Acceptable Bias Research Articles

Rapid Screening of Urinary 1-Hydroxypyrene Glucuronide by Multisegment Injection-Capillary Electrophoresis-Tandem Mass Spectrometry: A High-Throughput Method for Biomonitoring of Recent Smoke Exposures.

Urinary 1-hydroxypyrene (HP) is a widely used biomarker of polycyclic aromatic hydrocarbon exposure relevant for biomonitoring the deleterious health impacts from tobacco smoke and ambient air pollution, as well as the hazards of certain occupations. Conventional methods for urinary HP analysis based on liquid chromatography with native fluorescence detection or tandem mass spectrometry (MS/MS) and gas chromatography-mass spectrometry (GC-MS) are limited by low sample throughput and complicated sample workup protocols that are prone to bias. Herein, we introduce a high throughput method to directly analyze the intact glucuronide conjugate of HP (HP-G) in human urine after a simple acidified ether extraction procedure when using multisegment injection-capillary electrophoresis-tandem mass spectrometry (MSI-CE-MS/MS). Multiplexed analyses of 13 independent urine extracts are achieved in a single run (<3 min/sample) with stringent quality control while avoiding enzyme deconjugation and precolumn chemical derivatization. Method validation demonstrates good technical precision (CV = 7.7%, n = 45) and accuracy with a mean recovery of (93 ± 3%) for urinary HP-G at three concentration levels with adequate detection limits (7 ng/L, S/N = 3). An interlaboratory method comparison of urine samples collected from firefighters deployed in the 2016 Fort McMurray wildfire also confirms good mutual agreement with an acceptable negative bias (mean bias = 15%, n = 55) when measuring urinary HP-G by MSI-CE-MS/MS as compared to total hydrolyzed urinary HP by GC-MS due to the low residual levels of free HP and its sulfate conjugate. This multiplexed separation platform is optimal for large-scale biomonitoring studies of air pollution relevant to global health as well as occupational smoke exposures in firefighters susceptible to dermal PAH absorption when using personal protective equipment.

Effort and liberal acceptance bias in patients with schizophrenia

ABSTRACT Introduction: A liberal acceptance bias is implicated in the formation and maintenance of delusions in schizophrenia. The present study tested the hypothesis that patients with schizophrenia are more quickly satisfied with their task performance than controls despite poor objective performance. Methods: Fifty patients with schizophrenia and 50 healthy controls performed the newly developed copy figure task in which participants copy a complex geometrical figure up to eight times until they are satisfied with the result. Objective performance was scored blind to group status. Subjective performance was rated on a 10-point scale. Carefulness of the drawing using anchor points served as a proxy for effort. Results: Patients made as many attempts as controls to copy the figure despite their worse subjective and objective performance. The number of attempts was negatively correlated with (persecutory) delusions and the PANSS total score. Neither effort nor possible frustration due to a plateau in performance was a reason for task termination. Conclusions: This exploratory study is in line with predictions based on the liberal acceptance model. For future studies, we recommend further cross-validating this paradigm and testing whether patients’ retrospective assessment of their performance is exaggerated relative to controls. We also suggest that researchers pursue this line of research with personally meaningful material where a decreased threshold of acceptance may more easily translate into the subsequent fixation of ideas.

Validation of noninvasive continuous arterial pressure measurement by ClearSight System\u2122 during induction of anesthesia for cardiovascular surgery

