 years. In fully adjusted mortality models containing both BMI and body fat percentage, low BMI (hazard ratio [HR], 1.44 [95% CI, 1.30 to 1.59] for quintile 1 and 1.12 [CI, 1.02 to 1.23] for quintile 2) and high body fat percentage (HR, 1.19 [CI, 1.08 to 1.32] for quintile 5) were associated with higher mortality in women. In men, low BMI (HR, 1.45 [CI, 1.17 to 1.79] for quintile 1) and high body fat percentage (HR, 1.59 [CI, 1.28 to 1.96] for quintile 5) were associated with increased mortality. All participants were referred for BMD testing, which may limit generalizability. Serial measures of BMD and weight were not used. Some measures, such as physical activity and smoking, were unavailable. Low BMI and high body fat percentage are independently associated with increased mortality. These findings may help explain the counterintuitive relationship between BMI and mortality. None.

  8. Measurement of susceptibility artifacts with histogram-based reference value on magnetic resonance images according to standard ASTM F2119.

    PubMed

    Heinrich, Andreas; Teichgräber, Ulf K; Güttler, Felix V

    2015-12-01

    The standard ASTM F2119 describes a test method for measuring the size of a susceptibility artifact based on the example of a passive implant. A pixel in an image is considered to be a part of an image artifact if the intensity is changed by at least 30% in the presence of a test object, compared to a reference image in which the test object is absent (reference value). The aim of this paper is to simplify and accelerate the test method using a histogram-based reference value. Four test objects were scanned parallel and perpendicular to the main magnetic field, and the largest susceptibility artifacts were measured using two methods of reference value determination (reference image-based and histogram-based reference value). The results between both methods were compared using the Mann-Whitney U-test. The difference between both reference values was 42.35 ± 23.66. The difference of artifact size was 0.64 ± 0.69 mm. The artifact sizes of both methods did not show significant differences; the p-value of the Mann-Whitney U-test was between 0.710 and 0.521. A standard-conform method for a rapid, objective, and reproducible evaluation of susceptibility artifacts could be implemented. The result of the histogram-based method does not significantly differ from the ASTM-conform method.

  9. The Bears Family Projective Test: evaluating stories of children with emotional difficulties.

    PubMed

    Iandolo, Giuseppe; Esposito, Gianluca; Venuti, Paola

    2012-06-01

    The aim of this study was to describe and analyze the storytelling of children with emotional difficulties. Forty children with emotional and relational difficulties (inhibited and impulsive), ages between 5.5 and 9.4 years old, were assessed by a multiaxial procedure and the bears family projective test. The bears family test is a constructive-thematic-projective method based on an anthropomorphic family of bears that children can manipulate to tell a story. The stories of 40 children without emotional difficulties (matched by IQ, socio-economic status, and gender) and 322 typically developing children, aged between four and 10 years old, were used as a reference for comparisons. Results indicated that the stories of children with emotional difficulties showed many unsolved problematic events, unclear characters, negative relationships, and negative behaviors. Unlike the stories of children without emotional difficulties, positive contents didn't prevail over negative, and there wasn't a positive compensation for negative elements.

  10. Clinical evidence vs preliminary speculation in newspaper coverage of diabetes innovations: a quantitative analysis.

    PubMed

    Vehof, H; Sanders, J; van Dooren, A; Heerdink, E; Das, E

    2018-05-04

    Researchers have discussed that journalistic reporting of medical developments is often characterised by exaggeration or lack of context, but additional quantitative evidence to support this claim is needed. This study introduces a quantitative approach to assessing coverage of medical innovations, by aiming at provided references to observed clinical effects. Although observed clinical effects reflect increased chances for future medical applications, it is unknown to which extent newspaper articles refer to it when spreading health information. We aimed to assess, over a 6-year period, newspaper publication characteristics of diabetes innovations, arising from all scientific areas of interest, regarding the total count and the proportion of articles that provide references to demonstrated clinical efficacy. Quantitative content analysis of newspaper articles covering innovative treatments for diabetes. We performed a systematic review of newspaper articles between 2011 and 2016 printed in the largest six Dutch newspapers. By assessing in-article references, it was possible to quickly distinguish between (1) articles that referred to actual clinical efficacy demonstrated in a scientific setting and (2) articles that presented either predictions, fundamental research, preclinical research or personal experiences and recommendations. Proportion differences between scientific areas of interest were analysed using the chi-squared test. A total of 613 articles were categorised. Total newspaper publication frequency increased with 9.9 articles per year (P = .031). In total, 17% of the articles contained a reference to any proven clinical efficacy. Articles about human nutrition science (7%; P = .001) and (neuro)psychology (4.3%; P = .014) less frequently provided a reference to actual clinical efficacy. Our findings show that less than one in five newspaper articles about diabetes research contains a reference to relevant clinical effects, while the publication count is increasing. These statistics may contribute to feelings of false hope and confusion in patients. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  11. A Phobos-Deimos Mission as an Element of the NASA Mars Design Reference Architecture 5.0

    NASA Technical Reports Server (NTRS)

    Hoffman, Stephen J.

    2011-01-01

    NASA has conducted a series of mission studies over the past 25 years examining the eventual exploration of the surface of Mars by humans. The latest version of this evolutionary series of design reference missions/architectures - Design Reference Architecture 5 or DRA-5 - was completed in 2007. This paper examines the implications of including a human mission to explore the moons of Mars and teleoperate robots in various locations, but not to land the human crews on Mars, as an element of this reference architecture. Such a mission has been proposed several times during this same 25 year evolution leading up to the completion of DRA-5 primarily as a mission of testing the in-space vehicles and operations while surface vehicles and landers are under development. But such a precursor or test mission has never been explicitly included as an element of this Architecture. This paper will first summarize the key features of the DRA-5 to provide context for the remainder of the assessment. This will include a description of the in-space vehicles that would be the subject of a shakedown test during the Mars orbital mission. A decision tree will be used to illustrate the factors that will be analyzed, and the sequence in which they will be addressed, for this assessment. The factors that will be analyzed include the type of interplanetary transfer orbit (opposition class versus conjunction class), the type of parking orbit (circular versus elliptical), and the type of propulsion technology (high thrust chemical versus nuclear thermal rocket). The manner in which each of these factors impacts an individual mission will be described. In addition to the direct impact of these factors, additional considerations impacting crew health and overall programmatic outcomes will be discussed. Numerical results for each of the factors in the decision tree will be grouped with derived qualitative impacts from crew health and programmatic consideration. These quantitative and qualitative results will be summarized in a pros/cons table as a summary for this analysis.

  12. Some possible reference materials for fire toxicity tests

    NASA Technical Reports Server (NTRS)

    Hilado, C. J.; Solis, A. N.

    1977-01-01

    Suitable reference materials need to be selected in order to standardize any test method. The evaluation of cotton, polyethylene, polyether sulfone, polycarbonate, polystyrene, and polyurethane flexible and rigid foams as possible reference materials for the University of San Francisco/NASA toxicity screening test method is discussed.

  13. Idiographic duo-trio tests using a constant-reference based on preference of each consumer: Sample presentation sequence in difference test can be customized for individual consumers to reduce error.

    PubMed

    Kim, Min-A; Sim, Hye-Min; Lee, Hye-Seong

    2016-11-01

    As reformulations and processing changes are increasingly needed in the food industry to produce healthier, more sustainable, and cost effective products while maintaining superior quality, reliable measurements of consumers' sensory perception and discrimination are becoming more critical. Consumer discrimination methods using a preferred-reference duo-trio test design have been shown to be effective in improving the discrimination performance by customizing sample presentation sequences. However, this design can add complexity to the discrimination task for some consumers, resulting in more errors in sensory discrimination. The objective of the present study was to investigate the effects of different types of test instructions using the preference-reference duo-trio test design where a paired-preference test is followed by 6 repeated preferred-reference duo-trio tests, in comparison to the analytical method using the balanced-reference duo-trio. Analyses of d' estimates (product-related measure) and probabilistic sensory discriminators in momentary numbers of subjects showing statistical significance (subject-related measure) revealed that only preferred-reference duo-trio test using affective reference-framing, either by providing no information about the reference or information on a previously preferred sample, improved the sensory discrimination more than the analytical method. No decrease in discrimination performance was observed with any type of instruction, confirming that consumers could handle the test methods. These results suggest that when repeated tests are feasible, using the affective discrimination method would be operationally more efficient as well as ecologically more reliable for measuring consumers' sensory discrimination ability. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. An Internet Protocol-Based Software System for Real-Time, Closed-Loop, Multi-Spacecraft Mission Simulation Applications

    NASA Technical Reports Server (NTRS)

    Davis, George; Cary, Everett; Higinbotham, John; Burns, Richard; Hogie, Keith; Hallahan, Francis

    2003-01-01

    The paper will provide an overview of the web-based distributed simulation software system developed for end-to-end, multi-spacecraft mission design, analysis, and test at the NASA Goddard Space Flight Center (GSFC). This software system was developed for an internal research and development (IR&D) activity at GSFC called the Distributed Space Systems (DSS) Distributed Synthesis Environment (DSE). The long-term goal of the DSS-DSE is to integrate existing GSFC stand-alone test beds, models, and simulation systems to create a "hands on", end-to-end simulation environment for mission design, trade studies and simulations. The short-term goal of the DSE was therefore to develop the system architecture, and then to prototype the core software simulation capability based on a distributed computing approach, with demonstrations of some key capabilities by the end of Fiscal Year 2002 (FY02). To achieve the DSS-DSE IR&D objective, the team adopted a reference model and mission upon which FY02 capabilities were developed. The software was prototyped according to the reference model, and demonstrations were conducted for the reference mission to validate interfaces, concepts, etc. The reference model, illustrated in Fig. 1, included both space and ground elements, with functional capabilities such as spacecraft dynamics and control, science data collection, space-to-space and space-to-ground communications, mission operations, science operations, and data processing, archival and distribution addressed.

  15. A Distributed Simulation Software System for Multi-Spacecraft Missions

    NASA Technical Reports Server (NTRS)

    Burns, Richard; Davis, George; Cary, Everett

    2003-01-01

    The paper will provide an overview of the web-based distributed simulation software system developed for end-to-end, multi-spacecraft mission design, analysis, and test at the NASA Goddard Space Flight Center (GSFC). This software system was developed for an internal research and development (IR&D) activity at GSFC called the Distributed Space Systems (DSS) Distributed Synthesis Environment (DSE). The long-term goal of the DSS-DSE is to integrate existing GSFC stand-alone test beds, models, and simulation systems to create a "hands on", end-to-end simulation environment for mission design, trade studies and simulations. The short-term goal of the DSE was therefore to develop the system architecture, and then to prototype the core software simulation capability based on a distributed computing approach, with demonstrations of some key capabilities by the end of Fiscal Year 2002 (FY02). To achieve the DSS-DSE IR&D objective, the team adopted a reference model and mission upon which FY02 capabilities were developed. The software was prototyped according to the reference model, and demonstrations were conducted for the reference mission to validate interfaces, concepts, etc. The reference model, illustrated in Fig. 1, included both space and ground elements, with functional capabilities such as spacecraft dynamics and control, science data collection, space-to-space and space-to-ground communications, mission operations, science operations, and data processing, archival and distribution addressed.

  16. Reference standards to assess physical fitness of children and adolescents of Brazil: an approach to the students of the Lake Itaipú region-Brazil.

    PubMed

    Hobold, Edilson; Pires-Lopes, Vitor; Gómez-Campos, Rossana; de Arruda, Miguel; Andruske, Cynthia Lee; Pacheco-Carrillo, Jaime; Cossio-Bolaños, Marco Antonio

    2017-01-01

    The importance of assessing body fat variables and physical fitness tests plays an important role in monitoring the level of activity and physical fitness of the general population. The objective of this study was to develop reference norms to evaluate the physical fitness aptitudes of children and adolescents based on age and sex from the lake region of Itaipú, Brazil. A descriptive cross-sectional study was carried out with 5,962 students (2,938 males and 3,024 females) with an age range of 6.0 and 17.9 years. Weight (kg), height (cm), and triceps (mm), and sub-scapular skinfolds (mm) were measured. Body Mass Index (BMI kg/m 2 ) was calculated. To evaluate the four physical fitness aptitude dimensions (morphological, muscular strength, flexibility, and cardio-respiratory), the following physical education tests were given to the students: sit-and-reach (cm), push-ups (rep), standing long jump (cm), and 20-m shuttle run (m). Females showed greater flexibility in the sit-and-reach test and greater body fat than the males. No differences were found in BMI. Percentiles were created for the four components for the physical fitness aptitudes, BMI, and skinfolds by using the LMS method based on age and sex. The proposed reference values may be used for detecting talents and promoting health in children and adolescents.

  17. More on Pay-for-Performance: New Developments in the Field Provide Insights for Policymaking. The Progress of Education Reform. Volume 12, Number 5

    ERIC Educational Resources Information Center

    Thompson, Barbara; Baumann, Paul

    2011-01-01

    Whether referred to as "pay-for-performance" (PFP) or "merit pay," attempting to tie educators' compensation to their performance in the classroom and students' performance on high-stakes tests has been a key component of many educator compensation reform efforts in the last five years. This issue looks at PFP systems broadly…

  18. The Air Force's central reference laboratory: maximizing service while minimizing cost.

    PubMed

    Armbruster, D A

    1991-11-01

    The Laboratory Services Branch (Epi Lab) of the Epidemiology Division, Brooks AFB, Texas, is designated by regulation to serve as the Air Force's central reference laboratory, providing clinical laboratory testing support to all Air Force medical treatment facilities (MTFs). Epi Lab recognized that it was not offering the MTFs a service comparable to civilian reference laboratories and that, as a result, the Air Force medical system was spending hundreds of thousands of dollars yearly for commercial laboratory support. An in-house laboratory upgrade program was proposed to and approved by the USAF Surgeon General, as a Congressional Efficiencies Add project, to launch a two-phase initiative consisting of a 1-year field trial of 30 MTFs, followed by expansion to another 60 MTFs. Major components of the program include overnight air courier service to deliver patient samples to Epi Lab, a mainframe computer laboratory information system and electronic reporting of results to the MTFs throughout the CONUS. Application of medical marketing concepts and the Total Quality Management (TQM) philosophy allowed Epi to provide dramatically enhanced reference service at a cost savings of about $1 million to the medical system. The Epi Lab upgrade program represents an innovative problem-solving approach, combining technical and managerial improvements, resulting in substantial patient care service and financial dividends. It serves as an example of successful application of TQM and marketing within the military medical system.

  19. Histomorphometric reference data of transiliac bone biopsy in children from 8 to 17 years old.

    PubMed

    Velásquez-Forero, Francisco H; Jiménez-Brau, Daniel A; Esparza-García, Mariela

    2018-01-01

    Histomorphometric analysis of bone samples is a key tool for studying bone metabolism; however, only a few pediatric reference data exist. The aim of the present study is to report more reference data and to investigate if histomorphometric differences exist between age and gender. We obtained 19 transiliac bone samples previously marked with tetracycline, from children between 8 and 17 years (13 were male), with normal blood test results and urine biochemical bone markers. We evaluated bone histomorphometric parameters using a digitalizing table with osteomeasure to obtain normative data of means and standard deviations, as well as median and range. Due to the small sample, a Monte Carlo simulation was applied. Structural, static, dynamic, and resorptic histomorphometric parameters were evaluated by age and gender following the American Society for Bone and Mineral Research recommendations. Bone volume (in the older children) and mineral apposition rate (in the younger children), the eroded surface (in boys), and the new bone wall thickness (in girls) were significantly increased. On the trabecular area of mineralization front, the modeling and the remodeling bone formation were similar (16 and 18%). The rest of the histomorphometric bone parameters by age and gender showed no significant difference. In healthy children, these bone histomorphometric findings, with these techniques and for this ages could be used as reference values. Copyright: © 2018 Permanyer.

  20. New reference charts for testicular volume in Dutch children and adolescents allow the calculation of standard deviation scores.

    PubMed

    Joustra, Sjoerd D; van der Plas, Evelyn M; Goede, Joery; Oostdijk, Wilma; Delemarre-van de Waal, Henriette A; Hack, Wilfried W M; van Buuren, Stef; Wit, Jan M

    2015-06-01

    Accurate calculations of testicular volume standard deviation (SD) scores are not currently available. We constructed LMS-smoothed age-reference charts for testicular volume in healthy boys. The LMS method was used to calculate reference data, based on testicular volumes from ultrasonography and Prader orchidometer of 769 healthy Dutch boys aged 6 months to 19 years. We also explored the association between testicular growth and pubic hair development, and data were compared to orchidometric testicular volumes from the 1997 Dutch nationwide growth study. The LMS-smoothed reference charts showed that no revision of the definition of normal onset of male puberty - from nine to 14 years of age - was warranted. In healthy boys, the pubic hair stage SD scores corresponded with testicular volume SD scores (r = 0.394). However, testes were relatively small for pubic hair stage in Klinefelter's syndrome and relatively large in immunoglobulin superfamily member 1 deficiency syndrome. The age-corrected SD scores for testicular volume will aid in the diagnosis and follow-up of abnormalities in the timing and progression of male puberty and in research evaluations. The SD scores can be compared with pubic hair SD scores to identify discrepancies between cell functions that result in relative microorchidism or macroorchidism. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  1. Age-related reference intervals for free and total prostate-specific antigen in a Singaporean population.

    PubMed

    Saw, S; Aw, T C

    2000-11-01

    Cancer of the prostate is the sixth most frequently found cancer in Singapore. Prostate-specific antigen (PSA) is the most clinically useful tumour marker available today for the diagnosis and management of prostate cancer. To enhance the value of PSA as a screening test we developed age-specific intervals for our ethnic population. The measurement of free PSA was included in the study to calculate the free:total ratio which enhances the differential diagnosis of prostate cancer from benign prostatic hyperplasia or prostatitis. The total PSA upper limits of 10-year intervals, beginning at 30-years-old, were 1.4, 1.7, 2.3, 4.0, 6.3 and 6.6 microg/l. Free PSA cut-off limits were 0.4, 0.5, 0.5, 1.0, 1.5 and 1.6 microg/l. The free:total ratio of PSA was not age dependent. Abbott AxSym standardised their calibration material for both free and total PSA assays with the Stanford 90:10 reference material. This laboratory has implemented these age-specific reference intervals and are currently following up their pick-up rate in the detection of prostate cancer.

  2. Bias in estimating accuracy of a binary screening test with differential disease verification

    PubMed Central

    Brinton, John T.; Ringham, Brandy M.; Glueck, Deborah H.

    2011-01-01

    SUMMARY Sensitivity, specificity, positive and negative predictive value are typically used to quantify the accuracy of a binary screening test. In some studies it may not be ethical or feasible to obtain definitive disease ascertainment for all subjects using a gold standard test. When a gold standard test cannot be used an imperfect reference test that is less than 100% sensitive and specific may be used instead. In breast cancer screening, for example, follow-up for cancer diagnosis is used as an imperfect reference test for women where it is not possible to obtain gold standard results. This incomplete ascertainment of true disease, or differential disease verification, can result in biased estimates of accuracy. In this paper, we derive the apparent accuracy values for studies subject to differential verification. We determine how the bias is affected by the accuracy of the imperfect reference test, the percent who receive the imperfect reference standard test not receiving the gold standard, the prevalence of the disease, and the correlation between the results for the screening test and the imperfect reference test. It is shown that designs with differential disease verification can yield biased estimates of accuracy. Estimates of sensitivity in cancer screening trials may be substantially biased. However, careful design decisions, including selection of the imperfect reference test, can help to minimize bias. A hypothetical breast cancer screening study is used to illustrate the problem. PMID:21495059

  3. Nocturnal Blood Pressure in Young Adults and Cognitive Function in Midlife: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

    PubMed Central

    Ning, Hongyan; Muntner, Paul; Reis, Jared P.; Calhoun, David A.; Viera, Anthony J.; Levine, Deborah A.; Jacobs, David R.; Shimbo, Daichi; Liu, Kiang; Greenland, Philip; Lloyd-Jones, Donald

    2015-01-01

    BACKGROUND Nocturnal blood pressure (BP) is associated with risk for cardiovascular events. However, the relationship between nocturnal BP in young adults and cognitive function in midlife remains unclear. METHODS We used data from the ambulatory BP monitoring substudy of the Coronary Artery Risk Development in Young Adults Study, including 224 participants (mean age 30 years, 45% men, 63% African Americans). At the 20-year follow-up, the Stroop test (executive function), Digit Symbol Substitution Test (psychomotor speed), and Rey Auditory Verbal Learning Test (verbal memory) were assessed. RESULTS Baseline mean office, daytime, and nocturnal BP were 109/73, 120/74, and 107/59mm Hg, respectively. Nocturnal BP dipping, calculated as (nocturnal systolic BP [SBP] − daytime SBP) × 100/daytime SBP, was divided into quartiles (Q1: −39.3% to −16.9%; Q2: −16.8% to −13.2%, Q3 [reference]: −13.1% to −7.8%, and Q4: −7.7% to +56.4%). In multiple regression analyses, the least nocturnal SBP dipping (Q4 vs. reference) and higher nocturnal diastolic BP level were associated with worse Stroop scores, with adjustments for demographic and clinical characteristics, and cumulative exposure to office BP during follow-up (β [standard error]: 0.37 [0.18] and 0.19 [0.07], respectively; all P < 0.05). Digit Symbol Substitution Test and Rey Auditory Verbal Learning Test were not significantly associated with nocturnal SBP dipping or nocturnal SBP/diastolic BP levels. CONCLUSIONS Among healthy young adults, less nocturnal SBP dipping and higher nocturnal diastolic BP levels were associated with lower executive function in midlife, independent of multiple measures of office BP during long-term follow-up. PMID:25783740

  4. Filling in the gaps: estimating numbers of chlamydia tests and diagnoses by age group and sex before and during the implementation of the English National Screening Programme, 2000 to 2012.

    PubMed

    Chandra, Nastassya L; Soldan, Kate; Dangerfield, Ciara; Sile, Bersabeh; Duffell, Stephen; Talebi, Alireza; Choi, Yoon H; Hughes, Gwenda; Woodhall, Sarah C

    2017-02-02

    To inform mathematical modelling of the impact of chlamydia screening in England since 2000, a complete picture of chlamydia testing is needed. Monitoring and surveillance systems evolved between 2000 and 2012. Since 2012, data on publicly funded chlamydia tests and diagnoses have been collected nationally. However, gaps exist for earlier years. We collated available data on chlamydia testing and diagnosis rates among 15-44-year-olds by sex and age group for 2000-2012. Where data were unavailable, we applied data- and evidence-based assumptions to construct plausible minimum and maximum estimates and set bounds on uncertainty. There was a large range between estimates in years when datasets were less comprehensive (2000-2008); smaller ranges were seen hereafter. In 15-19-year-old women in 2000, the estimated diagnosis rate ranged between 891 and 2,489 diagnoses per 100,000 persons. Testing and diagnosis rates increased between 2000 and 2012 in women and men across all age groups using minimum or maximum estimates, with greatest increases seen among 15-24-year-olds. Our dataset can be used to parameterise and validate mathematical models and serve as a reference dataset to which trends in chlamydia-related complications can be compared. Our analysis highlights the complexities of combining monitoring and surveillance datasets. This article is copyright of The Authors, 2017.

