Mean Percentage Difference Research Articles

Effectiveness of structured teaching programme on transmission and prevention of human immunodeficiency virus/acquired immune deficiency syndrome among adolescent girls in Lowry Memorial High School, Bengaluru.

Background:Adolescence is a critical stage in human development. Most young people become sexually active during adolescence and are more likely to have multipartner and unprotected sex with high-risk behavior that predisposes them to sexually transmitted infections such as human immunodeficiency virus (HIV).Objectives:The objective of the study was to evaluate the effectiveness of a structured teaching programme on transmission and prevention of HIV/acquired immune deficiency syndrome (HIV/AIDS) among adolescent girls.Methods:An evaluative research approach was adopted, in which a preexperimental, one group pre- and post-test research design was used to evaluate the effectiveness of the structured teaching programme on transmission and prevention of HIV/AIDS among adolescent girls studying at Lowry Memorial High School, Bengaluru. A self-administered structured questionnaire was used for data collection. Data were presented in frequency tables and statistical graphs (bar charts) and analyzed using descriptive statistics (mean, standard deviation) and inferential statistical methods (Chi-square and paired “t”-tests) using SPSS version 21.Results:The findings of the study revealed that the mean percentage difference in the pre- and post-test knowledge scores was statistically significant at 5% level (P < 0.05). The overall mean post-test knowledge score of adolescent girls on transmission and prevention of HIV/AIDS was 88.83%. It is apparently higher compared to the pretest knowledge score, which was 67.67% with enhancement of 21.16%. This implies that the structured teaching programme was effective in gaining knowledge of adolescent girls regarding transmission and prevention of HIV/AIDS.Conclusion:Our study suggests that structured teaching programme enhanced the knowledge of the adolescent girls on transmission and prevention of HIV/AIDS. We, therefore, recommend that structured teaching programmes on transmission and prevention of HIV/AIDS should be encouraged among adolescents and youths to reduce the spread of HIV infection.

Tide-Induced Groundwater Flow Properties Along Sloping Unconfined Coastal Aquifer

Tidal attenuation on groundwater flow properties is a crucial aspect in understanding groundwater-surface water interaction along coastal beaches. In this article, an analytical model is developed for describing the flow in the sloping unconfined aquifer bounded by ocean water along one side. Closed form of the transient solution from the linearized Boussinesq equation is obtained with exponentially decreasing tidal boundary condition. Numerical solution of nonlinear hydrodynamic equation is derived to assess the validity of linearization method. In this regard, the Alternate Direction Implicit (ADI) Method is applied, which is further used to obtain the impact of recharge on groundwater flow from non-linear Advection-Convection equation. Sensitivity analysis for larger amplitudes over smaller mean depths of saturation is carried out to obtain the validity of linearization technique. For varying bed slopes, water table fluctuation is analyzed using various tidal components. The error statistics involving mean error and Relative Percentage Difference (RPD) show that both solutions are in good agreement with each other. The flow rate and volumetric exchange are discussed to elaborate the flow analysis of groundwater in the interaction. The bed slope is considered along the inland side and the results are discussed briefly with graphs. Similarly, the flow behavior along the coastal side is presented in tabular values.

The comprehensive characterization of adrenocortical steroidogenesis using two-dimensional ultra-performance liquid chromatography – electrospray ionization tandem mass spectrometry

