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Stable isotopes of C and N differ in their ability to reconstruct diets of cattle fed C 3-C 4 forage diets. Sci Rep 2022; 12:17138. [PMID: 36229636 PMCID: PMC9562360 DOI: 10.1038/s41598-022-21051-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 09/22/2022] [Indexed: 01/04/2023] Open
Abstract
Stable isotopes are useful for estimating livestock diet selection. The objective was to compare δ13C and δ15N to estimate diet proportion of C3-C4 forages when steers (Bos spp.) were fed quantities of rhizoma peanut (Arachis glabrata; RP; C3) and bahiagrass (Paspalum notatum; C4).Treatments were proportions of RP with bahiagrass hay: 100% bahiagrass (0%RP); 25% RP + 75% bahiagrass (25%RP); 50% RP + 50% bahiagrass (50%RP); 75% RP + 25% bahiagrass (75%RP); and 100% RP (100% RP). Feces, plasma, red blood cell (RBC), and hair were collected at 8-days intervals, for 32 days. Two-pool mixing model was utilized to back-calculate the proportion of RP based on the sample and forage δ13C or δ15N. Feces showed changes using δ13C by 8 days, and adj. R2 between predicted and observed RP proportion was 0.81 by 8 days. Plasma, hair, and RBC required beyond 32-days to reach equilibrium, therefore were not useful predictors of diet composition during the study. Diets were best represented using fecal δ13C at both 8-days and 32-days. By 32-days, fecal δ15N showed promise (R2 = 0.71) for predicting diet composition in C3-C4 diets. Further studies are warranted to further corroborate fecal δ15N as a predictor of diet composition in cattle.
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Fu Y, Colazo MG, De Buck J. Development of a blood calcium test for hypocalcemia diagnosis in dairy cows. Res Vet Sci 2022; 147:60-67. [DOI: 10.1016/j.rvsc.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 02/07/2022] [Accepted: 04/08/2022] [Indexed: 10/18/2022]
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Fehlberg L, Pineda A, Cardoso F. Validation of 2 urine pH measuring techniques in a prepartum negative dietary cation-anion difference diet and the relationship with production performance. JDS COMMUNICATIONS 2022; 3:13-18. [PMID: 36340683 PMCID: PMC9623720 DOI: 10.3168/jdsc.2021-0130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 09/14/2021] [Indexed: 06/16/2023]
Abstract
Negative dietary cation-anion difference (DCAD) diets have been implemented to combat hypocalcemia, a common peripartal disease in dairy cows; however, the extent of compensatory metabolic acidosis necessary and the subsequent effects on performance are still debated. Additionally, there is a need for an inexpensive, accurate method to measure urine pH on farm during the prepartum period to assess the extent of metabolic acidosis achieved by negative DCAD diets. Therefore, this experiment was conducted to determine the accuracy of Fisher pH sticks (pHF; ThermoFisher Scientific) and pHion balance test strips (pHI; pHion Balance) compared with a portable pH meter (pHP; Accumet AP115, ThermoFisher Scientific) in measuring urine pH (UpH) and the effect of UpH on pre- and postpartum dry matter intake (DMI), milk, and milk composition yields. Cows consumed a total mixed ration with a DCAD of -118 mEq/kg for 4 wk prepartum and 397 mEq/kg for 4 wk postpartum. Prepartum UpH measurements (n = 75) for each cow were averaged and used to classify cows in terms of urine pH as low (UpH ≤5.54; mean ± standard deviation; 5.44 ± 0.07), medium (UpH >5.54 and ≤5.90; 5.67 ± 0.09), or high (UpH >5.90; 6.42 ± 0.36). Cows were milked twice a day, and milk samples were taken on d 7 ± 1.3, 14 ± 1.4, and 28 ± 1.1 relative to calving. Milk yield and DMI were recorded daily and averaged weekly. Bland-Altman plots and Lin's concordance correlation coefficient (CCC) were used to assess the agreement between pHP and pHF or pHI (n = 375). Receiver operating characteristic curves were used to determine the threshold with pHF and pHI that best discriminated between UpH >5.75 and ≤5.75 compared with pHP, and area under the curve (AUC) was used to assess the accuracy. At the UpH threshold of 5.75 for pHF and pHI, the sensitivity, specificity, and AUC were 89.5 and 87.4, 99.1 and 97.0, and 0.94 and 0.92, respectively. The CCC was 0.93 for pHF and pHI, indicating near-perfect agreement with pHP. The UpH did not affect pre- or postpartum DMI. There was a tendency for a UpH × week interaction for milk yield, in which milk yields were less for cows in the low and medium groups. In conclusion, pHI and pHF are accurate measurements for UpH, and UpH did not affect DMI; however, when UpH was low or medium, milk yield was decreased at wk 1 postpartum.
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Affiliation(s)
- L.K. Fehlberg
- Department of Animal Sciences, University of Illinois, Urbana 61801
| | - A. Pineda
- Department of Animal Biosciences, University of Guelph, Guelph, ON, Canada, N1G 2W1
| | - F.C. Cardoso
- Department of Animal Sciences, University of Illinois, Urbana 61801
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King JL, Walley KC, Stauch C, Bifano S, Juliano P, Aynardi MC. Comparing the Efficacy of True-Volume Analysis Using Magnetic Resonance Imaging With Computerized Tomography and Conventional Methods of Evaluation in Cystic Osteochondral Lesions of the Talus: A Pilot Study. Foot Ankle Spec 2021; 14:501-508. [PMID: 32486861 DOI: 10.1177/1938640020928177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
UNLABELLED Background: Osteochondral lesions of the talus (OLT) often require advanced imaging if they prove to be refractory to preliminary microfracture. Orthopedic surgeons may misinterpret the size and morphology of the OLT when evaluating through conventional methods. The purpose of this study was to evaluate MRI as a modality for calculating true-volumes and compare its utility to that of CT true-volume and conventional methods of measuring lesion size. METHODS With IRB approval, an institutional radiology database was queried for patients with cystic OLT that had undergone and failed microfracture and had compatible CT and MR scans between 2011 and 2016. Five lesions, previously analyzed and described in the literature using CT true-volume, were selected. 10 orthopedic surgeons independently estimated the volume of these 5 OLT via standard MRI. Next, 3D reconstructions were created and morphometric true-volume (MTV) analysis measurements of each OLT were generated. The percent change in volumes from CT and MR was compared based upon MTVs determined from 3D reconstructive analysis. RESULTS The volume calculated using conventional methods in CT and MR scans grossly overestimated the size by of the OLT by 285-864% and 56-374% respectively when compared to 3D true-volume analysis of those CT and MR scans. CONCLUSIONS This study demonstrates that true-volume is more accurate for calculating lesion size than conventional methods. Additionally, when comparing MRI and CT, thin slice CT true-volume is superior to MRI true-volume. True-volume calculation improves accuracy with CT and MRI and should be recommended for use in revision OLT cases.Levels of Evidence: Level III: Case control study.
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Affiliation(s)
- Jesse L King
- Department of Orthopaedic Surgery, Penn State Hershey Bone and Joint Institute, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Kempland Corbin Walley
- Department of Orthopaedic Surgery, Penn State Hershey Bone and Joint Institute, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Chris Stauch
- Department of Orthopaedic Surgery, Penn State Hershey Bone and Joint Institute, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Shawn Bifano
- Department of Orthopaedic Surgery, Penn State Hershey Bone and Joint Institute, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Paul Juliano
- Department of Orthopaedic Surgery, Penn State Hershey Bone and Joint Institute, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Michael C Aynardi
- Department of Orthopaedic Surgery, Penn State Hershey Bone and Joint Institute, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
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Couto Serrenho R, Bruinjé TC, Morrison EI, Renaud DL, DeVries TJ, Duffield TF, LeBlanc SJ. Validation of a point-of-care handheld blood total calcium analyzer in postpartum dairy cows. JDS COMMUNICATIONS 2021; 2:41-45. [PMID: 36337292 PMCID: PMC9623686 DOI: 10.3168/jdsc.2020-0006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 10/21/2020] [Indexed: 05/09/2023]
Abstract
Our objective was to validate a point-of-care handheld blood total calcium analyzer (Ca meter, CM; TD-5220 Vet Ca2+, TaiDoc, New Taipei, Taiwan) to estimate circulating Ca concentrations in postpartum dairy cows. Whole blood was collected from 251 multiparous cows between 1 and 4 d in milk from 2 commercial dairy herds in Ontario, Canada. Blood total calcium concentration (tCa) was analyzed in whole blood, fresh plasma, and thawed plasma, and compared with tCa results from thawed serum analyzed in a diagnostic laboratory (using a Cobas Calcium Gen 2 kit, Roche Diagnostics, Indianapolis, IN) as the reference test (RT). Lin's concordance correlation coefficient (βrho;) and Bland-Altman (B-A) plots were assessed to evaluate the agreement between the RT and CM results in each type of sample. Receiver operating characteristic curve analyses were used to describe the accuracy of each test against the categorized RT results (at a cut-point of ≤2.14 mmol/L). Samples where the meter gave a nonquantitative result ("high" or "low"; thawed plasma: 3/247; fresh plasma: 6/100; and whole blood: 20/98) were not included in the βrho; and B-A analyses. Lin's correlation coefficients demonstrated poor agreement between tests (thawed plasma: βrho; = 0.16; fresh plasma: βrho; = 0.21; and whole blood: βrho; = 0.23). Fresh plasma (using a cut-point of 2.55 mmol/L as measured on the CM) had the greatest diagnostic sensitivity (72%), specificity (86%), and accuracy (77%) for determining subclinical hypocalcemia, but that would still misclassify 23% of samples. In addition to substantial variability, the B-A plots revealed bias with changing concentrations of calcium. Because of low sensitivity on whole blood (58%) or thawed plasma (56%), measurement with the CM is not recommended on these types of samples. This rapid and low-cost meter was not sufficiently accurate to quantify blood Ca concentration, but when used with fresh plasma it might be useful as a screening tool for subclinical hypocalcemia.
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Affiliation(s)
- Rita Couto Serrenho
- Population Medicine, University of Guelph, Guelph, ON, Canada N1G 2W1
- Corresponding author
| | - Tony C. Bruinjé
- Population Medicine, University of Guelph, Guelph, ON, Canada N1G 2W1
| | - Emma I. Morrison
- Population Medicine, University of Guelph, Guelph, ON, Canada N1G 2W1
| | - David L. Renaud
- Population Medicine, University of Guelph, Guelph, ON, Canada N1G 2W1
| | - Trevor J. DeVries
- Animal Biosciences, University of Guelph, Guelph, ON, Canada N1G 2W1
| | - Todd F. Duffield
- Population Medicine, University of Guelph, Guelph, ON, Canada N1G 2W1
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Cantürk M, Kocaoğlu N, Hakki M. [Correlation of the epidural space measured intraoperatively and estimated by MRI or US: an observational study]. Rev Bras Anestesiol 2020; 70:248-255. [PMID: 32711869 DOI: 10.1016/j.bjan.2020.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 02/25/2020] [Accepted: 03/22/2020] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To assess the agreement between the epidural depth measured from the surgical site with the epidural depths estimated with magnetic resonance imaging (MRI) and ultrasound scanning. METHODS Fifty patients of either sex, scheduled for L4-5 lumbar disc surgery under general anesthesia were enrolled in this prospective observational study, and the results of 49 patients were analyzed. The actual epidural depth was measured from the surgical site with a sterile surgical scale. The MRI-derived epidural depth was measured from the MRI scan. The ultrasound estimated epidural depth was measured from the ultrasound image obtained just before surgery. RESULTS The mean epidural depth measured from the surgical site was 53.80 ± 7.67mm, the mean MRI-derived epidural depth was 54.06 ± 7.36mm, and the ultrasound-estimated epidural depth was 53.77 ± 7.94mm. The correlation between the epidural depth measured from the surgical site and MRI-derived epidural depth was 0.989 (r2 = 0.979, p < 0.001), and the corresponding correlation with the ultrasound-estimated epidural depth was 0.990 (r2 = 0.980, p < 0.001). CONCLUSIONS Both ultrasound-estimated epidural depth and MRI-derived epidural depth have a strong correlation with the epidural depth measured from the surgical site. Preprocedural MRI-derived estimates of epidural depth are slightly deeper than the epidural depth measured from the surgical site, and the ultrasound estimated epidural depths are somewhat shallower. Although both radiologic imaging techniques provided reliable preprocedural estimates of the actual epidural depth, the loss of resistance technique cannot be discarded while inserting epidural needles.
