Cardiorespiratory fitness assessment among firefighters: Is the non-exercise estimate accurate?

Work ◽  
2020 ◽  
Vol 67 (1) ◽  
pp. 173-183
Author(s):  
Leonardo Correa Segedi ◽  
Daniel Rodrigues Ferreira Saint-Martin ◽  
Carlos Janssen Gomes da Cruz ◽  
Edgard M. K. Von Koenig Soares ◽  
Nayara Lima do Nascimento ◽  
...  
Keyword(s):  
Cardiorespiratory Fitness ◽  
Effect Size ◽  
Exercise Test ◽  
High Sensitivity ◽  
Maximum Exercise ◽  
Job Requirements ◽  
Fitness Assessment ◽  
Analysis Methods ◽  
Alternative Method ◽  
Sensitivity Specificity

BACKGROUND: Minimum cardiorespiratory fitness (CRF) has been recommended for firefighters due to job requirements. Thus, it is important to identify accurate and readily available methods to assess CRF in this population. Non-exercise CRF estimates (NEx-CRF) have been proposed but this approach requires validation in this population. OBJECTIVE: To evaluate the accuracy of a NEx-CRF, as compared to a field maximum exercise test, among career military firefighters of both genders using a comprehensive agreement analysis. METHODS: We evaluated the accuracy of a NEx-CRF estimate compared to the Cooper 12 min running test among 702 males and 106 female firefighters. RESULTS: Cooper and NEx-CRF tests yielded similar CRF in both genders (differences <1.8±4.7 ml/kg–1.min–1; effect size <0.34). However, NEx-CRF underestimated Cooper-derived CRF among the fittest firefighters. NEx-CRF showed moderate to high sensitivity/specificity to detect fit or unfit firefighters (71.9% among men and 100% among women). Among men, the NEx-CRF method correctly identified most firefighters with less than 11 METs or greater than 13 METs, but showed lower precision to discriminate those with CRF between 11–13 METs. CONCLUSIONS: The NEx-CRF method to estimate firefighters’ CRF may be considered as an alternative method when an exercise-based method is not available or may be used to identify those who require more traditional testing (CRF 11–13 METs).

TO SEPARATELY ASSESS THE DIAGNOSTIC POTENTIAL OF TVS & MRI IN THE TERMS OF SENSITIVITY AND SPECIFICITY BY CORRELATING THE IMAGING FINDINGS WITH HISTOPATHOLOGY

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Suraj Mathur
Keyword(s):  
Transvaginal Ultrasound ◽  
High Sensitivity ◽  
Imaging Evaluation ◽  
Medical College ◽  
Conventional Mri ◽  
Diagnostic Potential ◽  
Adc Mapping ◽  
Malignant Lesions ◽  
Sensitivity Specificity

This prospective study was done in the Department of Radio diagnosis Govt. Medical College, Kozhikode. A total of 65 patients who were referred to our department with clinical suspicion of endometrial lesions and incidentally detected endometrial lesions on ultrasonography underwent transvaginal ultrasound and subsequent Imaging evaluation of pelvis MRI has very high sensitivity (95%) and specificity (98%) and is almost as accurate (97%) as histopathology in differentiating benign from malignant lesions. Addition of DWI with ADC mapping to conventional MRI increases its accuracy even more. However there is inherent limitation to MRI in detecting carcinoma in situ and micrometastasis. Keywords: TVS, MRI, Sensitivity, Specificity, Histopathology.

scholarly journals Use of β-D-glucan in diagnosis of suspected Pneumocystis jirovecii pneumonia in adults with HIV infection

2021 ◽  
pp. 095646242110222
Author(s):  
Thomas Juniper ◽  
Chris P Eades ◽  
Eliza Gil ◽  
Harriet Fodder ◽  
Killian Quinn ◽  
...  
Keyword(s):  
Predictive Value ◽  
Diagnostic Tests ◽  
Elevated Serum ◽  
Clinical Information ◽  
High Sensitivity ◽  
Pneumocystis Pneumonia ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Alternative Diagnosis ◽  
Positive Threshold ◽  
Sensitivity Specificity

