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Accurate Assessment (accurate + assessment)
Selected AbstractsDevelopment of a Novel Immunoradiometric Assay Exclusively for Biologically Active Whole Parathyroid Hormone 1,84: Implications for Improvement of Accurate Assessment of Parathyroid FunctionJOURNAL OF BONE AND MINERAL RESEARCH, Issue 4 2001Ping Gao Abstract We developed a novel immunoradiometric assay (IRMA; whole parathyroid hormone [PTH] IRMA) for PTH, which specifically measures biologically active whole PTH(1,84). The assay is based on a solid phase coated with anti-PTH(39,84) antibody, a tracer of125I-labeled antibody with a unique specificity to the first N-terminal amino acid of PTH(1,84), and calibrators of diluted synthetic PTH(1,84). In contrast to the Nichols intact PTH IRMA, this new assay does not detect PTH(7,84) fragments and only detects one immunoreactive peak in chromatographically fractionated patient samples. The assay was shown to have an analytical sensitivity of 1.0 pg/ml with a linear measurement range up to 2300 pg/ml. With this assay, we further identified that the previously described non-(1,84)PTH fragments are aminoterminally truncated with similar hydrophobicity as PTH(7,84), and these PTH fragments are present not only in patients with secondary hyperparathyroidism (2° -HPT) of uremia, but also in patients with primary hyperparathyroidism (1° -HPT) and normal persons. The plasma normal range of the whole PTH(1,84) was 7,36 pg/ml (mean ± SD: 22.7 ± 7.2 pg/ml, n = 135), whereas over 93.9% (155/165) of patients with 1° -HPT had whole PTH(1,84) values above the normal cut-off. The percentage of biologically active whole PTH(1,84) (pB%) in the pool of total immunoreactive "intact" PTH is higher in the normal population (median: 67.3%; SD: 15.8%; n = 56) than in uremic patients (median:53.8%; SD: 15.5%; n = 318; p < 0.001), although the whole PTH(1,84) values from uremic patients displayed a more significant heterogeneous distribution when compared with that of 1° -HPT patients and normals. Moreover, the pB% displayed a nearly Gaussian distribution pattern from 20% to over 90% in patients with either 1° -HPT or uremia. The specificity of this newly developed whole PTH(1,84) IRMA is the assurance, for the first time, of being able to measure only the biologically active whole PTH(1,84) without cross-reaction to the high concentrations of the aminoterminally truncated PTH fragments found in both normal subjects and patients. Because of the significant variations of pB% in patients, it is necessary to use the whole PTH assay to determine biologically active PTH levels clinically and, thus, to avoid overestimating the concentration of the true biologically active hormone. This new assay could provide a more meaningful standardization of future PTH measurements with improved accuracy in the clinical assessment of parathyroid function. [source] Pulmonary Venous Wedge Pressure Provides an Accurate Assessment of Pulmonary Artery Pressure in Children with a Bidirectional Glenn ShuntJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 5 2003DANIEL H. GRUENSTEIN M.D. Purpose: In circulations with pulsatile pulmonary artery flow the pulmonary venous wedge pressure (PVWp) has been validated as a good estimate of pulmonary artery pressure (PAp), when PAp is low. The purpose of this study was to validate PVWp estimates of PAp in the less-pulsatile pulmonary circulation of children after bidirectional Glenn shunts. Methods: A retrospective study was performed of 22 simultaneous measurements of PVWp and PAp made during 20 catheterizations in 19 children who had undergone bidirectional Glenn procedures. The PAp was measured directly from the branch PA ipsilateral to the side of the PVWp, or in the SVC. Pulmonary resistance (Rp) was calculated with both PAp and PVWp, to assess the impact of PAp estimates on Rp determinations. Results: Patients ranged in age from 5 months to 10.7 years. There were a variety of univentricular cardiac malformations in the study group. Two children had antegrade pulmonary blood flow in addition to a bidirectional Glenn shunt. The mean PAp ranged from 4 to 14 mmHg, while mean PVWp ranged from 3 to 15 mmHg. Mean PVWp never differed from mean PAp by more than 3 mmHg. There was a significant linear relation between mean PAp and PVWp: PAp = 0.86 (PVWp) + 2.0 (R2= 0.89; P < 0.0001). PVWp provided a good approximation of PAp regardless of the presence (n = 2) or absence (n = 19) of antegrade pulmonary flow. There was a good linear correlation between the Rp calculated by both methods (RpPAp = 0.9 (RpVWp) + 0.5; R2= 0.74; P < 0.0001). Conclusion: The mean PVWp provides a close approximation of mean PAp in children with a bidirectional Glenn shunt and provides valuable hemodynamic information in cases where direct PAp measurements are unavailable. (J Interven Cardiol 2003;16:367,370) [source] Overestimation of Left Ventricular Mass and Misclassification of Ventricular Geometry in Heart Failure Patients by Two-Dimensional Echocardiography in Comparison with Three-Dimensional EchocardiographyECHOCARDIOGRAPHY, Issue 3 2010Dmitry Abramov M.D. Background: Accurate assessment of left ventricular hypertrophy (LVH) and ventricular geometry is important, especially in patients with heart failure (HF). The aim of this study was to compare the assessment of ventricular size and geometry by 2D and 3D echocardiography in normotensive controls and among HF patients with a normal and a reduced ejection fraction. Methods: One hundred eleven patients, including 42 normotensive patients without cardiac disease, 41 hypertensive patients with HF and a normal ejection fraction (HFNEF), and 28 patients with HF and a low ejection fraction (HFLEF), underwent 2DE and freehand 3DE. The differences between 2DE and 3DE derived LVM were evaluated by use of a Bland,Altman plot. Differences in classification of geometric types among the cohort between 2DE and 3DE were determined. Results: Two-dimensional echocardiography overestimated ventricular mass compared to 3D echocardiography (3DE) among normal (166 ± 36 vs. 145 ± 20 gm, P = 0.002), HFNEF (258 ± 108 vs. 175 ± 47gm, P < 0.001), and HFLEF (444 ± 136 vs. 259 ± 77 gm, P < 0.001) patients. The overestimation of mass by 2DE increased in patients with larger ventricular size. The use of 3DE to assess ventricular geometry resulted in reclassification of ventricular geometric patterns in 76% of patients with HFNEF and in 21% of patients with HFLEF. Conclusion: 2DE overestimates ventricular mass when compared to 3DE among patients with heart