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Affiliation(s)
- Mehmet Cantürk
- Ahi Evran University Training and Research Hospital, Department of Anesthesiology and Reanimation, Kırsehir, Turquia.
| | - Nazan Kocaoğlu
- Balikesir University Faculty of Medicine, Department of Anesthesiology and Reanimation, Balikesir, Turquia
| | - Meltem Hakki
- Ahi Evran University Training and Research Hospital, Department of Anesthesiology and Reanimation, Kırsehir, Turquia
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Ostenson J, Smith DS, Does MD, Damon BM. Slice-selective extended phase graphs in gradient-crushed, transient-state free precession sequences: An application to MR fingerprinting. Magn Reson Med 2020; 84:3409-3422. [PMID: 32697869 DOI: 10.1002/mrm.28381] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 05/08/2020] [Accepted: 05/24/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE Slice-selective, gradient-crushed, transient-state sequences such as those used in MR fingerprinting (MRF) relaxometry are sensitive to slice profile effects. Whereas balanced steady-state free precession MRF profile effects have been studied, less attention has been given to gradient-crushed MRF forms. Extensions of the extended phase graph (EPG) formalism, called slice-selective EPG (ssEPG), are proposed that model slice profile effects. THEORY AND METHODS The hard-pulse approximation to slice-selective excitation in the spatial domain is reformulated in k-space. Excitation is modeled by standard EPG shift and transition operators. This ssEPG modeling is validated against Bloch simulations and phantom slice profile measurements. ssEPG relaxometry accuracy and variability are compared with other EPG methods in phantoms and human leg in vivo. The role of ∆B0 interactions with slice profile and gradient crushers is investigated. RESULTS Simulations and slice profile measurements show that ssEPG can model highly dynamic slice profile effects of gradient-crushed sequences. The MRF ssEPG T2 estimates over 0 < T2 < 100 ms improve accuracy by > 10 ms at some values relative to other modeling approaches. Small deviations in B0 can produce substantial bias in T2 estimations from a range of MRF sequence types, and these effects can be modeled and understood by ssEPG. CONCLUSION Transient-state, gradient-crushed sequences such as those used in MRF are sensitive to slice profile effects, and these effects depend on RF pulse choice, gradient crusher strength, and ∆B0 . It was found ssEPG was the most accurate EPG-based means to model these effects.
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Affiliation(s)
- Jason Ostenson
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA.,Chemical and Physical Biology Program, Vanderbilt University, Nashville, TN, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - David S Smith
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Mark D Does
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA.,Department of Electrical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Bruce M Damon
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA.,Chemical and Physical Biology Program, Vanderbilt University, Nashville, TN, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA.,Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA
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Cantürk M, Kocaoğlu N, Hakki M. Correlation of the epidural space measured intraoperatively and estimated by MRI or US: an observational study. BRAZILIAN JOURNAL OF ANESTHESIOLOGY (ENGLISH EDITION) 2020. [PMID: 32711869 PMCID: PMC9373217 DOI: 10.1016/j.bjane.2020.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background and objectives To assess the agreement between the epidural depth measured from the surgical site with the epidural depths estimated with magnetic resonance imaging (MRI) and ultrasound scanning. Methods Fifty patients of either sex, scheduled for L4‒5 lumbar disc surgery under general anesthesia were enrolled in this prospective observational study, and the results of 49 patients were analyzed. The actual epidural depth was measured from the surgical site with a sterile surgical scale. The MRI-derived epidural depth was measured from the MRI scan. The ultrasound estimated epidural depth was measured from the ultrasound image obtained just before surgery. Results The mean epidural depth measured from the surgical site was 53.80 ± 7.67 mm, the mean MRI-derived epidural depth was 54.06 ± 7.36 mm, and the ultrasound-estimated epidural depth was 53.77 ± 7.94 mm. The correlation between the epidural depth measured from the surgical site and MRI-derived epidural depth was 0.989 (r2 = 0.979, p < 0.001), and the corresponding correlation with the ultrasound-estimated epidural depth was 0.990 (r2 = 0.980, p < 0.001). Conclusions Both ultrasound-estimated epidural depth and MRI-derived epidural depth have a strong correlation with the epidural depth measured from the surgical site. Preprocedural MRI-derived estimates of epidural depth are slightly deeper than the epidural depth measured from the surgical site, and the ultrasound estimated epidural depths are somewhat shallower. Although both radiologic imaging techniques provided reliable preprocedural estimates of the actual epidural depth, the loss of resistance technique cannot be discarded while inserting epidural needles.
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Cantürk M, Kocaoğlu N, Hakkı M. Preprocedural Ultrasound Estimates of Epidural Depth: Transverse Median Plane is Comparable to Paramedian Sagittal Oblique Plane in Non-Pregnant Patients. Turk J Anaesthesiol Reanim 2020; 48:31-37. [PMID: 32076677 PMCID: PMC7001808 DOI: 10.5152/tjar.2019.92342] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 03/12/2019] [Indexed: 11/22/2022] Open
Abstract
Objective The aim of this study was to assess the accuracy and precision of the actual epidural depth (ND) and ultrasound (US) estimates of the distance from the skin to the epidural space in the transverse median plane (ED/TM) and paramedian sagittal oblique plane (ED/PSO) in patients who were not pregnant and who were undergoing unilateral inguinal hernia repair surgery under combined spinal epidural anaesthesia. Methods A total of 100 patients with the American Society of Anaesthesiology status I–III of either gender were recruited. All epidurals were inserted at the L3–4 intervertebral space, and the epidural needle was marked with a sterile marker. The ND was measured between the marker and the tip of the needle. The ED/TM and ED/PSO were assessed with a 2–5 MHz curved array probe at the L3–4 intervertebral space. The Pearson correlation coefficient and Lin’s concordance correlation coefficient were used to assess the precision and the Bland–Altman test was used to assess the 95% limit of agreement. Results The ND was 48.98±6.91 mm, the ED/PSO was 48.92±6.91 mm and the ED/TM was 48.90±6.91 mm. The Pearson correlation coefficient between ND and ED/PSO was 0.995 (p<0.001) and 0.994 (p<0.001) with ED/TM. Lin’s concordance correlation coefficient for ND and ED/PSO was 0.995 (95%CI [confidence interval]: 0.992–0.997), and 0.993 for ND and ED/TM (95% CI: 0.990–0.996). The 95% limit of agreement between ND and ED/PSO was 0.70–1.37, and for ND and ED/TM, it was 0.79–1.54. Conclusion Preprocedural ultrasound (US) scanning in both planes provides reliable estimates for actual epidural depth in non-pregnant patient population.
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Affiliation(s)
- Mehmet Cantürk
- Department of Anaesthesiology and Reanimation, Kırşehir Ahi Evran University Training and Research Hospital, Kırşehir, Turkey
| | - Nazan Kocaoğlu
- Department of Anaesthesiology and Reanimation, Balıkesir University School of Medicine, Balıkesir, Turkey
| | - Meltem Hakkı
- Department of Anaesthesiology and Reanimation, Kırşehir Ahi Evran University Training and Research Hospital, Kırşehir, Turkey
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Lampasona V, Pittman DL, Williams AJ, Achenbach P, Schlosser M, Akolkar B, Winter WE. Islet Autoantibody Standardization Program 2018 Workshop: Interlaboratory Comparison of Glutamic Acid Decarboxylase Autoantibody Assay Performance. Clin Chem 2019; 65:1141-1152. [PMID: 31409598 DOI: 10.1373/clinchem.2019.304196] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 06/27/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND The Islet Autoantibody Standardization Program (IASP) aims to improve the performance of immunoassays measuring type 1 diabetes (T1D)-associated autoantibodies and the concordance of results among laboratories. IASP organizes international interlaboratory assay comparison studies in which blinded serum samples are distributed to participating laboratories, followed by centralized collection and analysis of results, providing participants with an unbiased comparative assessment. In this report, we describe the results of glutamic acid decarboxylase autoantibody (GADA) assays presented in the IASP 2018 workshop. METHODS In May 2018, IASP distributed to participants uniquely coded sera from 43 new-onset T1D patients, 7 multiple autoantibody-positive nondiabetic individuals, and 90 blood donors. Results were analyzed for the following metrics: sensitivity, specificity, accuracy, area under the ROC curve (ROC-AUC), partial ROC-AUC at 95% specificity (pAUC95), and concordance of qualitative and quantitative results. RESULTS Thirty-seven laboratories submitted results from a total of 48 different GADA assays adopting 9 different formats. The median ROC-AUC and pAUC95 of all assays were 0.87 [interquartile range (IQR), 0.83-0.89] and 0.036 (IQR, 0.032-0.039), respectively. Large differences in pAUC95 (range, 0.001-0.0411) were observed across assays. Of formats widely adopted, bridge ELISAs showed the best median pAUC95 (0.039; range, 0.036-0.041). CONCLUSIONS Several novel assay formats submitted to this study showed heterogeneous performance. In 2018, the majority of the best performing GADA immunoassays consisted of novel or established nonradioactive tests that proved on a par or superior to the radiobinding assay, the previous gold standard assay format for GADA measurement.
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Affiliation(s)
- Vito Lampasona
- San Raffaele Diabetes Research Institute, IRCCS San Raffaele Hospital, Milan, Italy;
| | - David L Pittman
- Department of Pathology, University of Florida, Gainesville, FL
| | - Alistair J Williams
- Diabetes and Metabolism, Translational Health Sciences, University of Bristol, Bristol, UK
| | - Peter Achenbach
- Institute of Diabetes Research, Helmholtz Center Munich, German Research Center for Environmental Health, Neuherberg, Germany
| | - Michael Schlosser
- Department of Surgery, University Medical Center Greifswald, Greifswald, Germany.,Institute of Pathophysiology, Research Group of Predictive Diagnostics, University of Greifswald, Karlsburg, Germany
| | - Beena Akolkar
- Division of Diabetes, Endocrinology, and Metabolic, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
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da Silva Selistre L, Rech DL, de Souza V, Iwaz J, Lemoine S, Dubourg L. Diagnostic Performance of Creatinine-Based Equations for Estimating Glomerular Filtration Rate in Adults 65 Years and Older. JAMA Intern Med 2019; 179:796-804. [PMID: 31034005 PMCID: PMC6547158 DOI: 10.1001/jamainternmed.2019.0223] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 01/20/2019] [Indexed: 12/27/2022]
Abstract
Importance Estimating glomerular filtration rate (GFR) is useful in many clinical conditions. However, very few studies have evaluated the performance of GFR-estimating equations in older adults at various degrees of kidney impairment. Objective To determine the performance of plasma-creatinine-based equations Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI), Lund-Malmö Revised, (LMR), full age spectrum (FAS), and Berlin Initiative Study (BIS) 1 in older adults across a broad spectrum of GFRs. Design, Setting, and Participants Single-center cross-sectional study performed in France including 2247 participants aged 65 to 90 years who underwent inulin GFR measurements from July 1, 2003, to July 30, 2017, for suspected or established renal dysfunction, for renal risk, before kidney donation, or after kidney transplant. Main Outcomes and Measures The main outcome measure was GRF measured by inulin clearance. Equation performance criteria considered bias (difference between estimated and measured GFR), precision (interquartile range of the median difference), and accuracy P30 (percentage of estimated GFRs lying between [measured GFR - 30% of measured GFR] and [measured GFR + 30% of measured GFR]). Results The mean (SD) age of the 2247 participants was 71.5 (5) years and 1192 (53.0%) were male. The difference in median (95% CI) bias was significant between CKD-EPI vs LMR (-4.0 [-4.0 to -3.5 mL/min/1.73 m2; P < .001]) and CKD-EPI vs FAS (-2.0 [-3.5 to -2.5] mL/min/1.73 m2, P < .001) but not significant between CKD-EPI vs BIS 1 (0.0 [-1.5 to 0.5], P = .07, Mood test). In patients aged 65 to 74 years with measured GFR<45 mL/min/1.73 m2, the difference in median P30 (95% CI) was not significant between CKD-EPI vs LMR (P = .08) and CKD-EPI vs FAS (P = .48) but significant vs BIS 1 (P = .004, McNemar test). In subjects 75 years and older, with measured GFR less than 45 mL/min/1.73 m2, LMR and BIS 1 were more accurate than CKD-EPI and FAS (P30 = 74.5 [70.0-79.5] and 73.0 [68.0-78.0] vs 69.0 [64.5-74.0] and 69.0 [65.5-72.0]). In all patients, despite small statistical differences, the performance of CKD-EPI equation was not clinically different from that of LMR, FAS, or BIS 1. Conclusions and Relevance In a referral group of patients 65 years and older who had GFR estimated using CDK-EPI, LMR, BIS 1, and FAS equations, a comparison with renal inulin clearance found that none of the equations had a superior diagnostic performance. Each had limitations regarding accuracy.
