894 resultados para Scaling Criteria
Resumo:
The clinical validity of at-risk criteria of psychosis had been questioned based on epidemiological studies that have reported much higher prevalence and annual incidence rates of psychotic-like experiences (PLEs as assessed by either self rating questionnaires or layperson interviews) in the general population than of the clinical phenotype of psychotic disorders (van Os et al., 2009). Thus, it is unclear whether “current at-risk criteria reflect behaviors so common among adolescents and young adults that a valid distinction between ill and non-ill persons is difficult” (Carpenter, 2009). We therefore assessed the 3-month prevalence of at-risk criteria by means of telephone interviews in a randomly drawn general population sample from the at-risk age segment (age 16–35 years) in the Canton Bern, Switzerland. Eighty-five of 102 subjects had valid phone numbers, 21 of these subjects refused (although 6 of them signaled willingness to participate at a later time), 4 could not be contacted. Sixty subjects (71% of the enrollment fraction) participated. Two participants met exclusion criteria (one for being psychotic, one for lack of language skills). Twenty-two at-risk symptoms were assessed for their prevalence and severity within the 3 months prior to the interview by trained clinical raters using (i) the Structured Interview for Prodromal Syndromes (SIPS; Miller et al., 2002) for the evaluation of 5 attenuated psychotic and 3 brief limited intermittent psychotic symptoms (APS, BLIPS) as well as state-trait criteria of the ultra-high-risk (UHR) criteria and (ii) the Schizophrenia Proneness Instrument, Adult version (SPI-A; Schultze-Lutter et al., 2007) for the evaluation of the 14 basic symptoms included in COPER and COGDIS (Schultze-Lutter et al., 2008). Further, psychiatric axis I diagnoses were assessed by means of the Mini-International Neuropsychiatric Interview, M.I.N.I. (Sheehan et al., 1998), and psychosocial functioning by the Scale of Occupational and Functional Assessment (SOFAS; APA, 1994). All interviewees felt ‘rather’ or ‘very’ comfortable with the interview. Of the 58 included subjects, only 1 (2%) fulfilled APS criteria by reporting the attenuated, non-delusional idea of his mind being literally read by others at a frequency of 2–3 times a week that had newly occurred 6 weeks ago. BLIPS, COPER, COGDIS or state-trait UHR criteria were not reported. Yet, twelve subjects (21%) described sub-threshold at-risk symptoms: 7 (12%) reported APS relevant symptoms but did not meet time/frequency criteria of APS, and 9 (16%) reported COPER and/or COGDIS relevant basic symptoms but at an insufficient frequency or as a trait lacking increase in severity; 4 of these 12 subjects reported both sub-threshold APS and sub-threshold basic symptoms. Table 1 displays type and frequency of the sub-threshold at-risk symptoms.
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To protect motorists and avoid tort liability, highway agencies expend considerable resources to repair damaged longitudinal barriers, such as w-beam guardrails. With limited funding available, though, highway agencies are unable to maintain all field-installed systems in the ideal as-built condition. Instead, these agencies focus on repairing only damage that has a detrimental effect on the safety performance of the barrier. The distinction between minor damage and more severe performance-altering damage, however, is not always clear. This paper presents a critical review of current United States (US) and Canadian criteria on whether to repair damaged longitudinal barrier. Barrier repair policies were obtained via comprehensive literature review and a survey of US and Canadian transportation agencies. In an analysis of the maintenance procedures of 40 US States and 8 Canadian transportation agencies, fewer than one-third of highway agencies were found to have quantitative measures to determine when barrier repair is warranted. In addition, no engineering basis for the current US barrier repair guidelines could be found. These findings underscore the importance of the development of quantitative barrier repair guidelines based on a strong technical foundation.
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Objectives: Previous research conducted in the late 1980s suggested that vehicle impacts following an initial barrier collision increase severe occupant injury risk. Now over 25years old, the data are no longer representative of the currently installed barriers or the present US vehicle fleet. The purpose of this study is to provide a present-day assessment of secondary collisions and to determine if current full-scale barrier crash testing criteria provide an indication of secondary collision risk for real-world barrier crashes. Methods: To characterize secondary collisions, 1,363 (596,331 weighted) real-world barrier midsection impacts selected from 13years (1997-2009) of in-depth crash data available through the National Automotive Sampling System (NASS) / Crashworthiness Data System (CDS) were analyzed. Scene diagram and available scene photographs were used to determine roadside and barrier specific variables unavailable in NASS/CDS. Binary logistic regression models were developed for second event occurrence and resulting driver injury. To investigate current secondary collision crash test criteria, 24 full-scale crash test reports were obtained for common non-proprietary US barriers, and the risk of secondary collisions was determined using recommended evaluation criteria from National Cooperative Highway Research Program (NCHRP) Report 350. Results: Secondary collisions were found to occur in approximately two thirds of crashes where a barrier is the first object struck. Barrier lateral stiffness, post-impact vehicle trajectory, vehicle type, and pre-impact tracking conditions were found to be statistically significant contributors to secondary event occurrence. The presence of a second event was found to increase the likelihood of a serious driver injury by a factor of 7 compared to cases with no second event present. The NCHRP Report 350 exit angle criterion was found to underestimate the risk of secondary collisions in real-world barrier crashes. Conclusions: Consistent with previous research, collisions following a barrier impact are not an infrequent event and substantially increase driver injury risk. The results suggest that using exit-angle based crash test criteria alone to assess secondary collision risk is not sufficient to predict second collision occurrence for real-world barrier crashes.
