Altman Method Research Articles

Can Visual Acuity Be Reliably Measured at Home? Validation of Telemedicine Remote Computerised Visual Acuity Measurements.

Purpose:The recent pandemic has identified the need for telemedicine assessment of ophthalmology patients. A vital component of such assessment is visual acuity (VA) measurement. The aim of this study was to determine the feasibility and reliability of computerised ‘at home’ VA measurements using COMPlog software.Methods:A Bland Altman method comparison study of worse eye ‘in clinic’ and ‘at home’ orthoptist-supervised COMPlog computerised VA measurements. Subjects underwent gold standard semi-automated computerised test and retest logMAR VA measurements on their habitually corrected worse eye both ‘in clinic’ and ‘at home.’ The orthoptist ran the test from the eye clinic with the patient viewing a secondary PC monitor either in the same clinic room or at home. A screen sharing voice and video conferencing application and standard consumer IT hardware were employed to present the test optotypes in the patient’s home.Results:23 paediatric and 13 adult patients with a range of ocular diseases and worse eye visual acuities were included (range –0.14 to 1.06 logMAR). No significant bias was found between ‘in clinic’ and ‘at home’ measurements (mean –0.01 logMAR and 95% confidence interval –0.03, 0.00 logMAR). Test-retest variability of ‘in clinic,’ ‘at home’ and ‘in clinic’ versus ‘at home’ measurements were within normal reported ranges at 0.12 logMAR (6 ETDRS letters) or less.Conclusion:Remote home VA testing performed by an eye care professional using a semi-automated VA measurement program and video conferencing application provided unbiased measurements with acceptable test-retest reliability. Home testing was both feasible and acceptably reliable in appropriately equipped patients.

Agreement between invasive and oscillometric arterial blood pressure measurement using a high-definition oscillometric device in normotensive New Zealand White rabbits using two different anaesthetic protocols

ObjectiveTo use American College of Veterinary Internal Medicine (ACVIM) criteria to evaluate a high-definition oscillometric (HDO) blood pressure monitoring device versus invasive blood pressure (IBP) measurement in normotensive rabbits anaesthetized with two different anaesthetic protocols. Study designProspective experimental study. AnimalsA group of 20 healthy adult New Zealand White rabbits weighing 4.36 ± 0.37 kg (mean ± standard deviation). Materials and methodsRabbits were premedicated with butorphanol 0.5 mg kg–1 and midazolam 0.5 mg kg–1 subcutaneously (SC, group BMA) or ketamine 25 mg kg–1 and medetomidine 0.4 mg kg–1 SC (group KM). Anaesthesia was induced with alfaxalone administered intravenously (group BMA) or isoflurane by face mask (group KM) and maintained with isoflurane in oxygen. IBP was measured from the central auricular artery. The cuff for the HDO monitor was placed distal to the left elbow and distal to the left tarsus. Agreement between invasive and HDO measurements was evaluated using Bland–Altman method. ResultsIn group KM there was better agreement between the HDO device and IBP when the cuff was placed on the thoracic limb, with 100% and 91% of the readings for mean (MAP) and diastolic arterial pressure (DAP), respectively, within 10 mmHg of the IBP measurements. The agreement, although worse, also met the ACVIM criteria for systolic arterial pressure (SAP; 53% of the readings within 10 mmHg). In group BMA, the device met the criteria with the cuff on the thoracic limb only, and only for MAP and DAP (73% and 75% of the measurements within 10 mmHg of the IBP, respectively) but not for SAP (12%). Conclusion and clinical relevanceThe HDO device met most of the ACVIM criteria for noninvasive blood pressure measurement in anaesthetized rabbits, specifically when the cuff was placed distal to the elbow and the anaesthetic protocol included ketamine and medetomidine.

