Rank-order Correlation Test Research Articles

Effect of Biopsy Location and Size on Proliferative Capacity of Ex Vivo Expanded Conjunctival Tissue

To evaluate the effect of location and size of biopsy on phenotype and proliferative capacity of cultured rat conjunctival epithelial cells. Pieces of conjunctiva were used from six areas: superior and inferior areas of bulbus, fornix, and tarsus of male Sprague-Dawley rats (n = 6). Explants were grown in RPMI 1640 with 10% fetal bovine serum on coverslips for 8 days or assayed for colony-forming efficiency (n = 9). Analysis included immunofluorescence microscopy and outgrowth measurements with ImageJ software. The Mann-Whitney test and Spearman's rank-order correlation test were used. Superior (23.9 ± 2.9-fold growth) and inferior (22.4 ± 1.2-fold growth) forniceal tissues yielded significantly more outgrowth with respect to explant size than superior bulbar (13.4 ± 1.9-fold growth; P < 0.05 and P < 0.01, respectively), inferior bulbar (13.6 ± 1.6-fold growth; P = 0.01 and P < 0.01, respectively), and inferior tarsal tissues (14.0 ± 1.3-fold growth; P = 0.01). Outgrowth size correlated positively with explant size (r(s) = 0.54; P < 0.001), whereas explant size correlated negatively with fold growth (r(s) = 0.36; P < 0.001). Superior forniceal cells displayed higher colony-forming efficiency (3.6% ± 0.9%) than superior bulbar (1.1% ± 0.3%; P < 0.05) and inferior bulbar cells (1.6% ± 0.8%; P < 0.05). Percentage of p63+ and PCNA+ cells correlated positively with explant and outgrowth size. Small forniceal conjunctival explants grow the most effectively; however, for transplantation purposes, the loss of p63+ and PCNA+ cells with small explants must be considered.

An Evaluation of English Language Grammar for College Students 1&amp;2: An EAP Coursebook Evaluation

The purpose of the present study is to do a detailed evaluation of English Language Grammar for Iranian College students. In order to accomplish the purpose of the research, the researchers used two instruments: 1) The questionnaire developed by Daoud and Celce-Murcia 2) The researcher-made checklist based on Bloom's taxonomy of language learning. Regarding the questionnaire, twenty available EFL teachers evaluated the book in terms of five key aspects of subject matter, vocabulary and structure, exercises, illustrations, and physical make up. Concerning the checklist, the researcher meticulously evaluated the book in terms of three domains of cognitive, affective, and psychomotor. In order to analyze the data in both instruments, descriptive as well as inferential statistics such as Kruskall-Wallis and Pearson Rank Order Correlation tests were applied. The result of statistics for the questionnaire revealed that subject matter, vocabulary and structure, and physical make up of the book are emphasized and two aspects of exercises and illustrations are ignored. And there is only correlation between subject matter and physical make up. Data analysis for the checklist indicated that within cognitive domain, only first stages are emphasized and the last stages of synthesis and evaluation are neglected. In addition, cognitive domain is more privileged than affective and psychomotor domains. Finally, some pedagogical implications for both teachers and syllabus designers are provided.

MRI pelvic landmark angles in the assessment of apical pelvic organ prolapse

The aim of the study was to evaluate the utility of magnetic resonance imaging (MRI) pelvic landmark angles and lines in the assessment of apical vault prolapse. Seventeen women were evaluated as part of a prospective surgical trial. Baseline data are presented as a pilot study of the utility of MRI in addition to this evaluation of 6 nulliparous volunteers without prolapse and 11 parous women with symptomatic ≥ stage II uterine prolapse. Each patient underwent assessment for pelvic organ prolapse quantification (POPQ) and pelvic MRI. Pelvic landmark angles and lines were measured. Mann-Whitney Rank sum test and Spearman's Rank order correlation test were used to assess agreement. Women with prolapse had a significantly larger h angle, g angle, and e angle at rest than those without prolapse. Correlation between apical vault descent was measured clinically by POPQ point C with MRI measurements: h angle (r = 0.61, p = 0.01), g angle (r = 0.64, p = 0.005), and e angle (r = 0.62, p = 0.007). MRI measurements of pelvic landmark angles reliably differentiate between women with and without uterine prolapse and correlate best with POPQ point C.

