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Low Sensitivity (low + sensitivity)
Selected AbstractsNanocrystalline Titanium(IV) Oxide as an Efficient Heterogeneous Catalyst for Tandem Michael and Nucleophilic 1,2-Addition to EnonesADVANCED SYNTHESIS & CATALYSIS (PREVIOUSLY: JOURNAL FUER PRAKTISCHE CHEMIE), Issue 7-8 2006Lakshmi Kantam Abstract Nanocrystalline titanium(IV) oxide was found to be an efficient heterogeneous catalyst for the conjugate 1,4-addition of indoles with ,,, - unsaturated ketones to afford ,-indolyl ketones in excellent yields. The subsequent catalytic 1,2-addition of Me3SiCN to carbonyl compounds can be performed in one pot with moderate to good yields. Low sensitivity towards traces of moisture and high tolerance of different functional groups make nanocrystalline titanium(IV) oxide suitable for carrying out multistep synthetic sequences. [source] Accuracy of Spirometry in Diagnosing Pulmonary Restriction in Elderly PeopleJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2009Simone Scarlata MD OBJECTIVES: To compare the accuracy of a diagnosis of pulmonary restriction made using forced vital capacity (FVC) less than the lower limit of normal (LLN) with the criterion standard diagnosis made using total lung capacity (TLC) less than the LLN in an elderly population. DESIGN: Retrospective analysis. SETTING: A teaching hospital. PARTICIPANTS: Five hundred sixty-four ambulatory and acute care hospital patients aged 65 to 96 underwent complete pulmonary function evaluation. MEASUREMENTS: Sensitivity, specificity, positive and negative predictive values (PPV, NPV) of diagnosis of pulmonary restriction defined as FVC less than the LLN were calculated in the overall sample and after stratification according to bronchial obstruction. Expected PPV and NPV at different background prevalence of true pulmonary restriction (5% and 15%) were calculated using the Bayes theorem. RESULTS: Low sensitivity (0.32) and high specificity (0.95) were found, with an area under the receiver operating characteristic curve (AUC) of 0.89. In participants without bronchial obstruction, specificity was even higher, although sensitivity decreased to 0.28 (AUC=0.92). The PPV was good (0.81), whereas with a low to moderate a priori probability (prevalence from 5% to 15%) the NPV was fair (,0.89). CONCLUSION: A reduction in FVC below LLN cannot reliably identify true pulmonary restriction in elderly people, confirming previous findings in the adult population. Normal FVC, instead, can effectively exclude pulmonary restriction regardless of the presence of bronchial obstruction when the a priori probability is low or moderately high. [source] Low sensitivity of retina to AMPA-induced calcificationJOURNAL OF NEUROSCIENCE RESEARCH, Issue 4 2003Noemí Andrés Abstract Glutamate is involved in most CNS neurodegenerative diseases. In particular, retinal diseases such as retinal ischemia, retinitis pigmentosa, and diabetic retinopathy are associated with an excessive synaptic concentration of this neurotransmitter. To gain more insight into retinal excitotoxicity, we carried out a dose,response study in adult rats using ,-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA), a glutamate analogue. AMPA intraocular injections (between 0.27 and 10.8 nmol) caused no morphologic modification, but a 10.8 + 21 nmol double injection in a 10-day interval produced a lesion characterized by discrete neuronal loss, astroglial and microglial reactions, and calcium precipitation. Abundant calcium deposits similar to those present in rat and human brain excitotoxicity or hypoxia-ischemia neurodegeneration were detected by alizarin red staining within the retinal surface and the optic nerve. Glial reactivity, associated normally with astrocytes in the nerve fiber, was assessed in Müller cells. GABA immunoreactivity was detected not only in neuronal elements but also in Müller cells. In contrast to the high vulnerability of the brain to excitotoxin microinjection, AMPA-induced retinal neurodegeneration may provide a useful model of low central nervous system sensitivity to excitotoxicity. © 2003 Wiley-Liss, Inc. [source] Development of a parathyroid database in Melbourne and review of the last 50 casesANZ JOURNAL OF SURGERY, Issue 9 2004Meei J. Yeung Background: Minimally invasive parathyroidectomy (MIP) is only possible if preoperative localization studies accurately identify the abnormal parathyroid tissue. The aim of the present paper was to evaluate the accuracy of these studies in our geographical region and the consequences on MIP. Methods: A Filemaker Pro database was designed and a retrospective analysis was carried out on the last 50 parathyroidectomies. Results: There were a total of 49 patients who underwent parathyroidectomy; with one patient having two operations. Forty-nine preoperative ultrasound localization studies were performed. Ultrasound sensitivity of correct localization of abnormal parathyroids was 41% with a false positive rate of 25%. Twenty-two sestamibi scans identified 14 abnormal parathyroids. Sestamibi scanning had a sensitivity of 32% for correct localization and a false positive rate of 32%. There were 16 different radiologists or nuclear medicine physicians involved with the nuclear medicine scans, and 22 different radiologists involved in the preoperative ultrasound scans. Forty-seven patients were cured of hyperparathyroidism after a primary operation, with a total of 48 patients in all being cured following re-exploration. One patient was lost to follow up. The success of primary exploration was therefore 96% and following re-exploration this increased to 98%. Conclusion: We found preoperative localization studies to have low sensitivities and high false positive rates. To move successfully towards MIP, we need to identify a radiologist with a special interest in localization studies to achieve greater accuracy. [source] Diagnostic value of high signal abnormalities on T2 weighted MRI in the differentiation of Alzheimer's, frontotemporal and vascular dementiasACTA NEUROLOGICA SCANDINAVICA, Issue 5 2002A. R. Varma Objective ,,The occurrence of high signal abnormalities on T2 weighted images is strongly age related. The diagnostic value of these changes in a younger population with dementia is not currently known. We studied the potential of high signal changes on magnetic resonance imaging (MRI) in differentiating Alzheimer's disease (AD), frontotemporal dementia (FTD) and vascular dementia (VaD) in younger patients. Methods ,,High signal abnormalities were rated, using a previously validated scale, from hard copies of T2 weighted axial images of 102 patients with AD (n=49), VaD (n=31), FTD (n=22) (mean ages 63,65 years). Results ,,High signal abnormalities were widespread across AD, VaD and FTD. Although they were most frequent and most severe in the VaD group only lacunes and grade III deep white matter hyperintensities (DWMH) were specific for these patients. Conclusions ,,High signal changes on T2 weighted images on MRI are common across degenerative (AD and FTD) and vascular dementias. Although lacunes and grade III DWMH are specific for VaD, the low sensitivities (sensitivities: for lacunes, 0.32; for grade III DWMH, 0.16) limit their use as diagnostic markers for VaD. High signal changes on MRI should be interpreted with caution in dementias. Their presence, even in younger patients, should not deter one from diagnosing AD or FTD. [source] Serological testing for Bartonella henselae infections in The Netherlands: clinical evaluation of immunofluorescence assay and ELISACLINICAL MICROBIOLOGY AND INFECTION, Issue 6 2007M. J. Vermeulen Abstract Cat-scratch disease (CSD), caused by Bartonella henselae infection, can mimic malignancy and can manifest atypically. Reliable serological testing is therefore of great clinical importance. The diagnostic performance of immunofluorescence assay (IFA) and ELISA was evaluated in a group of Dutch patients with proven CSD (clinical diagnosis confirmed by PCR). Sera of 51 CSD patients and 56 controls (patients with similar symptoms, but who were B. henselae PCR-negative and had an alternative confirmed diagnosis) were tested for anti- B. henselae IgM and IgG by IFA and ELISA. A commercially available IFA test for IgM had a sensitivity of 6%. In-house assays for IgM showed specificities of 93% (IFA) and 91% (ELISA), but with low sensitivities (53% and 65%, respectively). With a specificity of 82% (IFA) and 91% (ELISA), in-house IgG testing showed a significantly higher sensitivity in IFA (67%) than in ELISA (28%, p <0.01). Sensitivity was higher for genotype I (38,75%) than for genotype II (7,67%) infections, but this was only statistically significant for IgG ELISA (p <0.05). In conclusion, detection of IgM against B. henselae by in-house ELISA and IFA was highly specific for the diagnosis of CSD. The high seroprevalence in healthy individuals limits the clinical value of IgG detection for diagnosing CSD. Given the low sensitivity of the serological assays, negative serology does not rule out CSD and warrants further investigation, including PCR. Adding locally isolated (e.g., genotype II) B. henselae strains to future tests might improve the sensitivity. [source] Evaluation of 2 self-administered questionnaires to ascertain dermatitis among metal workers and its relation with exposure to metalworking fluidsCONTACT DERMATITIS, Issue 6 2007Berna Van Wendel de Joode We performed an exploratory study to evaluate 2 self-administered questionnaires assessing hand dermatitis and investigate a possible exposure,response relationship between dermal exposure to semi-synthetic metalworking fluids (SMWF) and dermatitis. In a cross-sectional survey on dermatitis, a symptom-based questionnaire and a picture-based skin screening list were applied in 80 SMWF-exposed workers and 67 referents. To evaluate the accuracy of the questionnaires, 47 subjects were examined by a dermatologist. Dermal exposure levels to SMWF were assessed on hands, forearms, and face with a observational method that was validated using a fluorescent tracer method. The symptom-based questionnaire had a relatively high sensitivity (0.86) but moderate specificity (0.64), and the skin screening list had a low sensitivity (0.36) and a relatively high specificity (0.84). The skin screening list seemed to represent the more severe cases of dermatitis and showed a significant relation with exposure for dermatitis on hands, forearms, or face. In epidemiological surveys where workers are not seen by a dermatologist, the skin screening list seems to be more appropriate to detect cases of dermatitis, as its higher specificity results in less false positives. Alternatively, it would be preferable applying the symptom-based questionnaire; workers with symptoms should be seen by a dermatologist to identify false positives. [source] Use of the Bruininks,Oseretsky Test of Motor Proficiency for identifying children with motor impairmentDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 11 2007Fotini Venetsanou MSc This study compared the consistency of the Short Form (SF) and the Long Form (LF) of the Bruininks,Oseretsky Test of Motor Proficiency (BOTMP) in identifying preschool children with motor impairment (MI). One hundred and forty-four Greek preschool children participated (74 males, 70 females; mean age 5y 2mo [SD 5mo], range 4y 6mo-5y 6mo). Although total SF and LF scores were highly correlated (r=0.85), paired t -tests indicated significant differences (t=-27.466, p=0.001). SF total scores (mean 58.72 [SD 7.28]) were higher than LF total scores (mean 47.38 [SD 9.43]). SF had low sensitivity (13.6%) and negative predictive value (72.5%) for identifying MI. The BOTMP-SF does not appear to be a valid test for the identification of MI in 5-year-old children. [source] HbA1c as a screening tool for detection of Type 2 diabetes: a systematic reviewDIABETIC MEDICINE, Issue 4 2007C. M. Bennett Abstract Aim To assess the validity of glycated haemoglobin A1c (HbA1c) as a screening tool for early detection of Type 2 diabetes. Methods Systematic review of primary cross-sectional studies of the accuracy of HbA1c for the detection of Type 2 diabetes using the oral glucose tolerance test as the reference standard and fasting plasma glucose as a comparison. Results Nine studies met the inclusion criteria. At certain cut-off points, HbA1c has slightly lower sensitivity than fasting plasma glucose (FPG) in detecting diabetes, but slightly higher specificity. For HbA1c at a Diabetes Control and Complications Trial and UK Prospective Diabetes Study comparable cut-off point of , 6.1%, the sensitivity ranged from 78 to 81% and specificity 79 to 84%. For FPG at a cut-off point of , 6.1 mmol/l, the sensitivity ranged from 48 to 64% and specificity from 94 to 98%. Both HbA1c and FPG have low sensitivity for the detection of impaired glucose tolerance (around 50%). Conclusions HbA1c and FPG are equally effective screening tools for the detection of Type 2 diabetes. The HbA1c cut-off point of > 6.1% was the recommended optimum cut-off point for HbA1c in most reviewed studies; however, there is an argument for population-specific cut-off points as optimum cut-offs vary by ethnic group, age, gender and population prevalence of diabetes. Previous studies have demonstrated that HbA1c has less intra-individual