  5. Young adolescents' sexual and romantic reference displays on Facebook.

    PubMed

    Doornwaard, Suzan M; Moreno, Megan A; van den Eijnden, Regina J J M; Vanwesenbeeck, Ine; Ter Bogt, Tom F M

    2014-10-01

    Social networking sites (SNSs) form increasingly popular venues for adolescents to express their developing identity, including their sexual self. This study investigated how and to what extent early and middle adolescents display sexuality and romance on SNSs and the demographic and psychosexual factors associated with their displays. Dutch adolescents aged 11-18 years were recruited and Facebook friended. Participants' Facebook profiles were evaluated for sexual and romantic references and Facebook engagement. Participants completed a digital questionnaire measuring constructs related to romantic and sexual development. Analyses included chi-square and Student's t-tests. A total of 104 adolescents (M(age) = 15.01, 68.3% female) were Facebook friended. Of 104 profiles, 25 (24.0%) contained 67 sexual references, and 27 (26.0%) contained 204 romantic references. Sexual references were mostly posted by others and referring to others or to no one in particular, whereas romantic references were predominantly posted by and referring to the profile owner. Displayers of sexual and romantic references were, compared with nondisplayers, older, more engaged in Facebook, more sexually experienced, and perceived more of their peers as approving of sex and as sexually active. In addition, sexual displayers were more likely boys and more sexually interested. There were no differences with respect to sexual intention and sexual attitudes. A minority of young adolescents display sexual and romantic references on SNSs. References may reflect adolescents' offline sexual and romantic experiences. Yet, they may be powerful in creating behavioral norms; therefore, guidance on interpreting and displaying such messages should be promoted. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  6. Seven-Year Clinical Surveillance Program Demonstrates Consistent MARD Accuracy Performance of a Blood Glucose Test Strip.

    PubMed

    Setford, Steven; Grady, Mike; Mackintosh, Stephen; Donald, Robert; Levy, Brian

    2018-05-01

    MARD (mean absolute relative difference) is increasingly used to describe performance of glucose monitoring systems, providing a single-value quantitative measure of accuracy and allowing comparisons between different monitoring systems. This study reports MARDs for the OneTouch Verio® glucose meter clinical data set of 80 258 data points (671 individual batches) gathered as part of a 7.5-year self-surveillance program Methods: Test strips were routinely sampled from randomly selected manufacturer's production batches and sent to one of 3 clinic sites for clinical accuracy assessment using fresh capillary blood from patients with diabetes, using both the meter system and standard laboratory reference instrument. Evaluation of the distribution of strip batch MARD yielded a mean value of 5.05% (range: 3.68-6.43% at ±1.96 standard deviations from mean). The overall MARD for all clinic data points (N = 80 258) was also 5.05%, while a mean bias of 1.28 was recorded. MARD by glucose level was found to be consistent, yielding a maximum value of 4.81% at higher glucose (≥100 mg/dL) and a mean absolute difference (MAD) of 5.60 mg/dL at low glucose (<100 mg/dL). MARD by year of manufacture varied from 4.67-5.42% indicating consistent accuracy performance over the surveillance period. This 7.5-year surveillance program showed that this meter system exhibits consistently low MARD by batch, glucose level and year, indicating close agreement with established reference methods whilste exhibiting lower MARD values than continuous glucose monitoring (CGM) systems and providing users with confidence in the performance when transitioning to each new strip batch.

  7. Random vs. systematic sampling from administrative databases involving human subjects.

    PubMed

    Hagino, C; Lo, R J

    1998-09-01

    Two sampling techniques, simple random sampling (SRS) and systematic sampling (SS), were compared to determine whether they yield similar and accurate distributions for the following four factors: age, gender, geographic location and years in practice. Any point estimate within 7 yr or 7 percentage points of its reference standard (SRS or the entire data set, i.e., the target population) was considered "acceptably similar" to the reference standard. The sampling frame was from the entire membership database of the Canadian Chiropractic Association. The two sampling methods were tested using eight different sample sizes of n (50, 100, 150, 200, 250, 300, 500, 800). From the profile/characteristics, summaries of four known factors [gender, average age, number (%) of chiropractors in each province and years in practice], between- and within-methods chi 2 tests and unpaired t tests were performed to determine whether any of the differences [descriptively greater than 7% or 7 yr] were also statistically significant. The strengths of the agreements between the provincial distributions were quantified by calculating the percent agreements for each (provincial pairwise-comparison methods). Any percent agreement less than 70% was judged to be unacceptable. Our assessments of the two sampling methods (SRS and SS) for the different sample sizes tested suggest that SRS and SS yielded acceptably similar results. Both methods started to yield "correct" sample profiles at approximately the same sample size (n > 200). SS is not only convenient, it can be recommended for sampling from large databases in which the data are listed without any inherent order biases other than alphabetical listing by surname.

  8. Comparison of three commercially available fit-test methods.

    PubMed

    Janssen, Larry L; Luinenburg, D Michael; Mullins, Haskell E; Nelson, Thomas J

    2002-01-01

    American National Standards Institute (ANSI) standard Z88.10, Respirator Fit Testing Methods, includes criteria to evaluate new fit-tests. The standard allows generated aerosol, particle counting, or controlled negative pressure quantitative fit-tests to be used as the reference method to determine acceptability of a new test. This study examined (1) comparability of three Occupational Safety and Health Administration-accepted fit-test methods, all of which were validated using generated aerosol as the reference method; and (2) the effect of the reference method on the apparent performance of a fit-test method under evaluation. Sequential fit-tests were performed using the controlled negative pressure and particle counting quantitative fit-tests and the bitter aerosol qualitative fit-test. Of 75 fit-tests conducted with each method, the controlled negative pressure method identified 24 failures; bitter aerosol identified 22 failures; and the particle counting method identified 15 failures. The sensitivity of each method, that is, agreement with the reference method in identifying unacceptable fits, was calculated using each of the other two methods as the reference. None of the test methods met the ANSI sensitivity criterion of 0.95 or greater when compared with either of the other two methods. These results demonstrate that (1) the apparent performance of any fit-test depends on the reference method used, and (2) the fit-tests evaluated use different criteria to identify inadequately fitting respirators. Although "acceptable fit" cannot be defined in absolute terms at this time, the ability of existing fit-test methods to reject poor fits can be inferred from workplace protection factor studies.

  9. The utilization rate of the regional health information exchange: how it impacts on health care delivery outcomes.

    PubMed

    Mäenpää, Tiina; Asikainen, Paula; Gissler, Mika; Siponen, Kimmo; Maass, Marianne; Saranto, Kaija; Suominen, Tarja

    2012-01-01

    Interest in improving quality and effectiveness is the primary driver for health information exchange efforts across a health care system to improve the provision of public health care services. The aim here was to describe and identify the impact of a regional health information exchange (HIE) using quantitative statistics for 2004-2008 in one hospital district in Finland. We conducted a comparative, longitudinal 5-year follow-up study to evaluate the utilization rates of HIE, and the impact on health care delivery outcomes. The selected outcomes were total laboratory tests, radiology examinations, appointments, emergency visits, and referrals. The HIE utilization rates increased annually in all 10 federations of municipalities, and the viewing of reference information increased steadily in each professional group over the 5-year study period. In these federations, a significant connection was found to the number of laboratory tests and radiology examinations, with a statistically significant increase in the number of viewed references and use of HIE. The higher the numbers of emergency visits and appointments, the higher the numbers of emergency referrals to specialized care, viewed references, and HIE usage among the groups of different health care professionals. There is increasing interest in HIE usage through regional health information system among health professionals to improve health care delivery regionally and bring information on the patient directly to care delivery. It will be important to study which changes in working methods in the service system are explained by RHIS. Also, the experiences of the change that has taken place should be studied among the different stakeholders, administrative representatives, and patients.

  10. Bioequivalence of two levothyroxine tablet formulations without and with mathematical adjustment for basal thyroxine levels in healthy Argentinian volunteers: a single-dose, randomized, open-label, crossover study.

    PubMed

    Di Girolamo, Guillermo; Keller, Guillermo A; de Los Santos, Antonio R; Schere, Daniel; Gonzalez, Claudio D

    2008-11-01

    Levothyroxine has a narrow therapeutic index; therefore, precise and accurate assessment of the bioequivalence of different levothyroxine products is critical. Bioavailability estimates of levothyroxine formulations might be affected by baseline concentrations of the hormone. The aim of this study was to assess the bioequivalence of 100 microg of a test (T4 Montpellier 100, Química Montpellier S.A., Buenos Aires, Argentina) and reference (Synthroid, Abbott Laboratories, Abbott Park, Illinois) formulation of levothyroxine. We also compared 2 methods of levothyroxine measurements: without and with baseline correction for endogenous levothyroxine. This randomized, open-label, 2-sequence, crossover study with a 65-day washout period was carried out in healthy, white, euthyroid volunteers following a single dose of sodium levothyroxine 600 microg. Blood samples were collected at 30 and 15 minutes prior to administration, and 0 (baseline), 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 10, 12, 24, and 48 hours to determine thyroxine; serum thyrotropin (TSH) concentrations were determined 30 minutes before administration and 48 hours after administration. Serum concentrations of thyroxine were determined through radioimmunoassay and serum TSH concentrations were determined by a validated 2-site immunoradiometric assay. The formulations are considered to be equivalent if the 90% CI ratios for C(max) and AUC(0-last) are within 80% to 125%, per the US Food and Drug Administration (FDA). Adverse event monitoring was performed throughout the study by assessing clinical parameters (eg, blood pressure, electrocardiogram) and patient reports. A total of 24 volunteers (16 male, 8 female; mean [SD] age, 30.2 [4.6] years [range, 21-40 years]; mean [SD] weight, 71.71 [7.52] kg [range, 58-83 kg]) were included in the study. Without adjustment for baseline levels of endogenous levothyroxine, geometric mean C(max) for the test and reference formulations were 8.92 and 9.39 microg/dL, respectively; AUC(0-last) values were 368.40 and 383.37 microg/mL . h(-1). The 90% CI of the geometric mean for the percent ratios (test: reference) of C(max) and AUC(0-last) were 95.1% (90% CI, 91.9-98.3) and 96.1% (90% CI, 94.0-98.2), respectively. With adjustment for baseline levels of endogenous levothyroxine, the geometric mean C(max) for the test and reference formulations were 3.16 and 3.39 microg/dL, respectively; AUC(0-last) values were 88.33 and 95.60 microg/mL . h(-1). Despite performing the adjustment, the 90% CI of the geometric mean for Cmax and AUC(0-last) test:reference ratios were 93.1% (90% CI, 84.9-102.2) and 92.4% (90% CI, 85.2-100.2), respectively. No significant between-group differences were found with regard to pharmacokinetic parameters. No adverse events were observed or reported. The results of this study suggest that the test formulation was bioequivalent to the reference formulation of levothyroxine in these healthy volunteers, according to the US FDA definition of bioequivalence. This was supported by the analysis of concentration-time profiles without and with correction for basal endogenous levothyroxine.

  11. 40 CFR 75.22 - Reference test methods.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 17 2012-07-01 2012-07-01 false Reference test methods. 75.22 Section...) CONTINUOUS EMISSION MONITORING Operation and Maintenance Requirements § 75.22 Reference test methods. (a) The owner or operator shall use the following methods, which are found in appendices A-1 through A-4 to part...

  12. A cross-sectional study of sarcopenia in Japanese men and women: reference values and association with cardiovascular risk factors.

    PubMed

    Sanada, K; Miyachi, M; Tanimoto, M; Yamamoto, K; Murakami, H; Okumura, S; Gando, Y; Suzuki, K; Tabata, I; Higuchi, M

    2010-09-01

    In this study of Japanese men and women, we determine reference values for sarcopenia and test the hypothesis that sarcopenia is associated with risk factors for cardiovascular disease, independent of waist circumference. A total of 1,488 Japanese men and women aged 18-85 years participated in this study. Appendicular muscle mass (AMM) was measured by dual-energy X-ray absorptiometry. Reference values for classes 1 and 2 sarcopenia (skeletal muscle index: AMM/height2, kg m-2) in each sex were defined as values one and two standard deviations below the sex-specific means of reference values obtained in this study from young adults aged 18-40 years. The reference values for class 1 and class 2 sarcopenia were 7.77 and 6.87 kg m-2 in men and 6.12 and 5.46 kg m-2 in women. In subjects both with class 1 and class 2 sarcopenia, body mass index and % body fat were significantly lower than in normal subjects. Despite whole-blood glycohaemoglobin A1c in men with class 1 sarcopenia was significantly higher than in normal subjects, and brachial-ankle pulse wave velocity in women both with class 1 and class 2 sarcopenia were significantly higher than in normal subjects, using one-way ANCOVA with adjustment for the covariate of waist circumference. Although sarcopenia is associated with thin body mass, it is associated with more glycation of serum proteins in men and with greater arterial stiffness in women, independent of waist circumference.

  13. National Survey of Adult and Pediatric Reference Intervals in Clinical Laboratories across Canada: A Report of the CSCC Working Group on Reference Interval Harmonization.

    PubMed

    Adeli, Khosrow; Higgins, Victoria; Seccombe, David; Collier, Christine P; Balion, Cynthia M; Cembrowski, George; Venner, Allison A; Shaw, Julie

    2017-11-01

    Reference intervals are widely used decision-making tools in laboratory medicine, serving as health-associated standards to interpret laboratory test results. Numerous studies have shown wide variation in reference intervals, even between laboratories using assays from the same manufacturer. Lack of consistency in either sample measurement or reference intervals across laboratories challenges the expectation of standardized patient care regardless of testing location. Here, we present data from a national survey conducted by the Canadian Society of Clinical Chemists (CSCC) Reference Interval Harmonization (hRI) Working Group that examines variation in laboratory reference sample measurements, as well as pediatric and adult reference intervals currently used in clinical practice across Canada. Data on reference intervals currently used by 37 laboratories were collected through a national survey to examine the variation in reference intervals for seven common laboratory tests. Additionally, 40 clinical laboratories participated in a baseline assessment by measuring six analytes in a reference sample. Of the seven analytes examined, alanine aminotransferase (ALT), alkaline phosphatase (ALP), and creatinine reference intervals were most variable. As expected, reference interval variation was more substantial in the pediatric population and varied between laboratories using the same instrumentation. Reference sample results differed between laboratories, particularly for ALT and free thyroxine (FT4). Reference interval variation was greater than test result variation for the majority of analytes. It is evident that there is a critical lack of harmonization in laboratory reference intervals, particularly for the pediatric population. Furthermore, the observed variation in reference intervals across instruments cannot be explained by the bias between the results obtained on instruments by different manufacturers. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  14. Immunoglobulin M indirect-fluorescent antibody test for the diagnosis of acute toxoplasmosis during pregnancy in the avidity era: A 14-year experience at the Tuscany Reference Center for Infectious Diseases in Pregnancy, Florence, Italy.

    PubMed

    Trotta, Michele; Borchi, Beatrice; Zammarchi, Lorenzo; Sterrantino, Gaetana; Brogi, Michela; Kiros, Seble Tekle; Lorini, Chiara; Bonaccorsi, Guglielmo; Colao, Maria Grazia; Bartoloni, Alessandro

    2016-12-01

    The aim of this study was to evaluate immunoglobulin M indirect-fluorescent antibody test (IgM IFAT) for the diagnosis of acute or chronic Toxoplasma infection in pregnancy. Pregnant women with suspected acute toxoplasmosis referred to the Tuscany Reference Center for Infectious Diseases in Pregnancy during the period 1998-2012 were retrospectively enrolled. All women were tested with a panel of serological tests, including enzyme-linked immunosorbent assay for IgG avidity and IgM IFAT. On the basis of anamnestic, clinical, and serological criteria, pregnant women were classified into three groups: recently infected (RI), latently infected (LI), and doubtful latently infected (DLI). Patients classified as DLI were excluded from the analysis. The association between IgM IFAT (positive or negative) and the diagnosis of infection (acute or chronic) was assessed. Positive predictive value and negative predictive value of the IgM IFAT were calculated. A total of 810 pregnant women were enrolled in the study: 302 in the RI group and 508 in the LI group. Fifty-two women classified as DLI were excluded. IgM IFAT was positive in 172 out of 302 (56.9%) pregnant women in the RI group and in 29 out of 508 (5.7%) in the LI group. The positive predictive value and negative predictive value of IgM IFAT in predicting RI was 85.6% and 78.6%, respectively. IgM IFAT has reasonable sensitivity and specificity in diagnosing recent infection and, mostly in case of borderline avidity test, could be considered as a further aid for an accurate diagnosis of acute toxoplasmosis in pregnancy. © 2016 Japan Society of Obstetrics and Gynecology.

  15. Low levels of neurocognitive impairment detected in screening HIV-infected men who have sex with men: The MSM Neurocog Study.

    PubMed

    Barber, T J; Bansi, L; Pozniak, A; Asboe, D; Nelson, M; Moyle, G; Davies, N; Margetts, A; Ratcliffe, D; Catalan, J; Boffito, M; Gazzard, B

    2017-06-01

    This study aimed to determine the prevalence of HIV neurocognitive impairment in HIV-infected men who have sex with men aged 18-50 years, using a simple battery of screening tests in routine clinical appointments. Those with suspected abnormalities were referred on for further assessment. The cohort was also followed up over time to look at evolving changes. HIV-infected participants were recruited at three clinical sites in London during from routine clinical visits. They could be clinician or self-referred and did not need to be symptomatic. They completed questionnaires on anxiety, depression, and memory. They were then screened using the Brief Neurocognitive Screen (BNCS) and International HIV Dementia Scale (IHDS). Two hundred and five HIV-infected subjects were recruited. Of these, 59 patients were excluded as having a mood disorder and two patients were excluded due to insufficient data, leaving 144 patients for analysis. One hundred and twenty-four (86.1%) had a normal composite z score (within 1 SD of mean) calculated for their scores on the three component tests of the BNCS. Twenty (13.9%) had an abnormal z score, of which seven (35%) were symptomatic and 13 (65%) asymptomatic. Current employment and previous educational level were significantly associated with BNCS scores. Of those referred onwards for diagnostic testing, only one participant was found to have impairment likely related to HIV infection. We were able to easily screen for mood disorders and cognitive impairment in routine clinical practice. We identified a high level of depression and anxiety in our cohort. Using simple screening tests in clinic and an onward referral process for further testing, we were not able to identify neurocognitive impairment in this cohort at levels consistent with published data.

  16. Anterior knee pain and thigh muscle strength after intramedullary nailing of a tibial shaft fracture: an 8-year follow-up of 28 consecutive cases.

    PubMed

    Väistö, Olli; Toivanen, Jarmo; Kannus, Pekka; Järvinen, Markku

    2007-03-01

    Chronic anterior knee pain is a common complication after intramedullary nailing of a tibial shaft fracture. The source of pain is often not known, although it correlates with a simultaneous decrease in thigh muscle strength. No long-term follow-up study has assessed whether weakness of the thigh muscles is associated with anterior knee pain after the procedure in question. Prospective study. University Hospital of Tampere, University of Tampere. The muscular performance of 40 consecutive patients with a nailed tibial shaft fracture was tested isokinetically in a follow-up examination an average of 3.2 +/- 0.4 (SD) years after the initial surgery. An 8-year follow-up was possible in 28 of these cases. Isokinetic muscle strength measurements were made in 28 patients at an average 8.1 +/- 0.3 (SD) years after nail insertion and an average 6.6 +/- 0.3 (SD) years after nail extraction. All nails were extracted at an average 1.6 +/- 0.2 years after the nailing. : Seven patients were painless initially and still were at final follow-up (never pain, or NP). In 13 patients, the previous symptom of anterior knee pain was no longer present at final follow-up [pain, no pain (PNP)], and the remaining 8 had anterior knee pain initially and at final follow-up [always pain group (AP)]. With reference to the hamstring muscles, the mean peak torque difference between the injured and uninjured limb was -2.2% +/- 12% in the NP group, 1.6% +/- 15% in the PNP group, and 10.3% +/- 30% in the AP group at a speed of 60 degrees/second (Kruskal-Wallis test; chi(2) = 1.0; P = 0.593). At a speed of 180 degrees/second, the corresponding differences were -2.9% +/- 23% and 7.0% +/- 19% and 4.4% +/- 16% (Kruskal-Wallis test; chi = 1.7; P = 0.429). With reference to the quadriceps muscles, the mean peak torque difference was -2.8% +/- 9% in the NP group, 5.9% +/- 15% in the PNP group, and -13.0% +/- 16% in the AP group at a speed of 60 degrees/second (Kruskal-Wallis test; chi(2) = 7.9; P = 0.019). At 180 degrees/second, the corresponding differences were -9.4% +/- 13% and 4.9% +/- 16% and -1.9% +/- 9%, respectively (Kruskal-Wallis test; chi(2) = 4.8; P = 0.092). Based on this prospective long-term follow-up study, it appears that the anterior knee pain symptoms that are present after intramedullary nailing of a tibial shaft fracture disappear in a number of patients 3 to 8 years after surgery. Quadriceps, but not hamstring weakness, and lower functional knee scores are associated with anterior knee pain at 8 years.

  17. Evaluation of Methods to Select Scale Velocities in Icing Scaling Tests

    NASA Technical Reports Server (NTRS)

    Anderson, David N.; Ruff, Gary A.; Bond, Thomas H. (Technical Monitor)

    2003-01-01

    A series of tests were made in the NASA Glenn Icing Research Tunnel to determine how icing scaling results were affected by the choice of scale velocity. Reference tests were performed with a 53.3-cm-chord NACA 0012 airfoil model, while scale tests used a 27.7-cm-chord 0012 model. Tests were made with rime, mixed, and glaze ice. Reference test conditions included airspeeds of 67 and 89 m/s, an MVD of 40 microns, and LWCs of 0.5 and 0.6 g/cu m. Scale test conditions were established by the modified Ruff (AEDC) scaling method with the scale velocity determined in five ways. The resulting scale velocities ranged from 85 to 220 percent of the reference velocity. This paper presents the ice shapes that resulted from those scale tests and compares them to the reference shapes. It was concluded that for freezing fractions greater than 0.8 as well as for a freezing fraction of 0.3, the value of the scale velocity had no effect on how well the scale ice shape simulated the reference shape. For freezing fractions of 0.5 and 0.7, the simulation of the reference shape appeared to improve as the scale velocity increased.

  18. The age-specific prevalence of human parvovirus immunity in Victoria, Australia compared with other parts of the world.

    PubMed Central

    Kelly, H. A.; Siebert, D.; Hammond, R.; Leydon, J.; Kiely, P.; Maskill, W.