BackgroundSince blood pressure tends to be unstable during induction of anesthesia in patients undergoing cardiovascular surgery, an artery catheter is often inserted before induction to continuously monitor arterial pressure during induction of anesthesia. ClearSight System™ enables noninvasive continuous measurement of beat-to-beat arterial pressure via a single finger cuff without pain using photoplethysmographic technology. If ClearSight System™ can replace intra-arterial pressure measurement, blood pressure could be easily and noninvasively assessed. However, the validity of ClearSight System™ during induction of anesthesia in patients undergoing cardiovascular surgery has not been evaluated. The aim of this study was to compare blood pressure measured by ClearSight System™ with intra-arterial pressure during induction of anesthesia for cardiovascular surgery.MethodsThis study was registered retrospectively. Data during induction of anesthesia for elective cardiovascular surgery were obtained for patients in whom noninvasive arterial pressure was measured by ClearSight System™ (APcs) and invasive radial arterial pressure (APrad) was measured simultaneously. According to the widely used criteria formulated by international standards from the Association for the Advancement of Medical Instrumentation, the acceptable bias and precision for arterial pressure measurements were fixed at < 5 mmHg and 8 mmHg, respectively.ResultsData for 18 patients were analyzed. For 3068 analyzed paired measurements, values of APcs vs APrad bias (precision) were 13.2 (17.5), − 9.1 (7.3) and − 3.9 (7.8) mmHg for systolic, diastolic, and mean arterial pressures, respectively.ConclusionsMean arterial pressure measured by ClearSight System™ could be considered as an alternative for mean radial arterial pressure during induction of anesthesia for elective cardiovascular surgery.

Searching for Gambles: Gambling Sentiment and Stock Market Outcomes

AbstractUsing Internet search volume for lottery to capture gambling sentiment shifts, we show that when the overall gambling sentiment is strong, investor demand for lottery stocks increases, these stocks earn positive short-run abnormal returns, managers are more likely to split stocks to cater to the increased demand for low-priced lottery stocks, and initial public offerings (IPOs) earn higher first day returns. Further, the sentiment-return relation is stronger among low institutional ownership firms, headquartered in regions where gambling is more acceptable and local bias is stronger. These results suggest that gambling sentiment has a spillover effect on the stock market.

Biometric and morphological features on magnetic resonance imaging of fetal bladder in lower urinary tract obstruction: new perspectives for fetal cystoscopy.

Incompatibility between currently available fetoscopes and the anatomical constraints of the distended fetal bladder, with the resulting curvature around the bladder neck, account for most technical difficulties during fetal cystoscopy in lower urinary tract obstruction (LUTO). The aim of this anatomical study was to assess by magnetic resonance imaging (MRI) the variation in three bladder angles (bladder-neck angle (BNA), vesicourethral angle (VUA) and angle between bladder dome and posterior urethra (DUA)), according to gestational age (GA), bladder volume and the presence of LUTO. From our fetal medicine database, we retrieved for review 46 MRI examinations of male fetuses between 2015 and 2019, including 17 with LUTO, examined at a mean GA of 28.1 (range, 17.3-35.0) weeks and 29 age-matched controls, examined at 29.9 (range, 21.9-35.0) weeks. We measured bladder volume, bladder-wall thickness and the three bladder angles, and used the Mann-Whitney U-test to compare values between groups. Variations according to GA and bladder volume were determined using analysis of variance (ANOVA). A reliability study was performed using the Bland-Altman method and Lin's correlation coefficient was calculated. Both bladder volume and bladder-wall thickness were significantly greater in the LUTO group (P < 0.01). BNA was significantly larger in LUTO compared with control fetuses: the mean (range) was 127.1° (101.6-161.6°) vs 111.2° (88.5-157.3°) (P < 0.01). DUA averaged 117° and showed no difference between the groups (P = 0.92). No statistical comparison was performed on VUA since this was not measurable in most control fetuses. ANOVA showed no variation of any angle with bladder volume in both LUTO fetuses and control fetuses. BNA in LUTO fetuses was the only angle to vary with GA, being larger after, compared with at or before, 25 weeks (P = 0.04). The reliability study showed an acceptable bias for both intra- and interobserver reproducibility for all three angles. The findings that BNA is increased by approximately 15° in fetuses with LUTO and DUA averages 117° could aid in development of a customized fetal cystoscope and help to overcome the current technical challenges of fetal cystoscopy. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

Influence of sample centrifugation on plasma platelet count and activated partial thromboplastin time using patient samples

