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Terms modified by Cutoff Selected AbstractsProposal for a new risk model in myelodysplastic syndrome that accounts for events not considered in the original International Prognostic Scoring SystemCANCER, Issue 6 2008Hagop Kantarjian MD Abstract BACKGROUND. Recent studies have highlighted issues with the International Prognostic Scoring System (IPSS) model in relation to the exclusion of many subgroups that now represent a large proportion of patients with myelodysplastic syndrome (MDS) (eg, secondary MDS, chronic myelomonocytic leukemia [CMML] with leukocytosis, prior therapy) and its lack of applicability to most patients on investigational programs, because many would have received prior therapies and would have had MDS for a significant length of time. METHODS. The authors analyzed 1915 patients with MDS who were referred from 1993 to 2005 (including those with CMML, secondary MDS, and MDS with prior therapy). Only 507 patients (26%) had primary MDS without prior therapy (ie, classifiable by the IPSS). Patients were divided randomly into a study group (n = 958) and a test group (n = 957). RESULTS. A multivariate analysis of prognostic factors in the study group identified the following adverse, independent factors as continuous and categoric values (P<.001): poor performance, older age, thrombocytopenia, anemia, increased bone marrow blasts, leukocytosis, chromosome 7 or complex (,3) abnormalities, and prior transfusions. Cutoffs for anemia, thrombocytopenia and blasts, and cytogenetic subsets were different according to the IPSS. The new MDS prognostic model divided patients into 4 prognostic groups with significantly different outcomes. The model was validated in the test group. Applying the prognostic score of the new model within the 4 IPSS risk groups, overall, and in patients who had primary MDS without prior therapy was found to be highly prognostic in each subset. Applying the IPSS within each of the 4 risk groups of the new MDS model was not found to be prognostic. CONCLUSIONS. The new model accounts for duration of MDS and prior therapy. It is applicable to any patient with MDS at any time during the course of MDS. Cancer 2008. © 2008 American Cancer Society. [source] Growth of YCOB single crystals by flux technique and their characterizationCRYSTAL RESEARCH AND TECHNOLOGY, Issue 5 2008R. Arun Kumar Abstract Nonlinear optical single crystals of YCOB with good optical quality were grown by the flux technique for the first time. Polycrystalline YCOB samples were synthesized by solid state reaction method. The thermal analysis of the sample was performed with lithium carbonate flux in different weight proportions and the growth temperature was optimised. Single crystals of YCOB with dimensions 3 × 3 × 5 mm3 were obtained by the method of ,slow-cooling'. The grown crystals were characterized by XRD, UV-VIS-NIR, EDAX, FTIR and etching studies. The powder XRD pattern revealed the formation of YCOB compound. The lattice parameters were identified through single crystal XRD studies. The UV-VIS-NIR results showed that the crystal has a sharp cutoff at 220 nm and is nearly 55% transparent over a wide wavelength range enabling applications in the UV region. The EDAX measurement revealed the ,flux-free' crystal formation. The presence of the functional groups belonging to the YCOB crystals was identified by the FTIR results. ,Hillock-like' patterns are observed in the etching studies. The primary emphasis in this study is laid to describe ,flux technique' as an alternative method to grow YCOB crystals. The results are presented and discussed. (© 2008 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] p27Kip1 Expression and grading of breast cancer diagnosed on cytological samplesDIAGNOSTIC CYTOPATHOLOGY, Issue 6 2004Giancarlo Troncone M.D. Abstract The progressive reduction in p27Kip1 (p27) protein immunohistochemical staining with increasing histological grading is a well-established finding occurring in breast cancer, and its role as diagnostic complement and prognostic marker has been thoroughly evaluated. To clarify whether this test may be applied to breast cytopathology, we performed p27 immunostaining on fresh fine-needle cytology (FNC) samples from 10 benign and 40 malignant breast lesions. On average, p27 immunostaining was significantly lower in carcinomas than in benign lesions (P < 0.005). In particular, among carcinomas, p27 immunostaining progressively reduced from well-to poorly differentiated lesions (G1 vs. G2, P < 0.05; G1 vs. G3, P < 0.001; G2 vs. G3; P < 0.001). A similar trend was noted in a subgroup of 20 matched FNCs and histological samples of breast carcinomas, when p27 immunostaining on FNCs was stratified according to the histological grading (G1 vs. G2, P = 0.18; G1 vs. G3, P < 0.05; G2 vs. G3, P < 0.05). In addition, p27 immunostaining on FNCs showed a good positive correlation with that on histology (Spearman R = 0.58; P < 0.01), with a diagnostic concordance between samples of 85%, by using the standard 50% positive cell cutoff. Taken in concert, our data suggest that p27 immunostaining is a reliable marker of tumor cell differentiation in breast cytopathology as well as in histopathology. Accordingly, staining FNCs for p27 may be an useful complement in addition to cytological grading in the preoperative assessment of breast cancer. Diagn. Cytopathol. 2004;30:375,380. © 2004 Wiley-Liss, Inc. [source] Effects of vegetation on channel morphodynamics: results and insights from laboratory experimentsEARTH SURFACE PROCESSES AND LANDFORMS, Issue 9 2010Michal Tal Abstract A series of laboratory experiments demonstrates that riparian vegetation can cause a braided channel to self-organize to, and maintain, a dynamic, single-thread channel. The initial condition for the experiments was steady-state braiding in non-cohesive sand under uniform discharge. From here, an experiment consisted of repeated cycles alternating a short duration high flow with a long duration low flow, and uniform dispersal of alfalfa seeds over the bed at the end of each high flow. Plants established on freshly deposited bars and areas of braidplain that were unoccupied during low flow. The presence of the plants had the effect of progressively focusing the high flow so that a single dominant channel developed. The single-thread channel self-adjusted to carry the high flow. Vegetation also slowed the rate of bank erosion. Matching of deposition along the point bar with