    2000-01-01

    The age-specific immunity to human parvovirus infection was estimated in Victoria, Australia using prospectively collected samples from the Royal Children's Hospital, the Royal Women's Hospital and the Australian Red Cross Blood Service and from sera stored at the Victorian Infectious Diseases Reference Laboratory (VIDRL). All testing was performed at VIDRL using a commercial enzyme-linked immunosorbent assay (Biotrin). Of the 824 sera tested, 28% of those drawn from people aged 0-9 years contained protective antibodies to human parvovirus. This rose to 51% in the next decade of life. There was then a slow rise to about 78% immunity over 50 years of age. An analysis of all requests for parvovirus serology at VIDRL from 1992 to 1998 suggested that parvovirus tended to occur in 4-year cycles, with 2 epidemic years followed by 2 endemic years. A review of published reports of parvovirus immunity suggested that parvovirus infection may be more common, with a correspondingly higher proportion of the community immune, in temperate as opposed to tropical countries. PMID:10982069

  19. The Comparison Of In-Flight Pitot Static Calibration Method By Using Radio Altimeter As Reference with GPS and Tower Fly By Methods On CN235-100 MPA

    NASA Astrophysics Data System (ADS)

    Derajat; Hariowibowo, Hindawan

    2018-04-01

    The new proposed In-Flight Pitot Static Calibration Method has been carried out during Development and Qualification of CN235-100 MPA (Military Patrol Aircraft). This method is expected to reduce flight hours, less human resources required, no additional special equipment, simple analysis calculation and finally by using this method it is expected to automatically minimized operational cost. At The Indonesian Aerospace (IAe) Flight Test Center Division, the development and updating of new flight test technique and data analysis method as specially for flight physics test subject are still continued to be developed as long as it safety for flight and give additional value for the industrial side. More than 30 years, Flight Test Data Engineers at The Flight Test center Division work together with the Air Crew (Test Pilots, Co-Pilots, and Flight Test Engineers) to execute the flight test activity with standard procedure for both the existance or development test techniques and test data analysis. In this paper the approximation of mathematical model, data reduction and flight test technique of The In-Flight Pitot Static Calibration by using Radio Altimeter as reference will be described and the test results had been compared with another methods ie. By using Global Position System (GPS) and the traditional method (Tower Fly By Method) which were used previously during this Flight Test Program (Ref. [10]). The flight test data case are using CN235-100 MPA flight test data during development and Qualification Flight Test Program at Cazaux Airport, France, in June-November 2009 (Ref. [2]).

  20. Factors affecting running performance in 6-12-year-olds: The Health Oriented Pedagogical Project (HOPP).

    PubMed

    Fredriksen, Per Morten; Mamen, Asgeir; Gammelsrud, Heidi; Lindberg, Morten; Hjelle, Ole Petter

    2018-05-01

    The purpose of this study was to examine factors affecting running performance in children. A cross-sectional study exploring the relationships between height, weight, waist circumference, muscle mass, body fat percentage, relevant biomarkers, and the Andersen intermittent running test in 2272 children aged 6 to 12 years. Parental education level was used as a non-physiological explanatory variable. Mean values (SD) and percentiles are presented as reference values. Height (β = 6.4, p < .0001), high values of haemoglobin (β = 18, p = .013) and low percentage of body fat (β = -7.5, p < .0001) showed an association with results from the running test. In addition, high parental education level showed a positive association with the running test. Boys display better running performance than girls at all age ages, except 7 years old, probably because of additional muscle mass and less fatty tissue. Height and increased level of haemoglobin positively affected running performance. Lower body fat percentage and high parental education level correlated with better running performance.

  1. [A case of pernicious anemia with type A gastritis in an extremely elderly patient with dementia and heart failure].

    PubMed

    Kuroda, Shoji; Morita, Sumiharu

    2008-05-01

    A 90-year-old woman was referred and admitted to our hospital because of progressing dementia, decreased appetite, and general fatigue. Blood tests on admission disclosed: white cell count, 2,900 /mm(3); hemoglobin 5.6 g/dl; mean corpuscular volume; 139.7 microm(3). Based on the presence of pancytopenia, macrocytic anemia, and elevated lactate dehydrogenises, we suspected pernicious anemia. We administered vitamin B12, which improved the blood test results and the signs of dementia. Gastrointestinal tract examination showed type A gastritis. Tests for anti-intrinsic factor antibody and anti-gastric parietal cell antibody were positive, which help confirm a diagnosis of pernicious anemia. Pernicious anemia is an autoimmune disease common among those aged 50-60 years. Cases aged over 90 years are rare. However, the numbers of extremely elderly patients are expected to increase with the growth of the elderly population. Fortunately, pernicious anemia is easy to treat. We need to make an appropriate diagnosis of pernicious anemia in the oldest elderly patients.

  2. Assessing clinical reasoning in optometry using the script concordance test.

    PubMed

    Faucher, Caroline; Dufour-Guindon, Marie-Pier; Lapointe, Gabrielle; Gagnon, Robert; Charlin, Bernard

    2016-05-01

    Clinical reasoning is central to any health profession but its development among learners is difficult to assess. Over the last few decades, the script concordance test (SCT) has been developed to solve this dilemma and has been used in many health professions; however, no study has been published on the use of the script concordance test in optometry. The purpose of this study was to develop and validate a script concordance test for the field of optometry. A 101-question script concordance test (27 short clinical scenarios) was developed and administered online to a convenience sample of 23 second-year and 19 fourth-year students of optometry. It was also administered to a reference panel of 12 experienced optometrists to develop the scoring key. An item-total correlation was calculated for each question. Cronbach's alpha coefficient was used to evaluate the script concordance test reliability and a t-test compared the two groups. A final 77-question script concordance test was created by eliminating questions with low item-total correlation. Cronbach's alpha for this optimised 77-question script concordance test was 0.80. A group comparison revealed that the second-year students' scores (n = 23; mean score = 66.4 ± 7.87 per cent) were statistically lower (t = -4.141; p < 0.001) than those of the fourth-year students (n = 19; mean score = 75.5 ± 5.97 per cent). The online script concordance test developed for this study was found to be both reliable and capable of discriminating between second- and fourth-year optometric students. These results demonstrate that the script concordance test may be considered as a new tool in the optometric educators' assessment arsenal. Further studies will be needed to cover additional levels of professional development. © 2016 The Authors. Clinical and Experimental Optometry © 2016 Optometry Australia.

  3. Recurrence of Helicobacter pylori infection in Bolivian children and adults after a population-based "screen and treat" strategy.

    PubMed

    Sivapalasingam, Sumathi; Rajasingham, Anu; Macy, Jonathan T; Friedman, Cindy R; Hoekstra, Robert M; Ayers, Tracy; Gold, Benjamin; Quick, Robert E

    2014-10-01

    Strategies to prevent gastric cancer by decreasing Helicobacter pylori infections in high-prevalence, low-income countries could include a population-based "screen and treat" eradication program. We tested residents of two rural villages for H. pylori infection using urea breath test (UBT), treated infected persons using directly observed therapy (DOT), retested for cure, and retested after 1 year later for H. pylori infection. We tested 1,065 (92%) of 1153 residents from two villages in rural Bolivia. Baseline H. pylori prevalence was 80% (95% confidence interval [CI]: 78-84). Age-specific cure rates were similar (≥92%) after DOT. Among those cured, 12% (95% CI: 8-15) had recurrent infection. Age-specific annual H. pylori recurrence rates for combined villages were 20% (95% CI: 10-29) in persons <5 years, 20% (95% CI: 10-29) in 5-9 years, 8% (95% CI: 1-15) in 10-14 years, and 8% (95% CI: 4-12) in persons ≥15 years. Compared with the referent population, those ≥15 years, recurrent infections were significantly more likely in children <5 years (odds ratios [OR] 2.7, 95% CI: 1.2-5.8) and 5-9 years (OR 2.7, 95% CI: 1.4-5.1). Children <10 years had high H. pylori recurrence rates following a population-based screen and treat program; this H. pylori eradication strategy may not be feasible in high-prevalence, low-income settings. © 2014 John Wiley & Sons Ltd.

  4. Validity and Reliability of a Glucometer Against Industry Reference Standards.

    PubMed

    Salacinski, Amanda J; Alford, Micah; Drevets, Kathryn; Hart, Sarah; Hunt, Brian E

    2014-01-01

    As an appealing alternative to reference glucose analyzers, portable glucometers are recommended for self-monitoring at home, in the field, and in research settings. The purpose was to characterize the accuracy and precision, and bias of glucometers in biomedical research. Fifteen young (20-36 years; mean = 24.5), moderately to highly active men (n = 10) and women (n = 5), defined by exercising 2 to 3 times a week for the past 6 months, were given an oral glucose tolerance test (OGTT) after an overnight fast. Participants ingested 50, 75, or 150 grams of glucose over a 5-minute period. The glucometer was compared to a reference instrument. The glucometer had 39% of values within 15% of measurements made using the reference instrument ranging from 45.05 to 169.37 mg/dl. There was both a proportional (-0.45 to -0.39) and small fixed (5.06 and 0.90 mg/dl) bias. Results of the present study suggest that the glucometer provided poor validity and reliability results compared to the results provided by the reference laboratory analyzer. The portable glucometers should be used for patient management, but not for diagnosis, treatment, or research purposes. © 2014 Diabetes Technology Society.

  5. Common Allergens Identified Based on Patch Test Results in Patients with Suspected Contact Dermatitis of the Scalp

    PubMed Central

    Aleid, Nouf M.; Fertig, Raymond; Maddy, Austin; Tosti, Antonella

    2017-01-01

    Background Contact dermatitis of the scalp is common and might be caused by many chemicals including metals, ingredients of shampoos and conditioners, dyes, or other hair treatments. Eliciting a careful history and patch tests are necessary to identify the responsible allergen and prevent relapses. Objectives To identify allergens that may cause contact dermatitis of the scalp by reviewing patch test results. Methods We reviewed the records of 1,015 patients referred for patch testing at the Dermatology Department of the University of Miami. A total of 226 patients (205 females and 21 males) with suspected scalp contact dermatitis were identified, and the patch test results and clinical data for those patients were analyzed. Most patients were referred for patch testing from a specialized hair clinic at our institution. Results The most common allergens in our study population were nickel (23.8%), cobalt (21.0%), balsam of Peru (18.2%), fragrance mix (14.4%), carba mix (11.6%), and propylene glycol (PG) (8.8%). The majority of patients were females aged 40–59 years, and scalp itching or burning were reported as the most common symptom. Conclusion Frequent sources of allergens for metals include hair clasps, pins, and brushes, while frequent sources of allergens for preservatives, fragrance mix, and balsam of Peru include shampoos, conditioners, and hair gels. Frequent sources of allergens for PG include topical medications. PMID:28611994

  6. Age, gender, and voided volume dependency of peak urinary flow rate and uroflowmetry nomogram in the Indian population

    PubMed Central

    Kumar, Vikash; Dhabalia, Jayesh V.; Nelivigi, Girish G.; Punia, Mahendra S.; Suryavanshi, Manav

    2009-01-01

    Objectives: The objective of this study was measurement of urine flow parameters by a non invasive urodynamic test. Variation of flow rates based on voided volume, age, and gender are described. Different nomograms are available for different populations and racial differences of urethral physiology are described. Currently, there has been no study from the Indian population on uroflow parameters. So the purpose of this study was to establish normal reference ranges of maximum and average flow rates, to see the influence of age, gender, and voided volume on flow rates, and to chart these values in the form of a nomogram. Methods: We evaluated 1,011 uroflowmetry tests in different age groups in a healthy population (healthy relatives of our patients) 16-50 year old males, >50 year old males, 5-15 year old children, and >15 year pre-menopausal and post-menopausal females. The uroflowmetry was done using the gravitimetric method. Flow chart parameters were analyzed and statistical calculations were used for drawing uroflow nomograms. Results: Qmax values in adult males were significantly higher than in the elderly and Qmax values in young females were significantly higher than in young males. Qmax values in males increased with age until 15 years old; followed by a slow decline until reaching 50 years old followed by a rapid decline after 50 years old even after correcting voided volume. Qmax values in females increased with age until they reached age 15 followed by decline in flow rate until a pre-menopausal age followed by no significant decline in post-menopausal females. Qmax values increased with voided volume until 700 cc followed by a plateau and decline. Conclusions: Qmax values more significantly correlated with age and voided volume than Qavg. Nomograms were drawn in centile form to provide normal reference ranges. Qmax values in our population were lower than described in literature. Patients with voided volume up to 50 ml could be evaluated with a nomogram. PMID:19955668

  7. Osteoarthritis year in review 2017: genetics and epigenetics.

    PubMed

    Peffers, M J; Balaskas, P; Smagul, A

    2018-03-01

    The purpose of this review is to describe highlights from original research publications related to osteoarthritis (OA), epigenetics and genomics with the intention of recognising significant advances. To identify relevant papers a Pubmed literature search was conducted for articles published between April 2016 and April 2017 using the search terms 'osteoarthritis' together with 'genetics', 'genomics', 'epigenetics', 'microRNA', 'lncRNA', 'DNA methylation' and 'histone modification'. The search term OA generated almost 4000 references. Publications using the combination of descriptors OA and genetics provided the most references (82 references). However this was reduced compared to the same period in the previous year; 8.1-2.1% (expressed as a percentage of the total publications combining the terms OA and genetics). Publications combining the terms OA with genomics (29 references), epigenetics (16 references), long non-coding RNA (lncRNA) (11 references; including the identification of novel lncRNAs in OA), DNA methylation (21 references), histone modification (3 references) and microRNA (miR) (79 references) were reviewed. Potential OA therapeutics such as histone deacetylase (HDAC) inhibitors have been identified. A number of non-coding RNAs may also provide targets for future treatments. There continues to be a year on year increase in publications researching miRs in OA (expressed as a percentage of the total publications), with a doubling over the last 4 years. An overview on the last year's progress within the fields of epigenetics and genomics with respect to OA will be given. Copyright © 2017 Osteoarthritis Research Society International. All rights reserved.

  8. Prospective Evaluation of Pretreatment Executive Cognitive Impairment and Depression in Patients Referred for Radiotherapy

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

    Fuller, Clifton D.; Graduate Division of Radiological Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX; Department of Radiation Medicine, Oregon Health and Science University, Portland, OR

    Purpose: Cancer patients are at risk of cognitive impairment and depression. We sought to ascertain the prevalence of executive, visuospatial, memory, and general cognitive performance deficits before radiotherapy in a radiation oncology clinic referral population and correlate the neurocognitive measures with the depression symptom burden. Methods and Materials: A total of 122 sequential patients referred for radiotherapy evaluation were administered a test battery composed of the Executive Interview (EXIT25), Executive Clock Drawing Task (CLOX1 and CLOX2), Mini Mental State Examination (MMSE), Memory Impairment Screen (MIS), and Geriatric Depression Scale (GDS). The mean age {+-} standard deviation was 58 {+-} 17more » years. Of 122 patients, 24 (20%) had been referred for breast cancer, 21 (17%) for gastrointestinal cancer, 17 (14%) for genitourinary disease, and 8 (7%) for brain lesions; the rest were a variety of tumor sites. The cognitive performance among the tumor cohorts was compared using Bonferroni-corrected analysis of variance and Tukey-Kramer tests. Pearson correlation coefficients were determined between each cognitive instrument and the GDS. Results: Of the 122 patients, 52 (43%) exhibited a detectable executive cognition decrement on one or more test measures. Five percent had poor memory performance (MIS), 18% had poor visuospatial performance (CLOX2), and 13% had poor global cognition (MMSE). Patients with brain tumors performed substantially worse on the EXIT25. No between-group differences were found for CLOX1, CLOX2, MIS, or GDS performance. The EXIT25 scores correlated significantly with the GDS scores (r = 0.26, p = 0.005). Conclusions: The results of this study have shown that patients referred for radiotherapy exhibit cognitive impairment profiles comparable to those observed in acutely ill medical inpatients. Executive control impairment appears more prevalent than global cognitive deficits, visuospatial impairment, or depression.« less

  9. Incidence of Fanconi anemia in children with congenital thumb anomalies referred for diepoxybutane testing.

    PubMed

    Webb, Michelle L; Rosen, Heather; Taghinia, Amir; McCarty, Erika R; Cerrato, Felecia; Upton, Joseph; Labow, Brian I

    2011-06-01

    Fanconi anemia (FA) is a rare genetic disorder of DNA repair that with near uniformity leads to bone marrow failure and resulting morbidity and mortality. Approximately 50% of FA patients are born with anomalies of the thumb or thumb and radius, and it has been recommended that all patients born with thumb anomalies undergo testing. However, the risk of FA in this population is unknown. We determined the incidence of FA in children with congenital thumb anomalies referred for FA testing and characterized those who tested positive. We queried our database for patients who presented with congenital thumb anomalies and who underwent diepoxybutane (DEB) testing for FA between 1999 and 2008 at Children's Hospital Boston and the Dana-Farber Cancer Institute. During this time period, 543 congenital thumb anomaly patients (235 with thumb hypoplasia) presented to our institution. A total of 81 patients with thumb abnormalities underwent DEB testing. Six patients (7% of those tested; 1% of the total; 3% of thumb hypoplasia patients) had a positive DEB test consistent with the diagnosis of FA; all had other non-upper-extremity anomalies associated with FA. Of 6 FA patients, 5 had bilateral involvement; all had some degree of thumb hypoplasia (3 also had radial dysplasia). Mean age at testing was 2.6 years (SD 4.3). Most of the patients tested had multiple physical anomalies (n = 66). The anomaly distribution was: thumb hypoplasia and radial dysplasia (n = 29), thumb hypoplasia (n = 26), radial polydactyly (n = 12), radial polydactyly and radial dysplasia (n = 1), and proximally placed thumb and radial dysplasia (n = 1). Twelve patients had other thumb anomalies. Although the incidence of FA in patients with thumb anomalies may be low, patients with thumb hypoplasia and other physical findings associated with FA, specifically café au lait spots and short stature, appear to have an increased risk of FA. Because hand surgeons see these patients early in life, they have the opportunity to refer these patients for FA testing to initiate early education, family genetic counseling, and treatment if warranted. Prognostic IV. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  10. Strategic Self-Presentation or Authentic Communication? Predicting Adolescents' Alcohol References on Social Media.

    PubMed

    Geusens, Femke; Beullens, Kathleen

    2017-01-01

    The current study is one of the first to examine how self-reported alcohol consumption, friends' perceived alcohol consumption, and the perceived number of friends sharing alcohol references on social networking sites (SNS) is associated with adolescents' sharing of alcohol references on SNS. A cross-sectional paper-and-pencil survey was administered among 3,172 adolescents (n = 3,133 used for analyses, mean age = 17.16 years, SD = 0.93; 50.7% male). Structural equation modeling was used to test the hypotheses. First, the results indicated that both self-reported drinking behavior and the perceived number of friends sharing alcohol references were related to sharing alcohol references on SNS, but the perceived number of friends sharing alcohol references was a stronger predictor than self-reported drinking behavior. Friends' perceived drinking behavior was not a significant predictor. In the second place, self-reported drinking behavior was a stronger predictor for girls than for boys, whereas the perceived number of friends sharing alcohol references was a stronger predictor for boys than for girls. Adolescents' alcohol-related self-representation is in line with their alcohol consumption and is also strongly related to what their friends are sharing. Thus, adolescents appear to communicate authentically about their drinking experiences, but the decision to do so is heavily influenced by the prevailing social norm regarding alcohol-related communication.

  11. Bayley-III Cognitive and Language Scales in Preterm Children.

    PubMed

    Spencer-Smith, Megan M; Spittle, Alicia J; Lee, Katherine J; Doyle, Lex W; Anderson, Peter J

    2015-05-01

    This study aimed to assess the sensitivity and specificity of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III), Cognitive and Language scales at 24 months for predicting cognitive impairments in preterm children at 4 years. Children born <30 weeks' gestation completed the Bayley-III at 24 months and the Differential Ability Scale, Second Edition (DAS-II), at 4 years to assess cognitive functioning. Test norms and local term-born reference data were used to classify delay on the Bayley-III Cognitive and Language scales. Impairment on the DAS-II Global Conceptual Ability, Verbal, and Nonverbal Reasoning indices was classified relative to test norms. Scores < -1 SD relative to the mean were classified as mild/moderate delay or impairment, and scores < -2 SDs were classified as moderate delay or impairment. A total of 105 children completed the Bayley-III and DAS-II. The sensitivity of mild/moderate cognitive delay on the Bayley-III for predicting impairment on DAS-II indices ranged from 29.4% to 38.5% and specificity ranged from 92.3% to 95.5%. The sensitivity of mild/moderate language delay on the Bayley-III for predicting impairment on DAS-II indices ranged from 40% to 46.7% and specificity ranged from 81.1% to 85.7%. The use of local reference data at 24 months to classify delay increased sensitivity but reduced specificity. Receiver operating curve analysis identified optimum cut-point scores for the Bayley-III that were more consistent with using local reference data than Bayley-III normative data. In our cohort of very preterm children, delay on the Bayley-III Cognitive and Language scales was not strongly predictive of future impairments. More children destined for later cognitive impairment were identified by using cut-points based on local reference data than Bayley-III norms. Copyright © 2015 by the American Academy of Pediatrics.

  12. OAO-3 end of mission tests report

    NASA Technical Reports Server (NTRS)

    Kalil, F.; Kull, F. J.; Mcintosh, R.; Ollendorf, S.; Margolies, D. L.; Gemmell, J.; Tasevoli, C. M.; Polidan, R. S.; Kochevar, H.; Chapman, C.

    1981-01-01

    Twelve engineering type tests were performed on several subsystems and experiment(s) of the OAO 3 spacecraft near its end of mission. The systems tested include: Princeton experiment package (PEP), fine error system guidance, inertial reference unit, star trackers, heat pipes, thermal control coatings, command and data handling, solar array; batteries, and onboard processor/power boost regulator. Generally, the systems performed well for the 8 1/2 years life of OAO 3, although some degradation was noted in the sensitivity of PEP and in the absorptivity of the skin coatings. Battery life was prolonged during the life of the mission in large part by carefully monitoring the charge-discharge cycle with careful attention not to overcharge.

  13. Participation on official proficiency test of the OPCW: case study of Brazilian Army – IDQBRN

    NASA Astrophysics Data System (ADS)

    Silva, T. C.; Ferreira, C. N.; Cardozo, M.; de Paula, R. L.

    2018-03-01

    In recent years, Brazil has been the scene of international events, gaining worldwide repercussion. However, this increases the risk of terrorist attacks using chemical warfare agents. It brings the need to achieve proficiency to do a quick and unequivocal identification of these dangerous compounds. Thinking about it, the Laboratory of Chemical Analyzes (LAQ) of Brazilian Army has participated since the end of 2010 in the interlaboratory tests promoted by the Organisation for the Prohibition of Chemical Weapons (OPCW). In this article, we discuss about the participation of LAQ in the 40th OPCW Proficiency Test, one more step in the way to become a laboratory designated by OPCW and an international reference.

  14. JPRS Report, East Europe

    DTIC Science & Technology

    1988-02-17

    Production Association of the Powder Metallurgical Industry. We refer to it in short as the Institute of Powder Metallurgy. This is another contri...ployed worker could exercise his ownership rights guar - anteed by the Constitution. These are the economists who point out that this model of enterprise...certification. This is not the only instance of an investigation that lasts for months if not for years. Anti-nicotine chewing gum is being tested ever

  15. Kala-azar in a Brazilian child

    PubMed Central

    Meunier, Yann A.; Hole, Michael K.