failure with both normal and low ejection fractions and leads to significant misclassification of ventricular geometry in many heart failure patients. (Echocardiography 2010;27:223-229) [source] Validation of the Chinese version of the Satisfaction with the Nursing Home InstrumentJOURNAL OF CLINICAL NURSING, Issue 12 2006Linda YK Lee MNurs Aim., To assess the psychometric properties of the Chinese version of the Satisfaction with the Nursing Home Instrument. Background., Resident's satisfaction has been regarded by the literature as a gold standard for quality of nursing home care. Accurate assessment of resident's satisfaction can provide valuable information for implementation of quality nursing home care. However, there is not a validated Chinese tool to serve the purpose. Design., A cross-sectional descriptive survey design. Methods., Content validity of the Chinese version of the Satisfaction with the Nursing Home Instrument was assessed by the use of expert panel. Construct validity of the Chinese version of the Satisfaction with the Nursing Home Instrument was determined by assessing the correlation between satisfaction with other theoretically related constructs. Internal consistency and stability of the Chinese version of the Satisfaction with the Nursing Home Instrument were determined by Cronbach's method and two-week test,retest reliability. The six-factor structure of the Chinese version of the Satisfaction with the Nursing Home Instrument was assessed by confirmatory factor analysis. Testing was performed on a cluster sample of 330 residents from 16 nursing homes in Hong Kong. Results., The Chinese version of the Satisfaction with the Nursing Home Instrument demonstrated good content validity by having content validity index of 0·93. High construct validity of the Chinese version of the Satisfaction with the Nursing Home Instrument was supported by its significant correlation with depression (r = ,0·42, P = 0·000), health-related quality of life (physical component) (r = 0·16, P = 0·042), health-related quality of life (mental component) (r = 0·41, P = 0·000) and global quality of care (r = 0·49, P = 0·000). The Chinese version of the Satisfaction with the Nursing Home Instrument demonstrated satisfactory internal consistency and good stability by having Cronbach's alpha of 0·79 and intra-class correlation coefficient of 0·94, respectively. The six-factor structure of the Chinese version of the Satisfaction with the Nursing Home Instrument was not fully supported by confirmatory factor analysis. Conclusions., The Chinese version of the Satisfaction with the Nursing Home Instrument is a useful instrument for assessing satisfaction of cognitively intact Chinese nursing home residents. Findings provided initial evidence on its validity and reliability. Further empirical testing is recommended to explore its factor structure. Relevance to clinical practice., The Chinese version of the Satisfaction with the Nursing Home Instrument can provide guidance to enhance delivery of high-quality nursing home care for the Chinese population. [source] Monitoring nutritional status accurately and reliably in adolescents with anorexia nervosaJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 1-2 2009Andrew C Martin Aim: Accurate assessment of nutritional status is a vital aspect of caring for individuals with anorexia nervosa (AN) and body mass index (BMI) is considered an appropriate and easy to use tool. Because of the intense fear of weight gain, some individuals may attempt to mislead the physician. Mid-upper arm circumference (MUAC) is a simple, objective method of assessing nutritional status. The setting is an eating disorders clinic in a tertiary paediatric hospital in Western Australia. The aim of this study is to evaluate how well MUAC correlates with BMI in adolescents with AN. Methods: Prospective observational study to evaluate nutritional status in adolescents with AN. Results: Fifty-five adolescents aged 12,17 years with AN were assessed between January 1, 2004 and January 1, 2006. MUAC was highly correlated with BMI (r = 0.79, P < 0.001) and individuals with MUAC ,20 cm rarely required hospitalisation (negative predictive value 93%). Conclusions: MUAC reflects nutritional status as defined by BMI in adolescents with AN. Lack of consistency between longitudinal measurements of BMI and MUAC should be viewed suspiciously and prompt a more detailed nutritional assessment. [source] Assessment of Infant Feeding: The Validity of Measuring Milk IntakeNUTRITION REVIEWS, Issue 8 2002Kelley S. Scanlon Ph.D., R.D. Accurate assessment of infant feeding is needed for clinical practice and research. We identified 32 studies that evaluated the validity of direct observation, test weighing, or doubly labeled water methods. Correlations with validation standards were highest for doubly labeled water and test weighing, and lowest for observation. Cost and availability of isotope may limit the doubly labeled water method to research studies, whereas observation may be useful for clinical practice. Test weighing could be applied to either setting, but it may be practical to sample less frequently over 24 hours. Validity results and intended use of the measurement should be considered when selecting a method. [source] The Challenge of Defining Bleeding Among Patients with Acute Coronary SyndromesCLINICAL CARDIOLOGY, Issue S2 2007Thomas W. Wallace M.D. Abstract Advances in the management of patients with acute coronary syndromes (ACS), specifically, the use of combined pharmacotherapy with antithrombotic and antiplatelet therapies and routine percutaneous coronary intervention (PCI), have greatly reduced rates of thrombotic outcomes and mortality in these patients. However, these same therapies also can increase the risk of bleeding and transfusion use, which are predictive of poor outcomes in patients with ACS. Accurate assessment of the risk-to-benefit ratio for any therapy depends on the use of clinically relevant, preferably standardized, definitions of endpoint events. Unfortunately, clinical trials of antithrombotic therapies have used various definitions for bleeding, most of which were originally developed for trials of fibrinolytic therapy in acute myocardial infarction (MI). These variations in bleeding definitions have complicated cross-study comparisons and assessments of drug class effects. Further, it is unclear whether these definitions remain clinically relevant in the era of routine PCI and aggressive antithrombotic therapy for ACS. Although an argument can be made for development of a