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Tests Used (test + used)
Kinds of Tests Used Selected AbstractsInsolvency law: a comparative analysis of the preference tests in the Hong Kong Special Administrative Region (HKSAR) and AustraliaINTERNATIONAL INSOLVENCY REVIEW, Issue 2 2007Shirley Quo This paper examines the unfair preference tests under corporate insolvency legislation in the Hong Kong Special Administrative Region (HKSAR) and Australia and undertakes a comparison of the law as it exists in relation to the tests in these jurisdictions. It suggests that the objective effects-based test used in the Australian provisions may be more effective in terms of challenging unfair preferences than the subjective ,desire' test based on the actual or presumed intention of the debtor company used in HKSAR. Copyright © 2007 John Wiley & Sons, Ltd. [source] Effectiveness of health management departments of universities that train health managers in Turkey,INTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT, Issue 4 2007Sevgul Karagoz Abstract In this research, it was aimed to examine the effectiveness of health management departments of universities that train health managers in Turkey. The study was taken on hand as comparative in respect to positions (lecturers and students) and variables of universities. Organisational effectiveness was attempted to describe in nine dimensions by being inspired from Cameron's study. Factor analysis was used for construction validity of the scale developed by the researcher. For internal consistency and reliability, Cronbach Alpha reliability coefficient and item total correlation were applied. A questionnaire was applied on total 207 persons in health management departments that form up the population in Turkey. In analysis of data were descriptive statistics and t -test used. According to research findings, at university level, lecturers found their departments more effective than their students. The highest effectiveness was perceived at Baskent University (private). In total belonging to each dimension, the perceptions of lecturers realised on a higher level compared to those of students. It was found that the effectiveness, which was the highest dimension, was the organisational health and the ability to acquire source the lowest dimension. Effectiveness level was found to be moderate in general total. Copyright © 2006 John Wiley & Sons, Ltd. [source] The Efficacy of Inducibility and Circumferential Ablation with Pulmonary Vein Isolation in Patients with Paroxysmal Atrial FibrillationJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 6 2007SHIH-LIN CHANG M.D. Introduction: Some conflicting results of the efficacy of the inducibility test used in the catheter ablation of atrial fibrillation (AF) have been reported. The aim of this study was to investigate the inducibility and efficacy of circumferential ablation with pulmonary vein isolation (PVI) in patients with paroxysmal AF and its relationship to the atrial substrate. Methods and Results: This study consisted of 88 patients with paroxysmal AF who underwent catheter ablation. Electroanatomic mapping using a NavX system was performed and the biatrial voltage was obtained during sinus rhythm. After successful circumferential ablation with PVI, an inducibility test was performed to determine the requirement for creating left atrial (LA) ablation line. After procedure, patients with inducible AF had a higher recurrence rate than did those with noninducibility of AF (55% vs 18%, P = 0.02). The patients with inducible AF after the PVI had a lower biatrial voltage than did those with negative inducibility. The patients with inducible AF after the final procedure who had a recurrence had a lower LA voltage (1.3 ± 0.4 vs 1.8 ± 0.4 mV, P = 0.02) and longer LA total activation time (99 ± 18 vs 88 ± 13 msec, P = 0.02) than did those with noninducible AF and no recurrence. None of the patients had occurrence of LA flutter during the follow-up. Conclusion: After a single procedure of circumferential ablation with PVI and noninducibility, 82% patients did not have recurrence of AF. The inducibility of AF was related to the recurrence of AF. The atrial substrate affected the outcome of the inducibility. [source] The Spectrum of Skin Disease Among Indian ChildrenPEDIATRIC DERMATOLOGY, Issue 1 2009D.N.B., Kabir Sardana M.D., M.N.A.M.S. A retrospective study was designed to evaluate the epidemiologic features of pediatric dermatoses in India. The setting was a tertiary care referral center in India (Kalawati Saran Children's Hospital, New Delhi) during January 1997 to December 2003. A total of 30,078 children less than 12 years of age with 32,341 new dermatoses were recorded, with a male to female ratio of 1.07:1. Most of the disease was seen in the 1- to 5-year age group (44.94%). The most common skin diseases were infections and infestations (47.15%) consisting of bacterial infections (58.09%) and scabies (21.54%), followed by eczemas (26.95%), infantile seborrheic dermatitis, scabies, and pityriasis alba. Other unique dermatoses in our settings were papular uticaria (3.59%), miliaria (5.46%), postinflammatory pigmentary abnormalities (1.68%), and nutritional deficiency dermatoses (0.45%). A majority of patients were diagnosed clinically and special diagnostic tests were conducted in 2.6% of patients. The most common diagnostic test used was KOH mount (59.2%), followed by skin biopsy (39%). Nearly 90% of patients were seen without any referral and in the remaining, a majority were referred by pediatricians (75%). A majority of patients were diagnosed to have infection followed by dermatitis in our setting. [source] Reproducibility and variability of activated clotting time measurements in the cardiac catheterization laboratoryCATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 3 2005Terence M. Doherty Abstract The objective of this study was to characterize the reproducibility and variability in the measurement to the activated clotting time (ACT) when performed on two different types of instruments, the HemoTec ACT (Medtronic) and the Hemochron 801 (International Technidyne). The ACT has evolved into the most common point-of-care test used in the cardiac catheterization lab to manage patient heparinization. Since the test has not been standardized, different systems frequently produce different results under the same clinical conditions. Duplicate paired ACT tests (n = 885) from 359 patients were performed on both