Acceptable Level (acceptable + level)

Distribution by Scientific Domains
Distribution within Medical Sciences


Selected Abstracts


A pediatric screening instrument to detect problematic infant,parent interactions: Initial reliability and validity in a sample of high- and low-risk infants

INFANT MENTAL HEALTH JOURNAL, Issue 4 2001
Barbara H. Fiese
The purpose of this study was to determine the initial reliability and validity of a screening instrument developed to detect problematic interactions between infants and parents as part of a pediatric well-baby exam. Participants included 117 infant,mother dyads (57 preterms and 60 full terms) assessed when infants were 6 to 9 months old. Mothers and infants were observed playing an interactional game such as peek-a-boo during the course of the pediatric exam. The game was scored for degree of interactional reciprocity using the Pediatric Infant Parent Exam (PIPE). Acceptable levels of interrater reliability were achieved. As predicted, higher risk infants and their mothers exhibited more problematic interactions than lower risk infants and their mothers. Results indicated that the PIPE was a reliable means of screening for interactional difficulties, that was sensitive to, but not synonymous with, neonatal health indices. ©2001 Michigan Association for Infant Mental Health. [source]


Errors in the Interpretation of Mohs Histopathology Sections Over a 1-Year Fellowship

DERMATOLOGIC SURGERY, Issue 12 2008
MICHAEL E. MURPHY MD
BACKGROUND Errors can occur in the interpretation of Mohs histopathology sections. Errors in histology interpretation can lead to incomplete removal of cancer and cancer persistence or the unnecessary removal of uninvolved tissue. Extensive proctored training is necessary to reduce these errors to an absolute minimum level. OBJECTIVE To analyze and quantify the number of cases and the amount of time required to reach a satisfactory level of expertise in the reading and interpretation of Mohs histopathology. METHODS A single-institution pilot study was designed to track errors in the interpretation and mapping of Mohs histopathology sections. A Mohs surgery fellow independently preread Mohs cases and rendered his interpretation on the Mohs map. One of the Mohs program directors subsequently reviewed and corrected all cases. Errors were scored on a graded scale and tracked over the 1-year fellowship to determine the number of cases and amount of time necessary to reduce errors to a baseline minimal level. RESULTS One thousand four hundred ninety-one Mohs surgery cases were required to generate 1,347 pathology specimens for review and grading over 6 months of Mohs surgery fellowship before reducing errors to a minimum acceptable level of less than 1 critical error per 100 cases read. CONCLUSIONS The number of cases and time required to reduce errors in the interpretation of Mohs histology is substantial. Direct and immediate mentored correction of errors is essential for improvement. These results can act as a guide for Mohs surgery training programs to help determine the minimum number of directly proctored cases required to obtain expertise in this crucial component of Mohs surgery. [source]


Interobserver agreement between primary graders and an expert grader in the Bristol and Weston diabetic retinopathy screening programme: a quality assurance audit

DIABETIC MEDICINE, Issue 8 2009
S. Patra
Abstract Aims, To assess the quality and accuracy of primary grading in the Bristol and Weston diabetic retinopathy screening programme and to set standards for future interobserver agreement reports. Methods, A prospective audit of 213 image sets from six fully trained primary graders in the Bristol and Weston diabetic retinopathy screening programme was carried out over a 4-week period. All the images graded by the primary graders were regraded by an expert grader blinded to the primary grading results and the identity of the primary grader. The interobserver agreement between primary graders and the blinded expert grader and the corresponding Kappa coefficient was determined for overall grading, referable, non-referable and ungradable disease. The audit standard was set at 80% for interobserver agreement with a Kappa coefficient of 0.7. Results, The interobserver agreement bettered the audit standard of 80% in all the categories. The Kappa coefficient was substantial (0.7) for the overall grading results and ranged from moderate to substantial (0.59,0.65) for referable, non-referable and ungradable disease categories. The main recommendation of the audit was to provide refresher training for the primary graders with focus on ungradable disease. Conclusion, The audit demonstrated an acceptable level of quality and accuracy of primary grading in the Bristol and Weston diabetic retinopathy screening programme and provided a standard against which future interobserver agreement can be measured for quality assurance within a screening programme. [source]


How to deal with multiple endpoints in clinical trials

FUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 6 2006
Markus Neuhäuser
Abstract Multiple endpoints are common in clinical trials. This article discusses statistical methods that can be applied to control the rate of false positive conclusions at an acceptable level. The considered methods include the Bonferroni adjustment and related methods, the intersection-union test, ordered hypotheses and gatekeeper procedures, composite endpoints and global assessment measures, closed testing procedures, and combinations of different approaches. [source]


Long-term reliability and observer comparisons in the radiographic diagnosis of periapical disease

