Use Of Threshold Values Research Articles

Levels of circulating cytokines in children with multiple sclerosis with different effectiveness of interferon therapy

Multiple sclerosis (MS) is a chronic, demyelinating disease that leads to disability. Understanding the etiology of MS contributes to the development of pathogenetic methods of treatment, and the search for informative biomarkers of the effectiveness of treatment will allow the patient to adjust therapy in time. The aim of this work was to determine informative cytokines and cytokine profiles to predict the effectiveness of IFN-β1a therapy in children with MS.Materials and methods. 66 children with MS aged 16 [14.2–17.5] years who are on INFß-1a therapy were examined: group 1 — patients with exacerbation of MS (with active foci of demyelination by MRI), n = 34; group 2 — patients in remission of MS (without active foci), n = 32. The content of cytokines in the blood serum of patients was assessed using the multiplex panel Human Th17 Magnetic Bead Panel.Results: There was a significant increase in cytokine concentrations in patients with exacerbation of MS compared with children in remission: IL5, IL6, IL9, IL12p70, IL17E/IL25, IL21, IL28A, GM-CSF, TNFß. Threshold values for IL9 (AUC = 0,785), IL6 (AUC = 0,750), TNFß (0,740), IL28A (AUC = 0,744) were obtained above which it is possible to predict an exacerbation of MS in patients: IL9 — 3.9 pg/ml (Sn — 70.6, Sp — 71.9), IL6 — 4.0 pg/ml (Sn — 70.6, Sp — 68.8), TNFß — 6.6 pg/ml (Sn — 70.6, Sp — 71.9), IL28A — 243.0 pg/ml (Sn — 70.6, Sp — 71.9). Cytokine profiles associated with T-lymphocytes and their functions were evaluated using z-score.Conclusions. For the first time, an increase in cytokine levels was demonstrated in children with active foci of demyelination compared to patients in remission of MS. An increase in proinflammatory cytokines and cytokine profiles associated with Th1 and Th17, as well as with Th2 and Th22 has been shown. The use of threshold values for IL9, IL6, TNFβ, IL28A will help predict the development of exacerbation in patients with MS.

Assessment of Effective and Minimal Slab Widths for Evaluating the Shear Capacity of RC Overhang Slabs

Abstract The effective width is a relevant parameter for the design of bridge overhang slabs under concentrated loads. Experimental tests have been used to assess expressions for its calculation. However, the load capacity increases with the width until a transition area is reached. Test specimens may have lacked enough width to reach full shear capacity, affecting thus the evaluation of the results. On the other hand, within the transition area, a threshold value has been hypothesized to match the effective width. This paper aims to provide recommendations for minimal widths that guarantee the full capacity of overhang slabs and to assess the calculation of the effective width by means of the threshold value and other formulations. The effect of the edge beam is also considered. A campaign of validated non-linear FE-simulations based on experiments on range of width-span ratios was performed. The results suggest using a width-span ratio of at least 4.0 for slabs without an edge beam and 5.3 for slabs with an edge beam for the experimental practice. The efficiency of the formulation for the effective widths is diffuse and the use of threshold value leads to unsafe predictions. Instead, linear-elastic FE-analyses are recommended for the design practice.

A Critical Review on the Use of Threshold Value in Calculating Similarity for Determining Copyright Infringement

A Critical Review on the Use of Threshold Value in Calculating Similarity for Determining Copyright Infringement

Identification of geochemical anomalies associated with Sn-W mineralization in the Dong Van region, North-Eastern Vietnam, using statistical methods

Sn-W multimetal mineralization in the Dong Van region, North-Eastern Vietnam was studied using statistical and multivariate approaches based on 890 samples of stream bottom sediments collected for assaying for 27 elements. The findings of frequency analysis demonstrated that Pb, As, Bi, Li, Sn, W, Ta, Ce, Ag, Sb, and Be have close ties with multimetal ores, implying that these elements can be used as prospecting indicators for multimetal mineralization. In addition, correlation matrix and dendrogram studies were also applied to subdivide the elements in the stream bottom sediment samples assays into two groups: associated with multimetal mineralization (Be-Sn-W-Bi, and, to a lesser extent, Li-Pb sub-groups) and not associated with the mineralization: (As-Cd-Sc-Cr-Ce-La, Co-Ni-V, and Ga-Ge-Ba sub-groups). Sn and W were found to be the best indicator elements for the mineralization, according to the findings of geochemical modeling and location of their anomalies in the region. Furthermore, extensive Sn and W anomalies were identified in the Dong Van region (using threshold values (mean ± 3 STD), providing the most important indications for multimetal mineralization prospecting in the region. The studies also suggest genetic ties between the region’s multimetal mineralization and the northwest-southeast fault system and concealed granitoid blocks. Finally, the performed statistical analyses (with the use of threshold values) of stream bottom sediments assays allowed revealing indicator elements and their geochemical anomalies and using them as an effective tool in further prospecting and exploration for multimetal mineralization in the region.