erosion along the outer bend enabled the channel to develop sinuosity and migrate laterally while suppressing channel splitting and the creation of new channel width. The experimental channels spontaneously reproduced many of the mechanisms by which natural meandering channels migrate and maintain a single dominant channel, in particular bend growth and channel cutoff. In contrast with the braided system, where channel switching is a nearly continuous process, vegetation maintained a coherent channel until wholesale diversion of flow via cutoff and/or avulsion occurred, by which point the previous channel tended to be highly unfavorable for flow. Thus vegetation discouraged the coexistence of multiple channels. Varying discharge was key to allowing expression of feedbacks between the plants and the flow and promoting the transition from braiding to a single-thread channel that was then dynamically maintained. Copyright © 2010 John Wiley & Sons, Ltd. [source] Morphodynamics of the exit of a cutoff meander: experimental findings from field and laboratory studies,EARTH SURFACE PROCESSES AND LANDFORMS, Issue 3 2010J. Le Coz Abstract The morphological evolution of the entrances and exits of abandoned river channels governs their hydrological connectivity. The study focusses on flow and sediment dynamics in the exit of a cutoff meander where the downstream entrance is still connected to the main channel, but the upstream entrance is closed. Two similar field and laboratory cases were investigated using innovative velocimetry techniques (acoustic Doppler profiling, image analysis). Laboratory experiments were conducted with a mobile-bed physical model of the Morava River (Slovakia). Field measurements were performed in the exit of the Port-Galland cutoff meander, Ain River (France). Both cases yielded consistent and complementary results from which a generic scheme for flow patterns and morphological evolution was derived. A simple analogy with flows in rectangular side cavities was used to explain the recirculating flow patterns which developed in the exit. A decelerating inflow deposits bedload in the downstream part of the cavity, while the upstream part is eroded by an accelerating outflow, leading to the retreat of the upstream bank. In the field, strong secondary currents were observed, especially in the inflow, which may enhance the scouring of the downstream corner of the cavity. Also, fine sediment deposits constituted a silt layer in a transitional zone, located between the mouth of the abandoned channel and the oxbow-lake within the cutoff meander. Attempts at morphological prediction should consider not only the flow and sediment conditions in the cavity, but also the dynamics of the main channel. Copyright © 2010 John Wiley & Sons, Ltd [source] Relationship between Strain Rate Imaging and Coronary Flow Reserve in Assessing Myocardial Viability after Acute Myocardial InfarctionECHOCARDIOGRAPHY, Issue 8 2010Ph.D., Seong-Mi Park M.D. Objectives: To evaluate the relationship between strain rate (SR) imaging and coronary flow reserve (CFR) in assessing viability of akinetic myocardium after acute myocardial infarction (MI). Methods: Forty patients with acute first ST-elevation MI were analyzed. SR imaging and CFR by intracoronary flow measurement were obtained on the same day, 3,5 days after primary percutaneous coronary intervention. Viability of the akinetic myocardium was determined on 6-week echocardiography. Results: Systolic SR (SRs, ,0.42 ± 0.10 vs. ,0.35 ± 0.11 per second, P = 0.03), early diastolic SR (SRe, 0.68 ± 0.31 vs. 0.41 ± 0.22 per second, P = 0.003), and systolic strain (Ss, ,5.9 ± 3.4 vs. ,2.5 ± 4.0%, P = 0.04) were greater in akinetic, but viable myocardium of 21 patients than in akinetic and nonviable myocardium of 19 patients. CFR was also higher in patients with akinetic, but viable myocardium (2.0 ± 0.5 vs. 1.5 ± 0.5, P < 0.001). SRs, SRe, and Ss were significantly related to CFR (r =,0.50, r = 0.58, r =,0.56, respectively, all P , 0.001) and SRe was most related to CFR (P < 0.001). The sensitivity and specificity to predict myocardial viability were 85.7% and 68.4% for CFR (cutoff = 1.75), and 90.5% and 57.9% for SRe (cutoff = 0.37 per second), respectively. Conclusions: The degree of myocardial deformation determined by SR imaging was related to the degree of microvascular integrity determined by CFR, and can be used as a noninvasive method to predict myocardial viability after acute MI. (Echocardiography 2010;27:977-984) [source] Ventricular Mechanical Asynchrony in Patients with Different Degrees of Systolic Dysfunction: Results from AVE Registry by the Italian Society of Cardiovascular Echography (SIEC)ECHOCARDIOGRAPHY, Issue 2 2010Scipione Carerj M.D. Objective: The aim of the study was to compare the prevalence of interventricular and intraventricular asynchrony in patients with different degrees of left ventricular (LV) dysfunction. Methods: We enrolled 182 patients (male 79%, mean age 64 ± 11 years) with LV ejection fraction (EF) < 50% and identified two groups: Group A (n = 79) with mild-to-moderate LV dysfunction (EF between 36% and 49%) and Group B (n = 103) with severe dysfunction (EF , 35%). An echocardiogram was performed in all patients and a delay longer than 40 msec in the time difference between the aortic and pulmonary preejection intervals was considered as an index of interventricular asynchrony. The electromechanical delays were assessed by pulsed tissue Doppler technique. A time difference between the earliest and the latest segment greater than 40 msec was considered the cutoff for intraventricular asynchrony. The sum of asynchrony was calculated by adding to the LV intraventricular delay the delay between the lateral basal right ventricular segment and the most delayed LV basal segment. Results: The prevalence of interventricular asynchrony was lower among Group A patients (19.8% vs. 37.9%; P = 0.007) while the prevalence of intraventricular asynchrony did not differ between groups (32.9% vs. 44% in Group A and Group B respectively; P = 0.18). The sum of asynchrony (cutoff >102 msec) did not differ between groups either (29.9% vs. 35.9%; P = 0.39). Conclusions: The prevalence of intraventricular asynchrony is independent of the LV systolic dysfunction severity. This could indicate the potential role of cardiac resynchronization therapy in patients with mild-moderate systolic dysfunction. (ECHOCARDIOGRAPHY 2010;27:110-116) [source] Incidence of Traumatic Lumbar PunctureACADEMIC