Is quantitative interpretation likely to increase sensitivity of dobutamine stress echocardiography? A study of false-negative results

Background: False-negative interpretations of do-butamine stress echocardiography (DSE) may be associated with reduced wall stress. using measurements of contraction, we sought whether these segments were actually ischemic but unrecognized or showed normal contraction. Methods. We studied 48 patients (29 men; mean age 60 +/- 10 years) with normal regional function on the basis of standard qualitative interpretation of DSE. At coronary angiography within. 6 months of DSE, 32 were identified as having true-negative and 16 as having false-negative results of DSE. Three apical views were used to measure regional function with color Doppler tissue, integrated backscatter, and strain rate imaging. Cyclic variation of integrated backscatter was measured in 16 segments, and strain rate and peak systolic strain was calculated in 6 walls at rest and peak stress. Results. Segments with false-negative results of DSE were divided into 2 groups with and without low wall stress according to previously published cut-off values. Age, sex, left ventricular mass, left ventricular geometric pattern, and peak workload were not significantly different between patients with true and false-negative results of DSE. Importantly, no significant differences in cyclic variation and strain parameters at rest and peak stress were found among segments with true-and false-negative results of DSE with and without low wall stress. Stenosis severity had no influence on cyclic variation and strain parameters at peak stress. Conclusions: False-negative results of DSE reflect lack of ischemia rather than underinterpretation of regional left ventricular function. Quantitative markers are unlikely to increase the sensitivity of DSE.

Speleothem master chronologies: combined Holocene O-18 and C-13 records from the North Island of New Zealand and their palaeoenvironmental interpretation

The stable isotope records of four stalagmites dated by 19 TIMS uranium series ages are combined to produce master chronologies for delta(18)O and delta(13)C The delta(18)O records display good overall coherence, but considerable variation in detail. Variability in the delta(13)C records is greater, but general trends can still be discerned. This implies that too fine an interpretation of the structure of individual isotopic records can be unreliable. Speleothem delta(18)O values are demonstrated to show a positive relationship with temperature by comparing trends with other proxy records, but also to respond negatively to rainfall amount. Speleothem delta(13)C is considered to be most influenced by rainfall. The postglacial thermal optimum occur-red around 10.8 ka BP, which is similar in timing to Antarctica but up to 2000 years earlier than most Northern Hemisphere sites. Increasingly negative delta(18)O values after 7.5 ka BP indicate that temperatures declined to a late mid-Holocene minimum centred around 3 ka BP, but more positive values followed to mark a warm peak about 750 years ago which coincided with the 'Mediaeval Warm Period' of Europe. Low 5110 values at 325 years BP suggest cooling coincident with the 'Little Ice Age'. A marked feature of the delta(13)C record is an asymmetric periodicity averaging c. 2250 years and amplitude of c. 1.9parts per thousand. It is concluded that this is mainly driven by waterbalance variations with negative swings representing particularly wet intervals. The 5110 record shows a higher-frequency cyclicity with a period of c. 500 years and an amplitude of c. 0.25 parts per thousand. This is most likely to be temperature-driven, but some swings may have been amplified by precipitation.

Interpretation of the temperature dependence of rate constants in biosensor studies

A comparison is made between Arrhenius and transition-state analyses of the temperature dependence of rate constants reported in four published biosensor studies. Although the Eyring transition-state theory seemingly affords a more definitive solution to the problem of characterizing the activation energetics, the analysis is equivocal because of inherent assumptions about reaction mechanism and the magnitude of the transmission coefficient. In view of those uncertainties it is suggested that a preferable course of action entails reversion to the empirical Arrhenius analysis with regard to the energy of activation and a preexponential factor. The former is essentially equivalent to the enthalpy of activation, whereas the magnitude of the latter indicates directly the extent of disparity between the frequency of product formation and the universal frequency factor (temperature multiplied by the ratio of the Boltzmann and Planck constants) and hence the likelihood of a more complicated kinetic mechanism than that encompassed by the Eyring transition-state theory. (C) 2004 Elsevier Inc. All rights reserved.