Software fault prediction using machine learning techniques with metric thresholds

BACKGROUND: Fault data is vital to predicting the fault-proneness in large systems. Predicting faulty classes helps in allocating the appropriate testing resources for future releases. However, current fault data face challenges such as unlabeled instances and data imbalance. These challenges degrade the performance of the prediction models. Data imbalance happens because the majority of classes are labeled as not faulty whereas the minority of classes are labeled as faulty. AIM: The research proposes to improve fault prediction using software metrics in combination with threshold values. Statistical techniques are proposed to improve the quality of the datasets and therefore the quality of the fault prediction. METHOD: Threshold values of object-oriented metrics are used to label classes as faulty to improve the fault prediction models The resulting datasets are used to build prediction models using five machine learning techniques. The use of threshold values is validated on ten large object-oriented systems. RESULTS: The models are built for the datasets with and without the use of thresholds. The combination of thresholds with machine learning has improved the fault prediction models significantly for the five classifiers. CONCLUSION: Threshold values can be used to label software classes as fault-prone and can be used to improve machine learners in predicting the fault-prone classes.

Application of Enzyme Indicators in Hydrogen Peroxide Biodecontamination Cycle Development: A Critical Evaluation of Indicator Variability and Correlation to Biological Indicator Results.

An important prerequisite for aseptic production of pharmaceuticals is the appropriate reduction of microbiological contamination. Hydrogen peroxide is commonly applied as decontamination agent for such processes in barrier systems. The development and validation of the barrier decontamination cycles is usually performed with the use of biological indicators (Geobacillus stearothermophilus). However, these indicators inherit certain drawbacks. A new type of indicators became available lately, based on the use of enzyme as a substance decomposed by hydrogen peroxide. There is no broad experience on the practical application of these enzyme indicators yet. Therefore, we investigated the practical use of enzyme indicators in comparison with biological indicators. To broaden the understanding on how these indicators might be used in practice, we provided an evaluation of indicator response variability and the correlation of enzyme indicator results to biological indicator results. In this study, we found the variability of the quantitative enzyme indicator reading to be < 30%, which is much smaller than the variability for spore enumeration of biological indicators (-50% to +300%). Further, we introduced a universal normalization approach to enable convenient comparison and evaluation of different enzyme indicator results. Finally, we discussed a new approach to establish a quantitative correlation between enzyme indicators and biological indicators with the use of threshold values to extrapolate theoretical biological indicator group results. We take the findings of this study as a basis for a suggestion on the practical application of enzyme indicators. We expect that the discussed possibilities of correlating enzyme indicator results to biological indicator results will allow the combined practical use of both indicator types. This would enable the continued application of proven approaches in new ways. Beyond this, the fast reading of enzyme indicators with the gain of significant quantitative information might result in faster and safer qualification and validation of pharmaceutical production equipment in the future.

Basin-scale and seasonal evaluation of automated threshold methods for surface water detection

ABSTRACT Estimating surface water using satellite data can improve estimates and predictions for hydroelectric energy generation. The goal of this research is to identify the best threshold method and image band combination to detect seasonal surface water at the basin scale. This paper explores Otsu, Minimum Entropy, and average of Otsu-Minimum Entropy threshold algorithms using Sentinel-2 narrow near-infrared band 8A (N-NIR), shortwave infrared bands 11 and 12 (SWIR-11 or SWIR-12) images for the Assiniboine River Basin (ARB). The highest precision (0.87) of surface water detection was obtained in autumn using Minimum Entropy (N-NIR & SWIR-11) threshold values for the ARB, however, the Minimum Entropy also had poor detection of surface water (low recall). Use of the naïve Bayesian classifier did not improve detection of surface water compared to using threshold values alone, and the use of threshold values generated for one basin was not transferable to another basin. We concluded that threshold methods should be assessed seasonally, at a per-tile scale before combining surface water products at a watershed scale, and products should be evaluated using non-balanced statistical measures for watersheds with high land-to-water ratios. Accuracy assessment is hampered by validation data which represents static hydrologic conditions, not contemporary, seasonal conditions.