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Affiliation(s)
- Luciano da Silva Selistre
- Service de Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
- Programa de Pós-graduação em Ciências da Saúde Universidade de Caxias do Sul, Caxias do Sul, Brazil
- CAPES Foundation, Ministry of Education of Brazil, Brasilia
- Núcleo de Apoio à Pesquisa–COEDI, Hospital Geral de Caxias do Sul, Caxias do Sul, Brasil
| | - Dener L. Rech
- Programa de Pós-graduação em Ciências da Saúde Universidade de Caxias do Sul, Caxias do Sul, Brazil
| | - Vandréa de Souza
- Service de Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
- Programa de Pós-graduação em Ciências da Saúde Universidade de Caxias do Sul, Caxias do Sul, Brazil
- Núcleo de Apoio à Pesquisa–COEDI, Hospital Geral de Caxias do Sul, Caxias do Sul, Brasil
| | - Jean Iwaz
- Université Claude Bernard Lyon 1, Lyon, France
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, Villeurbanne, France
| | - Sandrine Lemoine
- Service de Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Lyon, France
- Laboratoire CarMeN, Institution National de la Santé et de la Recherche Médicale 1060Université Lyon 1, Lyon, France
| | - Laurence Dubourg
- Service de Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
- Programa de Pós-graduação em Ciências da Saúde Universidade de Caxias do Sul, Caxias do Sul, Brazil
- Université Claude Bernard Lyon 1, Lyon, France
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique (UMR 5305 CNRS/Université Claude Bernard, Lyon 1), Lyon, France
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MR fingerprinting with simultaneous T 1, T 2, and fat signal fraction estimation with integrated B 0 correction reduces bias in water T 1 and T 2 estimates. Magn Reson Imaging 2019; 60:7-19. [PMID: 30910696 DOI: 10.1016/j.mri.2019.03.017] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 03/15/2019] [Accepted: 03/19/2019] [Indexed: 12/26/2022]
Abstract
PURPOSE MR fingerprinting (MRF) sequences permit efficient T1 and T2 estimation in cranial and extracranial regions, but these areas may include substantial fat signals that bias T1 and T2 estimates. MRI fat signal fraction estimation is also a topic of active research in itself, but may be complicated by B0 heterogeneity and blurring during spiral k-space acquisitions, which are commonly used for MRF. An MRF method is proposed that separates fat and water signals, estimates water T1 and T2, and accounts for B0 effects with spiral blurring correction, in a single sequence. THEORY AND METHODS A k-space-based fat-water separation method is further extended to unbalanced steady-state free precession MRF with swept echo time. Repeated application of this k-space fat-water separation to demodulated forms of the measured data allows a B0 map and correction to be approximated. The method is compared with MRF without fat separation across a broad range of fat signal fractions (FSFs), water T1s and T2s, and under heterogeneous static fields in simulations, phantoms, and in vivo. RESULTS The proposed method's FSF estimates had a concordance correlation coefficient of 0.990 with conventional measurements, and reduced biases in the T1 and T2 estimates due to fat signal relative to other MRF sequences by several hundred ms. The B0 correction improved the FSF, T1, and T2 estimation compared to those estimates without correction. CONCLUSION The proposed method improves MRF water T1 and T2 estimation in the presence of fat and provides accurate FSF estimation with inline B0 correction.
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Kurland BF, Peterson LM, Shields AT, Lee JH, Byrd DW, Novakova-Jiresova A, Muzi M, Specht JM, Mankoff DA, Linden HM, Kinahan PE. Test-Retest Reproducibility of 18F-FDG PET/CT Uptake in Cancer Patients Within a Qualified and Calibrated Local Network. J Nucl Med 2018; 60:608-614. [PMID: 30361381 DOI: 10.2967/jnumed.118.209544] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 10/01/2018] [Indexed: 11/16/2022] Open
Abstract
Calibration and reproducibility of quantitative 18F-FDG PET measures are essential for adopting integral 18F-FDG PET/CT biomarkers and response measures in multicenter clinical trials. We implemented a multicenter qualification process using National Institute of Standards and Technology-traceable reference sources for scanners and dose calibrators, and similar patient and imaging protocols. We then assessed SUV in patient test-retest studies. Methods: Five 18F-FDG PET/CT scanners from 4 institutions (2 in a National Cancer Institute-designated Comprehensive Cancer Center, 3 in a community-based network) were qualified for study use. Patients were scanned twice within 15 d, on the same scanner (n = 10); different but same model scanners within an institution (n = 2); or different model scanners at different institutions (n = 11). SUVmax was recorded for lesions, and SUVmean for normal liver uptake. Linear mixed models with random intercept were fitted to evaluate test-retest differences in multiple lesions per patient and to estimate the concordance correlation coefficient. Bland-Altman plots and repeatability coefficients were also produced. Results: In total, 162 lesions (82 bone, 80 soft tissue) were assessed in patients with breast cancer (n = 17) or other cancers (n = 6). Repeat scans within the same institution, using the same scanner or 2 scanners of the same model, had an average difference in SUVmax of 8% (95% confidence interval, 6%-10%). For test-retest on different scanners at different sites, the average difference in lesion SUVmax was 18% (95% confidence interval, 13%-24%). Normal liver uptake (SUVmean) showed an average difference of 5% (95% confidence interval, 3%-10%) for the same scanner model or institution and 6% (95% confidence interval, 3%-11%) for different scanners from different institutions. Protocol adherence was good; the median difference in injection-to-acquisition time was 2 min (range, 0-11 min). Test-retest SUVmax variability was not explained by available information on protocol deviations or patient or lesion characteristics. Conclusion: 18F-FDG PET/CT scanner qualification and calibration can yield highly reproducible test-retest tumor SUV measurements. Our data support use of different qualified scanners of the same model for serial studies. Test-retest differences from different scanner models were greater; more resolution-dependent harmonization of scanner protocols and reconstruction algorithms may be capable of reducing these differences to values closer to same-scanner results.
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Affiliation(s)
- Brenda F Kurland
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Lanell M Peterson
- Division of Medical Oncology, University of Washington/Seattle Cancer Care Alliance, Seattle, Washington
| | - Andrew T Shields
- Department of Radiology, University of Washington, Seattle, Washington; and
| | - Jean H Lee
- Department of Radiology, University of Washington, Seattle, Washington; and
| | - Darrin W Byrd
- Department of Radiology, University of Washington, Seattle, Washington; and
| | - Alena Novakova-Jiresova
- Division of Medical Oncology, University of Washington/Seattle Cancer Care Alliance, Seattle, Washington
| | - Mark Muzi
- Department of Radiology, University of Washington, Seattle, Washington; and
| | - Jennifer M Specht
- Division of Medical Oncology, University of Washington/Seattle Cancer Care Alliance, Seattle, Washington
| | - David A Mankoff
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Hannah M Linden
- Division of Medical Oncology, University of Washington/Seattle Cancer Care Alliance, Seattle, Washington
| | - Paul E Kinahan
- Department of Radiology, University of Washington, Seattle, Washington; and
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Walley KC, Gonzalez TA, Callahan R, Fairfull A, Roush E, Saloky KL, Juliano PJ, Lewis GS, Aynardi MC. The Role of 3D Reconstruction True-Volume Analysis in Osteochondral Lesions of the Talus: A Case Series. Foot Ankle Int 2018; 39:1113-1119. [PMID: 29701070 DOI: 10.1177/1071100718771834] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Evaluation and management of osteochondral lesions of the talus (OLTs) often warrant advanced imaging studies, especially in revision or cases with cystic defects. It is possible that orthopedic surgeons may overestimate the size and misinterpret the morphology of OLT from conventional computed tomography (CT), thereby influencing treatment strategies. The purpose of this study was to determine the utility of a novel means to estimate the true-volume of OLTs using 3D reconstructed images and volume analysis. METHODS With Institutional Review Board approval, an institutional radiology database was queried for patients with cystic OLTs that failed previous microfracture, having compatible CT scans and magnetic resonance imaging (MRI) between 2011 and 2016. Fourteen patients met inclusion criteria. Of these, 5 cases were randomly selected for 3D CT reconstruction modeling. Ten orthopedic surgeons independently estimated the volume of these 5 OLTs via standard CT. Then 3D reconstructions were made and morphometric true-volume (MTV) analysis measurements of each OLT were generated. The percent change in volumes from CT were compared to MTVs determined from 3D reconstructive analysis. RESULTS On average, the volume calculated by conventional CT scanner grossly overestimated the actual size of the OLTs. The volume calculated on conventional CT scanner overestimated the size of OLTs compared to the 3D MTV reconstructed analysis by 285% to 864%. CONCLUSIONS Our results showed that conventional measurements of OLTS with CT grossly overestimated the size of the lesion. The 3D MTV analysis of cystic osteochondral lesions may help clinicians with preoperative planning for graft selection and appropriate volume while avoiding unnecessary costs incurred with overestimation. LEVEL OF EVIDENCE Level IV, case series.
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Affiliation(s)
- Kempland C Walley
- 1 Department of Orthopaedic Surgery, Penn State Hershey Bone and Joint Institute, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Tyler A Gonzalez
- 2 Department of Orthopedic Surgery, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Ryan Callahan
- 1 Department of Orthopaedic Surgery, Penn State Hershey Bone and Joint Institute, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Aubree Fairfull
- 1 Department of Orthopaedic Surgery, Penn State Hershey Bone and Joint Institute, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Evan Roush
- 1 Department of Orthopaedic Surgery, Penn State Hershey Bone and Joint Institute, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Kaitlin L Saloky
- 1 Department of Orthopaedic Surgery, Penn State Hershey Bone and Joint Institute, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Paul J Juliano
- 1 Department of Orthopaedic Surgery, Penn State Hershey Bone and Joint Institute, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Gregory S Lewis
- 1 Department of Orthopaedic Surgery, Penn State Hershey Bone and Joint Institute, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Michael C Aynardi
- 1 Department of Orthopaedic Surgery, Penn State Hershey Bone and Joint Institute, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
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Accuracy of a cow-side test for the diagnosis of hyperketonemia and hypoglycemia in lactating dairy cows. Res Vet Sci 2017; 115:327-331. [DOI: 10.1016/j.rvsc.2017.06.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 05/31/2017] [Accepted: 06/26/2017] [Indexed: 11/23/2022]
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Ostenson J, Robison RK, Zwart NR, Welch EB. Multi-frequency interpolation in spiral magnetic resonance fingerprinting for correction of off-resonance blurring. Magn Reson Imaging 2017; 41:63-72. [PMID: 28694017 PMCID: PMC5612382 DOI: 10.1016/j.mri.2017.07.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 07/05/2017] [Accepted: 07/05/2017] [Indexed: 10/19/2022]
Abstract
Magnetic resonance fingerprinting (MRF) pulse sequences often employ spiral trajectories for data readout. Spiral k-space acquisitions are vulnerable to blurring in the spatial domain in the presence of static field off-resonance. This work describes a blurring correction algorithm for use in spiral MRF and demonstrates its effectiveness in phantom and in vivo experiments. Results show that image quality of T1 and T2 parametric maps is improved by application of this correction. This MRF correction has negligible effect on the concordance correlation coefficient and improves coefficient of variation in regions of off-resonance relative to uncorrected measurements.
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Affiliation(s)
- Jason Ostenson
- Vanderbilt University Institute of Imaging Science, Nashville, TN 37232, USA; Chemical and Physical Biology Program, Vanderbilt University, Nashville, TN 37232, USA
| | - Ryan K Robison
- Imaging Research, Barrow Neurological Institute, Phoenix, AZ 85013, USA
| | - Nicholas R Zwart
- Imaging Research, Barrow Neurological Institute, Phoenix, AZ 85013, USA
| | - E Brian Welch
- Vanderbilt University Institute of Imaging Science, Nashville, TN 37232, USA; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, USA.
