Unreliable Measurement Research Articles

Livedoid vaskülopatide anestezi ve düşük molekül ağırlıklı heparin kullanımı

Livedoid vasculopathy (LV) is a hyalinizing vascular disease characterized by painful purple macules and papules that subsequently ulcerate. This vasculopathy may be associated with chronic venous insufficiency, deep venous thrombosis, factor V Leiden mutation, protein C deficiency, antiphospholipid syndrome, increased homocysteine levels, abnormalities in fibrinolysis, increased platelet activation and sickle cell disease. Difficult venous access, unreliable measurement of peripheral O2 saturation and increased susceptibility to venous embolic events may be a challenge for anesthetists. There is limited data about anesthetic management of livedoid vasculopathy in the literature. This case report describes successful anesthetic management of two patients with livedoid vasculopathy.

Nonlinear circuit analysis of harmonic currents in a floating Langmuir probe with a capacitive load

Plasma diagnostics using the floating harmonic technique were first used to obtain the electron temperature in a tokamak plasma. In this technique, the electron temperature depends on the ratio of the harmonic currents in a resistive sheath. Because these harmonic currents are determined by a modulated sheath voltage, calculation of the exact modulated voltage across the sheath is important; in general, the voltage is calculated using a phase of the first harmonic current. However, when a series load capacitance is present, the second harmonic currents are abnormally reduced compared to those expected by the conventional floating harmonic model, resulting in an unreliable measurement of the electron temperature. To describe this phenomenon, we used a modified floating harmonic model by applying the harmonic balance technique, a method that analyzes nonlinear circuits. Theoretical prediction of the harmonic current obtained from the modified model was compared with the experimental results, and they are in good agreement. In addition, the degrees of sheath nonlinearity, defined as the ratio of the second harmonic current (or voltage) to the fundamental current (or voltage), are discussed.

The Effectiveness of Health Literacy Oriented Programs on Physical Activity Behaviour in Middle Aged and Older Adults with Type 2 Diabetes: A Systematic Review.

Health literacy is the first step to self-management of type II diabetes mellitus, of which physical activity is the least compliant behavior. However, no reviews have summarized the effect and the process of interventions of health literacy oriented programs on physical activity behavior among middle aged and older adults with type II diabetes mellitus. This article is the first to examine the effectiveness of health literacy oriented programs on physical activity behavior among middle aged and older adults with type II diabetes mellitus. This systematic review extracted articles from nine electronic databases between 1990 and 2013. Six interventional studies were extracted and reported in accordance with the guidance of Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Findings demonstrated that health literacy oriented programs increased the frequency and duration of physical activity among patients with high health literacy. Although some studies effectively improved the health literacy of physical activity, gap in literature remains open for the indistinct and unreliable measurement of physical activity within self-management programs of type II diabetes mellitus, and the questionable cross-culture generalizability of findings. Further studies with well-knit theory-based intervention with respect to patients’ cultural background, duration of intervention and objective measurements are encouraged to elucidate the relationship between health literacy oriented programs and physical activity behavior.

Longer duration of transient elastography predicts unreliable liver stiffness measurements