EMERGENCY MEDICINE, Issue 2 2003Kaushal H. Shah MD Abstract Objective: To determine the incidence of traumatic lumbar puncture (LP). Methods: A retrospective study was conducted at an urban, university tertiary care referral center with 50,000 annual emergency department (ED) visits. The study population included all patients who had cerebrospinal fluid (CSF) samples sent to the laboratory between August 15, 2000, and August 14, 2001. The numbers of red blood cells (RBCs) recorded in the first and last CSF tubes, the location where the LP was performed, and the discharge summary and the discharge diagnoses from the particular visit were obtained. All patients with intracranial pathology and CSF obtained via neurosurgical procedure or fluoroscopic guidance were excluded from the study group. Given no clear definition of traumatic LP in the literature, the incidence of traumatic LP was calculated using a cutoff of greater than 400 RBCs (visual threshold for bloody fluid) and 1,000 RBCs (arbitrary threshold selected by other authors) in CSF tube 1. Proportions were compared using chi-square statistics. Results: Seven hundred eighty-six CSF samples were recorded over one year. Twenty-four samples were obtained from patients with intracranial pathology or were obtained via a neurosurgical procedure. Of the remaining 762 CSF samples in the study population, 119 (15.6%) were traumatic using a cutoff of 400 RBCs, and 80 (10.5%) were traumatic, using a cutoff of 1,000 RBCs in tube 1. Five hundred three LPs were done in the ED and 259 were attributed to all other locations in the hospital. Using a cutoff of 400 RBCs, the incidence of traumatic LP in the ED was 13.3%, compared with 20% in the rest of the hospital (p < 0.025). Similarly, using a cutoff of 1,000 RBCs, the incidence of traumatic LP in the ED was 8.9%, compared with 13.5% in the rest of the hospital (p = 0.1). The incidence of "champagne taps" (defined as zero RBCs in the first and last tubes) in the ED was 34.4%, compared with 24.3% in the rest of the hospital (p < 0.01). Conclusions: The incidence of traumatic lumbar puncture is approximately 15% using a cutoff of 400 RBCs and 10% using a cutoff of 1,000 RBCs. In this study, the rate of traumatic lumbar puncture was significantly less (with a cutoff of 400 RBCs) and the rate of champagne tap was significantly greater for LPs done in the ED compared with the rest of the hospital. [source] Postoperative brachytherapy alone and combined postoperative radiotherapy and brachytherapy boost for squamous cell carcinoma of the oral cavity, with positive or close margins,HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 3 2004Michel Lapeyre MD Abstract Background. Postoperative radiotherapy is necessary for squamous cell carcinoma (SCC) of the oral cavity with positive or close margins. The aim of the study is to define the indications of postoperative brachytherapy (BRT). Methods. From 1979 to 1993, 82 patients with positive or close margins had postoperative BRT (58 T1,2, 24 T3,4, 45 mobile tongue, 37 floor of mouth). Forty-six patients had combined radiotherapy (RT) with a mean dose of 48 Gy, and BRT boost with a mean dose of 24 Gy. Thirty-six patients had BRT alone with a mean dose of 60 Gy. BRT was performed with interstitial low dose rate Iridium 192. Results. Overall survival (OS), cause-specific survival (CSS), and local control (LC) at 5 years were, respectively, for T1,2/N0N, with BRT, 75%, 85%, and 88%,and with RT-BRT 70%, 92%, and 92%; for T1,2/N+ with RT-BRT, 44%, 67%, and 78%; for T3,4/N, with RT-BRT, 42%, 90%, and 80%; and for T3,4/N+ with RT-BRT, 22%, 43%, and 57%. Prognostic factors for OS, CSS, and LC were N+ (p , .009), extracapsular spread (ECS+;p , .000001), and T stage for LC only (p = .02). Prognostic factors for complications were a high number of wires with a cutoff at five wires (p = .008), a high dose rate with a cutoff at 0.57 Gy/hr (p = .01), and a high total dose (BRT + RT) with a cutoff at 71 Gy (p = .07). Conclusions. BRT alone for SCC T1,2/N0N, is better than RT-BRT because, with equivalent results, it avoids the adverse events of postoperative RT (xerostomia) and permits the treatment of a second head and neck primary in nonirradiated tissue. The results for the T3,4/N, are acceptable with this approach (ie, RT-BRT) but may be improved for N+. © 2004 Wiley Periodicals, Inc. Head Neck26: 216,223, 2004 [source] FDG PET studies during treatment: Prediction of therapy outcome in head and neck squamous cell carcinomaHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 2 2002Eva Brun MD Background Positron emission tomography (PET) provides metabolic information of tissues in vivo. The purpose of this study was to assess the value of PET with 2-[18 F] fluoro-2-deoxy- D -glucose (FDG) in prediction of therapy outcome (tumor response, survival, and locoregional control) in locally advanced HNSCC. Methods Between 1993 and 1999 47 patients underwent PET before (PET1) and after (PET2) 1 to 3 weeks of radical treatment with evaluation of metabolic rate (MR) and standardized uptake value (SUV) of FDG. All patients received radiotherapy, and 10 also received neoadjuvant chemotherapy. Median follow-up time was 3.3 years. Results Low and high MR FDG at PET2, with median value as cutoff, was associated with complete remission in 96% and 62% (p = .007), with 5-year overall survival in 72% and 35% (p = .0042) and with local control in 96% and 55% (p = .002), respectively. Conclusions FDG PET in the early phase of treatment of HNSCC is associated with tumor response, survival, and local control. © 2002 John Wiley & Sons, Inc. [source] Long-term follow-up after successful interferon therapy of acute hepatitis CHEPATOLOGY, Issue 1 2004Johannes Wiegand Early treatment of acute hepatitis C infection with interferon alfa-2b (IFN-,-2b) prevents chronicity in almost all patients. So far, no data are available on the long-term outcome after interferon (IFN) therapy of acute hepatitis C. The aim of this study was to assess the clinical, virological, and immunological long-term outcome of 31 successfully treated patients with acute hepatitis C infection who were followed for a median of 135 weeks (52-224 weeks) after end of therapy. None of the individuals had clinical evidence of liver disease. Alanine aminotransferase (ALT) levels were normal in all but 1 patient. Serum hepatitis C virus (HCV) RNA was negative throughout follow-up, even when investigated with the highly sensitive transcription-mediated amplification (TMA) assay (cutoff 5-10 IU/mL). In addition, no HCV RNA was detected in peripheral blood mononuclear cells (PBMC) of 15 cases tested. The patients' overall quality-of-life scores as determined by the SF-36 questionnaire did not differ from the German reference control cohort. Ex vivo interferon gamma (IFN-,) ELISPOT analysis detected HCV-specific CD4+ T-helper cell reactivity in only 35% of cases, whereas HCV-specific CD8+ T-cell responses were found in 4 of 5 HLA -A2,positive individuals. Anti-HCV antibody levels decreased significantly during and after therapy in all individuals. In conclusion, early treatment of symptomatic acute hepatitis C with IFN-,-2b leads to a long-term virological, biochemical, and clinical response. Waning of anti-HCV humoral immunity and presence of HCV-specific CD8+ (but not CD4+) T cells highlights the complexity of T-cell and B-cell memory to HCV, which might be significantly altered by IFN treatment. (HEPATOLOGY 2004;40:98,107.) [source] The Chances for Children Teen Parent,Infant Project: Results of a pilot intervention for teen mothers and their infants in inner city high schools,INFANT MENTAL HEALTH JOURNAL, Issue 4 2008Hillary A. Mayers Adolescent motherhood poses serious challenges to mothers, to infants, and ultimately to society, particularly if the teen mother is part of a minority population living in an urban environment. This study examines the effects of a treatment intervention targeting low-income, high-risk teen mothers and their infants in the context of public high schools where daycare is available onsite. Our findings confirm the initial hypothesis that mothers who received intervention would improve their interactions with their infants in the areas of responsiveness, affective availability, and directiveness. In addition, infants in the treatment group were found to increase their interest in mother, respond more positively to physical contact, and improve their general emotional tone, which the comparison infants did not. Importantly, these findings remain even within the subset of mothers who scored above the clinical cutoff for depression on the Center for Epidemiological Studies-Depression Scale (CES-D; L. Radloff, 1977), confirming that it is possible to improve mother,infant interaction without altering the mother's underlying depression. The implications of these findings are significant both because it is more difficult and requires more time to alter maternal depression than maternal behavior and because maternal depression has been found to have such devastating effects on infants. [source] Sustained withdrawal behavior in clinic-referred and nonreferred infantsINFANT MENTAL HEALTH JOURNAL, Issue 3 2006Daphna Dollberg To examine the relations between infants' sustained withdrawal behavior and children's mental health status and maternal and child relational behavior, 36 clinic-referred and 43 control infants were evaluated. Families were visited at home, mother-child free play and feeding interactions were videotaped, and mothers completed self-report measures. Interactions were coded for sustained withdrawal using the Alarm Distress Baby Scale (ADBB; Guedeney and Fermanian, 2001) and for global relational patterns with the Coding of Interactive Behavior (CIB; Feldman, 1998). Higher ADBB scores were found for the referred group, with many infants (38.9% ) scoring above the clinical cutoff (vs. 11.6% in the control group). More negative relational patterns were found for the withdrawn group in terms of higher maternal intrusiveness, lower reciprocity, and lower child involvement. Associations were found between maternal and child behavior during play and feeding and child sustained withdrawal behavior at play. Sustained withdrawal also was associated with unpredictable child temperament and lower sense of parental self-efficacy. Maternal depressive symptoms were higher in the referred group and correlated with maternal and child relational patterns. The findings contribute to the construct and discriminant validity of the CIB and the ADBB coding systems, and suggest that sustained withdrawal may serve as a risk indicator for early socioemotional disorders. [source] Oral contrast-enhanced sonography for the diagnosis and grading of postsurgical recurrence of Crohn's diseaseINFLAMMATORY BOWEL DISEASES, Issue 9 2008Fabiana Castiglione MD Abstract Background: Postsurgical recurrence (PSR) is very common in patients with Crohn's disease (CD) and previous surgery. Endoscopy is crucial for the diagnosis of PSR, also showing high prognostic value. Bowel sonography (BS) with or without oral contrast enhancement (OCBS) is accurate for CD diagnosis but its role in PSR detection and grading is poorly investigated. The aim was to evaluate the diagnostic accuracy of BS and OCBS for PSR compared to the endoscopical Rutgeerts's grading system. Methods: We prospectively performed endoscopy, BS, and OCBS in 40 CD patients with previous bowel resection to provide evidence of possible PSR. Endoscopy, BS, and OCBS were executed 1 year after surgery, with PSR diagnosis and grading made in accordance with Rutgeerts. BS and OCBS were considered suggestive for PSR in the presence of bowel wall thickness (BWT) >3 mm. OCBS was performed after ingestion of 750 mL of polyethylene glycol (PEG). Also, a receiver operating characteristic (ROC) curve was constructed in order to define the best cutoff of BWT to discriminate mild from severe PSR (grade 0,2 versus 3,4 of Rutgeerts) for both BS and OCBS. Results: In all, 22 out of the 40 CD showed an endoscopic evidence of PSR (55%). A severe PSR was present in 14 patients (64%). Sensitivity, specificity, and positive and negative predictive values were 77%, 94%, 93%, and 80% for BS, and 82%, 94%, 93%, and 84% for OCBS. On the ROC curve a BWT >5 mm showed sensitivity, specificity, and positive and negative predictive values of 93%, 96%, 88%, and 97% for the diagnosis of severe PSR at BS, while a BWT >4 mm was the best cutoff differentiating the mild from the severe CD recurrence for OCBS, with a sensitivity, specificity, and positive and negative predictive values of 86%, 96%, 97%, and 79%, respectively. Conclusions: Both BS and OCBS show good sensitivity and high specificity for the diagnosis of PSR in CD, with a BWT >5 mm for BS and BWT >4 mm for OCBS strongly indicative of severe endoscopic PSR. Accordingly, these techniques could replace endoscopy for the diagnosis and grading of PSR in many cases. (Inflamm Bowel Dis 2008) [source] Fecal