instruments. Prothrombin times (PT) and activated partial thromboplastin times (aPTT) were also determined on subsets of these same samples (PT = 533; aPTT = 487). The performance and relationships between the two tests were determined using a variety of statistical analytical techniques. The average difference between the ACT devices was only 8 sec, yet more than 60% of the measurements varied by more than 10%. Over one-fourth of measurements varied by more than 20%. The reproducibility to the HemoTec instrument was superior to the Hemochron instrument across the entire range of ACTs measured (mean coefficient of variation 2.4% 54± 3.1% vs. 7.2% 54± 6.1% for HemoTec and Hemochron, respectively; P < 0.00001; range = 65,555 sec). The relationship between the two ACTs was nonlinear. In therapeutic ranges used for interventional procedures (200,350 sec), HemoTec and Hemochron ACTs are not comparable to one another. Statistical comparative analysis indicated that the HemoTec ACT has better overall performance. © 2005 Wiley-Liss, Inc. [source] Changes in IL-8 release and intracellular content in DMSO-differentiated HL-60 cells after treatment with 4-hydroxynonenalCELL BIOCHEMISTRY AND FUNCTION, Issue 5 2008Marina Maggiora Abstract 4-Hydroxynonenal (HNE), a chemotactic aldehyde produced by lipid peroxidation, has been shown to trigger exocytosis in HL-60 cells induced to differentiate toward the granulocytic cell line by DMSO. In this work we studied HNE effects on the intracellular content of IL-8 and its release in DMSO-differentiated HL-60 cells. Cell incubation at 37°C in the presence of 0.1,µM HNE induced a significant increase of IL-8 release after 30,min; the degree of HNE-induced IL-8 secretion became quite strong after 1,h, whereas the intracellular content showed no statistically significant changes. By contrast, 1,µM HNE induced a low decrease of the chemokine release; however, the used HNE concentrations failed to increase the release of lactate dehydrogenase (LDH), a test used to assay cell viability. The addition of 0.1,µM IL-8 to DMSO-differentiated HL-60 cells induced a strong increase of exocytosis, measured by , -glucuronidase secretion. Exocytosis stimulation by IL-8 was much higher than that given by the aldehyde; the addition of various HNE concentrations to cells incubated in the presence of IL-8 decreased the secretion given by the cytokine alone. However, HNE-induced exocytosis was likely to be a direct action of the aldehyde and was not mediated through the stimulation of IL-8 release since HNE was unable to modify IL-8 secretion during the short time of 10,min used in the exocytosis assay. Copyright © 2008 John Wiley & Sons, Ltd. [source] 1342: Communicating numerical results correctlyACTA OPHTHALMOLOGICA, Issue 2010T KIVELÄ Purpose To highlight some pearls and pitfalls in reporting numerical data related to the eye with special reference to the instructions of the EVER Journal, Acta Ophthalmologica. Methods Personal experience of the author as a writer, reviewer and editorial board member is used to highlight common issues specific for reporting statistics. The rules and the reasoning behind them are explained using abundant real life examples. Results Statistics and mathematical analyses applied should be described in the methods section, but the software used need not be referenced unless it is specific for the test used. The following rules regarding reporting are highly recommended: 1. Report proportions if the number of subjects is smaller than 10; percentages in integers if the number of subjects is less than 100; if the number of subjects is larger, one decimal place can be given but is seldom necessary. 2. Report summary statistics of normally distributed variables as mean with standard deviation; other variables as medium with range. 3. Use parametric and nonparametric statistical tests accordingly. 4. Give exact p-values (e.g. p=0.034); if p-value is less than 0.001, report p<0.001. 5. Give 95% confidence intervals for main findings. 6. Mention the statistical test used with the p-value (e.g. p=0.015, paired t-test) if multiple methods are used. Conclusion Efficient reporting and analysis of data related to the eye is not difficult as long as one is aware of the basic rules. Putting them into action helps to ensure that the conclusions the readers draw from your study are proper. [source] Mutations in GCK and HNF-1, explain the majority of cases with clinical diagnosis of MODY in SpainCLINICAL ENDOCRINOLOGY, Issue 4 2007Itziar Estalella Summary Objective, The aim of this study was to group patients with MODY (maturity-onset diabetes of the young) according to the genetic alterations underlying the disease and to investigate their clinical characteristics. Patients and methods, Molecular analysis of GCK (MODY2), HNF-1, (MODY3), HNF-4, (MODY1) and HNF-1, (MODY5) genes was performed by DNA sequencing in 95 unrelated index probands (47M/48F; mean age 9·9 ± 5·2 years) with clinical diagnosis of MODY. After classification into MODY subtypes according to the genetic alterations, clinical characteristics were compared between the groups. Results, Seventy-six families were shown to carry mutations in GCK (34 of them previously unreported), eight families presented HNF-1, mutations, and a large genomic rearrangement in HNF-1, was found in a family. No alteration was found in HNF-4,. Thus, relative frequencies in the group studied were 80% MODY2, 8·5% MODY3 and 1% MODY5. Comparison of clinical parameters according to genetic status showed significant differences between MODY2 and MODY3 patients in age at diagnosis (9·4 ± 5·4 years vs. 12·7 ± 4·6 years), diagnosis (impaired glucose tolerance vs. diabetes), diagnostic test used (OGTT vs. fasting glucose), treatment (diet and exercise vs. insulin/oral antidiabetic agents) and birth weight (2·96 ± 0·44 kg vs. 3·40 ± 0·67 kg). Conclusion, Almost 90% of the MODY cases in the group studied are explained by mutations in the major genes GCK (MODY2) and HNF-1,(MODY3), although differences in the relative prevalence of each form could be partly due to patient referral bias (paediatric vs. adult). In general, patients with MODY2 were diagnosed at an earlier age in life than MODY3 patients and had a milder form of diabetes. Moreover, the majority of patients with MODY2 mutations were treated with diet whereas half of MODY3 patients received pharmacological treatment. [source] Are point-of-care (POC) virological tests what is needed?CLINICAL MICROBIOLOGY AND INFECTION, Issue 