Assessed facial normality after Twin Block therapy

The first aim of this study was to identify any difference in the perception of facial normality between orthodontists and lay people of patients with the initial presentation of a Class II division 1 malocclusion, the second is to investigate whether there was an identifiable facial change following Twin Block (TB) therapy, and lastly, the relationship between identifiable facial change and clinical measurements was explored. Animated laser scans of 16 randomly selected adolescent patients, nine males aged 12-14 years and seven females aged 11-13 years with Class II division 1 malocclusions before and after TB therapy, were assessed on a visual analogue scale (VAS) by 34 orthodontists and 35 lay people. The 'Mark and Measure' and 'Orientated' techniques were used to determine soft tissue dimensions. Overjet was also recorded. Non-parametric statistical analyses were employed, including Mann-Whitney, Wilcoxon signed value, and Spearman's rank-order correlation tests. There was no statistically significant difference in facial normality scores of adolescents before TB therapy when assessed by orthodontists (46.2 mm) and lay people (50.9 mm; P = 0.120). However, TB therapy significantly improved the assessment score of the orthodontists (54.8 mm) and lay people (57.8 mm; P = 0.000). Using a 5 per cent threshold in categorization of change in VAS scores, the majority of assessors perceived an overall 'improvement' (87.0 per cent). An increase in soft tissue lower face height (ST LFH) and overjet reduction was strongly correlated with the higher assessments of lay people (r = 0.515) and orthodontists (r = -0.505), respectively. Although orthodontists and lay people assess facial normality of patients with Class II division 1 malocclusions similarly, following TB therapy an increase in ST LFH with lay people and overjet reduction with orthodontists were most closely related to improved facial normality.

A Quantity Study of Marital Satisfaction, Romantic Jealousy and Female’s Aggression (Psychological and Physical)

The objective of this study is to determine the relationship among marital satisfaction, romantic jealousy and female’s aggression (physical and psychological). The women who participated in this study were those already registered as aggressive women in the counselling clinics. All of the 337 wives who were included in this study suffered from level of physical and psychological aggression were selected randomly for this investigation. Physical and psychological aggression were measured through Conflict Tactics Scale (CTS). The Spearman’s Rho for Rank Order Correlation test was used to determine the relationship among marital satisfaction, romantic jealousy and physical aggression. The test showed a positive relationship between jealousy and women’s physical aggression and a negative relationship between marital satisfaction and women’s physical aggression. The Pearson’s Product-Moment Correlation Test was utilized to determine the relationship among jealousy, marital satisfaction and psychological aggression. It showed a positive relationship between jealousy and women’s psychological aggression. Also there was a negative relationship between marital satisfaction and women’s psychological aggression. The Multivariate Regression Analysis was used to answer the last objective. The analysis showed that from the two predictor variables such as marital satisfaction and romantic jealousy, were found to be significant in explaining the observed variation in psychological aggression (DV). Generally, the final model has explained 21.5% of total observed variance in psychological aggression.

A Study on the effectiveness of occupational trainings of insurance on the performance of the insurance companies’ employees in terms of entrepreneurial skills

This study aims to survey the effect of the occupational trainings of insurance on the performance of the insurance companies’ employees in terms of personal, managerial and technical skills of entrepreneurship and to present practical solutions to increase the occupational training of the insurance companies’ employees in terms of entrepreneurial skills. This study is an applied research and uses descriptive survey method. Research statistical community incorporates 1600 employees of the Isfahan's insurance company in 2009. The statistical sample of this study is estimated 301 persons through Cochran's formula and these persons are chosen through random cluster sampling. A researcher made questionnaire with the Cronbach's Alpha reliability of 0.84 was used which consisted of 52 five likert scale close-ended questions and 1 open-ended question. To measure the assumptions, T-test for independent and paired samples, Kruskale-Wallis test, ANOVA and the Spearman Rho rank order correlation test are used. The results show that there is a meaningful difference between the effect of academic educations and the beginning or in-service educations on the performance of the insurance companies’ employees in terms of entrepreneurial skills (personal, managerial and technical). The employees’ personal and managerial skills of entrepreneurship are different due to their kind of activity. However, there is not meaningful difference among the technical skills of entrepreneurship based on the kind of their activity. Also it is revealed that there is not meaningful difference between the performance of employees whose major is insurance management and employees whose major is different in terms of entrepreneurial skills. An entrepreneurial skill is different among the employees based on their education level, but there is not difference among entrepreneurial skills of employees based on their major. Personal skills of entrepreneurship are different based on employees’ gender, but managerial and technical skills of entrepreneurship of employees are not different based on gender. There isn’t correlation between the entrepreneurial skills and the employees’ service records. There is not meaningful difference among the employee's personal skills of entrepreneurship arised from the beginning or in-service educations based on their education level (diploma and upper), but there is meaningful difference among managerial and technical skills of entrepreneurship arised from the beginning or inservice educations based on the employees’ education level (diploma and upper). This study emphasizes the importance of occupational trainings of the entrepreneurial skills.