S100A12 and fecal calprotectin as noninvasive markers for inflammatory bowel disease in childrenINFLAMMATORY BOWEL DISEASES, Issue 3 2008Marc A. Sidler MD Abstract Background: Fecal calprotectin is a sensitive marker for gut inflammation. Recently, we have established that a related protein, S100A12, is elevated in the feces of children with inflammatory bowel disease (IBD). This may represent a specific and sensitive disease marker. The objective was to investigate the utility of fecal S100A12, in comparison to fecal calprotectin and standard inflammatory markers, as a screening marker for IBD in children with gastrointestinal symptoms. Methods: Stool samples were obtained from 61 children presenting with gastrointestinal symptoms requiring endoscopy. Fecal S100A12, calprotectin, and serum S100A12 levels were measured and correlated to final diagnosis and standard tests (ESR, CRP, platelet count, and albumin). Results: Children diagnosed with IBD (n = 31) had elevated fecal S100A12 (median 55.2 mg/kg) and calprotectin (median 1265 mg/kg) levels compared with the children without IBD (n = 30; S100A12: median 1.1 mg/kg, P < 0.0001; calprotectin: median 30.5 mg/kg; P < 0.0001). The sensitivity and specificity of fecal S100A12 (cutoff 10 mg/kg) for the detection of IBD were both 97%, whereas fecal calprotectin (cutoff 50 mg/kg) gave a sensitivity of 100% and a specificity of 67%. Conclusions: Both fecal markers were superior to the sensitivities and specificities of any standard inflammatory test. Both fecal S100A12 and calprotectin are sensitive markers of gastrointestinal inflammation, but fecal S100A12 provided exceptional specificity in distinguishing children with IBD from children without IBD. Fecal S100A12 is a simple, noninvasive test that can be used to screen and select children warranting further invasive and laborious procedures such as endoscopy for the investigation of their gastrointestinal symptoms. (Inflamm Bowel Dis 2007) [source] A longitudinal study of the development of dieting among 7,17-year-old Swedish girlsINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 1 2002Klara Halvarsson Abstract Objective To examine the extent to which the prevalence of self-reported dieting and the wish to be thinner changed in 7,15-year-old girls over a 3-year period, and to explore potential differences between cohorts recruited in 1995 and 1999. In addition, changes in eating attitudes (Children's Eating Attitudes Test [ChEAT]) were compared between 1995 and 1999. Method A three-wave longitudinal study including girls (n = 1,076,1,279) in five age groups (7, 9, 11, 13, 15, the Main Cohort) and an age-matched cross-sectional sample consisting of 1,759 girls (the Societal Cohort). Results A marked increase of the wish to be thinner was evident in the 10,14-year-old age range and significant increases in dieting attempts occurred mainly among 9,13-year-old girls. ChEAT scores were significantly higher among 11-year-olds in 1999 than in 1995. However, more 7-year-olds scored above the ChEAT cutoff (,15) in 1995 compared with 1999. Discussion There was an increasing trend in the wish to be thinner and in dieting attempts among 9,14-year-olds. Attitudes and behaviors associated with disturbed eating had increased between 1995 and 1999 only among the 11-year- olds. © 2002 John Wiley& Sons, Inc. Int J Eat Disord 31: 32,42, 2002. [source] DC and small-signal comparison of horizontal emitter designs of InGaP/GaAs heterojunction bipolar transistorsINTERNATIONAL JOURNAL OF NUMERICAL MODELLING: ELECTRONIC NETWORKS, DEVICES AND FIELDS, Issue 6 2009Juan M. López-González Abstract This paper describes the DC and small-signal performance of two InGaP/GaAs heterojunction bipolar transistors (HBTs) that have the same chip size. This is done in order to compare emitter,base designs using the TCAD ATLAS device simulator. The HBT devices analyzed have the same cutoff and maximum frequencies but significant differences are observed in other characteristics such as base,emitter turn-on voltage, saturation collector,emitter voltage, forward current gain, maximum transducer gain and maximum stable gain. Copyright © 2009 John Wiley & Sons, Ltd. [source] Convergence of the binding energy of oxygen on Cu(100): A cautionary tale for computational chemists using periodic bound conditions,INTERNATIONAL JOURNAL OF QUANTUM CHEMISTRY, Issue 2 2009Charles W. Bauschlicher Jr. Abstract The convergence of the binding energy of oxygen on Cu(100) as a function of the k-points, energy cutoff for the inclusion of plane waves, surface model, and oxygen coverage is studied. Overall the convergence is good, with an accuracy of 0.1 eV obtained for an affordable level of treatment. Published 2008 Wiley Periodicals, Inc. Int J Quantum Chem, 2009 [source] Sensitivity and Specificity of the Mini-Mental State Examination for Identifying Dementia in the Oldest-Old: The 90+ StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2007Kristin Kahle-Wrobleski PhD OBJECTIVES: To evaluate the sensitivity and specificity of the Mini-Mental State Examination (MMSE) in identifying dementia in the oldest-old when stratified by age and education. DESIGN: Cross-sectional. SETTING: Research clinic and in-home visits. PARTICIPANTS: Population-based sample of adults aged 90 and older (n=435) who are enrolled in the 90+ Study, a longitudinal, population-based study. MEASUREMENTS: Neurological examination to determine dementia diagnosis, MMSE, and demographic data. RESULTS: Receiver operating characteristic (ROC) analyses indicated that the MMSE had high diagnostic accuracy for identifying dementia in subjects aged 90 and older across different age and education groups (area under the ROC curve values ranged from 0.82 to 0.98). A range of possible cutoff values and corresponding sensitivity and specificity are provided for the following age groups: 90,93, 94,96, and ,97. Age groups were subdivided by educational attainment (,high school, vocational school or some college, college degree or higher). In subjects aged 90 to 93 with a college degree or higher, the suggested MMSE cutoff score is ,25 (sensitivity=0.82, specificity=0.80). In those aged 94 to 96 with a college degree or higher, the suggested cutoff is ,24 (sensitivity=0.85, specificity=0.80). Those aged 97 and older with an education of high school or less had the lowest suggested cutoff ,22 (sensitivity=0.80, specificity=0.76). CONCLUSION: Overall, the MMSE had good sensitivity and specificity across all age and educational