7 2007C. R. Madeley Abstract Point-of-care (POC) tests are becoming more available, although the way in which they should be used is currently undecided. Any ,laboratory'-based diagnosis of respiratory infections has three components: the specimen taken, the test used, and the interpretation of the results. Each of these components needs to be carefully addressed when using POC tests for the diagnosis of respiratory tract infections. Given the enthusiasm with which POC tests are being developed, it is likely that they will be used more and more widely. If so, the advantages and limitations of their use should be fully discussed and the implications recognised. [source] The assessment of insulin resistance in manDIABETIC MEDICINE, Issue 7 2002T. M. Wallace Abstract Background Insulin resistance exists when a normal concentration of insulin produces a less than normal biological response. The ability to measure insulin resistance is important in order to understand the aetiopathology of Type 2 diabetes, to examine the epidemiology and to assess the effects of intervention. Methods We assess and compare methods of measurement and have undertaken a literature review from 1966 to 2001. Results Quantitative estimates of insulin resistance can be obtained using model assessments, clamps or insulin infusion sensitivity tests. There is considerable variation in the complexity and labour intensity of the various methods. The most well-established methods are the euglycaemic clamp, minimal model assessment and homeostatic model assessment (HOMA). No single test is appropriate under all circumstances. Conclusions There are a number of well-established tests used to measure insulin resistance: the choice of method depends on the size and type of study to be undertaken. Although the so-called ,gold-standard' test, the euglycaemic clamp, is useful for intensive physiological studies on small numbers of subjects, a simpler tool such as HOMA is more appropriate for large epidemiological studies. It is important to be aware that most techniques measure stimulated insulin resistance whereas HOMA gives an estimate of basal insulin resistance. Caution should be exercised when making comparisons between studies due to variations in infusion protocols, sampling procedures and hormone assays used in different studies. [source] Detection of tumor cells in body cavity fluids by flow cytometric and immunocytochemical analysisDIAGNOSTIC CYTOPATHOLOGY, Issue 8 2006Awtar Krishan Ph.D. Abstract Measurement of electronic volume versus DNA content of nuclei can be used to discriminate between normal and malignant cells. Epithelial membrane antigen immunocytochemistry (EMA-ICC), a helpful ancillary test in body cavity fluids, is not universally accurate for detecting malignancy in effusions. The current study was undertaken to determine if multiparametric flow cytometry (based on simultaneous analysis of light scatter, nuclear volume, DNA, and nuclear protein content) in combination with (EMA-ICC) could be used for the detection of malignant cells in peritoneal and pleural fluids. We studied 130 body cavity fluids (68 peritoneal and 62 pleural fluids) by conventional cytology and multiparametric laser flow cytometry. EMA-ICC was performed using EMA antibodies and L-SAB detection system (DakoCytomation, Carpinteria, CA). EMA-ICC had significantly higher sensitivity than conventional cytology (79% versus 59%, P = 0.016) and ploidy (79% versus 38%, P = 0.001). Cytology had significantly higher specificity than ploidy (97% versus 82%, P = 0.012). The differences in specificity between EMA-ICC and ploidy (87% versus 82%, P= 0.607) or EMA-ICC and cytology (87% versus 97%, P = 0.109) were not statistically significant. However, assuming serial testing, sensitivity increased significantly for the combinations of cytology and EMA-ICC (79.4%, P = 0.016) and cytology and ploidy (73.5%, P = 0.004) as compared to cytology alone (58.8%). Also, the combination of cytology and ploidy had a higher sensitivity than ploidy alone (73% versus 38%, P < 0.0001). However, the sensitivity associated with the three tests used in serial (85.3%) was not significantly different from the sensitivities corresponding to the combination of cytology and EMA-ICC (79%) or cytology and ploidy (73%). Multiparametric flow cytometry utilizing high resolution DNA, nuclear volume, protein measurement, and ICC, in combination with cytomorphology, may be a valuable tool for rapid identification of malignant cells in body cavity fluids. Diagn. Cytopathol. 2006;34:528,541. © 2006 Wiley-Liss, Inc. [source] Early behavioral screening for antidepressants and anxiolyticsDRUG DEVELOPMENT RESEARCH, Issue 9 2006Vincent Castagné Abstract Early preclinical behavioral testing is an essential stage during the development of substances with potential antidepressant and/or anxiolytic activity. With the growing cost of drug development, optimal research strategies are needed to detect potential new treatments with high efficacy and minimal side effects and to confirm in vitro pharmacological studies. In the following article, we present simple rodent tests used for early behavioral testing for antidepressant-like and anxiolytic-like activity. Unpublished results from our laboratory are discussed with reference to published data to illustrate the predictive validity of several behavioral screening tests. Drug Dev. Res. 67:729,742, 2006. © 2006 Wiley-Liss, Inc. [source] Choosing among tests of emotional intelligence: What is the evidence?HUMAN RESOURCE DEVELOPMENT QUARTERLY, Issue 1 2006Mary Pat McEnrue This article provides a comprehensive review of research regarding five types of validity for each of four major tests used to measure emotional intelligence (EI). It culls and synthesizes information scattered among a host of articles in academic journals, technical reports, chapters, and books, as well as unpublished papers and manuscripts. It enables human resource development professionals and researchers to determine the absolute and incremental value they are likely to derive by using any one of the tests to assess and develop emotional intelligence among managers and employees. [source] Performance-Based Measures of Physical Function for High-Function PopulationsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2006J. David Curb MD OBJECTIVES: To improve and broaden the applicability of performance-based measures of function for use in clinical and research settings. DESIGN: Cross-sectional