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Skenandore CS, Pineda A, Bahr JM, Newell-Fugate AE, Cardoso FC. Evaluation of a commercially available radioimmunoassay and enzyme immunoassay for the analysis of progesterone and estradiol and the comparison of two extraction efficiency methods. Domest Anim Endocrinol 2017; 60:61-66. [PMID: 28454055 DOI: 10.1016/j.domaniend.2017.03.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 03/25/2017] [Accepted: 03/28/2017] [Indexed: 11/18/2022]
Abstract
The measurement of progesterone (P4) and estradiol (E2) is essential for monitoring reproductive cycles and can aid in diagnosing the cause of poor reproductive performance in dairy cattle. Readily available, reproducible, accurate, non-radioactive assays are needed for the assessment of P4 and E2 in bovine serum. The gold standard for hormone assessment, radioimmunoassay (RIA), was compared with enzyme-linked immunoassay (EIA). Serum collected from various points in the estrous cycle was extracted with radiolabeled P4 (ie, 3H-P4; HE) and without 3H-P4 (CE) before being used in the assay. For the assessment of P4, there is a great degree of correlation between the RIA and EIA (adjusted R-square = 0.95; Pearson correlation coefficient (PCC) = 0.98, P < 0.001). A difference between the RIA and EIA methods was not detected for E2 concentrations (P = 0.16), but the correlation between techniques was poor (adjusted R-squared = 0.73; PCC = 0.87, P = 0.002). There was no difference in the serum extraction efficiency as measured with 3H-P4 as opposed to without (P = 0.94). The two methods for the measurement of serum extraction efficiency were highly correlated (adjusted R-square = 0.83; PCC = 0.92, P < 0.001). The concordance correlation coefficient (CCC) showed an excellent agreement between RIA and EIA for P4 determination (0.89) and between HE and CE methods (0.90). Although the 95% limits of agreement of the Bland-Altman plots encompassed 89% (8/9) and 92% (12/13) of the differences between methods for P4 quantification and extraction respectively, the CCC indicated an excellent agreement among them. The CCC between RIA and EIA for E2 quantification was 0.68 which corresponds with a fair agreement; however, the 95% limits of agreement of the Bland-Altman plot encompassed 100% (9/9) of differences between methods. The EIA and CE methods are comparable alternatives to the RIA and HE methods, respectively and can be used to quantify P4 and E2 for bovine serum.
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Affiliation(s)
- C S Skenandore
- Department of Animal Sciences, University of Illinois, Animal Sciences Laboratory, 1207 W Gregory Drive, Urbana, IL 61801, USA; Department of Veterinary Physiology and Pharmacology, Texas A&M University, 4466 TAMU, College Station, TX 77843, USA
| | - A Pineda
- Department of Animal Sciences, University of Illinois, Animal Sciences Laboratory, 1207 W Gregory Drive, Urbana, IL 61801, USA
| | - J M Bahr
- Department of Animal Sciences, University of Illinois, Animal Sciences Laboratory, 1207 W Gregory Drive, Urbana, IL 61801, USA
| | - A E Newell-Fugate
- Department of Veterinary Physiology and Pharmacology, Texas A&M University, 4466 TAMU, College Station, TX 77843, USA.
| | - F C Cardoso
- Department of Animal Sciences, University of Illinois, Animal Sciences Laboratory, 1207 W Gregory Drive, Urbana, IL 61801, USA.
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Sinha A, Nagel CL, Thomas E, Schmidt WP, Torondel B, Boisson S, Clasen TF. Assessing Latrine Use in Rural India: A Cross-Sectional Study Comparing Reported Use and Passive Latrine Use Monitors. Am J Trop Med Hyg 2016; 95:720-727. [PMID: 27458042 PMCID: PMC5014284 DOI: 10.4269/ajtmh.16-0102] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 05/31/2016] [Indexed: 11/07/2022] Open
Abstract
Although large-scale programs, like India's Total Sanitation Campaign (TSC), have improved latrine coverage in rural settings, evidence suggests that actual use is suboptimal. However, the reliability of methods to assess latrine use is uncertain. We assessed the reliability of reported use, the standard method, by comparing survey-based responses against passive latrine use monitors (PLUMs) through a cross-sectional study among 292 households in 25 villages in rural Odisha, India, which recently received individual household latrines under the TSC. PLUMs were installed for 2 weeks and householders responded to surveys about their latrine use behavior. Reported use was compared with PLUM results using Bland-Altman (BA) plots and concordance statistics. Reported use was higher than corresponding PLUM-recorded events across the range of comparisons. The mean reported "usual" daily events per household (7.09, 95% confidence interval [CI] = 6.51, 7.68) was nearly twice that of the PLUM-recorded daily average (3.62, 95% CI = 3.29, 3.94). There was poor agreement between "usual" daily latrine use and the average daily PLUM-recorded events (ρc = 0.331, 95% CI = 0.242, 0.427). Moderate agreement (ρc = 0.598, 95% CI = 0.497, 0.683) was obtained when comparing daily reported use during the previous 48 hours with the average daily PLUM count. Reported latrine use, though already suggesting suboptimal adoption, likely exaggerates the actual level of uptake of latrines constructed under the program. Where reliance on self-reports is used, survey questions should focus on the 48 hours prior to the date of the survey rather than asking about "usual" latrine use behavior.
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Affiliation(s)
- Antara Sinha
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Corey L Nagel
- School of Public Health, Oregon Health and Science University, Portland, Oregon
| | - Evan Thomas
- The Portland State University SWEETLab, Portland, Oregon
| | - Wolf P Schmidt
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Belen Torondel
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Sophie Boisson
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Thomas F Clasen
- Department of Environment Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
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Lin L, Bivard A, Krishnamurthy V, Levi CR, Parsons MW. Whole-Brain CT Perfusion to Quantify Acute Ischemic Penumbra and Core. Radiology 2016; 279:876-87. [DOI: 10.1148/radiol.2015150319] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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20
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Rahbar H, Kurland BF, Olson ML, Kitsch AE, Scheel JR, Chai X, Usoro J, Lehman CD, Partridge SC. Diffusion-Weighted Breast Magnetic Resonance Imaging: A Semiautomated Voxel Selection Technique Improves Interreader Reproducibility of Apparent Diffusion Coefficient Measurements. J Comput Assist Tomogr 2016; 40:428-35. [PMID: 27192501 PMCID: PMC4874523 DOI: 10.1097/rct.0000000000000372] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To determine whether a semiautomated voxel selection technique improves interreader reproducibility for breast apparent diffusion coefficient (ADC) measurements. METHODS Three readers retrospectively performed ADC measurements of 31 breast lesions (16 malignant, 15 benign) and contralateral normal tissue in 26 women both unassisted (manual method) and assisted by a semiautomated software tool that excludes voxels below a dynamically specified signal intensity threshold. Reproducibility between readers for each technique was assessed by Bland-Altman analysis and concordance correlation coefficients (CCCs). RESULTS Differences between readers' measured ADCs of lesions were smaller with the semiautomated tool vs the manual method. Concordance correlation coefficients for each reader pair were greater with the semiautomated tool for lesions (mean CCC difference, 0.11; 95% confidence interval, 0.04-0.26). For normal tissue, reader agreement was lower than for lesions and did not differ based on software tools (mean CCC difference, 0.00; 95% confidence interval, -0.14 to 0.13). CONCLUSIONS A semiautomated voxel selection tool can improve interreader reproducibility of breast lesion ADC measures.
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Affiliation(s)
- Habib Rahbar
- University of Washington, Seattle Cancer Care Alliance, Department of Radiology, Breast Imaging Section, 825 Eastlake Avenue East, P.O. Box 19023, Seattle, WA 98109–1023, USA
| | - Brenda F. Kurland
- Fred Hutchinson Cancer Research Center, Clinical Research Division, 1100 Fairview Avenue North, P.O. Box 19024, Seattle, WA 98109-1024
| | - Matthew L. Olson
- University of Washington, Seattle Cancer Care Alliance, Department of Radiology, Breast Imaging Section, 825 Eastlake Avenue East, P.O. Box 19023, Seattle, WA 98109–1023, USA
| | - Averi E. Kitsch
- University of Washington, Seattle Cancer Care Alliance, Department of Radiology, Breast Imaging Section, 825 Eastlake Avenue East, P.O. Box 19023, Seattle, WA 98109–1023, USA
| | - John R Scheel
- University of Washington, Seattle Cancer Care Alliance, Department of Radiology, Breast Imaging Section, 825 Eastlake Avenue East, P.O. Box 19023, Seattle, WA 98109–1023, USA
| | - Xiaoyu Chai
- Fred Hutchinson Cancer Research Center, Clinical Research Division, 1100 Fairview Avenue North, P.O. Box 19024, Seattle, WA 98109-1024
| | - Joshua Usoro
- University of Washington, Seattle Cancer Care Alliance, Department of Radiology, Breast Imaging Section, 825 Eastlake Avenue East, P.O. Box 19023, Seattle, WA 98109–1023, USA
| | - Constance D. Lehman
- University of Washington, Seattle Cancer Care Alliance, Department of Radiology, Breast Imaging Section, 825 Eastlake Avenue East, P.O. Box 19023, Seattle, WA 98109–1023, USA
| | - Savannah C. Partridge
- University of Washington, Seattle Cancer Care Alliance, Department of Radiology, Breast Imaging Section, 825 Eastlake Avenue East, P.O. Box 19023, Seattle, WA 98109–1023, USA
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Pineda A, Cardoso F. Technical note: Validation of a handheld meter for measuring β-hydroxybutyrate concentrations in plasma and serum from dairy cows. J Dairy Sci 2015; 98:8818-24. [DOI: 10.3168/jds.2015-9667] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 08/30/2015] [Indexed: 11/19/2022]
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Krones E, Fickert P, Zitta S, Neunherz S, Artinger K, Reibnegger G, Durchschein F, Wagner D, Stojakovic T, Stadlbauer V, Fauler G, Stauber R, Zollner G, Kniepeiss D, Rosenkranz AR. The chronic kidney disease epidemiology collaboration equation combining creatinine and cystatin C accurately assesses renal function in patients with cirrhosis. BMC Nephrol 2015; 16:196. [PMID: 26627205 PMCID: PMC4665875 DOI: 10.1186/s12882-015-0188-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 11/13/2015] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Accurate measurement of renal function in cirrhotic patients is still challenging. To find the best test for the determination of the true glomerular filtration rate (GFR) in cirrhotic patients this study prospectively compared measured (m)GFR, the gold standard, with estimated (e)GFR using equations based on serum levels of creatinine and cystatin C. METHODS GFR was measured by sinistrin clearance using the bolus method in 50 patients with cirrhosis (Child Turcotte Pugh score A, B and C) and 24 age-matched healthy subjects as controls. Measured (m)GFR was compared to eGFR using bias, accuracy 10 % and 30 %, as well as correlation coefficients. RESULTS Creatinine-based equations generally overestimated GFR in patients with cirrhosis and showed a bias (average difference between mGFR and eGFR) of -40 (CG), -12 (MDRD) and -9 (CKD-EPI-Cr) ml/min/1.73 m(2). Cystatin C-based equations underestimated GFR, especially in patients with Child Turcotte Pugh score C (bias 17 ml/min/1.73 m(2)for CKD-EPI-CysC). Of these equations, the CKD-EPI equation that combines creatinine and cystatin C (CKD-EPI-Cr-CysC) showed a bias of 0.12 ml/min/1.73 m(2) as compared to measured GFR. CONCLUSIONS The CKD-EPI equation that combines serum creatinine and cystatin C measurements shows the best performance for accurate estimation of GFR in cirrhosis, especially at advanced stages.