groups. Optimal cutoff points were lower in the older age groups and those with less education, primarily to preserve specificity. This screening instrument is appropriate for use with the oldest-old. [source] Incidence of Dementia, Alzheimer's Disease, and Vascular Dementia in Italy.JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2002The ILSA Study OBJECTIVES: To estimate the incidence of dementia, Alzheimer's disease (AD), and vascular dementia (VaD) in older Italians and evaluate the relationship of age, gender, and education to developing dementia. DESIGN: Cohort incidence study in the context of the Italian Longitudinal Study on Aging. SETTING: Population sample from eight Italian municipalities. PARTICIPANTS: A dementia-free cohort of 3,208 individuals (aged 65,84), individuated after a baseline evaluation performed in 1992 / 93, aimed at detecting prevalent cases. MEASUREMENTS: The dementia-free cohort was reexamined in 1995 to identify incident cases. The Mini-Mental State Examination (cutoff 23 / 24) was employed to screen for dementia. Trained neurologists evaluated the individuals who screened positive. Final diagnoses had to meet Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised criteria for dementia, National Institute of Neurological and Communicative Disorders and Stroke,Alzheimer's Disease and Related Disorders Association criteria for AD, and International Classification of Diseases, Tenth Revision criteria for VaD. RESULTS: Before the follow-up examination, 382 individuals had died (232 had reliable information). Of the 2,826 survivors, 2,266 completed the study. Overall, 127 new dementia cases were identified. Average incidence rates per 1,000 person-years were 12.47 (95% confidence interval (CI) = 10.23,14.72) for dementia, 6.55 (95% CI = 4.92,8.17) for AD, and 3.30 (95% CI = 2.14,4.45) for VaD. Both AD and VaD showed age-dependent patterns. Education was protective against dementia and AD. Women carried a significantly higher risk of developing AD (hazard ratio = 1.67, 95% CI = 1.02,2.75), and men of developing VaD (hazard ratio = 2.23, 95% CI = 1.06,4.71). CONCLUSIONS: Incidence of dementia in Italy paralleled that in most industrialized countries. About 150,000 new cases per year are expected. A significant gender effect was evidenced for major dementia subtypes. The burden of VaD, especially in men, offers opportunities for prevention. [source] Diagnostic Accuracy of a New Instrument for Detecting Cognitive Dysfunction in an Emergent Psychiatric Population: The Brief Cognitive ScreenACADEMIC EMERGENCY MEDICINE, Issue 3 2010Steven P. Cercy PhD Abstract Objectives:, In certain clinical contexts, the sensitivity of the Mini-Mental State Examination (MMSE) is limited. The authors developed a new cognitive screening instrument, the Brief Cognitive Screen (BCS), with the aim of improving diagnostic accuracy for cognitive dysfunction in the psychiatric emergency department (ED) in a quick and convenient format. Methods:, The BCS, consisting of the Oral Trail Making Test (OTMT), animal fluency, the Clock Drawing Test (CDT), and the MMSE, was administered to 32 patients presenting with emergent psychiatric conditions. Comprehensive neuropsychological evaluation served as the criterion standard for determining cognitive dysfunction. Diagnostic accuracy of the MMSE was determined using the traditional clinical cutoff and receiver operating characteristic (ROC) curve analyses. Diagnostic accuracy of individual BCS components and BCS Summary Scores was determined by ROC analyses. Results:, At the traditional clinical cutoff, MMSE sensitivity (46.4%) and total diagnostic accuracy (53.1%) were inadequate. Under ROC analyses, the diagnostic accuracy of the full BCS Summary Score (area under the curve [AUC] = 0.857) was comparable to the MMSE (AUC = 0.828). However, a reduced BCS Summary Score consisting of OTMT Part B (OTMT,B), animal fluency, and the CDT yielded classification accuracy (AUC = 0.946) that was superior to the MMSE. Conclusions:, Preliminary findings suggest the BCS is an effective, convenient alternative cognitive screening instrument for use in emergent psychiatric populations. ACADEMIC EMERGENCY MEDICINE 2010; 17:307,315 © 2010 by the Society for Academic Emergency Medicine [source] Hybrids of poly(ethylene oxide- b -amide-6) and ZrO2 sol,gel: Preparation, characterization, and application in processes of membranes separationADVANCES IN POLYMER TECHNOLOGY, Issue 1 2002Rita Aparecida Zoppi Abstract Hybrids consisting of poly(ethylene oxide- b -amide-6), PEBAXTM, and zirconium oxide were prepared from hydrolysis and condensation of zirconium tetraisopropoxide in solution containing the dissolved organic polymer. These hybrids were characterized by thermogravimetric analysis, differential scanning calorimetry, infrared spectroscopy, and electron microscopy. Results show that the incorporation of the inorganic phase seems to promote the degradation of the organic polymer. Composite membranes consisting of a porous support of poly(vinylidene fluoride), PVDF, and a filter layer of PEBAX/ZrO2 were prepared and characterized by electron microscopy. Permeation tests of water or aqueous solutions containing poly(ethylene glycol) of different molar masses were carried out to determine the permeation rate and the membrane cutoff respectively. To determine the phosphate retention, permeation tests using a KH2PO4 aqueous solution were carried out. Independent of composition of the filter layer, values of phosphate retention were nearly equivalent to 80%. © 2002 John Wiley & Sons, Inc. Adv Polym Techn 21: 2,16, 2002; DOI 10.1002/adv.10011 [source] Anti-C1q antibodies: association with nephritis and disease activity in systemic lupus erythematosusJOURNAL OF CLINICAL LABORATORY ANALYSIS, Issue 1 2009Carlos Geraldo Moura Abstract Background: Anti-C1q antibodies have been described in systemic lupus erythematosus (SLE) as well as in other connective tissue diseases. They have been considered as a marker for disease activity and presence of nephritis. Objective: The aim of this study was to determine the prevalence of anti-C1q antibodies in Brazilian lupus patients as well as analyze their association with different clinical and serologic parameters. Methods: Sera from 81 SLE patients, based on the American College of Rheumatology (ACR) criteria, were collected from a lupus referral outpatient clinic in Salvador, Brazil. Antibodies to C1q were detected by an enzyme-linked immunoassay (ELISA) kit and antibodies