The perturbation of the homeostasis of adrenocortical steroids plays a fundamental role in several pathological conditions. Currently, only a few of the substances involved in steroidogenesis are routinely analysed in clinical laboratories for the diagnosis of these conditions.Recently, interest has grown over the development of clinical assays of endogenous steroids using liquid chromatography-tandem mass spectrometry (LC–MS/MS). However, no approaches have assessed the adrenocortical steroidogenesis comprehensively. Here, a novel LC–MS/MS assay is presented for evaluating the serum levels of all respective major substances (aldosterone, androstenedione, dehydroepiandrosterone, dehydroepiandrosterone sulfate, 11-deoxycorticosterone, 11-deoxycortisol, 21-deoxycortisol, dihydrotestosterone, 17α-hydroxypregnenolone, 17α-hydroxyprogesterone, corticosterone, cortisol, cortisone, pregnenolone, progesterone and testosterone). The analysis time was 5.5 min following highly efficient solid phase extraction conducted on a novel polymer phase with N-polyvinylpyrrolidine branches.The method was validated in accordance with the respective guideline of the European Medicines Agency. The cross-validation of 8 analytes with immunoassays was also accomplished.Two-dimensional chromatography allowed the elution of the 16 analytes between 2.3–4.6 min and with a sufficient resolution of isobaric compounds. Quantitation was performed throughout the clinically relevant concentration ranges. Within-run accuracy was 87.1–115%, 90.0–109%, 87.2–111% and 87.6–107% at spiking levels 1 thru 4, while the precision was 4.7–27.9%, 2.9–17.7%, 5.6–13.9% and 1.9–15.0%, respectively. Between-run accuracy was 81.0–119.5, 85.2–113, 87.4–113 and 93.1–113%, respectively, while the precision was 3.4–13.5%, 2.0–10.2%, 2.1–15.0%, and 1.5–6.6%, respectively. In cross-validation studies, the mean percentage differences ranged between −51.4% (dehydroepiandrosterone sulfate) and 17.5% (dehydroepiandrosterone).The approach allows the comprehensive characterization of the adrenocortical steroid homeostasis in clinical diagnostics.

Histopathological, histomorphometrical, and radiological evaluations of hydroxyapatite/bioactive glass and fluorapatite/bioactive glass nanocomposite foams as cell scaffolds in rat tibia: an in vivo study

Bone defects are common and persistent problems in clinical orthopedics and dentistry. The development of synthetic reconstruction materials is essential owing to the restricted access to natural bone grafts, disease transmission risks, surgical costs, donor-site morbidity, infections, and immune response-related complications. The present study was done to evaluate the histopathological, histomorphometrical, and radiological characteristics of composite foams containing hydroxyapatite/bioactive glass (HA/BG) and fluorapatite/bioactive glass (FA/BG) as cell scaffolds in rat tibia reconstruction. A total of 60 rats were divided into four equal groups, of which three groups were implanted with HA/BG, FA/BG, and CenoBone® biomaterials, and the fourth group served as the implant-free controls. Five rats from each group were sacrificed at 15, 30, or 60 days after implantation, and radiological, histopathological, and histomorphometrical assessments were carried out. Based on the findings, no foreign body reaction was present in the rats. Additionally, bone–biomaterial contact occurred directly without the involvement of connective tissues. The number of osteoblasts was reduced in the implant groups, whereas the trabecular thickness and rate of new bone formation were increased in all groups, where the increase in the FA/BG group was the most prominent. The mean percentage difference in bone density between the implant site and the host bone was greater in the FA/BG group at all three time points of the study. Based on the results of the present study and the positive characteristics of these nanocomposite foams, they can be suitable options for implantation in damaged tissues in tissue engineering.

Comparing Dose-Length Product-Based and Monte Carlo Simulation Organ-Based Calculations of Effective Dose in 16- and 64-MDCT Examinations Using Automatic Tube Current Modulation.

The purpose of this study is to compare dose-length product (DLP)-based calculation of effective dose (EDDLP) with Monte Carlo simulation organ-based calculation of effective dose (EDMCO) in 16- and 64-MDCT examinations, with the use of clinical examinations with automatic tube current modulation. Dose data were obtained from 50 consecutive unenhanced head CT examinations, unenhanced chest CT examinations, and unenhanced and contrast-enhanced abdominopelvic CT examinations performed using 16- and 64-MDCT scanners, as well as from 50 pulmonary CT angiography (CTA) examinations performed using a 64-MDCT scanner and 31 pulmonary CTA examinations performed using a 16-MDCT scanner. The EDMCO and the mean patient effective diameter were calculated using commercially available software. The EDDLP was also calculated. Both the mean difference and percentage difference between EDDLP and EDMCO were calculated, and they were statistically compared according to patient sex, type of examination performed, and type of scanner used. EDDLP significantly underestimated the EDMCO by 0.3 mSv (19%) for men who underwent unenhanced head CT, 0.5 mSv (29%) for women who underwent unenhanced head CT, 0.9-1.4 mSv (9-13%) for men who underwent chest CT, and 4.7-4.8 mSv (39%) for women who underwent chest CT (p < 0.001). The EDDLP overestimated the EDMCO by 1.9-2.0 mSv (12-14%) for men who underwent abdominopelvic CT (p < 0.001), with no significant difference noted for women who underwent abdominopelvic CT's. No significant difference was noted in the percentage difference in ED between the 16- and 64-MDCT scanners (p ≥ 0.13). EDDLP underestimates EDMCO, the reference standard for dose calculation, by 19-39% in unenhanced head CT examinations and, among women, in chest CT examinations. EDDLP deviates from EDMCO by less than 15% for chest CT examinations of men and for abdominopelvic CT. These differences can be attributed to variable patient body habitus, automatic tube current modulation, and sex-neutral k-coefficients, and they should be considered when calculating ED, particularly in women.