INTERNATIONAL ENDODONTIC JOURNAL, Issue 2 2002
O. Molven
Abstract Aim The aim of this study was to evaluate and compare the long-term diagnostic consistency of two examiners, an endodontist and a radiologist, and to make comparisons with findings recorded by an observer with more recent scientific and clinical experience in endodontics. Methodology Three groups, each consisting of 20 full mouth series of intraoral radiographs, with 79, 93 and 85 endodontically-treated roots, respectively, were successively evaluated for periapical disease. Evaluations were at first performed separately by the three observers. Disagreement and difficult, borderline cases were subjected to joint evaluation. Intra- and interexaminer comparisons were made. For two of the observers the observations were compared with findings recorded several years before for the same cases in the same radiographs. Results The intra- and interobserver long-term reliability of the two original examiners resulted in 83% overall agreement, the kappa values were 0.54, 0.57 and 0.53. Comparisons between all three observers disclosed 82%, 85% and 86% agreement and kappa values 0.55, 0.58 and 0.60. The joint evaluations and decisions did not indicate a dominating influence from any of the observers. Conclusions The long-term reliability of the two original observers was judged as being satisfactory. All three observers judged the overall disease status of the material in the same way. The joint discussions of selected cases might reduce observer variation to an acceptable level, avoid a number of false recordings and increase the reliability and validity of the findings. [source]


Comparison of haemoglobinometry by WHO Haemoglobin Colour Scale and copper sulphate against haemiglobincyanide reference method

INTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 4 2004
I. S. Timan
Summary Although estimation of haemoglobin is essential for diagnosing anaemia and assessing its severity, many health centres in developing countries do not have the facilities for haemoglobinometry. The WHO Haemoglobin Colour Scale (HCS) method is a simple and inexpensive clinical device that was recently developed in order to diagnose anaemia in such centres. In Indonesia, the copper sulphate specific gravity method is used for blood donor screening and also in primary health clinics in the rural and remote areas. In this study, the HCS method is compared with the copper sulphate method and with an earlier paper scale, the Tallquist method, against the standard haemiglobincyanide spectrophotometric method. The HCS method showed an acceptable level of precision and accuracy for use as a reliable screening tool to diagnose anaemia in patients and also for blood donor screening. [source]


A framework for network quality monitoring in the VoIP environment

INTERNATIONAL JOURNAL OF NETWORK MANAGEMENT, Issue 4 2007
Ana Flàvia M. de Lima
Monitoring speech quality in Voice over IP (VoIP) networks is important to ensure a minimal acceptable level of speech quality for IP calls running through a managed network. Information such as packet loss, codec type, jitter, end-to-end delay and overall speech quality enables the network manager to verify and accurately tune parameters in order to adjust network problems. The present article proposes the deployment of a monitoring architecture that collects, stores and displays speech quality information about concluded voice calls. This architecture is based on our proposed MIB (Management Information Base) VOIPQOS, deployed for speech quality monitoring purposes. Currently, the architecture is totally implemented, but under adjustment and validation tests. In the future, the VOIPQOS MIB can be expanded to automatically analyze collected data and control VoIP clients and network parameters for tuning the overall speech quality of ongoing calls. Copyright © 2006 John Wiley & Sons, Ltd. [source]


Transcoding media for bandwidth constrained mobile devices

INTERNATIONAL JOURNAL OF NETWORK MANAGEMENT, Issue 2 2005
Kevin Curran
Bandwidth is an important consideration when dealing with streaming media. More bandwidth is required for complex data such as video as opposed to a simple audio file. When delivering streaming media, sufficient bandwidth is required to achieve an acceptable level of performance. If the information streamed exceeds the bandwidth capacity of the client the result will be ,choppy' and incomplete with possible loss of transmission. Transcoding typically refers to the adaptation of streaming content. Typical transcoding scenarios exploit content-negotiation to negotiate between different formats in order to obtain the most optimal combination of requested quality and available resources. It is possible to transcode media to a lesser quality or size upon encountering adverse bandwidth conditions. This can be accomplished without the need to encode multiple versions of the same file at differing quality levels. This study investigates the capability of transcoding for coping with restrictions in client devices. In addition, the properties of transcoded media files are examined and evaluated to determine their applicability for streaming in relation to a range of broad device types capable of receiving streaming media.,Copyright © 2005 John Wiley & Sons, Ltd. [source]


Efficacy and toxicity of orally administered anticoccidial drugs for innovative treatments of Polysporoplasma sparis (Sitja-Bobadilla and Alvarez-Pellitero 1985) infection in Sparus aurata L.