Variability of three activated clotting time point-of-care systems in cardiac surgery: reinforcing available evidence

Cardiac surgery with extracorporeal circulation (ECC) requires the administration of anticoagulant drugs to maintain ACT ranges 400-600 seconds, which requires exhaustive coagulation monitoring for which various point-of-care devices are available. However, there is variability between them, so we aimed to compare the values in ACT measurement. Simultaneous ACT measurements were performed with the Hemochron Response®, Hemostasis Management System Plus® (HMS Plus®) and Hemochron Signature® systems. A total of 255 simultaneous measurements were taken, the mean and standard deviation (SD) of each device were: Hemochron Signature® 361.1 seconds (SD: 156.9), HMS Plus® 412.8 seconds (SD: 180.9) and Hemochron Response® 422.8 seconds (SD: 187.9), being these differences statistically significant (Fridman's test p < 0.01). For comparisons the Bland-Altman method was used, resulting the Hemochron Response® has 61.7 seconds higher mean values than the Hemochron Signature®, the Hemochron Response® 10 seconds higher than the HMS Plus® and the HMS Plus® 51.7 seconds higher than the Hemochron Signature®. The differences found in comparisons are considered to be clinically relevant, which is why it is considered important to make the variability of the different monitoring systems known and to take them into account for optimal control of this parameter and its clinical repercussions.

A bioimpedance spectroscopy technique to monitor bioprocess involving complex growth micro-organisms

Although analytical methods (often offline) are considered as references (gold standards) for monitoring industrial bioprocesses, real-time monitoring (online) is always preferable for maximizing such processes. However, many of the real-time methods that measure total cell concentration cannot distinguish living micro-organisms from the dead ones or even other materials. Moreover, some real-time methods also lead to possible wrong results when the micro-organism involved in the bioprocess exhibits significant metabolic, physiological, and kinetic changes as it grows. This study presents a real-time technique intended to monitor this class of micro-organisms and that is based on an alternative method of bioimpedance spectroscopy. The feasibility of the proposed technique was evaluated during bacterial growth experiments using the bacteria Bacillus thuringiensis var. israelensis (Bti) with initial inocula of 5%, 10%, and 15% (v/v on 220 ml). Each growth experiment was monitored every hour over 18 h by the proposed technique and by a classical offline method (McFarland method). The results of monitoring the studied bioprocess by both methods exhibited an average Pearson correlation coefficient (r̄) of above 0.9 and good agreement when the Bland–Altman method was used to compare them.

ANALISIS FINANCIAL DISTRESS BANK UMUM MILIK NEGARA (BUMN) MASA PANDEMI COVID 19

The purpose of this study was to analyze financial distress using the Altman (Z-Score) method at Bank Umum Milik Negara (BUMN) during pandemin Covid 19. The results showed that PT. BRI (Persero) Tbk with a condition that is not financial distress in years 2015 and 2016. In years 2017, 2018 and 2019 included in the gray area. PT. BNI 46 (Persero) Tbk in years 2015 meaning is not financial distress. Years 2016, 2017, 2018 and 2019 this means it is included in the gray area. PT. Bank Mandiri (Persero) Tbk, in year 2015, 2016, 2017, 2018 and 2019 it is included in a gray area. PT. BTN (Persero) Tbk in year 2015 included in the gray area, years 2016, 2017, 2018, 2019 this shows that PT. BTN (Persero) Tbk expriencing financial distress

Measurement of body composition: Agreement between methods of measurement by bioimpedance and computed tomography in patients with non-small cell lung cancer.