Preoperative Prediction of Small Bowel Length Using CT Scan and Tridimensional Reconstructions: a New Tool in Bariatric Surgery?

During Roux-en-Y-gastric Bypass, the limb lengths are preoperatively determined regardless of individual small bowel length (SBL), which presents a great variability. Few studies highlighted anthropometric factors associated with SBL, and none attempted to predict SBL preoperatively. The aim of this study is to evaluate factors correlated to SBL (anthropometric and radiologic) and to establish a preoperative SBL prediction. In this single-center prospective study, 30 adult patients who underwent laparotomy with a preoperative CT scan were included. Intraoperative SBL measurement was performed with an umbilical tape. Anthropometric parameters were age, gender, height, and BMI. 2D radiological measurements consisted of subcutaneous thickness, abdominal diameters, waist circumference, and mesenteric root length. 3D radiological volumetric reconstructions consisted of whole small bowel and mesentery (WSBM), lean small bowel and mesentery (LSBM), and fat small bowel and mesentery (FSBM). Mean intraoperative measurement of SBL was 531± 105cm. Among the clinical and radiological measurements, the FSBM volume presented the greatest dispersion. Height (p < 0.02) and LSBM volume (p < 0.01) were significantly correlated to the SBL in univariate analysis. LSBM volume was the only measurement significantly associated with SBL in multivariate analysis (p < 0.006). From the multivariate model, a formula was created to predict SBL. The mean percentage difference between predicted and intraoperative SBL measurements for all patients was 13.7%, and 8.4% for obese patients. LSBM volume is significantly correlated to the SBL. A preoperative SBL prediction with low percentage error could be performed with LSBM volume.

Computed tomography-based volumetric tool for standardized measurement of the maxillary sinus.

Volume measurements of maxillary sinus may be useful to identify diseases affecting paranasal sinuses. However, literature shows a lack of consensus in studies measuring the volume. This may be attributable to different computed tomography data acquisition techniques, segmentation methods, focuses of investigation, among other reasons. Furthermore, methods for volumetrically quantifying the maxillary sinus are commonly manual or semiautomated, which require substantial user expertise and are time-consuming. The purpose of the present study was to develop an automated tool for quantifying the total and air-free volume of the maxillary sinus based on computed tomography images. The quantification tool seeks to standardize maxillary sinus volume measurements, thus allowing better comparisons and determinations of factors that influence maxillary sinus size. The automated tool utilized image processing techniques (watershed, threshold, and morphological operators). The maxillary sinus volume was quantified in 30 patients. To evaluate the accuracy of the automated tool, the results were compared with manual segmentation that was performed by an experienced radiologist using a standard procedure. The mean percent differences between the automated and manual methods were 7.19% ± 5.83% and 6.93% ± 4.29% for total and air-free maxillary sinus volume, respectively. Linear regression and Bland-Altman statistics showed good agreement and low dispersion between both methods. The present automated tool for maxillary sinus volume assessment was rapid, reliable, robust, accurate, and reproducible and may be applied in clinical practice. The tool may be used to standardize measurements of maxillary volume. Such standardization is extremely important for allowing comparisons between studies, providing a better understanding of the role of the maxillary sinus, and determining the factors that influence maxillary sinus size under normal and pathological conditions.