A Test of Performance of Breast MRI Interpretation in a Multicentre Screening Study

Objectives: The aim of this study was to assess the consistency and performance of radiologists interpreting breast magnetic resonance imaging (MRI) examinations. Materials and Methods: Two test sets of eight cases comprising cancers, benign disease, technical problems and parenchymal enhancement were prepared from two manufacturers' equipment (X and Y) and reported by 15 radiologists using the recording form and scoring system of the UK MRI breast screening study [(MAgnetic Resonance Imaging in Breast Screening (MARIBS)]. Variations in assessments of morphology, kinetic scores and diagnosis were measured by assessing intraobserver and interobserver variability and agreement. The sensitivity and specificity of reporting performances was determined using receiver operating characteristic (ROC) curve analysis. Results: Intraobserver variation was seen in 13 (27.7%) of 47 of the radiologists' conclusions (four technical and seven pathological differences). Substantial interobserver variation was observed in the scores recorded for morphology, pattern of enhancement, quantification of enhancement and washout pattern. The overall sensitivity of breast MRI was high [88.6%, 95% confidence interval (CI) 77.4-94.7%], combined with a specificity of 69.2% (95% CI 60.5-76.7%). The sensitivities were similar for the two test sets (P=.3), but the specificity was significantly higher for the Manufacturer X dataset (P

Interpretation of the temperature dependence of equilibrium and rate constants

The objective of this review is to draw attention to potential pitfalls in attempts to glean mechanistic information from the magnitudes of standard enthalpies and entropies derived from the temperature dependence of equilibrium and rate constants for protein interactions. Problems arise because the minimalist model that suffices to describe the energy differences between initial and final states usually comprises a set of linked equilibria, each of which is characterized by its own energetics. For example, because the overall standard enthalpy is a composite of those individual values, a positive magnitude for AHO can still arise despite all reactions within the subset being characterized by negative enthalpy changes: designation of the reaction as being entropy driven is thus equivocal. An experimenter must always bear in mind the fact that any mechanistic interpretation of the magnitudes of thermodynamic parameters refers to the reaction model rather than the experimental system For the same reason there is little point in subjecting the temperature dependence of rate constants for protein interactions to transition-state analysis. If comparisons with reported values of standard enthalpy and entropy of activation are needed, they are readily calculated from the empirical Arrhenius parameters. Copyright (c) 2006 John Wiley & Sons, Ltd.

Ultrastructure of the spermatozoon of Myrmecocichla formicivora (Vieillot, 1881) and Philetairus socius (Latham, 1790) (Aves; Passeriformes), with a new interpretation of the passeridan acrosome

Passerine spermatozoa exhibit apomorphies that distinguish them from non-passerine neognaths and palaeognaths. The acrosome is longer than the nucleus (excepting the suboscines, most Corvida, and a few Passerida). A perforatorium and endonuclear canals are absent. The proximal centriole is absent (except in the suboscines). The distal centriole is secondarily short, contrasting with its elongate condition in palaeognaths and Galloanserae. In the Passerida a single mitochondrial strand winds extensively along the axoneme (restricted to the anterior axoneme in suboscines and Corvida). A fibrous, or amorphous, periaxonemal sheath, seen in palaeognaths and many non-passerines, respectively, is absent. The acrosome in Myrmecocichla formicivora and Philetairus socius is bipartite: an acrosome core is surmounted by an acrosome crest; the core is ensheathed by a layer which is a posterior extension of the crest. The acrosome helix is a lateral extension of the crest and the crest layer with (Myrmecocichla) or without (Philetairus) protrusion of material of the acrosome core into it. In M. formicivora, as in other muscicapoids, a fibrous helix is intertwined with at least the more proximal region of the mitochondrial helix. The fibrous helix is absent at maturity in Philetairus and other described passeroid spermatozoa with the possible exception of Passer italiae. In Philetairus a granular helix precedes the mitochondrial helix.

Cautionary tales in the interpretation of systematic reviews of therapy trials

This is the second in a series of articles emphasizing the cautions in the interpretation of health-care studies. Systematic reviews are presented as comprehensive, unbiased summaries of evidence and are often referred to by clinicians, guideline developers and health policy-makers. Their strengths and limitations, and how their results can be subject to bias and misinterpretation, are discussed.

The Constitutional (In)Validity of Religious Vilification Laws: Implications for Their Interpretation

A study is conducted to determine whether religious vilification laws are contrary to the implied freedom of political communication affirmed in the High Court's decision in Lange v Australian Broadcasting Corporation. He feels that to the extent that religious vilification laws are interpreted with principles, they are likely to leave sufficient place for freedom of religious discussion that happens to be relevantly political, at the same time the implied freedom of political means that the prohibitions imposed by religious vilification laws need to be interpreted narrowly and the exceptions construed widely, in order to leave room for political communication.