Transient elastography (TE) is a noninvasive, validated method to assess liver fibrosis by obtaining liver stiffness measurements (LSM). However, TE can be limited by unreliable measurement (UM). The relationship between the time taken to perform TE (duration) and UM has not been studied. To determine whether the duration of TE correlates with UM. We prospectively studied the frequency and predictors of UM over a 5-year period. UM was defined as follows: less than 10 successful measurements, success rate less than 60%, or interquartile range more than 30% of the median LSM value (IQR/LSM>30%). Among the 2834 patients with LSM analysed, UM occurred in 19.0%. Duration [odds ratio (OR) 4.2, 95% confidence interval (CI) 2.8-6.4; P<0.0001] was the strongest predictor of UM, followed by BMI more than 28 kg/m (OR 2.1, 95% CI 1.5-3.0; P<0.0001), age more than 52 (OR 1.6, 95% CI 1.1-2.3; P=0.007) and non-HBV aetiology (OR 1.6, 95% CI 1.1-2.3; P=0.02). An optimal cut-off of 3 min 47 s was calculated for predicting UM (sensitivity 70%, specificity 65%, OR 4.2, 95% CI 2.7-6.6, P<0.0001). Examinations that took longer than 8 min 10 s had a 90% chance of UM. In experienced hands, duration is a strong predictor of UM in patients undergoing TE. Examinations longer than 4 min are more likely to be unreliable. Examinations longer than 8 min are unlikely to yield a valid result and should be considered a futility endpoint. Older age and increased BMI and nonhepatitis B aetiology are independent, albeit weaker, predictors of UM.

P0518 : Arterial pressure suffices to increase liver stiffness independent of central venous pressure

etiologies in which TE measurements were made either with the M (3.5MHz) probe or with XL (2.5MHz) between January 2012 and October 2014. In patients in which reliable measurements could not be obtained by M probe, XL measurements were performed in the same session. In each patient 10 valid LSM were acquired with each probe, a median was calculated expressed in kiloPascals (kPa). Reliable measurements were defined as: median value of 10 valid LSM with a success rate (SR) ≥60% and an interquartile range interval (IQR) <30%. Unreliable TE measurement were considered the following situations: fewer than 10 valid shots; SR <60% and/or IQR ≥30%. Results: A total of 2046 patients were examined, 1156 (56.5%) overweight and 890 (43.5%) obese. In the 1156 overweight patients reliable LSM were obtained in 979 (84.7%) cases: in 729 (63.1%) by the standard M probe and in 250 (21.6%) by the XL probe. In the 890 obese patients, reliable measurements were obtained in 744 patients (83.6%), in 165 (18.5%) by the M probe, and in 522 (58.6%) by using the XL probe. Thus, by using both probes, reliable measurements were obtained in 1723 (84.2%) of the 2046 examined cases. Conclusions: By using both M and XL probes, reliable LSM by TE can be obtained in the majority of the obese and overweight patients (84.2%).

Quantifying an agreement study.

In medical and other related sciences, clinical or experimental measurements usually serve as a basis for diagnostic, prognostic, therapeutic, and performance evaluations. Examples can be assessing the reliability of multiple raters (or measurement methods), assessing the suitability for tumor evaluation of using a local laboratory or a central laboratory in a randomized clinical trial (RCT), validating surrogate endpoints in a study, determining that the important outcome measurements are interchangeable among the evaluators in an RCT. Any elegant study design cannot overcome the damage by unreliable measurement. Many methods have been developed to assess the agreement of two measurement methods. However, there is little attention to quantify how good the agreement of two measurement methods is. In this paper, similar to the type I error and the power in describing a hypothesis testing, we propose quantifying an agreement assessment using two rates: the discordance rate and the tolerance probability. This approach is demonstrated through examples.

Increasing Interrater Reliability Using Composite Performance Measures

LeBreton, Scherer, and James (2014) raise important questions about the implica- tions of unreliable criterion measurement in industrial – organizational (I – O) psy- chology. Although we do not share the authors’ bleak outlook concerning the state of cumulative knowledge in our field, we do agree that continuing to rely on a criterion with an average reliability of .52 (i.e., single-supervisor rating of overall job performance) is undesirable for the continued advancement of the science and practice of I–O psychology. However, contrary to the conclusions of LeBreton and colleagues, improving criterion reliability need not require abandoning supervisory ratings. Rather, by applying a contempo- rary understanding of the structure of job performance (Campbell, 2012), reliable and construct-valid supervisory ratings can indeed be obtained. In this commentary, we estimate the interrater reliability of a multidimensional job performance measure and demonstrate that the composite ratings derived from such a measure may amelio- rate many of the concerns that LeBreton et al. raise.