Improving time management in the South African construction industry

This paper aims to prioritise constraints to effective time management in the South African construction industry. Construction time is a basis for evaluating the success of a project and the efficiency of the project organisation. The study was limited to views expressed by registered members of the CIOB-South Africa in the Gauteng Province. The data was analysed using multi-attribute methods, content analysis and bi-variate analysis, involving rank order correlation tests. The findings of the study reveal the appropriateness of time management techniques as used by practitioners in scheduling various projects, prioritised or key constraints to effective time management, and ways of improving on-time project delivery. These findings will benefit the key role players in project development namely; clients, consultants and contractors in effective time management policy formulation and implementation.

Seasonality of nuclear abnormalities in gilthead sea bream Sparus aurata (L.) erythrocytes

The frequencies of erythrocyte nuclear abnormalities, such as irregularly shaped (ISN), vacuolated nuclei (VN), binucleated cells (BN), including micronuclei (MN), were monitored in the peripheral blood of cultured gilthead sea bream (Sparus aurata L.) from the southern Adriatic Sea (Croatia) and assessed for a relation to seasonality. Fish were sampled in February, April, June, and September. The lowest frequencies of ISN and MN were measured in April, and the lowest frequencies of VN and BN were found in February. The highest values of ISN and BN were detected in September. The highest values of MN and the most frequent occurrence of VN occurred in June and April, respectively. The Spearman rank order correlation test revealed a significant positive correlation between the frequencies of ISN, BN and MN; VN did not correlate with any of the measured parameters. The ISN had significantly higher nuclear surface area values than normal nuclei (P < 0.001). Our results demonstrate that the measured parameters displayed a distinct seasonality. Consequently, we conclude that seasonal variations should be taken into account when nuclear abnormalities are used as biomarkers. This variation should be well understood in order to successfully separate true contamination effects from seasonal factors that have the potential to affect the frequency and occurrence of nuclear abnormalities.

Welfare in a shelter dog rehomed with Alzheimer patients

Abstract This study evaluates whether a shelter dog could be rehomed successfully into a facility for people suffering from Alzheimer's disease (AD). The goal was to assess the effect on animal welfare of this form of pet ownership and of individual sessions of animal assisted activity (AAA) with some pre-selected patients. After the enrollment of a suitable shelter dog, the dog was introduced gradually into the facility. Upon adoption, the dog's welfare was monitored during the first 6 months by integrating indirect assessment (18-item questionnaire) with direct observations of behavioral and clinical responses (31-item score system table), and with an assay of hormonal changes. Only descriptive statistics were done on the questionnaire data. The findings suggest a progressive positive integration into the new environment. The qualitative data using direct observations were analyzed with the Spearman Rank order correlation test. Some data showed significant variation during the period of observation, suggesting a gradual reduction of the dog's stress during AAA sessions. The hormonal trend, especially for cortisol measured in hair, seemed to correlate with the clinical and behavioral findings.

Endometriosis: frequency and correlation between symptomatology and disease stage.