standardized bleeding definition, a more prudent approach may be to develop standardized data elements, which can then be used to tailor bleeding definitions according to the goals of future clinical investigations. Copyright © 2007 Wiley Periodicals, Inc. [source] The role of pdx1 and HNF6 in proliferation and differentiation of endocrine precursorsDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 2 2004Laura Wilding Abstract Ex vivo expansion of embryonic stem cells (ES cells) or pancreatic stem cells for insulin delivery to diabetic patients provides potential for the restoration of islet function in these individuals. Understanding the spatial and temporal requirements of crucial factors for endocrine progenitor specification, proliferation, and terminal differentiation remains a major challenge in the field of pancreas development. Here, we provide speculation as to the role of pdx1 and HNF6 in these different stages of pancreatic endocrine cell development. At the time when islets begin to form within the pancreas, the expression patterns of pdx1 and HNF6 diverge, suggesting distinct functions for each of the genes over the course of endocrine cell development. The current body of evidence provides support for a role of both factors in early endocrine specification as well as a requirement for pdx1 in the generation of mature pancreatic endocrine cells. The precise temporal requirement of HNF6 in the production of terminally differentiated endocrine cells remains unclear. Future studies in this area will rely on conditionally manipulatable systems in combination with lineage-tracing studies for a more accurate assessment of pdx1 and HNF6 function at different stages along the pathway of endocrine cell development. Copyright © 2004 John Wiley & Sons, Ltd. [source] Integrating DNA data and traditional taxonomy to streamline biodiversity assessment: an example from edaphic beetles in the Klamath ecoregion, California, USADIVERSITY AND DISTRIBUTIONS, Issue 5 2006Ryan M. Caesar ABSTRACT Conservation and land management decisions may be misguided by inaccurate or misinterpreted knowledge of biodiversity. Non-systematists often lack taxonomic expertise necessary for an accurate assessment of biodiversity. Additionally, there are far too few taxonomists to contribute significantly to the task of identifying species for specimens collected in biodiversity studies. While species level identification is desirable for making informed management decisions concerning biodiversity, little progress has been made to reduce this taxonomic deficiency. Involvement of non-systematists in the identification process could hasten species identification. Incorporation of DNA sequence data has been recognized as one way to enhance biodiversity assessment and species identification. DNA data are now technologically and economically feasible for most scientists to apply in biodiversity studies. However, its use is not widespread and means of its application has not been extensively addressed. This paper illustrates how such data can be used to hasten biodiversity assessment of species using a little-known group of edaphic beetles. Partial mitochondrial cytochrome oxidase I was sequenced for 171 individuals of feather-wing beetles (Coleoptera: Ptiliidae) from the Klamath ecoregion, which is part of a biodiversity hotspot, the California Floristic Province. A phylogram of these data was reconstructed via parsimony and the strict consensus of 28,000 equally parsimonious trees was well resolved except for peripheral nodes. Forty-two voucher specimens were selected for further identification from clades that were associated with many synonymous and non-synonymous nucleotide changes. A ptiliid taxonomic expert identified nine species that corresponded to monophyletic groups. These results allowed for a more accurate assessment of ptiliid species diversity in the Klamath ecoregion. In addition, we found that the number of amino acid changes or percentage nucleotide difference did not associate with species limits. This study demonstrates that the complementary use of taxonomic expertise and molecular data can improve both the speed and the accuracy of species-level biodiversity assessment. We believe this represents a means for non-systematists to collaborate directly with taxonomists in species identification and represents an improvement over methods that rely solely on parataxonomy or sequence data. [source] Sampling subterranean termite species diversity and activity in tropical savannas: an assessment of different bait choicesECOLOGICAL ENTOMOLOGY, Issue 4 2003Tracy Z. Dawes-Gromadzki Abstract., 1.,Cellulose baits are commonly used for semi-quantitative sampling of subterranean wood-feeding termites, with a single food choice sampling programme implemented most often. In most situations, however, the composition and feeding preferences of the subterranean termite assemblage remain unknown. 2.,The diversity, frequency, foraging activity, and intensity of attack of termites were assessed regularly at 144 baits representing 12 different bait choices over 8.5 months, in two northern Australian tropical savanna sites that differed in vegetation structure (closed vs open). Baits differed in type (paper rolls, cardboard, wooden stakes), position (surface, buried), and moisture status at installation (wet, dry). 3.,Sixteen species were recorded, including 11 wood-feeders. Average species diversity, foraging activity, and bait consumption were greater at buried baits than at surface baits. Wooden baits were most attractive early in the experiment, and paper baits more attractive later. Mean species diversity was greatest at wooden stakes in the closed site. Species frequency of occurrence varied across bait choices. 4.,A composite bait sampling protocol of stakes and paper rolls installed above and below ground gave an accurate assessment of the activity, diversity, and structure of the termite guild sampled across all baits over 8.5 months. 