Analysis Of Discrepancies Research Articles

Self- and informant-reported perspectives on symptoms of narcissistic personality disorder.

Because narcissistic individuals tend to have an inflated view of themselves and their abilities, the reliance on self-reported information in the assessment and diagnosis of narcissistic personality disorder (NPD) is problematic. Hence, the use of informants in the assessment of NPD may be necessary. In the current study we examined self- and informant-reported features of NPD using agreement, frequency, and discrepancy analyses. The results indicated that informants tended to report more NPD features than selves, and that there were either low or nonsignificant levels of self-informant agreement among the 9 NPD diagnostic criteria and its categorical diagnosis. Informants were increasingly more likely to report higher raw scores relative to selves, indicating that the discrepancy between self- and informant reports increases with the NPD scale. Informants also reported NPD features that selves often did not, suggesting that current prevalence estimates of NPD, which use only self-reported information, are most likely underestimates. These results highlight the importance of gathering informant-reported data in addition to self-reported data when assessing NPD. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Loop-Mediated Isothermal Amplification Compared to Real-Time PCR and Enzyme Immunoassay for Toxigenic Clostridium difficile Detection

Clostridium difficile infection is the primary cause of health care-associated diarrhea. While most laboratories have been using rapid antigen tests for detecting C. difficile toxins, they have poor sensitivity; newer molecular methods offer rapid results with high test sensitivity and specificity. This study was designed to compare the performances of two molecular assays (Meridian illumigene and BD GeneOhm) and two antigen assays (Wampole Quik Chek Complete and TechLab Tox A/B II) to detect toxigenic C. difficile. Fecal specimens from hospitalized patients (n = 139) suspected of having C. difficile infection were tested by the four assays. Nine specimens were positive and 109 were negative by all four methods. After discrepant analysis by toxigenic culture (n = 21), the total numbers of stool specimens classified as positive and negative for toxigenic C. difficile were 21 (15%) and 118 (85%), respectively. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were as follows: GeneOhm (95.2%, 100%, 100%, and 99.2%), illumigene (95.2%, 96.6%, 83.3%, and 99.2%), Tox A/B II (52.4%, 97.5%, 78.6%, and 92.4%), and Quik Chek Complete (47.6%, 100%, 100%, and 91.9%). The illumigene assay performed comparably to the GeneOhm assay with a slight decrease in test specificity; the sensitivities of both far exceeded those of the antigen assays. The clinical characteristics of the concordant and discrepant study patients were similar, including stool consistency and frequency. In the era of rapid molecular-based tests for toxigenic C. difficile, toxin enzyme immunoassays (EIAs) should no longer be considered the standard of care.

Peer and Self-assessment of Professionalism in Undergraduate Medical Students at the University of Calgary

Background: Peer and self assessment processes are integral to the development of professional behaviours. The purpose of this study was to assess the Rochester Peer Assessment Tool (RPAT) among a group of volunteer first year students.Methods: We assessed feasibility through participation rates. The evidence for the validity of instrument scores was ascertained through an exploratory factor analysis, MANOVA to determine age and gender differences, and a discrepancy analysis between the self and peer data. Reliability analyses included the Cronbach's alpha analysis and G- and D-studies. Students completed a feedback questionnaire to provide data about acceptability.Results: Self and peer data were collected for 46 and 44 students, respectively. Each student had a mean of 7.2 peer assessments (out of a possible 8). The factor analysis identified two factors, interpersonal skills and work study habits. The discrepancy analysis showed students in the lowest/highest quartiles, as assessed by peers, had higher/lower self means than peer means. The G-coefficient was Ep2 = 0.77. Student feedback was positive.Conclusions: RPAT was feasible in our setting, was acceptable to the students, and has been adopted as a mandatory part of our program for first and second year students. The study added to the evidence base for the reliability and validity of the RPAT instrument scores as a method of assessing professional behaviours.

A Simple Card Trick

Yet today, despite recent welcome additions, relatively little is written about teaching qualitative research. Why is that? This article reports out a relatively simple, yet appealing, pedagogical move, a lesson the author uses to teach qualitative data analysis. Data sorting and categorization, the use of tacit and explicit theory in data analysis, and discrepant case analysis can all be illustrated though use of a standard deck of playing cards. Use of playing cards appeals to those who learn best kinesthetically and is a welcome break from lecture-oriented, didactic teaching. It mirrors data sorting by hand and allows the instructor to highlight the importance of play in qualitative research.

Can DFT Accurately Predict Spin Densities? Analysis of Discrepancies in Iron Nitrosyl Complexes.