To determine the frequency of endometriosis in general gynecological and infertile women presenting to hospital and to correlate symptomatology and stage of disease. Cross-sectional study. Gynecology Department of Mother and Child Health Center, Pakistan Institute of Medical Sciences, Islamabad, from March 2000 to March 2002. Fifty patients with diagnosis of endometriosis on laparoscopy were included in the study. The degree of pain symptoms was graded according to 1-4 point verbal rating scale designed by Biberoglu and Behrman. Endometriosis was staged according to Revised American Fertility Society (R-AFS) scoring on laparoscopy. Correlation coefficient-Spearman rank order correlation test was applied to analyze data. The frequency of endometriosis in infertile women was 24% (33) and in women with general gynecological complaints, it was 23% (17). There was a significant positive correlation between chronic pelvic pain and R-AFS scoring. Increasing severity of pelvic pain was also positively correlated with presence of endometrioma and complete obliteration of pouch of Douglas. No correlation between dysmenorrhoea and R-AFS scoring could be detected. Dysmenorrhoea was strongly and positively correlated with the presence of superficial implants. Dyspareunia was found to have positive correlation with R-AFS score and also with complete obliteration of pouch of Douglas. The frequency of endometriosis in infertile women was 24% (33) and in women with general gynecological complaints, it was 23% (17). Chronic pelvic pain and dyspareunia had strong positive correlation with R-AFS score while dysmenorrhoea had no such correlation.

The impact of water resources development projects on water vapor pressure trends in a semi-arid region, Turkey

The aim of this study was to investigate long-term seasonal trends and decadal change patterns of monthly mean water vapor pressure (WVP) observation series at 16 meteorological stations scattered point-wisely over the Southeastern Anatolian Project (GAP) area in Turkey, where large-scale soil and water development projects have been put into practice since the 1970s. The record length of WVP observation series of each station varied between 31- and 41-years between 1962 and 2002. The monthly mean WVP observation series of each station was rearranged on seasonal basis. Sequential Mann–Kendall trend test, Sen’s slope estimator, and Spearman’s rank–order correlation tests were employed for detection of likely trends, and Kruskall–Wallis test was used to detect decadal variations in WVP series of each observation station. A possible area of representation for each meteorological station was determined by using the Thiessen polygons technique in a geographical information systems media. It was found that 15 seasonal WVP series have a positive trend covering 97% of the GAP area in the summer season; although one WVP series has a negative trend direction. However, in the spring season, 33% of the area had a positive trend, and a negative trend did not appear in any stations. WVP records in the winter season showed an increasing trend over 19% of the GAP area, whereas a decreasing trend prevailed in 9% of the area. The study results led us to conclude that the substantial increase of WVP observations in summer season could be attributed to both the shift from rain-fed agriculture to irrigated agriculture being made increasingly spacious year by year and building large water reservoirs in the GAP located in a semi-arid region. The results also indirectly suggested that the historical trends in the WVP parameters might be related to global climate change phenomenon.

Down‐regulated lymphocyte NF‐kB activation in breast cancer survivors following yoga participation

The purpose of the study was to examine lymphocyte NF-κB activation in female breast cancer survivors who participated in eight weeks of yoga. Survivors (Stages I-IV, age 61+7.4 yr, mean+SD) were randomly assigned to yoga (Y, n = 10) or waitlisted (WL, n = 9) groups. Iyengar yoga practice included two 90-minute classes per week plus one home practice. Demands of Illness (DOI) and lymphocyte NF-κB activation were evaluated pre- (T1) and post-yoga (T2). Lymphocyte NF-κB activation (Y, n = 5; WL, n = 4) was determined by EMSA following stimulation by phorbol 12-myristate 13-acetate, phytohemagglutinin and ionomycin. These data were initially analyzed by Mann-Whitney U test and Spearman Rank Order Correlation test. Results indicated that DOI significantly declined (p = 0.038) from T1 to T2 with yoga. The change in NF-κB activation from T1 (Y = 2563+1076, WL = 2029+1456, integrated density value/μg protein/106 cells) to T2 (Y = 1439+1142, WL = 2359+443) was significantly different (p = 0.039) between groups. Linear regression analysis of DOI and log transformed NF-κB activation data revealed a significant association between variables (r = 0.75, p = 0.01) in yoga participants only. These findings lend support to the hypothesis that yoga participation by breast cancer survivors can attenuate illness-related stressors and alter lymphocyte NF-κB regulation. Supported by Cancer Prevention and Research Center WSU; University of Washington Center for Women’s Health and Gender Research.

