Severity score system for progressive myelopathy: development and validation of a new clinical scale

Progressive myelopathies can be secondary to inborn errors of metabolism (IEM) such as mucopolysaccharidosis, mucolipidosis, and adrenomyeloneuropathy. The available scale, Japanese Orthopaedic Association (JOA) score, was validated only for degenerative vertebral diseases. Our objective is to propose and validate a new scale addressing progressive myelopathies and to present validating data for JOA in these diseases. A new scale, Severity Score System for Progressive Myelopathy (SSPROM), covering motor disability, sphincter dysfunction, spasticity, and sensory losses. Inter- and intra-rater reliabilities were measured. External validation was tested by applying JOA, the Expanded Disability Status Scale (EDSS), the Barthel index, and the Osame Motor Disability Score. Thirty-eight patients, 17 with adrenomyeloneuropathy, 3 with mucopolysaccharidosis I, 3 with mucopolysaccharidosis IV, 2 with mucopolysaccharidosis VI, 2 with mucolipidosis, and 11 with human T-cell lymphotropic virus type-1 (HTLV-1)-associated myelopathy participated in the study. The mean ± SD SSPROM and JOA scores were 74.6 ± 11.4 and 12.4 ± 2.3, respectively. Construct validity for SSPROM (JOA: r = 0.84, P < 0.0001; EDSS: r = -0.83, P < 0.0001; Barthel: r = 0.56, P < 0.002; Osame: r = -0.94, P < 0.0001) and reliability (intra-rater: r = 0.83, P < 0.0001; inter-rater: r = 0.94, P < 0.0001) were demonstrated. The metric properties of JOA were similar to those found in SSPROM. Several clinimetric requirements were met for both SSPROM and JOA scales. Since SSPROM has a wider range, it should be useful for follow-up studies on IEM myelopathies.

Vascular dysfunction by myofibroblast activation in patients with idiopathic pulmonary fibrosis and prognostic significance

In this study, we demonstrated the importance of telomerase protein expression and determined the relationships among telomerase, endothelin-1 (ET-1) and myofibroblasts during early and late remodeling of parenchymal and vascular areas in usual interstitial pneumonia (UIP) using 27 surgical lung biopsies from patients with idiopathic pulmonary fibrosis (IPF). Telomerase+, myofibroblasts α-SMA+, smooth muscle cells caldesmon+, endothelium ET-1+ cellularity, and fibrosis severity were evaluated in 30 fields covering normal lung parenchyma, minimal fibrosis (fibroblastic foci), severe (mural) fibrosis, and vascular areas of UIP by the point-counting technique and a semiquantitative score. The impact of these markers was determined in pulmonary functional tests and follow-up until death from IPF. Telomerase and ET-1 expression was significantly increased in normal and vascular areas compared to areas of fibroblast foci. Telomerase and ET-1 expression was inversely correlated with minimal fibrosis in areas of fibroblast foci and directly associated with severe fibrosis in vascular areas. Telomerase activity in minimal fibrosis areas was directly associated with diffusing capacity of the lung for oxygen/alveolar volume and ET-1 expression and indirectly associated with diffusing capacity of the lungs for carbon monoxide and severe fibrosis in vascular areas. Cox proportional hazards regression revealed a low risk of death for females with minimal fibrosis displaying high telomerase and ET-1 expression in normal areas. Vascular dysfunction by telomerase/ET-1 expression was found earlier than vascular remodeling by myofibroblast activation in UIP with impact on IPF evolution, suggesting that strategies aimed at preventing the effect of these mediators may have a greater impact on patient outcome.

Application of a modified sequential organ failure assessment score to critically ill patients