Evaluation and comparison of second-check monitor unit calculation software with Pinnacle3 treatment planning system

The purpose of this study was to evaluate and compare the accuracy of dose calculations in second check softwares (Diamond, IMSure, MuCheck, and RadCalc) against the Phillips Pinnacle3 treatment planning system. Eighteen previously treated patients’ treatment planning files consisting of a total of 204 beams were exported from the Pinnacle3 TPS to each of the four second check software. Of these beams, 145 of the beams used were IMRT plans while 59 were VMAT arcs. The values were represented as a percent difference between primary and secondary calculations and used for statistical analysis. Box plots, Pearson Correlation, and Bland-Altman analysis were performed in MedCalc. The mean percent difference in calculated dose for Diamond, IMSure, MuCheck, and RadCalc from Pinnacle3 were −0.67%, 0.31%, 1.51% and −0.36%, respectively. The corresponding variances were calculated to be 0.07%, 0.13%, 0.08%, and 0.03%; and the largest percent differences were −7.9%, 9.70%, 9.39%, and 5.45%. The dose differences of each of the second check software in this study can vary considerably and VMAT plans have larger differences than IMRT. Among the four second check softwares, RadCalc values has shown a high agreement on average with low variation, and had the smallest percent range from Pinnacle3 values. The closest in average percent difference from the Pinnacle3data was the IMSure software, but suffered from significantly larger variance and percent range. The values reported by Diamond and MuCheck had significantly high percent differences with TPS values.

An Alternative Approach for Supportive Supervision and Skill Measurements of Health Workers for Integrated Management of Neonatal and Childhood Illnesses Program in 10 Districts of Haryana.

Context:“Integrated Management of Neonatal and Childhood Illnesses” (IMNCI) needs regular supportive supervision (SS).Aims:The aim of this study was to find suitable SS model for implementing IMNCI.Settings and Design:This was a prospective interventional study in 10 high-focus districts of Haryana.Subjects and Methods:Two methods of SS were used: (a) visit to subcenters and home visits (model 1) and (b) organization of IMNCI clinics/camps at primary health center (PHC) and community health center (CHC) (model 2). Skill scores were measured at different time points. Routine IMNCI data from study block and randomly selected control block of each district were retrieved for 4 months before and after the training and supervision.Statistical Analysis Used:Change in percentage mean skill score difference and percentage difference in median number of children were assessed in two areas.Results:Mean skill scores increased significantly from 2.1 (pretest) to 7.0 (posttest 1). Supportive supervisory visits sustained and improved skill scores. While model 2 of SS could positively involve health system officials, model 1 was not well received. Outcome indicator in terms of number of children assessed showed a significant improvement in intervention areas.Conclusions:SS in IMNCI clinics/camps at PHC/CHC level and innovative skill scoring method is a promising approach.

Evaluation and Comparison of Stability and Reliability of CBC Parameters Determined by Using Automatic Celltac G MEK-9100 Hematology Analyzer during Extended Storage at 4°C

Introduction: Sample stability is necessary for the maintenance of the quality for the final results obtained at different storage time intervals during CBC analysis. In our present study, we have evaluated the stability of various CBC parameters of blood samples stored in k2-EDTA (BD) vials at 4°C (extended storage time: 10 days). Materials and methods: Blood sample (2.5 ml) was drawn directly in K2-EDTA vials. Measurements were done by using MEK-9100 hematology analyzer at regular intervals over an extended period up to 246 h (10 days). Significant differences were analyzed by Paired student’s t-test. Mean percent differences of the all intervals were compared with baseline means. Results: Among CBC parameters, WBC count was stable for up to 126 h, RBC and HGB levels were statistically stable for up to 186 h and 90 h. No significant changes were observed in NE, LY, MO, EO and BA for up to 42 h, 42 h, 66 h, 66 h, and 6 h respectively. PLT counts were stable for 6 h. Furthermore, results of HCT, MCV, MCH, MCHC, RDW-CV, RDW-S, PCT and MPV were statistically stable for up to 54 h, 42 h, 18 h, 30 h, 42 h, 30 h, 6 h and 6 h respectively. Conclusion: Estimation of RBC, WBC and HGB were qualitatively reliable ~186 h, 126 h and 90 h respectively. However, most parameters of CBC were unchanged ~48 h except for the PLT (6 h). To avoid changes in few parameters, such as MPV, basophiles, it is best to store the sample at 4°C if any delay is anticipated.

Accuracy of Ultrasound Estimated Fetal Weight in Small for Gestational Age and Appropriate for Gestational Age Grown Periviable Neonates.