to other cellular antigens identified by indirect immunofluorescence on HEp-2 cell substrate (ANA), or Crithidia luciliae (dsDNA), and to nucleosome by ELISA. A cutoff of 20,U wasestablished for anti-C1q and antinucleosome assays. Results: Anti-C1q antibodies were detected in 39.5% (32/81) of SLE sera. The presence of anti-C1q antibodies was associated with proteinuria (P=0.028) but not with other laboratory or clinical features, such as antinucleosome or anti-dsDNA antibodies, hematuria, urinary casts or renal failure, leukopenia, pericarditis, pleuritis, malar rash, seizures, and psychosis. There was a positive correlation between the titers of anti-C1q antibodies and the systemic lupuis erythematosus disease activity index (SLEDAI) score (r=0.370; P=0.001). Conclusion: This study in Brazilian SLE patients confirms previous findings of the association of anti-C1q antibodies with nephritis and disease activity. J. Clin. Lab. Anal. 23:19,23, 2009. © 2009 Wiley-Liss, Inc. [source] Competitive ELISA studies of neural thread protein in urine in Alzheimer's diseaseJOURNAL OF CLINICAL LABORATORY ANALYSIS, Issue 1 2007Susanna Levy Abstract A specific and reliable competitive affinity assay kit has been developed to quantitatively measure neural thread protein (NTP) in first morning urine samples. This assay, called the urine neural thread protein test (UNTP), is a competitive enzyme-linked immunosorbent assay (ELISA) format affinity assay using 32-well microtiter plates. The assay detects UNTP in the 10,60,µg/mL range (an improvement over earlier assays of 103 × ), is linear and more reproducible (average coefficient of variation [CV] 6.2% in precision studies). The utility of the assay has been demonstrated in urine samples from patients with Alzheimer's disease (AD) and controls (sensitivity of 90% and specificity of 91%). Test,retest assays of subjects with AD and controls were comparatively stable at intervals of 2 days to 4.5 years, which suggests that positive (elevated) or negative (normal) NTP levels do not fluctuate significantly over time with respect to the cutoff. J. Clin. Lab. Anal. 21:24,33, 2007. © 2007 Wiley-Liss, Inc. [source] Performance of mentally retarded forensic patients on the test of memory malingeringJOURNAL OF CLINICAL PSYCHOLOGY, Issue 4 2007Michael J. Simon The utility of the Test of Memory Malingering (TOMM) with mentally retarded forensic patients was assessed. Twenty-one adjudicated forensic inpatients, who had been diagnosed with mental retardation, were administered the TOMM. The majority of these patients also suffered from an Axis I mental disorder. The participants attained a mean score of 48.7 on Trial 2, with only 1 participant scoring below the standard cutoff for malingering (i.e., 45). The participants attained a mean score of 49.4 on the Retention Trial, with no participants falling below the cutoff for malingering. The results clearly indicate that mildly retarded forensic patients can perform well on the TOMM. The findings provide evidence that the TOMM can be used in the assessment of mildly retarded criminal defendants with little fear of obtaining false indications of malingering. © 2007 Wiley Periodicals, Inc. J Clin Psychol 63: 339,344, 2007. [source] Electrostatic energies and forces computed without explicit interparticle interactions: A linear time complexity formulationJOURNAL OF COMPUTATIONAL CHEMISTRY, Issue 8 2005Robert J. Petrella Abstract A rapid method for the calculation of the electrostatic energy of a system without a cutoff is described in which the computational time grows linearly with the number of particles or charges. The inverse of the distance is approximated as a polynomial, which is then transformed into a function whose terms involve individual particles, instead of particle pairs, by a partitioning of the double sum. In this way, the electrostatic energy that is determined by the interparticle interactions is obtained without explicit calculation of these interactions. For systems of positive charges positioned on a face-centered cubic lattice, the calculation of the energy by the new method is shown to be faster than the calculation of the exact energy, in many cases by an order of magnitude, and to be accurate to within 1,2%. The application of this method to increase the accuracy of conventional truncation-based calculations in condensed-phase systems is also demonstrated by combining the approximated long-range electrostatic interactions with the exact short-range interactions in a "hybrid" calculation. For a 20-Ĺ sphere of water molecules, the forces are shown to be six times as accurate using this hybrid method as those calculated with conventional truncation of the electrostatic energy function at 12 Ĺ. This is accomplished with a slight increase in speed, and with a sevenfold increase in speed relative to the exact all-pair calculation. Structures minimized with the hybrid function are shown to be closer to structures minimized with an exact all-pair electrostatic energy function than are those minimized with a conventional 13-Ĺ cutoff-based electrostatic energy function. Comparison of the energies and forces calculated with the exact method illustrate that the absolute errors obtained with standard truncation can be very large. The extension of the current method to other pairwise functions as well as to multibody functions, is described. © 2005 Wiley Periodicals, Inc. J Comput Chem 26: 755,787, 2005 [source] Clinical usefulness of carbohydrate antigen 19-9 as a screening test for pancreatic cancer in an asymptomatic populationJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 2 2004JEE-EUN KIM Abstract Background and Aim:, Although the prognosis for pancreatic cancer is generally poor, it is well known that the survival rate for resected pancreatic cancer is much higher than that for more conservative treatment. The importance of early detection is emphasized for resection of pancreatic cancer. Measurement of serum carbohydrate antigen (CA) 19-9 has shown satisfactory sensitivity and predictive value in symptomatic patients, but no available data has been found on healthy asymptomatic subjects. Thus, the authors aimed to determine the clinical usefulness of CA 19-9 as a screening tool for pancreatic cancer in asymptomatic subjects. Methods:, From December 1994 to November 2000, 70 940 asymptomatic persons visiting the Health Promotion Center at the Samsung Medical Center, Seoul, Korea, participated. All subjects underwent abdominal ultrasonography