variation and better predicts both micro- and macrovascular complications. Although the current cost of HbA1c is higher than FPG, the additional benefits in predicting costly preventable clinical complications may make this a cost-effective choice. [source] Utility of CD10 and RCCma in the diagnosis of metastatic conventional renal-cell adenocarcinoma by fine-needle aspiration biopsyDIAGNOSTIC CYTOPATHOLOGY, Issue 1 2005Aylin Simsir M.D. Abstract The cytologic diagnosis of primary conventional renal-cell adenocarcinoma (cRCC) is usually straightforward; however, metastatic cRCC must be distinguished from a variety of neoplasms with clear-cell features. CD10, a cell membrane-associated neutral endopeptidase, and renal-cell carcinoma marker (RCCma), an antibody against human proximal tubular brush border antigen, have recently been shown to be useful in the diagnosis of cRCC. We compared CD10 and RCCma in cell block material from fine-needle aspiration biopsies (FNABs) to assess their utility in the diagnosis of metastatic cRCC, in cytologic specimens. Seven primary and sixteen metastatic cRCCs were immunostained with CD10 and RCCma. The immunoreactivity results were compared with those of a variety of neoplasms originating from other sites such as the liver, lungs, breast, and the gastrointestinal tract. The sensitivity and specificity of CD10 for cRCC were 100% and 59%, respectively. The sensitivity and specificity of RCCma for cRCC were 35% and 100%, respectively. We conclude that CD10 has limited value in confirming the diagnosis of cRCC because of its low specificity. RCCma, when positive, is highly specific for cRCC, but its low sensitivity hinders its diagnostic usefulness. Diagn. Cytopathol. 2005;33:3,7. © 2005 Wiley-Liss, Inc. [source] The magnocellular theory of developmental dyslexiaDYSLEXIA, Issue 1 2001John Stein Abstract Low literacy is termed ,developmental dyslexia' when reading is significantly behind that expected from the intelligence quotient (IQ) in the presence of other symptoms,incoordination, left,right confusions, poor sequencing,that characterize it as a neurological syndrome. 5,10% of children, particularly boys, are found to be dyslexic. Reading requires the acquisition of good orthographic skills for recognising the visual form of words which allows one to access their meaning directly. It also requires the development of good phonological skills for sounding out unfamiliar words using knowledge of letter sound conversion rules. In the dyslexic brain, temporoparietal language areas on the two sides are symmetrical without the normal left-sided advantage. Also brain ,warts' (ectopias) are found, particularly clustered round the left temporoparietal language areas. The visual magnocellular system is responsible for timing visual events when reading. It therefore signals any visual motion that occurs if unintended movements lead to images moving off the fovea (,retinal slip'). These signals are then used to bring the eyes back on target. Thus, sensitivity to visual motion seems to help determine how well orthographic skill can develop in both good and bad readers. In dyslexics, the development of the visual magnocellular system is impaired: development of the magnocellular layers of the dyslexic lateral geniculate nucleus (LGN) is abnormal; their motion sensitivity is reduced; many dyslexics show unsteady binocular fixation; hence poor visual localization, particularly on the left side (left neglect). Dyslexics' binocular instability and visual perceptual instability, therefore, can cause the letters they are trying to read to appear to move around and cross over each other. Hence, blanking one eye (monocular occlusion) can improve reading. Thus, good magnocellular function is essential for high motion sensitivity and stable binocular fixation, hence proper development of orthographic skills. Many dyslexics also have auditory/phonological problems. Distinguishing letter sounds depends on picking up the changes in sound frequency and amplitude that characterize them. Thus, high frequency (FM) and amplitude modulation (AM) sensitivity helps the development of good phonological skill, and low sensitivity impedes the acquisition of these skills. Thus dyslexics' sensitivity to FM and AM is significantly lower than that of good readers and this explains their problems with phonology. The cerebellum is the head ganglion of magnocellular systems; it contributes to binocular fixation and to inner speech for sounding out words, and it is clearly defective in dyslexics. Thus, there is evidence that most reading problems have a fundamental sensorimotor cause. But why do magnocellular systems fail to develop properly? There is a clear genetic basis for impaired development of magnocells throughout the brain. The best understood linkage is to the region of the Major Histocompatibility Complex (MHC) Class 1 on the short arm of chromosome 6 which helps to control the production of antibodies. The development of magnocells may be impaired by autoantibodies affecting the developing brain. Magnocells also need high amounts of polyunsaturated fatty acids to preserve the membrane flexibility that permits the rapid conformational changes of channel proteins which underlie their transient sensitivity. But the genes that underlie magnocellular weakness would not be so common unless there were compensating advantages to dyslexia. In developmental dyslexics there may be heightened development of parvocellular systems that underlie their holistic, artistic, ,seeing the whole picture' and entrepreneurial talents. Copyright © 2001 John Wiley & Sons, Ltd. [source] Testing for cannabis in the work-place: a review of the evidenceADDICTION, Issue 3 2010Scott Macdonald ABSTRACT Background Urinalysis testing in the work-place has been adopted widely by employers in the United States to deter employee drug use and promote ,drug-free' work-places. In other countries, such as Canada, testing is focused more narrowly on identifying employees whose drug use puts the safety of others at risk. Aims We review 20 years of published literature on questions relevant to the objectives of work-place drug testing (WPDT), with a special emphasis on cannabis, the most commonly detected drug. Results We conclude (i) that the acute effects of smoking cannabis impair performance for a period of about 4 hours; (ii) long-term heavy use of cannabis can impair cognitive ability, but it is not clear that heavy cannabis users represent a meaningful job safety risk unless using before work or on the job; (iii) urine tests have poor validity and low sensitivity to detect employees who represent a safety risk; (iv) drug testing is