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Affiliation(s)
- Elisabeth Krones
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
| | - Peter Fickert
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
| | - Sabine Zitta
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
| | - Stefan Neunherz
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria. .,Department of Cardiology, Klinikum Leverkusen, Leverkusen, Germany.
| | - Katharina Artinger
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
| | - Gilbert Reibnegger
- Institute for Physiological Chemistry, Medical University of Graz, Graz, Austria.
| | - Franziska Durchschein
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
| | - Doris Wagner
- Division for General Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
| | - Tatjana Stojakovic
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
| | - Vanessa Stadlbauer
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
| | - Günter Fauler
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
| | - Rudolf Stauber
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
| | - Gernot Zollner
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
| | - Daniela Kniepeiss
- Department of Surgery, Division of Transplant Surgery, Medical University of Graz, Graz, Austria.
| | - Alexander R Rosenkranz
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
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De Souza V, Pottel H, Hoste L, Dolomanova O, Cartier R, Selistre L, Ranchin B, Hadj-Aïssa A, Lemoine S, Cochat P, Dubourg L. Can the height-independent Pottel eGFR equation be used as a screening tool for chronic kidney disease in children? Eur J Pediatr 2015; 174:1225-35. [PMID: 25846696 DOI: 10.1007/s00431-015-2523-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 02/27/2015] [Accepted: 03/12/2015] [Indexed: 01/01/2023]
Abstract
UNLABELLED Determination of plasma creatinine (Pcr) should be associated to an estimation of glomerular filtration rate (eGFR). Pottel et al. established a height-independent equation, eGFR = 107.3/(Pcr/Q) where Q is the median of Pcr (Pottel-Belgium). The aims were to 1) determine a local height-independent equation (Pottel-Lyon), 2) evaluate the performance of these equations compared to the Schwartz 2009 and Schwartz-Lyon equations, and 3) evaluate the height-independent equations in laboratory routine. Therefore, 1) all first pediatric Pcr determination (December 2009-June 2011) were collected, and median of Pcr was determined for each 1-year age interval (Q-Lyon), 2) GFR was measured (mGFR) in 359 children (438 measures) and compared to eGFR, and 3) all first Pcr determination (January 2012-June 2013) were used to calculate eGFR with the Pottel-Lyon and the Pottel-Belgium equations. Pcr was determined by an IDMS-standardized enzymatic assay. In the population with a mGFR, the Pottel-Lyon and the Schwartz-Lyon showed the best performance (bias, P10 and P30). However, the performance in identifying patients with a mGFR < 75 mL/min/1.73 m(2) was similar for all the studied equations. CONCLUSION The performance of the height-independent and dependent equations to identify mild renal dysfunction is similar. The height-independent Pottel equation could be proposed as an excellent screening tool for kidney disease when height information is not available. " WHAT IS KNOWN " • Determination of plasma creatinine in children is rarely associated to an estimation of glomerular filtration rate due to the lack of height information. • Pottel et al. developed a height-independent equation (eGFR = 107.3/(Pcr/Q) where Q is the median of Pcr for each age class. " WHAT IS NEW " • The performance of the height-independent (Pottel) or height-dependent (Schwartz) equations is similar to identify renal dysfunction (GFR < 75 mL/min/1.73 m (2) ) in children. • The height-independent Pottel equation could be an excellent screening tool for kidney disease in a general pediatric laboratory when height information is not available.
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Affiliation(s)
- Vandréa De Souza
- Exploration Fonctionnelle Rénale, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France,
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A novel cytologic sampling technique to diagnose subclinical endometritis and comparison of staining methods for endometrial cytology samples in dairy cows. Theriogenology 2015; 84:1438-46. [PMID: 26300274 DOI: 10.1016/j.theriogenology.2015.07.032] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 07/14/2015] [Accepted: 07/14/2015] [Indexed: 11/21/2022]
Abstract
The present article describes a study of the diagnosis of subclinical endometritis in dairy cows having two principal aims: first, to validate a novel technique for taking endometrial cytology samples to diagnose subclinical endometritis in dairy cows. Second, to compare the percentage of polymorphonuclear cells (PMNs) in cytology samples stained with Diff-Quik versus a specific staining method for PMNs, naphthol-AS-D-chloroacetate-esterase (CIAE). In the first experiment, Holstein-Friesian cows (n = 204) were used to take two cytology samples at the same time using the conventional cytobrush (CB) and the new cytotape (CT). Both devices were assembled within the same catheter allowing sampling at the same time, and approximately at the same location. Cytotape consisted of a 1.5-cm piece of paper tape rolled on the top of an insemination catheter covered with a double guard sheet. Parameters used to evaluate both methods were: PMNs percentage, total cellularity, quality of the smears, and red blood cell contamination. The concordance correlation coefficient analysis was used to assess agreement between continuous and Pearson chi-square tests for categorical variables. Agreement between the percentage of PMNs in both methods was good ρ = 0.84 (0.79, 0.87) with a minor standard error of 2%. Both methods yielded similar total cellularity (P = 0.62). Cytotape yielded better quality smears with more intact cells (P < 0.01) while samples that were taken by CB were more likely to be bloody (P < 0.01). Hence, CT and CB methods yielded smears with a similar PMNs percentage and a total number of cells, but CT provided smears with higher quality and significantly less blood contamination. For the second experiment, 114 duplicate cytology slides were stained using both Diff-Quik and CIAE. Agreement between PMNs percentage in both staining techniques was good ρc = 0.84 (0.78, 0.89) with a standard error of only 2%. Hence, Diff-Quik was confirmed as an easy, fast, and high-quality staining technique, which can be routinely used to stain endometrial cytology samples satisfactorily.
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Vandermosten M, Vanderauwera J, Theys C, De Vos A, Vanvooren S, Sunaert S, Wouters J, Ghesquière P. A DTI tractography study in pre-readers at risk for dyslexia. Dev Cogn Neurosci 2015; 14:8-15. [PMID: 26048528 PMCID: PMC6989819 DOI: 10.1016/j.dcn.2015.05.006] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 04/14/2015] [Accepted: 05/18/2015] [Indexed: 01/07/2023] Open
Abstract
In adults and school-aged children, phonological aspects of reading seem to be sustained by left dorsal regions, while ventral regions seem to be involved in orthographic word recognition. Yet, given that the brain reorganises during reading acquisition, it is unknown when and how these reading routes emerge and whether neural deficits in dyslexia predate reading onset. Using diffusion MRI in 36 pre-readers with a family risk for dyslexia (FRD(+)) and 35 well matched pre-readers without a family risk (FRD(-)), our results show that phonological predictors of reading are sustained bilaterally by both ventral and dorsal tracts. This suggests that a dorsal and left-hemispheric specialisation for phonological aspects of reading, as observed in adults, is presumably gradually formed throughout reading development. Second, our results indicate that FRD(+) pre-readers display mainly white matter differences in left ventral tracts. This suggests that atypical white matter organisation previously found in dyslexic adults may be causal rather than resulting from a lifetime of reading difficulties, and that the location of such a deficit may vary throughout development. While this study forms an important starting point, longitudinal follow-up of these children will allow further investigation of the dynamics between emerging literacy development and white matter connections.
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Affiliation(s)
- Maaike Vandermosten
- Parenting and Special Education Research Unit, KU Leuven, L. Vanderkelenstraat 32, PO Box 3765, 3000 Leuven, Belgium; Laboratory for Experimental ORL, KU Leuven, Herestraat 49, 3000 Leuven, Belgium.
| | - Jolijn Vanderauwera
- Parenting and Special Education Research Unit, KU Leuven, L. Vanderkelenstraat 32, PO Box 3765, 3000 Leuven, Belgium; Laboratory for Experimental ORL, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Catherine Theys
- Laboratory for Experimental ORL, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Astrid De Vos
- Parenting and Special Education Research Unit, KU Leuven, L. Vanderkelenstraat 32, PO Box 3765, 3000 Leuven, Belgium; Laboratory for Experimental ORL, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Sophie Vanvooren
- Parenting and Special Education Research Unit, KU Leuven, L. Vanderkelenstraat 32, PO Box 3765, 3000 Leuven, Belgium; Laboratory for Experimental ORL, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Stefan Sunaert
- Department of Translational MRI, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Jan Wouters
- Laboratory for Experimental ORL, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Pol Ghesquière
- Parenting and Special Education Research Unit, KU Leuven, L. Vanderkelenstraat 32, PO Box 3765, 3000 Leuven, Belgium
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Safety and pharmacodynamics of suprachoroidal injection of triamcinolone acetonide as a controlled ocular drug release model. J Control Release 2015; 203:109-17. [PMID: 25700623 DOI: 10.1016/j.jconrel.2015.02.021] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 02/07/2015] [Accepted: 02/15/2015] [Indexed: 11/21/2022]
Abstract
Suprachoroidal injection is an emerging technique for drug delivery to the posterior segment, which is hard to reach by non-invasive approaches. However, the injection technique varies and the associated ocular safety is not well understood. In addition, it is not clear if drug formulation is a major factor in optimizing pharmacodynamics using this technique. The current study was designed to compare the suprachoroidal injection of different drug formulations and to characterize the safety and pharmacodynamics of triamcinolone acetonide (TA) delivered by this technique. Both indocyanine green (ICG) solution and TA suspension, at 50μL, 100μL, and 150μL, were suprachoroidally injected and intraocular pressure (IOP) tonometry, fundus photography, and electroretinography were performed over multiple time points up to eight weeks. After 50μL TA (Kenalog-40) suprachoroidal injection, 4-5 animals at 7 time points were sacrificed for aqueous, vitreous, retina, and plasma collections. TA was quantitated using ultra-performance liquid chromatography tandem mass spectrometry. For comparative efficacy study, 50μL (2mg) suprachoroidal TA versus 20mg subtenon TA were performed 4weeks before induction of experimental uveitis with 10ng of intravitreal lipopolysaccharide. After suprachoroidal injection, IOP had an acute elevation, higher volume caused higher IOP (p<0.0001). Equivalent volume of ICG solution led to a significantly smaller IOP elevation than after TA suprachoroidal injection. This finding suggests better distribution of ICG solution than TA suspension in the suprachoroidal space. Following a 50μL suprachoroidal injection, peak TA concentration in the aqueous was below 1ng/mL. In contrast, the posterior vitreous and retina had 1912ng/mL and 400,369ng/mL TA, respectively. Maximum TA in plasma was 11.6ng/mL. Drug exposure to the posterior retina was 523,910 times more than that to the aqueous and 29,516 times more than systemic TA exposure. In the treatment of lipopolysaccharide-induced uveitis, compared with 20mg subtenon injection, suprachoroidal 2mg TA demonstrated much better efficacy with significantly less aqueous humor cells and lower vitreous opacity scores (p<0.05). Histology showed much less vitreous inflammation in the suprachoroidal injection group (p<0.0001). It seems that a 50μL suprachoroidal injection of TA was well tolerated in rabbit eyes and demonstrated excellent penetration into the posterior retina, providing better therapeutic effect than subtenon 20mg TA.
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Raunig DL, McShane LM, Pennello G, Gatsonis C, Carson PL, Voyvodic JT, Wahl RL, Kurland BF, Schwarz AJ, Gönen M, Zahlmann G, Kondratovich MV, O'Donnell K, Petrick N, Cole PE, Garra B, Sullivan DC. Quantitative imaging biomarkers: a review of statistical methods for technical performance assessment. Stat Methods Med Res 2015; 24:27-67. [PMID: 24919831 PMCID: PMC5574197 DOI: 10.1177/0962280214537344] [Citation(s) in RCA: 241] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Technological developments and greater rigor in the quantitative measurement of biological features in medical images have given rise to an increased interest in using quantitative imaging biomarkers to measure changes in these features. Critical to the performance of a quantitative imaging biomarker in preclinical or clinical settings are three primary metrology areas of interest: measurement linearity and bias, repeatability, and the ability to consistently reproduce equivalent results when conditions change, as would be expected in any clinical trial. Unfortunately, performance studies to date differ greatly in designs, analysis method, and metrics used to assess a quantitative imaging biomarker for clinical use. It is therefore difficult or not possible to integrate results from different studies or to use reported results to design studies. The Radiological Society of North America and the Quantitative Imaging Biomarker Alliance with technical, radiological, and statistical experts developed a set of technical performance analysis methods, metrics, and study designs that provide terminology, metrics, and methods consistent with widely accepted metrological standards. This document provides a consistent framework for the conduct and evaluation of quantitative imaging biomarker performance studies so that results from multiple studies can be compared, contrasted, or combined.
