Joint X̄ and R charts with variable parameters

Recent studies have shown that the X̄chart with variable parameters (Vp X̄ chart) detects process shifts faster than the traditional X̄ chart. This article extends these studies for processes that are monitored by both, X̄ and R charts. Basically, the X̄ and R values establish if the control should or should not be relaxed. When the X̄ and R values fall in the central region the control is relaxed because one will wait more to take the next sample and/or the next sample will be smaller than usual. When the X̄ or R values fall in the warning region the control is tightened because one will wait less to take the next sample and the next sample will be larger than usual. The action limits are also made variable. This paper proposes to draw the action limits (for both charts) wider than usual, when the control is relaxed and narrower than usual when the control is tightened. The Vp feature improves the joint X̄ and R control chart performance in terms of the speed with which the process mean and/or variance shifts are detected. © 1998 IIE.

Monadische Erweiterungen von monadic NP

Fagin zeigt in seiner bahnbrechenden Arbeit, dass die Komplexitätsklasse NP mit der logischen Sprache 'existentielle Logik zweiter Ordnung' identifiziert werden kann. Ein einfaches und daher greifbares Fragment dieser Sprache ist monadic NP. Fagin bezeichnet monadic NP als '...training ground for attacking the problems in their full generality'. In dieser Arbeit werden zwei Arten von monadischen Erweiterungen von monadic NP untersucht. Der erste Teil beschäftigt sich mit schwachen built-in Relationen.Einebuilt-in Relation B heißt schwach, falls: monadic NP + B + polynomielles Padding neq NP.Es werden zwei neue Klassen schwacher built-in Relationen (unendlich teilbare-und verpackbare built-in Relationen) eingeführt. Hauptergebnis dieses Teils ist eine Klassifizierung aller bekannten schwachen built-in Relationen mittels dieser beiden Klassen. Im zweiten Teil dieser Arbeit werden monadische Abschlüsse von monadic NP betrachtet. Besonderes Interesse gilt dabei den positiven Abschluss erster Ordnung von monadic NP (kurz: PFO(monNP)). Hauptergebnis dieses Teils ist die Aussage, dass nicht-k-Färbbarkeit (k=>3) nicht ausdrückbar ist in PFO(monNP).

Social Networking Charts

This project resulted in a chart illustrating connections in Social Networks.

Continuous monitoring of bovine spongiform encephalopathy rapid test performance by weak positive tissue controls and quality control charts

Bovine spongiform encephalopathy (BSE) rapid tests and routine BSE-testing laboratories underlie strict regulations for approval. Due to the lack of BSE-positive control samples, however, full assay validation at the level of individual test runs and continuous monitoring of test performance on-site is difficult. Most rapid tests use synthetic prion protein peptides, but it is not known to which extend they reflect the assay performance on field samples, and whether they are sufficient to indicate on-site assay quality problems. To address this question we compared the test scores of the provided kit peptide controls to those of standardized weak BSE-positive tissue samples in individual test runs as well as continuously over time by quality control charts in two widely used BSE rapid tests. Our results reveal only a weak correlation between the weak positive tissue control and the peptide control scores. We identified kit-lot related shifts in the assay performances that were not reflected by the peptide control scores. Vice versa, not all shifts indicated by the peptide control scores indeed reflected a shift in the assay performance. In conclusion these data highlight that the use of the kit peptide controls for continuous quality control purposes may result in unjustified rejection or acceptance of test runs. However, standardized weak positive tissue controls in combination with Shewhart-CUSUM control charts appear to be reliable in continuously monitoring assay performance on-site to identify undesired deviations.

Autosomal dominant neurohypophyseal diabetes insipidus in a Swiss family, caused by a novel mutation (C59Delta/A60W) in the neurophysin moiety of prepro-vasopressin-neurophysin II (AVP-NP II).

OBJECTIVE To study clinical, morphological and molecular characteristics in a Swiss family with autosomal dominant familial neurohypophyseal diabetes insipidus (adFNDI). PARTICIPANTS AND METHODS A 15-month-old girl presenting with symptoms of polydipsia and polyuria was investigated by water deprivation test. Evaluation of the family revealed three further family members with symptomatic vasopressin-deficient diabetes insipidus. T1-weighted magnetic resonance images of the posterior pituitary were taken in two affected adult family members and molecular genetic analysis was performed in all affected individuals. RESULTS The water deprivation test in the 15-month-old child confirmed the diagnosis of vasopressin-deficient diabetes insipidus and the pedigree was consistent with autosomal dominant inheritance. The characteristic bright spot of the normal vasopressin-containing neurophypophysis was absent in both adults with adFNDI. Direct sequence analysis revealed a new deletion (177-179DeltaCGC) in exon 2 of the AVP-NP II gene in all affected individuals. At the amino acid level, this deletion eliminates cysteine 59 (C59Delta) and substitutes alanine 60 by tryptophan (A60W) in the AVP-NP II precursor; interestingly, the remainder of the reading frame remains unchanged. According to the three-dimensional structure of neurophysin, C59 is involved in a disulphide bond with C65. CONCLUSIONS Deletion of C59 and substitution of A60W in the AVP-NP II precursor is predicted to disrupt one of the seven disulphide bridges required for correct folding of the neurophysin moiety and thus disturb the function of neurophysin as the vasopressin transport protein. These data are in line with the clinical and morphological findings in the reported family with adFNDI.