repeated-measures study. SETTING: Research clinic. PARTICIPANTS: Population-based sample of Japanese Americans without significant functional impairments aged 35 to 55 and 56 to 71 (N=203). MEASUREMENTS: Performance-based measures of physical function, including range of standard tests, newer automated measures of balance and strength and data on cognitive function, lifestyle, medical history, and physical activity. RESULTS: Of the nonplatform balance measures, only the one-leg stand was reliable (reliability coefficient (rc) =0.69) and able to discriminate between functional levels. Combining the Fourth National Health and Nutrition Examination Survey protocol of folded arm position while standing on a foam pad with the more-sophisticated balance platform test had the highest reliability and discrimination. With the strength chair, high rcs (0.88,0.96) were found for upper and lower extremity tests. Timed chair stands, a test of lower extremity and central strength were reliable. The 6-minute walk had a high rc (0.90). CONCLUSION: Many performance tests used today are not reliable. Only a few discriminate between the most highly functioning individuals and individuals with good function. Thus, a new recommended battery includes unassisted single-leg stand, balance platform "foam pad, eyes closed," elbow flexion and knee extension strength (strength chair), grip strength, timed chair stands, and the 6-minute walk. These simple performance-based tests have good reliability and discrimination across the range of function and can be used in most clinical and research settings to quickly assess global functional level. [source] Computerized psychological test usage in APA-accredited training programsJOURNAL OF CLINICAL PSYCHOLOGY, Issue 6 2001Kenneth R. Olson Despite the advantages of computerized psychological assessment and the proliferation of assessment software, many psychologists still do not use computerized assessment, and its utilization has not increased during the past decade. Two-hundred-fifty-one APA-accredited training programs in clinical and counseling psychology were surveyed concerning their use of computerized psychological assessment. Directors reported a median of only three computerized tests used in their training programs. Twenty-five percent of the respondents reported no computerized psychological tests in their training programs. The computerized tests most-often used in psychology programs were compared to results of surveys of psychological tests most-often used in clinical practice. © 2001 John Wiley & Sons, Inc. J Clin Psychol 57: 727,736, 2001. [source] A neuropsychological assessment of frontal cognitive functions in Prader,Willi syndromeJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 5 2007J. Jauregi Abstract Background Prader,Willi syndrome (PWS) is associated with a characteristic behavioural phenotype whose main features are, alongside compulsive hyperphagia, deficits in social behaviour: social withdrawal, temper tantrums, perseverative speech and behaviour, mental rigidity, stereotyped behaviour, impulsiveness, etc. Similar symptoms may also be found in autistic spectrum disorders and lesional pathologies of the frontal lobe. In both cases, such symptoms have been related to dysfunctions in frontal cognitive processes such as attention, working memory and executive functions. This study uses standardized neuropsychological instruments to analyse the degree to which these processes are affected in PWS. Methods The sample comprised 16 individuals with a genetically confirmed PWS diagnosis. Subjects' IQ (Wechsler Adult Intelligence Scale), academic level, laterality and body mass index (BMI) were calculated. Attention, memory and executive functions were analysed using standard, widely employed neuropsychological tests. We compared the results of the sample group with the general population. Correlation analyses were carried out with IQ, academic level and BMI. Results In all the neuropsychological measures focusing on attention, executive functions and visuoperceptual organization, the study sample scored significantly lower than the normative reference population. The scores of the tests used for measuring immediate memory were also significantly lower when trials required sequential processing, although not when they required simultaneous processing. In the memorization of a list of words, subjects showed an initial deficit which disappeared with repetition, enabling them to obtain scores similar to the reference population. No significant correlations were found with BMI, and a higher IQ or academic level did not improve scores in the majority of tests. Conclusions The study shows a deficit in elementary frontal cognitive processes in PWS patients. This deficit may be involved in the social behaviour disorders that characterize such patients, as described in other development or frontal syndrome pathologies. However, we cannot affirm that the deficits found are specific to PWS; they could also occur in other causes of intellectual disability. Although in the study sample IQ did not correlate with frontal deficits, further research is needed to establish whether the neuropsychological alterations described form part of a cognitive phenotype for PWS. We believe that our understanding of the social behaviours typical of PWS may be improved by taking into consideration the cognitive functioning models of the prefrontal lobe, particularly those applied to pervasive developmental disorders. [source] Residential Design Implications of Consumers' Recycling BehaviorsJOURNAL OF INTERIOR DESIGN, Issue 1-2 2003Sharon Macy M.A. ABSTRACT Each year landfills receive a growing amount of waste that could be eliminated by recycling practices supported through the design of kitchens. This study had three objectives: (a) to examine residential design implications for incorporating recycling within the home, (b) to examine consumer's feelings of environmental altruism and their behaviors toward recycling within the context of situational conditions within the home, and (c) to examine consumer's views regarding the convenience of their home's recycling facilities. The primary research instrument was a survey of consumer behaviors and attitudes toward recycling. Certified Kitchen Designers provided client names for whom they had designed a kitchen as part of a remodel or new home construction within the last five years. Questionnaires were mailed to 271 households with a 58.2% response rate achieved. Five