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Affiliation(s)
| | | | - Gene Pennello
- Food and Drug Administration/CDRH, Silver Spring, USA
| | | | - Paul L Carson
- University of Michigan Health System, Ann Arbor, USA
| | | | | | | | | | - Mithat Gönen
- Memorial Sloan Kettering Cancer Center, New York, USA
| | | | | | | | | | | | - Brian Garra
- Food and Drug Administration/CDRH, Silver Spring, USA
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De Souza V, Hadj-Aissa A, Dolomanova O, Rabilloud M, Rognant N, Lemoine S, Radenne S, Dumortier J, Chapuis-Cellier C, Beyerle F, Bon C, Iwaz J, Selistre L, Dubourg L. Creatinine- versus cystatine C-based equations in assessing the renal function of candidates for liver transplantation with cirrhosis. Hepatology 2014; 59:1522-31. [PMID: 24123197 DOI: 10.1002/hep.26886] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 09/19/2013] [Accepted: 10/07/2013] [Indexed: 02/06/2023]
Abstract
UNLABELLED Renal dysfunction is frequent in liver cirrhosis and is a strong prognostic predictor of orthotopic liver transplantation (OLT) outcome. Therefore, an accurate evaluation of the glomerular filtration rate (GFR) is crucial in pre-OLT patients. However, in these patients plasma creatinine (Pcr) is inaccurate and the place of serum cystatine C (CystC) is still debated. New GFR-predicting equations, based on standardized assays of Pcr and/or CystC, have been recently recommended in the general population but their performance in cirrhosis patients has been rarely studied. We evaluated the performance of the recently published Chronic Kidney Disease Epidemiology Collaboration equations (CKD-EPI-Pcr, CKD-EPI-CystC, and CKD-EPI-Pcr-CystC) and the more classical ones (4- and 6-variable MDRD and Hoek formulas) in cirrhosis patients referred for renal evaluation before OLT. Inulin clearance was performed in 202 consecutive patients together with the determination of Pcr and CystC with assays traceable to primary reference materials. The performance of the GFR-predicting equations was evaluated according to ascites severity (no, moderate, or refractory) and to hepatic and renal dysfunctions (MELD score ≤ or >15 and KDOQI stages, respectively). In the whole population, CystC-based equations showed a better performance than Pcr-based ones (lower bias and higher 10% and 30% accuracies). CKD-EPI-CystC equation showed the best performance whatever the ascites severity and in presence of a significant renal dysfunction (GFR <60 mL/min/1.73 m(2)). CONCLUSION Pcr-based GFR predicting equations are not reliable in pre-OLT patients even when an IDMS-traceable enzymatic Pcr assay is used. Whenever a CystC-assay traceable to primary reference materials is performed and when a true measurement of GFR is not possible, CystC-based equations, especially CKD-EPI-CystC, may be recommended to evaluate renal function and for KDOQI staging.
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Affiliation(s)
- Vandréa De Souza
- Exploration Fonctionnelle Rénale et Métabolique, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, France; Post-Graduate Program in Medical Sciences, FAMED-Programa de Pós Graduação em Saúde da Criança e do Adolescente-Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Universidade de Caxias do Sul, Centro de Ciências da Saúde, School of Medicine, Brazil
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Palmer J, Williams K, Inamoto Y, Chai X, Martin PJ, Tomas LS, Cutler C, Weisdorf D, Kurland BF, Carpenter PA, Pidala J, Pavletic SZ, Wood W, Jacobsohn D, Arai S, Arora M, Jagasia M, Vogelsang GB, Lee SJ. Pulmonary symptoms measured by the national institutes of health lung score predict overall survival, nonrelapse mortality, and patient-reported outcomes in chronic graft-versus-host disease. Biol Blood Marrow Transplant 2014; 20:337-44. [PMID: 24315845 PMCID: PMC3973401 DOI: 10.1016/j.bbmt.2013.11.025] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Accepted: 11/27/2013] [Indexed: 01/21/2023]
Abstract
The 2005 National Institutes of Health (NIH) Consensus Conference recommended assessment of lung function in patients with chronic graft-versus-host disease (GVHD) by both pulmonary function tests (PFTs) and assessment of pulmonary symptoms. We tested whether pulmonary measures were associated with nonrelapse mortality (NRM), overall survival (OS), and patient-reported outcomes (PRO). Clinician and patient-reported data were collected serially in a prospective, multicenter, observational study. Available PFT data were abstracted. Cox regression models were fit for outcomes using a time-varying covariate model for lung function measures and adjusting for patient and transplantation characteristics and nonlung chronic GVHD severity. A total of 1591 visits (496 patients) were used in this analysis. The NIH symptom-based lung score was associated with NRM (P = .02), OS (P = .02), patient-reported symptoms (P < .001) and functional status (P < .001). Worsening of NIH symptom-based lung score over time was associated with higher NRM and lower survival. All other measures were not associated with OS or NRM; although, some were associated with patient-reported lung symptoms. In conclusion, the NIH symptom-based lung symptom score of 0 to 3 is associated with NRM, OS, and PRO measures in patients with chronic GVHD. Worsening of the NIH symptom-based lung score was associated with increased mortality.
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Affiliation(s)
- Jeanne Palmer
- Division of Hematology/Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin.
| | - Kirsten Williams
- Division of Blood and Marrow Transplantation, Children's National Medical Center, Center for Cancer and Blood Disorders, Washington, District of Columbia
| | - Yoshihiro Inamoto
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Xiaoyu Chai
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Paul J Martin
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Linus Santo Tomas
- Pulmonary Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Corey Cutler
- Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Daniel Weisdorf
- Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, Minnesota
| | - Brenda F Kurland
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Paul A Carpenter
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Joseph Pidala
- Blood and Marrow Transplantation, Moffitt Cancer Center, Tampa, Florida
| | - Steven Z Pavletic
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - William Wood
- Linenberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - David Jacobsohn
- Division of Blood and Marrow Transplantation, Children's National Medical Center, Center for Cancer and Blood Disorders, Washington, District of Columbia
| | - Sally Arai
- Division of Blood and Marrow Transplantation, Stanford University Medical Center, Stanford, California
| | - Mukta Arora
- Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, Minnesota
| | - Madan Jagasia
- Hematology and Stem Cell Transplant Program, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Stephanie J Lee
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
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Abdel-Rahman SM, Paul IM, James LP, Lewandowski A. Evaluation of the Mercy TAPE: performance against the standard for pediatric weight estimation. Ann Emerg Med 2013; 62:332-339.e6. [PMID: 23602655 PMCID: PMC4039210 DOI: 10.1016/j.annemergmed.2013.02.021] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 02/19/2013] [Accepted: 02/21/2013] [Indexed: 11/19/2022]
Abstract
STUDY OBJECTIVE We assessed the performance of 2 new devices (2D- and 3D-Mercy TAPE) to implement the Mercy Method for pediatric weight estimation and contrasted their accuracy with the Broselow method. METHODS We enrolled children aged 2 months through 16 years in this prospective, multicenter, observational study. Height/length, weight, humeral length, and mid-upper arm circumference were obtained for each child, using calibrated scales and measures. We then made measurements with blinded versions of the 2D- and 3D-TAPEs. Using height/length data, we calculated the weight estimated by the Broselow method. We contrasted measures with mean error, mean percentage error, and percentage predicted within 10% and 20% of actual. RESULTS Six hundred twenty-four participants (median 8.5 years, 27.6 kg, 17.3 kg/m(2)) completed the study. Mean error was 0.3 kg (mean percentage error 1.6%), 0.2 kg (mean percentage error 1.9%), and -1.3 kg (mean percentage error -4.1%) for 2D-, 3D-, and Broselow, respectively. Concordance between both TAPE devices and the Mercy Method was greater than 0.99. The proportion of children predicted within 10% and 20% of actual weight was 76% and 98% for the 2D-TAPE and 65% and 93% for the 3D-TAPE. Excluding the 209 (33%) children who were too tall for the device, Broselow predictions were within 10% and 20% of actual weight in 59% and 91%. CONCLUSION The 2D- and 3D-Mercy TAPEs outperform the Broselow tape for pediatric weight estimation and can be used in a wider range of children.
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Affiliation(s)
- Susan M Abdel-Rahman
- Division of Clinical Pharmacology and Medical Toxicology, Children's Mercy Hospitals and Clinics, Kansas City, MO, and the Department of Pediatrics, University of Missouri-Kansas City, School of Medicine, Kansas City, MO.
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ERCC1 is a prognostic biomarker in locally advanced head and neck cancer: results from a randomised, phase II trial. Br J Cancer 2013; 109:2096-105. [PMID: 24064970 PMCID: PMC3798971 DOI: 10.1038/bjc.2013.576] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 08/20/2013] [Accepted: 08/26/2013] [Indexed: 12/12/2022] Open
Abstract
Background: Cisplatin-radiotherapy is a preferred standard for locally advanced, head and neck squamous cell carcinoma (HNSCC). However, the cisplatin-attributable survival benefit is small and toxicity substantial. A biomarker of cisplatin resistance could guide treatment selection and spare morbidity. The ERCC1-XPF nuclease is critical to DNA repair pathways resolving cisplatin-induced lesions. Methods: In a phase II trial, patients with untreated Stage III-IVb HNSCC were randomised to cisplatin-radiotherapy with/without erlotinib. Archived primary tumours were available from 90 of 204 patients for this planned substudy. Semi-quantitative ERCC1 protein expression (H-score) was determined using the FL297, 4F9, and 8F1 antibodies. The primary analysis evaluated the relationship between continuous ERCC1 protein expression and progression-free survival (PFS). Secondary analyses included two pre-specified ERCC1 cutpoints and performance in HPV-associated disease. Results: Higher ERCC1 expression was associated with inferior PFS, as measured by the specific antibodies FL297 (HR=2.5, 95% CI=1.1–5.9, P=0.03) and 4F9 (HR=3.0, 95% CI=1.2–7.8, P=0.02). Patients with increased vs decreased/normal ERCC1 expression experienced inferior PFS (HR=4.8 for FL297, P=0.003; HR=5.5 for 4F9, P=0.007). This threshold remained prognostic in HPV-associated disease. Conclusion: ERCC1-XPF protein expression by the specific FL297 and 4F9 antibodies is prognostic in patients undergoing definitive cisplatin-radiotherapy for HNSCC, irrespective of HPV status.
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Silver HJ, Niswender KD, Kullberg J, Berglund J, Johansson L, Bruvold M, Avison MJ, Welch EB. Comparison of gross body fat-water magnetic resonance imaging at 3 Tesla to dual-energy X-ray absorptiometry in obese women. Obesity (Silver Spring) 2013; 21:765-74. [PMID: 23712980 PMCID: PMC3500572 DOI: 10.1002/oby.20287] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Accepted: 05/13/2012] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Improved understanding of how depot-specific adipose tissue mass predisposes to obesity-related comorbidities could yield new insights into the pathogenesis and treatment of obesity as well as metabolic benefits of weight loss. We hypothesized that three-dimensional (3D) contiguous "fat-water" MR imaging (FWMRI) covering the majority of a whole-body field of view (FOV) acquired at 3 Tesla (3T) and coupled with automated segmentation and quantification of amount, type, and distribution of adipose and lean soft tissue would show great promise in body composition methodology. DESIGN AND METHODS Precision of adipose and lean soft tissue measurements in body and trunk regions were assessed for 3T FWMRI and compared to dual-energy X-ray absorptiometry (DXA). Anthropometric, FWMRI, and DXA measurements were obtained in 12 women with BMI 30-39.9 kg/m(2) . RESULTS Test-retest results found coefficients of variation (CV) for FWMRI that were all under 3%: gross body adipose tissue (GBAT) 0.80%, total trunk adipose tissue (TTAT) 2.08%, visceral adipose tissue (VAT) 2.62%, subcutaneous adipose tissue (SAT) 2.11%, gross body lean soft tissue (GBLST) 0.60%, and total trunk lean soft tissue (TTLST) 2.43%. Concordance correlation coefficients between FWMRI and DXA were 0.978, 0.802, 0.629, and 0.400 for GBAT, TTAT, GBLST, and TTLST, respectively. CONCLUSIONS While Bland-Altman plots demonstrated agreement between FWMRI and DXA for GBAT and TTAT, a negative bias existed for GBLST and TTLST measurements. Differences may be explained by the FWMRI FOV length and potential for DXA to overestimate lean soft tissue. While more development is necessary, the described 3T FWMRI method combined with fully-automated segmentation is fast (<30-min total scan and post-processing time), noninvasive, repeatable, and cost-effective.
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Affiliation(s)
- Heidi J Silver
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
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Holden-Douilly L, Pourcelot P, Desquilbet L, Falala S, Crevier-Denoix N, Chateau H. Equine hoof slip distance during trot at training speed: comparison between kinematic and accelerometric measurement techniques. Vet J 2013; 197:198-204. [PMID: 23489849 DOI: 10.1016/j.tvjl.2013.02.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Revised: 01/21/2013] [Accepted: 02/02/2013] [Indexed: 11/17/2022]
Abstract
Longitudinal sliding of horse's hooves at the beginning of stance can affect both performance and orthopaedic health. The objective of this study was to compare two measurement methods for quantifying hoof slip distances at training trot. The right front hoof of four French Trotters was equipped with an accelerometer (10 kHz) and kinematic markers. A firm wet sand track was equipped with a 50 m calibration corridor. A high-frequency camera (600 Hz) was mounted in a vehicle following each horse trotting at about 7 m/s. One of the horses was also trotted on raw dirt and harrowed dirt tracks. Longitudinal slip distance was calculated both from kinematic data, applying 2D direct linear transformation (2D-DLT) to the markers image coordinates, and from the double integration of the accelerometer signal. For each stride, both values were compared. The angle of the hoof with respect to the track was also measured. There was 'middling/satisfactory' agreement between accelerometric and 2D-DLT measurements for total slip and 'fairly good' agreement for hoof-flat slip. The influence of hoof rotation on total slip distance represented <6% of accelerometric measures. The differences between accelerometric and kinematic measures (from -0.5 cm to 2.1cm for total slip and from -0.2 cm to 1.4 cm for hoof-flat slip) were independent of slip distance magnitude. The accelerometric method was a simple method to measure hoof slip distances at a moderate training speed trot which may be useful to compare slip distances on various track surfaces.