BackgroundDiagnostic coagulation testing is vulnerable to factors of the pre-analytical phase such as sample centrifugation. Despite this, centrifugation conditions differ widely among European laboratories. Here we use samples from patients referred for Activated partial thromboplastin time (APTT) testing to investigate if different centrifugation conditions result in platelet-poor plasma (PPP) (plasma platelet count < 10 × 109/L) and how the variation in centrifugation conditions affect APTT measurements. MethodsCentrifugation of 2000g (10 min) were compared with 3000g (10 min) using samples from patients referred for APTT testing (n = 70). Plasma platelet count and APTT were measured to investigate the influence of the centrifugation conditions. Differences were evaluated using Bland Altman Plots and Student’s t-test. ResultsCentrifugation at 3000g for 10 min produced PPP for more of the samples (64%) than centrifugation at 2000g (6%) (p < 0.001). No statistically significant difference for APTT (p = 0.265) was found for samples with APTT < 37 s while samples with prolonged APTT (>37 s) showed a statistically significant difference (p = 0.025). The Bland Altman plot did not reveal a clinically significant difference (mean difference 0.30 s/0.68%) when compared to a maximum acceptable bias of 10%. ConclusionNone of the centrifugation conditions used in this study adequately secured PPP for all samples. Despite a statistically significant difference between samples with prolonged APTT, no clinically significant difference was observed when comparing all APTT measurements.

Deep learning-guided estimation of attenuation correction factors from time-of-flight PET emission data.

Attenuation correction (AC) is essential for quantitative PET imaging. In the absence of concurrent CT scanning, for instance on hybrid PET/MRI systems or dedicated brain PET scanners, an accurate approach for synthetic CT generation is highly desired. In this work, a novel framework is proposed wherein attenuation correction factors (ACF) are estimated from time-of-flight (TOF) PET emission data using deep learning. In this approach, referred to as called DL-EM), the different TOF sinogram bins pertinent to the same slice are fed into a multi-input channel deep convolutional network to estimate a single ACF sinogram associated with the same slice. The clinical evaluation of the proposed DL-EM approach consisted of 68 clinical brain TOF PET/CT studies, where CT-based attenuation correction (CTAC) served as reference. A two-tissue class consisting of background-air and soft-tissue segmentation of the TOF PET non-AC images (SEG) as a proxy of the technique used in the clinic was also included in the comparative evaluation. Qualitative and quantitative PET analysis was performed through SUV bias maps quantification in 63 different brain regions. The DL-EM approach resulted in 6.1±9.7% relative mean absolute error (RMAE) in bony structures compared to SEG AC method with RMAE of 16.1±8.2% (p-value <0.001). Considering the entire head region, DL-EM led to a root mean square error (RMSE) of 0.3±0.01 outperforming the SEG method with RMSE of 0.8±0.02 SUV (p-value <0.001). The region-wise analysis of brain PET studies revealed less than 7% absolute SUV bias for the DL-EM approach, whereas the SEG method resulted in more than 14% absolute SUV bias (p-value <0.05). Qualitative assessment and quantitative PET analysis demonstrated the superior performance of the DL-EM approach over the segmentation-based technique with clinically acceptable SUV bias. The results obtained using the DL-EM approach are comparable to state-of-the-art MRI-guided AC methods. Yet, this approach enables the extraction of interesting features about patient-specific attenuation which could be employed not only as a stand-alone AC approach but also as complementary/prior information in other AC algorithms.

Capillary glucose concentration during oral glucose tolerance test for the diagnosis of gestational diabetes.