Clinicians use estimated fetal weight (EFW) as a proxy for birth weight (BW) in the antenatal period. Our objective was to compare the accuracy of EFW obtained by ultrasound to BW among infants born during the periviable period and determine if accuracy of EFW varied among small for gestational age (SGA) versus appropriate for gestational age (AGA) grown neonates. We included women who delivered between 230/7 and 256/7 weeks' gestation and had an EFW within 7 days of delivery. Mean percentage difference and median absolute percentage difference between EFW and BW were calculated. Our cohort included 226 neonates with a mean gestational age of 241/7 ± 0.8 weeks and median BW of 653 g (interquartile range [IQR]: 580-750 g). The median absolute percentage difference between EFW and BW of fetal weight estimates was 9.2% (IQR: 3.6-17.2). EFW overestimated BW for 75% (n = 171) of the cohort. Among SGA infants, the mean percentage difference in EFW and BW was 16.2 ± 19.4% versus 6.9% ± 13.1% in AGA infants (p = 0.019). EFW overestimated BW in this cohort. In addition, ultrasound was less accurate among infants born SGA. These data are important to consider when counseling families facing periviable delivery.

Hang Height of Enteral Nutrition Influences the Delivery of Enteral Nutrition.

Adequate enteral nutrition (EN) delivery to critically ill patients is difficult to achieve. Given the large number of unpreventable influences affecting adequate caloric intake, further research on preventable influences of adequate EN administration is warranted. The purpose of this study was to evaluate whether hang height of EN formula, formula viscosity, or flow rate influences pump accuracy and formula delivery. Formulas of varying viscosities (1.0, 1.5, and 2.0 kcal/mL) were infused at different hang heights (0, 6, 12, and 18 inches) and rates (20, 40, and 80 mL/h). The mean percent difference and the bias between the programmed volume, volume reported, and volume delivered were calculated for the different hang heights, formula compositions, and infusion rates studied. For all prespecified hang heights and infusion rates, the volume delivered was less than the programmed volume and volume reported; the mean percent difference increased as the hang height decreased. The volume was overestimated for both the programmed volume (14.4% ± 5.5%) and volume reported (12.9% ± 6.7%) compared with volume delivered. The overestimation bias was significantly influenced by differences in hang height as well as type of formula (P < .0001, each) but not by rate of delivery (P = .4633 for programmed volume and .8411 for volume reported). Measures should be taken in clinical practice to ensure adequate hang height of EN. Appropriate hang height of EN may result in more accurate delivery of nutrition provisions to the critically ill patient and subsequently reduce complications related to underfeeding.

Chest Radiograph Measurement Technique Facilitates Accurate Bedside Peripherally Inserted Central Catheter Placement in Children.

To report the chest radiograph measurement technique for placing bedside peripherally inserted central catheters (PICCs). Two hundred and thirty-two consecutive pediatric patients, mean age of 56.3months (range: 0-203months), underwent PICC placement from January 2015 to May 2017 (28months) with a total of 232 PICCs placed. Measurements were taken from the cavoatrial junction to clavicle, clavicle to medial margin of mid-humeral head, and medial margin of mid-humeral head to mid-humerus. The difference between total radiographic measured length and actual PICC length was then calculated, and the percent difference (from actual cut length) was recorded. An equivalence test was performed using the two, one-sided test method. Mean±standard deviation cavoatrial junction to clavicle length was 5.29±2.20cm (range: 2.1-12.6cm). Mean clavicle to shoulder length was 8.20±3.59cm (range: 3.23-19.06cm). Mean shoulder to mid-humerus length was 7.88±3.87cm (range: 2.01-16.8cm). Mean total radiographic measured length was 21.37±9.19cm (range: 7.42-43.6cm). Mean actual cut PICC length was 20.64±8.72cm (range: 8.5-44cm). The mean difference between predicted, or total radiographic measured length, and actual cut PICC length was 0.73 ±2.51 (range:-5.42-8.60cm). The mean percent difference was 4.07±12.65% (range:-23.84-47.80%). An equivalence test rejected the null hypothesis of the true percent difference greater/less than±6.67% with a p value of 0.002. The chest radiograph measurement technique is an accurate method to determine catheter length for PICC placement at bedside in the pediatric population.