JOURNAL OF APPLIED ICHTHYOLOGY, Issue 5 2004
F. Athanassopoulou
Summary The purpose of this study was to test experimentally different drugs and therapeutic schemes in order to find a efficient commercial treatment for fish infected with myxosporeans. Two series of land-based experiments and one experimental cage trial were performed for this purpose. In the first land-based experiment, 10 and 30 g Sparus aurata naturally infected in the kidneys with Polysporoplasma sparis were used. Initially, six different doses of Fumagillin, two doses of Toltrazuril, and one dose of Amprolium, ESB3 and Salinomycin were tested. In the second land-based experiment, 25 and 50 g fish infected with the same parasite were treated with Origanum essential oils, Toltrazuril with propylene glycol, Amprolium, and a combination of Salinomycin 12% + Amprolium (SA). In the field trials, 15 and 155 g S. aurata infected with the same parasite were treated with SA, Origanum essential oils and Fumagillin. In all trials the drugs were incorporated in food and administered according to the selected schemes, while their efficacy was evaluated in terms of mortality (acceptable level <2%), pathology and prevalence rate of P. sparis. According to our results the SA combination proved to be the most effective treatment against P. sparis infection in S. aurata: (i) the therapeutic scheme and commercial product used was not toxic and (ii) a significant reduction in percentage of prevalence was observed. [source]


Molecular markers and determinants of prostate cancer metastasis

JOURNAL OF CELLULAR PHYSIOLOGY, Issue 3 2001
Rahul V. Gopalkrishnan
Although intensely studied, the molecular and biochemical determinants of prostate cancer development and progression remain ill-defined. Moreover, current markers and methodologies cannot distinguish between a tumor that will remain indolent and not impinge on patient survival, versus a tumor with aggressive traits culminating in metastatic spread and death. Once prostate cancer is confirmed the most significant threat to a patient's survival and quality of life involves tumor metastasis. Radical surgery notwithstanding, prostate cancer accounts for 10% of all cancer-related deaths primarily arising through development of metastasis. Metastasis markers demonstrating an acceptable level of reliability are an obvious necessity if disproportionate and costly treatment is to be avoided and a reasonably accurate determination of clinical prognosis and measure of successful response to treatment is to be made. Therapeutic strategies that specifically inhibit metastatic spread are not presently possible and may not become available in the immediate future. This is because, while localized tumorigenesis has been relatively amenable to detection, analysis and treatment, metastasis remains a relatively undefined, complex and underexplored area of prostate cancer research. New findings in the field such subclasses of genes called metastasis suppressors and cancer progression suppressors, have opened up exciting avenues of investigation. We review current methodological approaches, model experimental systems and genes presently known or having potential involvement in human prostate cancer metastasis. © 2001 Wiley-Liss, Inc. [source]


,But everyone else is doing it': a closer look at the occupational taxpaying culture of one business sector

JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 3 2008
Julie S. Ashby
Abstract When individuals embark on their careers they not only become acculturated into their occupational sectors' day-to-day norms and practices, but also their taxpaying ones. Although the research on taxpaying cultures is still in its infancy, understanding more about taxpaying cultures could improve our understanding of the processes underlying tax compliance. To this end, this study aimed to build a detailed picture of the taxpaying culture (i.e. the norms and values) of one business sector,the hairdressing/beauty industry. Nineteen small business and self-employed hairdressers/beauticians were interviewed and a variant of Grounded theory was used to uncover the main themes that ran through the interviews as a whole. The main themes that emerged,which appear to characterize this sector's culture,include a reliance on accountants/tax advisors, the notion of an acceptable level of cash-in-hand payments, and the use of different mental accounts for different types of income. Although some of these themes have already arisen in the small business literature they have often been couched in individualistic terms. We build a case that these issues are more cultural than individual,they are tied to occupational group membership as they are socially constructed within occupational groups and are a key component of the group's taxpaying culture. Implications and directions for future research are discussed. Copyright © 2007 John Wiley & Sons, Ltd. [source]


Accidental Shooting: An Analysis

JOURNAL OF CONTINGENCIES AND CRISIS MANAGEMENT, Issue 3 2000
Michael T. Charles
Despite efforts at managing crises, they tenaciously occur at the most inopportune times. The crisis manager understands that the risk of a catastrophic failure never equals zero when the human species interacts with nature or man-made structures and processes. However, the role of responsible managers is to limit risk or at least to make a best effort in assuring that acceptable precautions are taken to reduce risk to an acceptable level. In this case study, the author discusses the elements of risk taking and the causes of error in a police firearms training environment. Also discussed are the goals of firearms training, and the impact of that training design on the firearms training environment which is put into perspective. The author looks at the mitigation, preparedness, response and recovery stages of crisis management as they relate to police firearms training. The author discusses precautions and how those precautions were violated in an established environment of safety, resulting in the accidental shooting in the gun-cleaning area. Also included are alternative safety measures designed to further negate the possibility of a recurrence of such an accident. [source]