related to reductions in the prevalence of cannabis positive tests among employees, but this might not translate into fewer cannabis users; and (v) urinalysis has not been shown to have a meaningful impact on job injury/accident rates. Conclusions Urinalysis testing is not recommended as a diagnostic tool to identify employees who represent a job safety risk from cannabis use. Blood testing for active tetrahydrocannabinol (THC) can be considered by employers who wish to identify employees whose performance may be impaired by their cannabis use. [source] Theoretical framework for the distribution of trace metals among the operationally defined speciation phases of a sedimentENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 4 2001René A. Nome Abstract The use of a model based on Langmuir's isotherm to evaluate the metal associated with separate geochemical phases of a sediment is proposed and its validity tested with sediments of certified composition. The model takes into account a standard procedure for a certified reference material (CRM601), which defines, experimentally, a set of sequential extractions that divide the sediment into four operational fractions. The derived equations allow the treatment of data from sediment of Flumendosa Lake, Italy, and certified material CRM601 and also allow the computation of corrected concentrations, i.e., the metal affinities for each fraction. Experimental values for Ni show its low sensitivity and an equal distribution among different phases, which suggests a similar adsorption mechanism in all cases. In the case of Cd, the corrected concentration in the Fe/Mn oxide phase is nine times higher than for the residual fraction. For sediment of the Bčsos River, Spain, results show the percentage distribution of Ni over different fractions. Affinity values for Ni on a Flumendosa Lake sediment have also been calculated. The present model is simple to apply and shows satisfactory agreement with experimental data. [source] Evaluation of decision criteria for detection of spinal cord compression based on cervical myelography in horses: 38 cases (1981,2001)EQUINE VETERINARY JOURNAL, Issue 1 2004J. Van Biervliet Summary Reasons for performing study: Different criteria have been described based on height reduction of the total myelographic contrast column and components of it as tests for compression of the spinal cord due to cervical stenotic myelopathy (CSM). Fifty percent height reduction of the dorsal myelographic column (DMC), <2 mm empiric height of the DMC and a 40% reduction of the ratio of stenosis calculated based on the height reduction of the entire dural diameter (DD) have been described as decision criteria for considering the test result positive. The reasons for selecting these decision criteria or their accuracies have rarely been reported. Objectives: To evaluate the accuracy of diagnostic criteria based on reduced height of the total myelographic column and components of it for diagnosing extradural spinal cord compression using different decision criteria, and make recommendations for consistent myelographic interpretation in horses suspected of having CSM. Methods: Four measurements were obtained by 2 readers in a retrospective sample population of 38 horses in which both cervical myelography and histopathological examination of the cervical spinal cord were performed. The prevalence of CSM in the sample was 50%. At intervertebral sites, the minimum heights of the DD and DMC were measured. At intravertebral sites, the maximum heights of the entire DD and DMC were obtained. Percent height reductions of the DMC and DD were determined as the ratio of minimum intervertebral height to maximum intravertebral height within the next cranial vertebra. Histological examination was used as the gold standard for determining the actual site of spinal cord compression. Sensitivity and specificity for the diagnostic criteria were estimated at each site in neutral and flexed neck positions using several different decision criteria. Conclusions: At C6-C7, in neutral or flexed neck position and using 20% reduction of DD, the test was highly sensitive and specific for CSM. At other sites, reduced height of the myelographic column generally was not accurate for diagnosing extradural spinal cord compression. Using 20% reduction of DD in neutral position at the mid-cervical sites, the test had only low sensitivity and high specificity. Flexion of the neck appeared to increase detection of spinal cord compression in the mid-cervical region, but also substantially increased the frequency of false-positive diagnoses. Potential relevance: By using the reported sensitivity and specificity estimates, readers may decide on a decision criterion for diagnosis of extradural spinal cord compression due to CSM. However, in planning a surgical correction, it is difficult to define a decision criterion that combines acceptable sensitivity and specificity, especially at the mid-cervical sites. [source] Correlation of echocardiography parameters with cardiac magnetic resonance imaging in transfusion-dependent thalassaemia majorEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 1 2007Athanassios Aessopos Abstract Background and objective:,Heart iron load (cardiac Fe) can be indirectly quantified by cardiac magnetic resonance (CMR) T2*. CMR accessibility is limited, whereas echocardiography (Echo) is relatively inexpensive and readily available. The objective was to find Echo parameters that may be useful for predicting cardiac Fe. Design and methods:,We compared a number of parameters derived from Echo to cardiac Fe in 142 thalassaemia major patients who had undergone a CMR study. Results:,All patients with decreased left ventricular (LV) function had cardiac Fe. After removing those patients from the analysis, the total diameter index (Tdi) >5.57 cms/m2, left atrial diameter index >2.41 cm/m2, and the diastolic parameter E/A > 1.96 were highly specific (91.4%, 97.1% and 96.9% respectively) but had low sensitivity (31.8%, 20.45% and 21.8%) in predicting iron load. A right ventricular index >1.47 cm/m2, LV systolic index >2.26 cm/m2 or Tdi >6.26 cm/m2 discriminated between patients with no, or mild to moderate cardiac Fe from those with heavy load, with specificity of 91%, 98.5%, and 98.5%, respectively, but with low sensitivity. Interpretation and conclusions:,Echo parameters for cardiac Fe prediction have restricted value, whereas CMR is essential to assess cardiac Fe. However, patients with decreased LV systolic function should be considered a priori as having cardiac Fe, and chelation therapy should be intensified. This also applies to patients who have the above-described