and serum CA 19-9 measurement. The authors analyzed the sensitivity, specificity, and predictive values of CA 19-9 for detecting pancreatic cancer. Also, those subjects who had a serum CA 19-9 level above the cut-off value were followed up using a serial check of CA 19-9, computed tomography, or endoscopic retrograde cholangiopancreatography. Results:, The number of subjects with a level of CA 19-9 above the cutoff of 37 U/mL was 1063 (1.5%), including four cases diagnosed with pancreatic cancer. The prevalence of pancreatic cancer over the age of 30 years is 13.66 per 100 000 population in Korea. Therefore, the sensitivity is 100% and the specificity 98.5%. However, the positive predictive value of CA 19-9 for detecting pancreatic cancer is only 0.9% in the asymptomatic population. Conclusion:, Mass screening for pancreatic cancer using CA 19-9 levels in asymptomatic subjects is ineffective because of a very low positive predictive value, despite its high sensitivity and specificity. [source] Hybrid Framework for Managing Uncertainty in Life Cycle InventoriesJOURNAL OF INDUSTRIAL ECOLOGY, Issue 6 2009Eric D. Williams Summary Life cycle assessment (LCA) is increasingly being used to inform decisions related to environmental technologies and polices, such as carbon footprinting and labeling, national emission inventories, and appliance standards. However, LCA studies of the same product or service often yield very different results, affecting the perception of LCA as a reliable decision tool. This does not imply that LCA is intrinsically unreliable; we argue instead that future development of LCA requires that much more attention be paid to assessing and managing uncertainties. In this article we review past efforts to manage uncertainty and propose a hybrid approach combining process and economic input,output (I-O) approaches to uncertainty analysis of life cycle inventories (LCI). Different categories of uncertainty are sometimes not tractable to analysis within a given model framework but can be estimated from another perspective. For instance, cutoff or truncation error induced by some processes not being included in a bottom-up process model can be estimated via a top-down approach such as the economic I-O model. A categorization of uncertainty types is presented (data, cutoff, aggregation, temporal, geographic) with a quantitative discussion of methods for evaluation, particularly for assessing temporal uncertainty. A long-term vision for LCI is proposed in which hybrid methods are employed to quantitatively estimate different uncertainty types, which are then reduced through an iterative refinement of the hybrid LCI method. [source] The Prognostic Value of Combined Fractional Flow Reserve and TIMI Frame Count Measurements in Patients with Stable Angina Pectoris and Acute Coronary SyndromeJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 5 2010ALI M. ESEN M.D. Background:,The aim of this study was to evaluate the prognostic value of different fractional flow reserve (FFR) cutoff values and corrected thrombolysis in myocardial infarction frame (TIMI) count (CTFC) measurements in a series of consecutive patients with moderate coronary lesions, including patients with unstable angina, myocardial infarction, and/or positive noninvasive functional test findings. Methods:,We included 162 consecutive coronary patients in whom revascularization of a moderate coronary lesion was deferred based on a FFR value ,0.75. Patients were divided according to the results of the intracoronary pressure and flow measurements into four groups: group A: 0.75 , FFR , 0.85 and CTFC > 28 (n=22), group B: 0.75 , FFR , 0.85 and CTFC , 28 (n = 55), group C: 0.85 < FFR and CTFC > 28 (n = 19), and group D: 0.85 < FFR and CTFC , 28 (n = 66). Adverse cardiac events and the presence of angina were evaluated at follow-up. Results:,At a mean follow-up of 18 ± 10 months, cardiac event rate in patients with 0.75 , FFR , 0.85 and FFR > 0.85 were 22% and 9%, respectively (P = 0.026) and also, a trend was observed toward a higher cardiac event rate in case of an abnormal CTFC (CTFC > 28) compared to a normal CTFC (24% vs 12%, P = 0.066). Furthermore, a significantly higher cardiac event rate was observed when group A was compared to group D (31.8% vs 7.6%, respectively, P = 0.004). Conclusion:,Patients with potential microvascular dysfunction and borderline FFR values should be interpreted with caution, and management strategies should be guided not only by pressure measurement, but also by possibly supplementary clinical risk stratification and noninvasive tests. (J Interven Cardiol 2010;23:421,428) [source] Resovist enhanced MR imaging of the liver: Does quantitative assessment help in focal lesion classification and characterization?JOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 5 2009Lucia Santoro MD Abstract Purpose: To improve characterization of focal liver lesions by a prospective quantitative analysis of percentage signal intensity change, in dynamic and late phases after slow (0.5 mL/s) Resovist administration. Materials and Methods: Seventy-three patients were submitted on clinical indication to MR examination with Resovist. Signal intensity of 92 detected focal lesions (5,80 mm) were measured with regions of interest and normalized to paravertebral muscle in arterial, portal, equilibrium and T1/T2 late phases, by two observers in conference. Five values of percentage variations per patient were obtained and statistically evaluated. Results: The enhancement obtained on dynamic study is more suitable in hemangiomas and focal nodular hyperplasias than in adenomas and hepatocellular carcinomas. To discriminate benign versus malignant lesions on late-phase-T2-weighted images, a cutoff = ,26%, allowed sensitivity and specificity values of 97.4% and 97.7%, respectively. Area under the receiver operating characteristic (ROC) curve was 0.99. To differentiate hemangioma versus all other focal liver lesions, on late-phase-T1-weighted images, a cutoff = +40% permitted sensitivity and specificity values of 90.5% and 98.0%, respectively. Area under the ROC curve was 0.98. Conclusion: Late phase quantitative evaluation after slow Resovist administration, allows to differentiate malignant from benign hepatic masses and hemangiomas from all the others focal liver lesions, on T2-/T1-weighted acquisitions, respectively. J. Magn. Reson. Imaging 2009;30:1012,1020. © 2009 Wiley-Liss, Inc. [source] | ||||||||||||||||||||||||||||||||||||||||||||||||||||