Iron nitrosyl complexes are a particularly challenging case for density functional theory. In particular, for the low-spin state, different exchange-correlation functionals yield very different spin densities [ Conradie , J. ; Ghosh , A. J. Phys. Chem. B 2007 , 111 , 12621 - 12624 ]. Here, we investigate the origin of these differences in detail by analyzing the Kohn-Sham molecular orbitals. Furthermore, to decide which exchange-correlation functionals yield the most accurate spin densities, we make comparisons to CASSCF calculations. To ensure that the spin densities are converged with respect to the size of the active space, this comparison is performed for [Fe(NO)](2+) as a model system. We find that none of the investigated exchange-correlation functionals are able to reproduce the CASSCF spin densities accurately.

Precision of the Northeast Arctic cod age determination under variable environmental and information conditions

For 16 years (1992–2007) comparative age-reading studies for cod were carried out by the two national laboratories: Polar Research Institute of Marine Fisheries and Oceanography (PINRO), Murmansk, Russia, and Institute of Marine Research (IMR), Bergen, Norway. Pairs (6786) of Northeast Arctic cod otoliths were read and compared to assess the precision of age estimation between the two laboratories. Cod otoliths which provide basic information for stock assessment were re-analysed to determine if there were any discrepancies since additional information on fish length may or may not have been available. Two groups of otoliths which were sampled during 1992 and 1994 were analysed in parallel: 285 otoliths with known length data and 661 otoliths without length data available. Knowing the length of the cod appeared to increase the discrepancies between the two laboratories. Analysis of long-term discrepancies in cod age determinations between two laboratories showed that variability of ageing is influenced by environmental variability (temperature and food supply) observed when the otoliths were formed.

Discrepancy Analysis of State Sequences

In this article, the authors define a methodological framework for analyzing the relationship between state sequences and covariates. Inspired by the principles of analysis of variance, this approach looks at how the covariates explain the discrepancy of the sequences. The authors use the pairwise dissimilarities between sequences to determine the discrepancy, which makes it possible to develop a series of statistical significance–based analysis tools. They introduce generalized simple and multifactor discrepancy-based methods to test for differences between groups, a pseudo- R2 for measuring the strength of sequence-covariate associations, a generalized Levene statistic for testing differences in the within-group discrepancies, as well as tools and plots for studying the evolution of the differences along the time frame and a regression tree method for discovering the most significant discriminant covariates and their interactions. In addition, the authors extend all methods to account for case weights. The scope of the proposed methodological framework is illustrated using a real-world sequence data set.

Using complex resistivity imaging to infer biogeochemical processes associated with bioremediation of an uranium-contaminated aquifer

[1] Experiments at the Department of Energy's Integrated Field Research Challenge (IFRC) site near Rifle, Colorado, have demonstrated the ability to remove uranium from groundwater by stimulating the growth and activity of Geobacter species through acetate amendment. Prolonging the activity of these strains in order to optimize uranium bioremediation has prompted the development of minimally invasive and spatially extensive monitoring methods diagnostic of their in situ activity and the end products of their metabolism. Here we demonstrate the use of complex resistivity imaging for monitoring biogeochemical changes accompanying stimulation of indigenous aquifer microorganisms during and after a prolonged period (100+ days) of acetate injection. A thorough raw data statistical analysis of discrepancies between normal and reciprocal measurements and incorporation of a new power law phase-error model in the inversion were used to significantly improve the quality of the resistivity phase images over those obtained during previous monitoring experiments at the Rifle IFRC site. The imaging results reveal spatiotemporal changes in the phase response of aquifer sediments, which correlate with increases in Fe(II) and precipitation of metal sulfides (e.g., FeS) following the iterative stimulation of iron and sulfate-reducing microorganisms. Only modest changes in resistivity magnitude were observed over the monitoring period. The largest phase anomalies (>40 mrad) were observed hundreds of days after halting acetate injection, in conjunction with accumulation of Fe(II) in the presence of residual FeS minerals, reflecting preservation of geochemically reduced conditions in the aquifer, a prerequisite for ensuring the long-term stability of immobilized, redox-sensitive contaminants such as uranium.

P1-S3.05 Attributable proportion of tubal factor infertility caused by chlamydia: an estimate based on serological evidence adjusted for test resolution

BackgroundMany published studies compare the prevalence of Chlamydia trachomatis (CT) antibody in women with Tubal Factor Infertility (TFI) and a control group. In principle these studies can be used to...

P3-S1.02 Evaluation of screening tests for Chlamydia trachomatis: bias associated with the patient infected status algorithm

This study illustrates the bias associated with the use of an estimation approach called the patient infected status algorithm (PISA), which has been recently introduced and is increasingly used to...