Cancer cachexia is a muscle wasting syndrome which is promoted by the presence of inflammation and metabolic changes. Cancer cachexia has shown predictable for survival, progression of physical impairment as well as patient-reported outcomes. Being able to identify these patients with a clinically applicable method for measuring body composition could lead to early nutritional intervention, possibly preventing progression of cancer cachexia. This study aimed to investigate the agreement between body composition recorded with bioelectrical impedance analysis (BIA) and software analysis of CT scans of patients suffering from cancer with a special emphasis on muscle mass. This is a cross-sectional study of newly diagnosed patients with non-small cell lung cancer. All patients had muscle mass (MM) and fat mass (FM) measured by BIA with Tanita Segmental Body Composition Analyzer (BC-418) and by software analysis of CT scans at L3-level with VikingSlice. Secondary parameters (systemic inflammation, physical performance and electrolyte balance) were investigated for possible pitfalls of BIA. Patients who fulfilled best standard practice for BIA measurements, including 4h of fasting, absence of oedema and no metallic implants, participated in a subgroup analysis. Agreement between method of measurements is investigated with the Bland and Altman method and pitfalls with paired t-test. A satisfactory agreement of BIA and CT measurements is established as ±10%. A total of 60 patients participated in the study amongst which 37 participated in the subgroup analysis. The bias between methods of measurement for MM was 4.74±11.55% (P=0.002) with limits of agreement (LoA) of-17.91 to 27.38%. In the subgroup analysis, the bias of MM was 3.06±10.71% (P=0.091) and LoA were-17.94 to 24.06%. In the analysis of secondary parameters, significant differences between methods were found in patients with normal hand grip strength (1.83kg, P=0.023) and those performing under gender and age-specific cut-offs in the 30-s sit to stand test (5.15kg, P=0.009). BIA and CT image analysis were not comparable for body composition measurements. BIA overestimated MM and underestimated FM with LoA outside that of the clinically assessed acceptable difference. Bias was reduced and LoA narrowed in the subgroup analysis however not to acceptable levels. This study finds it possible that patients with low physical performance are liable to larger overestimations of MM with BIA than those with normal physical performance.

Validity and reliability of the RAC adult infection risk scale: A new instrument to measure healthcare‐associated infection risk

Healthcare-associated infections represent a public health problem, and they have repercussions for patient safety. The aim of this study was to determine the psychometric properties of the Rodríguez-Almeida-Cañon (RAC) adult infection risk scale, focusing on the construct and predictive validity and reliability. The study enrolled 278 patients at a large hospital in southern Brazil. The research process involved the following three phases: construct validation, assessing predictive validity, and assessing reliability. Confirmatory factor analysis showed a good fit using a two-factor model with 15 items. The logistic regression analysis showed an association between the scale score and prediction of developing healthcare-associated infections (odds ratio: 1.18; 95% confidence interval: 1.08-1.28). The Cronbach's alpha was 0.72 for intrinsic factors subscale and 0.71 for extrinsic factors subscale. A high level of inter-rater agreement (intraclass correlation coefficient ≥0.97) was found for both subscales. The Bland and Altman method showed narrow agreement limits, demonstrating good agreement between evaluators. The findings of this study showed that the RAC adult infection risk scale is a new, reliable, and psychometrically valid instrument to assess healthcare-associated infections risk. Future research using this scale may lead to a better understanding of the healthcare-associated infections risk and assist health professionals in decision-making for interventions to improve patient safety.

Agreement between wireless and standard measurements of vital signs in acute exacerbation of chronic obstructive pulmonary disease: a clinical validation study

Objective. Wireless sensors for continuous monitoring of vital signs have potential to improve patient care by earlier detection of deterioration in general ward patients. We aimed to assess agreement between wireless and standard (wired) monitoring devices in patients hospitalized with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Approach. Paired measurements of vital signs were recorded with 15 min intervals for two hours. The primary outcome was agreement between wireless and standard monitor measurements using the Bland and Altman method to calculate bias with 95% limits of agreement (LoA). We considered LoA of less than ±5 beats min−1 (bpm) acceptable for heart rate (HR), whereas agreement of peripheral oxygen saturation (SpO2), respiratory rate (RR), and blood pressure (BP) were acceptable if within ±3%-points, ±3 breaths min−1 (brpm), and ±10 mmHg, respectively. Main results. 180 sample-pairs of vital signs from 20 with AECOPD patients were recorded for comparison. The wireless versus standard monitor bias was 0.03 (LoA −3.2 to 3.3) bpm for HR measurements, 1.4% (LoA −0.7% to 3.6%) for SpO2, −7.8 (LoA −22.3 to 6.8) mmHg for systolic BP and −6.2 (LoA −16.8 to 4.5) mmHg for diastolic BP. The wireless versus standard monitor bias for RR measurements was 0.75 (LoA −6.1 to 7.6) brpm. Significance. Commercially available wireless monitors could accurately measure HR in patients admitted with AECOPD compared to standard wired monitoring. Agreement for SpO2 were borderline acceptable while agreement for RR and BP should be interpreted with caution.

