Inaccurate Interpretation Research Articles

Clinical and laboratory approaches to evaluate diarrheal disorders.

Diarrheal disorders are the result of excessive fluid and electrolyte loss through the gastrointestinal tract. Many different underlying mechanisms are known to cause diarrhea. Fordtran suggested that in secretory diarrhea the osmolality of stool water should be accounted for by its electrolyte contents. Therefore, the osmotic gap between the measured osmolality and that estimated from electrolyte contents should be small. In osmotic diarrhea, due to the presence of the osmotic agent, there should be a greater gap between the measured and the estimated osmolalities. Osmotic gaps varying from 100 to 40 mOsm have been used arbitrarily in literatures to define the underlying pathogenesis. Because of the uncertainty, the usefulness of these measurements remains in question. In this article, methods used to measure stool osmolality and electrolyte contents are reviewed. Limitations of these measurements are discussed. Measurements derived from various diarrheal disorders revealed that the basic concepts put forward by Fordtran are corrected. However, we found that the osmotic gaps (measured osmolality - 2 [Na + K] in secretory diarrheal disorders are frequently negative numbers. In osmotic diarrhea, the osmotic gap (greater than 160 mOsm) is substantially greater than the figures used in the literature. In many diarrheal disorders the osmotic gap falls between the two extremes and the pathogenesis is multifactorial in origin. Under these circumstances, stool osmolality and electrolyte measurements provide little insight into the underlying mechanism causing the diarrhea. Furthermore, stool contains many biologically active organisms which can alter the stool osmolality. Unless these effects are appreciated, an inaccurate interpretation of these measurements may result.

The Effects of Lag Time on Interpreter Errors

A popular but naive notion that sign language interpreters should strive for perfect temporal synchrony with the source message has persisted for a long time. This study provides evidence that imposing such a constraint or expectation upon interpreters results in inaccurate interpretation and an increase in interpreter errors or miscues. An analysis and count of miscues in actual interpreter performances has been compared with interpreters’ lag time (i.e. the time between delivery of the original message and delivery of the interpreted message). The result shows an inverse relationship between the amount of lag time and the number of interpreter errors. This relationship has serious implications for interpreter educational programs, interpreter assessment programs, and programs intended to make consumers aware of interpreting’s limitations.

Estimating sodium pump activity in beating heart muscle

There are substantial problems associated with the biochemical estimation of sodium pump activity. These have been often neglected, resulting in an inaccurate interpretation of results. The on-going sodium pump activity and the capacity of the sodium pump has to be considered separately. In beating heart muscle, the best direct approximation of these parameters results from estimation of ouabain-sensitive 86Rb + uptake observed during a short incubation period under conditions in which rate of Na + influx is suddenly increased. A more accurate, though indirect, estimation of sodium pump inhibition may be obtained from measuring the reduction in initial velocity of the [ 3H]ouabain binding reaction using tissue homogenates obtained from drug-exposed preparations.

Exceptions to the Relationship Between Plate Tectonics and Sandstone Composition

ABSTRACT Routine use of QFL, QpLsmLvm, and LmLsLv plate-tectonic provenance diagrams has led to the recognition of error populations. For these sandstones, the interpretation of tectonic setting based on data exclusive of petrography does not coincide with the interpretation of tectonic setting based on their location on compositional diagrams. The anomalous sandstones can be separated into at least four categories: i) sandstones deposited during the transition between tectonic regimes may be derived, in part, from relict source rocks; ii) the relative enrichment of sandstones in detrital quartz by weathering and/or depositional reworking may lead to an inaccurate interpretation of tectonic setting from compositional data; iii) sandstones deposited in tectonic settings as yet unrepresented on he provenance diagrams may plot between the provenance fields or overlap existing fields; iv) the role of detrital carbonate rock fragments directly affects the location of data points on provenance diagrams, and is an unresolved problem. The first two categories represent permanent problems in the use of sandstone composition as an indicator of plate-tectonic setting, whereas the last two may only be temporary problems that can be solved by more data and a consensus on determining detrital modes. Recognition of anomalous sandstones in the rock record will reduce the probability of erroneous interpretations of tectonic setting and enhance the use of sandstone petrology as an indicator of plate-tectonic setting.

A Silk Purse from a Sow's Ear?

In the 1970s it became axiomatic that a manuscript discussing the value of the white blood cell (WBC) count and differential would be an object lesson in flawed study design and inaccurate interpretation of prior literature. Somehow I always seem to get dragged into the argument with the mistaken impression that I feel, as misquoted by Dr Karniski, that a "CBC could accurately distinguish between any child with bacteremia and a child with a viral illness."

Lay attribution of personal problems and psychological help-seeking

This paper proposes and tests a theory based on social comparison processes, causal attribution and the arousal phenomenon to account for interpretation of normal, temporary emotional problems as arising from within. It is suggested that individuals with a repertoire of psychiatric-psychological labels with which to interpret unusual feelings will attribute those feelings as arising from their disposition rather than the environment, and that dispositional attribution of discomfort will be positively related to psychological help-seeking. Results based on a systematic random sample of 300 undergraduates indicate (1) a minimal, but consistent, tendency for individuals with greater psychiatric contact and sophistication to interpret personal problems as dispositional; (2) a consistent tendency for dispositional interpretation of problems to be associated with use of psychiatric and psychological services; and (3) a positive association between psychiatric contact and sophistication and use of psychiatric and psychological services. It is concluded that lay attribution of personal problems can result in both under and over estimation of the utility of mental health professionals. Inaccurate interpretation of emotions may prompt one to seek unneeded treatment or avoid needed treatment.