Extended duration of torsional loading reduced the survival of the NP cells of the intervertebral disc

Introduction Previous studies on the influence of torsion and combined torsion-compression loading revealed a positive effect on the cell viability when a repetitive short-term torsion was applied at a physiological magnitude to intervertebral disc organ culture.1 However, after an extended period (8 hours) of combined torsion-compression loading, substantial cell death was detected in the nucleus pulposus (NP).2 In this follow-up study, we aimed to investigate the relationship, if any, between the duration of torsion applied to the intervertebral disc (IVD) and the level of NP cell viability. Materials and Methods Bovine caudal discs were harvested and cultured in a custom-built multiaxis dynamic loading bioreactor.2 Torsion (± 2 degrees) was applied to the samples at a frequency of 0.2 Hz. Torsion was applied for durations of 0, 1, 4, and 8 h/d, repeated over 7 days. After the last day of loading, disc tissue was dissected for analysis of cell viability and gene expression. Results Disc NP cell viability remained above 85% after torsional loading for 0, 1, or 4 h/d. Viability was statistical significantly reduced to below 70% when torsion was applied for 8 h/d (p = 0.03) (Table 1). The daily duration of torsional loading did not affect the AF cell viability (> 80% for all loading durations). The trend of collagen 2 gene upregulation and matrix metalloproteases 13 downregulation with an increasing duration of torsion was observed in both NP and AF (Fig. 1).Conclusion We have demonstrated that an extended duration of torsion could inhibit the survival of NP cells within the IVD in organ culture. Acknowledgments Funds from the Orthopedic Department of the Insel University Hospital of Bern and a private donation from Prof. Dr. Paul Heini, Spine Surgeon, Sonnenhof Clinic Bern were received to support this work. Disclosure of Interest None declared References References 1 Chan SC, Ferguson SJ, Wuertz K, Gantenbein-Ritter B. Biological response of the intervertebral disc to repetitive short-term cyclic torsion. Spine 2011;36(24):2021–2030 2 Chan SC, Walser J, Käppeli P, Shamsollahi MJ, Ferguson SJ, Gantenbein-Ritter B. Region specific response of intervertebral disc cells to complex dynamic loading: an organ culture study using a dynamic torsion-compression bioreactor. PLoS ONE 2013;8(8):e72489

Risk charts to guide targeted HIV-1 viral load monitoring of ART: development and validation in patients from resource-limited settings.

BACKGROUND HIV-1 RNA viral load (VL) testing is recommended to monitor antiretroviral therapy (ART) but not available in many resource-limited settings. We developed and validated CD4-based risk charts to guide targeted VL testing. METHODS We modeled the probability of virologic failure up to 5 years of ART based on current and baseline CD4 counts, developed decision rules for targeted VL testing of 10%, 20% or 40% of patients in seven cohorts of patients starting ART in South Africa, and plotted cut-offs for VL testing on colour-coded risk charts. We assessed the accuracy of risk chart-guided VL testing to detect virologic failure in validation cohorts from South Africa, Zambia and the Asia-Pacific. FINDINGS 31,450 adult patients were included in the derivation and 25,294 patients in the validation cohorts. Positive predictive values increased with the percentage of patients tested: from 79% (10% tested) to 98% (40% tested) in the South African, from 64% to 93% in the Zambian and from 73% to 96% in the Asia-Pacific cohorts. Corresponding increases in sensitivity were from 35% to 68% in South Africa, from 55% to 82% in Zambia and from 37% to 71% in Asia-Pacific. The area under the receiver-operating curve increased from 0.75 to 0.91 in South Africa, from 0.76 to 0.91 in Zambia and from 0.77 to 0.92 in Asia Pacific. INTERPRETATION CD4-based risk charts with optimal cut-offs for targeted VL testing may be useful to monitor ART in settings where VL capacity is limited.