areas of information were addressed in the survey: sociode-mographics, behaviors and situational design factors, altruistic values, perceived inconvenience, and economic factors. Descriptive and inferential statistics were used for analysis with Chi-square tests used to examine relationships between variables. Results support including an area for recycling in the kitchen or a space that is directly adjacent such as an attached garage; convenience was found to be a primary factor in the recycling behaviors of highly altruistic individuals. It is important to design an environment that supports recycling. Whether recycling is convenient or not will have an influence on an individual's recycling behaviors. With environments that support recycling behaviors, consumers will increase their quantity and accuracy in recycling, which in turn could lead to an increase in attitudes toward other pro-environmental actions. [source] Clinicopathologic Evaluation of Hepatic Lipidosis in Periparturient Dairy CattleJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 4 2007Emmanouil Kalaitzakis Background: Fatty change of the liver (FCL) is very common in dairy cattle periparturiently. Many laboratory methods have been implicated in order to assist the diagnosis. Hypothesis: To investigate whether FCL in dairy cattle could be evaluated by assessment of ornithine carbamoyl transferase (OCT) by means of an assay modified for bovine serum, other enzyme activity, serum bile acids (SBA) concentration, or other biochemical constituents. Animals: A total of 187 dairy cattle were included: 106 were suspected to have liver dysfunction and were examined after referral by veterinarians; 70 were clinically healthy with mild FCL; and 11 were clinically healthy without FCL. Methods: Blood and liver biopsy samples were obtained after clinical examination. Histologic examination by light microscopy and classification of samples according to the severity of FCL was done, and total lipid and triglyceride concentration was measured. In serum, OCT, aspartate aminotransferase (AST), alanine aminotransferase (ALT), sorbitol dehydrogenase (SDH), glutamate dehydrogenase (GDH), alkaline phosphatase (ALP), and ,-glutamyltransferase (,-GT) activity as well as SBA, glucose, ketones, total bilirubin (tBIL), and nonesterified fatty acids (NEFA) concentration were measured. Results: OCT and AST activity and tBIL concentration correlate well with the degree of FCL. SBA concentration does not contribute well to FCL diagnosis. The majority of FCL cases appeared within the first 21 days-in-milk (DIM). The majority of moderate-to-severe and severe FCL cases arose in the first 7 DIM. Conclusions and Clinical Importance: Except for OCT, AST, and tBIL, none of the biochemical tests used, including SBA, had sufficient discriminatory power to differentiate reliably between mild and severe FCL because of poor sensitivity. A weak correlation between clinical signs and the extent of FCL was evident. [source] Electrophysiological and neuropsychological tests for the diagnosis of subclinical hepatic encephalopathy and prediction of overt encephalopathyLIVER INTERNATIONAL, Issue 3 2002Nandini Saxena Abstract: Background: Subclinical hepatic encephalopathy (SHE) features in 30,84% of patients with cirrhosis of the liver. Its clinical significance with regards to progression to overt encephalopathy has however, not been established. Aims: The present study was conducted (i) to compare the diagnostic usefulness of neuropsychological tests with that of electrophysiological (EP) tests in detection of SHE, and (ii) to examine the natural course of SHE. Methods: Seventy-five-nonencephalopathic cirrhotics (11 females, 64 males; mean (± SD) age 43.6 (± 11.7) years; mean (± SD) education 11(± 3) years) were studied using a battery of tests for intelligence and memory, the number connection test (NCT), and EP tests viz. electroencephalogram (EEG) and auditory P300 event related potentials (P3ERP). All the patients were followed up for a period of 6 months to 2 years for development of overt encephalopathy. Results: Thirty-five out of 75(47%) patients were diagnosed to have SHE based on at least one abnormal test result. The P3ERP latencies detected SHE in maximum number of patients (23%) followed by EEG (21%). Nearly 59% of patients with SHE progressed to overt encephalopathy within a mean duration of 4 months. Multivariate analysis showed that prior episode of encephalopathy (RR = 6.3; 95% CI = 2.0,19.7), abnormality on EEG (RR = 7.5; 95% CI = 2.2,25.3), abnormal performance on psychometric battery of tests (RR = 35.2; 95% CI = 4.3,287.3), occurrence of gastrointestinal bleed (RR = 19.3; 95% CI = 4.1,88.9), occurrence of dehydration (RR = 10.7; 95% CI = 2.5,45.4) and infection (RR = 11.4; 95% CI = 2.0,64.4) had significantly higher risk for development of overt encephalopathy. Conclusions: EP methods were more sensitive in detection of SHE. Amongst all the tests used, presence of only an abnormal EEG was significantly associated with development of overt encephalopathy along with the precipitating factors. [source] Consultants' opinion on a new practice-based assessment programme for first-year residents in anaesthesiologyACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 9 2002C. Ringsted Background: Assessment in postgraduate education is moving towards using a broad spectrum of practice-based assessment methods. This approach was recently introduced in first-year residency in anaesthesiology in Denmark. The new assessment programme covers: clinical skills, communication skills, organizational skills and collaborative skills, scholarly proficiencies and professionalism. Eighteen out of a total of 21 assessment instruments were used for pass/fail decisions. The aim of this study was to survey consultants' opinions of the programme in terms of the representativeness of competencies tested, the suitability of the programme as a basis for pass/fail decisions and the relevance and sufficiency of the content of the different assessment instruments. Methods: A description of the assessment programme and a questionnaire were sent to all consultants of anaesthesiology in Denmark. The questionnaire consisted of items, to be answered on a five-point scale, asking the consultants' opinions about representativeness, suitability and content of the programme. Results: The response rate was 251/382 (66%). More than 75% of the respondents agreed that the assessment programme offered adequate coverage