Structural characteristics of annual precipitation data in Jordan

Thirteen meteorological stations distributed across Jordan are selected in order to analyze the structure of annual precipitation data for the country. The length of data, for all stations, is 50 years, covering the common period 1953–2002. The analysis is based on a series of tests designed to determine if the annual total precipitation data taken from each station are consistent, random, and trend free. Consistency is defined simply using the classical doublemass curve, and a non-parametric test is used to determine randomness. The Fisher test is also employed to test for randomness of the series. In order to determine if the data are trend free, a simple linear trend model, as well as the Spearman Rank Order Correlation test, is used. Jump analysis is also performed following application of the segmentation procedure, and finally, the probability distribution fitted to the data set is determined using the Probability Plot Correlation Coefficient test. The study concludes with a description of the structural characteristics and temporal and spatial variation of annual precipitation data in Jordan, together with possible projections for the future.

Nuclear receptors in human immune cells: Expression and correlations

Nuclear receptors (NR) are key modulators of gene transcription. Their activity is ligand induced and modulates a large variety of tissue-specific cellular functions. However, for many NR little is known about their role in cells of the immune system. In this study, expression patterns and distribution of 24 NR were investigated in human peripheral blood mononuclear cells. We provide the first evidence of the expression of the 12 receptors CAR, CoupTFα, CoupTFβ, FXR, GCNF, HNF4α, PPARβ/δ, PXR, RevErbβ, TR2, TR4 and TLX in highly purified CD4, CD8, CD19, CD14 cells. The expression profile of RevErbα and LXRα previously observed in B cell and macrophages, respectively, has been extended to CD4, CD8 and CD14 cells. Except for RARβ, which was absence in any of the cells tested, our results suggest an almost ubiquitous expression of the NR in the different cell lineages of the immune system. The expression of CAR, CoupTFα, FXR was also confirmed at a protein level and despite conspicuous mRNA levels of HNF4α, only low levels of this receptor were detectable in the nuclear fraction of PBMCs. Expression of the latter receptors was mostly only a fraction (4–20%) of their expression in the thyroid gland, the adrenal gland, the lung or subcutaneous adipose tissue. The Spearman rank order correlation test was performed to examine the correlation in expression between individual nuclear receptor pairs in the four cell types for several donors. Distinct correlation patterns were observed between receptor pairs in the individual cell types. In CD4 T cells four NR, GCNF, PPARγ, PPARα7 and RevErbβ are perfectly correlated with each other ( P ≥ 0.0167). In the other cell types correlations between NR pairs were more diverse, but also statistically highly significant. Interestingly, the relative expression level of a number of receptor pairs ranked identical or similar in at least three (CoupTFα and PPARβ/δ, CoupTFβ and HNF4α as well as RORβ and PXR) or four cell types (CoupTFα and CoupTFβ, PPARγ and RevErbβ). Despite the variability of NR expression in immune cells, these results suggest that some of the NR may be co-regulated in human immune cells.