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Affiliation(s)
- Laurène Holden-Douilly
- Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, USC BPLC 957, Maisons-Alfort F-94704, France.
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Carrasco JL, Phillips BR, Puig-Martinez J, King TS, Chinchilli VM. Estimation of the concordance correlation coefficient for repeated measures using SAS and R. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2013; 109:293-304. [PMID: 23031487 DOI: 10.1016/j.cmpb.2012.09.002] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Revised: 09/04/2012] [Accepted: 09/04/2012] [Indexed: 06/01/2023]
Abstract
The concordance correlation coefficient is one of the most common approaches used to assess agreement among different observers or instruments when the outcome of interest is a continuous variable. A SAS macro and R package are provided here to estimate the concordance correlation coefficient (CCC) where the design of the data involves repeated measurements by subject and observer. The CCC is estimated using U-statistics (UST) and variance components (VC) approaches. Confidence intervals and standard errors are reported along with the point estimate of the CCC. In the case of the VC approach, the linear mixed model output and variance components estimates are also provided. The performance of each function is shown by means of some examples with real data sets.
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Affiliation(s)
- Josep L Carrasco
- Biostatistics Unit, Public Health Department, University of Barcelona, Barcelona, Spain.
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Duarte MES, Freitag CPF, Fornari F, Kruel CRP, Sanches PRS, Thomé PRO, Callegari-Jacques SM, Möllerke RO, Vicente YAMVA, Goldani HAS, Barros SGS. Gastric yield pressure and gastric yield volume to assess anti-reflux barrier in a porcine model. J INVEST SURG 2013; 26:80-4. [PMID: 23273175 DOI: 10.3109/08941939.2012.695429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Anti-reflux barrier (ARB) resistance may be useful to test new treatments for gastroesophageal reflux (GER). The ARB has been estimated by increasing gastric yield pressure (GYP) and gastric yield volume (GYV) in animal models but has not been validated. This study aimed to develop an experimental model suitable for assessing the ARB resistance to increasing intragastric pressure and volume and its reproducibility in a seven-day interval. Ten two-month-old female Large-White swine were studied. Intragastric pressure and volume were recorded using a digital system connected to a Foley catheter inserted through gastrostomy into the stomach. GYP and GYV were defined as the gastric pressure and volume able to yield gastric contents into the esophagus detected by esophageal pH. A sudden pH drop below 3 sustained during 5 min was considered diagnostic for gastric yield. Animals were studied again after seven days. On days 0 and 7, there were no significant differences for GYP (mean ± SD = 7.66 ± 3.02 mmHg vs. 7.07 ± 3.54 mmHg, p = .686) and GYV (636.70 ± 216.74 ml vs. 608.30 ± 276.66 ml; p = .299), respectively. Concordance correlation coefficient (ρc) was significant for GYP (ρc = 0.634, 95% CI = 0.141-0.829, p = .006), but not for GYV (ρc = 0.291, 95% CI = -0.118 to 0.774, p = .196). This study demonstrated an experimental model, assessing the ARB resistance. GYP seems to be a more reliable parameter than GYV for assessment of ARB resistance.
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Affiliation(s)
- Marcos E S Duarte
- Programa de Pós-graduação Ciências em Gastroenterologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul UFRGS, Porto Alegre, Brazil
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De Souza VC, Rabilloud M, Cochat P, Selistre L, Hadj-Aissa A, Kassai B, Ranchin B, Berg U, Herthelius M, Dubourg L. Schwartz formula: is one k-coefficient adequate for all children? PLoS One 2012; 7:e53439. [PMID: 23285295 PMCID: PMC3532344 DOI: 10.1371/journal.pone.0053439] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Accepted: 11/28/2012] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND/OBJECTIVE Plasma-creatinine-based equations to estimate the glomerular filtration rate are recommended by several clinical guidelines. In 2009, Schwartz et al. adapted the traditional Schwartz equation to children and adolescents but did not find different k-coefficients between children and adolescents (k = 36.5 for all patients). We reevaluated the coefficient of the 2009-Schwartz formula according to sex and age in a pediatric population. PATIENTS/METHODS We used linear mixed-effects models to reestimate the 2009-Schwartz k-coefficient in 360 consecutive French subjects aged 1 to 18 years referred to a single centre between July 2003 and July 2010 (965 measurements). We assessed the agreement between the estimated glomerular filtration rate obtained with the new formula (called Schwartz-Lyon) and the rate measured by inulin clearance. We then compared this agreement to the one between the measured glomerular filtration rate and 2009-Schwartz formula, first in the French then in a Swedish cohort. RESULTS In Schwartz-Lyon formula, k was estimated at 32.5 in boys <13 years and all girls and at 36.5 in boys aged ≥13 years. The performance of this formula was higher than that of 2009-Schwartz formula in children <13 years. This was first supported by a statistically significant reduction of the overestimation of the measured glomerular filtration rate in both cohorts, by better 10% and 30% accuracies, and by a better concordance correlation coefficient. CONCLUSIONS The performance and simplicity of Schwartz formula are strong arguments for its routine use in children and adolescents. The specific coefficient for children aged <13 years further improves this performance.
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Affiliation(s)
- Vandrea Carla De Souza
- Centre de Référence des Maladies Rénales Rares, Service de Néphrologie et Rhumatologie Pédiatriques, Hospices Civils de Lyon, Lyon, France.
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van Soest-Poortvliet MC, van der Steen JT, Zimmerman S, Cohen LW, Reed D, Achterberg WP, Ribbe MW, de Vet HCW. Selecting the best instruments to measure quality of end-of-life care and quality of dying in long term care. J Am Med Dir Assoc 2012; 14:179-86. [PMID: 23165164 DOI: 10.1016/j.jamda.2012.09.019] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Revised: 09/17/2012] [Accepted: 09/18/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To compare available instruments and investigate which best measure the quality of end-of-life care (QOC) and quality of dying (QOD) in long term care settings, in terms of validity, reliability, and feasibility. DESIGN Family and professional caregivers of long term care decedents completed postdeath interviews and questionnaires between November 2007 and April 2009. SETTING Nursing home and residential care/assisted living settings in the United States and the Netherlands. PARTICIPANTS Two hundred and sixty four families of decedents with (48%) and without (52%) dementia in the United States, and 70 families and 103 professional caregivers of decedents with dementia in The Netherlands. MEASUREMENTS Ten instruments to evaluate the QOC and QOD in long term care, an additional overall assessment of QOC/QOD, and an assessment of the perception of the relevance and ease of use of each instrument. Criteria for validity, reliability, and feasibility were set forth for good, intermediate, and poor performance. RESULTS None of the instruments scored positively on all criteria. In both countries, of the QOC instruments, the End-of-Life in Dementia-Satisfaction With Care (EOLD-SWC) best met the criteria, followed by the Family Assessment of Treatment at the End-of-Life Short Version, the Family Perception of Care Scale, and Family Perception of Physician-Family Caregiver Communication. Of the QOD instruments, the End-of-Life in Dementia-Comfort Assessment at Dying (EOLD-CAD) and Mini-Suffering State Examination (MSSE) met more of the criteria than others. The EOLD-CAD performed better on content and construct validity than the MSSE. The MSSE performed better on feasibility. CONCLUSION We recommend the EOLD-SWC to measure QOC, and the EOLD-CAD and MSSE to measure QOD in populations with dementia and in mixed long term care populations of nursing home or residential care home/assisted living residents, because they performed best in both countries. Use of the same instruments allows for comparison of the results between studies.
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Affiliation(s)
- Mirjam C van Soest-Poortvliet
- Department of General Practice & Elderly Care Medicine, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
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Pula JH, Kattah JC, Wang H, Marshall J, Eggenberger ER. Ability of a neuro-ophthalmologist to estimate retinal nerve fiber layer thickness. Clin Ophthalmol 2012; 6:1477-81. [PMID: 23055667 PMCID: PMC3460702 DOI: 10.2147/opth.s34573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Qualitative description of the optic disc has clinical value, but optical coherence tomography (OCT) has provided the ability to quantify retinal nerve fiber layer (RNFL) thickness. Methods We asked three neuro-ophthalmologists of at least 20 years’ experience to estimate the average OCT RNFL thickness of 37 eyes based on fundus photos. Results The overall correlation coefficient for RNFL thickness estimation variance between two physicians and between physician and OCT was 0.53. The likelihood that the RNFL thickness estimation between physicians, or between physician and OCT, was within 10 μm of each other was 47%–62%. All physicians had disparities in RNFL thickness estimation greater than 30 μm. Conclusion This study provides information on the ability of an experienced neuro-ophthalmologist to estimate the RNFL thickness based on fundus photos.
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Affiliation(s)
- John H Pula
- University of Illinois College of Medicine at Peoria, Illinois Neurologic Institute, Peoria, IL, USA
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Comparison of Gross Body Fat-Water Magnetic Resonance Imaging at 3 Tesla to Dual-Energy X-Ray Absorptiometry in Obese Women. Obesity (Silver Spring) 2012. [DOI: 10.1038/oby.2012.147] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Wang Y, Holland SK, Vannest J. Concordance of MEG and fMRI patterns in adolescents during verb generation. Brain Res 2012; 1447:79-90. [PMID: 22365747 DOI: 10.1016/j.brainres.2012.02.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Revised: 01/31/2012] [Accepted: 02/01/2012] [Indexed: 10/14/2022]
Abstract
In this study we focused on direct comparison between the spatial distributions of activation detected by functional magnetic resonance imaging (fMRI) and localization of sources detected by magnetoencephalography (MEG) during identical language tasks. We examined the spatial concordance between MEG and fMRI results in 16 adolescents performing a three-phase verb generation task that involves repeating the auditorily presented concrete noun and generating verbs either overtly or covertly in response to the auditorily presented noun. MEG analysis was completed using a synthetic aperture magnetometry (SAM) technique, while the fMRI data were analyzed using the general linear model approach with random-effects. To quantify the agreement between the two modalities, we implemented voxel-wise concordance correlation coefficient (CCC) and identified the left inferior frontal gyrus and the bilateral motor cortex with high CCC values. At the group level, MEG and fMRI data showed spatial convergence in the left inferior frontal gyrus for covert or overt generation versus overt repetition, and the bilateral motor cortex when overt generation versus covert generation. These findings demonstrate the utility of the CCC as a quantitative measure of spatial convergence between two neuroimaging techniques.
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Affiliation(s)
- Yingying Wang
- Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Research Foundation, Cincinnati, OH 45229-3039, USA.
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Tidholm A, Bodegård-Westling A, Höglund K, Ljungvall I, Häggström J. Comparisons of 2- and 3-Dimensional Echocardiographic Methods for Estimation of Left Atrial Size in Dogs with and without Myxomatous Mitral Valve Disease. J Vet Intern Med 2011; 25:1320-7. [DOI: 10.1111/j.1939-1676.2011.00812.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Revised: 07/24/2011] [Accepted: 08/15/2011] [Indexed: 11/27/2022] Open
Affiliation(s)
| | | | - K. Höglund
- Department of Anatomy; Physiology and Biochemistry ; Faculty of Veterinary Medicine; Swedish University of Agricultural Sciences; Uppsala; Sweden
| | - I. Ljungvall
- Department of Clinical Sciences; Faculty of Veterinary Medicine; Swedish University of Agricultural Sciences; Uppsala; Sweden
| | - J. Häggström
- Department of Clinical Sciences; Faculty of Veterinary Medicine; Swedish University of Agricultural Sciences; Uppsala; Sweden
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Lampasona V, Schlosser M, Mueller PW, Williams AJK, Wenzlau JM, Hutton JC, Achenbach P. Diabetes antibody standardization program: first proficiency evaluation of assays for autoantibodies to zinc transporter 8. Clin Chem 2011; 57:1693-702. [PMID: 21980171 DOI: 10.1373/clinchem.2011.170662] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Zinc transporter 8 (ZnT8) is a recently identified major autoantigen in type 1 diabetes, and autoantibodies to ZnT8 (ZnT8A) are new markers for disease prediction and diagnosis. Here we report the results of the first international proficiency evaluation of ZnT8A assays by the Diabetes Antibody Standardization Program (DASP). METHODS After a pilot workshop in 2007, an expanded ZnT8A workshop was held in 2009, with 26 participating laboratories from 13 countries submitting results of 63 different assays. ZnT8A levels were measured in coded sera from 50 patients with newly diagnosed type 1 diabetes and 100 blood donor controls. Results were analyzed comparing area under the ROC curve (ROC-AUC), sensitivity adjusted to 95% specificity (AS95), concordance of sample ZnT8A positive or negative designation, and autoantibody levels. RESULTS ZnT8A radio binding assays (RBAs) based on combined immunoprecipitation of the 2 most frequent ZnT8 COOH-terminal domain polymorphic variants showed a median ROC-AUC of 0.848 [interquartile range (IQR) 0.796-0.878] and a median AS95 of 70% (IQR 60%-72%). These RBAs were more sensitive than assays using as antigen either 1 ZnT8 variant only or chimeric constructs joining NH(2)- and COOH-terminal domains, assays based on immunoprecipitation and bioluminescent detection, or assays based on immunofluorescent staining of cells transfected with full-length antigen. CONCLUSIONS The DASP workshop identified immunoprecipitation-based ZnT8A assays and antigen constructs that achieved both a high degree of sensitivity and specificity and were suitable for more widespread clinical application.