To assess concordance between two point-of-care testing (POCT) devices and the standard laboratory method in screening for gestational diabetes mellitus (GDM) in Huesca. Pregnant women who met criteria for an oral glucose tolerance test (OGTT) and attended the laboratory between October 2017 and November 2018 were recruited in this prospective observational study. Glucose was measured in venous (laboratory) and capillary blood (Accu-Chek or Contour Next glucometers). GDM was diagnosed attending to NDDG criteria for venous samples or capillary-specific cut-off. Linear regression, Passing-Bablok, Bland-Altman, and the kappa coefficient were used to study concordance between POCT and laboratory method. Data from 109 women were analyzed (57 for Accu-Chek, 52 for Contour Next). Statistical analyses showed good agreement between both POCT and laboratory method. There were no statistical differences in fasting glucose measurements between capillary and venous samples and both POCT devices meet the ISO 15197 standard. Accu-Chek showed good agreement (k=0.629) regarding the laboratory method in classifying GDM, with an acceptable inter-evaluator bias of 3.5% (P<0.001). POCT can be used to obtain fasting values and reduce overall waiting times for patients. Additionally, Accu-Chek can be used to diagnose GDM in remote areas applying specific cut-off values.

Voriconazole: an audit of hospital-based dosing and monitoring and evaluation of the predictive performance of a dose-prediction software package.

Therapeutic drug monitoring (TDM) is recommended to guide voriconazole therapy. To determine compliance of hospital-based voriconazole dosing and TDM with the Australian national guidelines and evaluate the predictive performance of a one-compartment population pharmacokinetic voriconazole model available in a commercial dose-prediction software package. A retrospective audit of voriconazole therapy at an Australian public hospital (1 January to 31 December 2016) was undertaken. Data collected included patient demographics, dosing history and plasma concentrations. Concordance of dosing and TDM with Australian guidelines was assessed. Observed concentrations were compared with those predicted by dose-prediction software. Measures of bias (mean prediction error) and precision (mean squared prediction error) were calculated. Adherence to dosing guidelines for 110 courses of therapy (41% for prophylaxis and 59% for invasive fungal infections) was poor, unless oral formulation guidelines recommended a 200 mg dose, the most commonly prescribed dose (56% of prescriptions). Plasma voriconazole concentrations were obtained for 82% (90/110) of courses [median of 3 (range: 1-27) obtained per course]. A minority (27%) of plasma concentrations were trough concentrations [median concentration: 1.5 mg/L (range: <0.1 to >5.0 mg/L)]. Of trough concentrations, 57% (58/101) were therapeutic, 37% (37/101) were subtherapeutic and 6% (6/101) were supratherapeutic. The dose-prediction software performed well, with acceptable bias and precision of 0.09 mg/L (95% CI -0.08 to 0.27) and 1.32 (mg/L)2 (95% CI 0.96-1.67), respectively. Voriconazole dosing was suboptimal based on published guidelines and TDM results. Dose-prediction software could enhance TDM-guided therapy.

Missing data in cross-sectional networks – An extensive comparison of missing data treatment methods

This paper compares several missing data treatment methods for missing network data on a diverse set of simulated networks under several missing data mechanisms. We focus the comparison on three different outcomes: descriptive statistics, link reconstruction, and model parameters. The results indicate that the often used methods (analysis of available cases and null-tie imputation) lead to considerable bias on descriptive statistics with moderate or large proportions of missing data. Multiple imputation using sophisticated imputation models based on exponential random graph models (ERGMs) lead to acceptable biases in descriptive statistics and model parameters even under large amounts of missing data. For link reconstruction multiple imputation by simple ERGM performed well on small data sets, while missing data was more accurately imputed in larger data sets with multiple imputation by complex Bayesian ERGMs (BERGMs).

Left Ventricular End Diastolic Volume and Ejection Fraction Calculation: Correlation between Three Echocardiographic Methods.