    2011-01-01

    We report the case of a six-year-old Brazilian girl referred for splenomegaly who first presented with fever, asthenia, and weight loss. Geographical location, clinical exam, and blood laboratories suggested kala-azar. Serology confirmed kala-azar diagnosis, but direct evidence of the parasites was not made. A treatment by meglumine antimoniate is given under hospital surveillance for two weeks. Thereupon, the patient is asymptomatic and all tests are normal. PMID:24765289

  16. Use of Fiber Reinforced Plastics in the Marine Industry

    DTIC Science & Technology

    1990-09-06

    surface should be molded or machined into the hull. 129 Design of Detais Marine Composites With single skin laminates, holes are normally drilled...SH), FIre and Toxicity Test Methods and Qualification Procedure for Composite Material Systems Used In Hull, Machinely and Structural Applications...date on the state of the marine composites industry and should for many years serve as an excellent reference and source book for designers and

  17. Adaptive Two Dimensional RLS (Recursive Least Squares) Algorithms

    DTIC Science & Technology

    1989-03-01

    in Monterey wonderful. IX I. INTRODUCTION Adaptive algorithms have been used successfully for many years in a wide range of digital signal...SIMULATION RESULTS The 2-D FRLS algorithm was tested both on computer-generated data and on digitized images. For a baseline reference the 2-D L:rv1S...Alexander, S. T. Adaptivt Signal Processing: Theory and Applications. Springer- Verlag, New York. 1986. 7. Bellanger, Maurice G. Adaptive Digital

  18. Do You See What I Mean? Shared Reference in Non-Native, Early Signing Deaf Children

    ERIC Educational Resources Information Center

    Falkman, Kerstin W.; Hjelmquist, Erland

    2006-01-01

    A group of non-native, early signing deaf children between the ages of 7 and 11 years were tested on a referential communication task. A group of hearing children matched for sex and mental and chronological age were also included in the study. The aim was to study the deaf children's ability to take another person's perspective in a task that…

  19. Activities at the State Time and Frequency Standard of Russia

    DTIC Science & Technology

    2010-11-01

    measurements within a new calibration campaign arranged by the BIPM. Two TWSTFT stationary stations and a transportable one were tested in VNIIFTRI...receiver last year. Just now, we have completed new measurements within a new calibration campaign arranged by the BIPM. Two TWSTFT stationary stations and...TTS4 time transfer systems differentially calibrated relative to the VNIIFTRI reference receiver. The equipment for the TWSTFT system has been

  20. Identifying harmful drinking using a single screening question in a psychiatric consultation-liaison population.

    PubMed

    Massey, Suena H; Norris, Lorenzo; Lausin, Melissa; Nwaneri, Chinyere; Lieberman, Daniel Z

    2011-01-01

    Harmful drinking is common in medical inpatients, yet commonly missed due in part to time pressures. A screening question about past year heavy drinking recommended by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) has been validated in primary care and emergency room settings. We tested the psychometric properties of a modified single screening question (SSQ) in hospitalized patients referred to a consultation-liaison service. A psychiatry attending (n = 40), a psychiatry resident (n = 30) and a medical student (n = 30) administered the SSQ, followed by a self-report 10-item Alcohol Use Disorders Identification Test (AUDIT) to a sample of 100 consultation-liaison patients who were able to give informed consent for participation. Using the AUDIT as a reference, the sensitivity and specificity of the SSQ to detect harmful drinking in this sample were .96 and .82, respectively. Gender differences in specificity were not found. The single question also had a strong correlation with dependence (r(b) = .457, p < .001), and harmful use (r(b) = .620, p < .001) subscales of the AUDIT. The SSQ about past year heavy drinking can rapidly identify harmful drinking in alert nonpsychotic consultation-liaison patients. Copyright © 2011 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  1. [Measurement of human body fat by means of gravimetry. Application of Archimedes' principle].

    PubMed

    Dettwiler, W; Ribordy, M; Donath, A; Scherrer, J R

    1978-12-02

    The weighing of the human body under water is an application of Archimedes' law. Fat being lighter than water or than the structures of lean body mass, body fat can be measured by determining the specific gravity of the human body; that is, by underwater weighing. Body fat has been determined in an "ideal" sample of 14 men and 23 women, all aged 20 years. Testing against a reference measure of body fat makes it possible to test the validity of some anthropometric measurements and of some indices of obesity. These indices offer no advantages over anthropometric measurements.

  2. Self-reported knee pain and disability among healthy individuals: reference data and factors associated with the Knee injury and Osteoarthritis Outcome Score (KOOS) and KOOS-Child.

    PubMed

    Baldwin, J N; McKay, M J; Simic, M; Hiller, C E; Moloney, N; Nightingale, E J; Burns, J

    2017-08-01

    To develop normative reference data for the Knee injury and Osteoarthritis Outcome Score (KOOS) and KOOS-Child, as well as investigate socio-demographic, psychological and physical factors associated with knee pain and disability among healthy adults. The KOOS or KOOS-Child (each containing five subscales) was administered to participants aged 8-101 years within the 1000 Norms Project, an observational study of 1000 self-reported healthy individuals. Self-efficacy, physical activity, body mass index (BMI), lower limb alignment, knee frontal plane projection angle (FPPA), knee range of motion (ROM), knee and hip strength, six-minute walk, 30-second chair stand and timed up and down stairs tests were collected. KOOS data were dichotomised using established cut-off scores and logistic regression analyses were conducted for each subscale. Socio-demographic characteristics were similar to the Australian population. Normative reference data were generated for children (8-17 years) and adults (18-101 years). Female adults were up to twice as likely to report knee pain, symptoms and sport/recreation (Sport/Rec) limitations compared to males (P < .05). Older age, lower self-efficacy, greater BMI, varus lower limb alignment, lower knee flexion ROM and lower hip external rotation (ER) strength were independently associated with knee pain and disability among adults. Age- and gender-stratified reference data for the KOOS and KOOS-Child have been developed to guide interpretation of results in practice and research for individuals with knee disorders. Psychological and physical factors are linked with self-reported knee pain/disability among adults, and longitudinal studies to investigate causation are required. Copyright © 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  3. Feasibility Study of HIV Sentinel Surveillance using PMTCT data in Cameroon: from Scientific Success to Programmatic Failure.

    PubMed

    Billong, Serge C; Dee, Jacob; Fokam, Joseph; Nguefack-Tsague, Georges; Ekali, Gabriel L; Fodjo, Raoul; Temgoua, Edith S; Billong, Edson-Joan; Sosso, Samuel M; Mosoko, Jembia J; Monebenimp, Francisca; Ndjolo, Alexis; Bissek, Anne-Cecile Z-K; Bolu, Omotayo; Elat, Jean-Bosco N

    2017-01-03

    In low-income countries (LICs), HIV sentinel surveillance surveys (HIV-SSS) are recommended in between two demographic and health surveys, due to low-cost than the latter. Using the classical unlinked anonymous testing (UAT), HIV-SSS among pregnant women raised certain ethical and financial challenges. We therefore aimed at evaluating how to use prevention of mother-to-child transmission of HIV (PMTCT) routine data as an alternative approach for HIV-SSS in LICs. A survey conducted through 2012 among first antenatal-care attendees (ANC1) in the ten regions of Cameroon. HIV testing was performed at PMTCT clinics as-per the national serial algorithm (rapid test), and PMTCT site laboratory (PMTCT-SL) performances were evaluated by comparison with results of the national reference laboratory (NRL), determined as the reference standard. Acceptance rate for HIV testing was 99%, for a total of 6521 ANC1 (49 · 3% aged 15-24) enrolled nationwide. Among 6103 eligible ANC1, sensitivity (using NRL testing as the reference standard) was 81 · 2%, ranging from 58 · 8% (South region) to 100% (West region); thus implying that 18 · 8% HIV-infected ANC1 declared HIV-negative at the PMTCT-SL were positive from NRL-results. Specificity was 99 · 3%, without significant disparity across sites. At population-level, this implies that every year in Cameroon, ~2,500 HIV-infected women are wrongly declared seronegative, while ~1,000 are wrongly declared seropositive. Only 44 · 4% (16/36) of evaluated laboratories reached the quality target of 80%. The study identified weaknesses in routine PMTCT HIV testing. As Cameroon transitions to using routine PMTCT data for HIV-SSS among pregnant women, there is need in optimizing quality system to ensure robust routine HIV testing for programmatic and surveillance purposes.

  4. Effectiveness of Cool Roof Coatings with Ceramic Particles

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

    Brehob, Ellen G; Desjarlais, Andre Omer; Atchley, Jerald Allen

    2011-01-01

    Liquid applied coatings promoted as cool roof coatings, including several with ceramic particles, were tested at Oak Ridge National Laboratory (ORNL), Oak Ridge, Tenn., for the purpose of quantifying their thermal performances. Solar reflectance measurements were made for new samples and aged samples using a portable reflectometer (ASTM C1549, Standard Test Method for Determination of Solar Reflectance Near Ambient Temperature Using a Portable Solar Reflectometer) and for new samples using the integrating spheres method (ASTM E903, Standard Test Method for Solar Absorptance, Reflectance, and Transmittance of Materials Using Integrating Spheres). Thermal emittance was measured for the new samples using amore » portable emissometer (ASTM C1371, Standard Test Method for Determination of Emittance of Materials Near Room 1 Proceedings of the 2011 International Roofing Symposium Temperature Using Portable Emissometers). Thermal conductivity of the coatings was measured using a FOX 304 heat flow meter (ASTM C518, Standard Test Method for Steady-State Thermal Transmission Properties by Means of the Heat Flow Meter Apparatus). The surface properties of the cool roof coatings had higher solar reflectance than the reference black and white material, but there were no significant differences among coatings with and without ceramics. The coatings were applied to EPDM (ethylene propylene diene monomer) membranes and installed on the Roof Thermal Research Apparatus (RTRA), an instrumented facility at ORNL for testing roofs. Roof temperatures and heat flux through the roof were obtained for a year of exposure in east Tennessee. The field tests showed significant reduction in cooling required compared with the black reference roof (~80 percent) and a modest reduction in cooling compared with the white reference roof (~33 percent). The coating material with the highest solar reflectivity (no ceramic particles) demonstrated the best overall thermal performance (combination of reducing the cooling load cost and not incurring a large heating penalty cost) and suggests solar reflectivity is the significant characteristic for selecting cool roof coatings.« less

  5. Food allergy in infants and children: clinical evaluation and management.

    PubMed

    Levy, Y; Kornbroth, B; Ofer, I; Garty, B Z; Danon, Y L

    1994-12-01

    A total of 122 infants and children up to age 17 (69 males and 53 females) who were referred for food allergy to the Pediatric Allergy and Clinical Immunology Unit were evaluated by complete history, emphasizing the implicated foods, clinical presentation and involvement of various organ systems, physical examination, and prick skin tests to food allergens. Fourteen infants with a history of egg white allergy and positive skin tests to egg white also underwent skin tests (prick and intradermal in 1:100 dilution) to measles-mumps-rubella (MMR) vaccine; 35 children under 3 years old had 41 oral challenges with the suspected foods; and 9 children over 3 years old had 12 oral challenges with the suspected foods. We found that cow milk/humanized milk formula, egg white, soybean, and peanut are the main allergenic foods in the pediatric population. Thirteen children had 13 positive oral challenges: 12 to cow milk/humanized milk formula and one to egg white. Symptoms reproduced by oral challenges included urticarial and erythematous rash, conjunctival itching, angioedema, abdominal pain, vomiting, diarrhea, and rhinorrhea. No anaphylactic shock was reported. Negative skin test has an excellent predictive accuracy for negative oral challenge with the suspected food in children > 3 years old. The negative predictive accuracy of cow milk skin test in children < 3 years was 73%. Positive skin test is not a good predictor of a clinical reaction to food. Oral food challenge performed cautiously in a medical setting is the "gold standard" for diagnosis. MMR vaccine can be safely administered to infants with egg white allergy after skin tests with the vaccine are performed.

  6. Predictive value and efficiency of laboratory testing.

    PubMed

    Galen, R S

    1980-11-01

    Literature on determining reference values and reference intervals on "normal" or "healthy" individuals is abundant. It is impossible, however, to evaluate a data set of reference values and select a suitable reference interval that will be meaningful for the practice of medicine. The reference interval, no matter how derived statistically, tells us nothing about disease. This is the main reason the concepts of "normal values" have failed us and why "reference values" will prove similarly disappointing. By studying these same constituents in a variety of disease states as well, it will be possible to select "referent values" that will make the test procedure meaningful for diagnostic purposes. In order to obtain meaningful referent values for predicting disease, it is necessary to study not only the "healthy" reference population, but patients with the disease in question, and patients who are free of the disease in question but who have other diseases. Studies of this type are not frequently found for laboratory tests that are in common use today.

  7. Self, memory, and imagining the future in a case of psychogenic amnesia.

    PubMed

    Rathbone, Clare J; Ellis, Judi A; Baker, Ian; Butler, Chris R

    2015-01-01

    We report a case of psychogenic amnesia and examine the relationships between autobiographical memory impairment, the self, and ability to imagine the future. Case study JH, a 60-year-old male, experienced a 6-year period of pervasive psychogenic amnesia covering all life events from childhood to the age of 53. JH was tested during his amnesic period and again following hypnotherapy and the recovery of his memories. JH's amnesia corresponded with deficits in self-knowledge and imagining the future. Results are discussed with reference to models of self and memory and processes involving remembering and imagining.

  8. Searching for Clinoforms in a Possible Delta

    NASA Image and Video Library

    2015-07-01

    A delta is a pile of sediment dumped by a river where it enters a standing body of water. Evidence for deltas that formed billions of years ago on Mars has been mounting in recent years. One line of evidence not yet investigated is to search for what are called clinoforms. In geology, a clinoform refers to a steep slope of sediment on the outer margin of a delta. This image seeks to test whether those features are visible and help confirm that Mars in ancient times had a standing body of water in this location. http://photojournal.jpl.nasa.gov/catalog/PIA19848

  9. [Unclassified cardiomyopathy or Lyme carditis? A three year follow-up].

    PubMed

    Konopka, Marcin; Kuch, Marek; Braksator, Wojciech; Walczak, Ewa; Jakuciński, Maciej; Lipowski, Dariusz; Dłużniewski, Mirosław

    2013-01-01

    Lyme carditis can be a clinical manifestation of the early disseminated stage of Lyme disease caused by the tick-transmitted pathogen Borrelia burgdorferi. We present the case of a 41 year-old Caucasian woman referred to our hospital with symptoms of fatigue, progressive exertional dyspnoea, supraventricular cardiac arrhythmia, and an enlarged heart revealed on chest radiography. Following an untypical result of transthoracic echocardiography, cardiac magnetic resonance was performed. This showed structural cardiac changes and focus of late gadolinium enhancement in the midwall of the apex region. Further diagnostic processes, including endomyocardial biopsy and serology tests, made it possible to diagnose Lyme carditis. Clinical observation was followed-up for three years.

  10. Metronidazole immediate release formulations: a fasting randomized open-label crossover bioequivalence study in healthy volunteers.

    PubMed

    de Freitas Silva, M; Schramm, S G; Kano, E K; Koono, E E M; Manfio, J L; Porta, V; dos Reis Serra, C H

    2012-10-01

    Metronidazole is a BCS (Biopharmaceutics Classification System) class 1 drug, traditionally considered the choice drug in the infections treatment caused by protozoa and anaerobic microorganisms. This study aimed to evaluate bioequivalence between 2 different marketed 250 mg metronidazole immediate release tablets. A randomized, open-label, 2×2 crossover study was performed in healthy Brazilian volunteers under fasting conditions with a 7-day washout period. The formulations were administered as single oral dose and blood was sampled over 48 h. Metronidazole plasma concentrations were determined by a liquid chromatography mass spectrometry (LC-MS/MS) method. The plasma concentration vs. time profile was generated for each volunteer and the pharmacokinetic parameters Cmax, Tmax, AUC0-t, AUC0-∞, ke, and t1/2 were calculated using a noncompartmental model. Bioequivalence between pharmaceutical formulations was determined by calculating 90% CIs (Confidence Intervall) for the ratios of Cmax, AUC0-t, and AUC0-∞ values for test and reference using log-transformed data. 22 healthy volunteers (11 men, 11 women; mean (SD) age, 28 (6.5) years [range, 21-45 years]; mean (SD) weight, 66 (9.3) kg [range, 51-81 kg]; mean (SD) height, 169 (6.5) cm [range, 156-186 cm]) were enrolled in and completed the study. The 90% CIs for Cmax (0.92-1.06), AUC0-t (0.97-1.02), and AUC0-∞ (0.97-1.03) values for the test and reference products fitted in the interval of 0.80-1.25 proposed by most regulatory agencies, including the Brazilian agency ANVISA. No clinically significant adverse effects were reported. After pharmacokinetics analysis, it concluded that test 250 mg metronidazole formulation is bioequivalent to the reference product according to the Brazilian agency requirements. © Georg Thieme Verlag KG Stuttgart · New York.

  11. Hamstring-and-Lower-Back Flexibility in Male Amateur Soccer Players.

    PubMed

    van der Horst, Nick; Priesterbach, Annique; Backx, Frank; Smits, Dirk-Wouter

    2017-01-01

    This study investigated the hamstring-and-lower-back flexibility (HLBF) of male adult amateur soccer players, using the sit-and-reach test (SRT), with a view to obtaining population-based reference values and to determining whether SRT scores are associated with player characteristics. Cross-sectional cohort study. Teams from high-level Dutch amateur soccer competitions were recruited for participation. Dutch male high-level amateur field soccer players (n = 449) of age 18 to 40 years. Players with a hamstring injury at the moment of SRT-measurement or any other injury that prevented them from following the SRT protocol were excluded. Sit-and-reach test scores were measured and then population-based reference values were calculated as follows: >2SD below mean (defining "very low" HLBF), 1SD-2SD below mean ("low" HLBF), 1SD below mean to 1SD above mean ("normal" HLBF), 1SD-2SD above mean ("high" HLBF), and >2SD above mean ("very high" HLBF). Whether SRT scores were correlated with player characteristics was determined using a Pearson correlation coefficient or Spearman rho. Sit-and-reach test scores ranged from 0 to 43.5 cm (mean 22.0 cm, SD 9.2). The cutoff points for population-based reference values were <3.5 cm for "very low", 3.5 to 13.0 cm for "low", 13.0 to 31.0 cm for "normal", 31.0 to 40.5 cm for "high", and >40.5 cm for "very high". Sit-and-reach test scores were significantly associated with players' height (ρ = -0.132, P = 0.005), body mass index (r = 0.114, P = 0.016), and history of anterior cruciate ligament surgery (P < 0.001). This study is the first to describe the HLBF of amateur soccer players. The SRT reference values with cutoff points may facilitate evidence-based decision making regarding HLBF, and the SRT might be a useful tool to assess injury risk, performance, or for diagnostic purposes.

  12. Online clinical reasoning assessment with the Script Concordance test: a feasibility study

    PubMed Central

    Sibert, Louis; Darmoni, Stefan J; Dahamna, Badisse; Weber, Jacques; Charlin, Bernard

    2005-01-01

    Background The script concordance (SC) test is an assessment tool that measures capacity to solve ill-defined problems, that is, reasoning in context of uncertainty. This tool has been used up to now mainly in medicine. The purpose of this pilot study is to assess the feasibility of the test delivered on the Web to French urologists. Methods The principle of SC test construction and the development of the Web site are described. A secure Web site was created with two sequential modules: (a) The first one for the reference panel (n = 26) with two sub-tasks: to validate the content of the test and to elaborate the scoring system; (b) The second for candidates with different levels of experience in Urology: Board certified urologists, residents, medical students (5 or 6th year). Minimum expected number of participants is 150 for urologists, 100 for residents and 50 for medical students. Each candidate is provided with an individual access code to this Web site. He/she may complete the Script Concordance test several times during his/her curriculum. Results The Web site has been operational since April 2004. The reference panel validated the test in June of the same year during the annual seminar of the French Society of Urology. The Web site is available for the candidates since September 2004. In six months, 80% of the target figure for the urologists, 68% of the target figure for the residents and 20% of the target figure for the student passed the test online. During these six months, no technical problem was encountered. Conclusion The feasibility of the web-based SC test is successful as two-thirds of the expected number of participants was included within six months. Psychometric properties (validity, reliability) of the test will be evaluated on a large scale (N = 300). If positive, educational impact of this assessment tool will be useful to help urologists during their curriculum for the acquisition of clinical reasoning skills, which is crucial for professional competence. PMID:15967034

  13. Maximal exercise testing variables and 10-year survival: fitness risk score derivation from the FIT Project.

    PubMed

    Ahmed, Haitham M; Al-Mallah, Mouaz H; McEvoy, John W; Nasir, Khurram; Blumenthal, Roger S; Jones, Steven R; Brawner, Clinton A; Keteyian, Steven J; Blaha, Michael J

    2015-03-01

    To determine which routinely collected exercise test variables most strongly correlate with survival and to derive a fitness risk score that can be used to predict 10-year survival. This was a retrospective cohort study of 58,020 adults aged 18 to 96 years who were free of established heart disease and were referred for an exercise stress test from January 1, 1991, through May 31, 2009. Demographic, clinical, exercise, and mortality data were collected on all patients as part of the Henry Ford ExercIse Testing (FIT) Project. Cox proportional hazards models were used to identify exercise test variables most predictive of survival. A "FIT Treadmill Score" was then derived from the β coefficients of the model with the highest survival discrimination. The median age of the 58,020 participants was 53 years (interquartile range, 45-62 years), and 28,201 (49%) were female. Over a median of 10 years (interquartile range, 8-14 years), 6456 patients (11%) died. After age and sex, peak metabolic equivalents of task and percentage of maximum predicted heart rate achieved were most highly predictive of survival (P<.001). Subsequent addition of baseline blood pressure and heart rate, change in vital signs, double product, and risk factor data did not further improve survival discrimination. The FIT Treadmill Score, calculated as [percentage of maximum predicted heart rate + 12(metabolic equivalents of task) - 4(age) + 43 if female], ranged from -200 to 200 across the cohort, was near normally distributed, and was found to be highly predictive of 10-year survival (Harrell C statistic, 0.811). The FIT Treadmill Score is easily attainable from any standard exercise test and translates basic treadmill performance measures into a fitness-related mortality risk score. The FIT Treadmill Score should be validated in external populations. Copyright © 2015 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  14. EMQN/CMGS best practice guidelines for the molecular genetic testing of Huntington disease.

    PubMed

    Losekoot, Monique; van Belzen, Martine J; Seneca, Sara; Bauer, Peter; Stenhouse, Susan A R; Barton, David E

    2013-05-01

    Huntington disease (HD) is caused by the expansion of an unstable polymorphic trinucleotide (CAG)n repeat in exon 1 of the HTT gene, which translates into an extended polyglutamine tract in the protein. Laboratory diagnosis of HD involves estimation of the number of CAG repeats. Molecular genetic testing for HD is offered in a wide range of laboratories both within and outside the European community. In order to measure the quality and raise the standard of molecular genetic testing in these laboratories, the European Molecular Genetics Quality Network has organized a yearly external quality assessment (EQA) scheme for molecular genetic testing of HD for over 10 years. EQA compares a laboratory's output with a fixed standard both for genotyping and reporting of the results to the referring physicians. In general, the standard of genotyping is very high but the clarity of interpretation and reporting of the test result varies more widely. This emphasizes the need for best practice guidelines for this disorder. We have therefore developed these best practice guidelines for genetic testing for HD to assist in testing and reporting of results. The analytical methods and the potential pitfalls of molecular genetic testing are highlighted and the implications of the different test outcomes for the consultand and his or her family members are discussed.