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Affiliation(s)
- Vito Lampasona
- Genomic Unit for the Diagnosis of Human Pathologies, Center for Translational Genomics and Bioinformatics, San Raffaele Scientific Institute, Milan, Italy.
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In vitro comparison of water displacement method and 3 Tesla MRI for MR-volumetry of the olfactory bulb: which sequence is appropriate? Acad Radiol 2011; 18:1233-40. [PMID: 21782479 DOI: 10.1016/j.acra.2011.06.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2011] [Revised: 06/24/2011] [Accepted: 06/27/2011] [Indexed: 11/21/2022]
Abstract
RATIONALE AND OBJECTIVES Magnetic resonance imaging olfactory bulb (OB) volumetry (OBV) is already used as a complementary prognostic tool to assess olfactory disorders. However, a reference standard in imaging for OBV has not been established. The aim of this in vitro study was to compare volumetric results of different magnetic resonance sequences for OBV at 3 T to genuine OB volumes measured by water displacement. MATERIALS AND METHODS The volumes of 15 human cadaveric OBs were measured using the water displacement method in this institutional review board-approved prospective study. The magnetic resonance imaging protocol at 3 T included constructive interference in steady state (CISS), T2-weighted (T2w) three-dimensional (3D) sampling perfection with application-optimized contrasts using different flip-angle evolutions (SPACE), T2w two-dimensional (2D) turbo spin-echo (TSE), and T1-weighted (T1w) 3D fast low-angle shot (FLASH) sequences. Two blinded observers independently performed two OB volumetric assessments per bulbus and sequence. Intraobserver and interobserver reliabilities were assessed by intraclass correlation coefficients. Bland-Altman plots were analyzed to evaluate systematic biases and concordance correlation coefficients to assess reproducibility. RESULTS For both observers, intraclass correlation coefficient analysis yielded almost perfect results for intraobserver reliability (CISS, 0.94-0.98; T2w 3D SPACE, 0.93-0.98; T2w 2D TSE, 0.98-0.98; T1w 3D FLASH, 0.95-0.99). Interobserver reliability showed almost perfect agreement for all sequences (CISS, 0.98; T2w 3D SPACE, 0.89; T2w 2D TSE, 0.93; T1w 3D FLASH, 0.97). The CISS sequence yielded the highest mean concordance correlation coefficient (0.95) and the highest combination of precision (0.97) and accuracy (0.98) values. In comparison with the water displacement method, Bland-Altman analyses revealed the lowest systematic bias (-0.5%) for the CISS sequence, followed by T1w 3D FLASH (-1.3%), T2w 3D SPACE (-7.5%), and T2w 2D TSE (-10.9%) sequences. CONCLUSIONS Compared to the water displacement method, the CISS sequence is suited best to validly and reliably measure OB volumes because of its highest values for accuracy and precision and lowest systematic bias.
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Psychometric properties of instruments to measure the quality of end-of-life care and dying for long-term care residents with dementia. Qual Life Res 2011; 21:671-84. [PMID: 21814875 PMCID: PMC3323818 DOI: 10.1007/s11136-011-9978-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2011] [Indexed: 11/30/2022]
Abstract
Purpose Quality of care for long-term care (LTC) residents with dementia at the end-of-life is often evaluated using standardized instruments that were not developed for or thoroughly tested in this population. Given the importance of using appropriate instruments to evaluate the quality of care (QOC) and quality of dying (QOD) in LTC, we compared the validity and reliability of ten available instruments commonly used for these purposes. Methods We performed prospective observations and retrospective interviews and surveys of family (n = 70) and professionals (n = 103) of LTC decedents with dementia in the Netherlands. Results Instruments within the constructs QOC and QOD were highly correlated, and showed moderate to high correlation with overall assessments of QOC and QOD. Prospective and retrospective ratings using the same instruments differed little. Concordance between family and professional scores was low. Cronbach’s alpha was mostly adequate. The EOLD–CAD showed good fit with pre-assumed factor structures. The EOLD–SWC and FPCS appear most valid and reliable for measuring QOC, and the EOLD–CAD and MSSE for measuring QOD. The POS performed worst in this population. Conclusions Our comparative study of psychometric properties of instruments allows for informed selection of QOC and QOD measures for LTC residents with dementia.
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Burmeister HP, Baltzer PAT, Möslein C, Bitter T, Gudziol H, Dietzel M, Guntinas-Lichius O, Kaiser WA. Reproducibility and repeatability of volumetric measurements for olfactory bulb volumetry: which method is appropriate? An update using 3 Tesla MRI. Acad Radiol 2011; 18:842-9. [PMID: 21669350 DOI: 10.1016/j.acra.2011.02.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2011] [Revised: 02/05/2011] [Accepted: 02/25/2011] [Indexed: 10/18/2022]
Abstract
RATIONALE AND OBJECTIVES The aim of this study was to compare different sequences for olfactory bulb volumetry using 3-T magnetic resonance imaging, evaluating reproducibility, repeatability, and systematic biases. MATERIALS AND METHODS Twenty-two volunteers underwent 3-T magnetic resonance imaging of the frontal skull base in this prospective study. Imaging included constructive interference in steady state (CISS), T2-weighted (T2w) three-dimensional (3D) sampling perfection with application-optimized contrasts using different flip-angle evolutions, and T2w two-dimensional (2D) turbo spin-echo sequences. Two observers independently performed two olfactory bulb volumetric studies per bulb and sequence. Intraobserver and interobserver reliability was assessed using intraclass correlation coefficients. For the evaluation of reproducibility, concordance correlation coefficients were determined, and for repeatability and systematic biases, Bland-Altman plots were analyzed. RESULTS Intraclass correlation coefficient analysis of the specialized observer yielded almost perfect results for intraobserver reliability (0.94, 0.85, and 0.93 for the CISS, T2w 3D, and T2w 2D sequences, respectively). For the less experienced observer, the results were 0.86 0.78, and 0.74 for the CISS, T2w 3D, and T2w 2D sequences, respectively. Interobserver reliability showed almost perfect agreement for all sequences (0.92, 0.86, and 0.86, respectively). The CISS sequence yielded the highest concordance correlation coefficient (0.84), precision (0.85), and accuracy (0.99). Bland-Altman plot analyses revealed the lowest repeatability coefficients for the T2w 2D sequence. Volumetric measurements of T2w 2D imaging showed systematically lower volumetric results compared to the CISS sequence (-22.7%) and the T2w 3D sequence (-8.3%). CONCLUSIONS Comparison of three imaging sequences for olfactory bulb volumetry yielded the best values for the CISS sequence in terms of intraobserver and interobserver reliability, reproducibility, accuracy, and precision. Given that even less experienced observers achieve almost perfect results, the CISS sequence is recommended for olfactory bulb volumetry.
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Landis JR, King TS, Choi JW, Chinchilli VM, Koch GG. Measures of Agreement and Concordance With Clinical Research Applications. Stat Biopharm Res 2011. [DOI: 10.1198/sbr.2011.10019] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Harreld JH, Bhore R, Chason DP, Twickler DM. Corpus callosum length by gestational age as evaluated by fetal MR imaging. AJNR Am J Neuroradiol 2010; 32:490-4. [PMID: 21183616 DOI: 10.3174/ajnr.a2310] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Although suspected corpus callosum abnormality is a common indication for fetal MR imaging, biometric data specific to MR imaging are sparse. We sought to characterize growth in corpus callosum length by EGA with fetal MR imaging. Corpus callosum segments were assessed and overall corpus callosum length was measured and plotted against the EGA for 68 anatomically normal fetal brains ranging in EGA from 18.5 to 37.7 weeks, and linear and polynomial regression models were calculated. The body of the corpus callosum was identified in all fetuses, followed in frequency by the splenium (91.2%), genu (85.3%), and rostrum (32.4%). Measurements of corpus callosum length by MR imaging were in agreement with values established by sonography. A second-degree polynomial function was the best fit for callosal length by EGA. Understanding this normal growth pattern may enhance detection of subtle growth abnormalities.
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Affiliation(s)
- J H Harreld
- Department of Radiology, University of Texas Southwestern Medical Center at Dallas, USA.
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Hutson AD. A multi-rater nonparametric test of agreement and corresponding agreement plot. Comput Stat Data Anal 2010. [DOI: 10.1016/j.csda.2009.07.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
BACKGROUND The statistical measure used to quantify the degree of agreement or congruence between two research subjects has been the intraclass or the Pearson correlation coefficient; however, the concordance correlation coefficient (CCC) is another measure of agreement used to examine agreement between two observers or raters. OBJECTIVES The aims of this study were to (a) highlight the differences among three statistical measures used to quantify the degree of agreement or congruence, (b) demonstrate the use of the CCC in examining agreement between heart failure (HF) patients and their family members, and (c) provide nurse researchers another method for evaluating agreement. METHODS Symptom evaluation scores obtained from HF patients and their family members were used in the analysis of this study. To explain the use of the CCC in this analysis, a distinction between Pearson correlation coefficient and intraclass correlation coefficient is discussed. The CCC calculation is then described in detail. RESULTS The HF patients in this sample were 71 +/- 9.6 years in age, 40% male, and 41.4% African American. Most (75%) family members were female. There were several different categories of family members, but most were spouses. The CCC results indicated that no symptom achieved good agreement, and 8 of 14 symptoms were in moderate agreement (.4 <or= CCC <or= .7) within the dyads. Of the six symptoms with poor agreement (0<or= CCC < .4), HF patients and their family members agreed least on worsening cough (CCC = .152, 95% confidence interval = -.134 to .413) and bloated abdomen (CCC = .055, 95% confidence interval = -.224 to .325). DISCUSSION Applying the CCC to dyadic data from HF patients and family members, symptoms in which the patient and family member had the most and least agreement were identified. The six symptoms with poor agreement were symptoms that can show HF decline and may be important when examining future nursing interventions. Further study is needed using the CCC with dyadic data along with other family factors that influence agreement.
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van der Steen JT, Gijsberts MJ, Knol DL, Deliens L, Muller MT. Ratings of symptoms and comfort in dementia patients at the end of life: comparison of nurses and families. Palliat Med 2009; 23:317-24. [PMID: 19346275 DOI: 10.1177/0269216309103124] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
After-death reporting by proxies on end-of-life outcomes is used in research and can also be used to target institutions directly to improve practice. We compared the scores of family caregivers and nurses on two End-of-Life in Dementia Scales (EOLD) scales: Symptom Management (SM; range 0-45) over the last 3 months of life and Comfort Assessment in Dying (CAD; range 14-42). Higher scores represent better outcomes. Four Dutch nursing homes retrospectively enrolled 48 decedents with dementia. Total mean scores for family caregivers and nurses were 28.7 (SD 9.6) versus 25.2 (SD 12.7) for the SM and 31.7 (SD 5.5) versus 32.8 (SD 8.2) for the CAD. Mean item scores also did not differ much. Concordance Correlation Coefficients were 0.42 (SM) and 0.04 (CAD). Mean evaluations of end of life with dementia corresponded reasonably well between family and professional caregivers, but correspondence of individual observations was poor to moderate, suggesting serious differences in individual ratings but little systematic difference.
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Affiliation(s)
- J T van der Steen
- EMGO Institute, Department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands.
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