Magnetic resonance imaging in radiotherapy treatment target volumes definition for brain tumours: a systematic review and meta-analysis

AbstractPurposeThe aim of this study is to establish clinical evidence regarding the use of magnetic resonance imaging (MRI) in target volume definition for radiotherapy treatment planning of brain tumours.MethodsPrimary studies were systematically retrieved from six electronic databases and other sources. Studies included were only those that quantitatively compared computed tomography (CT) and MRI in target volume definition for radiotherapy of brain tumours. Study characteristics and quality were assessed and the data were extracted from eligible studies. Effect estimates for each study was computed as mean percentage difference based on individual patient data where available. The included studies were then combined in meta-analysis using Review Manager (RevMan) software version 5.0.ResultFive studies with a total number of 72 patients were included in this review. The quality of the studies was rated strong. The percentages mean differences of the studies were 7·47, 11·36, 30·70, 41·69 and −24·6% using CT as the baseline. The result of statistical analysis showed small-to-moderate heterogeneity; τ2=36·8; χ2=6·23; df=4 (p=0·18); I2=36%. The overall effect estimate was −1·85 [95% confidence interval (CI); −7·24, 10·94], Z=0·40 (p=0·069&gt;0·5).ConclusionBrain tumour volumes measured using MRI-based method for radiotherapy treatment planning were larger compared with CT defined volumes but the difference lacks statistical significance.

Capillary and venous point-of-care testing of lactate concentrations in the emergency department: a prospective observational study

BackgroundHyperlactatemia is a sensitive marker for early identification of patients who are critically ill. Rapid capillary lactate measurement using a handheld device can hasten the identification of patients at risk. We aimed to compare capillary lactate with venous blood lactate assessed using a blood gas analyser in the emergency department. MethodsThis was a prospective observational study of patients presenting to the emergency department in Hong Kong SAR. Venous and fingertip capillary blood samples were collected for lactate analysis. Venous lactate concentrations measured using a point-of-care blood gas analyser was used as a reference method (VL-Ref). Capillary lactate concentrations were measured using two handheld analysers: (1) Nova StatStrip Xpress (CL-Nova); and (2) Lactate Scout+ (CL-Scout+). Venous lactate measurements were also done using two handheld analysers (VL-Nova and VL-Scout+). Bland-Altman analysis was used to determine the agreement between different methods of measurement. Ethics approval was obtained from the Institutional Review Board of the Chinese University of Hong Kong (CREC 2015.624). Written consent was obtained either from the patient or a relative in all cases. The study is registered with ClinicalTrials.gov (NCT02694887). FindingsBetween March and July, 2016, we recruited 240 patients (aged 18 years or older) who were triage category 3 (urgent) presenting to the emergency department. Of 240 patients (mean age 69·9 years; 54% men), lactate concentrations were in the range 0·70–5·38 mmol/L (mean 1·96mmol/L). 151 patients (63%) had lactate concentrations (VL-Ref) less than 2 mmol/L, and 89 patients (37%) had lactate concentrations of at least 2 mmol/L. The results of a Bland-Altman analysis showed that percentage of mean difference were −6·2% between VL-Ref and CL-Scout+, 29·9% between VL-Ref and CL-Nova, with 95% limits of agreement of −79·3 to 66·8% and −43·8 to 103·6%, respectively. Regarding venous blood lactate, the results showed bias values of 13% between VL-Ref and VL-Scout+, 55·3% between VL-Ref and VL-Nova, with limits of agreement being −23·9 to 49·9% and 20·7 to 90·0%, respectively. InterpretationAn overall low systemic bias were observed in CL-Scout+ (bias −6·2%) and VL-Scout+ (bias 13%), suggesting the potential clinical utility of the Scout+ handheld analyser. However, the wide range of limits of agreement implies poor precision of using fingertip capillary blood for lactate testing. Further studies are needed to validate the use of capillary lactate in emergency settings. FundingDirect Grant for Research, The Chinese University of Hong Kong.

Effect of liraglutide on atrial natriuretic peptide, adrenomedullin, and copeptin in PCOS.

