Diagnostic performance of visual screening tests in the elderly

This study aimed to determine and evaluate the diagnostic accuracy of visual screening tests for detecting vision loss in elderly. This study is defined as study of diagnostic performance. The diagnostic accuracy of 5 visual tests -near convergence point, near accommodation point, stereopsis, contrast sensibility and amsler grid—was evaluated by means of the ROC method (receiver operating characteristics curves), sensitivity, specificity, positive and negative likelihood ratios (LR+/LR−). Visual acuity was used as the reference standard. A sample of 44 elderly aged 76.7 years (±9.32), who were institutionalized, was collected. The curves of contrast sensitivity and stereopsis are the most accurate (area under the curves were 0.814−p = 0.001, C.I.95%[0.653;0.975]— and 0.713−p = 0.027, C.I.95%[0,540;0,887], respectively). The scores with the best diagnostic validity for the stereopsis test were 0.605 (sensitivity 0.87, specificity 0.54; LR+ 1.89, LR−0.24) and 0.610 (sensitivity 0.81, specificity 0.54; LR+1.75, LR−0.36). The scores with higher diagnostic validity for the contrast sensibility test were 0.530 (sensitivity 0.94, specificity 0.69; LR+ 3.04, LR−0.09). The contrast sensitivity and stereopsis test's proved to be clinically useful in detecting vision loss in the elderly.

Diagnostic performance of visual screening tests in the elderly

The aging of Portuguese population is characterized by an increase of individuals aged older than 65 years. Preventable visual loss in older persons is an important public health problem. Tests used for vision screening should have a high degree of diagnostic validity confirmed by means of clinical trials. The primary aim of a screening program is the early detection of visual diseases. Between 20% and 50% of older people in the UK have undetected reduced vision and in most cases is correctable. Elderly patients do not receive a systematic eye examination unless a problem arises with their glasses or suspicion vision loss. This study aimed to determine and evaluate the diagnostic accuracy of visual screening tests for detecting vision loss in elderly. Furthermore, it pretends to define the ability to find the subjects affected with vision loss as positive and the subjects not affected with the same disease as negative. The ideal vision screening method should have high sensitivity and specificity for early detection of risk factors. It should be also low cost and easy to implement in all geographic and socioeconomic regions. Sensitivity is the ability of an examination to identify the presence of a given disease and specificity is the ability of the examination to identify the absence of a given disease. It was not an aim of this study to detect abnormalities that affect visual acuity. The aim of this study was to find out what´s the best test for the identification of any vision loss.

Grid structure impact in sparse point representation of derivatives

In the Sparse Point Representation (SPR) method the principle is to retain the function data indicated by significant interpolatory wavelet coefficients, which are defined as interpolation errors by means of an interpolating subdivision scheme. Typically, a SPR grid is coarse in smooth regions, and refined close to irregularities. Furthermore, the computation of partial derivatives of a function from the information of its SPR content is performed in two steps. The first one is a refinement procedure to extend the SPR by the inclusion of new interpolated point values in a security zone. Then, for points in the refined grid, such derivatives are approximated by uniform finite differences, using a step size proportional to each point local scale. If required neighboring stencils are not present in the grid, the corresponding missing point values are approximated from coarser scales using the interpolating subdivision scheme. Using the cubic interpolation subdivision scheme, we demonstrate that such adaptive finite differences can be formulated in terms of a collocation scheme based on the wavelet expansion associated to the SPR. For this purpose, we prove some results concerning the local behavior of such wavelet reconstruction operators, which stand for SPR grids having appropriate structures. This statement implies that the adaptive finite difference scheme and the one using the step size of the finest level produce the same result at SPR grid points. Consequently, in addition to the refinement strategy, our analysis indicates that some care must be taken concerning the grid structure, in order to keep the truncation error under a certain accuracy limit. Illustrating results are presented for 2D Maxwell's equation numerical solutions.

Two-way MANCOVA: an application to public health

The aim of this work is to use the MANCOVA model to study the influence of the phenotype of an enzyme - Acid phosphatase - and a genetic factor - Haptoglobin genotype - on two dependent variables - Activity of Acid Phosphatase (ACP1) and the Body Mass Index (BMI). Therefore it's used a general linear model, namely a multivariate analysis of covariance (Two-way MANCOVA). The covariate is the age of the subject. This covariate works as control variable for the independent factors, serving to reduce the error term in the model. The main results showed that only the ACP1 phenotype has a significant effect on the activity of ACP1 and the covariate has a significant effect in both dependent variables. The univariate analysis showed that ACP1 phenotype accounts for about 12.5% of the variability in the activity of ACP1. In respect to this covariate it can be seen that accounts for about 4.6% of the variability in the activity of ACP1 and 37.3% in the BMI.