Implementation and Operational Research: Risk Charts to Guide Targeted HIV-1 Viral Load Monitoring of ART: Development and Validation in Patients From Resource-Limited Settings.

BACKGROUND HIV-1 RNA viral load (VL) testing is recommended to monitor antiretroviral therapy (ART) but not available in many resource-limited settings. We developed and validated CD4-based risk charts to guide targeted VL testing. METHODS We modeled the probability of virologic failure up to 5 years of ART based on current and baseline CD4 counts, developed decision rules for targeted VL testing of 10%, 20%, or 40% of patients in 7 cohorts of patients starting ART in South Africa, and plotted cutoffs for VL testing on colour-coded risk charts. We assessed the accuracy of risk chart-guided VL testing to detect virologic failure in validation cohorts from South Africa, Zambia, and the Asia-Pacific. RESULTS In total, 31,450 adult patients were included in the derivation and 25,294 patients in the validation cohorts. Positive predictive values increased with the percentage of patients tested: from 79% (10% tested) to 98% (40% tested) in the South African cohort, from 64% to 93% in the Zambian cohort, and from 73% to 96% in the Asia-Pacific cohort. Corresponding increases in sensitivity were from 35% to 68% in South Africa, from 55% to 82% in Zambia, and from 37% to 71% in Asia-Pacific. The area under the receiver operating curve increased from 0.75 to 0.91 in South Africa, from 0.76 to 0.91 in Zambia, and from 0.77 to 0.92 in Asia-Pacific. CONCLUSIONS CD4-based risk charts with optimal cutoffs for targeted VL testing maybe useful to monitor ART in settings where VL capacity is limited.

Comparison of the in-house made Carba-NP and Blue-Carba tests: Considerations for better detection of carbapenemase-producing Enterobacteriaceae

The in-house Carba-NP and Blue-Carba tests were compared using 30 carbapenemase- and 33 non-producing Enterobacteriaceae. Tests were read by three operators. 100% sensitivity was reported for both tests, but Carba-NP was slightly more specific than Blue-Carba (98.9% vs. 91.7%). We describe potential sources of error during tests' preparation and reading.

Estimates of hospital and physician costs of epilepsy in the United States for 1995 comparing the provider -based survey method and a patient -based medical charts and billing method

This investigation compares two different methodologies for calculating the national cost of epilepsy: provider-based survey method (PBSM) and the patient-based medical charts and billing method (PBMC&BM). The PBSM uses the National Hospital Discharge Survey (NHDS), the National Hospital Ambulatory Medical Care Survey (NHAMCS) and the National Ambulatory Medical Care Survey (NAMCS) as the sources of utilization. The PBMC&BM uses patient data, charts and billings, to determine utilization rates for specific components of hospital, physician and drug prescriptions. ^ The 1995 hospital and physician cost of epilepsy is estimated to be $722 million using the PBSM and $1,058 million using the PBMC&BM. The difference of $336 million results from $136 million difference in utilization and $200 million difference in unit cost. ^ Utilization. The utilization difference of $136 million is composed of an inpatient variation of $129 million, $100 million hospital and $29 million physician, and an ambulatory variation of $7 million. The $100 million hospital variance is attributed to inclusion of febrile seizures in the PBSM, $−79 million, and the exclusion of admissions attributed to epilepsy, $179 million. The former suggests that the diagnostic codes used in the NHDS may not properly match the current definition of epilepsy as used in the PBMC&BM. The latter suggests NHDS errors in the attribution of an admission to the principal diagnosis. ^ The $29 million variance in inpatient physician utilization is the result of different per-day-of-care physician visit rates, 1.3 for the PBMC&BM versus 1.0 for the PBSM. The absence of visit frequency measures in the NHDS affects the internal validity of the PBSM estimate and requires the investigator to make conservative assumptions. ^ The remaining ambulatory resource utilization variance is $7 million. Of this amount, $22 million is the result of an underestimate of ancillaries in the NHAMCS and NAMCS extrapolations using the patient visit weight. ^ Unit cost. The resource cost variation is $200 million, inpatient is $22 million and ambulatory is $178 million. The inpatient variation of $22 million is composed of $19 million in hospital per day rates, due to a higher cost per day in the PBMC&BM, and $3 million in physician visit rates, due to a higher cost per visit in the PBMC&BM. ^ The ambulatory cost variance is $178 million, composed of higher per-physician-visit costs of $97 million and higher per-ancillary costs of $81 million. Both are attributed to the PBMC&BM's precise identification of resource utilization that permits accurate valuation. ^ Conclusion. Both methods have specific limitations. The PBSM strengths are its sample designs that lead to nationally representative estimates and permit statistical point and confidence interval estimation for the nation for certain variables under investigation. However, the findings of this investigation suggest the internal validity of the estimates derived is questionable and important additional information required to precisely estimate the cost of an illness is absent. ^ The PBMC&BM is a superior method in identifying resources utilized in the physician encounter with the patient permitting more accurate valuation. However, the PBMC&BM does not have the statistical reliability of the PBSM; it relies on synthesized national prevalence estimates to extrapolate a national cost estimate. While precision is important, the ability to generalize to the nation may be limited due to the small number of patients that are followed. ^