The purpose of the present study was to explore the usefulness of the Mexican sequential organ failure assessment (MEXSOFA) score for assessing the risk of mortality for critically ill patients in the ICU. A total of 232 consecutive patients admitted to an ICU were included in the study. The MEXSOFA was calculated using the original SOFA scoring system with two modifications: the PaO2/FiO2 ratio was replaced with the SpO2/FiO2 ratio, and the evaluation of neurologic dysfunction was excluded. The ICU mortality rate was 20.2%. Patients with an initial MEXSOFA score of 9 points or less calculated during the first 24 h after admission to the ICU had a mortality rate of 14.8%, while those with an initial MEXSOFA score of 10 points or more had a mortality rate of 40%. The MEXSOFA score at 48 h was also associated with mortality: patients with a score of 9 points or less had a mortality rate of 14.1%, while those with a score of 10 points or more had a mortality rate of 50%. In a multivariate analysis, only the MEXSOFA score at 48 h was an independent predictor for in-ICU death with an OR = 1.35 (95%CI = 1.14-1.59, P < 0.001). The SOFA and MEXSOFA scores calculated 24 h after admission to the ICU demonstrated a good level of discrimination for predicting the in-ICU mortality risk in critically ill patients. The MEXSOFA score at 48 h was an independent predictor of death; with each 1-point increase, the odds of death increased by 35%.

Utility of a novel risk score for prediction of ventricular tachycardia and cardiac death in chronic Chagas disease - the SEARCH-RIO study

The SEARCH-RIO study prospectively investigated electrocardiogram (ECG)-derived variables in chronic Chagas disease (CCD) as predictors of cardiac death and new onset ventricular tachycardia (VT). Cardiac arrhythmia is a major cause of death in CCD, and electrical markers may play a significant role in risk stratification. One hundred clinically stable outpatients with CCD were enrolled in this study. They initially underwent a 12-lead resting ECG, signal-averaged ECG, and 24-h ambulatory ECG. Abnormal Q-waves, filtered QRS duration, intraventricular electrical transients (IVET), 24-h standard deviation of normal RR intervals (SDNN), and VT were assessed. Echocardiograms assessed left ventricular ejection fraction. Predictors of cardiac death and new onset VT were identified in a Cox proportional hazard model. During a mean follow-up of 95.3 months, 36 patients had adverse events: 22 new onset VT (mean±SD, 18.4±4‰/year) and 20 deaths (26.4±1.8‰/year). In multivariate analysis, only Q-wave (hazard ratio, HR=6.7; P<0.001), VT (HR=5.3; P<0.001), SDNN<100 ms (HR=4.0; P=0.006), and IVET+ (HR=3.0; P=0.04) were independent predictors of the composite endpoint of cardiac death and new onset VT. A prognostic score was developed by weighting points proportional to beta coefficients and summing-up: Q-wave=2; VT=2; SDNN<100 ms=1; IVET+=1. Receiver operating characteristic curve analysis optimized the cutoff value at >1. In 10,000 bootstraps, the C-statistic of this novel score was non-inferior to a previously validated (Rassi) score (0.89±0.03 and 0.80±0.05, respectively; test for non-inferiority: P<0.001). In CCD, surface ECG-derived variables are predictors of cardiac death and new onset VT.

3D Mesh Simplification. A survey of algorithms and CAD model simplification tests

Simplification of highly detailed CAD models is an important step when CAD models are visualized or by other means utilized in augmented reality applications. Without simplification, CAD models may cause severe processing and storage is- sues especially in mobile devices. In addition, simplified models may have other advantages like better visual clarity or improved reliability when used for visual pose tracking. The geometry of CAD models is invariably presented in form of a 3D mesh. In this paper, we survey mesh simplification algorithms in general and focus especially to algorithms that can be used to simplify CAD models. We test some commonly known algorithms with real world CAD data and characterize some new CAD related simplification algorithms that have not been surveyed in previous mesh simplification reviews.

Corn germ with pericarp in relation to whole corn: nutrient contents, food and protein efficiency, and protein digestibility-corrected amino acid score

The germ fraction with pericarp (bran) is generated in the industrial processing of corn kernel, and it is used for oil extraction and animal feed. This study evaluated the nutritional and protein quality of this fraction in relation to whole corn. The proximate composition, mineral contents, and amino acid profile of the germ fraction with pericarp and of whole corn were determined. A 4-week experiment was conducted using 36 weanling male Wistar rats, and three 10%-protein diets (reference, germ with 15% lipids and casein with 15% lipids), two 6%-protein diets (whole corn and casein), and a protein-free diet were prepared. The germ showed higher contents of proteins, lipids, dietary fiber (27.8 g.100 g-1), ash, minerals (Fe and Zn- approximately 5 mg.100 g-1), and lysine (57.2 mg.g-1 protein) than those of corn. The germ presented good quality protein (Relative Protein Efficiency Ratio-RPER = 80%; Protein Digestibility-Corrected Amino Acid Score-PDCAAS = 86%), higher than that of corn (RPER = 49%; PDCAAS = 60%). The corn germ fraction with pericarp is rich in dietary fiber, and it is a source of good quality protein as well as of iron and zinc, and its use as nutritive raw material is indicated in food products for human consumption.