  15. Rhabdomyolysis and coeliac disease: A causal or casual association? A case report and review of literature.

    PubMed

    Mandato, Claudia; Rossi, Alessandro; Caldore, Mariano; Lamba, Marta; Rocco, Michele; Auricchio, Renata; Vajro, Pietro; Siani, Paolo

    2018-02-01

    Rhabdomyolysis is a rare, potentially life-threatening condition, caused by multiple disorders. The association with Coeliac Disease (CD) has been rarely reported and in these cases muscular damage was imputed to hypokalemia. Herein we describe a new case of severe rhabdomyolysis in a child subsequently diagnosed as affected by CD, and review previous reports. A 3-year-old boy was referred for diarrhea, brown urine, muscular pain/weakness, and no history of muscular trauma. At entry, laboratory tests showed elevated levels of creatine kinase (CK) (x100 unv) and aspartate aminotransferase (AST) (x10 unv), alanine aminotrasferase (ALT) (x5 unv); electrolytes were within the reference range. Twenty-four hours after admission serum CK peaked 115,000 U/L and transaminases increased up to 30 times unv. Hyperhydration treatment was started with renal function monitoring. Urine output decreased little, while serum creatinine and urea nitrogen stayed within the reference range. Serum potassium levels went down to 2.8 mEq/L at day 3, in spite of supplementation. The patient completely recovered at day 16. Main metabolic causes of rhabdomyolysis were ruled out by appropriate tests. Because of rarely reported cases of CD/rhabdomyolysis, anti-tissue transglutaminase (tTG) antibodies were measured and found positive (IgA 34 U/mL, unv <9). HLA typing was DQA1 05:02, DQB1 03:02. As jejunal biopsy showed patchy villous atrophy, gluten free diet (GFD) was prescribed. One year after starting GFD, histology was normal. Literature (search engines: PUB MED and GOOGLE SCHOLAR) from 1980 to 2016 retrieved 8 cases (age range: 12 to 75 years old) previously described. The present case suggests to check for CD in children with severe rhabdomyolysis. Because severe rhabdomyolysis itself may elevate the serum potassium levels, hypokalemia might go unrecognized as the cause of muscular damage. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  16. [Reference values for the blood coagulation tests in Mexico: usefulness of the pooled plasma from blood donors].

    PubMed

    Calzada-Contreras, Adriana; Moreno-Hernández, Manuel; Castillo-Torres, Noemi Patricia; Souto-Rosillo, Guadalupe; Hernández-Juárez, Jesús; Ricardo-Moreno, María Tania; Sánchez-Fernández, Maria Guadalupe de Jesús; García-González, América; Majluf-Cruz, Abraham

    2012-01-01

    The blood coagulation system maintains the blood in a liquid state and bleeding and thrombosis are the manifestations of its malfunction. Blood coagulation laboratory evaluates the physiology of this system. To establish both, the reference values for several tests performed at the blood coagulation laboratory as well as the utility of the pooled plasma to perform these assays. MATERIAL AND: In this descriptive, cross-sectional, randomized study, we collected plasma from Mexican Mestizos. Each pooled plasma was prepared with the plasma from at least 20 blood donors. We performed screening and special tests and the Levey-Jennings graphs were built and interpreted after each pass. Results of the tests were analyzed and their distribution was established using the Kolmogorov-Smirnov test. To establish the reference values we used 95% confidence intervals. We collected 72 pooled plasmas. The distribution for PT, APTT, and TT tests was abnormal. Although the PT test showed a bimodal distribution it was normal for factor VII. The reference values for the hemostatic, anticoagulant, and fibrinolytic factors were different from those suggested by the manufacturers. We established the reference values for the blood coagulation tests in the adult Mexican population. We have shown that the pooled plasma must be used for the screening tests. We suggest that each clinical laboratory should establish its own reference values (at least for the screening tests). To reach this objective, we encourage the use of the pooled plasma.

  17. D-dimer test for excluding the diagnosis of pulmonary embolism.

    PubMed

    Crawford, Fay; Andras, Alina; Welch, Karen; Sheares, Karen; Keeling, David; Chappell, Francesca M

    2016-08-05

    Pulmonary embolism (PE) can occur when a thrombus (blood clot) travels through the veins and lodges in the arteries of the lungs, producing an obstruction. People who are thought to be at risk include those with cancer, people who have had a recent surgical procedure or have experienced long periods of immobilisation and women who are pregnant. The clinical presentation can vary, but unexplained respiratory symptoms such as difficulty breathing, chest pain and an increased respiratory rate are common.D-dimers are fragments of protein released into the circulation when a blood clot breaks down as a result of normal body processes or with use of prescribed fibrinolytic medication. The D-dimer test is a laboratory assay currently used to rule out the presence of high D-dimer plasma levels and, by association, venous thromboembolism (VTE). D-dimer tests are rapid, simple and inexpensive and can prevent the high costs associated with expensive diagnostic tests. To investigate the ability of the D-dimer test to rule out a diagnosis of acute PE in patients treated in hospital outpatient and accident and emergency (A&E) settings who have had a pre-test probability (PTP) of PE determined according to a clinical prediction rule (CPR), by estimating the accuracy of the test according to estimates of sensitivity and specificity. The review focuses on those patients who are not already established on anticoagulation at the time of study recruitment. We searched 13 databases from conception until December 2013. We cross-checked the reference lists of relevant studies. Two review authors independently applied exclusion criteria to full papers and resolved disagreements by discussion.We included cross-sectional studies of D-dimer in which ventilation/perfusion (V/Q) scintigraphy, computerised tomography pulmonary angiography (CTPA), selective pulmonary angiography and magnetic resonance pulmonary angiography (MRPA) were used as the reference standard.• Adults who were managed in hospital outpatient and A&E settings and were suspected of acute PE were eligible for inclusion in the review if they had received a pre-test probability score based on a CPR.• quantitative, semi quantitative and qualitative D-dimer tests.• Target condition: acute symptomatic PE.• Reference standards: We included studies that used pulmonary angiography, V/Q scintigraphy, CTPA and MRPA as reference standard tests. Two review authors independently extracted data and assessed quality using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). We resolved disagreements by discussion. Review authors extracted patient-level data when available to populate 2 × 2 contingency tables (true-positives (TPs), true-negatives (TNs), false-positives (FPs) and false-negatives (FNs)). We included four studies in the review (n = 1585 patients). None of the studies were at high risk of bias in any of the QUADAS-2 domains, but some uncertainty surrounded the validity of studies in some domains for which the risk of bias was uncertain. D-dimer assays demonstrated high sensitivity in all four studies, but with high levels of false-positive results, especially among those over the age of 65 years. Estimates of sensitivity ranged from 80% to 100%, and estimates of specificity from 23% to 63%. A negative D-dimer test is valuable in ruling out PE in patients who present to the A&E setting with a low PTP. Evidence from one study suggests that this test may have less utility in older populations, but no empirical evidence was available to support an increase in the diagnostic threshold of interpretation of D-dimer results for those over the age of 65 years.

  18. Importance of an Interprofessional Team Approach in Achieving Improved Management of the Dizzy Patient.

    PubMed

    Rodriguez, Amanda I; Zupancic, Steven; Song, Michael M; Cordero, Joehassin; Nguyen, Tam Q; Seifert, Charles

    2017-03-01

    Because of its multifaceted nature, dizziness is difficult for clinicians to diagnose and manage independently. Current treatment trends suggest that patients are often referred to the otolaryngologist for intervention despite having a nonotologic disorder. Additionally, many individuals with atypical presentations are often misdiagnosed and spend a significant amount of time waiting for consultation by the otolaryngologist. Few studies have alluded that implementation of an interprofessional team approach in the diagnosis and management of the dizzy patient can improve clinical decision-making. However, to the authors' knowledge, there is no information specifically quantifying the outcomes and potential benefits of using an interprofessional balance care team approach. To compare dizziness diagnoses trends and referral practices with and without the use of an interprofessional management approach within a university healthcare system. Over the course of a 3-yr period, a retrospective review of the diagnosis and management of dizziness was performed with and without implementation of an interprofessional team. To observe potential differences, year 3 incorporated the interprofessional management approach while years 1-2 did not. The two periods were then compared to each other. A total of 134 patients referred to a university hearing clinic for a vestibular and balance function evaluation. Diagnoses and management trends were examined with descriptive statistics (percentages and frequencies). Fisher's exact tests, analysis of contingency tables, were conducted to evaluate the influence of interprofessional management on dizziness diagnoses and treatment patterns. Results demonstrated that before implementation of an interprofessional team approach, (1) referring clinicians used unspecific dizziness diagnosis codes (e.g., dizziness and giddiness), (2) a low number of patients with dizziness were referred for balance function testing, (3) diagnoses remained unspecific following the balance function assessment, and (4) the most frequently occurring vestibular diagnoses were unilateral vestibular hypofunction and benign paroxysmal positional vertigo. Following the use of an interprofessional management approach, it was determined that (1) disease-specific diagnoses increased, (2) patients with dizziness were referred for balance function testing mainly by otolaryngologists, (3) dizziness was considered to be multifaceted for a greater number of patients, (4) a larger percentage of patients were referred to a specialist other than the otolaryngologist as a result of their diagnosis, and (5) patients reported reduction or resolution of their symptoms. An interprofessional management approach for the dizzy patient can lead to more specific diagnoses and provide alternative referral pathways to other health-care professionals (e.g., audiologists, physical therapists, and pharmacists) in an effort to reduce over-referral to one specialist. Future studies should address the utility of an interprofessional team approach in the overall management of patients with dizziness. American Academy of Audiology

  19. Does the Cambridge Automated Neuropsychological Test Battery (CANTAB) Distinguish Between Cognitive Domains in Healthy Older Adults?

    PubMed

    Lenehan, Megan E; Summers, Mathew J; Saunders, Nichole L; Summers, Jeffery J; Vickers, James C

    2016-04-01

    The Cambridge Neuropsychological Test Automated Battery (CANTAB) is a semiautomated computer interface for assessing cognitive function. We examined whether CANTAB tests measured specific cognitive functions, using established neuropsychological tests as a reference point. A sample of 500 healthy older (M = 60.28 years, SD = 6.75) participants in the Tasmanian Healthy Brain Project completed battery of CANTAB subtests and standard paper-based neuropsychological tests. Confirmatory factor analysis identified four factors: processing speed, verbal ability, episodic memory, and working memory. However, CANTAB tests did not consistently load onto the cognitive domain factors derived from traditional measures of the same function. These results indicate that five of the six CANTAB subtests examined did not load onto single cognitive functions. These CANTAB tests may lack the sensitivity to measure discrete cognitive functions in healthy populations or may measure other cognitive domains not included in the traditional neuropsychological battery. © The Author(s) 2015.

  20. Rapid diagnostic tests for malaria

    PubMed Central

    Daily, Jennifer; Hotte, Nora; Dolkart, Caitlin; Cunningham, Jane; Yadav, Prashant

    2015-01-01

    Abstract Maintaining quality, competitiveness and innovation in global health technology is a constant challenge for manufacturers, while affordability, access and equity are challenges for governments and international agencies. In this paper we discuss these issues with reference to rapid diagnostic tests for malaria. Strategies to control and eliminate malaria depend on early and accurate diagnosis. Rapid diagnostic tests for malaria require little training and equipment and can be performed by non-specialists in remote settings. Use of these tests has expanded significantly over the last few years, following recommendations to test all suspected malaria cases before treatment and the implementation of an evaluation programme to assess the performance of the malaria rapid diagnostic tests. Despite these gains, challenges exist that, if not addressed, could jeopardize the progress made to date. We discuss recent developments in rapid diagnostic tests for malaria, highlight some of the challenges and provide suggestions to address them. PMID:26668438

  1. Relative bioavailability of a newly developed 5-mg levomethadone hydrochloride IR tablet (L-Polamidon® 5 mg tablets) in comparison with the 5-mg levomethadone hydrochloride oral solution (L-Polamidon® solution for substitution) as reference product.

    PubMed

    Blume, Henning H; Wedemeyer, Ralf-Steven; Donath, Frank; Roscher, Katrin; Elvert, Gerd; Wagner, Daniel; Bley, Oliver; Vuia, Alexander; Todorova-Sanjari, Marina; Villalobos, Ramon; Schug, Barbara

    2015-04-01

    To establish the relative bioavailability (rBA) between two p.o. 5-mg levomethadone hydrochloride formulations, i.e., L-Polamidon® 5 mg tablets (test) vs. L-Polamidon® solution for substitution (reference). To assess the safety and tolerability of both formulations. A total of 33 healthy male subjects, aged 29 ± 6 years (BMI: 23.9 ± 2.5 kg/m2) completed this single center, open-label, randomized, 2-period cross-over study with single dose administrations under fasting conditions and coadministration with naltrexone for safety reasons. Administrations of both investigational products were separated by a washout period of at least 2 weeks, i.e., 13 treatmentfree days. The total dose for each subject was 2 x 5 mg resulting in 10 mg levomethadone hydrochloride. For pharmacokinetic evaluation, blood samples were withdrawn until 72 hours postdose. A validated non-stereoselective liquid chromatography-tandem mass spectroscopy method (LC-MS/MS) was applied for the determination of levomethadone in plasma. The lower limit of quantitation was 0.100 ng/mL. Adverse events were descriptively analyzed in the study population. The geometric means of the parameters related with the extent of total exposure of levomethadone, i.e., AUC(0-tlast) and AUC(0-∞), were 244.422 ng x h/mL and 332.999 ng x h/mL for test and 246.837 ng x h/mL and 329.467 ng×h/mL for reference, respectively. The geometric means of the peak exposure for levomethadone, i.e., Cmax, were 8.923 ng/mL for test and 8.635 ng/mL for reference. The point estimates (PEs) of the Test/Reference (T/R) adjusted geometric mean ratios of AUC(0-last), AUC(0-∞), and C(max) were 99.20%, 101.42%, and 104.11%, respectively, and all of them showed 90%-confidence intervals (CIs) within the range of 80.00 - 125.00% as suggested by regulatory requirements for bioequivalence assessment In total, 21 subjects experienced 55 AEs during the study, the most frequently reported AE, i.e., headache, accounted for 13 out of the total 55 AEs (23.6%) and no AEs of severe intensity were reported. Bioequivalence could be demonstrated in terms of rate and extent of absorption after administration of test and reference products under naltrexone protection. Concerning the safety evaluation, no negative implications on the possible use of the test formulation could be determined.

  2. Cost-effectiveness of tubal patency tests.

    PubMed

    Verhoeve, H R; Moolenaar, L M; Hompes, P; van der Veen, F; Mol, B W J

    2013-04-01

    Guidelines are not in agreement on the most effective diagnostic scenario for tubal patency testing; therefore, we evaluated the cost-effectiveness of invasive tubal testing in subfertile couples compared with no testing and treatment. Cost-effectiveness analysis. Decision analytic framework. Computer-simulated cohort of subfertile women. We evaluated six scenarios: (1) no tests and no treatment; (2) immediate treatment without tubal testing; (3) delayed treatment without tubal testing; (4) hysterosalpingogram (HSG), followed by immediate or delayed treatment, according to diagnosis (tailored treatment); (5) HSG and a diagnostic laparoscopy (DL) in case HSG does not prove tubal patency, followed by tailored treatment; and (6) DL followed by tailored treatment. Expected cumulative live births after 3 years. Secondary outcomes were cost per couple and the incremental cost-effectiveness ratio. For a 30-year-old woman with otherwise unexplained subfertility for 12 months, 3-year cumulative live birth rates were 51.8, 78.1, 78.4, 78.4, 78.6 and 78.4%, and costs per couple were €0, €6968, €5063, €5410, €5405 and €6163 for scenarios 1, 2, 3, 4, 5 and 6, respectively. The incremental cost-effectiveness ratios compared with scenario 1 (reference strategy), were €26,541, €19,046, €20,372, €20,150 and €23,184 for scenarios 2, 3, 4, 5 and 6, respectively. Sensitivity analysis showed the model to be robust over a wide range of values for the variables. The most cost-effective scenario is to perform no diagnostic tubal tests and to delay in vitro fertilisation (IVF) treatment for at least 12 months for women younger than 38 years old, and to perform no tubal tests and start immediate IVF treatment from the age of 39 years. If an invasive diagnostic test is planned, HSG followed by tailored treatment, or a DL if HSG shows no tubal patency, is more cost-effective than DL. © 2013 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2013 RCOG.

  3. Splanchnic, Thoracoabdominal, and Cerebral Blood Flow Volumes in Healthy Children and Young Adults in Fasting and Postprandial States: Determining Reference Ranges by Using Phase-Contrast MR Imaging.

    PubMed

    Muthusami, Prakash; Yoo, Shi-Joon; Chaturvedi, Rajiv; Gill, Navjot; Windram, Jonathan; Schantz, Daryl; Prsa, Milan; Caro-Dominguez, Pablo; Seed, Mike; Grosse-Wortmann, Lars; Ling, Simon C; Chavhan, Govind B

    2017-10-01

    Purpose To estimate reference ranges for blood flow volume (BFV) in major splanchnic, thoracoabdominal, and neck vessels by using phase-contrast magnetic resonance (MR) imaging in children and young adults in fasting and postprandial states. Materials and Methods In this institutional research ethics board-approved prospective study, healthy volunteers underwent phase-contrast MR imaging in a fasting state and again after a standardized meal. BFV values were reported as medians and ranges, and postmeal to premeal BFV ratios were calculated. BFVs in volunteers divided into two groups according to age (≤18 years old and >18 years old) were compared by using the Mann-Whitney test adjusted for multiple comparisons. Linear regression for internal validation of BFV and Pearson correlation and Bland-Altman analysis for interobserver agreement were used. Results Reference ranges for BFVs were estimated in 39 volunteers (23 male and 16 female; mean age, 21.2 years ± 8.5; range, 9-40 years) and were indexed according to body surface area, with internal validation (R 2 = 0.84-0.92) and excellent interobserver agreement (R 2 = 0.9928). There was an almost 30% increase in total abdominal BFV (P < .0001) in response to a meal, which was the result of a threefold increase in superior mesenteric artery BFV (P < .0001). BFV after the meal remained unaffected in the celiac artery and cerebral circulation. Significantly higher normalized BFVs in the cerebral circulation were measured in children with both preprandial (P = .039) and postprandial (P = .008) status than those in adults. Conclusion Reference ranges for BFVs and changes in BFVs in response to a meal in major splanchnic, thoracoabdominal, and neck vessels were estimated by using phase-contrast MR imaging in healthy volunteers to allow hemodynamic assessment of children and young adults with various diseases. © RSNA, 2017 Online supplemental material is available for this article.

  4. Safety and efficacy of Implanon, a single-rod implantable contraceptive containing etonogestrel.

    PubMed

    Funk, Sidney; Miller, Michael M; Mishell, Daniel R; Archer, David F; Poindexter, Alfred; Schmidt, Juergen; Zampaglione, Edio

    2005-05-01

    The safety and efficacy of a single-rod implantable contraceptive containing etonogestrel (Implanontrade mark) were investigated in a multicenter clinical trial. Sexually active American women (N=330) with apparently normal menstrual cycles used the implant for up to 2 years. All subjects recorded bleeding and/or spotting daily in a diary. Safety was assessed through adverse experiences (AEs), laboratory tests and physical and gynecologic examinations. Total exposure was 474 woman-years (6186 cycles), and 68% of subjects had at least 1 year of exposure. No pregnancies occurred. The most common bleeding pattern observed throughout the study was infrequent bleeding, defined as less than three episodes of bleeding in a reference period (excluding amenorrhea). The least common pattern was frequent bleeding, defined as more than five episodes of bleeding in a reference period. Infrequent, prolonged and frequent bleeding patterns were most common early in the study and declined thereafter. During the 3-month Reference Periods 2-8 (Months 4-24), the incidence of amenorrhea ranged from 14% to 20%. Forty-three subjects (13%) withdrew from the study because of bleeding pattern changes and 76 subjects (23%) discontinued because of other AEs. Other common AEs leading to discontinuation, besides bleeding irregularities, were emotional lability (6.1%), weight increase (3.3%), depression (2.4%) and acne (1.5%). Use of Implanon (etonogestrel subdermal implant, referred to herein as ENG implant) for up to 2 years had no clinically significant effects on laboratory parameters, physical and pelvic examinations, vital signs or body mass index. The average length of time required for ENG implant insertion and that for removal were 0.5 and 3.5 min, respectively, and all the procedures were uncomplicated. The return to normal menstrual cycles and fertility was rapid after removal. Implanon is a safe, highly effective and rapidly reversible new method of contraception.

  5. Lower white blood cell counts in elite athletes training for highly aerobic sports.

    PubMed

    Horn, P L; Pyne, D B; Hopkins, W G; Barnes, C J

    2010-11-01

    White cell counts at rest might be lower in athletes participating in selected endurance-type sports. Here, we analysed blood tests of elite athletes collected over a 10-year period. Reference ranges were established for 14 female and 14 male sports involving 3,679 samples from 937 females and 4,654 samples from 1,310 males. Total white blood cell counts and counts of neutrophils, lymphocytes and monocytes were quantified. Each sport was scaled (1-5) for its perceived metabolic stress (aerobic-anaerobic) and mechanical stress (concentric-eccentric) by 13 sports physiologists. Substantially lower total white cell and neutrophil counts were observed in aerobic sports of cycling and triathlon (~16% of test results below the normal reference range) compared with team or skill-based sports such as water polo, cricket and volleyball. Mechanical stress of sports had less effect on the distribution of cell counts. The lower white cell counts in athletes in aerobic sports probably represent an adaptive response, not underlying pathology.

  6. Micronucleus assay as a biomarker of genotoxicity in the occupational exposure to agrochemicals in rural workers.

    PubMed

    Gentile, N; Mañas, F; Bosch, B; Peralta, L; Gorla, N; Aiassa, D

    2012-06-01

    This paper aims to evaluate the genotoxic effect of agrochemicals in rural workers occupationally exposed by the micronucleus assay in peripheral blood lymphocytes and to promote the development of health and environmental preventive and protective practices. A total of 30 blood samples from 20 individuals occupationally exposed to different agrochemicals and 10 unexposed persons, who formed the reference group, were analyzed. We found statistically significant differences (p < 0.0005, Student's t Test) in the frequency of micronuclei between the two groups (7.20 ± 1.55 and 15.15 ± 5.10 CBMN for reference and exposed groups respectively). The analysis of age showed a positive correlation (Pearson Correlation Test) with the frequency of micronuclei in exposed population (p < 0.05; r(2) = 0.47), in contrast with smoking habits and years of exposure. Micronucleus assay allows an early detection of populations at higher risk of having genetic damage, allowing us to implement strategies of intervention for the purpose of contributing to reduce that risk.

  7. 46 CFR 162.027-2 - Design, construction, testing and marking requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... the requirements of ASTM F 1546 (incorporated by reference, see § 162.027-1). (b) All inspections and tests required by ASTM F 1546 (incorporated by reference, see § 162.027-1) must be performed by an... completion of the testing required by ASTM F 1546 (incorporated by reference, see § 162.027-1). [CGD 95-027...