Analysis Application of Altman (Z-Score) Method and Springate (S-Score) Method to Assess Financial Distress Potential at PT Anugerah

The emergence of potential financial distress is an early indication of a decline in the company's financial condition. The purpose of this research is to determine the potential of financial distress at PT Anugerah, so that it will help management anticipate the potential financial distress in the company. In this research, the assessment of financial distress potential uses the Altman (Z-score) method and Springate (S-score) method. The type of data in this research is quantitative and qualitative sourced from secondary data and obtained through interviews, documentation, and observation. The data analysis technique used is a qualitative/descriptive analysis technique. The results of research study are the financial distress potential of PT Anugerah by using the Altman (Z-score) method in 2016-2019 shows PT Anugerah is in a non-financial distress condition, because the score is in the condition of Z’’&gt; 2.6. Furthermore, PT Anugerah financial distress potential using the Springate (S-score) method in 2016-2019 shows that PT Anugerah is in a non-financial distress condition, because the score is at S &gt; 0.862.

Aplikasi Kebangkrutan dengan Menggunakan Metode Altman Z-Score (Studi pada PT Jaya Agra Wattie Tbk Periode 2010-2019)

This research aim is to know the condition of the finance in PT Jaya Agra Wattie Tbk on 2010 – 2018. This research is used by the Altman Method. This method usually use for bankrupt analysis. After finishing the research, the company will able to know the condition of the finance and also will make the right policy. Also, it has known the condition of company finance in the beginning and be able to anticipate a finance problem which will happen in the future. It is used the secondary data which is a finance report of PT Jaya Agra Wattie. The data is taken from the official website of the company in 2010 – 2018. The result of this research shows that PT Jaya Agra Wattie is in the bankrupt condition (grey area) in 2010 to 2012 because of the result of the Zero Score has showed in between 2.6 to 1.11. So, it has the average Zero score 2.519153. Meanwhile, in 2013 to 2018 the finance of the company has in the low condition that has the average Zero Score -0.41076. The score has in bankrupt area (financial distress) with the clarification Zero Score in the low of 1.11.

Mean Absolute Relative Difference of Blood Glucose Monitoring Systems and Relationship to ISO 15197.

The analytical quality of a blood glucose monitoring system (BGMS) is often assessed according to the requirements described in the international standard ISO 15197. However, the mean absolute relative difference (MARD) is sometimes used as well. This analysis aims at providing empirical data from BGMS evaluation studies conducted according to ISO 15197 and at providing an estimation of how MARD and percentage of measurement results within ISO accuracy limits are related. Results of 77 system accuracy evaluations conducted according to ISO 15197 were used to calculate MARD between BGMS and a laboratory comparison method's results (glucose oxidase or hexokinase method). Additionally, bias and 95%-limits of agreement (LoA) using the Bland and Altman method were calculated. MARD results ranged from 2.3% to 20.5%. The lowest MARD of a test strip lot that showed <95% of results within ISO limits was 6.1%. The distribution of MARD results shows that only 3.6% of test strip lots with a MARD equal to or below 7% showed <95% of results within ISO limits (2.2% of all test strip lots). Bias of test strip lots that showed ≥95% of results within the limits ranged from -10.3% to +7.4%. The half-width of the 95%-LoA of test strip lots that showed ≥95% of results within the limits ranged from 4.8% to 24.0%. There is a threshold MARD that may allow an estimate whether ISO 15197 requirements are fulfilled, but this statement cannot be made with certainty.