of the competencies of a first-year resident and was appropriate for making pass/fail decisions. There was strong agreement that the content of the 18 tests used for pass/fail decisions was relevant and sufficient for pass/fail decisions. Conclusion: Judging from the consultants' opinions, the assessment programme for first-year residency in anaesthesiology appears to be appropriate regarding the range of competencies assessed, the appropriateness as a basis for pass/fail decisions, and regarding the content of the tests used for pass/fail decisions. Further studies are needed to assess the feasibility and acceptability of the programme in practice. [source] Weaknesses of goodness-of-fit tests for evaluating propensity score models: the case of the omitted confounder,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 4 2005Sherry Weitzen PhD Abstract Purpose Propensity scores are used in observational studies to adjust for confounding, although they do not provide control for confounders omitted from the propensity score model. We sought to determine if tests used to evaluate logistic model fit and discrimination would be helpful in detecting the omission of an important confounder in the propensity score. Methods Using simulated data, we estimated propensity scores under two scenarios: (1) including all confounders and (2) omitting the binary confounder. We compared the propensity score model fit and discrimination under each scenario, using the Hosmer,Lemeshow goodness-of-fit (GOF) test and the c-statistic. We measured residual confounding in treatment effect estimates adjusted by the propensity score omitting the confounder. Results The GOF statistic and discrimination of propensity score models were the same for models excluding an important predictor of treatment compared to the full propensity score model. The GOF test failed to detect poor model fit for the propensity score model omitting the confounder. C-statistics under both scenarios were similar. Residual confounding was observed from using the propensity score excluding the confounder (range: 1,30%). Conclusions Omission of important confounders from the propensity score leads to residual confounding in estimates of treatment effect. However, tests of GOF and discrimination do not provide information to detect missing confounders in propensity score models. Our findings suggest that it may not be necessary to compute GOF statistics or model discrimination when developing propensity score models. Copyright © 2004 John Wiley & Sons, Ltd. [source] Analgesic and antiinflammatory activity of Cyclamen repandum S. et S.PHYTOTHERAPY RESEARCH, Issue 7 2007E. Speroni Abstract According to folk medicine some species belonging to the genus Cyclamen were used for their biological activities. Early investigation of the different species of the genus resulted in the isolation of triterpenic saponins. No phytochemical and biological data are available on C. repandum. As part of a series of phytochemical investigations for bioactive compounds from medicinal plants, Cyclamen repandum S. et S. was investigated. The present study sought to find the antiinflammatory and antinociceptive activities of C. repandum tubers in rats and mice. A preliminary screening was conducted with three different extracts in the tests used, particularly the paw edema and the writhing tests. Subsequently some saponins isolated from the ME extract, the more effective one, have been identified. This paper also describes the results of fractionation and bioassay guided chemical studies. Chemical investigation of the active extract afforded the isolation and characterization of six triterpenic saponins. The possible antiinflammatory and analgesic properties were investigated as the saponin content of the fractions allows to speculate on such aspect. Copyright © 2007 John Wiley & Sons, Ltd. [source] Physical training and testing in patients with chronic obstructive pulmonary diseaseTHE CLINICAL RESPIRATORY JOURNAL, Issue 1 2007Ragnheišur Harpa Arnardóttir Abstract Introduction:, The effects of different training modes need to be investigated further in patients with chronic obstructive pulmonary disease (COPD). Both advanced laboratory tests and field tests are used in patients with COPD to evaluate effects of interventions such as pulmonary rehabilitation. Aims:, The overall aims of the studies were to investigate the effects of different training modalities on exercise capacity and on health-related quality of life (HRQoL) in patients with moderate or severe COPD and, further, to explore two of the physical field tests used in pulmonary rehabilitation, the 12-min walk test and the incremental shuttle walking test (ISWT). Materials and Methods:, Patients with moderate or severe COPD were included. In study I (n = 57), the 12-min walk test was performed three times within 1 week. Exercise-induced hypoxemia (EIH) was assessed by pulse oximeter and was defined as SpO2 < 90%. In study II (n = 93), performance on ISWT was compared to performance on two different cycle tests. In study III (n = 42), the effects of two different combination training programmes were compared when training twice a week for 8 weeks. One programme was mainly based on endurance training (group A), and the other was based on resistance training and on callisthenics (group B). In study IV (n = 60), endurance training with interval resistance was compared to endurance training with continuous resistance. Results:, In study I, the 12-min walking distance (12MWD) did not increase on retesting in patients with EIH, but increased significantly on retesting in the non-EIH patients. In study II, the ISWT was as good a predictor of peak exercise capacity (W peak) as peak oxygen uptake (VO2 peak) was. In study III, W peak and 12MWD increased in group A but not in group B. HRQoL, anxiety and depression were unchanged in both groups. Ratings of perceived exertion at rest were significantly lower in group A than in group B after training and during 12 months of follow-up. Twelve months post training, 12MWD was back to baseline in group A, but was significantly shorter than at baseline in group B. Patients with moderate and severe COPD responded to training in the same way. In study IV, both interval and continuous endurance training increased W peak, VO2 peak, peak exhaled carbon dioxide (VCO2 peak) and 12MWD. Likewise, HRQoL, dyspnoea during activities of daily life, anxiety and depression improved similarly in both groups. At a