Background Left ventricular ejection fraction (LVEF) and end diastolic volume (EDV) are measured using Simpson's biplane (SB), 3-dimensional method (3DE), and speckle tracking (STE). Comparisons between methods in routine practice are limited. Our purpose was to compare and to determine the correlations between these three methods in clinical setting. Methods LVEF and EDV were measured by three methods in 474 consecutive patients and compared using multiple Bland–Altman (BA) plots. The correlations (R) between methods were calculated. Results Median (IQR) LVEF_SB, LVEF_STE, and LVEF_3DE were 63.0% (60–69)%, 61% (57–65)%, and 62% (57–68)%. Median (IQR) EDV_SB, EDV_STE, and EDV_3DE were 85 ml (71–106) ml, 82 ml (69–100) ml, and 73 ml (59–89) ml. R between LVEF_SB and LVEF_3DE was 0.65 when echogenicity was good and 0.43 when poor. R for EDV_SB and EDV_3DE was 0.75 when echogenicity was good and 0.45 when poor. On BA analysis, biases were acceptable (<3.5% for LVEF) but limits of agreement (LOA) were large: 95% of the differences were between −15.4% and +18.8% for LVEF as evaluated by SB in comparison with 3DE, with a bias of 1.7%. In the comparison EDV_SB and EDV_3DE, the bias was 14 ml and the LOA were between −24 ml and +53 ml. On linear regressions, LVEF_3DE = 17.92 + 0.69 LVEF_SB and EDV_3DE = 18.94 + 0.63 EDV_SB. Conclusions The three methods were feasible and led to acceptable bias but large LOA. Although these methods are not interchangeable, our results allow 3DE value prediction from SB, the most commonly used method.

Quantification of Furanylfentanyl and its Metabolites in Human and Rat Plasma Using LC-MS-MS.

Fentanyl analogs (novel and traditional) continue to impact the ever-growing opioid epidemic. Furanylfentanyl (FuF) is one analog equipotent to fentanyl that has documented involvement in thousands of intoxication and fatality cases around the world. Due to its prevalence, toxicologists need to improve detection and understanding of this analog. A method for the quantification of FuF and its metabolites (4-ANPP, furanyl norfentanyl (FuNorF)) in a small volume (100μL) of human plasma by LC-MS-MS was developed and validated according to ANSI/ASB Standard. The method was cross validated in rat plasma for a future pharmacokinetic (PK)/pharmacodynamic (PD) study. In human plasma, calibration ranges were 0.025-25ng/mL (FuF and 4-ANPP) and 0.5-25ng/mL (FuNorF). Limits of detection were 0.0125ng/mL (FuF and 4-ANPP) and 0.25ng/mL (FuNorF). Lower limits of quantification coincided with lowest calibrator concentrations of 0.025ng/mL (FuF and 4-ANPP) and 0.5ng/mL (FuNorF). Precision and bias values were determined to be acceptable for all analytes. Matrix effects were acceptable for all analytes (-8.6-25.0%), except FuNorF with suppression >25%. Extraction recoveries ranged from 84.5 to 98.1%. No carryover or endogenous interferences were observed. Qualitative interferences with 4-ANPP were observed from some n-acyl substituted fentanyl analogs predicted to be low-concentration standard impurities. Analytes were stable under all conditions and dilution integrity was sustained. The method was successfully cross validated in rat plasma with acceptable bias (-7.4-8.4%), precision (within-run<19%CV and between-run<12.6%CV), matrix effects (-9.3-17.2%, except FuNorF with >25% suppression), recoveries (79.2-94.5%) and dilution integrity (1/2 and 1/10).

Comparative evaluation of urinary dipstick and pH-meter for cattle urine pH measurement

Urinary dipsticks are often used for the diagnosis of kidney, liver, metabolic, and urogenital diseases in cattle clinical practice for the simplicity of use and ease of access. The aims of the present study were to evaluate the agreement between urinary dipsticks and pH-meter for the urine pH in dairy cattle, and also to compare the urine pH before and after centrifugation from each method. The agreement between urine dipstick and pH-meter methods before and after centrifuge were calculated by Passing-Bablok regression analysis demonstrated constant differences (intercept) at 0.60 and -1.01 and positive proportional differences (slope) at 0.94 and 1.13; respectively. Total bias estimated by Bland-Altman plot analysis before (0.20) and after (0.14) centrifuge were lower than the acceptable bias in urine samples. The regression analysis of this study emphasized that the urinary dipstick can be used to determine the cattle urine.