Urine Interleukin-8 as a Marker of Vesicoureteral Reflux in Infants

Vesicoureteral reflux (VUR) is a common finding in children presenting with urinary tract infection (UTI) and prenatally diagnosed urinary tract dilatation and in relatives of index patients. Children with VUR are at risk for ongoing renal damage with subsequent infections. Detecting VUR and renal scarring currently depends on imaging modalities with associated problems of radiation, invasiveness, and expense. Noninvasive methods would greatly facilitate diagnosis and would also help in identifying relatives of index cases who should be screened. Interleukin-8 (IL-8) is produced by epithelial cells of the renal tract in response to inflammatory stimuli and has been shown to increase during acute UTI. The objective of this study was to assess the urine levels of IL-8 as a noninvasive marker of VUR in infants in the absence of a recent UTI episode. We evaluated urine concentrations of IL-8 in 59 infants aged 1 month to 2 years. All infants were free of UTI for a minimum of 3 weeks before IL-8 evaluation. Infants were divided into 3 groups: group A, subjects with proven VUR (24 infants aged 0.15-1.95 years, median 0.43); group B, subjects with a history of UTI but negative investigation for VUR (14 infants aged 0.32-1.95 years, median 0.57); and group C, subjects without any history of acute or chronic condition that might impair renal function (21 infants aged 0.08-1.92 years, median 0.33). IL-8 concentrations were determined by a commercially available quantitative enzyme-linked immunosorbent assay. To avoid dilution effects, urinary levels of IL-8 were expressed as the ratio of cytokine-to-urinary creatinine. Results were presented as medians and ranges. The Kruskal-Wallis test, the Mann-Whitney rank sum U test, and the Spearman rank order correlation test were performed for the univariate analysis. Two-tailed P values were calculated and the conventional level of significance P < .05 was applied in all cases. Infants in groups A and B had been free of UTI for a period of 3 to 52 weeks (median, 5.0 weeks) and 3 to 78 weeks (median, 4.5 weeks), respectively, before IL-8 determination. No significant difference was noted in the length of the UTI-free period between groups A and B (P = .469). Urine creatinine concentrations did not differ among groups A, B, and C (medians 1.15, 2.25, and 1.15 micromol/mL, respectively; P = .080). The median urine IL-8/creatinine concentrations (pg/micromol) were 40.5 (range, 2.04-3874) in group A, 1.91 (range, 0.001-386) in group B, and 2.47 (range, 0.002-55.6) in group C. Urine IL-8/creatinine concentrations were significantly higher in group A than both in group B (P = .0003) and in group C (P < .0001). No significant difference was observed between groups B and C (P = .749). In group A, no significant correlation was shown between IL-8/creatinine concentrations and the presence of renal parenchymal damage (P = .506), reflux grade (P = .770), or time from UTI (P = .155). A receiver-operator characteristic curve was constructed by plotting the sensitivity versus the specificity for different cutoff concentrations of IL-8/creatinine. With a cutoff concentration of urinary IL-8/creatinine at 5 pg/micromol, the sensitivity of this marker in diagnosing VUR was 88%, the specificity 69%, the positive prognostic value 66%, and the negative prognostic value 89%. In higher cutoff concentrations, specificity of the marker increased but sensitivity rapidly decreased. We present evidence that urine IL-8 concentrations remain elevated in infants with VUR even in the absence of UTI and that a cutoff of 5 pg/micromol IL-8/creatinine is of high sensitivity and adequate specificity for diagnosing VUR. Elevated urine IL-8 levels in VUR and renal scarring have already been reported; however, the present study is, to our knowledge, the first to confirm significant differences between infants with VUR and infants with a history of UTI alone and healthy controls, and to suggest a reliable cutoff concentration for diagnosing VUR. Our findings additionally suggest that inflammatory process in VUR is ongoing even after UTI has resolved, pointing against the currently held belief that sterile reflux cannot harm kidneys. The chronic inflammatory cell infiltrate associated with reflux nephropathy rather than VUR itself might offer an explanation for the secretion of IL-8, which may well be independent of reflux grade. Using urine IL-8 for diagnosing VUR is not free of limitations, because IL-8 may be elevated as a result of urinary tract manipulation or undetected UTI. In addition, this study focused on infants and not in older children with longstanding VUR. Increased urine IL-8 concentrations after UTI has resolved is a promising noninvasive marker for an initial screening for VUR in infancy with high sensitivity and adequate specificity.

Intrahepatic Hepatitis B Virus Covalently Closed Circular DNA Can Be a Predictor of Sustained Response to Therapy

This study aimed to determine whether intrahepatic hepatitis B virus (HBV) covalently closed circular (ccc) DNA and total HBV DNA levels at the end of therapy would predict sustained response to therapy. Hepatitis B e antigen (HBeAg)-positive chronic hepatitis B patients receiving either lamivudine monotherapy or combination of peginterferon and lamivudine had liver biopsy at the end of 1 year therapy and were followed for 52 more weeks after cessation of therapy. Serum HBV DNA, intrahepatic HBV ccc DNA, and total HBV DNA levels were determined. Forty-seven patients, including 34 males and 13 females, were studied. Twenty-seven patients received combination therapy, and 20 patients received lamivudine monotherapy. Twenty-nine patients had end-of-treatment virologic response, and 15 patients had sustained response 52 weeks after therapy. At the end of treatment, log serum HBV DNA levels correlated well with log intrahepatic HBV cccDNA and log intrahepatic total HBV DNA levels. Log intrahepatic cccDNA and log intrahepatic total DNA levels were significantly lower among patients with sustained virologic response. The adjusted odds ratio for log cccDNA was 5.3 (95% CI: 1.5-18.2, P = .009) and, for log intrahepatic HBV DNA, was 4.4 (95% CI: 1.3-14.7, P = .015) to predict sustained virologic response. Using log cccDNA at -0.80 copies/genome equivalent as cutoff, the sensitivity, specificity, and positive and negative predictive values and accuracy of predicting sustained virologic response were 73%, 78%, 56%, 86%, and 77% respectively. Intrahepatic HBV cccDNA and intrahepatic total HBV DNA levels at the end of therapy are superior to serum HBV DNA as surrogates of sustained virologic response.