Echo criterion values, even if CMR is not available. Once a patient is found by CMR to have cardiac Fe, then the above Echo criterion values may be useful for ongoing monitoring. [source] Advanced resonant ultrasound spectroscopy for measuring anisotropic elastic constants of thin filmsFATIGUE & FRACTURE OF ENGINEERING MATERIALS AND STRUCTURES, Issue 8 2005H. OGI ABSTRACT This paper presents an advanced resonant ultrasound spectroscopy (RUS) method to determine the elastic constants Cij of thin films. Polycrystalline thin films often exhibit elastic anisotropy between the film growth direction and the in-plane direction, and they macroscopically show five independent elastic constants. Because all of the Cij of a deposited thin film affect the mechanical resonance frequencies of the film/substrate layer specimen, measuring resonance frequencies enables one to determine the Cij of the film with known density, dimensions and the Cij of the substrate. Resonance frequencies have to be measured accurately because of low sensitivity of the Cij of films to them. We achieved this by a piezoelectric tripod. Mode identification has to be made unambiguously. We made this measuring displacement,amplitude distributions on the resonated specimen surface by laser Doppler interferometry. We applied our technique to copper thin film and diamond thin film. They show elastic anisotropy and the Cij smaller than bulk values of Cij. Micromechanics calculations indicate the presence of incohesive bonded regions. [source] The effect of temperature and ventilation condition on the toxic product yields from burning polymersFIRE AND MATERIALS, Issue 1 2008A. A. Stec Abstract A major cause of death or permanent injury in fires is inhalation of toxic gases. Moreover, every fire is unique, and the range of products, highly dependant on fire conditions, produces a wide variety of toxic and irritant species responsible for the most fire fatalities. Therefore, to fully understand each contribution to the toxicity it is necessary to quantify the decomposition products of the material under the test. Fires can be divided into a number of stages from smouldering combustion to early well-ventilated flaming through to fully developed under-ventilated flaming. These stages can be replicated by certain bench-scale physical fire models using different fuel-to-oxygen ratios, controlled by the primary air flow, and expressed in terms of the equivalence ratio (the actual fuel/air ratio divided by the stoichiometric fuel/air ratio). This work presents combustion product yields generated using a small-scale fire model. The Purser Furnace apparatus (BS7990 and ISO TS 19700) enables different fire stages to be created. Identification and quantification of combustion gases and particularly their toxic components from different fire scenarios were undertaken by continuous Fourier transform infrared spectroscopy. The relationship between type of the fire particularly the temperature and ventilation conditions and the toxic product yields for four bulk polymers, low-density polyethylene, polystyrene (PS), Nylon 6.6 and polyvinyl chloride (PVC) is reported. For all the polymers tested, except PVC, there is a dramatic increase in the yield of products of incomplete combustion (CO and hydrocarbons) with increase in equivalence ratio, as might be expected. For PVC there is a consistently high level of products of incomplete combustion arising both from flame inhibition by HCl and oxygen depletion. There is a low sensitivity to furnace temperature over the range 650,850°C, except that at 650°C PS shows an unexpectedly high yield of CO under well-ventilated conditions and PVC shows a slightly higher hydrocarbon yield. This demonstrates the dependence of toxic product yields on the equivalence ratio, and the lack of dependence on furnace temperature, within this range. Copyright © 2007 John Wiley & Sons, Ltd. [source] Guideline threshold limit values (TLVs) for discomfort in repetitive assembly workHUMAN FACTORS AND ERGONOMICS IN MANUFACTURING & SERVICE INDUSTRIES, Issue 5 2007L. O'Sullivan This study focused on two of the main occupational risk factors associated with work-related musculoskeletal disorders in light repetitive electronic assembly work, namely repetition and force. Present-day evaluation techniques are primarily posture based and show low sensitivity with regard to rating repetition and force. A simulated assembly task was conducted to investigate the interactions of risk factors and the suitability of hand activity level (HAL) and TLV values for electronics assembly work. Subjects completed the assembly task for three levels of repetition and force. For each treatment a subjective rating of discomfort was recorded. Repeated measures ANOVA identified repetition and force as highly significant factors in light electronic assembly work ( p < .001, p < .05, respectively). The task was also rated using HAL and normalized peak forces (NPF). This study questioned the ability of TLVs in rating discomfort and amendments to the TLVs are suggested. © 2007 Wiley Periodicals, Inc. Hum Factors Man 17: 423,434, 2007. [source] Validation of microarray-based resequencing of 93 worldwide mitochondrial genomes,HUMAN MUTATION, Issue 1 2009Anne Hartmann Abstract The human mitochondrial genome consists of a multicopy, circular dsDNA molecule of 16,569 base pairs. It encodes for 13 proteins, two ribosomal genes, and 22 tRNAs that are essential in the generation of cellular ATP by oxidative phosphorylation in eukaryotic cells. Germline mutations in mitochondrial DNA (mtDNA) are an important cause of maternally inherited diseases, while somatic mtDNA mutations may play important roles in aging and cancer. mtDNA polymorphisms are also widely used in population and forensic genetics. Therefore, methods that allow the rapid, inexpensive and accurate sequencing of mtDNA are of great interest. One such method is the Affymetrix GeneChip® Human Mitochondrial Resequencing Array 2.0 (MitoChip v.2.0) (Santa Clara, CA). A direct comparison of 93 worldwide mitochondrial genomes sequenced by both the MitoChip and dideoxy terminator sequencing revealed an average call rate of 99.48% and an accuracy of ,99.98% for the MitoChip. The good performance was achieved by using in-house software for the automated analysis of additional probes on the array that cover the most common haplotypes in the hypervariable regions (HVR). Failure to call a base was associated mostly with the presence of either a run of ,4,C bases or a sequence variant within 12 bases up- or downstream of that base. A major drawback of the MitoChip is its inability to detect insertions/deletions and its low