Using Data from Randomized Trials to Assess the Likely Generalizability of Educational Treatment-Effect Estimates from Regression Discontinuity Designs

This article assesses the likely generalizability of educational treatment-effect estimates from regression discontinuity designs (RDDs) when treatment assignment is based on academic pretest scores. Our assessment uses data on outcome and pretest measures from six educational experiments, ranging from preschool through high school, to estimate RDD generalization bias. We then compare those estimates (reported as standardized effect sizes) with the What Works Clearinghouse (WWC) standard for acceptable bias size (≤ 0.05 for two target populations, one spanning a half–standard deviation pretest-score range and another spanning a full–standard deviation pretest-score range. Our results meet this standard for all 18 study/outcome/pretest scenarios examined given the narrower target population, and for 15 scenarios given the broader target population. Fortunately, two of the three exceptions represent pronounced “ceiling effects” that can be identified empirically, making it possible to avoid unwarranted RDD generalizations, and the third exception is very close to the WWC standard.

Submaximal Exercise Testing in Cardiovascular Rehabilitation Settings (BEST Study).

BackgroundThis study compared changes in measured versus predicted peak aerobic power (V̇O2peak) following cardiovascular rehabilitation (CR). Peak cardiopulmonary exercise testing (CPET) results were compared to four V̇O2peak estimation methods: the submaximal modified Bruce treadmill, Astrand-Ryhming cycle ergometer, and Chester step tests, and the Duke Activity Status Index (DASI).MethodsAdults with cardiovascular disease (CVD) who completed a 12-week CR program were assessed at baseline and 12 weeks follow-up. CPET, the DASI and three subsequent submaximal exercise tests were performed in a random order.ResultsOf the 50 adults (age: 57 ± 11 years) who participated, 46 completed the 12-week CR program and exercise tests. At baseline 69, 68, and 38% of the treadmill, step and cycle tests were successfully completed, respectively. At follow-up 67, 80, and 46% of the treadmill, step and cycle tests were successfully completed, respectively. No severe adverse events occurred. Significant improvements in V̇O2peak were observed with CPET (3.6 ± 5.5 mL.kg–1.min–1, p < 0.001) and the DASI (2.3 ± 4.2 mL.kg–1.min–1, p < 0.001). Bland-Altman plots of the change in V̇O2peak between CPET and the four V̇O2peak estimation methods revealed the following: a proportional bias and heteroscedastic 95% limits of agreement (95% LoA) for the treadmill test, and for the cycle and step tests and DASI, mean bias’ and 95% LoA of 1.0 mL.kg–1.min–1 (21.3, −19.3), 1.4 mL.kg–1.min–1 (15.0, −12.3) and 1.0 mL.kg–1.min–1 (13.8, −11.8), respectively.ConclusionGiven the greater number of successful tests, no serious adverse events and acceptable mean bias, the step test appears to be a valid and safe method for assessing group-level mean changes in V̇O2peak among patients in CR. The DASI also appears to be a valid and practical questionnaire. Wide limits of agreement, however, limit their use to predict individual-level changes.

Towards Criteria Characterizing the Metrological Performance of Full-field Measurement Techniques