The Copper Content in Soil of Olive Orchards from Dalmatia, Croatia

The goals of this study were to determine the concentrations of Cu in the soil of olive orchards grown on the Terra rossa and to examine how close the Cu concentration is to contamination limits defined by different soil quality standards. A total of 40 composite topsoil (0–25 cm) samples were collected in the traditional dry farming and highly fragmented olive orchards that covered an area of 3200 ha and located in the Middle Dalmatia, Croatia. The aqua regia Cu concentration was determined by ICP-OES; and basic soil properties (pH, carbonates, SOC, and particle size distribution), by standard analytical procedures. The mean value of Cu concentration of 68.4 mg kg–1 was more than twice as high as the mean values of the naturally occurring concentration of Cu in the Terra rossa soil. High mean value and a wide range of copper in the soil (33.8–250 mg kg–1) are due to the long-lasting application of Cu-based fungicides related to the fact that the olive growing area and vines overlap. The Cu contamination risk assessment in olive orchards was calculated by comparing the detected concentrations of Cu with the soil quality standards prescribed by the Finnish Decree and Croatian Ordinance and using the threshold value of the regional background data on Cu concentration in Terra rossa soil. According to the Finnish Decree, in 7.5% of cases, Cu concentration in soils exceeded the threshold limit of 100 mg kg–1, which indicates the need for further assessment of the potential contamination of the area. In 7.5% of cases, Cu exceeded the critical limit of 150 mg kg–1 that presents an ecological risk. By applying the Croatian Ordinance, in 10% of cases, the concentration of Cu exceeded the maximum admissible concentration of 120 mg kg–1, so that the soil can be considered contaminated and unsuitable for agriculture. The regional threshold value for the background concentration of Cu in the Terra rossa soil amounted to 55 mg kg–1, and its use in 47.5% of cases indicates the need for further assessment of the potential contamination in the area. The presented results showed significant differences between national soil guideline values (SGVs) and the regional threshold value for Cu and confirmed the fact that there is no general and accurate reference method for soil contamination assessment that can be applied at all sites. The use of threshold values derived for a particular soil type that dominates in a given area would be more reliable than the national soil quality standards. Research has pointed to the problem of soil contamination with Cu under olive orchards and has highlighted the need for studying the given issue in the areas, where olives share space with vines, and in particular, where mixed or consociate cropping system is present.

Recent Developments in the Determination of Biomarkers of Tobacco Smoke Exposure in Biological Specimens: A Review.

Environmental tobacco smoke exposure (ETS) and smoking have been described as the most prevalent factors in the development of certain diseases worldwide. According to the World Health Organization, more than 8 million people die every year due to exposure to tobacco, around 7 million due to direct ETS and the remaining due to exposure to second-hand smoke. Both active and second-hand exposure can be measured and controlled using specific biomarkers of tobacco and its derivatives, allowing the development of more efficient public health policies. Exposure to these compounds can be measured using different methods (involving for instance liquid- or gas-chromatographic procedures) in a wide range of biological specimens to estimate the type and degree of tobacco exposure. In recent years, a lot of research has been carried out using different extraction methods and different analytical equipment; this way, liquid–liquid extraction, solid-phase extraction or even miniaturized procedures have been used, followed by chromatographic analysis coupled mainly to mass spectrometric detection. Through this type of methodologies, second-hand smokers can be distinguished from active smokers, and this is also valid for e-cigarettes and vapers, among others, using their specific biomarkers. This review will focus on recent developments in the determination of tobacco smoke biomarkers, including nicotine and other tobacco alkaloids, specific nitrosamines, polycyclic aromatic hydrocarbons, etc. The methods for their detection will be discussed in detail, as well as the potential use of threshold values to distinguish between types of exposure.