sensitivity and specificity in the detection of heteroplasmy. However, the vast majority of haplogroup defining polymorphism in the mtDNA phylogeny could be called unambiguously and more rapidly than with conventional sequencing. Hum Mutat 0,1,8, 2008. © 2008 Wiley-Liss, Inc. [source] Low power switched-current circuits with low sensitivity to the rise/fall time of the clockINTERNATIONAL JOURNAL OF CIRCUIT THEORY AND APPLICATIONS, Issue 5 2010Radek Rudnicki Abstract The switched-current (SI) technique permits realizing analog discrete-time circuits in standard digital CMOS technology. A very important property of the analog part of a system on a chip is the possibility it offers for realizing some functions of a digital circuit, but with reduced power consumption. In this paper, a low power SI integrator is presented. It is shown that an integrator consuming a fraction of a milliwatt can be designed in 0.35µm CMOS technology with the use of narrow transistor channels, and with the channel length as a design parameter. The impact of the rise/fall time of the clock signal on the integrator operation is observed. It is shown that this effect can be reduced when the proper switch dimensions are taken for the integrator. Analysis and measurements of the integrator noise are presented. The integrator was built with equal size transistors, yielding less sensitivity to variations in production parameters. An experimental chip in 0.35µm CMOS technology was fabricated, and measurements are compared with results obtained during analysis and simulations. In order to verify the properties of the designed integrator experimentally, a first-order filter is built with the use of elementary cells on the chip. Copyright © 2008 John Wiley & Sons, Ltd. [source] Sensitivity of comparative analyses to population variation in trait values: clutch size and cavity excavation tendenciesJOURNAL OF AVIAN BIOLOGY, Issue 4 2000Mikko Mönkkönen Importance of within-species (population) variation in trait values to correlations of traits among species has received very little attention in comparative analyses. We use randomization and bootstrapping techniques to provide a sensitivity analysis of the influence of population variation on correlations between clutch size and propensity to excavate. These traits are predicted to be negatively correlated under the limited breeding opportunities hypothesis, but opposing results have been found by two studies using different population estimates for western Palearctic Paridae. Our analyses support the limited breeding opportunities hypothesis and suggest low sensitivity to within-species variation in trait values. Yet, a small proportion of population data provide non-significant results. Checking for the effects of this variation on the postulated association between traits is necessary in comparative studies if one wishes to avoid type I and type II errors. [source] Validation of ECG Indices of Ventricular Repolarization Heterogeneity: A Computer Simulation StudyJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 10 2005BART HOOFT VAN HUYSDUYNEN M.D. Introduction: Repolarization heterogeneity (RH) is functionally linked to dispersion in refractoriness and to arrhythmogenicity. In the current study, we validate several proposed electrocardiogram (ECG) indices for RH: T-wave amplitude, -area, -complexity, and -symmetry ratio, QT dispersion, and the Tapex-end interval (the latter being an index of transmural dispersion of the repolarization (TDR)). Methods and Results: We used ECGSIM, a mathematical simulation model of ECG genesis in a human thorax, and varied global RH by increasing the standard deviation (SD) of the repolarization instants from 20 (default) to 70 msec in steps of 10 msec. T-wave amplitude, -area, -symmetry, and Tapex-end depended linearly on SD. T-wave amplitude increased from 275 ± 173 to 881 ± 456 ,V, T-wave area from 34 × 103± 21 × 103 to 141 × 103± 58 × 103,V msec, T-wave symmetry decreased from 1.55 ± 0.11 to 1.06 ± 0.23, and Tapex-end increased from 84 ± 17 to 171 ± 52 msec. T-wave complexity increased initially but saturated at SD = 50 msec. QT dispersion increased modestly until SD = 40 msec and more rapidly for higher values of SD. TDR increased linearly with SD. Tapex-end increased linearly with TDR, but overestimated it. Conclusion: T-wave complexity did not discriminate between differences in larger RH values. QT dispersion had low sensitivity in the transitional zone between normal and abnormal RH. In conclusion, T-wave amplitude, -area, -symmetry, and, with some limitations, Tapex-end and T-wave complexity reliably reflect changes in RH. [source] Nasogastric Aspiration and Lavage in Emergency Department Patients with Hematochezia or Melena Without HematemesisACADEMIC EMERGENCY MEDICINE, Issue 2 2010Nicholas Palamidessi MD Abstract Objectives:, The utility of nasogastric aspiration and lavage in the emergency management of patients with melena or hematochezia without hematemesis is controversial. This evidence-based emergency medicine review evaluates the following question: does nasogastric aspiration and lavage in patients with melena or hematochezia and no hematemesis differentiate an upper from lower source of gastrointestinal (GI) bleeding? Methods:, MEDLINE, EMBASE, the Cochrane Library, and other databases were searched. Studies were selected for inclusion in the review if the authors had performed nasogastric aspiration (with or without lavage) in all patients with hematochezia or melena and performed esophagogastroduodenal endoscopy (EGD) in all patients. Studies were excluded if they enrolled patients with history of esophageal varices or included patients with hematemesis or coffee ground emesis (unless the data for patients without hematemesis or coffee ground emesis could be separated out). The outcome was identifying upper GI hemorrhage (active bleeding or high-risk lesions potentially responsible for hemorrhage) and the rate of complications associated with the nasogastric tube insertion. Quality of the included studies was assessed using standard criteria for diagnostic accuracy studies. Results:, Three retrospective studies met our inclusion and exclusion criteria. The prevalence of an upper GI source for patients with melena or hematochezia without hematemesis was 32% to 74%. According to the included studies, the diagnostic performance of the nasogastric aspiration and lavage for predicting upper GI bleeding is poor. The sensitivity of this test ranged from 42% to 84%, the specificity from 54% to 91%, and negative likelihood ratios from 0.62 to 0.20. Only one study reported the rate complications associated with nasogastric aspiration