  8. Phonemic verbal fluency task in adults with high-level literacy.

    PubMed

    Opasso, Patrícia Romano; Barreto, Simone Dos Santos; Ortiz, Karin Zazo

    2016-01-01

    To establish normative parameters for the F-A-S form of the phonemic verbal fluency test, in a population of Brazilian Portuguese speaking adults with high-level literacy. The sample comprised 40 male and female volunteers aged 19 to 59 years, and at least 8 years of formal education. Volunteers were first submitted to the Mini-Mental State Examination and the Clock Drawing cognitive screening tests, then to the F-A-S Verbal Phonemic Fluency Test; in this test, examinees were given 60 seconds to generate as many words as possible beginning with each of the three test letters. The means for number of words beginning the letters F, A and S and for total number of words beginning with either letter generated per minute corresponded to 15.3, 14.4, 13.9 and 43.5, respectively. Reference values obtained from young adults with high levels of literacy submitted to the F-A-S Verbal Phonemic Fluency Test in this study were similar to those reported in the international literature. These reference values can be used for clinical assessment of language disorder and neuropsychological evaluation. Obter parâmetros de normalidade na tarefa de fluência verbal fonêmica, versão F-A-S, em uma população de alto letramento de adultos falantes do português brasileiro. A amostra foi constituída por 40 voluntários, de ambos os sexos, com idade entre 19 e 59 anos, e com mais de 8 anos de estudo. Todos os voluntários foram inicialmente submetidos ao Miniexame do Estado Mental e ao Teste do Desenho do Relógio, para fins de rastreio cognitivo, e, então, ao Teste de Fluência Verbal Fonêmica F-A-S. Neste último, os indivíduos foram orientados a produzirem o maior número de palavras que conseguissem, iniciadas com cada uma das três letras ditas pelo examinador, em um intervalo de 60 segundos cada. As médias das palavras produzidas com as letras F-A-S foram as seguintes: "F" = 15,3 palavras por minuto; "A" = 14,4 palavras por minuto; e "S" = 13,9 palavras por minuto. A média do total de palavras emitidas iniciada com todas as letras do teste foi de 43,5 palavras. Foram obtidos valores de referência para o Teste de Fluência Verbal Fonêmica F-A-S para indivíduos adultos jovens de alto grau de letramento semelhantes aos de estudos internacionais. Tais valores podem ser utilizados na avaliação clínica de transtornos da linguagem e na avaliação neuropsicológica.

  9. Predictive Accuracy of Sweep Frequency Impedance Technology in Identifying Conductive Conditions in Newborns.

    PubMed

    Aithal, Venkatesh; Kei, Joseph; Driscoll, Carlie; Murakoshi, Michio; Wada, Hiroshi

    2018-02-01

    Diagnosing conductive conditions in newborns is challenging for both audiologists and otolaryngologists. Although high-frequency tympanometry (HFT), acoustic stapedial reflex tests, and wideband absorbance measures are useful diagnostic tools, there is performance measure variability in their detection of middle ear conditions. Additional diagnostic sensitivity and specificity measures gained through new technology such as sweep frequency impedance (SFI) measures may assist in the diagnosis of middle ear dysfunction in newborns. The purpose of this study was to determine the test performance of SFI to predict the status of the outer and middle ear in newborns against commonly used reference standards. Automated auditory brainstem response (AABR), HFT (1000 Hz), transient evoked otoacoustic emission (TEOAE), distortion product otoacoustic emission (DPOAE), and SFI tests were administered to the study sample. A total of 188 neonates (98 males and 90 females) with a mean gestational age of 39.4 weeks were included in the sample. Mean age at the time of testing was 44.4 hr. Diagnostic accuracy of SFI was assessed in terms of its ability to identify conductive conditions in neonates when compared with nine different reference standards (including four single tests [AABR, HFT, TEOAE, and DPOAE] and five test batteries [HFT + DPOAE, HFT + TEOAE, DPOAE + TEOAE, DPOAE + AABR, and TEOAE + AABR]), using receiver operating characteristic (ROC) analysis and traditional test performance measures such as sensitivity and specificity. The test performance of SFI against the test battery reference standard of HFT + DPOAE and single reference standard of HFT was high with an area under the ROC curve (AROC) of 0.87 and 0.82, respectively. Although the HFT + DPOAE test battery reference standard performed better than the HFT reference standard in predicting middle ear conductive conditions in neonates, the difference in AROC was not significant. Further analysis revealed that the highest sensitivity and specificity for SFI (86% and 88%, respectively) was obtained when compared with the reference standard of HFT + DPOAE. Among the four single reference standards, SFI had the highest sensitivity and specificity (76% and 88%, respectively) when compared against the HFT reference standard. The high test performance of SFI against the HFT and HFT + DPOAE reference standards indicates that the SFI measure has appropriate diagnostic accuracy in detection of conductive conditions in newborns. Hence, the SFI test could be used as adjunct tool to identify conductive conditions in universal newborn hearing screening programs, and can also be used in diagnostic follow-up assessments. American Academy of Audiology

  10. Collaborative derivation of reference intervals for major clinical laboratory tests in Japan.

    PubMed

    Ichihara, Kiyoshi; Yomamoto, Yoshikazu; Hotta, Taeko; Hosogaya, Shigemi; Miyachi, Hayato; Itoh, Yoshihisa; Ishibashi, Midori; Kang, Dongchon

    2016-05-01

    Three multicentre studies of reference intervals were conducted recently in Japan. The Committee on Common Reference Intervals of the Japan Society of Clinical Chemistry sought to establish common reference intervals for 40 laboratory tests which were measured in common in the three studies and regarded as well harmonized in Japan. The study protocols were comparable with recruitment mostly from hospital workers with body mass index ≤28 and no medications. Age and sex distributions were made equal to obtain a final data size of 6345 individuals. Between-subgroup differences were expressed as the SD ratio (between-subgroup SD divided by SD representing the reference interval). Between-study differences were all within acceptable levels, and thus the three datasets were merged. By adopting SD ratio ≥0.50 as a guide, sex-specific reference intervals were necessary for 12 assays. Age-specific reference intervals for females partitioned at age 45 were required for five analytes. The reference intervals derived by the parametric method resulted in appreciable narrowing of the ranges by applying the latent abnormal values exclusion method in 10 items which were closely associated with prevalent disorders among healthy individuals. Sex- and age-related profiles of reference values, derived from individuals with no abnormal results in major tests, showed peculiar patterns specific to each analyte. Common reference intervals for nationwide use were developed for 40 major tests, based on three multicentre studies by advanced statistical methods. Sex- and age-related profiles of reference values are of great relevance not only for interpreting test results, but for applying clinical decision limits specified in various clinical guidelines. © The Author(s) 2015.

  11. Development and Characterization of Reference Materials for Genetic Testing: Focus on Public Partnerships.

    PubMed

    Kalman, Lisa V; Datta, Vivekananda; Williams, Mickey; Zook, Justin M; Salit, Marc L; Han, Jin Yeong

    2016-11-01

    Characterized reference materials (RMs) are needed for clinical laboratory test development and validation, quality control procedures, and proficiency testing to assure their quality. In this article, we review the development and characterization of RMs for clinical molecular genetic tests. We describe various types of RMs and how to access and utilize them, especially focusing on the Genetic Testing Reference Materials Coordination Program (Get-RM) and the Genome in a Bottle (GIAB) Consortium. This review also reinforces the need for collaborative efforts in the clinical genetic testing community to develop additional RMs.

  12. Impact of reference change value (RCV) based autoverification on turnaround time and physician satisfaction

    PubMed Central

    Fernández-Grande, Esther; Valera-Rodriguez, Carolina; Sáenz-Mateos, Luis; Sastre-Gómez, Amparo; García-Chico, Pilar; Palomino-Muñoz, Teodoro J.

    2017-01-01

    Background For a quicker delivery of laboratory test results to the hospital emergency department (ED), we implemented an autoverification system based on the reference change value (RCV). The aim of this study was to assess how the RCV based autoverification reflected on turnaround time (TAT) and on physician satisfaction. Materials and methods The laboratory information system (LIS) was programmed to autoverify the results as long as they were within the range settled by RCV, so that the autoverified results were reported to the physician as soon as the tests were carried out, without any further intervention. We analyzed the same three-month periods’ TAT and verification time (VFT) from the years prior to and following the implementation of RCV autoverification. The change in physicians’ satisfaction levels was assessed using the hospital’s Annual Physician Satisfaction Survey (APSS). Over sixty percent of physicians completed the questionnaire, and the amount of daily ED test requests (nearly three hundred) did not vary throughout the duration of this study. Results Mann-Whitney U test showed that the VFT was significantly reduced in all the test but troponin I. There were substantial reductions in TAT medians (haemogram, 75%; fibrinogen, 41%; prothrombin time, 40%; sodium, 27%). The percentage of physicians satisfied with the haematological and biochemical tests´ TAT increased from 84% to 93% and from 86% to 91% respectively. Conclusions Our results reveal that VFT and TAT were severely reduced in most emergency tests, greatly improving physicians’ satisfaction with TAT. PMID:28694725

  13. Radiant Temperature Nulling Radiometer

    NASA Technical Reports Server (NTRS)

    Ryan, Robert (Inventor)

    2003-01-01

    A self-calibrating nulling radiometer for non-contact temperature measurement of an object, such as a body of water, employs a black body source as a temperature reference, an optomechanical mechanism, e.g., a chopper, to switch back and forth between measuring the temperature of the black body source and that of a test source, and an infrared detection technique. The radiometer functions by measuring radiance of both the test and the reference black body sources; adjusting the temperature of the reference black body so that its radiance is equivalent to the test source; and, measuring the temperature of the reference black body at this point using a precision contact-type temperature sensor, to determine the radiative temperature of the test source. The radiation from both sources is detected by an infrared detector that converts the detected radiation to an electrical signal that is fed with a chopper reference signal to an error signal generator, such as a synchronous detector, that creates a precision rectified signal that is approximately proportional to the difference between the temperature of the reference black body and that of the test infrared source. This error signal is then used in a feedback loop to adjust the reference black body temperature until it equals that of the test source, at which point the error signal is nulled to zero. The chopper mechanism operates at one or more Hertz allowing minimization of l/f noise. It also provides pure chopping between the black body and the test source and allows continuous measurements.

  14. 40 CFR 160.105 - Test, control, and reference substance characterization.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... concomitantly according to written standard operating procedures, which provide for periodic analysis of each...) PESTICIDE PROGRAMS GOOD LABORATORY PRACTICE STANDARDS Test, Control, and Reference Substances § 160.105 Test...

  15. 40 CFR 160.105 - Test, control, and reference substance characterization.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... concomitantly according to written standard operating procedures, which provide for periodic analysis of each...) PESTICIDE PROGRAMS GOOD LABORATORY PRACTICE STANDARDS Test, Control, and Reference Substances § 160.105 Test...

  16. 40 CFR 160.105 - Test, control, and reference substance characterization.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... concomitantly according to written standard operating procedures, which provide for periodic analysis of each...) PESTICIDE PROGRAMS GOOD LABORATORY PRACTICE STANDARDS Test, Control, and Reference Substances § 160.105 Test...

  17. 40 CFR 160.105 - Test, control, and reference substance characterization.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... concomitantly according to written standard operating procedures, which provide for periodic analysis of each...) PESTICIDE PROGRAMS GOOD LABORATORY PRACTICE STANDARDS Test, Control, and Reference Substances § 160.105 Test...

  18. 40 CFR 160.105 - Test, control, and reference substance characterization.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... concomitantly according to written standard operating procedures, which provide for periodic analysis of each...) PESTICIDE PROGRAMS GOOD LABORATORY PRACTICE STANDARDS Test, Control, and Reference Substances § 160.105 Test...

  19. Rabies vaccine standards: comparison of the 5th and 6th WHO international reference standards to the USDA veterinary reference standard.

    PubMed

    Hermann, J; Fry, A; Reising, M; Patterson, P; Siev, D; Gatewood, D

    2012-11-06

    Ensuring rabies vaccines are potent and effective is paramount in preventing transmission of this deadly disease and safeguarding public health. Efficacy of human and veterinary vaccines is ensured by evaluating relative potency estimates of the vaccine compared to a rabies reference standard using the National Institutes of Health (NIH) test. Reference vaccines are based on the International Standard for Rabies Vaccine provided by the World Health Organization (WHO). A comparison study was conducted to determine the relative potency of the 5th WHO, 6th WHO, and United States Department of Agriculture's (USDA) 08-14 reference standards using the NIH test. Results from the study demonstrate that the 6th WHO reference standard is approximately twice as potent as the 5th WHO reference when reconstituted to contain 1 IU per ml. Based on these results, the Center for Veterinary Biologics (CVB) doubled the reconstitution volume of USDA veterinary reference 08-14 from 13 ml to 26 ml, for an initial use dilution of 0.7 IU per ml for use by veterinary biologics manufacturers in the NIH test. This study emphasizes the importance of reference standard calibration for use in the National Institutes of Health test. Published by Elsevier Ltd.

  20. Age- and sex-specific reference values of a test of neck muscle endurance.

    PubMed

    Peolsson, Anneli; Almkvist, Cecilia; Dahlberg, Camilla; Lindqvist, Sara; Pettersson, Susanne

    2007-01-01

    This study evaluates age- and sex-specific reference values for neck muscle endurance (NME). In this cross-sectional study, 116 randomly selected, healthy volunteers (ages 25-64 years) stratified according to age and gender participated. Dorsal and ventral NME was measured in seconds until exhaustion in a laying-down position. A weight of 4 kg for men or 2 kg for women was used in the dorsal procedure. The ventral procedure was performed without external load. Background and physical activity data were obtained and used in the analysis of NME performance. Mean values for dorsal and ventral NME were about 7 and 2.5 minutes for men and 8.5 and 0.5 minutes for women, respectively. The cutoff values for subnormal dorsal and ventral NME were 157 and 56 seconds for men and 173 and 23 seconds for women, respectively. Women's NME was 122% of men's NME in the dorsal (P = .17) and 24% of men's NME in the ventral (P < .0001) procedure. There were no significant differences among age groups. In multiple regression analysis, physical activity explained 4% of variability in the performance of the dorsal NME; and sex explained 37% of the variability in the performance of ventral NME. The reference values and the cutoff points obtained could be used in clinical practice to identify patients with a subnormal NME. Sex is an important consideration when using both the test procedure and the reference values.

  1. [Troubleshooting of bioinequivalence of compound valsartan tablets].

    PubMed

    Shao, Da; Zhang, Yi-Fan; Zhan, Yan; Chen, Xiao-Yan; Zhong, Da-Fang

    2014-04-01

    The study aims to evaluate the bioequivalence of valsartan hydrochlorothiazide tablets, and to investigate the potential cause of bioinequivalence. This was a single-center study with an open, randomized double-way crossover design. Test and reference preparations containing 160 mg of valsartan and 25 mg of hydrochlorothiazide were given to 36 healthy male volunteers. Plasma concentrations of valsartan and hydrochlorothiazide were determined simultaneously by LC-MS/MS. The pharmacokinetic parameters and relative bioavailability were calculated, while the bioequivalence between test and reference preparations were evaluated. The dissolution profiles of test and reference preparations in four different mediums were determined via dissolution test and HPLC. The similarity was investigated according to the similarity factors (f2). The F(o-t) and F(0-infinity) were (139.4 +/- 65.2)% and (137.5 +/- 61.2)% for valsartan of test preparations. It led to get the conclusion that test and reference preparations were not bioequivalent for valsartan. A significant difference was observed between test and reference tablets in the valsartan dissolution test of pH 1.2 hydrochloric acid solution. The key factor of the bioinequivalence might be that dissolution of valsartan in acid medium has marked difference between two preparations.

  2. Laboratory and Field Evaluation of a New Rapid Test for Detecting Wuchereria bancrofti Antigen in Human Blood

    PubMed Central

    Weil, Gary J.; Curtis, Kurt C.; Fakoli, Lawrence; Fischer, Kerstin; Gankpala, Lincoln; Lammie, Patrick J.; Majewski, Andrew C.; Pelletreau, Sonia; Won, Kimberly Y.; Bolay, Fatorma K.; Fischer, Peter U.

    2013-01-01

    Global Program to Eliminate Lymphatic Filariasis (GPELF) guidelines call for using filarial antigen testing to identify endemic areas that require mass drug administration (MDA) and for post-MDA surveillance. We compared a new filarial antigen test (the Alere Filariasis Test Strip) with the reference BinaxNOW Filariasis card test that has been used by the GPELF for more than 10 years. Laboratory testing of 227 archived serum or plasma samples showed that the two tests had similar high rates of sensitivity and specificity and > 99% agreement. However, the test strip detected 26.5% more people with filarial antigenemia (124/503 versus 98/503) and had better test result stability than the card test in a field study conducted in a filariasis-endemic area in Liberia. Based on its increased sensitivity and other practical advantages, we believe that the test strip represents a major step forward that will be welcomed by the GPELF and the filariasis research community. PMID:23690552

  3. Denied pregnancy.

    PubMed

    Kaplan, R; Grotowski, T

    1996-12-01

    To review the literature on the topic of denied pregnancy and present a case study that illustrates some salient points. A 21-year-old woman was unaware of her pregnancy until she went into labour, at which time she went into a state of panic. She delivered a dead baby. She was interviewed over the 5 days following delivery and referred for psychiatric assessment. She was discharged when cleared of serious psychiatric illness. At follow-up she was well but haunted by recollections of the delivery. She was referred for further counselling. Denial of pregnancy is more common than realised. It is a heterogeneous condition associated with different coping styles and psychiatric diagnoses. Early testing for pregnancy is recommended in young women with nausea, weight gain and menstruation-like bleeding.

  4. Pharmacokinetics and bioequivalence study of a fixed dose combination of rabeprazole and itopride in healthy Indian volunteers.

    PubMed

    Sahoo, Bijay Kumar; Das, Ayan; Agarwal, Sangita; Bhaumik, Uttam; Bose, Anirbandeep; Ghosh, Debotri; Roy, Bikash; Pal, Tapan Kumar

    2009-01-01

    The aim of the present study was to compare the pharmacokinetics of rabeprazole (CAS 117976-89-3) and itopride (CAS 122898-67-3) after oral administration of a rabeprazole (20 mg)-itopride (150 mg) fixed dose combination (FDC) in healthy human volunteers. The bioequivalence of two formulations (test and reference) was determined in 12 healthy Indian male volunteers (age: 25.25 +/- 4.69 years; weight: 60.50 +/- 5.04 kg) in a randomized, single-dose, two-period, two-treatment crossover study. Both formulations were administered orally as a single dose, with the treatments separated by a washout period of 1 week. Rabeprazole and itopride plasma levels were determined by a validated HPLC method using UV detection. The formulations were compared using the pharmacokinetic parameters area under the plasma concentration-time curve (AUC(0-t)), area under the plasma concentration-time curve from zero to infinity (AUC(0-infinity)) and peak plasma concentration (Cmax). General linear model (GLM) procedures were used in which sources of variation were subject, treatment and period. The results indicated that there were no statistically significant differences (P > 0.05) between the logarithmically transformed AUC(0-infinity) and Cmax values between test and reference formulation. The 90% confidence interval for the ratio of the logarithmically transformed AUC(0-t), AUC(0-infinity) and Cmax were within the bioequivalence limits of 0.8-1.25 and the relative bioavailability of rabeprazole and itopride test and reference formulations was 98.24 and 93.65%, respectively.

  5. Reference standards to assess physical fitness of children and adolescents of Brazil: an approach to the students of the Lake Itaipú region—Brazil

    PubMed Central

    Hobold, Edilson; Pires-Lopes, Vitor; Gómez-Campos, Rossana; de Arruda, Miguel; Andruske, Cynthia Lee; Pacheco-Carrillo, Jaime

    2017-01-01

    Background The importance of assessing body fat variables and physical fitness tests plays an important role in monitoring the level of activity and physical fitness of the general population. The objective of this study was to develop reference norms to evaluate the physical fitness aptitudes of children and adolescents based on age and sex from the lake region of Itaipú, Brazil. Methods A descriptive cross-sectional study was carried out with 5,962 students (2,938 males and 3,024 females) with an age range of 6.0 and 17.9 years. Weight (kg), height (cm), and triceps (mm), and sub-scapular skinfolds (mm) were measured. Body Mass Index (BMI kg/m2) was calculated. To evaluate the four physical fitness aptitude dimensions (morphological, muscular strength, flexibility, and cardio-respiratory), the following physical education tests were given to the students: sit-and-reach (cm), push-ups (rep), standing long jump (cm), and 20-m shuttle run (m). Results and Discussion Females showed greater flexibility in the sit-and-reach test and greater body fat than the males. No differences were found in BMI. Percentiles were created for the four components for the physical fitness aptitudes, BMI, and skinfolds by using the LMS method based on age and sex. The proposed reference values may be used for detecting talents and promoting health in children and adolescents. PMID:29204319

  6. Implementing rapid HIV testing in outreach and community settings: results from an advancing HIV prevention demonstration project conducted in seven U.S. cities.

    PubMed

    Bowles, Kristina E; Clark, Hollie A; Tai, Eric; Sullivan, Patrick S; Song, Binwei; Tsang, Jenny; Dietz, Craig A; Mir, Julita; Mares-DelGrasso, Azul; Calhoun, Cindy; Aguirre, Daisy; Emerson, Cicily; Heffelfinger, James D

    2008-01-01

    The goals of this project were to assess the feasibility of conducting rapid human immunodeficiency virus (HIV) testing in outreach and community settings to increase knowledge of HIV serostatus among groups disproportionately affected by HIV and to identify effective nonclinical venues for recruiting people in the targeted populations. Community-based organizations (CBOs) in seven U.S. cities conducted rapid HIV testing in outreach and community settings, including public parks, homeless shelters, and bars. People with reactive preliminary positive test results received confirmatory testing, and people confirmed to be HIV-positive were referred to health-care and prevention services. A total of 23,900 people received rapid HIV testing. Of the 267 people (1.1%) with newly diagnosed HIV infection, 75% received their confirmatory test results and 64% were referred to care. Seventy-six percent were from racial/ethnic minority groups, and 58% identified themselves as men who have sex with men, 72% of whom reported having multiple sex partners in the past year. Venues with the highest proportion of new HIV diagnoses were bathhouses, social service organizations, and needle-exchange programs. The acceptance rate for testing was 60% among sites collecting this information. Findings from this demonstration project indicate that offering rapid HIV testing in outreach and community settings is a feasible approach for reaching members of minority groups and people at high risk for HIV infection. The project identified venues that would be important to target and offered lessons that could be used by other CBOs to design and implement similar programs in the future.

  7. Long term trends of fish after liming of Swedish streams and lakes

    NASA Astrophysics Data System (ADS)

    Holmgren, Kerstin; Degerman, Erik; Petersson, Erik; Bergquist, Björn

    2016-12-01

    Thousands of Swedish acidified lakes and streams have been regularly limed for about 30 years. Standard sampling of fish assemblages in lakes and streams was an important part of monitoring the trends after liming, i.e. sampling with multi-mesh gillnets in lakes (EN 14757) and electrofishing in streams (EN 14011). Monitoring data are nationally managed, in the National Register of Survey test-fishing and the Swedish Electrofishing Register. We evaluated long-term data from 1029 electrofishing sites in limed streams and gillnet sampling in 750 limed lakes, along with reference data from 195 stream sites and 101 lakes with no upstream liming in their catchments. The median year of first liming was 1986 for both streams and lakes. The proportion of limed stream sites with no fish clearly decreased with time, mean species richness and proportion of sites with brown trout (Salmo trutta) recruits increased. There were no consistent trends in fish occurrence or species richness at non-limed sites, but occurrence of brown trout recruits also increased in acid as well as neutral reference streams. Abundance of brown trout, perch (Perca fluviatilis) and roach (Rutilus rutilus) increased significantly more at limed sites than at non-limed reference sites sampled before and after 1986. The mean species richness did not change consistently in limed lakes, but decreased in low alkalinity reference lakes, and fish abundance decreased significantly in limed as well as in non-limed lakes.

  8. Data Link Test and Analysis System/ATCRBS Transponder Test System Technical Reference

    DOT National Transportation Integrated Search

    1990-05-01

    This document references material for personnel using or making software changes : to the Data Link Test and Analysis System (DATAS) for Air Traffic Control Radar : Beacon System (ATCRBS) transponder testing and data collection. This is one of : a se...