fixed, sub-maximal workload (isotime), the interval training reduced oxygen cost and ventilatory demand significantly more than the continuous training did. Conclusions:, EIH affects the retest effects on 12MWD. W peak can be predicted from an ISWT similarly well as from VO2 peak. A short training programme can improve W peak and 12MWD when based mainly on endurance training. Both patients with moderate and severe COPD respond to training in the same way. A short endurance training intervention can possibly delay decline in 12MWD for 1 year. Both interval and continuous endurance training improves physical performance and HRQoL. Interval training lowers the energy cost of sub-maximal work more than continuous training does. [source] Good Ethics Requires Good Science: Why Transplant Programs Should NOT Disclose Misattributed ParentageAMERICAN JOURNAL OF TRANSPLANTATION, Issue 4 2010L. F. Ross In 1996, I argued that the recommendation by the Institute of Medicine (IOM) to inform women when tests reveal misattributed paternity and not to disclose this information to the women's partners was morally wrong. I argued in favor of disclosure to both parties. It is a position that I still hold. But claims of misattributed paternity are not ,incidental findings' as it was called in the old genetics literature, but a rather serious indictment of biological infidelity. In this paper I argue that the tests used by transplant programs for living donor,recipient compatibility are inadequate to accurately determine misattributed paternity. Further I argue that it is not the responsibility of the transplant community to undertake such serious forensic evaluations. Genetic inconsistencies in ABO and HLA inheritance should be reported as variations. Families who want further clarification should be referred to a genetic professional. [source] Predicting occult malignancy in nipple dischargeANZ JOURNAL OF SURGERY, Issue 9 2010Chris Alcock Abstract Background:, This study was a retrospective analysis of patients who underwent minor or major duct surgery for pathological nipple discharge. The results of clinical examination, mammography, ultrasonography and cytodiagnosis of the nipple discharge were studied in order to predict those patients at risk of underlying or occult malignancy. Methods:, Between January 2004 and December 2006, 55 female patients aged between 24 and 82 years old underwent major or minor duct excision, 49 of which were for pathological nipple discharge. Results of several preoperative investigations were compared with the surgical pathology to determine how their sensitivity and specificity faired in predicting malignant ductal pathology. Results:, Of the 49 patients undergoing surgery for nipple discharge, 21 were diagnosed with intraductal papilloma, 19 with duct ectasia, 6 with carcinoma, 2 with benign breast disease and 1 with lobular carcinoma in situ. In all of the patients determined to have malignancy, none demonstrated malignant changes on mammography or ultrasonography. Only 2 of the 6 patients with malignancy were found to have atypical cells on cytological analysis. The sensitivity of blood detected in nipple discharge at predicting malignancy was 0.83, specificity of 0.53, positive predictive value of 0.20 and negative predictive value 0.96. Conclusions:, Despite the various tests used in the assessment of pathological nipple discharge, this study highlights their limited help at predicting the cause. This, together with several other studies, demonstrates that ductal surgery remains the only reliable way of providing a diagnosis, in addition to being the major therapeutic measure. [source] Primary necrotizing lymphocytic central nervous system vasculitis due to perforin deficiency in a four-year-old girlARTHRITIS & RHEUMATISM, Issue 3 2007Despina Moshous We report the case of a 4-year-old girl who presented with headaches, ataxia, and visual disturbances. Cranial magnetic resonance imaging showed multiple supra- and infratentorial lesions with peripheral contrast enhancement and central necrosis. Brain biopsy revealed necrotizing lymphocytic vasculitis of undetermined etiology. Perforin expression was found to be significantly reduced in the patient's peripheral blood cells, and sequence analysis of the patient's perforin gene showed a compound heterozygous state with 1 nonsense mutation and 2 missense alterations in exon 2. Central nervous system (CNS) vasculitis was thus attributed to the perforin deficiency, and the patient was successfully treated by transplantation of stem cells from an HLA-identical brother. The findings described herein indicate that, even in the absence of classic non-neurologic symptoms of hemophagocytic lymphohistiocytosis, measurement of perforin expression should be one of the diagnostic tests used to identify the cause of unexplained CNS vasculitis, since this may have profound implications regarding therapy. [source] Towards ground truthing exploration in the central Arctic Ocean: a Cenozoic compaction history from the Lomonosov RidgeBASIN RESEARCH, Issue 2 2010M. O'Regan ABSTRACT The Integrated Ocean Drilling Program's Expedition 302, the Arctic Coring Expedition (ACEX), recovered the first Cenozoic sedimentary sequence from the central Arctic Ocean. ACEX provided ground truth for basin scale geophysical interpretations and for guiding future exploration targets in this largely unexplored ocean basin. Here, we present results from a series of consolidation tests used to characterize sediment compressibility and permeability and integrate these with high-resolution measurements of bulk density, porosity and shear strength to investigate the stress history and the nature of prominent lithostratigraphic and seismostratigraphic boundaries in the ACEX record. Despite moderate sedimentation rates (10,30 m Myr,1) and high permeability values (10,15,10,18 m2), consolidation and shear strength measurements both suggest an overall state of underconsolidation or overpressure. One-dimensional compaction modelling shows that to maintain such excess pore pressures, an in situ fluid source is required that exceeds the rate of fluid expulsion generated by mechanical compaction alone. Geochemical and sedimentological evidence is presented that identifies the Opal A,C/T transformation of biosiliceous rich sediments as a potential additional in situ fluid source. However, the combined rate of chemical and mechanical compaction remain too low to fully account for the observed pore pressure gradients, implying