Comparison of GUF and Monte Carlo methods to evaluate task-specific uncertainty in laser tracker measurement

Measurement uncertainty plays an important role in laser tracking measurement analyses. In the present work, the guides to the expression of uncertainty in measurement (GUM) uncertainty framework (GUF) and its supplement, the Monte Carlo method, were used to estimate the uncertainty of task-specific laser tracker measurements. First, the sources of error in laser tracker measurement were analyzed in detail, including instruments, measuring network fusion, measurement strategies, measurement process factors (such as the operator), measurement environment, and task-specific data processing. Second, the GUM and Monte Carlo methods and their application to laser tracker measurement were presented. Finally, a case study involving the uncertainty estimation of a cylindricity measurement process using the GUF and Monte Carlo methods was illustrated. The expanded uncertainty results (at 95% confidence levels) obtained with the Monte Carlo method are 0.069 mm (least-squares criterion) and 0.062 mm (minimum zone criterion), respectively, while with the GUM uncertainty framework, none but the result of least-squares criterion can be got, which is 0.071 mm. Thus, the GUM uncertainty framework slightly underestimates the overall uncertainty by 10%. The results demonstrate that the two methods have different characteristics in task-specific uncertainty evaluations of laser tracker measurements. The results indicate that the Monte Carlo method is a practical tool for applying the principle of propagation of distributions and does not depend on the assumptions and limitations required by the law of propagation of uncertainties (GUF). These features of the Monte Carlo method reduce the risk of an unreliable measurement of uncertainty estimation, particularly in cases of complicated measurement models, without the need to evaluate partial derivatives. In addition, the impact of sampling strategy and evaluation method on the uncertainty of the measurement results can also be taken into account with Monte Carlo method, which plays a guiding role in measurement planning.

Hide and Seek: Does the TBI Allow for Earlier Recognition of PAD in Diabetic Patients?

Introduction: It is assumed that in diabetic patients, calcification of the ankle arteries may cause unreliable measurement of the anklebrachial index (ABI). Clinical guidelines recommend the toebrachial index (TBI) as an alternative in diabetic patients with ‘falsely elevated’ ankle pressures, arbitrarily defined as an ABI >1.4. Considering that arterial calcification is also common among diabetics with an ABI <1.4, and may thus result in a ‘falsely normal’ ABI and subsequent under-diagnosis of PAD. We investigated whether diabetics have a lower TBI at similar ABI as compared to non-diabetics, and if the TBI may enable earlier detection of PAD in diabetics. Methods: We randomly selected 326 diabetic and non-diabetic patients (512 legs) with suspected PAD from our vascular lab registry. Mean difference between ABI and TBI was compared for diabetics and non-diabetics. In addition, a Bland-Altman plot was constructed with 95% limits of agreement established from nondiabetics. Separate analyses were performed including only patients with Fontaine stages 2 or 3, or an ABI within the normal reference range (0.91e1.4). Results: Diabetic and non-diabetic patients were similar with regard to age and sex distribution. Median ABI did not differ between both groups (Table 1). Median TBI was higher in diabetics, but overall the difference between ABI and TBI was similar. Remarkably, in patients with Fontaine 2 or 3, mean difference between ABI and TBI was larger for non-diabetics (mean difference 0.11, 95% CI 0.20 to 0.03; p 1⁄4 0.008). Among patients with a normal ABI, both the TBI and the difference between ABI and TBI were similar for diabetics and non-diabetics (Table 1). The difference between ABI and TBI for diabetics overlapped the reference range established from non-diabetics, independent of the magnitude of the measurements (Figure 1). Conclusion: We found no indication that the TBI may enable earlier detection of PAD in diabetics. The TBI and ABI are strongly correlated, and this relation is not influenced by the presence of diabetes. In patients with Fontaine 2 or 3, TBIs were actually lower in non-diabetics at similar ABIs. As such, initial assessment of the TBI in diabetics, compared to non-diabetics, generally does not yield additional information if the ABI is not obviously elevated.