CONSUMER ACCEPTANCE AND PURCHASE INTENT OF A NOVEL LOW-FAT SUGAR-FREE SHERBET CONTAINING SOY PROTEIN

JOURNAL OF FOOD QUALITY, Issue 2010
J. WALKER
ABSTRACT This research was designed to develop low-fat sugar-free frozen sherbet products containing an acceptable level of soy protein (SP) recommended by the Food and Drug Administration and to determine consumer sensory profile driving consumer acceptance and purchase intent. Four orange-flavored sherbets were manufactured using four levels of SP isolate (6.0, 6.5, 7.5 and 7.9 g/serving) and evaluated by 140 consumers. Consumers evaluated each sample for acceptability of appearance/color, flavor, sweetness, sourness, texture/mouthfeel and overall liking. Consumers also evaluated overall acceptance and purchase intent of these products. All four formulations were overall different (multivariate analysis of variance, Pr > F = 0.0003). Appearance and sweetness were not used by the consumers to differentiate among the four sherbet formulations. Formulations with 7.9 g and 6.0 g SP were equally liked with the mean overall liking score of 5.60,5.66. Formulation with 6.0 g SP had the highest acceptance (65.0%) and purchase intent (55.7%) after consumers had been informed of soy health benefits. Specifically, overall liking and texture were identified as the two most critical attributes affecting overall acceptance and purchase intent of these products. PRACTICAL APPLICATIONS Consumer interest in healthy eating is increasing. Soy-based products have moved into the marketplace and are becoming increasingly popular. Consumers tend to associate consuming soy with healthy eating habits. In this study, consumer acceptability of low-fat sugar-free sherbets containing soy protein (SP) was evaluated. Development of a frozen dessert with SP would give consumers another venue to satisfy consumer's eating desire and provide them with the health benefits of soy. [source]


FREQUENCY OF SALMONELLA, CAMPYLOBACTER, LISTERIA AND ENTEROBACTERIACEAE DETECTION IN COMMERCIALLY COOL WATER-WASHED SHELL EGGS

JOURNAL OF FOOD SAFETY, Issue 4 2006
DEANA R. JONES
ABSTRACT The effect of cool water washing on shell egg temperature and pathogen detection was examined. Three temperature schemes were utilized in commercial dual washer systems: (1) HH = 48.9C, 48.9C; (2) HC = 48.9C, 23.9C; and (3) CC = 23.9C, 23.9C. HH eggsmaintainedthe highest surface temperature (26.25C in-line, 20.25C off-line and 23.25C combined, P < 0.05). The lowest temperatures were found in the CC eggs (21.25C in-line, 17.25C off-line and 19.25C combined). The frequency of Enterobacteriaceae detection in shell and membrane emulsions was greatest for the CC eggs (P < 0.05 for in-line and combined). There was no difference in Enterobacteriaceae detection for the off-line facility. Salmonella was detected in three of 384 samples from the in-line facility. They were found in HC (2) and CC (1) shell emulsions. Two of 384 samples were positive for Campylobacter from the in-line facility (CC). Three wash water samples were positive for Listeria in the off-line facility (1 HC, 2 CC). No pathogens were detected in the egg contents during this study. The results of this study indicate that warm followed by cool water washing has the potential of decreasing egg temperature while maintaining surface microbiology at an acceptable level. [source]


NOVEL NONTHERMAL METHODS TO REDUCE VIBRIO VULNIFICUS IN RAW OYSTERS

JOURNAL OF FOOD SAFETY, Issue 3 2003
ABDOLSAMAD BORAZJANI
ABSTRACT Vibrio vulnificus is a foodborne pathogen associated with consumption of raw oyster. No scientific data is available on postharvest treatments of oyster by ultrasound, ozone, and organic acids. This study was designed to investigate the effects of these treatments on inactivation of V. vulnificus naturally present in the in-shell or half-shelled oysters. In in-shell oysters, these treatments were not effective in reducing the number of this pathogen. Half-shelled oysters treated with ultrasound, and ozone in 2% saline for 30 min had 1 and 1.5 log less V. vulnificus, respectively (p<0.05). Treatment of half-shelled oysters by 50 and 100% lemon juice, 5% citric acid, 10% citric acid, or vinegar for 30 min resulted in a significant reduction (2,4 log) in the numbers of V. vulnificus (p<0.05). Although these methods significantly reduced the population of V. vulnificus in raw oysters, they were not able to reduce the numbers of this pathogen to acceptable level (<3 MPN/g). [source]


Microbial Assessment in School Foodservices and Recommendations for Food Safety Improvement

JOURNAL OF FOOD SCIENCE, Issue 6 2008
Y. Yoon
ABSTRACT:, This study evaluated microbial food safety in school foodservices. Five school foodservices were randomly selected, and samples from water, cooking utensils, tableware, foodservice surroundings, and linen were collected in summer and winter (N= 420). Tap and drinking water samples were collected, samples of food contact surfaces were collected by swab-kit, and samples for foodservice workers' hands and gloves were prepared by glove juice method. Aerobic plate count (APC) and coliform bacterial populations were enumerated on plate count agar (PCA) and desoxycholate lactose agar, respectively. The presence of Escherichia coli, Salmonella, Listeria monocytogenes, and Staphylococcus aureus was also examined by biochemical identification tests. In addition, PCA agar for APCs and Baird-Parker agar for S. aureus were used to enumerate airborne microorganisms. Higher APCs (< 0 to 5.1 log CFU/mL) than acceptable level were generally observed in water samples, while low coliform counts were found in the samples. High APCs were enumerated in cooking utensils, foodservice workers, tableware, and foodservice surroundings, and coliforms were also found in the samples for both seasons. The presence of Salmonella was found from only 10% of plastic glove samples (summer), and the presence of L. monocytogenes was not observed in all samples. S. aureus was detected in some of water, cooking utensils, tableware, employees, and foodservice surroundings, and E. coli was observed in cooking utensils (10% to 20%; summer). No obvious airborne bacteria were detected. These results showed that sanitation practice in school foodservices should be improved, and the results may be useful in microbial assessment of school foodservices. [source]