Comments on the paper "c-erbB-2 expression and nuclear pleomorphism in canine mammary tumors"

,Dutra et al. (1) evaluated the influence of c-erbB-2 expression and nuclear polymor-phism on survival using a semiquantitativescoring system. Survival was calculated us-ing the Spearman rank correlation test. Theyobtained a regression coefficient of r = 0.441for c-erbB-2 expression and of r = -0.295 fornuclear polymorphism, with P > 0.05 inboth cases. Therefore, the authors concludedthat neither c-erbB-2 nor nuclear polymor-phism could be considered to be prognosticfactors.We would like to discuss some of themethodological aspects of the study.1. In survival studies some individualswill still be alive at the end. Others may havebeen lost to follow-up some time earlier andthus survival times will be unknown for asubset of the study group. There is a consen-sus that these so-called “censored” casesmust be included in the analysis. Most sur-vival analyses use Kaplan-Meier plots, logrank tests or the Cox proportional hazardregression (2). A Spearman rank order cor-relation test, as carried out by Dutra et al.(1), can only be used if all the animals underobservation die (2).2. Both variables examined, c-erbB-2expression and nuclear pleomorphism, wereevaluated using a semiquantitative scoringsystem. Categorizing variables that are meas-ured on a continuum is a frequently usedprocedure in medicine, especially in surgicalpathology. By looking, for instance, at re-cently published issues of this Journal, wecan see considerable variation in the scoringsystems applied in histopathology, not onlybetween different groups but also within thesame laboratory (1,3-6).It is well known that categorization maybe useful for clinical decision-making, treat-ment recommendations, determining studyeligibility, or for illustration purposes (7),but we should be well aware that this proce-dure is dangerous for several reasons.When the probability of an event associ-ated with a quantitative prognostic factorvaries monotonously, the selection of a cut-off point is always arbitrary. This may createscientifically unrealistic models because thisprocedure discards potentially important in-formation since all values between the cut-off levels have an equal effect on the model.Therefore, categorization considerably low-ers the statistical test-power and can be seenas an introduction of measurement errors (8-14).This can be easily illustrated with a simpleexperiment. In Table 1 we simulated a pos-sible situation similar to that of the study ofDutra et al. (1): let us assume that 10 of 17dogs with neoplasia died. The percentages ofc-erbB-2-positive cells in the tumors had

Validity of using a panoramic radiograph for initial dental classification of Army recruits.

The objective of this study was to examine the validity of classifying Initial Entry Training (IET) soldiers into dental fitness classification 2 or 3 based solely on examining panoramic radiographs. The dental readiness classification, derived from a clinical screening examination versus a panoramic radiological examination, was compared for 1,050 Fort Sill Basic Training recruits during a 1-month period. The dentist who reviewed the panoramic radiograph and determined a dental classification was blinded to the earlier dental classification from the clinical examination. The Spearman's rank order correlation test was used to determine if a statistically significant correlation existed between classifications based on the clinical examination versus classification by review of the panoramic radiograph alone. The project identified that 18% (n = 186) and 23.7% (n = 249) of the sample population had at least one class 3 condition identified from the clinical screening examination and the panoramic radiograph review, respectively. Of the 186 dental fitness category 3 conditions identified from the routine dental screening, 81.7% (152) of them were also identified from the review of the panoramic radiograph. Spearman's rank order correlation test statistic was 0.633 for a p < 0.001, indicating a statistically significant correlation in the identification of IET soldiers with class 3 conditions using a screening examination with a review of the panoramic radiograph. The findings of this study suggest that panoramic radiograph review can identify IET soldiers with dental fitness category 3 conditions and implies that a policy change may be prudent to allow this type of initial classification.