Annatto seed residue (Bixa orellana L.): nutritional quality

Considering that annatto seeds are rich in protein, the present work aimed to evaluate the biological quality of this nutrient in the meal residue originating from annatto seed processing. We determined the general composition, mineral levels, amino acid composition and chemical scores, antinutritional factors, and protein quality using biological assays. The following values were obtained: 11.50% protein, 6.74% moisture, 5.22% ash, 2.22% lipids, 42.19% total carbohydrates and 28.45% fiber. The residue proved to be a food rich in fiber and also a protein source. Antinutritional factors were not detected. The most abundant amino acids were lysine, phenylalanine + tyrosine, leucine and isoleucine. Valine was the most limiting amino acid (chemical score 0.22). The protein quality of the seed residue and the isolated protein showed no significant differences. The biological value was lower than that of the control protein but higher than that found in other vegetables. Among the biochemical analyses, only creatinine level was decreased in the two test groups compared to the control group. Enzyme tests did not indicate liver toxicity. The results showed favorable aspects for the use of annatto seed residue in the human diet, meriting further research.

Aplicabilidade da avaliação global subjetiva e malnutrition inflammation score na avaliação do estado nutricional na doença renal crônica

Até o momento, não há um método único capaz de diagnosticar com fidedignidade a condição nutricional do paciente com doença renal crônica (DRC). Por essa razão, tem se recomendado o emprego de vários marcadores nutricionais. A avaliação global subjetiva (AGS) se baseia na história física e no exame clínico do paciente e, desde sua criação, novas versões foram elaboradas. A partir da AGS, foi criado o malnutrition inflammation score (MIS), composto por 70% das questões comuns à AGS acrescido de questões objetivas do estado nutricional. Como muitas modificações foram feitas na forma original da AGS e o emprego tanto da AGS quanto do MIS em pacientes com DRC aumentou significativamente na prática clínica, este trabalho tem como objetivo fazer uma revisão sobre a aplicabilidade desses métodos para avaliação do estado nutricional em pacientes com DRC.

Standardized electrical tests for electrical equipment in road vehicles Case: Visedo Oy PowerMASTER M-frame

Electrical road vehicles were common at the begin of the 20th century but internal combustion engines took a victory from electrical motors in road vehicles. The acknowledgement of the environment, and the price and the availability of the crude oil are reasons for the comeback of the electrical vehicles. Advancement in industrial technology and political atmosphere in EU as the directive 20--20--20, which consists of reducing fossil emission, increasing renewable energy and increasing the energy efficiency, have made the electrification popular again. In this thesis tests based on standard ISO 16750--2 electrical loads for electrical equipment in road vehicles are made for Visedo Oy's PowerMASTER M-frame power electronics device. This device is designed for mainly drive trains in mobile work machines and marine vessels but can be used in other application in its power range which also includes road vehicles. The functionality of the device is tested with preliminary tests which act as a framework for the tests based on standards.

Trying to Score a Goal

1980/1981 season. Pictured here are Joel Walton (#4) and Tony Carboni (#13).

Problem solving and computer-assisted instruction in science education : analysis of research findings and the research process /