and lavage (1.6%). Conclusions:, Nasogastric aspiration, with or without lavage, has a low sensitivity and poor negative likelihood ratio, which limits its utility in ruling out an upper GI source of bleeding in patients with melena or hematochezia without hematemesis. ACADEMIC EMERGENCY MEDICINE 2010; 17:126,132 © 2010 by the Society for Academic Emergency Medicine [source] Analytical Techniques for Nucleation Studies in Lipids: Advantages and DisadvantagesJOURNAL OF FOOD SCIENCE, Issue 9 2004M. Cerdeira ABSTRACT: Crystallization is generally considered a 2-step process. The 1st step, nucleation, involves the formation of molecular aggregates with a critical size great enough to become stable. During the 2nd step, nuclei grow and develop into crystals. Distinguishing between nucleation and growth constitutes a major challenge in lipid crystallization studies. Thus, it is of great importance to discuss the information obtained from the different techniques that are usually used to study nucleation behavior such as nuclear magnetic resonance (NMR), differential scanning calorimetry (DSC), rheological techniques, light-scattering techniques such as turbidimetry and scanning diffusive light scattering (SDLS), polarized light microscopy (PLM), and laser polarized optical sets such as laser polarizedlight turbidimetry (LPLT). Techniques to describe the nucleation process must be very sensitive to disregard growth. When crystallization is followed by methods such as DSC, NMR, and rheological measurements, at times, small amounts of crystals are present in the melt before any solids are detected. Clearly, at this stage, well beyond the induction time for nucleation (,), these methods are measuring crystal growth. Techniques of low sensitivity for solid fat contents lower than 0.1% must not be used to evaluate nucleation effects. Sensitive turbidimeters with detectors that saturate below 0.3% solid fat content give good results as do scanning diffusive light-scattering equipment. Although the PLM technique is sensitive enough for these kinds of studies, an understanding of important basic concepts is essential. Laser optical sets are the most appropriated methods to study nucleation in fats systems. [source] Determination of cardiac involvement in sarcoidosis by magnetic resonance imaging and Doppler echocardiographyJOURNAL OF INTERNAL MEDICINE, Issue 5 2002C. M. Sköld Abstract. Sköld CM, Larsen FF, Rasmussen E, Pehrsson SK, Eklund AG (Karolinska Hospital and Institutet, Stockholm, Sweden). Determination of cardiac involvement in sarcoidosis by magnetic resonance imaging and Doppler echocardiography. J Intern Med 2002; 252: 465,471. Objectives. To elucidate whether cardiac magnetic resonance imaging (MRI) could be useful in disclosing structural changes in the myocardium in sarcoidosis patients and to relate echo-Doppler derived indices of left ventricular function to electrocardiogram (ECG) findings. Design. The MRI was performed in 18 consecutive patients with sarcoidosis. Left ventricular ejection fraction (LVEF), i.e. systolic function, was estimated echocardiographically by Simpson's two-dimensional method (n = 16). Diastolic function was estimated by age-corrected Doppler-derived indices: isovolumetric relaxation time (IVRT), deceleration time (DT) and early filling/atrial contraction ratio (E/A ratio). Results. Eleven patients had conduction defects or dysrhythmias (ECG+) whilst seven patients had a normal ECG (ECG,). In two patients, high signalling, contrast-enhanced, isolated regions, suggestive of deposits, were seen in the left ventricular myocardium on MRI. Both these patients had abnormal ECGs and signs of systolic and/or diastolic dysfunction on echocardiography. LVEF was subnormal in seven of 10 of the ECG+ patients and in two of six of the ECG,. Signs of diastolic dysfunction were found in 59% and 56% of the measurements in the ECG+ and ECG, patients, respectively. Conclusion. We conclude (i) that myocardial deposits on MRI in sarcoidosis patients have a high specificity for cardiac involvement but a rather low sensitivity; (ii) that a substantial proportion of sarcoidosis patients with abnormal ECGs have echocardiographic signs of systolic and/or diastolic dysfunction. [source] Evaluation of chondromalacia of the patella with axial inversion recovery,fast spin-echo imagingJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 3 2001Sang Hoon Lee MD The purpose of our study was to assess the accuracy of inversion recovery,fast spin-echo (IR-FSE) imaging for the evaluation of chondromalacia of the patella. Eighty-six patients were included, they underwent magnetic resonance (MR) examination and subsequent knee arthroscopy. Medial and lateral facets of the patella were evaluated separately. Axial images were obtained by using IR-FSE (TR/TE/TI = 3000/25/150 msec; echo train length, 8; 4-mm thickness; 12-cm field of view; 512 × 256 matrix; two, number of excitations) with a 1.5-T MR machine. MR interpretation of chondromalacia was made on the basis of the arthroscopic grading system. Of a total of 172 facets graded, arthroscopy revealed chondromalacia in 14 facets with various grades (G0, 158; G1, 1; G2, 3; G3, 6; G4, 4). Sensitivity, specificity, and accuracy in the chondromalacia grades were 57.1%, 93.0%, and 90.1%, respectively. There was one false-negative case (G4) and 11 false-positive cases (G1, eight; G2, two; G3, one). Sensitivity and specificity corrected by one grade difference were improved to 85.7% and 98.1%, respectively. When cartilage changes were grouped into early (corresponding to grade 1 and 2) and advanced (grade 3 and 4) diseases, sensitivity and specificity of the early and advanced diseases were 75% and 94% and 80% and 99%, respectively. IR-FSE imaging of the knee revealed high specificity but low sensitivity for the evaluation of chondromalacia of the patella. J. Magn. Reson. Imaging 2001;13:412,416. © 2001 Wiley-Liss, Inc. [source] Combination of T2*W and FLAIR Abnormalities for the Prediction of Parenchymal Hematoma Following Thrombolytic Therapy in 100 Stroke PatientsJOURNAL OF NEUROIMAGING, Issue 4 2009Jens Fiehler MD ABSTRACT INTRODUCTION The objective of our study was to determine whether the combination of hypointense spots ("cerebral microbleeds," CMBs) with a leukoaraiosis is associated with the risk of parenchymal hematoma (PH) after thrombolytic therapy. PATIENTS AND METHODS We analyzed magnetic resonance imaging (MRI) scans acquired within 6 hours after symptom onset from 100 ischemic stroke patients. Multiparametric MRI including a T2*-weighted (T2*w) MRI and fluid attenuated inversion recovery (FLAIR) was performed before thrombolysis in all