The admissible amount of borrowings as a problem of organization of research work and of quality control

The aim of the research . The determination of the permissible amount of non-original text in the automated verification of scientific documents for plagiarism has become a new, but already common phenomenon in Russia. The experience with the use of threshold values shows that it may have different effects on the final quality of such documents and therefore needs special consideration. The purpose of the article is to study the positive and negative consequences of using the allowable amount of borrowing. Methods and materials. Studying local normative acts, issued by national higher education institutions and the analysis of the results of anti-plagiarism tests carried out at the Russian State Library for research documents revealed certain peculiarities of application of the “threshold levels”. The results. The “threshold levels” usage would doubtlessly simplify the treatment of the plagiarism test results. In addition, authors of research works obtain a certain stimulus to more careful and thorough work over their papers, lecturers and academic advisors could detect compilation texts far easier than ever before. Meanwhile different organizations set different frames for volumes of borrowings when the same type of research work being considered, and there can be found no grounds related to the branches of science. The introduction of the restrictions on the amount of borrowing does not change the current Copyright legislation of the Russian Federation, nor does it make plagiarism legitimate. In that respect a matter of a particular importance turns out to explain to students and postgraduates the main principles of scientific ethics and of the specific features of the plagiarism tests. A significant negative consequence of using the allowable amount of borrowing is that in different organizations the same text can be evaluated quite differently. The diversity of concepts of the admissible amount of borrowings makes it hard to compare the results of the plagiarism tests carried out at different establishments and determining a final level for the text quality. The admissible amount of borrowings would often correspond to the demand to quote other publications in the volumes justified by the aims of the quotation. The problems emerge when the number of the correct quotations satisfies the demand but their total volume exceeds the set frames. Another possible problem comes when the part of the borrowings fits those frames while the appropriateness of quotations remains questionable. The data on the borrowed volumes received by the primary computer plagiarism test cannot be considered objective if the volume of text taken by one author from another one’s work is viewed. To detect the degree of borrowings (either correct or incorrect) the report of the system on each of the documents is to be verified by the specialist. Since the year of 2009, the Russian State Library (RSL) has carried out over 4,000 plagiarism tests with usage of specialized software “Antiplagiat.RSL”. Documents were compared to the texts of the sources of the Digital Dissertation Library of the RSL, and the results of the tests revealed diverse forms of plagiarism. Conclusion. The organizational and methodological problems accompanying application of restrictions for borrowings remain unsolved for the moment. In addition, irrespective of the character of those restrictions the conclusion concerning the scientific value and the legitimacy of the research paper is to be made by the members of the academic community, not by the information systems.

Use and Misuse of Cost-Effectiveness Analysis Thresholds in Low- and Middle-Income Countries: Trends in Cost-per-DALY Studies

ObjectivesTo determine what thresholds are most often cited in the cost-effectiveness literature for low- and middle-income countries (LMICs), given various recommendations proposed and used in the literature to date, and thereafter to assess whether studies appropriately justified their use of threshold values. MethodsWe reviewed the contents of the Tufts Medical Center Global Health Cost-Effectiveness Analysis Registry, a repository of all English language cost-per-disability-adjusted life-year averted studies indexed in PubMed. Our review included all catalogued cost-per-disability-adjusted life-year studies published from 2000 through 2015. We restricted attention to studies that investigated interventions in LMICs. ResultsOur analysis identified 381 studies (80%) focused on LMICs. Of these studies, 250 (66%) cited the World Health Organization’s 1 to 3 times gross domestic product per capita threshold. A full-text review of 60 (24%) of these articles (randomly selected) revealed that none justified use of this threshold in the particular country or countries studied beyond citing (generic) guideline documents. ConclusionsCost-effectiveness analysis can help inform health care spending, but its value depends on incorporating assumptions that are valid for the applicable setting. Rather than rely on commonly used, generic economic thresholds, we encourage authors to use context-specific thresholds that reflect local preferences.