Stroke volume averaging for individualized goal-directed fluid therapy with oesophageal Doppler

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 1 2009
C. C. JØRGENSEN
Background: An individualized fluid optimization strategy, based on maximization of cardiac stroke volume (SV) with colloid boluses (goal-directed therapy), improves outcome after surgery. Oesophageal Doppler (OD) is used for SV maximization in most randomized studies, but evidence-based guidelines for the SV maximization procedure are lacking and variation in SV may influence the indication for fluid administration. We measured beat-to-beat OD SV before and after fluid optimization in order to estimate the number of heartbeats for which SV needs to be averaged to provide an acceptable accuracy for goal-directed therapy with this technology. Methods: Twenty patients scheduled for surgery were anaesthetized, followed by OD SV assessment. Thirty seconds of beat-to-beat data were recorded before and after volume optimization performed by successive boluses of 200 ml colloid until SV did not increase ,10%. SV variability was assessed before and after the volume optimization when SV was measured beat to beat and when it was averaged over 2,10 heartbeats. Results: Nineteen (95%) and 17 (85%) patients demonstrated an SV variability ,10% before and after volume optimization, respectively, when SV was measured beat to beat. However, when SV was averaged over 10 heartbeats, only two (10%) and one (5%) of the patients demonstrated an SV variability ,10% before and after optimization, respectively (P<0.0001). Conclusion: OD SV variability is significantly reduced and reaches an acceptable level when SV is averaged over 10 heartbeats. The use of a shorter averaging period for SV may lead to incorrect volume administration in goal-directed fluid management. [source]


The impact of detergent chemistry on TBN retention

LUBRICATION SCIENCE, Issue 3 2000
W. van Dam
Abstract Historically, the characterisation of fresh and used diesel engine lubricants has been based on a limited number of analytical techniques. One of the most important methods of analysis has been total base number (TBN) measurement. Although TBN measurements are informative, easy, and quick, it can be misleading to base the judgement of an oil's performance solely on one criterion. This paper offers some observations from a field test, showing that some detergent types gave unacceptable performance even though the TBNs were at an acceptable level. It is hypothesised that some detergents do not effectively neutralise all acidic species present in the lubricant, thereby reserving their own base, while in fact the oil may no longer provide sufficient protection against bearing corrosion. This hypothesis is supported by bench and engine test data. It is recommended that, at a minimum, total acid number (TAN) measurements be included in any analysis, and where time and cost permit, wear metals content, oxidation, soot content, and viscosity should also be evaluated. [source]


Pricing training and development programs using stochastic CVP analysis

MANAGERIAL AND DECISION ECONOMICS, Issue 3 2005
James A. Yunker
This paper sets forth, analyzes and applies a stochastic cost-volume-profit (CVP) model specifically geared toward the determination of enrollment fees for training and development (T+D) programs. It is a simpler model than many of those developed in the research literature, but it does incorporate one advanced component: an ,economic' demand function relating the expected sales level to price. Price is neither a constant nor a random variable in this model but rather the decision-maker's basic control variable. The simplicity of the model permits analytical solutions for five ,special prices': (1) the highest price which sets breakeven probability equal to a minimum acceptable level; (2) the price which maximizes expected profits; (3) the price which maximizes a Cobb,Douglas utility function based on expected profits and breakeven probability; (4) the price which maximizes breakeven probability; and (5) the lowest price which sets breakeven probability equal to a minimum acceptable level. The model is applied to data provided by the Center for Management and Professional Development at the authors' university. The results suggest that there could be a significant payoff to fine-tuning a T+D provider's pricing strategy using formal analysis. Copyright © 2005 John Wiley & Sons, Ltd. [source]


Reliability of the Amsterdam Clinical Challenge Scale (ACCS): a new instrument to assess the level of difficulty of patient cases in medical education

MEDICAL EDUCATION, Issue 7 2000
Gercama
Introduction In problem-based medical curricula, consideration should be given to the level of difficulty of patient cases used for training and assessment. The Amsterdam Clinical Challenge Scale (ACCS) has been developed to assess the degree of difficulty of patient cases in a systematic and reproducible manner. To determine the reliability of the instrument two research questions were addressed: (1) How many judges are required, on the basis of the total score of the ACCS, to obtain a reliable estimate of the difficulty of a single case? (2) How many cases and/or how many judges are needed to reach an acceptable level of reliability of the total score of the ACCS? Method Four judges scored 36 patient scripts reflecting a wide range of patient problems encountered in general practice. Each script was scored four times. In the reliability analysis, the generalizability theory was applied. Results The results show that the judges did, indeed, use the whole range of difficulty ratings. When the ACCS is applied to a single case, eight or more judges are needed to reach an acceptable level of reliability. When more cases are involved, fewer judges are needed; for 10 or more cases one judge will be sufficient. Conclusions Given the typical length, for example of an objective structured clinical examination, the ACCS makes it possible to provide a reliable estimate of the level of difficulty of such a test with only a limited number of judges. [source]