patients. Initial T2*w imaging was rated by two independent observers for the presence of CMBs smaller than 5 mm. White matter changes were evaluated using an adapted scale of Fazekas and Schmidt. PH was defined in follow-up imaging. FINDINGS A PH was observed in seven per 100 patients. CMBs were detected by observer 1 in 22 and observer 2 in 20 patients. We found a very low sensitivity (0.14) for prediction of PH by the presence of CMBs. We found a concordant increase in the rate of PH when the periventricular hyperintensity in FLAIR was larger than a thin lining. Sensitivity was good-to-perfect (0.86 and 1.00, observers 1 and 2) and specificity was substantial (0.65 and 0.66). Using the combination of a periventricular matter lesion (PVML)>1 and the presence of CMBs did not improve the prediction of PH. DISCUSSION A marked periventricular hyperintensity in FLAIR imaging seems to be associated with a substantially increased risk of PH. A combination of CMBs with leukoaraiosis scores did not appear to be beneficial for prognosis. [source] Comparative study of four candidate strategies to detect cervical cancer in different health care settingsJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 4 2007Meherbano M. Kamal Abstract Aim:, Considering the differing but potentially supplementary properties of visual inspection of the cervix with acetic acid (VIA) and the cytological examination (CYTO) of cervical smears for the screening of cervical cancers, we examined the performance of these two tests and their combinations for the screening of cervical cancer in different health care settings. Methods:, In this cross-sectional diagnostic test performance evaluation study of 4235 female subjects in the reproductive age group, we assessed the screening performance of four strategies: VIA alone, CYTO alone, VIA and CYTO combined in a parallel fashion, and VIA and CYTO combined in tandem. Subjects were recruited from three settings: Hospital, Urban Community and Rural Community. Colposcopy was used as the reference standard. Screening performance was assessed using sensitivity, specificity, post-test probabilities and likelihood ratios (LR), diagnostic odds, area under receiver operating characteristic curve and LR ,2. Results:, Both VIA and CYTO when used alone had a low sensitivity but high specificity, especially in the Rural Community setting. A combination of the results of VIA and CYTO improved the diagnostic accuracy but the strategy using a parallel combination of VIA and CYTO was the most accurate. In general, all screening strategies using VIA and CYTO showed a modest screening performance. Conclusions:, In the settings of varying levels of health care and low resources, caution is needed for a generalized use of VIA for cervical cancer screening. Further evaluation of the cost-effective ways of combining VIA and CYTO is needed in these circumstances. [source] Prevalence of myofascial temporomandibular disorder in US community womenJOURNAL OF ORAL REHABILITATION, Issue 11 2008M. N. JANAL Summary, This study estimates the prevalence of the myofascial subtype of temporomandibular disorders (M-TMD) defined by Research Diagnostic Criteria (RDC), and relates that prevalence to the surveyed report of facial pain. From among 20 000 women selected at random in the NY metropolitan area who completed a telephone survey of facial pain, 2000 were invited for an RDC/TMD examination; 782 examinations were completed. Prevalence was estimated in analyses that were weighted to correct sampling biases. Differences among demographic strata were evaluated with logistic regression. The prevalence of M-TMD was estimated to be 10·5% (95% CL = 8·5,13·0%). Prevalence was significantly higher among younger women, among women of lower socio-economic status, among Black women, and among non-Hispanic women. The report of facial pain in the telephone survey (10·1%) had high specificity for M-TMD diagnosis (94·7%), but low sensitivity (42·7%). M-TMD is a fairly common disorder among American women. Among those reporting facial pain during the last month, half met RDC palpation criteria for M-TMD; thus, a formal physical examination is imperative to establish this diagnosis. Prevalence varies with age, socio-economic status, race and Hispanic ethnicity. A substantial number of RDC-diagnosed cases of M-TMD did not report facial pain in the survey; the reason for this requires further study. [source] Meta-analysis of the diagnostic accuracy of transesophageal echocardiography for assessment of atherosclerosis in the ascending aorta in patients undergoing cardiac surgeryACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 9 2008B. VAN ZAANE Background: Stroke after cardiac surgery may be caused by emboli emerging from an atherosclerotic ascending aorta (AA). Epiaortic ultrasound scanning (EUS), the current ,gold' standard for detecting AA atherosclerosis, has not gained widespread use because there is a lack of optimized ultrasound devices, it lengthens the procedure, it endangers sterility, and there is a false belief by many surgeons that palpation is as sensitive as EUS. Furthermore there is no clear evidence proving that the use of epiaortic scanning changes outcome in cardiac surgery. Various researchers investigated the ability of transesophageal echocardiography (TEE) to discriminate between the presence and absence of AA atherosclerosis. It is acknowledged that TEE has limited value in this, but it has never been supported by a meta-analysis estimating the true diagnostic accuracy of TEE based on all quantitative evidence. We aimed to do this using state-of-the-art methodology of diagnostic meta-analyses. Methods: We searched multiple databases for studies comparing TEE vs. EUS for detection of atherosclerosis. A random-effects bivariate meta-regression model was used to obtain summary estimates of sensitivity and specificity, incorporating the correlation between sensitivity and specificity as well as covariates to explore heterogeneity across studies. Results: We extracted six studies with a total of 346 patients, of whom 419 aortic segments were analyzed, including 100 segments with atherosclerosis [median prevalence 25% (range 17,62%)]. Summary estimates of sensitivity and specificity were 21% (95% CI 13,32%) and 99% (96,99%), respectively. Conclusions: Because of the low sensitivity of TEE for the detection of AA atherosclerosis, a negative test result requires verification by additional testing using epiaortic scanning. In case of a positive test result, AA atherosclerosis can be considered as present, and less manipulative strategies might be indicated. [source] | ||||||||||||||||||||||||||||||||||||||||||||||