Performance and clinical significance of direct antimicrobial susceptibility testing on urine from hospitalized patients

Urinary tract infections (UTIs) are common infections in the community and the hospital. With increasing antimicrobial resistance, specifically in the Gram-negative uropathogens, reliable, rapid antimicrobial susceptibility data would be useful to guide antimicrobial treatment. Direct antimicrobial susceptibility testing (DST) of urine with microscopic evidence of Gram-negative bacterial infection and its clinical significance was investigated in this study. DST was performed by Kirby-Bauer disk diffusion method using undiluted urine as a non-standardized inoculum. Urine specimens with Gram-negative bacteria on microscopy were included. DST results from growth of Gram-negative bacteria were compared to routine antimicrobial susceptibility testing by Phoenix automated system (AST). Errors were scored as 'very major error' if susceptible by DST but resistant by AST and as 'major error' if resistant by DST but susceptible by AST. All other discrepancies were defined as 'minor error'. Discrepancies were resolved by determination of minimum inhibitory concentrations (MICs) using Etests. After discrepancy analysis, errors were scored as above using the Etest as the reference method. For analysis, specimens were divided into 3 categories: category A: 1 isolate found by DST as well as by routine culture; category B: 1 isolate detected by DST, but more than 1 isolate found on routine culture; category C: more than 1 isolate found by both DST and routine culture. The clinical significance of DST was determined prospectively by investigating the potential impact of DST on antimicrobial therapy. One hundred and sixteen urine specimens were included. For DST and AST there was agreement in 96% of 1152 comparisons in category A (n = 100), 88% of 41 comparisons in category B (n = 4), and 88% of 110 comparisons in category C (n = 12). The 64 discrepancies included 18 very major errors, 7 major errors, and 39 minor errors. Eight very major errors and 11 minor errors were not investigated because the isolates were not available. After Etest MIC determination for the 45 remaining discrepancies, DST showed 1 very major error, 1 major error, and 8 minor errors in category A, none in category B, and 5 major errors and 4 minor errors in category C. Antimicrobial therapy for UTI was prescribed for 53 patients. For 4 patients (8%) therapy was adjusted based on DST because of antimicrobial resistance and for 12 patients (23%) antimicrobial treatment could have been streamlined. DST on urine is reliable in monobacterial Gram-negative infections. With increasing antimicrobial resistance, DST can make an important contribution to patient management and reduce the use of broad-spectrum antimicrobials.

The analytic performance of a TaqMelt PCR assay for the detection of KRAS mutations (codons 12/13 and 61) in formalin-fixed paraffin-embedded tissue (FFPET) samples of colorectal carcinoma (CRC).

e21032 Background: KRAS mutation testing is now mandatory to select patients with metastatic CRC for treatment with anti-EGFR antibodies such as cetuximab and panitumumab. Multiple studies have shown that these agents do not benefit patients with KRAS-mutant CRC, and may even be deleterious. Thus there is a need for a well-validated diagnostic test to detect these mutations. Although current U.S. guidelines recommend testing for codon 12 and 13 mutations, clinical data indicate that codon 61 mutations are also predictive of nonresponsiveness to anti-EGFR antibodies. Recent studies have observed a higher prevalence of codon 61 mutations than previously reported. Methods: We describe the analytic performance of a TaqMelt PCR research assay (cobas KRAS Mutation Test), which is designed to detect 19 mutations in codons 12, 13 and 61. A panel of 187 CRC samples was tested with two different lots of the PCR test and results compared to 2x bidirectional Sanger sequencing. Results: Preliminary discrepant analysis was performed on the thirteen discordant samples (7.0%) using a quantitative deep sequencing method (454 GS-Titanium). Three (1.6%) PCR-pos Sanger-neg samples yielded 454 results that agreed with their Sanger results. Eight (4.3%) of the 11 PCR-pos, Sanger-neg samples and 2 (1.1%) of the 2 PCR-neg, Sanger-pos samples gave 454 results consistent with their respective PCR results. When a panel of six tumor samples, including two near the limit of analytical sensitivity and two with low tumor content, was repeatedly tested by two operators, using different instruments and reagent lots, a correct result was observed for 100% of tests. PCR test results were not affected by repeated freezing and thawing of the DNA sample, or by addition of hemoglobin or triglycerides. Conclusions: These studies show that this PCR test is a robust reproducible assay that 1) detects mutations in codons 12, 13 and 61 of the KRAS gene, 2) requires a small amount of DNA and 3) appears to be more sensitive than bidirectional Sanger sequencing. Test method Sanger MUT WT PCR 85 11 96 MUT 2 89 91 WT 87 100 187

Reducing the Risk of Being a Victim of Crime in South Africa: You can tell and be Heard!