Testing high SPF sunscreens: a demonstration of the accuracy and reproducibility of the results of testing high SPF formulations by two methods and at different testing sites

PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE, Issue 4 2002
Patricia Poh Agin
Background/Purpose: The goals of this study were (i) to demonstrate that existing and widely used sun protection factor (SPF) test methodologies can produce accurate and reproducible results for high SPF formulations and (ii) to provide data on the number of test-subjects needed, the variability of the data, and the appropriate exposure increments needed for testing high SPF formulations. Methods: Three high SPF formulations were tested, according to the Food and Drug Administration's (FDA) 1993 tentative final monograph (TFM) ,very water resistant' test method and/or the 1978 proposed monograph ,waterproof' test method, within one laboratory. A fourth high SPF formulation was tested at four independent SPF testing laboratories, using the 1978 waterproof SPF test method. All laboratories utilized xenon arc solar simulators. Results: The data illustrate that the testing conducted within one laboratory, following either the 1978 proposed or the 1993 TFM SPF test method, was able to reproducibly determine the SPFs of the formulations tested, using either the statistical analysis method in the proposed monograph or the statistical method described in the TFM. When one formulation was tested at four different laboratories, the anticipated variation in the data owing to the equipment and other operational differences was minimized through the use of the statistical method described in the 1993 monograph. Conclusions: The data illustrate that either the 1978 proposed monograph SPF test method or the 1993 TFM SPF test method can provide accurate and reproducible results for high SPF formulations. Further, these results can be achieved with panels of 20,25 subjects with an acceptable level of variability. Utilization of the statistical controls from the 1993 sunscreen monograph can help to minimize lab-to-lab variability for well-formulated products. [source]


Assessing the regulatory model for water supply in Jakarta

PUBLIC ADMINISTRATION & DEVELOPMENT, Issue 4 2008
Michiko Iwanami
Abstract This article assesses the regulatory model for urban water supply services in Jakarta, the capital of Indonesia. Water supply services have been privately operated there since February 1998 after two companies,Thames PAM Jaya (TPJ), operating in Eastern Jakarta, and PAM Lyonnaise Jaya (PALYJA), operating in Western Jakarta,signed 25-years concession contracts with the state-owned Jakarta City Water Company (PAM Jaya). An independent regulatory body, the Jakarta Water Supply Regulatory Body (JWSRB) was established in 2001. The article compares the regulatory system in Jakarta with the French and English approaches to water regulation. It then assesses this regulatory system from the perspective of customers in order to assess how well customer protection, a central purpose of regulation, is being performed. The article concludes that although the essential regulatory mechanisms and activities are operating in Jakarta, the key regulatory role of customer protection is not being performed because customers do not perceive that they receive an acceptable level of water supply services. Copyright © 2008 John Wiley & Sons, Ltd. [source]


Disposable MagLev Centrifugal Blood Pump Utilizing a Cone-Shaped Impeller

ARTIFICIAL ORGANS, Issue 8 2010
Wataru Hijikata
Abstract To enhance the durability and reduce the blood trauma of a conventional blood pump with a cone-shaped impeller, a magnetically levitated (MagLev) technology has been applied to the BioPump BPX-80 (Medtronic Biomedicus, Inc., Minneapolis, MN, USA), whose impeller is supported by a mechanical bearing. The MagLev BioPump (MagLev BP), which we have developed, has a cone-shaped impeller, the same as that used in the BPX-80. The suspension and driving system, which is comprised of two degrees of freedom, radial-controlled magnetic bearing, and a simply structured magnetic coupling, eliminates any physical contact between the impeller and the housing. To reduce both oscillation of the impeller and current in the coils, the magnetic bearing system utilizes repetitive and zero-power compensators. In this article, we present the design of the MagLev mechanism, measure the levitational accuracy of the impeller and pressure-flow curves (head-quantity [HQ] characteristics), and describe in vitro experiments designed to measure hemolysis. For the flow-induced hemolysis of the initial design to be reduced, the blood damage index was estimated by using computational fluid dynamics (CFD) analysis. Stable rotation of the impeller in a prototype MagLev BP from 0 to 2750 rpm was obtained, yielding a flow rate of 5 L/min against a head pressure in excess of 250 mm Hg. Because the impeller of the prototype MagLev BP is levitated without contact, the normalized index of hemolysis was 10% less than the equivalent value with the BPX-80. The results of the CFD analysis showed that the shape of the outlet and the width of the fluid clearances have a large effect on blood damage. The prototype MagLev BP satisfied the required HQ characteristics (5 L/min, 250 mm Hg) for extracorporeal circulation support with stable levitation of the impeller and showed an acceptable level of hemolysis. The simulation results of the CFD analysis indicated the possibility of further reducing the blood damage of the prototype MagLev BP. [source]