Su1006 Longer Duration of Transient Elastography Predicts Unreliable Measurements and Measurement Failure

Introduction: Transient elastography (TE) is a noninvasive, validated method to assess liver fibrosis by obtaining liver stiffness measurements (LSM). Measurement failure (MF) and unreliable measurement (UM) occur in up to 3% and 15% of patients, respectively. The relationship between time taken to perform TE (duration) and UM has not been studied. Aim: To determine whether the examination duration correlates with unreliable measurement and measurement failure of transient elastography. Materials and Methods: This is a prospective study of the frequency and predictors of UM based on LSM obtained by FibroscanTM from September 2008 to June 2013. UM was defined as any of the following: 30% of the median LSM. MF was defined as zero valid measurements. All operators had performed >100 prior examinations. Data collected included age, sex, BMI (kg/m2), probe used (M or XL), stiffness (LSM in kPa), duration of TE (in minutes:seconds) and aetiology of liver disease. Patients were categorised as cirrhotic according to validated disease-specific median liver stiffness cut-offs. Multivariate binary logistic regression was performed to identify factors independently associated with UM. Results: Liver stiffness measurements of 2835 patients were analysed (55% male, median age 51 years [IQR 4160]). The aetiologies of liver disease were hepatitis B (42.7%), hepatitis C (23.7%), nonalcoholic fatty liver disease (7.8%), alcohol (3.4%) and other (22.4%). MF and UM occurred in 3.1% and 19.0%, respectively. Duration, LSM and obesity were independent predictors of UM. The area under the receiver operating curve (AUROC) of duration for diagnosing UM was 0.716 (0.69-0.74) with an optimal cut-off of 3mins 47s (sensitivity 70%, specificity 65%, odds ratio (OR) 4.2[95% CI 2.7-6.6], P 30kg/m2) was an independent predictor of UM (OR 1.9[1.2-3.0], P=0.009). Patients with median LSM falling in the cirrhosis range were more likely to have UM (OR 2.3[1.4-3.9], P=0.002). The majority of these UM (72.7%) were attributed to IQR >30%, indicating higher variability at the upper ranges of LSM. Conclusions: In experienced hands, duration is a strong predictor of UM in patients undergoing TE. Examinations longer than 4 minutes are more likely to be unreliable. Examinations longer than 8 minutes are unlikely to yield a valid result and should be considered a futility endpoint. Obesity and elevated LSM in the cirrhosis range are independent, albeit weaker, predictors of UM. Table1. Duration cut-offs for UM at 90, 95 and 99% specificity

Su1007 Tenofovir or Lamivudine Use in Late Pregnancy Safely Reduces Perinatal Transmission of Hepatitis B Virus in Real-Life Practice