an additional diagenetic fluid source from within or below the recovered Cenozoic sediments from ACEX. Recognition of the Opal A,C/T reaction front in the ACEX record has broad reaching regional implications on slope stability and subsurface pressure evolution, and provides an important consideration for interpreting and correlating the spatially limited seismic data from the Arctic Ocean. [source] Psychological tests used in child custody evaluations,BEHAVIORAL SCIENCES & THE LAW, Issue 4 2001Francella A. Quinnell Ph.D. Controversy has long surrounded the use of psychological testing in child custody evaluations. The present study explored the current status of psychological testing in these evaluations using a national survey of 198 psychologists. Findings revealed that participants viewed testing as one source among many for data collection, neither under- nor over-valuing its importance. Results also indicated that participants were more discriminating in their test selection, with a greater focus on objective assessment, particularly in the use of parent inventories and rating scales. These findings tend to negate much of the past criticism and reflect closer adherence to APA guidelines. Copyright © 2001 John Wiley & Sons, Ltd. [source] Some remarks on characterization and application of stationary phases for RP-HPLC determination of biologically important compoundsBIOMEDICAL CHROMATOGRAPHY, Issue 1 2006Sylwia Kowalska Abstract Biologically active compounds such as vitamins, steroids, nucleosides, peptides and proteins play a very important role in coordinating living organism functions. Determination of those substances is indispensable in pathogenesis. Their complex structure and physico-chemical properties cause many analytical problems. Chromatography is the most common technique used in pharmaceutical and biomedical analysis. The interaction between analyte and stationary phase plays a major role in the separation process. The structure of the packing has a significant influence on the results of the separation process. Various types of spectroscopic techniques, such as nuclear magnetic resonance spectroscopy, infrared spectroscopy, fluorescence spectroscopy and photoacoustic spectroscopy can be useful tools for the characterization of packings. Surface area measurements, elemental analysis, thermal analysis and microcalorimetric measurements are also helpful in this field. Part of the paper contains a description of chromatographic tests used for the determination of column properties. The description of the possibilities of surface characterization is not complete, but is focused on the most popular techniques and practical chromatographic tests. All the presented methods made possible the design and quality control of a new generation stationary phases, which are the future of high-performance liquid chromatography. Copyright © 2005 John Wiley & Sons, Ltd. [source] Combination of cervical interleukin-6 and -8, phosphorylated insulin-like growth factor-binding protein-1 and transvaginal cervical ultrasonography in assessment of the risk of preterm birthBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 8 2001Merja Kurkinen-Räty Objective To determine the value of combinations of cervical interleukin-6 (IL-6), cervical interleukin-8 (IL-8), the phosphorylated isoform of insulin-like growth-factor binding protein-1 (IGFBP-1), and cervical ultrasonography in the prediction of preterm birth. Design Prospective follow up. Setting Oulu University Hospital maternity clinic from February 1997 to July 1998. Population Women with singleton pregnancies (n= 77), referred from outpatient clinics at 22,32 weeks of gestation with symptoms (uterine contractions) or signs (cervical change) of threatened preterm birth. Symptomless women (n= 78) matched for gestational age, parity and maternal age at recruitment were studied as a reference group. Methods A urine sample for bacterial culture was collected, and cervical swab samples for assays of interleukin-6 and -8 and phoshorylated IGFBP-1 were taken before digital cervical examination. A Pap smear for analysis of bacterial vaginosis and samples for analysis of chlamydia and streptococci were also obtained. Cervical measurements were made by transvaginal ultrasonography. The same sampling and cervical measurement were repeated twice at two-week intervals. The cutoff values of the markers were determined by receiver-operating characteristic curve analysis. Main outcome measure Preterm birth (<37 weeks). Results The preterm birth (<37 weeks) rate for women in the study group was 16% (12/77). The cervical interleukin-6 cutoff value (61 ng/L) at first visit had a sensitivity of 73% and a specificity of 61% in predicting preterm birth, with a positive likelihood ratio (LR+) of 1.9 (95% CI 1.2,3.0). An ultrasonographically measured cervical index value of > 0.36 at recruitment predicted preterm birth in 25% (5/20) of the study group compared with 9% (5/54); LR+ 2.2 (95% CI 1.03,4.7). Cervical phosphorylated IGFBP-1 > 6.4,g/L [LR+ 1.8 (95% CI 0.7,2.9)], interleukin-8 > 3739 ng/L [LR+ 1.4 (95% CI 0.9,2.4)], and ultrasonograpic cervical length < 29.3 mm [LR+ 2.7 (95% CI 0.8,9.7)] increased the risk of preterm birth. According to the logistic regression model, a combination of IL-6, and IL-8 and cervical index increased the specificity to 97%, but the sensitivity fell to 30% in detecting preterm birth. There was a significantly increased incidence of puerperal infections if phosphorylated IGFBP-1 concentrations were elevated (> 21.0 ,g/L), 36% (4/11) compared with 4.6% (3/65), LR+ 6.7 (95% CI 2.7,17), the sensitivity being 67% (4/6) and the specificity 90% (63/70). Elevated phosphorylated IGFBP-1 concentrations (> 21.6,g/L) were also associated with an increased risk of neonatal infections; LR+ 8.0 (95% CI 3.5,18). Conclusions An increase in cervical IL-6 concentration and the ultrasonographically measured cervical index appear to be associated with preterm birth. A combination of these markers with measurement of cervical IL-8 appears to be the best predictor of preterm birth. Neither the sensitivity nor specificity of the tests used in this study are good enough to predict preterm birth for clinical decision making. Cervical phosphorylated IGFBP-1 seems to be a marker of puerperal and neonatal infectious morbidity in cases of threatened preterm delivery, suggesting early tissue degradation at the choriodecidual interface. [source] | |||||||||||||||||||||||||||||||||||||