ContextWomen with polycystic ovary syndrome (PCOS) have an increased risk of cardiovascular disease (CVD), and biomarkers can be used to detect early subclinical CVD. Midregional-pro-adrenomedullin (MR-proADM), midregional-pro-atrial natriuretic peptide (MR-proANP) and copeptin are all associated with CVD and part of the delicate system controlling fluid and hemodynamic homeostasis through vascular tonus and diuresis. The GLP-1 receptor agonist liraglutide, developed for treatment of type 2 diabetes (T2D), improves cardiovascular outcomes in patients with T2D including a decrease in particular MR-proANP.ObjectiveTo investigate if treatment with liraglutide in women with PCOS reduces levels of the cardiovascular biomarkers MR-proADM, MR-proANP and copeptin.MethodsSeventy-two overweight women with PCOS were treated with 1.8 mg/day liraglutide or placebo for 26 weeks in a placebo-controlled RCT. Biomarkers, anthropometrics, insulin resistance, body composition (DXA) and visceral fat (MRI) were examined.ResultsBaseline median (IQR) levels were as follows: MR-proADM 0.52 (0.45–0.56) nmol/L, MR-proANP 44.8 (34.6–56.7) pmol/L and copeptin 4.95 (3.50–6.50) pmol/L. Mean percentage differences (95% CI) between liraglutide and placebo group after treatment were as follows: MR-proADM −6% (−11 to 2, P = 0.058), MR-proANP −25% (−37 to −11, P = 0.001) and copeptin +4% (−13 to 25, P = 0.64). Reduction in MR-proANP concentration correlated with both increased heart rate and diastolic blood pressure in the liraglutide group. Multiple regression analyses with adjustment for BMI, free testosterone, insulin resistance, visceral fat, heart rate and eGFR showed reductions in MR-proANP to be independently correlated with an increase in the heart rate.ConclusionIn an RCT, liraglutide treatment in women with PCOS reduced levels of the cardiovascular risk biomarkers MR-proANP with 25% and MR-proADM with 6% (borderline significance) compared with placebo. The decrease in MR-proANP was independently associated with an increase in the heart rate.

Reference values for spirometry in Chinese aged 4-80 years.

Although there are over 1.34 billion Chinese in the world, nationwide spirometric reference values for Chinese are unavailable, which is usually based on Caucasian conversion. The aim of this study was to establish spirometric reference values for Chinese with a national wide sample. We enrolled healthy non-smokers in 24 centers in Northeast, North, Northwest, Southwest, South, East and Central China from January 2007 to June 2010. Spirometry was performed according to American Thoracic Society and European Respiratory Society guidelines. Reference equations were established using the Lambda-Mu-Sigma (LMS) method for forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC, peak expiratory flow (PEF) and maximal midexpiratory flow (MMEF). Popular Caucasian reference values adjusted with ethnic conversion factors were validated with Chinese measured spirometry data. The present study also compared with other published Chinese equations for spirometry. A total of 7,115 eligible individuals aged 4 to 80 years (50.9% females) were recruited. Reference equations against age and height by gender were established, including predicted values and lower limits of normal (LLNs). Validated with Chinese data, the mean percentage differences of Caucasian reference values adjusted with ethnic conversion factors were -10.2% to 1.8%, and the percentages of total subjects under LLNs were 0.1% to 8.9%. Compared with this study, the percentage differences of previous Chinese studies ranged from -17.8% to 11.4%, which were found to significantly overestimate or underestimate lung function. This study established new reference values for better interpretation of spirometry in Chinese aged 4 to 80 years, while Caucasian references with adjustment were inappropriate for Chinese.

Predicting water and nitrogen requirements for maize under semi-arid conditions using the CSM-CERES-Maize model

Abstract Crop models can be useful tools for optimizing irrigation water and fertilizer management to improve crop productivity. The goal of this study was to assess the performance of the Cropping System Model (CSM)-CERES-Maize for its capability to simulate soil moisture content in relation to plant growth, development and grain yield and to determine optimum irrigation and fertilizer inputs under semiarid conditions. The model simulations were compared with the observed results from field trials that were conducted during 2009 and 2010 with a combination of three irrigation regimes (full irrigation, water deficit at vegetative and at reproductive stage) and five nitrogen (N) rates using a split plot design for a total of 15 treatments. To determine the most appropriate combination of nitrogen fertilizer and irrigation, a combination of three irrigation regimes and five N rates ranging from 100 to 300 kg N ha−1 for a total of 15 scenarios were simulated for 35 years of historical daily weather data. The model was calibrated with an optimum treatment from the 2010 experiment, while the remainder of the data were used for model evaluation. The results showed that the model successfully predicted (R2 = 0.98) soil moisture content throughout the growing season. The observed (calibrated) mean percentage differences (MPD) for the numbers of grains per ear, leaf area index (LAI) and total dry matter (TDM) were 5.98, 11.4, and 4.85%, respectively. The MPD was zero for yield, anthesis and maturity days. The normalized root mean square error (nRMSE) for grain yield was 10.4% and 11.4% in 2009 and 2010, respectively. Based on the economic analysis, the management scenario with an N fertilizer application rate of 300 kg N ha−1 in three splits and total irrigation of 525 mm was dominant with the highest mean grain yield (7973 kg ha−1) and a gross margin of US $ 548 ha−1. The outcomes of this study can be used for determining the optimum water and N requirements for maize production under semi-arid conditions. The modeled genetic coefficients might be helpful for plant breeders to develop maize cultivars for semi-arid regions that may give the optimum yield under above recommended N and water management practices.