Log-Sum Distance Measures and Its Application to Human-Activity Monitoring and Recognition Using Data From Motion Sensors

For the detection of human activities using motion data many techniques employ feature extraction and machine learning. But detection rates and incorrect classification rates require further increase and decrease, respectively. We address both the problems. We propose a novel distance measure, called log-sum distance, for evaluating difference between two sequences of positive numbers. We use the proposed log-sum distance measure to develop algorithms for recognition of human activities from the motion data. The sequences of $m$ positive numbers are residual sum of squares errors produced from modeling $m$ motion time-series with the multiple linear regression method . To reduce incorrect classification, we define a threshold test and use it in our proposed novel algorithm. We have defined an optimization function and used it for computing optimal threshold values. Extensive evaluation of our activity detection algorithm with two different sets of data sets show increased activity recognition rates and decreased incorrect classification rates compared with other existing methods. In one data set, the proposed algorithm detects all activities with 100% accuracy and in the another data set, it detects all activities with 99% or higher accuracy. The proposed use of threshold values for classification of activities decreased incorrect classification rates.

Evaluating Flow Metric-Based Stream Classification Systems to Support the Determination of Ecological Flows in North Carolina

Hydroecological classification systems are typically based on an assemblage of streamflow metrics and seek to divide streams into ecologically relevant classes. Assignment of streams to classes is suggested as an initial step in the process of establishing ecological flow standards. We used two distinct hydroecological river classification systems available within North Carolina to evaluate the ability of a hydrologic model to assign the same classes as those determined by observed streamflows and to assess the transferability of such systems to ungaged streams. Class assignments were examined by rate of overall matches, rate of class matches, spatial variability in matches, and time period used in class assignment. The findings of this study indicate assignments of stream class: (1) are inconsistent among different classification systems; (2) differ between observed and modeled data; and (3) are sensitive to the period of record within observed data. One clear source of inconsistency/sensitivity in class assignments lies with the use of threshold values for metrics that distinguish stream classes, such that even small changes in metric values can result in different class assignments. Because these two hydroecological classification systems are representative of other classification systems that rely on quantitative decision thresholds, it can be surmised that the use of such systems based on stream flow metrics is not a reliable approach for guiding ecological flow determinations.

Age-related changes of thoracic aorta geometry used to predict the risk for acute type B dissection

AimsRisk models that use a single aortic diameter threshold have failed to successfully predict acute type B aortic dissection (TBAD). We sought to identify meaningful age-indexed anatomical variables to predict TBAD risk. Methods and resultsA geometric deformable model, consisting of virtual elastic balloons that inflate inside a vessel lumen, was developed to quantify thoracic aorta geometry. In the presence of TBAD, true and total artery lumen morphology were assessed. A stepwise logistic model was built to predict TBAD risk. Initial covariates included age, gender, body mass index and all anatomic variables not directly related to the dissected segment. Patients with acute TBAD (n=34, 62±12years old, 57% male gender) were compared with subjects with symptoms of dissection, but with a subsequent negative diagnosis (n=51, 62±12years old, 76% male gender). Patient risk factors did not differ between groups. Most aortic anatomical variables were age-dependent. Aortic size was larger in every segment of the dissected with respect to non-dissected aortas (p<0.001). Variables entering the TBAD risk prediction model were aortic arch diameter, thoracic aorta length and age (predictability=0.9764, r=0.85), confirmed by a bootstrap internal validation. In dissected aortas, the true lumen volume was correlated to age (r=0.72). ConclusionsTBAD probability increases with a larger aortic arch diameter and a longer thoracic aorta, whereas threshold values increase with age. The aortic morphology was age-dependent. After dissection, true lumen volume correlated to age. The use of threshold values indexed to age should be encouraged to better prevent and eventually treat TBAD.

Assessment of land use impact on hydraulic threshold conditions for gully head cut initiation

Abstract. A gully as an accelerated erosion process is responsible for land degradation under various environmental conditions and has been known as a threshold phenomenon. Although the effects of gullying processes have been well documented, few soil erosion models have taken into account the threshold condition necessary for gully development. This research was devoted to determining the effects of land use change on hydraulic threshold condition and stream power of water flow through an in situ experimental flume (15 m × 0.4 m). Results indicated that head cut initiation and detachment rates showed a better correlation to stream power indices than shear stress (τcr). The threshold unit stream power value (ωu) for head cut initiation in rangeland, abandoned land, and dry farming land was 0.0276, 0.0149, and 4.5 × 10−5 m s−1, respectively. Moreover, the micro-relief condition of soil surface and surface vegetation affected the flow regime of discharge and velocity. It is seen that the composite hydraulic criteria of Froude number (Fr) and discharge (Q) can clearly discriminate the land uses' threshold. In fact, the remarkable decrease of τcr in dry farming was related to the effect of tillage practice on soil susceptibility and aggregate strength. The findings indicated that using the unit steam power index instead of critical shear stress could increase the models' precision for prediction of head cut development. Compared to the Ephemeral Gully Erosion Model (EGEM) equation for critical shear stress, it is important to point out that for modelling of gully erosion, using single soil attributes can lead to an inaccurate estimation for τcr. In addition, based on the findings of this research, the use of threshold values of τcr = 35 dyne cm−2 and ωu = 0.4 cm s−1 in physically based soil erosion models is susceptible to high uncertainty when assessing gully erosion.