The Role of Rotation Type used to Extract Dietary Patterns through Principal Component Analysis, on their Short-Term Repeatability

Principal components analysis (PCA) is a widely used technique in nutritional epidemiology, to extract dietary patterns. To improve the interpretation of the derived patterns, it has been suggested to rotate the axes defined by PCA. This study aimed to evaluate whether rotation inuences the repeatability of these patterns. For this reason PCA was applied in nutrient data of 500 participants (37 ± 15 years, 38% male) who were voluntarily enrolled in the study and asked to complete a semi-quantitative food frequency questionnaire (FFQ), twice within 15 days. The varimax and the quartimax orthogonal rotation methods, as well as the non-orthogonal promax and the oblimin methods were applied. The degree of agreement between the similar extracted patterns by each rotation method was assessed using the Bland and Altman method and Kendall's tau-b coefficient. Good agreement was observed between the two administrations of the FFQ for the un-rotated components, while low-to-moderate agreement was observed for all rotation types (the quartimax and the oblimin method lead to more repeatable results). To conclude, when rotation is needed to improve food patterns' interpretation, the quartimax and the oblimin methods seems to produce more robust results.

Validity and reliability of the French version of the Pediatric Quality of Life Inventory™ brain tumor module.

Assessing health-related quality of life (HRQoL) is an increasingly important aspect of standard care in pediatric oncology. Currently, there is a gap in the availability of French questionnaires to assess the quality of life of French-speaking pediatric brain tumor (PBT) patients, which has important implications in the care of this population. The first aim of this study was to translate the original English Pediatric Quality of Life Inventory™ (PedsQL) brain tumor module version into French. The second aim was to describe the stability, repeatability and convergent validity of the French PedsQL brain tumor module. A total of 61 PBT patients were included in this study. Among them, 15 children and 20 parents participated in the translation process. As part of the validation study, 48 children and 48 parents answered the PedsQL brain tumor module twice, and the PedsQL generic core scales and the patient-reported outcomes measurement information system (PROMIS-37 pediatric profile v2.0) questionnaire were administered once to the participants. The mean age of the 25 boys and 23 girls was 8.3 ± 4.8years. For temporal stability, we used intraclass correlation coefficients (ICCs), for repeatability, we used the Bland and Altman method to assess the accuracy at a 1-week interval, and we used Pearson's correlation coefficients for convergent validity between the PedsQL brain tumor module, PedsQL general module and the PROMIS. Temporal stability for the parent proxy-reports (average ICC = 0.98) and the child self-reports (average ICC = 0.98) were excellent. There was a high absolute stability over a 1-week interval for the parent proxy-reports (ICC > 0.96) and child self-reports (ICC > 0.96). Convergent validity between parent proxy-reports and child self-reports was supported by positive correlations for five subscales. Children reported higher scores in cognitive problems and the movement and balance parameters than their parents and reported lower scores on the worry parameter than their parents. The strong psychometric properties of the French version of the PedsQL brain tumor module indicate that it is a validate and reliable questionnaire to measure HRQoL in PBT patients. The availability of a French version of the PedsQL brain tumor module supports the wider dissemination of the assessment of HRQOL in PBT patients.

Estimation of cardiac output variations induced by hemodynamic interventions using multi-beat analysis of arterial waveform: a comparative off-line study with transesophageal Doppler method during non-cardiac surgery