Introduction: Transient elastography (TE) is a noninvasive, validated method to assess liver fibrosis by obtaining liver stiffness measurements (LSM). Measurement failure (MF) and unreliable measurement (UM) occur in up to 3% and 15% of patients, respectively. The relationship between time taken to perform TE (duration) and UM has not been studied. Aim: To determine whether the examination duration correlates with unreliable measurement and measurement failure of transient elastography. Materials and Methods: This is a prospective study of the frequency and predictors of UM based on LSM obtained by FibroscanTM from September 2008 to June 2013. UM was defined as any of the following: 30% of the median LSM. MF was defined as zero valid measurements. All operators had performed >100 prior examinations. Data collected included age, sex, BMI (kg/m2), probe used (M or XL), stiffness (LSM in kPa), duration of TE (in minutes:seconds) and aetiology of liver disease. Patients were categorised as cirrhotic according to validated disease-specific median liver stiffness cut-offs. Multivariate binary logistic regression was performed to identify factors independently associated with UM. Results: Liver stiffness measurements of 2835 patients were analysed (55% male, median age 51 years [IQR 4160]). The aetiologies of liver disease were hepatitis B (42.7%), hepatitis C (23.7%), nonalcoholic fatty liver disease (7.8%), alcohol (3.4%) and other (22.4%). MF and UM occurred in 3.1% and 19.0%, respectively. Duration, LSM and obesity were independent predictors of UM. The area under the receiver operating curve (AUROC) of duration for diagnosing UM was 0.716 (0.69-0.74) with an optimal cut-off of 3mins 47s (sensitivity 70%, specificity 65%, odds ratio (OR) 4.2[95% CI 2.7-6.6], P 30kg/m2) was an independent predictor of UM (OR 1.9[1.2-3.0], P=0.009). Patients with median LSM falling in the cirrhosis range were more likely to have UM (OR 2.3[1.4-3.9], P=0.002). The majority of these UM (72.7%) were attributed to IQR >30%, indicating higher variability at the upper ranges of LSM. Conclusions: In experienced hands, duration is a strong predictor of UM in patients undergoing TE. Examinations longer than 4 minutes are more likely to be unreliable. Examinations longer than 8 minutes are unlikely to yield a valid result and should be considered a futility endpoint. Obesity and elevated LSM in the cirrhosis range are independent, albeit weaker, predictors of UM. Table1. Duration cut-offs for UM at 90, 95 and 99% specificity

P1094 FIBROSIS REGRESSION IN PERSONS TREATED FOR HBV UTILIZING TRANSIENT ELASTOGRAPHY (FIBROSCAN)

Introduction: Transient elastography (TE) is a noninvasive, validated method to assess liver fibrosis by obtaining liver stiffness measurements (LSM). Measurement failure (MF) and unreliable measurement (UM) occur in up to 3% and 15% of patients, respectively. The relationship between time taken to perform TE (duration) and UM has not been studied. Aim: To determine whether the examination duration correlates with unreliable measurement and measurement failure of transient elastography. Materials and Methods: This is a prospective study of the frequency and predictors of UM based on LSM obtained by FibroscanTM from September 2008 to June 2013. UM was defined as any of the following: 30% of the median LSM. MF was defined as zero valid measurements. All operators had performed >100 prior examinations. Data collected included age, sex, BMI (kg/m2), probe used (M or XL), stiffness (LSM in kPa), duration of TE (in minutes:seconds) and aetiology of liver disease. Patients were categorised as cirrhotic according to validated disease-specific median liver stiffness cut-offs. Multivariate binary logistic regression was performed to identify factors independently associated with UM. Results: Liver stiffness measurements of 2835 patients were analysed (55% male, median age 51 years [IQR 4160]). The aetiologies of liver disease were hepatitis B (42.7%), hepatitis C (23.7%), nonalcoholic fatty liver disease (7.8%), alcohol (3.4%) and other (22.4%). MF and UM occurred in 3.1% and 19.0%, respectively. Duration, LSM and obesity were independent predictors of UM. The area under the receiver operating curve (AUROC) of duration for diagnosing UM was 0.716 (0.69-0.74) with an optimal cut-off of 3mins 47s (sensitivity 70%, specificity 65%, odds ratio (OR) 4.2[95% CI 2.7-6.6], P 30kg/m2) was an independent predictor of UM (OR 1.9[1.2-3.0], P=0.009). Patients with median LSM falling in the cirrhosis range were more likely to have UM (OR 2.3[1.4-3.9], P=0.002). The majority of these UM (72.7%) were attributed to IQR >30%, indicating higher variability at the upper ranges of LSM. Conclusions: In experienced hands, duration is a strong predictor of UM in patients undergoing TE. Examinations longer than 4 minutes are more likely to be unreliable. Examinations longer than 8 minutes are unlikely to yield a valid result and should be considered a futility endpoint. Obesity and elevated LSM in the cirrhosis range are independent, albeit weaker, predictors of UM. Table1. Duration cut-offs for UM at 90, 95 and 99% specificity