  9. Analysis of the Local Lymph Node Assay (LLNA) variability for assessing the prediction of skin sensitisation potential and potency of chemicals with non-animal approaches.

    PubMed

    Dumont, Coralie; Barroso, João; Matys, Izabela; Worth, Andrew; Casati, Silvia

    2016-08-01

    The knowledge of the biological mechanisms leading to the induction of skin sensitisation has favoured in recent years the development of alternative non-animal methods. During the formal validation process, results from the Local Lymph Node Assay (LLNA) are generally used as reference data to assess the predictive capacity of the non-animal tests. This study reports an analysis of the variability of the LLNA for a set of chemicals for which multiple studies are available and considers three hazard classification schemes: POS/NEG, GHS/CLP and ECETOC. As the type of vehicle used in a LLNA study is known to influence to some extent the results, two analyses were performed: considering the solvent used to test the chemicals and without considering the solvent. The results show that the number of discordant classifications increases when a chemical is tested in more than one solvent. Moreover, it can be concluded that study results leading to classification in the strongest classes (1A and EXT) seem to be more reliable than those in the weakest classes. This study highlights the importance of considering the variability of the reference data when evaluating non-animal tests. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. The magic shrinking machine revisited: The presence of props at recall facilitates memory in 3-year-olds.

    PubMed

    Dahl, Jonna J; Kingo, Osman S; Krøjgaard, Peter

    2015-12-01

    In a seminal study Simcock and Hayne (2002) showed that 3-year-olds were unable to use newly acquired words to describe a "magic" event experienced 6 or 12 months earlier. In the reference study the children's verbal recall was tested without props being present. Inspired by recent evidence, the original design was replicated, testing 33-and 39-month-olds (n = 180), but with props present at recall while controlling for potential online reasoning. The results revealed that the children did use newly acquired words to describe their preverbal memory. Thus, the present study shows that nonverbal memories can be verbalized if the recall setting provides a high level of contextual support, a finding relevant to researchers investigating the offset of childhood amnesia. (c) 2015 APA, all rights reserved).

  11. A case of hyper-reactive malarial splenomegaly. The role of rapid antigen-detecting and PCR-based tests.

    PubMed

    Mothe, B; Lopez-Contreras, J; Torres, O H; Muñoz, C; Domingo, P; Gurgui, M

    2008-03-01

    Hyper-reactive malarial splenomegaly (HMS) - originally referred to as tropical splenomegaly syndrome - is characterized by a massive splenomegaly, high titres of anti-malarial antibodies and polyclonal IgM hypergammaglobulinemia. It is believed to be a consequence of an aberrant immunological response to prolonged exposure to malarial parasites. Although it is a frequent disease in the tropics, it is infrequent in western countries and is only seen in long-term residents from endemic areas. We describe the case of a 67-year-old Spanish man, a missionary in Cameroon for 30 years, who presented with a clinical history that fulfilled the diagnosis of HMS. We discuss the role and importance of PCR-based techniques in demonstrating lowgrade malarial parasitemia and the usefulness of new rapid antigen-detecting dipstick tests.

  12. [Benign ethnic neutropenia; an unrecognised cause of leukopenia in negroid patients].

    PubMed

    van Rooijen, Cleo R; Slieker, Walentina A T; Simsek, Suat

    2012-01-01

    Leukopenia has a high incidence and is usually a reason for additional testing. Benign ethnic neutropenia is a relatively common cause of neutropenia in the negroid population. It can be the cause of aberrant laboratory results in negroid patients. A 55-year-old woman from Ghana was referred to the outpatient clinic because of malaise, leukopenia and neutropenia. Viral infection, haematological malignancy, auto-immune disease and vitamin deficiency were considered, but could not be confirmed by additional testing. Upon further investigation, the neutropenia in this patient was found to have existed for years. Moreover, our patient's son also had asymptomatic leukopenia. Therefore, benign ethnic neutropenia was considered the most likely diagnosis. Serological analysis of the patient's erythrocytes revealed the absence of Duffy (Fy) blood group antigens Fy(a) and Fy(b), which is associated with benign ethnic neutropenia.

  13. Advanced Turbine Technology Applications Project (ATTAP)

    NASA Technical Reports Server (NTRS)

    1989-01-01

    ATTAP activities during the past year were highlighted by an extensive materials assessment, execution of a reference powertrain design, test-bed engine design and development, ceramic component design, materials and component characterization, ceramic component process development and fabrication, component rig design and fabrication, test-bed engine fabrication, and hot gasifier rig and engine testing. Materials assessment activities entailed engine environment evaluation of domestically supplied radial gasifier turbine rotors that were available at the conclusion of the Advanced Gas Turbine (AGT) Technology Development Project as well as an extensive survey of both domestic and foreign ceramic suppliers and Government laboratories performing ceramic materials research applicable to advanced heat engines. A reference powertrain design was executed to reflect the selection of the AGT-5 as the ceramic component test-bed engine for the ATTAP. Test-bed engine development activity focused on upgrading the AGT-5 from a 1038 C (1900 F) metal engine to a durable 1371 C (2500 F) structural ceramic component test-bed engine. Ceramic component design activities included the combustor, gasifier turbine static structure, and gasifier turbine rotor. The materials and component characterization efforts have included the testing and evaluation of several candidate ceramic materials and components being developed for use in the ATTAP. Ceramic component process development and fabrication activities were initiated for the gasifier turbine rotor, gasifier turbine vanes, gasifier turbine scroll, extruded regenerator disks, and thermal insulation. Component rig development activities included combustor, hot gasifier, and regenerator rigs. Test-bed engine fabrication activities consisted of the fabrication of an all-new AGT-5 durability test-bed engine and support of all engine test activities through instrumentation/build/repair. Hot gasifier rig and test-bed engine testing activities were performed.

  14. Identifying Significant Changes in Cerebrovascular Reactivity to Carbon Dioxide.

    PubMed

    Sobczyk, O; Crawley, A P; Poublanc, J; Sam, K; Mandell, D M; Mikulis, D J; Duffin, J; Fisher, J A

    2016-05-01

    Changes in cerebrovascular reactivity can be used to assess disease progression and response to therapy but require discrimination of pathology from normal test-to-test variability. Such variability is due to variations in methodology, technology, and physiology with time. With uniform test conditions, our aim was to determine the test-to-test variability of cerebrovascular reactivity in healthy subjects and in patients with known cerebrovascular disease. Cerebrovascular reactivity was the ratio of the blood oxygen level-dependent MR imaging response divided by the change in carbon dioxide stimulus. Two standardized cerebrovascular reactivity tests were conducted at 3T in 15 healthy men (36.7 ± 16.1 years of age) within a 4-month period and were coregistered into standard space to yield voxelwise mean cerebrovascular reactivity interval difference measures, composing a reference interval difference atlas. Cerebrovascular reactivity interval difference maps were prepared for 11 male patients. For each patient, the test-retest difference of each voxel was scored statistically as z-values of the corresponding voxel mean difference in the reference atlas and then color-coded and superimposed on the anatomic images to create cerebrovascular reactivity interval difference z-maps. There were no significant test-to-test differences in cerebrovascular reactivity in either gray or white matter (mean gray matter, P = .431; mean white matter, P = .857; paired t test) in the healthy cohort. The patient cerebrovascular reactivity interval difference z-maps indicated regions where cerebrovascular reactivity increased or decreased and the probability that the changes were significant. Accounting for normal test-to-test differences in cerebrovascular reactivity enables the assessment of significant changes in disease status (stability, progression, or regression) in patients with time. © 2016 by American Journal of Neuroradiology.

  15. An integrated model of academic self-concept development: Academic self-concept, grades, test scores, and tracking over 6 years.

    PubMed

    Marsh, Herbert W; Pekrun, Reinhard; Murayama, Kou; Arens, A Katrin; Parker, Philip D; Guo, Jiesi; Dicke, Theresa

    2018-02-01

    Our newly proposed integrated academic self-concept model integrates 3 major theories of academic self-concept formation and developmental perspectives into a unified conceptual and methodological framework. Relations among math self-concept (MSC), school grades, test scores, and school-level contextual effects over 6 years, from the end of primary school through the first 5 years of secondary school (a representative sample of 3,370 German students, 42 secondary schools, 50% male, M age at grade 5 = 11.75) support the (1) internal/external frame of reference model: Math school grades had positive effects on MSC, but the effects of German grades were negative; (2) reciprocal effects (longitudinal panel) model: MSC was predictive of and predicted by math test scores and school grades; (3) big-fish-little-pond effect: The effects on MSC were negative for school-average achievement based on 4 indicators (primary school grades in math and German, school-track prior to the start of secondary school, math test scores in the first year of secondary school). Results for all 3 theoretical models were consistent across the 5 secondary school years: This supports the prediction of developmental equilibrium. This integration highlights the robustness of support over the potentially volatile early to middle adolescent period; the interconnectedness and complementarity of 3 ASC models; their counterbalancing strengths and weaknesses; and new theoretical, developmental, and substantive implications at their intersections. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  16. Diagnostic accuracy research in glaucoma is still incompletely reported: An application of Standards for Reporting of Diagnostic Accuracy Studies (STARD) 2015.

    PubMed

    Michelessi, Manuele; Lucenteforte, Ersilia; Miele, Alba; Oddone, Francesco; Crescioli, Giada; Fameli, Valeria; Korevaar, Daniël A; Virgili, Gianni

    2017-01-01

    Research has shown a modest adherence of diagnostic test accuracy (DTA) studies in glaucoma to the Standards for Reporting of Diagnostic Accuracy Studies (STARD). We have applied the updated 30-item STARD 2015 checklist to a set of studies included in a Cochrane DTA systematic review of imaging tools for diagnosing manifest glaucoma. Three pairs of reviewers, including one senior reviewer who assessed all studies, independently checked the adherence of each study to STARD 2015. Adherence was analyzed on an individual-item basis. Logistic regression was used to evaluate the effect of publication year and impact factor on adherence. We included 106 DTA studies, published between 2003-2014 in journals with a median impact factor of 2.6. Overall adherence was 54.1% for 3,286 individual rating across 31 items, with a mean of 16.8 (SD: 3.1; range 8-23) items per study. Large variability in adherence to reporting standards was detected across individual STARD 2015 items, ranging from 0 to 100%. Nine items (1: identification as diagnostic accuracy study in title/abstract; 6: eligibility criteria; 10: index test (a) and reference standard (b) definition; 12: cut-off definitions for index test (a) and reference standard (b); 14: estimation of diagnostic accuracy measures; 21a: severity spectrum of diseased; 23: cross-tabulation of the index and reference standard results) were adequately reported in more than 90% of the studies. Conversely, 10 items (3: scientific and clinical background of the index test; 11: rationale for the reference standard; 13b: blinding of index test results; 17: analyses of variability; 18; sample size calculation; 19: study flow diagram; 20: baseline characteristics of participants; 28: registration number and registry; 29: availability of study protocol; 30: sources of funding) were adequately reported in less than 30% of the studies. Only four items showed a statistically significant improvement over time: missing data (16), baseline characteristics of participants (20), estimates of diagnostic accuracy (24) and sources of funding (30). Adherence to STARD 2015 among DTA studies in glaucoma research is incomplete, and only modestly increasing over time.

  17. Reference values for fatigued versus non-fatigued limb symmetry index measured by a newly designed single-leg hop test battery in healthy subjects: a pilot study.

    PubMed

    Leister, Iris; Mattiassich, Georg; Kindermann, Harald; Ortmaier, Reinhold; Barthofer, Jürgen; Vasvary, Imre; Katzensteiner, Klaus; Stelzhammer, Christine; Kulnik, Stefan Tino

    2018-01-01

    There is sparse evidence for return to sport criteria after knee injury. Functional performance deficits, particularly in fatigued muscular condition, should be verified prior to the attempt to return to high-risk pivoting sports. The purpose of this study was to generate reference values for the limb symmetry index (LSI) of healthy subjects in fatigued and non-fatigued muscular condition in a newly designed test battery. Forty-two healthy subjects [22 females, 20 males; mean (SD) age 30.4 (6.6) years] were evaluated using a test battery consisting of an isometric strength test, a series of five single-leg hop tests and an integrated fatigue protocol. Subjective physical activity was assessed with the Tegner Activity Scale (TAS). The cut-off values for healthy subjects were calculated considering the fifth percentile as the minimum reference value for the LSI and single-leg hop distance. The mean (SD) overall LSI was 98.8% (4.6). No significant gender or age specific differences in limb symmetry were observed. The comparison of the non-fatigued LSI with the overall LSI revealed no clinically relevant change due to muscular fatigue. Repeated measures ANOVA revealed a significant within effect on fatigue/non-fatigue condition ( F (1,38)  = 18.000; p  < 0.001, η 2  = 0.321) on absolute single-leg hop distance. Moreover, a significant between effect on the TAS-parameter ( F (1,38)  = 5.928; p  = 0.020, η 2  = 0.135 between: TAS ≤ 5/TAS > 5) and on gender ( F (1,38)  = 23.956; p  < 0.001, η 2  = 0.387) could be detected. The absolute jumping distance in the single-leg hop for distance was significantly reduced due to fatigue. No clinically relevant effect of muscular fatigue was observed on limb symmetry in our study sample. Gender and physical activity are important factors to be considered when interpreting reference values.

  18. Comparison of different commercial ELISAs for detection of antibodies against porcine respiratory and reproductive syndrome virus in serum.

    PubMed

    Sattler, Tatjana; Wodak, Eveline; Revilla-Fernández, Sandra; Schmoll, Friedrich

    2014-12-18

    In recent years, several new ELISAs for the detection of antibodies against the porcine reproductive and respiratory disease virus (PRRSV) in pig serum have been developed. To interpret the results, specificity and sensitivity data as well as agreement to a reference ELISA must be available. In this study, three commercial ELISAs (INgezim PRRS 2.0 - ELISA II, Priocheck® PRRSV Ab porcine - ELISA III and CIVTEST suis PRRS E/S PLUS - ELISA IV, detecting PRRSV type 1 antibodies) were compared to a standard ELISA (IDEXX PRRS X3 Ab Test - ELISA I). The serum of three pigs vaccinated with an attenuated PRRSV live vaccine (genotype 2) was tested prior to and several times after the vaccination. Furthermore, serum samples of 245 pigs of PRRSV positive herds, 309 pigs of monitored PRRSV negative herds, 256 fatteners of assumed PRRSV negative herds with unknown herd history and 92 wild boars were tested with all four ELISAs. ELISAs II and III were able to detect seroconversion of vaccinated pigs with a similar reliability. According to kappa coefficient, the results showed an almost perfect agreement between ELISA I as reference and ELISA II and III (kappa > 0.8), and substantial agreement between ELISA I and ELISA IV (kappa = 0.71). Sensitivity of ELISA II, III and IV was 96.0%, 100% and 91.5%, respectively. The specificity of the ELISAs determined in samples of monitored PRRSV negative herds was 99.0%, 95.1% and 96.4%, respectively. In assumed negative farms that were not continually monitored, more positive samples were found with ELISA II to IV. The reference ELISA I had a specificity of 100% in this study. All tested ELISAs were able to detect a PRRSV positive herd. The specificity and sensitivity of the tested commercial ELISAs, however, differed. ELISA II had the highest specificity and ELISA III had the highest sensitivity in comparison to the reference ELISA. ELISA IV had a lower sensitivity and specificity than the other ELISAs.

  19. A novel expert system for objective masticatory efficiency assessment

    PubMed Central

    2018-01-01

    Most of the tools and diagnosis models of Masticatory Efficiency (ME) are not well documented or severely limited to simple image processing approaches. This study presents a novel expert system for ME assessment based on automatic recognition of mixture patterns of masticated two-coloured chewing gums using a combination of computational intelligence and image processing techniques. The hypotheses tested were that the proposed system could accurately relate specimens to the number of chewing cycles, and that it could identify differences between the mixture patterns of edentulous individuals prior and after complete denture treatment. This study enrolled 80 fully-dentate adults (41 females and 39 males, 25 ± 5 years of age) as the reference population; and 40 edentulous adults (21 females and 19 males, 72 ± 8.9 years of age) for the testing group. The system was calibrated using the features extracted from 400 samples covering 0, 10, 15, and 20 chewing cycles. The calibrated system was used to automatically analyse and classify a set of 160 specimens retrieved from individuals in the testing group in two appointments. The ME was then computed as the predicted number of chewing strokes that a healthy reference individual would need to achieve a similar degree of mixture measured against the real number of cycles applied to the specimen. The trained classifier obtained a Mathews Correlation Coefficient score of 0.97. ME measurements showed almost perfect agreement considering pre- and post-treatment appointments separately (κ ≥ 0.95). Wilcoxon signed-rank test showed that a complete denture treatment for edentulous patients elicited a statistically significant increase in the ME measurements (Z = -2.31, p < 0.01). We conclude that the proposed expert system proved able and reliable to accurately identify patterns in mixture and provided useful ME measurements. PMID:29385165

  20. Implementation and Operational Research: Strengthening HIV Test Access and Treatment Uptake Study (Project STATUS): A Randomized Trial of HIV Testing and Counseling Interventions.

    PubMed

    McNaghten, A D; Schilsky Mneimneh, Allison; Farirai, Thato; Wamai, Nafuna; Ntiro, Marylad; Sabatier, Jennifer; Makhunga-Ramfolo, Nondumiso; Mwanasalli, Salli; Awor, Anna; Moore, Jan

    2015-12-01

    To determine which of 3 HIV testing and counseling (HTC) models in outpatient departments (OPDs) increases HIV testing and entry of newly identified HIV-infected patients into care. Randomized trial of HTC interventions. Thirty-six OPDs in South Africa, Tanzania, and Uganda were randomly assigned to 3 different HTC models: (A) health care providers referred eligible patients (aged 18-49, not tested in the past year, not known HIV positive) to on-site voluntary counseling and testing for HTC offered and provided by voluntary counseling and testing counselors after clinical consultation; (B) health care providers offered and provided HTC to eligible patients during clinical consultation; and (C) nurse or lay counselors offered and provided HTC to eligible patients before clinical consultation. Data were collected from October 2011 to September 2012. We describe testing eligibility and acceptance, HIV prevalence, and referral and entry into care. Chi-square analyses were conducted to examine differences by model. Of 79,910 patients, 45% were age eligible and 16,099 (45%) age eligibles were tested. Ten percent tested HIV positive. Significant differences were found in percent tested by model. The proportion of age eligible patients tested by Project STATUS was highest for model C (54.1%, 95% confidence interval [CI]: 42.4 to 65.9), followed by model A (41.7%, 95% CI: 30.7 to 52.8), and then model B (33.9%, 95% CI: 25.7 to 42.1). Of the 1596 newly identified HIV positive patients, 94% were referred to care (96.1% in model A, 94.7% in model B, and 94.9% in model C), and 58% entered on-site care (74.4% in model A, 54.8% in model B, and 55.6% in model C) with no significant differences in referrals or care entry by model. Model C resulted in the highest proportion of all age-eligible patients receiving a test. Although 94% of STATUS patients with a positive test result were referred to care, only 58% entered care. We found no differences in patients entering care by HTC model. Routine HTC in OPDs is acceptable to patients and effective for identifying HIV-infected persons, but additional efforts are needed to increase entry to care.

  1. Diagnostic characteristics and prognoses of primary-care patients referred for clinical exercise testing: a prospective observational study.

    PubMed

    Nilsson, Gunnar; Mooe, Thomas; Stenlund, Hans; Samuelsson, Eva

    2014-04-18

    Evaluation of angina symptoms in primary care often includes clinical exercise testing. We sought to identify clinical characteristics that predicted the outcome of exercise testing and to describe the occurrence of cardiovascular events during follow-up. This study followed patients referred to exercise testing for suspected coronary disease by general practitioners in the County of Jämtland, Sweden (enrolment, 25 months from February 2010). Patient characteristics were registered by pre-test questionnaire. Exercise tests were performed with a bicycle ergometer, a 12-lead electrocardiogram, and validated scales for scoring angina symptoms. Exercise tests were classified as positive (ST-segment depression >1 mm and chest pain indicative of angina), non-conclusive (ST depression or chest pain), or negative. Odds ratios (ORs) for exercise-test outcome were calculated with a bivariate logistic model adjusted for age, sex, systolic blood pressure, and previous cardiovascular events. Cardiovascular events (unstable angina, myocardial infarctions, decisions on revascularization, cardiovascular death, and recurrent angina in primary care) were recorded within six months. A probability cut-off of 10% was used to detect cardiovascular events in relation to the predicted test outcome. We enrolled 865 patients (mean age 63.5 years, 50.6% men); 6.4% of patients had a positive test, 75.5% were negative, 16.4% were non-conclusive, and 1.7% were not assessable. Positive or non-conclusive test results were predicted by exertional chest pain (OR 2.46, 95% confidence interval (CI) 1.69-3.59), a pathologic ST-T segment on resting electrocardiogram (OR 2.29, 95% CI 1.44-3.63), angina according to the patient (OR 1.70, 95% CI 1.13-2.55), and medication for dyslipidaemia (OR 1.51, 95% CI 1.02-2.23). During follow-up, cardiovascular events occurred in 8% of all patients and 4% were referred to revascularization. Cardiovascular events occurred in 52.7%, 18.3%, and 2% of patients with positive, non-conclusive, or negative tests, respectively. The model predicted 67/69 patients with a cardiovascular event. Clinical characteristics can be used to predict exercise test outcome. Primary care patients with a negative exercise test have a very low risk of cardiovascular events, within six months. A predictive model based on clinical characteristics can be used to refine the identification of low-risk patients.

  2. Incidence and characteristics of early childhood wheezing, Dhaka, Bangladesh, 2004-2010.

    PubMed

    Dawood, Fatimah S; Fry, Alicia M; Goswami, Doli; Sharmeen, Amina; Nahar, Kamrun; Anjali, Bilkis Ara; Rahman, Mustafizur; Brooks, W Abdullah

    2016-06-01

    Early childhood wheezing substantially impacts quality of life in high-income countries, but data are sparse on early childhood wheezing in low-income countries. We estimate wheezing incidence, describe wheezing phenotypes, and explore the contribution of respiratory viral illnesses among children aged <5 years in urban Bangladesh. During 2004-2010, respiratory illness surveillance was conducted through weekly home visits. Children with fever or respiratory illness were referred for examination by study physicians including lung auscultation. During 2005-2007, every fifth referred child had nasal washes tested for human metapneumovirus, respiratory syncytial viruses, and influenza and parainfluenza viruses. During April 2004-July 2010, 23,609 children were enrolled in surveillance. Of these, 11,912 (50%) were male, median age at enrollment was 20 months (IQR 5-38), and 4,711 (20%) had ≥1 wheezing episode accounting for 8,901 episodes (733 [8%] associated with hospitalization); 25% wheezed at <1 year of age. Among children aged <5 years, incidences of wheezing and wheezing hospitalizations were 2,335/10,000 and 192/10,000 child-years. Twenty-eight percent had recurrent wheezing. Recurrent versus non-recurrent wheezing episodes were more likely to be associated with oxygen saturation <93% (OR 6.9, 95%CI 2.8-17.3), increased work of breathing (OR 1.6, 95%CI 1.4-1.8), and hospitalization (OR 2.0, 95%CI 1.6-2.4). Respiratory viruses were detected in 66% (578/873) of episodes with testing. In urban Bangladesh, early childhood wheezing is common and largely associated with respiratory virus infections. Recurrent wheezing is associated with more severe illness and may predict children who would benefit most from closer follow-up and targeted interventions. Pediatr Pulmonol. 2016;51:588-595. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  3. Performance of a Deep-Learning Neural Network Model in Assessing Skeletal Maturity on Pediatric Hand Radiographs.