Multi-beat analysis (MBA) of the radial arterial pressure (AP) waveform is a new method that may improve cardiac output (CO) estimation via modelling of the confounding arterial wave reflection. We evaluated the precision and accuracy using the trending ability of the MBA method to estimate absolute CO and variations (ΔCO) during hemodynamic challenges. We reviewed the hemodynamic challenges (fluid challenge or vasopressors) performed when intra-operative hypotension occurred during non-cardiac surgery. The CO was calculated offline using transesophageal Doppler (TED) waveform (COTED) or via application of the MBA algorithm onto the AP waveform (COMBA) before and after hemodynamic challenges. We evaluated the precision and the accuracy according to the Bland & Altman method. We also assessed the trending ability of the MBA by evaluating the percentage of concordance with 15% exclusion zone between ΔCOMBA and ΔCOTED. A non-inferiority margin was set at 87.5%. Among the 58 patients included, 23 (40%) received at least 1 fluid challenge, and 46 (81%) received at least 1 bolus of vasopressors. Before treatment, the COTED was 5.3 (IQR [4.1–8.1]) l min−1, and the COMBA was 4.1 (IQR [3–5.4]) l min−1. The agreement between COTED and COMBA was poor with a 70% percentage error. The bias and lower and upper limits of agreement between COTED and COMBA were 0.9 (CI95 = 0.82 to 1.07) l min−1, −2.8 (CI95 = −2.71 to−2.96) l min−1 and 4.7 (CI95 = 4.61 to 4.86) l min−1, respectively. After hemodynamic challenge, the percentage of concordance (PC) with 15% exclusion zone for ΔCO was 93 (CI97.5 = 90 to 97)%. In this retrospective offline analysis, the accuracy, limits of agreements and percentage error between TED and MBA for the absolute estimation of CO were poor, but the MBA could adequately track induced CO variations measured by TED. The MBA needs further evaluation in prospective studies to confirm those results in clinical practice conditions.

Agreement and reliability of the Feline Grimace Scale among cat owners, veterinarians, veterinary students and nurses

This study aimed to evaluate the agreement and reliability of the Feline Grimace Scale (FGS) among cat owners, veterinarians, veterinary students and nurses/technicians. Raters (n = 5/group) scored 100 images using the FGS (ear position, orbital tightening, muzzle tension, whiskers position and head position). Intra-class correlation coefficients (ICC) were used to assess inter- and intra-rater reliability. Agreement between each group and the veterinarian group (gold-standard) was calculated using the Bland–Altman method. Effects of gender, age and number of cats owned on FGS scores were assessed using linear mixed models. Inter-rater reliability was good for FGS final scores (ICC > 0.8). The muzzle and whiskers yielded lower reliability (ICC = 0.39 to 0.74). Intra-rater reliability was excellent for students and veterinarians (ICC = 0.91), and good for owners and nurses (ICC = 0.87 and 0.81, respectively). A very good agreement between all groups and veterinarians (bias < 0.1 and narrow limits of agreement) was observed. Female raters assigned higher FGS scores than males (p = 0.006); however, male raters were underrepresented in this study. Scores were not affected by age or number of cats owned. The FGS is reliable for feline acute pain assessment when used by individuals with different experience.

Measuring liveweight changes in lactating dairy ewes with an automated walk-over-weighing system

Monitoring liveweight (LW) is an important part of sound management practices at the individual and flock level (e.g., controlling for nutritional status based on body condition, reproduction, and health-related issues), but it is time consuming and stressful. To our knowledge, no literature has reported on the evaluation of automated weighing systems in dairy sheep as an alternative to conventional static scales. The objective of this research was to evaluate the practical feasibility of using an automated walk-over-weighing (WoW) prototype to measure daily LW changes in dairy ewes without human intervention. We used adult Lacaune dairy ewes in 2 complementary trials conducted indoors. Trial 1 aimed at evaluating the repeatability, precision, and accuracy of LW measures recorded using WoW scales compared with a static scale (the gold standard). Forty-two adult ewes (LW ± standard deviation = 71.3 ± 10.4 kg) were randomly drafted from the main flock and used in a 1-day session. The trial included 3 passages. In each passage, ewes were weighed first on a static scale; once a static position was achieved and LW recorded, they continued the circuit and immediately traversed the WoW scale for an automated LW record. Trial 2 aimed to demonstrate the feasibility of using the WoW device under real-world conditions in a dairy sheep-farming system. The WoW scale was installed in the exit race of the milking parlor and evaluated over 7 wk with adult ewes in mid lactation (n = 93; LW 78.5 ± 8.1 kg). Once the ewes were acclimated to the WoW system, 1 group of ewes (n = 48) continued to receive the same feeding regimen (controls), and the other group (n = 45) underwent a nutritional challenge [challenged; 2 wk of undernutrition and then back to control regimen (refeeding) for 1 wk]. We evaluated the ability of the WoW to detect small changes in LW. We collected LW data (2 weighings per ewe per day) from the WoW after each of the 2 milking sessions (morning and evening). We also obtained LW values by weighing the ewes using a static scale once a week. The automated WoW system showed substantial agreement with the gold standard when assessed using Lin's concordance correlation coefficient and Bland and Altman's method, largely due to high repeatability. The WoW system was adequate for detecting small daily variations in LW during undernutrition and refeeding periods. Misbehaviors resulted in spurious WoW values in trial 2, requiring us to use filtration methods to exclude outlier weights and allow meaningful assessment of small LW changes. The WoW system evaluated here is an alternative to the static scales conventionally used on dairy sheep farms. If sound filtration of raw data is applied, WoW could contribute to the close (daily) monitoring of individual LW without operator intervention (i.e., voluntary weighing) and taking animal welfare into account (i.e., no stress related to the weighing session on static scales).