Indentation Size Effect in Autopolymerized and Microwave Post Treated Poly(methyl methacrylate) Denture Reline Resins

Various hardness test methods have been used to determine the polymer materials resistance to local plastic deformation in scientific community. The most commonly used method is Vickers microindentation. However, it is of crucial importance to fully understand the influence of the indentation load, since its value influences the obtained result. In this paper, two commercial PMMA dental reline resins in untreated and microwave treated condition have been tested. Vickers microindentation with different loads has been used to assess the materials microhardness: 30, 50, 70, 200, 300 and 500 gf. One way ANOVA statistical analysis followed by Tukey's test was used to determine the statistical differences between various groups. Finally, three models that quantitatively describe load-dependence of the measured Vickers hardness values were used: Meyer's law, PSR and modified PSR model. It was found that the optimal load for determining PMMA dental reline resins in both untreated and microwave treated conditions is 300 gf. This value may be regarded as loading independent hardness, or HLIH. At lower loads, a more or less pronounced indentation size effect was noticed, while at higher loads, forked crack development leads to an unreliable indentation diagonal measurement and therefore an unreliable microhardness result. The most adequate load-dependence model was found to be modified PSR, that takes into consideration the surface stresses induced by specimen preparation by grinding.

Food intake increases liver stiffness measurements and hampers reliable values in patients with chronic hepatitis B and healthy controls: the PROLIFICA experience in The Gambia

By increasing the hepatic blood circulation, food intake has been suggested to increase liver stiffness measurement (LSM) values in HCV-infected patients. To investigate prospectively the effects of food intake on LSM in hepatitis B virus (HBV)-infected patients and healthy controls. In The Gambia, patients included in the PROLIFICA project are screened for HBV at the community level and then invited for fasting assessment including LSM. Between April 2012 and October 2012, each day, the first five participants were invited to participate in this study. After the initial examination, a standardised 850 Kcal breakfast was provided. Effect of food intake was assessed by examining mean difference of LSM, IQR and IQR/LSM at T0 (fasting LSM1), T30min (LSM2) and T120min (LSM3) respectively. A total of 209 subjects were enrolled in this study (133 were HBV positive, 76 healthy controls). Unreliable measurements occurred more frequently after food intake (5%, 24% and 18% at T0, T30min and T120min respectively). In both groups, median LSM2 was significantly higher than LSM1 [6.2 (IQR: 5.4, 7.9)] vs. 4.9 (4.2, 6.2), P < 0.0001. LSM3 was still higher than the baseline, but lower than LSM2. In multivariable analysis, no factor modified the effect of breakfast on LSM. In a subgroup of patients having liver biopsies, we confirmed that food intake can overestimate liver fibrosis. Food intake significantly increases liver stiffness measurement and its IQR values in patients with chronic hepatitis B as well as healthy individuals; and also the number of unreliable liver stiffness measurement values.

Development of a cost effective three-dimensional posture analysis tool: validity and reliability

BackgroundThe lack of clear understanding of the association between sitting posture and adolescent musculoskeletal pain, might reflect invalid and/or unreliable posture measurement instruments. The psychometric properties of any new measurement instrument should be demonstrated prior to use for research or clinical purposes. This paper describes psychometric testing of a new three-dimensional (3D), portable, non-invasive posture analysis tool (3D-PAT), from sequential studies using a mannequin and high school students.MethodsThe first study compared the 3D-(X-, Y- and Z-) coordinates of reflective markers placed on a mannequin using the 3D-PAT, and the Vicon motion analysis system. This study also tested the reliability of taking repeated measures of the 3D-coordinates of the reflective markers. The second study determined the concurrent validity and test-retest reliability of the 3D-PAT measurements of nine sitting postural angles of high school students undertaking a standard computing task. In both studies, concordance correlation coefficients and Intraclass correlation coefficients described test-retest reliability, whilst Pearson product moment correlation coefficients and Bland-Altman plots demonstrated concurrent validity.ResultsThe 3D-PAT provides reliable and valid 3D measurements of five of the nine postural angles i.e. head flexion, neck flexion, cranio-cervical angle, trunk flexion and head lateral bending in adolescents undertaking a standard task.ConclusionsThe 3D-PAT is appropriate for research and clinical settings to measure five upper quadrant postural angles in three dimensions. As a measurement instrument it can provide further understanding of the relationship between sitting posture, changes to sitting posture and adolescent musculoskeletal pain.