The quantitative component of this study examined the effect of computerassisted instruction (CAI) on science problem-solving performance, as well as the significance of logical reasoning ability to this relationship. I had the dual role of researcher and teacher, as I conducted the study with 84 grade seven students to whom I simultaneously taught science on a rotary-basis. A two-treatment research design using this sample of convenience allowed for a comparison between the problem-solving performance of a CAI treatment group (n = 46) versus a laboratory-based control group (n = 38). Science problem-solving performance was measured by a pretest and posttest that I developed for this study. The validity of these tests was addressed through critical discussions with faculty members, colleagues, as well as through feedback gained in a pilot study. High reliability was revealed between the pretest and the posttest; in this way, students who tended to score high on the pretest also tended to score high on the posttest. Interrater reliability was found to be high for 30 randomly-selected test responses which were scored independently by two raters (i.e., myself and my faculty advisor). Results indicated that the form of computer-assisted instruction (CAI) used in this study did not significantly improve students' problem-solving performance. Logical reasoning ability was measured by an abbreviated version of the Group Assessment of Lx)gical Thinking (GALT). Logical reasoning ability was found to be correlated to problem-solving performance in that, students with high logical reasoning ability tended to do better on the problem-solving tests and vice versa. However, no significant difference was observed in problem-solving improvement, in the laboratory-based instruction group versus the CAI group, for students varying in level of logical reasoning ability.Insignificant trends were noted in results obtained from students of high logical reasoning ability, but require further study. It was acknowledged that conclusions drawn from the quantitative component of this study were limited, as further modifications of the tests were recommended, as well as the use of a larger sample size. The purpose of the qualitative component of the study was to provide a detailed description ofmy thesis research process as a Brock University Master of Education student. My research journal notes served as the data base for open coding analysis. This analysis revealed six main themes which best described my research experience: research interests, practical considerations, research design, research analysis, development of the problem-solving tests, and scoring scheme development. These important areas ofmy thesis research experience were recounted in the form of a personal narrative. It was noted that the research process was a form of problem solving in itself, as I made use of several problem-solving strategies to achieve desired thesis outcomes.

Linking of stress offset score (SOS), work satisfaction, and organizational commitment to intentions to quit

The purpose of this study was to identify the impact of stressors and offsetting satistiers, measured in this study with Stress Offset Score (SOS), on intentions to quit and examine the mediating and moderating effects of three facets of work satisfaction (job satisfaction, pay satisfaction, and satisfaction with supervisor) and two facets of organizational commitment (affective and nonnative commitment) on this relationship. The sample was composed of 2990 employees from 21 public and private organizations. The interaction of each type of work satisfaction and organizational commitment, with SOS, was tested using Ordinary Least Squares (OLS) procedures. Intentions to quit was the dependent variable. The research questions were determine: (1) Does SOS predict intentions to quit? (2) Does work satisfaction mediate the predictive relationship of SOS on intentions to quit? (3) Does organizational commitment mediate the predictive relationship of SOS on intent to quit? (4) Does work satisfaction moderate the predictive relationship of SOS on intentions to quit? and (5) Does organizational commitment moderate the predictive relationship of SOS on intentions to quit? The results indicated that SOS was negatively correlated with intentions to quit. Each of the types of work satisfaction and organizational commitment variables showed a partial mediated relationship with SOS and each relationship was highly significant, while normative commitment explained more of the relationship then other mediators. The study also tested for interactions but no statistical significant relationships where established between any of the interaction terms (e.g., SOSxJob Satisfaction and SOSxAffcctive Commitment) and intentions to quit.

A comparison of cognitive processes and components of neurological maturation in 3-and-11 year-old children

The relationship between the child's cogni tive development and neurological maturation has been of theoretical interest for many year s. Due to diff iculties such as the lack of sophisticated techniques for measur ing neurolog ical changes and a paucity of normative data, few studies exist that have attempted to correlate the two factors. Recent theory on intellectual development has proposed that neurological maturation may be a factor in the increase of short-term memory storage space. Improved technology has allowed reliable recordings of neurolog ical maturation.. In an attempt to correlate cogni tive development and neurological maturation, this study tested 3-and II-year old children. Fine motor and gross motor short-term memory tests were used to index cogni tive development. Somatosensory evoked potentials elici ted by median nerve stimulation were used to measure the time required for the sensation to pass along the nerve to specific points on the somatosensory pathway. Times were recorded for N14, N20, and P22 interpeak latencies. Maturation of the central nervous system (brain and spinal cord) and the peripheral nervous system (outside the brain and spinal cord) was indi~ated by the recorded times. Signif icant developmental di fferences occurred between 3-and ll-year-olds in memory levels, per ipheral conduction velocity and central conduction times. Linear regression analyses showed that as age increased, memory levels increased and central conduction times decreased. Between the ll-year-old groups, there were no significant differences in central or peripheral nervous system maturation between subjects who achieved a 12 plus score on the digit span test of the WISC-R and those who scored 7 or lower on the same test. Levels achieved on the experimental gross and fine motor short-term memory tests differed significantly within the ll-year-old group.