Basic Fibroblast Growth Factor Coating and Endothelial Cell Seeding of a Decellularized Heparin-coated Vascular Graft

ARTIFICIAL ORGANS, Issue 7 2004
Brian S. Conklin
Abstract:, The objective of this study was to determine the effect of basic fibroblast growth factor (bFGF) coating on endothelial cell seeding and proliferation on a decellularized heparin coated vascular graft and to determine the retention of seeded cells on the graft under flow conditions. Disks of heparin coated decellularized grafts were incubated for 24 h as controls or with bFGF. Human microvascular endothelial cells (HMECs) or canine peripheral blood endothelial progenitor cells (CEPC) were seeded onto the disks and incubated for 96 h or 48 h, respectively. HMECs were also seeded onto the luminal surfaces of two heparin-coated decellularized grafts for 3 h. One graft was placed in a perfusion culture system and cultured for an additional 6 h with flow and pressure. After culturing, there were 4.7 ± 1.4 cells/mm2 HMECs on control grafts and 11.4 ± 1.4 cells/mm2 in bFGF treated grafts (P < 0.05). Likewise, with CEPCs, there were 14.8 ± 4.8 cells/mm2 in control grafts and 33.3 ± 7.3 cells/mm2 in bFGF treated grafts. After only 3 h of cell attachment, 60% of HMECs were retained in the intact graft exposed flow relative to the static control graft, which is an acceptable level. These data demonstrate that bFGF coating on the heparin bound decellularized grafts significantly increases both HMEC and dog EPC proliferation and that seeded cells are stable under perfusion conditions. [source]


Outcome of pregnancies achieved by in vitro fertilisation techniques and diagnosed as twins at the 6 week ultrasound

AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 6 2004
Gabor T. KOVACS
Abstract Background: To bring the success rate of in vitro fertilisation (IVF) procedures to an acceptable level, multiple embryos have historically been replaced. This has resulted in an ,epidemic' of multiple births. The pendulum has now swung full circle and the number of embryos transferred is now being limited. Such high numbers of IVF twins will not be produced in the future. Aim: To review retrospectively the outcome of a series of pregnancies achieved by IVF where the 6 week ultrasound showed the presence of two sacs. Methods: Retrospective study in a university IVF programme that produced 746 IVF pregnancies with twins at 6 weeks of gestation (1991,1999). Results: The main outcome measures were perinatal mortality, pregnancy outcome, gestation at delivery and obstetrics complications reported. Interestingly, by 20 weeks gestation, 184 (24.7%) of pregnancies spontaneously reduced to a singleton, whereas 49 (6.6%) lost both twins. Of the 513 (68.8%) viable twin pregnancies (>20 weeks), 154 (20.6%) went on to term (>37 weeks), whereas 250 (33.5%) delivered between 33 and 36 weeks gestation. The perinatal mortality per 1000 births was 6.5 over 37 weeks, 8.0 for 33,36 weeks, 41.7 for 29,32 weeks and 500 for under 28 weeks. [source]


Middleboxes: Controllable media firewalls

BELL LABS TECHNICAL JOURNAL, Issue 1 2002
Paul Sijben
Internet technology is promised for the broadband multi-service future. However, it is unclear how this technology can bring service providers the needed revenue, since today this technology cannot provide basic quality guarantees for the services rendered. Generally, over-provisioning of the bandwidth is used to get the services to an acceptable level, but this is costly and cannot work in areas where high aggregation rates are necessary (such as the local loop). Today IP (router) technology lacks mechanisms for high-granularity access control, per-user accounting, and quality of service (QoS) policing. We believe that, for a service provider to deploy billable services, these issues need to be resolved. Only if access to the service is controlled and only when the network provides information about the usage of the network elements can next-generation services in the telecommunication industry, like voice over IP (VoIP) and multimedia conferencing, be rolled out profitably. In this paper, we present a technology that can address these needs. We employ controllable firewalls that have the ability to prevent unwanted IP traffic from entering a network. Creating pinholes that allow individual calls (voice or real-time multimedia streams) in controllable firewalls can be done very fast and efficiently. Traditional firewalls have no such provisioning. Multiple application servers should be able to request pinholes to one or more controllable firewalls. This approach, while familiar from the public switched telephone network (PSTN), is a new paradigm for IP networks. © 2002 Lucent Technologies Inc. [source]