People who use Augmentative and Alternative Communication (AAC) know that silence is not always golden. Persons with disabilities and in particular those with complex communication needs, have a heightened risk of becoming victims of crime, abuse, and neglect. This study looked at the vocabulary needed to disclose or report crime or abuse in South Africa, and also focussed on the development of communication boards for this purpose, in four of the 11 official South African languages (Afrikaans, English, Sepedi, and isiZulu). Thirty-six participants in four language-based focus groups (English, Afrikaans, Sepedi, and isiZulu) were asked to generate a list of possible words they deemed important when wanting to disclose a crime, abuse or neglect. Participants then prioritized the top 55 words. A total of 56 words appeared on two or more of the lists from the four language groups. The board was developed using Picture Communication Symbols (PCS), the most frequently used symbol set in South Africa, according to an electronic mail survey. A discrepancy analysis revealed that these 56 words could be represented by 219 symbols. Symbols were developed for two words (swear, threaten) for which no PCS symbols existed. The process of developing the communication boards described in this paper may be useful to AAC communities in other countries, and the boards can serve as templates for other languages.

Comprehensive intermaxillary tooth width proportion of Bangkok residents

Proper occlusion depends on the correct width ratio between upper and lower teeth, known as Bolton's ratio. In fact, this ratio can be calculated for each pair of teeth from the central incisor to the first permanent molar. This set of ratios, known as comprehensive cumulative percentage ratios (CPRs), can be used not only to determine which tooth or teeth have a tooth width discrepancy, but can also enable the partial graphical analysis of tooth width discrepancy when there is agenesis of certain permanent teeth. Although CPRs have been calculated for Caucasians, tooth width is known to vary depending on racial origin. Therefore, a test of differences between racial groups should be carried out. If these ratios of the Caucasians and Bangkokians are significantly different, the ratio of the Bangkokians is recommended. The objective of this study was to measure tooth size disproportion for Thai patients and to calculate a corresponding set of CPRs. Thirty-seven pairs of dental models were made from a group of Bangkok residents with normal occlusion. Mesiodistal tooth width was measured for each model. The intra- and inter-examiner measurement errors were ascertained as insignificant (p > 0.05). CPRs were then calculated and compared to those derived from other studies. Ten of thirteen CPRs were significantly different from corresponding values derived from Caucasians. We conclude that tooth width ratios vary between different racial groups, and therefore that these should be calculated specifically for each patient racial group.

Kabul cosmopolitan: Geopolitical empire from the planner’s viewpoint

This article uses cosmopolitanism as a theoretical lens to explore both the urbanism and the ethics of planning in Kabul. The Cosmopolis arguments of Sandercock is synthesized with the political argument of Mouffe to articulate a concept of agonistic cosmopolitanism in contrast to a concept of globalizing cosmopolitanism. The practices that shape urban life in Kabul resemble what Simone describes as worlding processes in cities of sub-Saharan Africa. Under such adverse conditions, Kabulis demonstrate vital aspects of agonistic pluralism. Conversely, a transnational community in Kabul embodies a less critical, presumptively global cosmopolitanism through the production of a Global Village that encourages socially disruptive land speculation. The value of a more critical, agonistic understanding is then demonstrated through the analysis of an unexpected discrepancy in planning ideals between the national and local planning agencies in Kabul. This analysis suggests a new ethical task for urban planners: to challenge geopolitical empire through a cosmopolitan ethic that embraces the substantive conflicts which come with actual recognition and political inclusion of the Other.

Revisiting “Discrepancy Analysis in Continuing Medical Education: A Conceptual Model”

Disclosure: The author reports none. Dr. Fox: Professor Emeritus of Educational Leadership and Policy Studies, University of Oklahoma. Correspondence: Robert D. Fox, 813 Elm Court, Marco Island, FL, 34145; e-mail: [email protected]. This article was previously published in Mobius. Fox RD. Discrepancy analysis in continuing medical education: a conceptual analysis. Mobius. 1983;3(3):37-44. Reprinted in J Cont Educ Health Prof. 2011;31:71-76. Published online in Wiley Online Library (wileyonlinelibrary.com).