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Region-specific empirically based ground-truth (EBGT) criteria used to estimate the epicentral-location accuracy of seismic events have been developed for the Main Ethiopian Rift and the Tibetan plateau. Explosions recorded during the Ethiopia-Afar Geoscientific Lithospheric Experiment (EAGLE), the International Deep Profiling of Tibet, and the Himalaya (INDEPTH III) experiment provided the necessary GT0 reference events. In each case, the local crustal structure is well known and handpicked arrival times were available, facilitating the establishment of the location accuracy criteria through the stochastic forward modeling of arrival times for epicentral locations. In the vicinity of the Main Ethiopian Rift, a seismic event is required to be recorded on at least 8 stations within the local Pg/Pn crossover distance and to yield a network-quality metric of less than 0.43 in order to be classified as EBGT5(95%) (GT5 with 95% confidence). These criteria were subsequently used to identify 10 new GT5 events with magnitudes greater than 2.1 recorded on the Ethiopian Broadband Seismic Experiment (EBSE) network and 24 events with magnitudes greater than 2.4 recorded on the EAGLE broadband network. The criteria for the Tibetan plateau are similar to the Ethiopia criteria, yet slightly less restrictive as the network-quality metric needs to be less than 0.45. Twenty-seven seismic events with magnitudes greater than 2.5 recorded on the INDEPTH III network were identified as GT5 based on the derived criteria. When considered in conjunction with criteria developed previously for the Kaapvaal craton in southern Africa, it is apparent that increasing restrictions on the network-quality metric mirror increases in the complexity of geologic structure from craton to plateau to rift. Accession Number: WOS:000322569200012
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We present a multistage strategy to define the scale and geographic distribution of 'local' ceramic production at Lydian Sardis based on geochemical analysis (NAA) of a large diverse ceramic sample (n = 281). Within the sphere of local ceramic production, our results demonstrate an unusual pattern of reliance on a single resource relative to other contemporary Iron Age centers. When our NAA results are combined with legacy NAA provenience data for production centers in Western Anatolia, we can differentiate ceramic emulation from exchange, establish probable proveniences for the non-local component of the dataset, and define new non-local groups with as yet no known provenience. (C) 2012 Elsevier Ltd. All rights reserved.
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Objectives To determine the diagnostic accuracy of World Health Organization (WHO) 2010 and 2006 as well as United States Department of Health and Human Services (DHHS) 2008 definitions of immunological failure for identifying virological failure (VF) in children on antiretroviral therapy (ART). Methods Analysis of data from children (<16 years at ART initiation) at South African ART sites at which CD4 count/per cent and HIV-RNA monitoring are performed 6-monthly. Incomplete virological suppression (IVS) was defined as failure to achieve ≥1 HIV-RNA ≤400 copies/ml between 6 and 15 months on ART and viral rebound (VR) as confirmed HIV-RNA ≥5000 copies/ml in a child on ART for ≥18 months who had achieved suppression during the first year on treatment. Results Among 3115 children [median (interquartile range) age 48 (20-84) months at ART initiation] on treatment for ≥1 year, sensitivity of immunological criteria for IVS was 10%, 6% and 26% for WHO 2006, WHO 2010 and DHHS 2008 criteria, respectively. The corresponding positive predictive values (PPV) were 31%, 20% and 20%. Diagnostic accuracy for VR was determined in 2513 children with ≥18 months of follow-up and virological suppression during the first year on ART with sensitivity of 5% (WHO 2006/2010) and 27% (DHHS 2008). PPV results were 42% (WHO 2010), 43% (WHO 2006) and 20% (DHHS 2008). Conclusion Current immunological criteria are unable to correctly identify children failing ART virologically. Improved access to viral load testing is needed to reliably identify VF in children.
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The widening gap between the numbers of patients on the waiting list for organ transplantation and the insufficient numbers of organ donors results in the use of "critical" donors, so-called marginal donors or extended criteria donors. Data concerning the evaluation of extended criteria donors (ECD) in Switzerland are sparse.
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Aim: The study was designed to determine the effect on clinical variables, subgingival bacteria and local immune response brought about by additional application of hyaluronan-containing gels in early wound healing after scaling and root planing (SRP). Material and Methods: In this randomised clinical study, data from 34 individuals with chronic periodontitis was evaluated after full-mouth SRP. In the test group (n = 17), hyaluronan gels in two molecular weights were additionally applied during the first two weeks after SRP. The control group (n = 17) was treated with SRP only. Probing depth (PD) and attachment level (AL) were recorded at baseline and after 3 and 6 months, and subgingival plaque and sulcus fluid samples were taken for microbiological and biochemical analysis. Results: In both groups, PD and AL were significantly reduced (p < 0.001). The changes in PD and the reduction of the numbers of pockets with PD ≥ 5mm were significantly higher in the test group after 3 (p = 0.014; p = 0.021) and 6 months (p = 0.046; p = 0.045). Six months after SRP, the counts of Treponema denticola were significantly reduced in both groups (both p = 0.043), those of Campylobacter rectus in the test group only (p = 0.028). Prevotella intermedia and Porphyromonas gingivalis increased in the control group. Conclusions: The adjunctive application of hyaluronan may have positive effects on probing depth reduction and may prevent recolonization by periodontopathogens.
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The aim of this study is to determine in a randomized trial the impact on treatment outcome after 12 months of different subgingival irrigation solutions during scaling and root planing (SRP).