Preserving amortized costs within a fair-value-accounting framework: reclassification of gains and losses on available-for-sale securities upon realization

SFAS No. 115 requires firms to recognize available-for-sale (AFS) securities at fair value with accumulated unrealized gains and losses (AUGL) recorded in accumulated other comprehensive income. Firms reclassify AUGL to net income when they realize gains and losses. We refer to the amount reclassified each period by “RECLASS.” As of 1998, SFAS No. 130 requires firms to present RECLASS prominently in their financial statements. We investigate the incremental explanatory power of RECLASS for banks’ market values and market-adjusted returns. In the market value analysis, we control for AUGL, other components of book value of equity, net income before extraordinary items and RECLASS (NIBEXother), and other components of comprehensive income. In the returns analysis, we control for ΔAUGL, ΔNIBEXother, and extraordinary items. We find high positive coefficients on RECLASS in both analyses, consistent with investors pricing RECLASS as a relatively permanent component of net income. Exploring possible explanations for these pricing implications, we find no evidence that they are attributable to RECLASS remedying unreliable fair value measurement of AUGL. We provide three distinct analyses indicating that RECLASS’s pricing implications are explained in significant part by it helping investors predict banks’ future performance. Our results illustrate that an important type of amortized cost accounting information, realized gains and losses, remains highly useful to investors despite the overall fair-value-accounting framework for AFS securities.

Identification of Developmentally Appropriate Screening Items for Disruptive Behavior Problems in Preschoolers

Screening preschool-aged children for disruptive behavior disorders is a key step in early intervention. The study goal was to identify screening items with excellent measurement properties at sub-clinical to clinical levels of disruptive behavior problems within the developmental context of preschool-aged children. Parents/caregivers of preschool-aged children (N = 900) were recruited from four pediatric primary care settings. Participants (mean age = 31, SD = 8) were predominantly female (87%), either white (55%) or African-American (42%), and biological parents (88%) of the target children. In this cross-sectional survey, participants completed a sociodemographic questionnaire and two parent-report behavioral rating scales: the PSC-17 and the BPI. Item response theory analyses provided item parameter estimates and information functions for 18 externalizing subscale items, revealing their quality of measurement along the continuum of disruptive behaviors in preschool-aged children. Of 18 investigated items, 5 items measured only low levels of disruptive behaviors among preschool-aged children. The remaining 13 items measured sub-clinical to clinical levels of disruptive behavior problems (i.e., >1.5 SD); however, 5 of these items offered less information, suggesting unreliable measurement. The remaining 8 items had high discrimination and difficulty parameters, offering considerable measurement information at sub-clinical to clinical levels of disruptive behavior problems. Behaviors measured by the 8 selected parent-report items were consistent with those identified in recent efforts to distinguish developmentally typical misbehaviors from clinically concerning behaviors among preschool-aged children. These items may have clinical utility in screening young children for disruptive behavior disorders.