Users of full-field measurement methods like Digital Image Correlation (DIC) often aim to perform measurements with the best trade-off between spatial resolution, bias and measurement resolution. Whenever two full-field methods are compared, it is essential that these criteria are taken into consideration. Recently a metrological efficiency indicator for full-field measurements has been proposed and discussed. This indicator combines measurement resolution and spatial resolution. It has been shown to be invariant to the subset size in the case of Local DIC. The goal of this article is to discuss a method, which determines both the spatial and the measurement resolutions for a given bias for two different DIC methods, in order to obtain the metrological efficiency indicator for each of these methods. The benefit of this indicator is that it does not depend on setting parameters such as the subset size, which are chosen by the user. As such, it can be considered as intrinsic to each technique, thus enabling fair comparison. Local DIC and triangular finite element based Global DIC will be the subject of this investigation. With this setting, their respective subset and triangular element sizes will be related to the spatial resolution of both methods for a given acceptable bias. By using the metrological efficiency indicator, the performance of the two methods will be compared and discussed to a new level of detail. Generally speaking, the indicator shows that the metrological performance of both methods is similar, confirming their popularity. However, it will be shown that, depending on the choice of what an acceptable bias is, one of the method may be preferred to another. The results show that for the specific DIC versions used in the study, for cases for which a significant bias is acceptable, Local DIC outperforms Global DIC, while the opposite is true in the case for which the bias requirements are more stringent. Finally, the quadratic versions of both DIC versions are shown to significantly outperform their respective linear versions.

Clinical Reliability of point-of-care tests to support community based acute ambulatory care

Objective: To ensure clinicians can rely on point-of-care testing results, we assessed agreement between point-of-care tests for creatinine, urea, sodium, potassium, calcium, Hb, INR, CRP and subsequent corresponding laboratory tests. Participants: Community-dwelling adults referred to a community-based acute ambulatory care unit. Interventions: The Abbott i-STATTM (Hb, clinical chemistry, INR) and the AfinionTM Analyser (CRP) and corresponding laboratory analyses. Outcomes: Agreement (Bland-Altman) and bias (Passing-Bablok regression). Results: Among 462 adults we found an absolute mean difference between point-of-care and central laboratory analyses of 6.4g/L (95%LOA -7.9 to +20.6) for haemoglobin, -0.5mmol/L (95%LOA -4.5 to +3.5) for sodium, 0.2mmol/L (95%LOA -0.6 to +0.9) for potassium, 0.0mmol/L (95%LOA -0.3 to +0.3) for calcium, 9.0 μmol/L (95%LOA -18.5 to +36.4) for creatinine, 0.0mmol/L (95%LOA -2.7 to +2.6) for urea, -0.2 (95%LOA -2.4 to +2.0) for INR, -5.0 mg/L (95%LOA -24.4 to +14.4) for CRP. Conclusions: There was acceptable agreement and bias for these analytes, except for haemoglobin and creatinine.

Heart Rate Thresholds to Limit Activity in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients (Pacing): Comparison of Heart Rate Formulae and Measurements of the Heart Rate at the Lactic Acidosis Threshold during Cardiopulmonary Exercise Testing

Introduction: Based on the hypothesis that oxidative metabolism is impaired in ME/CFS, a previous study recommended a pacing self-management strategy to prevent post-exertional malaise. This strategy involved a prescription to maintain a heart rate below the anaerobic threshold during physical activities. In the absence of lactate sampling or a cardiopulmonary exercise test (CPET), the pacing self-management formula defines 55% of the age-specific predicted maximal heart rate as the heart rate at the anaerobic threshold. Thus far there has been no empiric evidence to test this self-pacing method of predicting heart rate at anaerobic threshold. The aim of this study was to compare published formula-derived heart rates at the anaerobic threshold with the actual heart rate at the lactic acidosis threshold as determined by CPET. Methods and Results: Adults with ME/CFS who had undergone a symptom-limited CPET were eligible for this study (30 males, 60 females). We analysed males and females separately because of sex-based differences in peak oxygen consumption. From a review paper, formulae to calculate maximal predicted heart rate were used for healthy subjects. We compared the actual heart rate at the lactic acid threshold during CPET to the predicted heart rates determined by formulae. Using Bland-Altman plots, calculated bias: the mean difference between the actual CPET heart rate at the anaerobic threshold and the formula predicted heart rate across several formulae varied between -28 and 19 bpm in male ME/CFS patients. Even in formulae with a clinically acceptable bias, the limits of agreement (mean bias ± 2SD) were unacceptably high for all formulae. For female ME/CFS patients, bias varied between 6 and 23 bpm, but the limits of agreement were also unacceptably high for all formulae. Conclusion: Formulae generated in an attempt to help those with ME/CFS exercise below the anaerobic threshold do not reliably predict actual heart rates at the lactic acidosis threshold as measured by a cardiopulmonary exercise test. Formulae based on age-dependent predicted peak heart rate multiplied by 55% have a wide age-specific variability and therefore have a limited application in clinical practice.