5.,The choice of bait, its presentation, and time of examination are critical to the success of a termite baiting programme. If the aim is to characterise the structure and foraging activity of the subterranean termite assemblages that are attracted to baits, composite baiting protocols should be implemented. [source] CAFTA, CAMPAIGN CONTRIBUTIONS, AND THE ROLE OF SPECIAL INTERESTSECONOMICS & POLITICS, Issue 3 2010JAMES M. DEVAULT This paper analyzes the passage of the Central American Free Trade Agreement (CAFTA) in 2005, paying particular attention to the role of campaign contributions. The CAFTA vote is significant in that the context in which it occurred was one in which campaign contributions were more likely to influence votes. By more carefully identifying the special interest groups actively involved in the CAFTA debate, I provide a more accurate assessment of the impact of the contributions made by these groups. I use instrumental variables to control for the potential endogeneity of campaign contributions and find that these contributions played at best a secondary role in determining the outcome of the CAFTA vote in the U.S. House of Representatives. [source] Assessment of protein-incorporated arginine methylation in biological specimens by CZE UV-detectionELECTROPHORESIS, Issue 23 2007Angelo Zinellu Dr. Abstract Protein arginine methyltransferases methylate post-translationally arginine residues in proteins to synthesize monomethylarginine (MMA), asymmetric dimethylarginine (ADMA), or symmetric dimethylarginine. Protein arginine methylation is involved in the regulation of signal transduction, RNA export, and cell proliferation. Moreover, upon proteolysis, arginines are released into the cytosol in which they exert important biological effects. Both MMA and ADMA are inhibitors of nitric oxide synthase and especially elevated levels of ADMA are associated with endothelial dysfunction and cardiovascular disease. Quantification of these analytes is commonly performed by HPLC after sample cleanup and derivatization. We propose a CE method in which these steps have been avoided and the procedure for sample preparation has been simplified. After acidic hydrolysis of proteins, samples were dried, resuspended in water, and directly injected in CE. A baseline separation of analytes was reached in a 60 cm×75,,m id uncoated silica capillary, by using a Tris-phosphate run buffer at pH,2.15. This method allows an accurate assessment of protein arginine methylation degree in different biological samples such as whole blood, plasma, red blood cells, cultured cells, and tissue. Moreover, its good sensitivity permits to evaluate the methylation of a single protein type after the opportune purification steps. A method applicability concerns both clinical laboratories, where the evaluation of blood protein from numerous samples could be rapidly performed, and research laboratories where the factors affecting the arginine protein methylation degree could be easily studied. [source] Using spatial models and kriging techniques to optimize long-term ground-water monitoring networks: a case studyENVIRONMETRICS, Issue 5-6 2002Kirk Cameron Abstract In a pilot project, a spatial and temporal algorithm (geostatistical temporal,spatial or GTS) was developed for optimizing long-term monitoring (LTM) networks. Data from two monitored ground-water plumes were used to test the algorithm. The primary objective was to determine the degree to which sampling, laboratory analysis, and/or well construction resources could be pared without losing key statistical information concerning the plumes. Optimization of an LTM network requires an accurate assessment of both ground-water quality over time and trends or other changes in individual monitoring wells. Changes in interpolated concentration maps over time indicate whether ground-water quality has improved or declined. GTS separately identifies temporal and spatial redundancies. Temporal redundancy may be reduced by lengthening the time between sample collection. Spatial redundancy may be reduced by removing wells from the network which do not significantly impact assessment of ground-water quality. Part of the temporal algorithm in GTS involves computation of a composite temporal variogram to determine the least redundant overall sampling interval. Under this measure of autocorrelation between sampling events, the lag time at which the variogram reaches a sill is the sampling interval at which same-well measurements lack correlation and are therefore non-redundant. The spatial algorithm assumes that well locations are redundant if nearby wells offer nearly the same statistical information about the underlying plume. A well was considered redundant if its removal did not significantly change: (i) an interpolated map of the plume; (ii) the local kriging variances in that section of the plume; and (iii) the average global kriging variance. To identify well redundancy, local kriging weights were accumulated into global weights and used to gauge each well's relative contribution to the interpolated plume map. By temporarily removing that subset of wells with the lowest global kriging weights and re-mapping the plume, it was possible to determine how many wells could be removed without losing critical information. Test results from the Massachusetts Military Reserve (MMR) indicated that substantial savings in sampling, analysis and operational costs could be realized by utilizing GTS. Annual budgetary savings that would accrue were estimated at between 35 per cent and 5 per cent for both LTM networks under study.Copyright © 2002 John Wiley & Sons, Ltd. [source] An investigation of computer literacy and attitudes amongst Greek post-graduate dental studentsEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 3 2007Kimon Divaris An accurate assessment of the computer skills of students is a pre-requisite for the success of any e-learning interventions. The aim of the present study was to assess objectively the computer literacy and attitudes in a group of Greek post-graduate students, using a task-oriented questionnaire developed and validated in the University of Malmö, Sweden. 50 post-graduate students in the Athens University School of Dentistry in April 2005 took part in the study. A total competence score of 0,49 was calculated. Socio-demographic characteristics were recorded. Attitudes towards computer use were assessed. Descriptive statistics and linear regression modeling were employed for data analysis. Total competence score was normally distributed (Shapiro,Wilk test: W = 0.99, V = 0.40, P = 0.97) and ranged from 5 to 42.5, with a mean of 22.6 (±8.4). Multivariate analysis revealed ,gender', ,e-mail ownership' and ,enrollment in non-clinical programs' as significant predictors of computer literacy. Conclusively, computer literacy of Greek post-graduate dental students was increased amongst males, students in non-clinical programs and those with more positive attitudes towards the implementation of computer assisted learning. [source] Impact of treatment provision on the epidemiological recording of root cariesEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 