Application of ISOCS system in the laboratory efficiency calibration

ISOCS (In Situ Counting Object System) from Canberra is applied in laboratory for creating efficiency calibrations of good quality without using radioactive standards. Besides of typical sample containers used in laboratory, ISOSC system also allows modelling containers and objects of almost any shape and elemental composition.The study was based on gamma spectrometry with HPGe semiconductor detector with electronics and software spectrum analysis GENIE 2000 + ISOCS. Measuring set is equipped with portable shield system with set of collimators ISOCS Shield Systems Model ISOXSHLD from Canberra. This shielding system provides attenuation of gamma background radiation with average value 33 (for gamma energies from 186 keV to 2615.5 keV).The portable shield system can be used for low-background laboratory measurements. For this purpose a measuring vessel of new geometry was constructed: the polystyrene cylinder with a height of 40 mm and a diameter of 70 mm. The efficiency calibration for this container was performed using both ISOCS system and classical calibration standard in the same geometry. In order to verify the correctness of performed calibration procedures, the measurements of radioactive standard CBSS 2 were made. The results of both calibrations were compared with the data from the standard certificate. Satisfactory agreement was achieved. Mean percentage difference between results from ISOCS calibration compared to reference values is 6% for all isotopes activities in CBSS 2 standard.The set of collimators was used to develop efficiency calibration for in situ measurements of the soil surface. Test measurements were carried out at the area of the Institute of Nuclear Physics Polish Academy of Sciences in Kraków, Poland (IFJ PAN). Two measurement methods were compared: in situ and laboratory gamma spectroscopy. The obtained average results (from all 10 measuring points) are consistent within the range of measurement uncertainty.

3D patient-specific models for left atrium characterization to support ablation in atrial fibrillation patients

BackgroundRadiofrequency ablation (RFA) is an important and promising therapy for atrial fibrillation (AF) patients. Optimization of patient selection and the availability of an accurate anatomical guide could improve RFA success rate. In this study we propose a unified, fully automated approach to build a 3D patient-specific left atrium (LA) model including pulmonary veins (PVs) in order to provide an accurate anatomical guide during RFA and without PVs in order to characterize LA volumetry and support patient selection for AF ablation. MethodsMagnetic resonance data from twenty-six patients referred for AF RFA were processed applying an edge-based level set approach guided by a phase–based edge detector to obtain the 3D LA model with PVs. An automated technique based on the shape diameter function was designed and applied to remove PVs and compute LA volume. 3D LA models were qualitatively compared with 3D LA surfaces acquired during the ablation procedure. An expert radiologist manually traced the LA on MR images twice. LA surfaces from the automatic approach and manual tracing were compared by mean surface-to-surface distance. In addition, LA volumes were compared with volumes from manual segmentation by linear and Bland-Altman analyses. ResultsQualitative comparison of 3D LA models showed several inaccuracies, in particular PVs reconstruction was not accurate and left atrial appendage was missing in the model obtained during RFA procedure. LA surfaces were very similar (mean surface-to-surface distance: 2.3±0.7mm). LA volumes were in excellent agreement (y=1.03x−1.4, r=0.99, bias=−1.37ml (−1.43%) SD=2.16ml (2.3%), mean percentage difference=1.3%±2.1%). ConclusionsResults showed the proposed 3D patient-specific LA model with PVs is able to better describe LA anatomy compared to models derived from the navigation system, thus potentially improving electrograms and voltage information location and reducing fluoroscopic time during RFA. Quantitative assessment of LA volume derived from our 3D LA model without PVs is also accurate and may provide important information for patient selection for RFA.