Assessment of survey protocol for estimates of abundance for elusive nocturnal primates

Abstract ContextEstimates of a species abundance and habitat preferences provide vital information on their status and the appropriate conservation management. For nocturnal arboreal primates, obtaining reliable estimates of these parameters is particularly challenging because of their cryptic behaviour, often resulting in a small number of detections. Although techniques are available for assessing the abundance of species with a low probability of detection, most require strict assumptions that are difficult to meet. AimsHere, we aimed to explore the possibility of improving nocturnal-primate abundance estimates when detection probability is low and to determine the minimal effort required to calculate reasonable estimates of their overall abundance and the effect of habitat type on abundance estimates. MethodsWe used count data obtained from spotlighting along line transects for estimating density of Bengal slow loris (Nycticebus bengalensis) in north-eastern Thailand with N-mixture hierarchical modelling, to run simulations of varying survey parameters and asses the effort needed to produce robust estimates based on the relative bias from each simulation. Key resultsN-mixture analysis showed that the data obtained from our study were still biased (9%), with a lambda of 1.79 lorises, detection probability of 0.11, 50 survey sites and a maximum of 12 sample occasions. The simulation results found that increasing the number of sample occasions to 14 per transect would produce an acceptable bias (&amp;lt;5%). ConclusionsWe recommend that future studies on nocturnal arboreal species should use preliminary surveys to gauge the specific lambda and probability of detection so as to establish the effort needed to produce reasonable estimates of abundance. ImplicationsOur study showed that count data obtained from spotlighting can be used to produce robust abundance estimates of nocturnal arboreal species. Unlike simple encounter rate, this method incorporates detection probability and habitat preferences, yet does not require additional trained field technicians.

Climatic projections of heating season in Ukraine up to the middle of the 21st century

The paper presents projections for the balanced scenario A1B of specialized climatic indicators of the heating period for the territory of Ukraine for decades until the middle of the 21st century. Prediction of mean temperature, duration and heating degree-days are based on calculations of the previously formed and adapted to Ukraine ensemble of 10 regional climate models from the European project ENSEMBLES. The main and specialized climatic indicators calculated on all nodes of a regular grid of 25×25 km were verified by E-Obs data for the period 2001―2010. A negligible bias in the heating period mean temperature (in average less than 0.01°C) and an acceptable bias in duration (with a mean value of less than 6,4 days or <4 %) were found in the verification that resulted in obtaining an average bias in heating degree-days by about 4 %. Forecasting of specialized indicators of the heating season for future periods was performed with corresponding bias corrections. The spatial and temporal changes of heating period indices for the decades to the middle of the 21st century have been analyzed and averaging values for administrative units of Ukraine have been calculated. Obtained insignificant, within the limits of 0―0,2 °С , increase of the mean heating period temperature for most of the country in the modern decade of 2011―2020 in relation to the base period of 2001―2010, reducing the heating period duration by an average of 3 days and reducing values of heating degree-days by 2―3 %. By the middle of the 21st century the mean heating period temperature will increase significantly with maximum values of 1,5 °С in the northeastern, central and eastern parts of the country, and the least increasing of 0,8 °С to the south, southwest and the Crimea. The heating period duration will be reduced by 15―18 days in average, with a maximum of 20 days to the south. The values of heating degree-days will decrease in most areas by 12―16 %, with maximum by 20 % in the Crimea, and the minimum reduction by 9―12 % in the Carpathians. Results obtained in the study may be used, primarily, for the calculation of heating costs and other needs of the energy sector and other national economy sectors for the overall development of infrastructure and other needs of any settlement in the territory of Ukraine.