1 2000A. W. G. Walls The estimation of root caries prevalence and the identification of risk factors for decay depend upon the successful identification of carious lesions in epidemiological studies. Root surface restorations can either be placed to manage decay or cervical wear/sensitivity. The handling of data for restorations during epidemiological surveys is critical to the accurate assessment of caries prevalence. The objective of this study was to determine the relative frequency of dentists' placing root surface restorations according to their reason for placement. Data for 696 restorations were recorded from 35 dentists. Forty-five % of restorations were placed because of decay compared with 55% for cervical wear/sensitivity. There were no significant differences in proportion of placement of restoration with age of the patient or between regular and irregular attenders of different ages. Using these data a correction factor was developed for inclusion in the Root Caries Index (RCI) to make allowance for the proportion of restorations placed because of wear/sensitivity. When this correction factor was introduced into an existing data-set for root caries, the RCI was reduced for all groups. This reduction was greatest in regular attenders. When these data were analysed without making allowance for treatment effects, there was a significant difference in RCI between regular and irregular attenders. When the correction factor was applied to these data, this difference was eliminated. [source] An advanced methodology for steady-state security assessment of power systemsEUROPEAN TRANSACTIONS ON ELECTRICAL POWER, Issue 4 2001D. P. Popovic The basic objective of this paper is to present the relevant aspects of an advanced methodology for steady-state security assessment of power systems. This methodology consists of the following relevant parts: procedure for forming the unified external network equivalents, with adaptive buffer system selection, procedure for fast contingency selection and simple method for the fast and sufficiently accurate assessment of dynamic variation of power system frequency during the time of its primary control. For the potentially critical contingency, the continuation of iterative procedure is performed. Full contingency analysis is based on specially developed method, which enables successive solution of the load-flow problem for a set of characteristic post-dynamic quasi-stationary states. The characteristics of the developed methodology are tested on the example of the existing electric power interconnection in the Balkans. [source] Observer variation in immunohistochemical analysis of protein expression, time for a change?HISTOPATHOLOGY, Issue 7 2006T Kirkegaard Aim :,Immunohistochemical analysis of protein expression is central to most clinical translational studies and defines patient treatment or selection criteria for novel drugs. Interobserver variation is rarely analysed despite recognition that this is a key area of potential inaccuracy. Therefore our aim was to examine observer variation and suggest the revision of current standards. Methods and results :,We analysed inter- and intra-observer variation, by interclass correlation coefficient (ICCC) and , statistics, in 8661 samples. Intra-observer assessment of nuclear, cytoplasmic and membrane staining for seven proteins in 1323 samples resulted in an ICCC of 0.94 and a , -value of 0.787. Interobserver reproducibility, assessed on 28 proteins by seven observer pairs in 8661 carcinomas, gave an ICCC of 0.90 and a , -value of 0.70. No significant effect of either antibody or cellular compartmentalization was observed. Conclusion :,We have demonstrated that ICCC is a consistent method to assess observer variation when a continuous scoring system is used, compared with , statistics, which depends on a categorical system. Given the importance of accurate assessment of protein expression in diagnostic and experimental medicine, we suggest raising thresholds for observer variation: ICCC of 0.7 should be regarded as the minimum acceptable standard, ICCC of 0.8 as good and ICCC of ,,0.9 as excellent. [source] An in vitro comparison of three thermal gutta percha systemsINTERNATIONAL ENDODONTIC JOURNAL, Issue 4 2001M. P. Horrocks Aim,The aim of this study was to compare the ability of three contemporary obturation techniques to resist microleakage, using root canals prepared in extracted single rooted teeth by a standardized method. Methodology,The shaping technique involved the use of tapered nickel titanium rotary files to create a uniform 0.08-mm/mm taper. Six groups were compared, two representing control groups, a third group being obturated with a warm vertical condensation technique, a fourth group by an injection thermoplasticized system, a fifth group with a thermomechanical compaction method and a sixth group using cold lateral condensation. A zinc oxide/eugenol sealer was used as the sealant in all the obturation procedures. Forty-six extracted teeth were used in the study, three teeth in each control group and 10 teeth in each of the remaining four groups. Microleakage was compared using dye leakage with Indian ink. Penetration of the dye at the gutta percha/dentine interface was visualized after the root had been rendered transparent. Dye leakage was then measured from four aspects with the use of a stereomicroscope and export of a digital image to a software package, to facilitate accurate assessment of dye penetration. Two parameters were measured for each sample, the mean dye penetration and maximum dye penetration. Results,The mean values for linear dye leakage in the thermomechanical compaction group was 0.53 mm, the warm vertical condensation group was 0.73 mm, the injection thermoplasticized group was 0.15 mm and the cold lateral condensation group was 0.53 mm. There was no statistical difference between the means of the different groups (P > 0.05). The mean of the maximum values for dye leakage in the thermomechanical compaction group was 0.65 mm, the warm vertical condensation group was 1.02 mm, the injection-thermoplasticized group was 0.28 mm and the cold lateral condensation group was 0.74 mm. There was no statistical difference between the means of the different groups (P > 0.05). Conclusions,Within the conditions of this study, there was no statistical difference between the different groups with respect to either mean or maximum dye leakage. [source] Evaluation of F cells in sickle cell disorders by flow cytometry , comparison with the Kleihauer,Betke's slide methodINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 6 2007K. Y. ITALIA Summary Adult F cell numbers are raised in inherited haemoglobin disorders, such as , -thalassaemia and sickle cell anaemia, hereditary persistence of foetal haemoglobin, and some acquired conditions, such as juvenile myelomonocytic leukaemia, during acute erythropoietic stress and pregnancy. True foetal erythrocytes containing foetal amounts of HbF can also occur in the adult circulation during the leakage of HbF-containing cells from the foetus to the maternal circulation. In normal adults, HbF is restricted to a small proportion (3,7%) of red blood cells (RBC), termed ,F cells'. Techniques estimating the amount of HbF use lysates prepared from RBC, whereas those that estimate the adult F cell count use intact RBC. An accurate assessment of adult F cells in sickle cell disorders is important because increased adult F cells are associated with decreased morbidity in these disorders. In the present study, HbF levels were measured and adult F cell numbers were estimated in 100 blood samples (25 normal individuals, 25 sickle heterozygotes, 25 sickle homozygotes and 25 sickle , -thalassaemia cases), using high pressure liquid chromatography for HbF levels, and flow cytometry and the Kleihauer,Betke (KB) acid elution microscope slide method for cell counts. Flow cytometry gave a more accurate assessment of adult F cells, eliminating any manual error, as compared to KB, which was less sensitive and precise as it is based on subjective visual interpretation. [source] Significant differences between capillary and venous complete blood counts in the neonatal periodINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 1 2003S.M. Kayiran Summary The normal capillary and venous hematologic values for neonates have not been defined clearly. It is well known that capillary blood has higher hemoglobin (Hb) and hematocrit (Hct) values than venous blood. In a recent study, we reported differences between capillary and venous complete blood counts (CBC) in healthy term neonates on day 1 of life. The aim of this study was to extend our previous investigation. Term neonates (n=141) were stratified into four groups by days of postnatal age: group 2 (day 7, n=38), group 3 (day 14, n=35), group 4 (day 21, n=32) and, group 5 (day 28, n=36). Data from our previous study were included in the statistical analysis as group 1 (day 1, n=95). A CBC and differential count were carried out on each capillary and venous sample drawn simultaneously. Within each group, the mean and standard deviation for each parameter in capillary and venous blood were calculated and then compared using the paired sample t -test. In all groups, the capillary blood samples had higher Hb, Hct, red blood cell (RBC), white blood cell (WBC), and lymphocyte counts. In each group, venous platelet counts were significantly higher than the corresponding capillary values. There was also a trend toward higher venous mean corpuscular volume, higher capillary polymorphonuclear leukocyte (PML) count and mean platelet volume in all groups. In both capillary and venous blood, Hb, Hct, RBC, MCV values and WBC, lymphocyte, PML counts decreased and platelet counts increased steadily during neonatal period. This study reveals that CBC parameters and differential counts may differ depending on the blood sampling used. The findings underline the importance of considering the sample source when using hematologic reference ranges for healthy or septic neonates. When interpreting results, the term ,peripheral blood' should be replaced with ,capillary blood' or ,venous blood' so that an accurate assessment can be made. [source] Falls risk assessment, multitargeted interventions and the impact on hospital fallsINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 5 2004Heather McFarlane-Kolb RN BN(Hons) There is an urgent need for inquiry to validate existing scales in the accurate assessment of falls risk. Moreover, where fall prevention projects have targeted specific risk factors of falling, such as cognitive impairment, few have measured the impact of their intervention on fall outcomes. A comparative design compared and described differences in falls data within and between two study cohorts before and after a multitargeted intervention was introduced. A cut-off score of , 50 using the Morse Scale was a good baseline indicator for accurate identification of fall risk and outcomes verify that the modified Morse Falls Scale, in combination with other risk factors, more accurately profiled fall risk among this population. Fall incidence among the intervention cohort did not increase significantly despite a rise in the number of hospital admissions and a significantly higher reported fall risk potential. [source] Assessment of pulp vitality: a reviewINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 1 2009VELAYUTHAM GOPIKRISHNA Background., One of the greatest diagnostic challenges in clinical practice is the accurate assessment of pulp status. This may be further complicated in paediatric dentistry where the practitioner is faced with a developing dentition, traumatized teeth, or young children who have a limited ability to recall a pain history for the tooth in question. A variety of pulp testing approaches exist, and there may be confusion as to their validity or appropriateness in different clinical situations. Aim., The aim of this paper is to provide the clinician with a comprehensive review of current pulp testing methods. A key objective is to highlight the difference between sensitivity testing and vitality testing. A biological basis for pulp testing is also provided to allow greater insight into the interpretation of pulp testing results. The rationale for, and methods of, assessing pulpal blood flow are described. [source] Positional relationships between the masticatory muscles and their innervating nerves with special reference to the lateral pterygoid and the midmedial and discotemporal muscle bundles of temporalisJOURNAL OF ANATOMY, Issue 2 2000KEIICHI AKITA For an accurate assessment of jaw movement, it is crucial to understand the comprehensive formation of the masticatory muscles with special reference to the relationship to the disc of the temporomandibular joint. Detailed dissection was performed on 26 head halves of 14 Japanese cadavers in order to obtain precise anatomical information of the positional relationships between the masticatory muscles and the branches of the mandibular nerve. After complete removal of the bony elements, the midmedial muscle bundle in all specimens and