Should the Lambda (λ) Remain Silent?

When making decisions regarding the funding of new health technologies (e.g. pharmaceuticals), a key consideration should be the opportunity cost associated with a positive funding decision in terms of other patients’ health. Lambda (k) is a term that has been used to refer to a maximum acceptable value (cost-effectiveness threshold) for the incremental cost-effectiveness ratio (ICER) of a new technology, which should reflect the opportunity cost of funding decisions. In 2006, Gafni and Birch [1] discussed the ‘silence of the k’ with respect to the justification of its numerical value within the decision-making process. They noted that the use of threshold values, which do not represent the true opportunity cost of new and generally more expensive technologies, can lead to increased health expenditures with little evidence of increases in population health. In this commentary, we interpret the ‘silence of the k0 with respect to the lack of explicit recognition of the use of a cost-effectiveness threshold by national funding bodies that use the threshold in the decision-making process. We also discuss the potential impact of this silence on health systems. As an example, the Australian Pharmaceutical Benefits Advisory Committee (PBAC) makes recommendations regarding the public funding of pharmaceuticals, on the basis of clinical effectiveness, safety and cost effectiveness (value for money). No official statement has ever been made about the use of a cost-effectiveness threshold to determine whether a pharmaceutical provides value for money. Although our focus is on the Australian PBAC decisionmaking process, the discussion can be applied more widely—first, to many other national funding bodies that use economic evaluation to inform funding decisions but do not explicitly acknowledge the use of a threshold, e.g. the Medical Services Advisory Committee in Australia (MSAC) or the Canadian Agency for Drugs and Technologies in Health, and second, to any collectively funded health system that fails to consider the opportunity costs of its decisions.

Assessment of Left Ventricular Enlargement at Multidetector Computed Tomography.

Because left ventricular (LV) enlargement (LVE) is indicative of an array of cardiac pathologies, including cardiomyopathic, ischemic, and valvular heart diseases, it is important to recognize it early in the course of these diseases. The recognition of LVE on nongated contrast-enhanced computed tomography (CT) scans should be facilitated by the availability of a dimensional index. To our knowledge, no CT index of LVE has been proposed. Therefore, the study aimed to define whether the maximum LV diameter (LVd) measured on nongated multidetector computed tomography can identify LVE when referencing echocardiography as the diagnostic standard. The patient population consisted of 438 consecutive patients who had a contrast-enhanced, nongated 16- or 64-detector CT of the chest for evaluation of pulmonary embolism or aortic dissection between January 2006 and March 2008. One hundred fifty-five patients in this group also had an echocardiogram within 2 months of the CT study. The maximum LV cavity size, septal to lateral wall dimension, was measured perpendicularly to the long axis of the left ventricle on the axial CT scans by 2 observers blinded to the echocardiography data.An receiver operating characteristic analysis was performed to identify a highly specific cutoff for the diagnosis of LVE on CT, using echocardiogram as the standard of reference. Interobserver agreement was assessed using Bland-Altman analysis. A total of 84 females and 71 males were evaluated (female to male ratio of 1.09). The mean age for the 155 patients was 58 years. Six percent of these patients had a diagnosis of LVE on 2-dimensional echocardiography. The mean (SEM) LV internal diameter at nongated multidetector computed tomography between the group with normal LV and the group with LVE by echocardiography was 4.4 (0.7) cm for the normal LV and 5.9 (1.2) cm for the dilated LVs (P < 0.0001). With the use of threshold value of LVd of 5.6 cm, a sensitivity of 78%, specificity of 100%, positive likelihood ratio of 113.5, and negative likelihood ratio of 0.22 were calculated. The LVd measurements had an excellent agreement between observers on the Bland-Altman analysis. Left ventricular enlargement can be reliably identified on nongated contrast-enhanced multidetector CT when the maximum luminal diameter of the LV is greater than 5.6 cm. Nongated contrast-enhanced CT scan can be used to recognize LVE.