91726 Screening for Obesity related renal damage in adolescent women - Body Surface area matters

ABSTRACT IMPACT: This change will improve primary care physicians and pediatrics ability to identify, intervene and prevent obesity related renal damage in the vulnerable population of young adults OBJECTIVES/GOALS: Obesity related glomerulopathy has a reversible stage manifested as hyperfiltration. Early intervention depends on the ability to identify hyperfiltration. Hyperfiltration prevalence is underestimated using the currently recommended formula We investigated whether calculating BSA-adjusted GFR will more readily identify hyperfiltration. METHODS/STUDY POPULATION: We extracted data from a large urban, multi-institutional Electronic Health Records (EHR) clinical data research network to construct an EHR data base of 60,549 women and girls ages 12-21 years from the New York metropolitan area. EGFR was calculated in two ways, 1) according to age appropriate formula, and 2) according to age appropriate formula and adjusted to body surface area (BSA). BMI-for-age values were classified according to the World Health Organization schema and grouped according to the CDC definitions. BSA was calculated according to the Du-Bois formula. Hyperfiltration was defined by a threshold of 135ml/min. The Bland Altman method assessed the agreement between formulas across the different BMI groups. RESULTS/ANTICIPATED RESULTS: Serum creatinine values were similar across different BMI groups. Comparing eGFR values, hyperfiltration rates were similar across BMI groups, ranging between 4%-6.6%. BSA-adjusted GFR was different across BMI groups: hyperfiltration rates were 0.81% for the underweight group, 2.56% for the normal weight, 12.18% for the overweight and 39% in the obese group. This trend of hyperfiltration paralleled the the rise in urine creatinine across BMI groups. DISCUSSION/SIGNIFICANCE OF FINDINGS: BSA-adjusted GFR more sensitively detects hyperfiltration due to obesity than does eGFR. Calculating BSA-adjusted GFR will improve primary care and pediatric physicians’ ability to identify, intervene and prevent early ORG. Changes in body composition may account for the increasing discordance between BSA-adjusted and eGFR as BMI rises.

Validation of a measure of parental responsiveness: Comparison of the brief Parental Responsiveness Rating Scale with a detailed measure of responsive parental behaviours.

Parental responsiveness is vital for child language development. Its accurate measurement in clinical settings could identify families who may benefit from preventative interventions; however, coding of responsiveness is time-consuming and expensive. This study investigates in a clinical context the validity of the Parental Responsiveness Rating Scale (PaRRiS): a time- and cost-effective global rating scale of parental responsiveness. Child health nurse (CHN) PaRRiS ratings are compared to a detailed coding of parental responsiveness. Thirty parent–child dyads completed an 8-min free-play session at their 27-month health review. CHNs rated the interaction live using PaRRiS. Videos of these interactions were then blindly coded using the more detailed coding system. PaRRiS ratings and detailed codings were compared using correlational analysis and the Bland–Altman method. PaRRiS and the detailed coding showed a moderate-strong correlation (rs (28) = 0.57, 95% CI [0.26, 0.77]) and high agreement (Bland–Altman). CHNs using PaRRiS can capture parental responsiveness as effectively as trained clinicians using detailed coding. This may allow (1) increased accuracy and efficiency in identifying toddlers at risk for long-term language difficulties; (2) more accurate allocation to speech and language therapy (SLT) services; (3) decreased burden on SLT resources by empowering CHNs to make more informed referral decisions.