Water storage in a bare and cropped sandy loam soil

Summary The first objective of this paper is to establish and compare a complete field water balance of a bare soil with a cropped soil (rye grass) on a sandy loam. Evapotranspiration and deep drainage were estimated by integrating soil water content profiles, obtained through neutron probe measurements down to a depth of 110 cm and using a zero flux plane below the lower boundary of the rootzone. The plane of zero flux could be determined by measuring the directions of the hydraulic head gradients in the soil profile using tensiometer data. The second objective was to compare the fluxes (drainage) at the lower boundary of the control volume estimated from the changes in soil water content profiles under the zero flux plane (water balance equation) and those from field hydraulic conductivity data (Darcy's equation). Due to the spatial variability of the K (θ) relation in the field and the steep slope of this relation of the drainage flux, using Darcy's equation can lead to inaccurate interpretation.

Cautionary Note on the Use of Short State-Anxiety Measures

The report noted that the use of high item-remainder coefficients as the sole criterion in the selection of items for short state-anxiety scales from full scales can lead to inaccurate interpretation of results. It was demonstrated that the use of a four-item state-anxiety scale from the State-Trait Anxiety Inventory A-State scale based on high item-remainder coefficients changed relationships in a previously reported study which used full-scale scores. It was proposed that such changes in relationships were the result of selecting four items which happen to load on only one of three dimensions of the A-State scale. The criterion of high item-remainder coefficents alone may be inadequate in the formation of short state-anxiety scales.

Demineralization of bone matrix: observations from electron microscope and electron-probe analysis.

Displacement or removal of mineral during the processing of calcified tissues for electron microscopy is a recognized phenomenon. An electron microscope analysis has been made of artefactual mineral loss during ultramicrotomy of osteogenic tissue. It is concluded from morphological investigation and the use of electron diffraction that this loss of crystalline mineral during sectioning can considerably change the morphology of calcified tissues and may lead to inaccurate interpretation of cell and matrix morphology. Electron probe X-ray microanalysis has been used to demonstrate in a semi-quantitative manner, the artefactual loss of calcium and phosphorus. Problems of specimen preparation for such analytical work are discussed.

Lumbar Sympathectomy

Advances in technology have led to a massive expansion in the capacity for genomic analysis, with a commensurate fall in costs. The clinical indications for genomic testing have evolved markedly; the volume of clinical sequencing has increased dramatically; and the range of clinical professionals involved in the process has broadened. There is general acceptance that our early dichotomous paradigms of variants being pathogenic–high risk and benign–no risk are overly simplistic. There is increasing recognition that the clinical interpretation of genomic data requires significant expertise in disease–gene-variant associations specific to each disease area. Inaccurate interpretation can lead to clinical mismanagement, inconsistent information within families and misdirection of resources. It is for this reason that ‘national subspecialist multidisciplinary meetings’ (MDMs) for genomic interpretation have been articulated as key for the new NHS Genomic Medicine Service, of which Cancer Variant Interpretation Group UK (CanVIG-UK) is an early exemplar. CanVIG-UK was established in 2017 and now has >100 UK members, including at least one clinical diagnostic scientist and one clinical cancer geneticist from each of the 25 regional molecular genetics laboratories of the UK and Ireland. Through CanVIG-UK, we have established national consensus around variant interpretation for cancer susceptibility genes via monthly national teleconferenced MDMs and collaborative data sharing using a secure online portal. We describe here the activities of CanVIG-UK, including exemplar outputs and feedback from the membership.

Ureteral Pain as Determined by Faradic Stimulation in Man

In studying the ureteral contractions by the electrical method as described by Paladini, it occurred to us that the localization of ureteral pain could be studied by applying a stimulus to the electrode and having the patient describe the area in which the pain was felt. Experiments of this kind have been extensively done on the pleura, pericardium and peritoneum by Capps and more recently by Boyden and Rigler on the gastrointestinal tract. Since the electrodes used in the contraction studies were not quite suitable for pain distribution studies, a special electrode with a single metal contact at the tip was manufactured for this purpose by the American Cystoscope Makers, Inc. A Harvard inductorium was used for the source of current with 6 volts on the primary circuit. The inactive electrode was applied to the chest. The patient was cystoscoped, the ureteral catheter electrode was introduced into the ureter and stimulation was made at various levels up the ureter. The distance between stimulation points was 5 cm., since it was felt that too frequent stimulation led to indefinite and inaccurate interpretation. After the conclusion of the experiment pyeloureterograms were taken to exclude pathology in the urinary tract. In the lower one to 2 cm. of the ureter, the pain was referred suprapubically, being almost in the midline and extending upward about 4 cm. Pain into the perineum occurred in some cases but was not constant. Five centimeters from the ureteral orifice the pain was higher and somewhat lateral to the midline. The pain was always below the iliac crest and somewhat medial to McBurney's point.