Precise millisecond annealing for advanced material processing

AbstractFlash lamp annealing (FLA) reduces the thermal budget on the bulk and thus hinders undesired thermal diffusion. For reliable process control, however, a temperature measurement concept is needed that is capable of facing the high radiation background of the flash lamps and the millisecond detection regime at the same time (Reichel et al., Crit. Rev. Solid State Mater. Sci. 36, 102 (2011) [1]). A new concept has been developed for precise in‐situ temperature measurement during flash‐lamp millisecond annealing. There has been taking advantage of FLA for various applications. Implantation and subsequent FLA were used to obtain III‐V semiconductor quantum dots on silicon pillars (Prucnal et al., Nano Lett. 11, 2814 (2011) [2]). The same procedure was applied to achieve superconductivity with conventional silicon technolog (Fiedler et al., Phys. Rev. B 83, 214504 (2011) [3]). FLA was further used for advanced doping of “dirty‐silicon” solar cells. The short annealing cycles allow for successful dopant activation while undesired metal impurities remain electrically inactive (Prucnal et al., Acta Phys. Pol. A 120, 192 (2011) [4]). These examples show that in‐situ process control is required to make sure the major advantage of millisecond annealing is not narrowed by unreliable temperature measurement. In this contribution, a method will be presented that satisfies this issue by in‐situ distinction between thermal and flash lamp radiation (© 2012 WILEY‐VCH Verlag GmbH &amp; Co. KGaA, Weinheim)

Measuring Six Sigma Project Effectiveness using Fuzzy Approach

Six Sigma methodology for process improvement is being used by industries to improve customer satisfaction, business results or both. The success of Six Sigma implementation can be measured by evaluating the effectiveness of the completed projects. The other objective of project effectiveness measurement scheme is to keep the team focused and motivated. A good measurement system should be able to measure and compare projects of various types and need, including benefits from the projects. The project effectiveness measurement scheme should include success factors like project selection, involvement of management, results achieved, conduct of the project and monitoring and review of the project. A Six Sigma project effectiveness evaluation system is generally based on the perception of people that can result in unreliable measurement. To overcome this deficiency, we used a fuzzy approach based on linguistic variables and fuzzy numbers for measuring the project effectiveness in this study by using the perception of management. Two methods for measuring effectiveness of selected sample projects are suggested. The outcome from this research would be helpful for the practicing industries to use this methodology for an unbiased evaluation of completed projects. Copyright © 2012 John Wiley &amp; Sons, Ltd.

Diagnosis of liver fibrosis and cirrhosis using liver stiffness measurement: Comparison between M and XL probe of FibroScan®

Unreliable results of liver stiffness measurement are obtained in 16% of cases and are independently associated with body mass index (BMI) greater than 30 kg/m(2). A new FibroScan® probe (XL probe) was designed specifically for obese patients. The aim of this study was to evaluate the accuracy of liver stiffness measurement using M and XL probes of Fibroscan® for the diagnosis of fibrosis and cirrhosis in a large cohort of patients. Consecutive patients undergoing liver biopsies for chronic liver disease were prospectively recruited. Liver stiffness measurement was performed within 1 week before liver biopsy using both M and XL probes of FibroScan®. A total of 286 patients were evaluated. A reliable liver stiffness measurement using M probe was obtained in 79.7% of cases. In the other 21.3%, liver stiffness measurement using XL probe was obtained in 56.9% of patients. A strong correlation was found between M and XL values, regardless of BMI. In all groups, median liver stiffness measurement using the XL probe was significantly lower than liver stiffness measurement using the M probe. By multivariate analysis, unsuccessful liver stiffness examination with M probe was independently associated with age >50 years and BMI >30 kg/m(2). By univariate analysis, only BMI >30 kg/m(2) was associated with unsuccessful liver stiffness measurement with XL probe. No significant difference was observed between the M and XL probes for the diagnosis of liver fibrosis. Liver stiffness measurement with either M or XL probe is possible in 91.2% of patients with comparable diagnostic accuracy. In clinical practice, the M probe could be used as first step for liver stiffness measurement. In case of no valid shot or unreliable measurement, the XL probe could be used. This result could be useful for the assessment of liver fibrosis in NAFLD and/or obese patients.