Motor Function Assessment of Upper Limb in Stroke Patients.

Background Quantitative assessment of motor function is extremely important for poststroke patients as it can be used to develop personalized treatment strategies. This study aimed to propose an evaluation method for upper limb motor function in stroke patients. Methods Thirty-four stroke survivors and twenty-five age-matched healthy volunteers as the control group were recruited for this study. Inertial sensor data and surface electromyography (sEMG) signals were collected from the upper limb during voluntary upward reaching. Five features included max shoulder joint angle, peak and average speeds, torso balance calculated from inertial sensor data, and muscle synergy similarity extracted from sEMG data by the nonnegative matrix factorization algorithm. Meanwhile, the Fugl–Meyer score of each patient was graded by professional rehabilitation therapist. Results Statistically significant differences were observed among severe, mild-to-moderate, and control group of five features (p ≤ 0.001). The features varied as the level of upper limb motor function changes since these features significantly correlated with the Fugl–Meyer assessment scale (p ≤ 0.001). Moreover, the Bland–Altman method was conducted and showed high consistency between the evaluation method of five features and Fugl–Meyer scale. Therefore, the five features proposed in this paper can quantitatively evaluate the motor function of stroke patients which is very useful in the rehabilitation process.

In vitro validation of Digital Image Analysis Sequence (DIAS) for the assessment of the marginal fit of cement-retained implant-supported experimental crowns

BackgroundThe replica technique with its modifications (negative replica) has been used for the assessment of marginal fit (MF). However, identification of the boundaries between prosthesis, cement, and abutment is challenging. The recently developed Digital Image Analysis Sequence (DIAS) addresses this limitation. Although DIAS is applicable, its reliability has not yet been proven.The purpose of this study was to verify the DIAS as an acceptable method for the quantitative assessment of MF at cemented crowns, by conducting statistical tests of agreement between different examiners.MethodsOne hundred fifty-one implant-supported experimental crowns were cemented. Equal negative replicas were produced from the assemblies. Each replica was sectioned in six parts, which were photographed under an optical microscope. From the 906 standardized digital photomicrographs (0.65 μm/pixel), 130 were randomly selected for analysis. DIAS included tracing the profile of the crown and the abutment and marking the margin definition points before cementation. Next, the traced and marked outlines were superimposed on each digital image, highlighting the components’ boundaries and enabling MF measurements.One researcher ran the analysis twice and three others once, independently. Five groups of 130 measurements were formed. Intra- and interobserver reliability was evaluated with intraclass correlation coefficient (ICC). Agreement was estimated with the standard error of measurement (SEM), the smallest detectable change at the 95% confidence level (SDC95%), and the Bland and Altman method of limits of agreement (LoA).ResultsMeasured MF ranged between 22.83 and 286.58 pixels. Both the intra- and interobserver reliability were excellent, ICC = 1 at 95% confidence level. The intra- and interobserver SEM and SDC95% were less than 1 and 3 pixels, respectively. The Bland–Altman analysis presented graphically high level of agreement between the mean measurement of the first observer and each of the three other observers’ measurements. Differences between observers were normally distributed. In all three cases, the mean difference was less than 1 pixel and within ± 3 pixels LoA laid at least 95% of differences. T tests of the differences did not reveal any fixed bias (P > .05, not significant).ConclusionThe DIAS is an objective and reliable method able to detect and quantify MF at ranges observed in clinical practice.