Pretreatment of hybrid poplar by aqueous ammonia

BIOTECHNOLOGY PROGRESS, Issue 2 2009
Rajesh Gupta
Abstract Enzymatic hydrolysis of hybrid poplar treated by ammonia recycle percolation (ARP) was studied applying cellulase enzyme supplemented with additional xylanase or pectinase. The effect of xylanase addition was much more significant than pectinase addition. Conversion of ARP-treated hybrid poplar to ethanol was carried out by simultaneous saccharification and fermentation (SSF) and SS and cofermentation (SSCF). The maximum ethanol yield observed from the SSCF experiment was 78% of theoretical maximum based on the total carbohydrate (glucan + xylan). The same feedstock was also treated by soaking in aqueous ammonia (SAA), a batch pretreatment process with lower severity than ARP. The test results indicated that relatively high severity is required to attain acceptable level of digestibility of hybrid poplar. In order to lower the severity of the pretreatment, addition of H2O2 was attempted in the SAA. Addition of H2O2 significantly enhanced delignification of hybrid poplar due to its oxidative degradation of lignin. Several different H2O2 feeding schemes and different temperature profiles were attempted in operation of the SAA to investigate the effects of H2O2 on degradation of lignin and carbohydrates in hybrid poplar. More than 60% of lignin in hybrid poplar was removed with stepwise-increase of temperature (60,120°C after 4h of reaction). Increase of carbohydrate degradation was also observed under this condition. © 2009 American Institute of Chemical Engineers Biotechnol. Prog., 2009 [source]


Postmarketing surveillance for human teratogenicity: A model approach,

BIRTH DEFECTS RESEARCH, Issue 5 2001
Christina D. Chambers
Background Most congenital defects associated with prenatal exposures are notable for a pattern of major and minor malformations, rather than for a single major malformation. Thus, traditional epidemiological methods are not universally effective in identifying new teratogens. The purpose of this report is to outline a complementary approach that can be used in addition to other more established methods to provide the most comprehensive evaluation of prenatal exposures with respect to teratogenicity. Methods We describe a multicenter prospective cohort study design involving dysmorphological assessment of liveborn infants. This design uses the Organization of Teratology Information Services, a North American network of information providers who also collaborate for research purposes. Procedures for subject selection, methods for data collection, standard criteria for outcome classification, and the approach to analysis are detailed. Results The focused cohort study design allows for evaluation of a spectrum of adverse pregnancy outcomes ranging from spontaneous abortion to functional deficit. While sample sizes are typically inadequate to identify increased risks for single major malformations, the use of dysmorphological examinations to classify structural anomalies provides the unique advantage of screening for a pattern of malformation among exposed infants. Conclusions As the known human teratogens are generally associated with patterns of structural defects, it is only when studies of this type are used in combination with more traditional methods that we can achieve an acceptable level of confidence regarding the risk or safety of specific exposures during pregnancy. Teratology 64:252,261, 2001. © 2001 Wiley-Liss, Inc. [source]


Salvage reoperation for complications after ileal pouch,anal anastomosis

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 6 2005
N. Dehni
Background: Surgical revision may be possible in patients with a poor outcome following ileal pouch,anal anastomosis (IPAA), using either a transanal approach or a combined abdominoperineal approach with pouch revision and reanastomosis. Methods: Sixty-four patients underwent revisional surgery. The indication for salvage was sepsis in 47 patients, mechanical dysfunction in ten, isolated complications of the residual glandular epithelial cuff in three and previous intraoperative difficulties in four patients. Results: A transanal approach was used in 19 patients and a combined abdominoperineal procedure in 45. Six of the latter had pouch enlargement and 25 received a new pouch. During a mean(s.d.) follow-up of 30(25) months, three patients required pouch excision because of Crohn's disease. Two patients had poor continence after abdominoperineal surgery. At last follow-up 60 (94 per cent) of 64 patients had a functional pouch. Half of the patients experienced some degree of daytime and night-time incontinence, but it was frequent in only 15 per cent. Of 58 patients analysed, 27 of 40 who had an abdominoperineal procedure and 13 of 18 who had transanal surgery rated their satisfaction with the outcome as good to excellent. Conclusion: Surgical revision after failure of IPAA was possible in most patients, yielding an acceptable level of bowel function in two-thirds of patients. Copyright © 2005 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]


Validity of the Danish Prostate Symptom Score questionnaire in stroke

ACTA NEUROLOGICA SCANDINAVICA, Issue 6 2009
S. Tibaek
Objective,,, To determine the content and face validity of the Danish Prostate Symptom Score (DAN-PSS-1) questionnaire in stroke patients. Materials and methods,,, Content validity was judged among an expert panel in neuro-urology. The judgement was measured by the content validity index (CVI). Face validity was indicated in a clinical sample of 482 stroke patients in a hospital-based, cross-sectional survey. Results,,, I-CVI was rated >0.78 (range 0.94,1.00) for 75% of symptom and bother items corresponding to adequate content validity. The expert panel rated the entire DAN-PSS-1 questionnaire highly relevant (S-CVI = 1.00). No experts suggested items omitted or improved. The response rate was 84% and face validity had an acceptable level of completed response for each symptom items (96,98%) and bother items (93,96%) indicating that all items were well interpreted. Conclusion,,, The DAN-PSS-1 questionnaire appears to be content and face valid for measuring lower urinary tract symptoms after stroke. [source]