Does attribute cut-off elicitation affect choice consistency? Contrasting hypothetical and real-money choice experiments

The use of threshold values (cut-offs) is a well-recognized simplifying strategy in real life decision-making processes. Recent stated preference studies show that strategies used by respondents in hypothetical settings are consistent with how they normally process information in real markets. Of the different discrete choice models using cut-offs, the Swait (2001) model allows different heuristics to be captured. The few applications of this soft cut-off approach mainly focus on the effects of cut-offs on attribute estimates and willingness to pay, but scant attention has been paid to the consequences of cut-off elicitation. We focussed our investigation on the effects of self-reported cut-offs on choice consistency. In line with studies on context and complexity effects in choice modelling, we parameterize the scale parameter on the basis of two alternative measures related to the stated cut-offs: (1) the number of potential violations included in the choice cards, and (2) the number of cut-offs stated at the most severe level. Moreover, we investigated whether different treatments (hypothetical vs. real-money) affect cut-off elicitations, violations and choice consistency.We tested our models using an empirical dataset generated by a field choice experiment on consumers׳ preferences for apples. The data show that most respondents stated they had cut-off values in mind when buying apples, but, as expected, in most cases they violated them in their actual choices. Estimation of heteroskedastic logit models shows that the proposed measures related to stated cut-offs have a systematic effect on the variance of the error term, but only in the hypothetical treatment. That is, respondents were found to be less consistent as the number of potential violations or the number of cut-offs stated at the most severe level increased. In the real-money treatment, neither of the coefficients of the two measures was statistically significant. This may indicate that when choices are binding, consumers put necessary effort into each choice card, regardless of the number of potential violations, and they are more consistent.

Economic Evaluations of Hematological Malignancies Compared with Solid Tumors

Introduction: Cancer care costs escalated with the introduction of novel therapies. Therefore, cancer–related Cost Utility Analyses (CUAs) are used to guide policy makers. Since numerous methods (criteria) exist to evaluate CUAs, we compared these criteria between CUAs of solid tumors and those of hematological malignancies. Methods: A systemic MEDLINE search of English-language publications between 2001 and 2012 was performed. Strict inclusion criteria were limited to CUAs examining one single intervention and one single study comparator. Standard data of 66 variables, based on the Drummond criteria, were collected to review each CUA for clarity, completeness, and health economic methodological quality. Results: Among 8,515 screened papers on Pubmed, 177 cancer-related CUAs (2%) were eligible. Solid tumors and hematological malignancies CUAs constituted 161(91%) and 16(9%). Among the standardized methods for evaluating CUAs, those of solid tumors reported more frequently the presentation of cost-effectiveness acceptability curve (p=0.02) and the use of threshold value to interpret study results (p=0.024) than those of hematological malignancies. Further, CUAs of solid tumors were more frequently multicenter-based (p=0.014); however, CUAs of hematological malignancies listed differential quality adjusted life year separately more frequently (p=0.02). Outcomes of CUAs of solid tumors were more frequently reported as significant (p=0.014). Conclusions: CUAs of solid tumors abided more frequently with the standardized methods (criteria) than those of hematological malignancies, which may be due in part to their multiple study sites. CUAs of hematological malignancies may warrant more methodological standardization and incorporate more study sites.

A Novel Threshold Technique and Fuzzy C-Means Algorithm for Segmentation of Wound

Skin color based wound region segmentation is proposed by using threshold segmentation and fuzzy-C means techniques. This letter gives wound on skin location should be precisely identified. These methods are identified the edge regions of the wound part that can help clinicians in their diagnosis. This letter describes the use of threshold values and FCM clustering algorithms for detection of wounds on the skin. In this letter This paper presents the application of fuzzy Cmeans clustering algorithm for skin color segmentation problem. This proposed method is able to take both the distributions of color space and the spatial interaction between surrounding pixels during clustering. This clustering algorithm have more advantages the result obtained from different wound images have been discussed.