Travelling wave profiles in some models with nonlinear diffusion

We study some properties of the monotone solutions of the boundary value problem (p(u'))' - cu' + f(u) = 0, u(-infinity) = 0, u(+infinity) = 1, where f is a continuous function, positive in (0, 1) and taking the value zero at 0 and 1, and P may be an increasing homeomorphism of (0, 1) or (0, +infinity) onto [0, +infinity). This problem arises when we look for travelling waves for the reaction diffusion equation partial derivative u/partial derivative t = partial derivative/partial derivative x [p(partial derivative u/partial derivative x)] + f(u) with the parameter c representing the wave speed. A possible model for the nonlinear diffusion is the relativistic curvature operator p(nu)= nu/root 1-nu(2). The same ideas apply when P is given by the one- dimensional p- Laplacian P(v) = |v|(p-2)v. In this case, an advection term is also considered. We show that, as for the classical Fisher- Kolmogorov- Petrovski- Piskounov equations, there is an interval of admissible speeds c and we give characterisations of the critical speed c. We also present some examples of exact solutions. (C) 2014 Elsevier Inc. All rights reserved.

Joining models with stair nesting

In the stair nested designs with u factors we have u steps and a(1), ... , a(u) "active" levels. We would have a(1) observations with different levels for the first factor each of them nesting a single level of each of the remaining factors; next a(2) observations with level a(1) + 1 for the first factor and distinct levels for the second factor each nesting a fixed level of each of the remaining factors, and so on. So the number of level combinations is Sigma(u)(i=1) a(i). In meta-analysis joint treatment of different experiments is considered. Joining the corresponding models may be useful to carry out that analysis. In this work we want joining L models with stair nesting.

Study of the interactions in a three-way crossed classification model

Crossed classification models are applied in many investigations taking in consideration the existence of interaction between all factors or, in alternative, excluding all interactions, and in this case only the effects and the error term are considered. In this work we use commutative Jordan algebras in the study of the algebraic structure of these designs and we use them to obtain similar designs where only some of the interactions are considered. We finish presenting the expressions of the variance componentes estimators.

Activation of effector immune cells promotes tumor stochastic extinction: A homotopy analysis approach

In this article we provide homotopy solutions of a cancer nonlinear model describing the dynamics of tumor cells in interaction with healthy and effector immune cells. We apply a semi-analytic technique for solving strongly nonlinear systems – the Step Homotopy Analysis Method (SHAM). This algorithm, based on a modification of the standard homotopy analysis method (HAM), allows to obtain a one-parameter family of explicit series solutions. By using the homotopy solutions, we first investigate the dynamical effect of the activation of the effector immune cells in the deterministic dynamics, showing that an increased activation makes the system to enter into chaotic dynamics via a period-doubling bifurcation scenario. Then, by adding demographic stochasticity into the homotopy solutions, we show, as a difference from the deterministic dynamics, that an increased activation of the immune cells facilitates cancer clearance involving tumor cells extinction and healthy cells persistence. Our results highlight the importance of therapies activating the effector immune cells at early stages of cancer progression.

A hybrid procedure to identify the optimal stiffness coefficients of elastically restrained beams

The formulation of a bending vibration problem of an elastically restrained Bernoulli-Euler beam carrying a finite number of concentrated elements along its length is presented. In this study, the authors exploit the application of the differential evolution optimization technique to identify the torsional stiffness properties of the elastic supports of a Bernoulli-Euler beam. This hybrid strategy allows the determination of the natural frequencies and mode shapes of continuous beams, taking into account the effect of attached concentrated masses and rotational inertias, followed by a reconciliation step between the theoretical model results and the experimental ones. The proposed optimal identification of the elastic support parameters is computationally demanding if the exact eigenproblem solving is considered. Hence, the use of a Gaussian process regression as a meta-model is addressed. An experimental application is used in order to assess the accuracy of the estimated parameters throughout the comparison of the experimentally obtained natural frequency, from impact tests, and the correspondent computed eigenfrequency.

Spectral and dynamical invariants in a complete clustered network

The main result of this work is a new criterion for the formation of good clusters in a graph. This criterion uses a new dynamical invariant, the performance of a clustering, that characterizes the quality of the formation of clusters. We prove that the growth of the dynamical invariant, the network topological entropy, has the effect of worsening the quality of a clustering, in a process of cluster formation by the successive removal of edges. Several examples of clustering on the same network are presented to compare the behavior of other parameters such as network topological entropy, conductance, coefficient of clustering and performance of a clustering with the number of edges in a process of clustering by successive removal.

Symbolic dynamics and big bang bifurcation in Weibull-Gompertz-Fréchet's growth models

In this paper, motivated by the interest and relevance of the study of tumor growth models, a central point of our investigation is the study of the chaotic dynamics and the bifurcation structure of Weibull-Gompertz-Fréchet's functions: a class of continuousdefined one-dimensional maps. Using symbolic dynamics techniques and iteration theory, we established that depending on the properties of this class of functions in a neighborhood of a bifurcation point PBB, in a two-dimensional parameter space, there exists an order regarding how the infinite number of periodic orbits are born: the Sharkovsky ordering. Consequently, the corresponding symbolic sequences follow the usual unimodal kneading sequences in the topological ordered tree. We verified that under some sufficient conditions, Weibull-Gompertz-Fréchet's functions have a particular bifurcation structure: a big bang bifurcation point PBB. This fractal bifurcations structure is of the so-called "box-within-a-box" type, associated to a boxe ω1, where an infinite number of bifurcation curves issues from. This analysis is done making use of fold and flip bifurcation curves and symbolic dynamics techniques. The present paper is an original contribution in the framework of the big bang bifurcation analysis for continuous maps.