    PubMed

    Larson, David B; Chen, Matthew C; Lungren, Matthew P; Halabi, Safwan S; Stence, Nicholas V; Langlotz, Curtis P

    2018-04-01

    Purpose To compare the performance of a deep-learning bone age assessment model based on hand radiographs with that of expert radiologists and that of existing automated models. Materials and Methods The institutional review board approved the study. A total of 14 036 clinical hand radiographs and corresponding reports were obtained from two children's hospitals to train and validate the model. For the first test set, composed of 200 examinations, the mean of bone age estimates from the clinical report and three additional human reviewers was used as the reference standard. Overall model performance was assessed by comparing the root mean square (RMS) and mean absolute difference (MAD) between the model estimates and the reference standard bone ages. Ninety-five percent limits of agreement were calculated in a pairwise fashion for all reviewers and the model. The RMS of a second test set composed of 913 examinations from the publicly available Digital Hand Atlas was compared with published reports of an existing automated model. Results The mean difference between bone age estimates of the model and of the reviewers was 0 years, with a mean RMS and MAD of 0.63 and 0.50 years, respectively. The estimates of the model, the clinical report, and the three reviewers were within the 95% limits of agreement. RMS for the Digital Hand Atlas data set was 0.73 years, compared with 0.61 years of a previously reported model. Conclusion A deep-learning convolutional neural network model can estimate skeletal maturity with accuracy similar to that of an expert radiologist and to that of existing automated models. © RSNA, 2017 An earlier incorrect version of this article appeared online. This article was corrected on January 19, 2018.

  4. Diffusion-controlled reference material for VOC emissions testing: proof of concept.

    PubMed

    Cox, S S; Liu, Z; Little, J C; Howard-Reed, C; Nabinger, S J; Persily, A

    2010-10-01

    Because of concerns about indoor air quality, there is growing awareness of the need to reduce the rate at which indoor materials and products emit volatile organic compounds (VOCs). To meet consumer demand for low emitting products, manufacturers are increasingly submitting materials to independent laboratories for emissions testing. However, the same product tested by different laboratories can result in very different emissions profiles because of a general lack of test validation procedures. There is a need for a reference material that can be used as a known emissions source and that will have the same emission rate when tested by different laboratories under the same conditions. A reference material was created by loading toluene into a polymethyl pentene film. A fundamental emissions model was used to predict the toluene emissions profile. Measured VOC emissions profiles using small-chamber emissions tests compared reasonably well to the emissions profile predicted using the emissions model, demonstrating the feasibility of the proposed approach to create a diffusion-controlled reference material. To calibrate emissions test chambers and improve the reproducibility of VOC emission measurements among different laboratories, a reference material has been created using a polymer film loaded with a representative VOC. Initial results show that the film's VOC emission profile measured in a conventional test chamber compares well to predictions based on independently determined material/chemical properties and a fundamental emissions model. The use of such reference materials has the potential to build consensus and confidence in emissions testing as well as 'level the playing field' for product testing laboratories and manufacturers.

  5. Results of the 1983 NASA/JPL balloon flight solar cell calibration program

    NASA Technical Reports Server (NTRS)

    Downing, R. G.; Weiss, R. S.

    1984-01-01

    The 1983 solar cell calibration balloon flight was successfully completed and met all objectives of the program. Thirty-four modules were carried to an altitude of 36.0 kilometers. The calibrated cells can now be used as reference standards in simulator testing of cells and arrays. Cell calibration data are tabulated as well as the repeatability of standard solar cell BFS-17A (35 flights over a 21-year period).

  6. Epidemiological analyses on animal parasitoses: recent activity of the I.M.I.P.P.V.

    PubMed

    Battelli, G; Capelli, G; Martini, M; Poglayen, G; Restani, R; Roda, R

    1989-01-01

    The paper presents a selected review of the epidemiological analyses performed in recent years (1984-1988) in the Institute of Malattie Infettive, Profilassi e Polizia Veterinaria of the University of Bologna on animal parasitoses, with special reference to the evaluation of some risk factors of bovine, swine and canine helminthoses, and to the validity of the coprological test for some parasites of the red fox.

  7. Foreign Comparative Testing (FCT) Program Procedures Manual

    DTIC Science & Technology

    1994-01-01

    Public Law 101-189, "National Defense Authorization Act for Fiscal Years 1990 and 1991," November 29, 1989 (e) Federal Acquisition Regulation (FAR...reference (b)) shall be met for any subsequent acquisition (assuming the T&E is successful ). f. Factors, if any, that would mandate subsequent production of...States on an urgent basis. The Commander, U.S. Army Chemical Defense Research Institute, Fort Pinkerton, AL, acting in his capacity as the User

  8. How Explicit and Implicit Test Instructions in an Implicit Learning Task Affect Performance

    PubMed Central

    Witt, Arnaud; Puspitawati, Ira; Vinter, Annie

    2013-01-01

    Typically developing children aged 5 to 8 years were exposed to artificial grammar learning. Following an implicit exposure phase, half of the participants received neutral instructions at test while the other half received instructions making a direct, explicit reference to the training phase. We first aimed to assess whether implicit learning operated in the two test conditions. We then evaluated the differential impact of age on learning performances as a function of test instructions. The results showed that performance did not vary as a function of age in the implicit instructions condition, while age effects emerged when explicit instructions were employed at test. However, performance was affected differently by age and the instructions given at test, depending on whether the implicit learning of short or long units was assessed. These results suggest that the claim that the implicit learning process is independent of age needs to be revised. PMID:23326409

  9. Analysis of semen parameters in male referrals: impact of reference limits, stratification by fertility categories, predictors of change, and comparison of normal semen parameters in subfertile couples.

    PubMed

    Baker, Karen; Li, Jianbo; Sabanegh, Edmund

    2015-01-01

    To [1] determine the impact of semen reference limits on referrals for male fertility evaluations, [2] analyze the stratification of subjects based on published "normal" thresholds, [3] analyze the odds of changing fertility categories during serial tests and thereby the potential impact of inherent variability of semen parameters on referrals, and [4] determine variable(s) predictive of change. Retrospective chart review. Academic referral center for male fertility. New encounters in a male fertility clinic over a 5-year period that straddles the publication of World Health Organization (WHO) 2010 reference values. None. Demographic and clinical variables, semen values, and fertility categories as follows: BE (below WHO 2010 criteria), BTWN (above WHO 2010 but below WHO 1999 criteria), and N (above WHO 1999 criteria). A total of 82.3% of initial semen tests were categorized as BE, and the predominance of this category was unchanged by publication of the WHO 2010 criteria. Men with initial semen analysis categorized as BTWN or N represented 16.2% and 1.5% of the referral population, respectively. Subjects initially categorized as BTWN were more likely to change fertility categories, and overwhelmingly this migration was downward. Analysis of normal individual semen parameters revealed statistically worse mean concentration and motility when at least one other parameter fell below the WHO 2010 criteria. Men with semen results above reference criteria are underrepresented, indicating that reference limits influence referral patterns for male fertility evaluations. Normal mean concentration and motility were lower in men with at least one other individual semen parameter below the 2010 criteria, suggesting global dysfunction in spermatogenesis. Published by Elsevier Inc.

  10. Evaluation of serological diagnostic tests for typhoid fever in Papua New Guinea using a composite reference standard.

    PubMed

    Siba, Valentine; Horwood, Paul F; Vanuga, Kilagi; Wapling, Johanna; Sehuko, Rebecca; Siba, Peter M; Greenhill, Andrew R

    2012-11-01

    Typhoid fever remains a major global health problem. A major impediment to improving outcomes is the lack of appropriate diagnostic tools, which have not significantly improved in low-income settings for 100 years. We evaluated two commercially available rapid diagnostic tests (Tubex and TyphiDot), a prototype (TyphiRapid TR-02), and the commonly used single-serum Widal test in a previously reported high-burden area of Papua New Guinea. Samples were collected from 530 outpatients with axillary temperatures of ≥37.5°C, and analysis was conducted on all malaria-negative samples (n = 500). A composite reference standard of blood culture and PCR was used, by which 47 participants (9.4%) were considered typhoid fever positive. The sensitivity and specificity of the Tubex (51.1% and 88.3%, respectively) and TyphiDot (70.0% and 80.1%, respectively) tests were not high enough to warrant their ongoing use in this setting; however, the sensitivity and specificity for the TR-02 prototype were promising (89.4% and 85.0%, respectively). An axillary temperature of ≥38.5°C correlated with typhoid fever (P = 0.014). With an appropriate diagnostic test, conducting typhoid fever diagnosis only on patients with high-grade fever could dramatically decrease the costs associated with diagnosis while having no detrimental impact on the ability to accurately diagnose the illness.

  11. Does the prognostic value of dobutamine stress echocardiography differ among different age groups?

    PubMed

    Bernheim, Alain M; Kittipovanonth, Maytinee; Takahashi, Paul Y; Gharacholou, S Michael; Scott, Christopher G; Pellikka, Patricia A

    2011-04-01

    Age is associated with reduced exercise capacity and greater prevalence of coronary artery disease. Whether the prognostic information obtained from dobutamine stress echocardiography (DSE), a stress test commonly used for patients unable to perform an exercise test, provides differential information based on age is not well known. We studied 6,655 consecutive patients referred for DSE. Patients were divided into 3 age groups: (1) <60 years (n = 1,389), (2) 60 to 74 years (n = 2,978), and (3) ≥75 years (n = 2,288). Mean follow-up was 5.5 ± 2.8 years. End points included all-cause mortality and cardiac events, including myocardial infarction and late (>3 months) coronary revascularization. Peak stress wall motion score index was an independent predictor of cardiac events in all age groups (<60 years: hazard ratio [HR] 1.14, P = .02; 60-74 years: HR 1.70, P < .0001; ≥75 years: HR 1.10, P = .006). In patients ≥75 years, peak wall motion score index (HR 1.10, P < .0001) and abnormal left ventricular end-systolic volume response (HR 1.25, P = .03) were independent predictors of death. In patients aged 60 to 74 years, abnormal left ventricular end-systolic volume response (HR 1.43, P = .0003) was independently related to death, whereas in patients <60 years, the echocardiographic data assessed during stress were not a predictor. Dobutamine stress echocardiography provided independent information predictive of cardiac events among all age groups and death in patients ≥60 years. However, among patients <60 years, stress-induced echocardiographic abnormalities were not independently associated with mortality. Comorbidities, which have precluded exercise testing, may be most relevant in predicting mortality in patients <60 years undergoing DSE. Copyright © 2011 Mosby, Inc. All rights reserved.

  12. Reflectance characteristics of the Viking lander camera reference test charts

    NASA Technical Reports Server (NTRS)

    Wall, S. D.; Burcher, E. E.; Jabson, D. J.

    1975-01-01

    Reference test charts provide radiometric, colorimetric, and spatial resolution references for the Viking lander cameras on Mars. Reflectance measurements of these references are described, including the absolute bidirectional reflectance of the radiometric references and the relative spectral reflectance of both radiometric and colorimetric references. Results show that the bidirection reflectance of the radiometric references is Lambertian to within + or - 7% for incidence angles between 20 deg and 60 deg, and that their spectral reflectance is constant with wavelength to within + or - 5% over the spectral range of the cameras. Estimated accuracy of the measurements is + or - 0.05 in relative spectral reflectance.

  13. Functional capacities of Polish adults of 60-87 years and risk of losing functional independence.

    PubMed

    Ignasiak, Zofia; Sławinska, Teresa; Skrzek, Anna; Rożek, Krystyna; Kozieł, Sławomir; Posłuszny, Pawel; Malina, Robert M

    2017-09-01

    To characterise the functional capacities of Polish men and women aged 60-87 years and evaluate their status relative to criteria for functional independence. Four hundred and thirty-one women and 125 men, aged 60-87 years, who were residents of Wrocław, southwestern Poland, were recruited. Height and weight were measured and BMI was calculated. The Fullerton Functional Fitness Test was administered to test upper and lower body strength, upper and lower body flexibility, agility-dynamic balance and aerobic endurance. The Paffenbarger physical activity questionnaire was completed. Characteristics of individuals classified by the number of tests which equalled or exceeded criterion-referenced standards for functional independence (excluding flexibility) were compared. Polish older adults compared favourably to American reference values. Percentages meeting the criteria for all four, for two or three and for one or no tests were, respectively, 21%, 54% and 25% in women and 37%, 45% and 18% in men. Adults meeting the criteria for all four tests were lighter, with a lower BMI and more physically active than those meeting the criteria on two or three tests and on one or no tests. The majority of Polish older adults were not at risk for loss of physical independence. The most functionally independent adults of both sexes had a lower BMI and less obesity, and were physically more active; the converse was true for those not meeting the criteria.

  14. Feeding Methods at Discharge Predict Long-term Feeding and Neurodevelopmental Outcomes in Preterm Infants Referred for Gastrostomy Evaluation

    PubMed Central

    Jadcherla, Sudarshan; Khot, Tanvi; Moore, Rebecca; Malkar, Manish; Gulati, Ish; Slaughter, Jonathan

    2017-01-01

    Objective To test the hypothesis that oral (PO) feeding at first neonatal intensive care unit (NICU) discharge is associated with less neurodevelopmental impairment and better feeding milestones, as compared with discharge with a gastrostomy tube (g-tube). Study design We studied outcomes for a retrospective cohort of 194 neonates < 37 weeks gestation referred for evaluation and management of feeding difficulties between July 2006–July 2012. Discharge milestones, length of hospitalization, and Bayley Scales of Infant Development scores at 18–24 months were examined. Chi-Square, Mann-Whitney U, or t-tests and multivariable logistic regression models were used. Results 60% (n=117) of infants were discharged on PO feedings; of these, 96% remained PO-fed at 1-year. The remaining 40% (n=77) were discharged on g-tube feedings; of these, 31 (40%) remained g-tube dependent, 17 (22%) became PO-fed, and 29 (38%) were on PO and g-tube feedings at one year. Infants discharged on a g-tube had lower cognitive (p<0.01), communication (p=0.03), and motor (p<0.01) composite scores. The presence of a g-tube, younger gestation, bronchopulmonary dysplasia, or intraventricular hemorrhage was significantly associated with neurodevelopmental delay. Conclusions For infants referred for feeding concerns, g-tube evaluations and feeding management, the majority did not require a g-tube. Full PO feeding at first NICU discharge was associated with superior feeding milestones and less long-term neurodevelopmental impairment, relative to full or partial g-tube feeding. Evaluation and feeding management before and after g-tube placement may improve long-term feeding and neurodevelopmental outcomes. PMID:27939123

  15. Hypersensitivity to beta-lactam antibiotics: a three-year study.

    PubMed

    Mota, I; Gaspar, Â; Chambel, M; Piedade, S; Morais-Almeida, M

    2016-11-01

    Beta-lactams antibiotics (BL) are the most frequent elicitors of allergic drug reactions. The aim of our study was to characterize the patients referred with suspected hypersensitivity (HS) to BL. Over a three-year period (2011-2013), a total of 234 adult and paediatric patients (pts) with suspected HS to BL were investigated according to the European Network for Drug Allergy guidelines. HS to BL was confirmed in 43 pts (18%), without differences between adult and paediatric pts; anaphylaxis was reported by 20 pts. Diagnosis was ascertained by: serum-specific IgE antibodies in 5 pts (12%), skin prick tests in 5 (12%), intradermal tests in 25 (58%), 3 with delayed reading, and the remaining 8 (18%) by drug provocation tests. Penicillins / derivatives were the culprit drugs in 39 pts, mainly amoxicillin, and cephalosporins in 4. In most of these patients with suspected HS to BL, allergological work-up was negative and HS was excluded. One fourth of confirmed cases had a plausible non-IgE mediated mechanism.

  16. The Effects of Using Space to Teach Standard Elementary School Curriculum

    NASA Technical Reports Server (NTRS)

    Ewell, Robert N.

    1996-01-01

    This brief report and recommendation for further research brings to a formal close this effort, the original purpose of which is described in detail in The effects of using space to teach standard elementary school curriculum, Volume 1, included here as the Appendix. Volume 1 describes the project as a 3-year research program to determine the effectiveness of using space to teach. The research design is quasi experimental using standardized test data on students from Aldrin Elementary School and a District-identified 'control' school, which shall be referred to as 'School B.' Students now in fourth through sixth grades will be compared now (after one year at Aldrin) and tracked at least until the present sixth graders are through the eighth grade. Appropriate statistical tests will be applied to standardized test scores to see if Aldrin students are 'better' than School B students in areas such as: Overall academic performance; Performance in math/science; and Enrollments in math/science in middle school.

  17. [Compliance with current standards for the early detection of neonatal hearing loss].

    PubMed

    Rojas-Godoy, Andrea L; Gómez-Gómez, Olga; Rivas-Muñoz, Fabio A

    2014-01-01

    Assessing compliance with the section "Assessment of hearing" stipulated in the Technical Standard to Detect Alteration in children aged less than 10 years-old in Bogota. This was a cross-sectional study which involved reviewing the medical records of all children born between July 1st and December 31st 2010 in two healthcare institutions in Bogota. Records were selected in which any of the following risk factors appeared: neonatal hyperbilirubinaemia involving phototherapy, neonatal exposure to ototoxic substances and/or <1.500 gr low birth weight. It was also ascertained whether children had been referred to an auditory evoked potential test as the prescribed screening test for neonatal hearing, as stipulated in mandatory Colombian technical standards for detecting abnormal growth and developmental in children aged less than ten years-old. Neither of the two institutions was making the aforementioned referral test. The results indicated significant difficulties in adherence to the protocol for the early detection of hearing loss regarding pertinent/current neonatal Colombian regulations.

  18. Associations between displayed alcohol references on Facebook and problem drinking among college students

    PubMed Central

    Moreno, Megan A; Christakis, Dimitri A; Egan, Katie G; Brockman, Libby N; Becker, Tara

    2011-01-01

    Objective Alcohol screening is uncommon among college students; however, many students display references to alcohol on Facebook. The objective of this study was to examine associations between displayed alcohol use and intoxication/problem drinking (I/PD) references on Facebook and self-reported problem drinking using a clinical scale. Design Content analysis and cross-sectional survey Setting www.Facebook.com Participants Undergraduate students from two state universities between the ages of 18 and 20 with public Facebook profiles Main exposures Profiles were categorized into one of three distinct categories: Non-Displayers, Alcohol Displayers and Intoxication/Problem Drinking (I/PD) Displayers. Outcome measures An online survey measured problem drinking using the AUDIT scale. Analyses examined associations between alcohol display category and 1) AUDIT problem drinking category using logistic regression, 2) AUDIT score using negative binomial regression, and 3) alcohol-related injury using Fisher’s exact test. Results Of 307 profiles identified, 224 participants completed the survey (73% response rate). The average age was 18.8 years, 122 (54%) were female, 152 (68%) were Caucasian, and approximately half were from each university. Profile owners who displayed I/PD were more likely (OR=4.4 [95% CI 2.0-9.4]) to score in the problem drinking category of the AUDIT scale, had 64% (IRR=1.64 [95% CI: 1.27-11.0] higher AUDIT scores overall and were more likely to report an alcohol-related injury in the past year (p=0.002). Conclusions Displayed references to I/PD were positively associated with AUDIT scores suggesting problem drinking as well as alcohol-related injury. Results suggest that clinical criteria for problem drinking can be applied to Facebook alcohol references. PMID:21969360

  19. A patient with Cushing disease lateralizing a pituitary adenoma by inferior petrosal sinus sampling using desmopressin: a case report.

    PubMed

    Lim, Joo Hee; Kim, Soo Jung; Jung, Mo Kyung; Kim, Ki Eun; Kwon, Ah Reum; Chae, Hyun Wook; Kim, Duk Hee; Kim, Ho-Seong

    2016-03-01

    A 14-year-old girl was referred for evaluation of the etiology of Cushing syndrome. During the previous 2 years, she had experienced weight gain, secondary amenorrhea, growth retardation, and back pain. Random serum cortisol level, 24-hour urinary free cortisol excretion, and overnight and low-dose dexamethasone suppression tests suggested Cushing syndrome. Midnight adrenocorticotropic hormone (ACTH) level and high-dose dexamethasone suppression test confirmed Cushing disease. Pituitary magnetic resonance imaging was suspicious for microadenoma. To eliminate ectopic ACTH syndrome, and lateralize the pituitary tumor, inferior petrosal sinus sampling (IPSS) was performed by desmopressin use to stimulate ACTH. Finally, the patient was diagnosed with Cushing disease due to ACTH-secreting pituitary microadenoma, lateralized to the left side; subsequently underwent transsphenoidal surgery. Here we report a case of a 14-year-old girl diagnosed with Cushing disease with a pituitary tumor lateralized by IPSS using desmopressin, which is very rare in pediatric Cushing disease.

  20. Implementation and assessment of a model to increase HIV testing among men who have sex with men and transgender women in Thailand, 2011-2016.

    PubMed

    Wasantioopapokakorn, Montinee; Manopaiboon, Chomnad; Phoorisri, Thanongsri; Sukkul, Akechittra; Lertpiriyasuwat, Cheewanan; Ongwandee, Sumet; Langkafah, Farida; Kritsanavarin, Usanee; Visavakum, Prin; Jetsawang, Bongkoch; Nookhai, Somboon; Kitwattanachai, Prapaporn; Weerawattanayotin, Wanwimon; Losirikul, Mana; Yenyarsun, Naruemon; Jongchotchatchawal, Nuchapong; Martin, Michael

    2018-06-27

    HIV testing among men who have sex with men (MSM) and transgender (TG) women remains low in Thailand. The HIV prevention program (PREV) to increase HIV testing and link those who tested HIV-positive to care provided trainings to peer educators to conduct target mapping, identify high risk MSM and TG women through outreach education and offer them rapid HIV testing. Trained hospital staff provided HIV testing and counseling with same-day results at hospitals and mobile clinics and referred HIV-positive participants for care and treatment. We used a standardized HIV pre-test counseling form to collect participant characteristics and analyzed HIV test results using Poisson regression and Wilcoxon rank sum trend tests to determine trends over time. We calculated HIV incidence using data from participants who initially tested HIV-negative and tested at least one more time during the program. Confidence intervals for HIV incidence rates were calculated using the Exact Poisson method. From September 2011 through August 2016, 5,629 participants had an HIV test; their median age was 24 years, 1,923 (34%) tested at mobile clinics, 5,609 (99.6%) received their test result, and 1,193 (21%) tested HIV positive. The number of people testing increased from 458 in 2012 to 1,832 in 2016 (p < 0.001). Participants testing at mobile clinics were younger (p < 0.001) and more likely to be testing for the first time (p < 0.001) than those tested at hospitals. Of 1,193 HIV-positive participants, 756 (63%) had CD4 testing. Among 925 participants who returned for HIV testing, HIV incidence was 6.2 per 100 person-years. Incidence was highest among people 20-24 years old (10.9 per 100 person-years). HIV testing among MSM and TG women increased during the PREV program. HIV incidence remains alarmingly high especially among young participants. There is an urgent need to expand HIV prevention services to MSM and TG women in Thailand.

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