Methods for the Rapid Screening of Group A Streptococci: Fluorescent in situ Hybridization versus Immunochromatography

Objective: To evaluate the accuracy of detection for screening group A streptococci (GAS) in pediatric clinics using fluorescent in situ hybridization (FISH) and immunochromatographic assay (ICA). Subjects and Methods: A group of 630 children who attended an outpatient clinic with signs and symptoms of acute upper respiratory tract infection were enrolled in this study. Specimens were collected using a double-swab collection device. Culturing methods were employed as the gold standard for comparison. Discordant results (i.e., positive results for FISH or ICA along with negative culture results) were further evaluated by using Todd-Hewitt broth (THB) with subsequent subculture for group A selective streptococcus agar. True-positive or false-positive of GAS was determined by the presence or absence of THB subculture. The diagnostic characteristics of FISH and ICA were assessed. Results: After discrepant analysis, the sensitivity, specificity and positive and negative predictive values were as follows: 89.2, 100, 100 and 95.4%, respectively, for FISH; corresponding values for ICA were 76.8, 98.6, 96.1 and 90.5%. Conclusion: The results demonstrated that the FISH assay had a higher detection sensitivity than ICA and is suitable for rapid and accurate GAS screening in pediatric clinics.

Validation of a norovirus multiplex real-time RT-PCR assay for the detection of norovirus GI and GII from faeces samples

Norovirus is a leading cause of infectious non-bacterial gastroenteritis. The virus is highly contagious and has multiple modes of transmission, presenting a growing challenge to hospital-based healthcare. In this study, a total of 120 stool samples are tested for the presence of norovirus GI and GII by the Roche two-step Lightcycler 2.0 assay incorporating primers and probes produced by TIB Molbiol, and the results are compared with results from the National Virus Reference Laboratory. The Roche/TIB Molbiol assay produced 51 positive results and 69 negative results. Discrepancy analysis was performed for six conflicting results using a second real-time polymerase chain reaction (PCR) assay (Roche/TIB Molbiol) and this confirmed that four of the five discrepant positive results were true positives. A single discrepant negative result generated by the Roche assay remained negative using the second assay. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated to be 98%, 98.6%, 98.0% and 98.6 %, respectively. Melting curve analysis was used to differentiate genogroups I and II and this showed that 92% of strains belonged to genogroup II.

Evaluation of the Cobas TaqMan MTB Test for Direct Detection of Mycobacterium tuberculosis Complex in Respiratory Specimens

The Cobas TaqMan MTB test, based on real-time PCR technology, was evaluated for direct detection of Mycobacterium tuberculosis complex (MTBC) in respiratory specimens. A total of 1,093 samples from 446 patients, including 118 acid-fast smear-positive and 975 acid-fast smear-negative specimens, were investigated. Diagnostic cultures performed with 7H11 agar, Löwenstein-Jensen medium, and the Bactec MGIT 960 system were considered the reference methods. When discrepant results between the Cobas TaqMan MTB test and culture occurred, additional results from the BD MGIT TBc identification test and the GenoType Mycobacterium CM test performed on growth-positive and acid-fast-stain-positive MGIT tubes and review of the patient's medical history were used for discrepancy analysis. The overall sensitivity, specificity, positive predictive value, and negative predictive value for the Cobas TaqMan MTB test were 91.5%, 98.7%, 91.5%, and 98.7%, respectively. In general, the performance of the new Cobas TaqMan MTB test was comparable to that of the replaced Cobas Amplicor MTB system. The most prominent feature of the new system was its extraordinarily high sensitivity (79.5%) for detecting MTBC in smear-negative specimens; out of 44 smear-negative but culture-positive specimens, 35 were positive by the new system. The Cobas TaqMan MTB assay, including DNA extraction, can be completed within 3 h.

A influência do gênero e da escolaridade no diagnóstico de demência

Um problema no diagnóstico das demências é a ausência de informação prévia sobre o nível cognitivo dos pacientes, anterior às manifestações atuais. A análise das discrepâncias nos testes cognitivos torna-se assim uma referência para o diagnóstico. A relação entre gênero, nível de escolaridade, experiência profissional e resultados da avaliação neuropsicológica foi analisada a partir de prontuários clínicos de pacientes idosos. A amostra masculina de nível superior apresentou médias significativamente menores nas subescalas de execução em relação às verbais. Apesar do nível de escolaridade e da atividade intelectual ocultarem a perda de performance nos quadros demenciais, a análise das discrepâncias evidencia as quedas de rendimento. Na amostra feminina, com menor nível de escolaridade, embora os resultados mostrassem deficiência cognitiva, não ocorreram diferenças significativas entre os subtestes verbais e de execução. A análise da covariância indicou que o nível de escolaridade, e não o gênero, foi o fator responsável pela diferença.