The effect of maxillomandibular advancement on the pharyngeal airway and apnea-hypopnea index in obstructive sleep apnea syndrome patients

Problem: Maxillomandibular advancement (MMA) surgery has demonstrated good success for the treatment of obstructive sleep apnea syndrome (OSAS). MMA has been shown to increase the pharyngeal airway space postoperatively. This is thought to be one of the reasons for the decrease in apnea-hypopnea index (AHI) found during postoperative polysomnographic studies. The purpose of this study is to determine if there is a correlation between the increase in pharyngeal airway space and decrease in AHI. Methods: Charts were reviewed for OSAS patients who received MMA surgery between October 1996 and April 2002. The inclusion criteria were: 1) completion of a polysomnographic study before and a minimum of 6 months following surgery, 2) a standardized lateral cephalometric radiograph taken before and within 48 hours postoperatively, 3) a preoperative AHI greater than 10. The outline of the posterior pharyngeal wall, soft palate and base of tongue were traced preand postoperatively. The minimum perpendicular distance between the posterior pharyngeal wall and both the soft palate and base of tongue were measured. The airway measurements as well as the AHI were analyzed using the Wilcoxon signed rank test for significance between the pre and postoperative values. Changes in pharyngeal airway space and AHI were analyzed using the Spearman Rank Order Correlation Test. Results: A total of 48 patients received MMA surgery as treatment for OSAS during this time period with 20 satisfying the requirements (18 male and 2 female). The average age was 44 years (range of 34 to 61). Twelve patients had MMA, 7 patients had MMA in conjunction with genioplasty and 1 patient had maxillary advancement with a unilateral sagittal split osteotomy. The median increase in distance between the posterior pharyngeal wall and soft palate was 96% (maximum 325%, minimum 14%; first quartile 64%, third quartile 96%). The median increase in distance between the posterior pharyngeal wall and base of tongue was 108% (maximum 500%, minimum 0%; first quartile 73%, third quartile 157%). The median decrease in AHI was 78% (maximum 100%, minimum 23%; first quartile 52%, third quartile 98%). The Spearman Rank Order Correlation test was calculated and revealed no correlation between the increase in pharyngeal airway and decrease in AHI. Conclusions: Treatment of OSAS using MMA surgery resulted in an average decrease in AHI of 73% for this patient population. There was no correlation found between the increase in posterior pharyngeal airway space and the decrease in AHI postoperatively.

Plasma levels of dosulepine and heart electric field

Antidepressants, particularly tricyclic (TCA) antidepressants, may have cardiotoxic effects, such as cardiac arrhythmias, especially in patients with cardiovascular diseases. For most of TCA, no exact correlation between dosage, plasma levels and changes of ECG parameters of standard ECG has been found. So far, no relationship between dosulepine plasma levels and heart electric field parameters has been studied. We selected 18 female outpatient subjects diagnosed with recurrent depressive disorders, currently in the remission phase (HAMD &lt; 10), without any cardiovascular disease. Patients were treated with daily dosulepine doses of 25-125 mg for 4-8 weeks. 30 heart electric field parameters were analyzed by Cardiag 128.1 diagnostic system as part of BSPM (Body Surface Potential Mapping). Acquired data were correlated with dosulepine plasma levels by means of Spearman's rank order correlation test. Four ECG parameters showed a significant correlation with dosulepine plasma levels: QRS axis deviation in frontal plane (p=0.01), DIAM 40 max (p&lt;0.05), QRS-STT angle in transversal and left sagittal plane (p&lt;0.05). The demonstrated changes confirmed dosulepine influence on the early myocardium depolarization phase and the correlation of this effect with dosulepine dose (its plasma concentration). The higher the dosulepine level, the more marked are the changes of the QRS-STT angle in transversal and sagittal planes and the changes in the QRS axis deviation in frontal plane. Repeatedly recorded changes in the heart electric field were dosulepine-specific and dependent on its plasma levels.