Caracterización del contenido de nitratos y la composición nutricional en zanahoria (Daucus carota L.) cultivada con diferentes dosis de fertilización NP

La zanahoria (Daucus carota L.) es una de las hortalizas de mayor importancia y difusión en el mundo. Los consumidores la valorizan nutricionalmente por ser una excelente fuente de vitaminas y minerales. Es común su empleo como alimento para bebé, como así también en gran variedad de productos procesados. La calidad nutricional e higiénico-sanitaria de esta hortaliza depende de las prácticas agronómicas como la fertilización. El objetivo de este trabajo es determinar el contenido de nitratos y la composición centesimal en zanahoria (Daucus carota L.) en un agroecosistema con aplicaciones crecientes de nitrógeno y fósforo, en el momento de la cosecha. Se realizó un ensayo en campo con zanahoria doble propósito en el INTA- EEA La Consulta, Mendoza, con 3 niveles de N (0, 150 y 300 kg N ha-1; N0, N1, N2 respectivamente) y tres de P (0, 30 y 60 kg P ha-1, P0, P1, P2), en un diseño en bloque completos al azar con arreglo factorial y tres repeticiones. Sobre N0P0, N1P1 y N2P2 se realizaron muestreos destructivos de planta entera a los 86, 107, 128 y 142 días después de la siembra (dds). Se separaron en raíz y parte aérea, efectuándose el peso fresco. En el laboratorio, luego de secado procesado el material por separado, se determinó: peso seco, N, P, K, Ca, Mg, nitratos y los principios orgánicos (Cenizas, Proteínas, Grasas, Fibra Bruta, Extracto no Azoado). La determinación de nitratos se realizó por una metodología con electrodo selectivo y por un método colorimétrico. Los principales resultados arrojaron lo siguiente: los contenidos de N, P, K, durante el ciclo de cultivo, en hojas no han respondido a los distintos niveles de fertilización. El Ca y el Mg, han mostrado acumularse en mayor cantidad cuando no se fertilizó. La absorción total de nutrientes mayores al final del ciclo de cultivo muestra una tendencia a la absorción mayor con N1P1. El cultivo extrae gran cantidad de K (400 kg ha-1), Los contenidos de Ca y K en raíz a la cosecha, superan las referencias bibliográficas; lo mismo sucede con el rubro Cenizas. Los valores de nitratos a la cosecha en raíz, oscilaron entre 498 y 1060 mg/ kg ssf, encontrándose los más altos en los tratamientos con 150 y 300 kg N ha-1. Estos contenidos de nitratos superarían los permitidos para niños y lactantes (200 mg kg-1 ssf), tanto en la UE como en la legislación argentina. El método rápido del electrodo selectivo no se ajusta a la determinación de nitratos en raíz de zanahoria, si bien resulta óptimo para el seguimiento del estado nutricional nitrogenado de la planta. En futuros estudios se propone estudiar aspectos del manejo del cultivo, selección de variedades, puesta a punto de técnicas analíticas para la determinación de nitratos

Range charts of stratigraphically important radiolarian species in sediments of ODP Leg 165 sites

The Paleogene sequences from three sites in the Caribbean were examined for radiolarians. In general, samples are highly lithified, requiring lengthy and repetitive cleaning procedures, and the assemblages are usually fragmented and/or partially dissolved. Both abundances and preservation of the assemblages vary considerably from site to site and within a single site; even within a single sample more than one degree of preservation was observed. It was possible, however, to construct at least partial stratigraphies for each of the three sites. Because the abundance of radiolarians is high even in extremely poorly preserved assemblages, we conclude that the differences in biogenic silica preservation are the result of postdepositional processes and not productivity. In both Sites 999 and 1001, near the Paleocene/Eocene boundary (Bekoma bidartensis Zone [RP7]), there is a short interval in which the abundance and preservation state of the radiolarians improves relative to overlying and underlying assemblages. In each case the intervals corresponds to the level, identified by calcareous microfossils, as representing changes in paleoceanographic conditions associated with the late Paleocene thermal maximum.