the discotemporal muscle bundle in 6 specimens, derivatives of the temporalis, which insert into the disc were observed. On the anterior area of the articular capsule and the disc of the temporomandibular joint, the upper head of the lateral pterygoid, the midmedial muscle bundle of temporalis and the discotemporal bundle of temporalis were attached mediolaterally, and in 3 specimens the posterosuperior margin of the zygomaticomandibularis was attached to the anterolateral area of the disc. It is suggested that these muscles and muscle bundles contribute to various mandibular movements. Although various patterns of the positional relationships between the muscles and muscle bundles and the their innervating nerves are observed in the present study, relative positional relationships of the muscles and muscle bundles and of nerves of the mandibular nerve are consistent. A possible scheme of the developmental formation of the masticatory muscles based on the findings of the positional relationships between the muscles and the nerves is presented. [source] Impact of intraoperative sonography on resection and cryoablation of liver tumorsJOURNAL OF CLINICAL ULTRASOUND, Issue 5 2001Diana Gaitini MD Abstract Purpose We retrospectively analyzed the impact of intraoperative sonography (IOUS) on the management of patients referred for resection of liver tumors. Methods Forty patients underwent IOUS with a 7-MHz curved-array sector transducer; in selected cases, a 5-MHz linear-array transducer attached to a color Doppler unit was also used. The number, size, and location of tumors on IOUS, including tumor proximity to or invasion of major vessels or invasion of the diaphragm, were compared to findings on preoperative imaging studies. The effect of these findings on surgical management was assessed. Unresectable lesions were treated by cryoablation under ultrasound guidance. Results IOUS detected preoperatively unsuspected lesions in 7 patients (18%). Metastases suspected on CT arterial portography were ruled out in 2 patients (5%), and indeterminate lesions were diagnosed as cysts by IOUS in 2 other patients (5%). Vascular proximity or vascular or diaphragmatic invasion detected by IOUS rendered lesions unresectable in 4 patients (10%). Cryoablation under IOUS guidance and monitoring was attempted in 11 patients (28%) and performed successfully in 10. Conclusions IOUS changed the management in 38% of patients and guided cryoablation in 28% of patients. IOUS performed by an experienced sonologist is invaluable for the accurate assessment of liver tumor resectability; the detection of additional, preoperatively unknown lesions; and the guidance of cryoablation of unresectable tumors. © 2001 John Wiley & Sons, Inc. J Clin Ultrasound 29:265,272, 2001. [source] Relating Instrumental Texture, Determined by Variable-Blade and Allo-Kramer Shear Attachments, to Sensory Analysis of Rainbow Trout, Oncorhynchus mykiss, FilletsJOURNAL OF FOOD SCIENCE, Issue 7 2010Aunchalee Aussanasuwannakul Abstract:, Texture is one of the most important quality attributes of fish fillets, and accurate assessment of variation in this attribute, as affected by storage and handling, is critical in providing consistent quality product. Trout fillets received 4 treatments: 3-d refrigeration (R3), 7-d refrigeration (R7), 3-d refrigeration followed by 30-d frozen storage (R3F30), and 7-d refrigeration followed by 30-d frozen storage (R7F30). Instrumental texture of raw and cooked fillets was determined by 3 approaches: 5-blade Allo-Kramer (AK) and variable-blade (VB) attachment with 12 blades arranged in perpendicular (PER) and parallel (PAR) orientations to muscle fibers. Correlation between instrumental texture and sensory hardness, juiciness, elasticity, fatness, and coarseness was determined. Muscle pH remained constant at 6.54 to 6.64. Raw fillets lost 3.66% of their original weight after 30-d frozen storage. After cooking, weight loss further increased to 15.97%. Moisture content decreased from 69.11 to 65.02%, while fat content remained constant at 10.41%. VBPER detected differences in muscle sample strength (P= 0.0019) and demonstrated effect of shear direction reported as maximum force (g force/g sample). AKPER detected differences in energy of shear (g × mm; P= 0.0001). Fillets that received F30 treatments were less extensible. Cooking increased muscle strength and toughness. Force determined by VBPER was correlated with sensory hardness (r= 0.423, P= 0.0394) and cook loss (r= 0.412, P= 0.0450). VB attachment is accurate, valid, and less destructive in fillet texture analysis. Practical Application:, A new shearing device was validated with sensory analysis. Settings and parameters obtained could be used to define fillet texture quality associated with muscle fiber orientation. [source] A method for calculating effective bulk composition modification due to crystal fractionation in garnet-bearing schist: implications for isopleth thermobarometryJOURNAL OF METAMORPHIC GEOLOGY, Issue 6 2004T. P. Evans Abstract Quantitative P,T path determination in metamorphic rocks is commonly based on the variation in composition of growth-zoned garnet. However, some component of growth zoning in garnet is necessarily the result of an effective bulk composition change within the rock that has been generated by crystal fractionation of components into the core of garnet. Therefore, any quantitative calculation of the P,T regime of garnet growth should be completed using an accurate assessment of the composition of the chemical system from which garnet is growing. Consequently, a method for calculating the extent of crystal fractionation that provides a means of estimating the composition of the unfractionated rock at any stage during garnet growth is developed. The method presented here applies a Rayleigh fractionation model based on measured Mn content of garnet to generate composition v. modal proportion curves for garnet, and uses those curves to estimate the vectors of crystal fractionation. The technique is tested by calculating the precision of the equilibrium between three garnet compositional variables within the chemical system determined to be appropriate for each of a series of microprobe analyses from garnet. Application of the fractionation calculations in conjunction with the P,T estimates based on intersecting compositional isopleths provides a means of calculating P,T conditions of garnet growth that is based on individual point-analyses on a garnet grain. Such spatially precise and easily obtainable P,T data allow for detailed parallel