Limitations of the Odds Ratio in Gauging the Performance of a Diagnostic or Prognostic Marker

A marker that is strongly associated with outcome (or disease) is often assumed to be effective for classifying individuals according to their current or future outcome. However, for this to be true, the associated odds ratio must be of a magnitude rarely seen in epidemiological studies. An illustration of the relationship between odds ratios and receiver operating characteristic (ROC) curves shows, for example, that a marker with an odds ratio as high as 3 is in fact a very poor classification tool. If a marker identifies 10 percent of controls as positive (false positives) and has an odds ratio of 3, then it will only correctly identify 25 percent of cases as positive (true positives). Moreover, the authors illustrate that a single measure of association such as an odds ratio does not meaningfully describe a marker’s ability to classify subjects. Appropriate statistical methods for assessing and reporting the classification power of a marker are described. The serious pitfalls of using more traditional methods based on parameters in logistic regression models are illustrated.

Active renin versus plasma renin activity to define aldosterone-to-renin ratio for primary aldosteronism

BACKGROUND: In recent years, the assessment of the plasma aldosterone-to-renin ratio (ARR) has become an established screening method for the diagnosis of primary aldosteronism. Plasma renin activity (PRA) is usually measured to define ARR although, increasingly, renin concentration alone is often measured in clinical routine. OBJECTIVE: To determine the threshold of ARR using active renin concentration to screen for primary aldosteronism. DESIGN AND PARTICIPANTS: To determine the ARR threshold based on plasma immunoreactive renin concentration (irR), we measured plasma aldosterone concentration (PAC), irR and PRA in 36 hypertensive patients, nine thereof with adrenal adenoma, and compared ARRs calculated from irR and PRA, respectively. SETTING: Single-centre, hypertension clinic in a tertiary care hospital. RESULTS: PRA ranged from 0.41-14.9 ng/ml per h and irR from 1.1-72 ng/l. There was an excellent correlation between PRA and irR (r = 0.98, P < 0.0001) and between ARRPRA and ARRirR (r = 0.96, P < 0.0001). An ARRPRA > 750 pmol/l per ng/ml per h was previously found to be highly predictive of primary aldosteronism because 90% of the corresponding patients failed to suppress PAC upon saline infusion or fludrocortisone. The corresponding threshold value for ARRirR was 150 pmol/ng in our patients. Using these cut-offs, nine subjects had both increased ARRPRA and ARRirR while, in three patients, either ARRPRA or ARRirR were increased. The nine patients with increased ARRPRA and ARRirR also had PAC > 650 pmol/l. Only these patients had adrenal adenomas. CONCLUSIONS: The ARR threshold to screen for primary aldosteronism may be based on measurement of irR. An ARRirR > 150 pmol/ng may indicate primary aldosteronism.

Torque converter turbine noise and cavitation noise over varying speed ratio

These investigations will discuss the operational noise caused by automotive torque converters during speed ratio operation. Two specific cases of torque converter noise will be studied; cavitation, and a monotonic turbine induced noise. Cavitation occurs at or near stall, or zero turbine speed. The bubbles produced due to the extreme torques at low speed ratio operation, upon collapse, may cause a broadband noise that is unwanted by those who are occupying the vehicle as other portions of the vehicle drive train improve acoustically. Turbine induced noise, which occurs at high engine torque at around 0.5 speed ratio, is a narrow-band phenomenon that is audible to vehicle occupants currently. The solution to the turbine induced noise is known, however this study is to gain a better understanding of the mechanics behind this occurrence. The automated torque converter dynamometer test cell was utilized in these experiments to determine the effect of torque converter design parameters on the offset of cavitation and to employ the use a microwave telemetry system to directly measure pressures and structural motion on the turbine. Nearfield acoustics were used as a detection method for all phenomena while using a standardized speed ratio sweep test. Changes in filtered sound pressure levels enabled the ability to detect cavitation desinence. This, in turn, was utilized to determine the effects of various torque converter design parameters, including diameter, torus dimensions, and pump and stator blade designs on cavitation. The on turbine pressures and motion measured with the microwave telemetry were used to understand better the effects of a notched trailing edge turbine blade on the turbine induced noise.

Implementation of a Variable Compression Ratio Mechanism in a Four Cylinder Engine

Ever since the invention of the internal combustion engine, generating more power and achieving better efficiency has been a major goal for the designers. Variable compression ratio technology is way to achieve those goals. This paper will discuss the method of varying the compression ratio of an inline 4-cylinder engine through the use of a 4-bar linkage and gear mechanism. This mechanism was proven to easily vary the compression ratio of the engine and shows promise of becoming a technology used for future engine designer.

The Effect of the Cu:Fe''' Ratio Upon the Current Efficiency in the Electrolysis of a Copper Sulfate Solution Containing Iron Sulfate

It is a well-known fact that, in the electrolysis of a CuSO4 solution containing iron sulfate, using insoluble anodes, with the depletion of copper, the point is finally reached where the current efficiency becomes zero. This decrease in current efficiency is due to the oxidation of the ferrous sulfate to the ferric condition at the anode, by the oxygen liberated. The resulting ferric sulfate diffuses over to the cathode and there dissolves copper from the cathode according to the chemical equation Cu + Fe2 (SO4)3 = CuSO4 + 2FeSO4. This copper, which has been deposited at the cathode by the electric current, is thus redissolved by the Fe2(SO4)3. The solution of the copper causes at the same time a formation of FeSO4 which in turn diffuses over to the anode and is there oxidized to Fe2(SO4)3; and so the cycle continues, using electric current without rendering useful work. E. H. Larison has noted that a definite amount of ferric salts must be reduced to the ferrous condition before all the copper will remain on the cathode; he does not state, however, just what this point is. L. Addicks has plotted the relation between current efficiency and ferric sulphate content. The existence of the results scattered the points more or less, although the decrease in current efficiency with increased ferric sulphate content is clearly indicated. E. T.Kern has likewise noted that the smaller the amount of copper in the solution, the greater is the reduction of current efficiency. In this work, therefore, it was desired to determine what amount of ferric iron was permissible in a copper sulfate solution of definite concentration before the current efficiency would drop to zero, and what, if any, was the effect of definite Cu:Fe’’’ratio upon the current efficiency of the electrolysis.

The Effect of the Fe2: Fe3 Ratio upon the Current Efficiency in the Electrolysis of a Copper Sulfate Solution Containing Iron Sulfate

In the treatment of copper ores by hydro-electro-metallurgical methods, not only is copper deposited, but other metals are also dissolved. In practice it has been found* that iron, under certain conditions, causes the copper to deposit on the cathode as a nonadherent precipitate and also that the iron in solution causes a great decrease in current efficiency, es­pecially when the electrolysis is conducted by operating with a higher current density at the cathode than at the anode. The present investigation deals with the effects of the two valences of iron on the current efficiency and endeavors to determine whether or not there is a ratio of the two at which point the efficiency becomes zero or approaches it.