studies of the microstructural, the P,T, and the chemical evolution of metamorphosed pelites. This method provides a means of studying the dynamics of orogenic systems at a resolution that was previously unattainable. [source] Missed opportunities for a diagnosis of acute otitis media in Aboriginal childrenJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 7 2003KB Gibney Objective: Severe otitis media and its sequelae are common in rural and remote Aboriginal children. Identification of acute otitis media (AOM) is likely to reduce the number of children who go on to develop chronic suppurative otitis media and associated complications. The aim of this study was to compare the diagnoses made by researchers with that documented in the medical records of children admitted to the paediatric isolation ward of the Royal Darwin Hospital, Darwin, Northern Territory. Methods: Children aged <8 years admitted to Royal Darwin Hospital were eligible for assessment by pneumatic otoscopy, video-otoscopy and tympanometry. A diagnosis was made for each child according to the state of their worst ear. Comparisons were made between the researcher diagnoses of ear disease and those documented in the hospital notes by medical staff. Results: Thirty-one children were enrolled during 32 admissions. Most were aged <2 years, Aboriginal, and resided in remote communities. Sixty-one video-otoscopic assessments were attempted and sufficiently good images to allow diagnosis were obtained in 105 of 122 ears. Acute otitis media was diagnosed by the research team in 20 of 32 child admissions. Of 29 children who had ear examinations documented by hospital staff, only seven had a diagnosis of AOM recorded. Overall, the research team were almost three times more likely to make this diagnosis (relative risk 2.9, 95% confidence interval 1.6, 5.2). This difference was unlikely to have occurred by chance (P = 0.0002, McNemar's Chi-squared test). Conclusions: In this small study, young Aboriginal children with clear bulging of their tympanic membrane were not diagnosed with AOM by medical staff. Further training in diagnosis, including cleaning of the ear canal, may lead to more accurate assessment and appropriate recommendations for ongoing management. [source] Future Prospects for Biomarkers of Alcohol Consumption and Alcohol-Induced DisordersALCOHOLISM, Issue 6 2010Willard M. Freeman The lack of reliable measures of alcohol intake is a major obstacle to the diagnosis, treatment, and research of alcohol abuse and alcoholism. Successful development of a biomarker that allows for accurate assessment of alcohol intake and drinking patterns would not only be a major advance in clinical care but also a valuable research tool. A number of advances have been made in testing the validity of proposed biomarkers as well as in identifying potential new biomarkers through systems biology approaches. This commentary will examine the definition of a biomarker of heavy drinking, the types of potential biomarkers, the steps in biomarker development, the current state of biomarker development, and critical obstacles for the field. The challenges in developing biomarkers for alcohol treatment and research are similar to those found in other fields. However, the alcohol research field must reach a competitive level of rigor and organization. We recommend that NIAAA consider taking a leadership role in organizing investigators in the field and providing a common set of clinical specimens for biomarker validation studies. [source] Assessment of middle ear disease in the dog: a comparison of diagnostic imaging modalitiesJOURNAL OF SMALL ANIMAL PRACTICE, Issue 4 2007R. Doust Objectives: To compare radiography and ultrasound for the assessment of the tympanic bulla against computed tomography results. Methods: Thirty-one dogs had dorsoventral, left and right lateral oblique and rostrocaudal open mouth radiographs compared with ultrasound images and computed tomography scans of the tympanic bullae. Results: Radiography was superior to ultrasonography for the evaluation of the middle ear. However, computed tomography assessment was best predicted by a combination of radiographic and ultrasonographic findings. Clinical Significance: A combination of radiography and ultrasound can provide a more accurate assessment of the bulla than either of them alone. Ultrasound may have a role in the evaluation of middle ear disease in the dog. Results are operator dependent and not reproducible with current recording techniques. [source] Comparison of Serum-Free Thyroxine Concentrations Determined by Standard Equilibrium Dialysis, Modified Equilibrium Dialysis, and 5 Radioimmunoassays in DogsJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 3 2004Sara Schachter Measurement of serum-free thyroxine (fT4) concentration provides a more accurate assessment of thyroid gland function than serum thyroxine (T4) or 3,5,3'-triiodothyronine (T3). Techniques for measuring serum fT4 concentration include standard equilibrium dialysis (SED), radioimmunoassay (RIA), and a combination of both (modified equilibrium dialysis [MED]). This study compared results of serum fT4 measurements by means of SED, MED, and 5 RIAs in 30 healthy dogs, 10 dogs with hypothyroidism, and 31 euthyroid dogs with concurrent illness for which hypothyroidism was a diagnostic consideration. Serum fT4 concentrations were comparable when determined by the SED and MED techniques, and mean serum fT4 concentrations were significantly (P<.01) lower in dogs with hypothyroidism than in healthy dogs and euthyroid dogs with concurrent illness. Significant (P < .05) differences in fT4 concentrations were identified among the 5 RIAs and among the RIAs and MED and SED. Serum fT4 concentrations were consistently lower when fT4 was determined by the RIAs, compared with either equilibrium dialysis technique. Serum fT4 concentrations were significantly lower (P < .01) in dogs with hypothyroidism than in healthy dogs for all RIAs; were significantly lower (P < .05) in dogs with hypothyroidism than in euthyroid dogs with concurrent illness for 4 RIAs; and were significantly lower (P < .01) in euthyroid dogs with concurrent illness than in healthy dogs for 4 RIAs. RIAs had the highest number of low serum fT4 concentrations in euthyroid dogs with concurrent illness. This study documented differences in test results among fT4 assays, emphasizing the importance of maintaining consistency in the assay used to measure serum fT4 concentrations in the clinical or research setting. [source] | |||||||||||||||||||||||||||||||||||||||||||