Objectives: An elevated serum (1-3)-β-D-glucan (BDG) concentration has high sensitivity for a diagnosis of Pneumocystis pneumonia (PCP) in people with HIV (PWH). At the current manufacturer-recommended positive threshold of 80 pg/mL (Fungitell), specificity for PCP is variable and other diagnostic tests are required. We evaluated the utility of serum BDG for diagnosis of suspected PCP in PWH at three inner-London hospitals to determine BDG concentrations for diagnosis and exclusion of PCP. Methods: From clinical case records, we abstracted demographic and clinical information and categorised patients as having confirmed or probable PCP, or an alternative diagnosis. We calculated sensitivity, specificity and positive predictive value (PPV) of serum BDG concentrations >400 pg/mL and negative predictive value (NPV) of BDG <80 pg/mL. Results: 76 patients were included; 29 had laboratory-confirmed PCP, 17 had probable PCP and 30 had an alternative diagnosis. Serum BDG >400 pg/mL had a sensitivity of 83%, specificity of 97% and PPV 97% for diagnosis of PCP; BDG <80 pg/mL had 100% NPV for exclusion of PCP. Conclusions: In PWH with suspected PCP, BDG <80 pg/mL excludes a diagnosis of PCP, whereas BDG concentrations >400 pg/mL effectively confirm the diagnosis. Values 80–400 pg/mL should prompt additional diagnostic tests.

scholarly journals Cardiorespiratory fitness assessment using risk-stratified exercise testing and dose–response relationships with disease outcomes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tomas I. Gonzales ◽  
Kate Westgate ◽  
Tessa Strain ◽  
Stefanie Hollidge ◽  
Justin Jeon ◽  
...  
Keyword(s):  
Cardiorespiratory Fitness ◽  
Maximal Oxygen Consumption ◽  
Estimation Method ◽  
The Novel ◽  
Exercise Tests ◽  
Metabolic Equivalent ◽  
Fitness Assessment ◽  
Disease Outcomes ◽  
All Cause Mortality ◽  
The Uk

AbstractCardiorespiratory fitness (CRF) is associated with mortality and cardiovascular disease, but assessing CRF in the population is challenging. Here we develop and validate a novel framework to estimate CRF (as maximal oxygen consumption, VO2max) from heart rate response to low-risk personalised exercise tests. We apply the method to examine associations between CRF and health outcomes in the UK Biobank study, one of the world’s largest and most inclusive studies of CRF, showing that risk of all-cause mortality is 8% lower (95%CI 5–11%, 2670 deaths among 79,981 participants) and cardiovascular mortality is 9% lower (95%CI 4–14%, 854 deaths) per 1-metabolic equivalent difference in CRF. Associations obtained with the novel validated CRF estimation method are stronger than those obtained using previous methodology, suggesting previous methods may have underestimated the importance of fitness for human health.

scholarly journals The Child Behavior Checklist as a Screening Instrument for PTSD in Refugee Children

Children ◽  
2021 ◽  
Vol 8 (6) ◽  
pp. 521
Author(s):  
Ina Nehring ◽  
Heribert Sattel ◽  
Maesa Al-Hallak ◽  
Martin Sack ◽  
Peter Henningsen ◽  
...  
Keyword(s):  
Child Behavior ◽  
Child Behavior Checklist ◽  
High Sensitivity ◽  
Roc Curves ◽  
Structured Interview ◽  
Screening Instrument ◽  
Screening Tools ◽  
Refugee Children ◽  
Post Traumatic Stress ◽  
Sensitivity Specificity

Thousands of refugees who have entered Europe experienced threatening conditions, potentially leading to post traumatic stress disorder (PTSD), which has to be detected and treated early to avoid chronic manifestation, especially in children. We aimed to evaluate and test suitable screening tools to detect PTSD in children. Syrian refugee children aged 4–14 years were examined using the PTSD-semi-structured interview, the Kinder-DIPS, and the Child Behavior Checklist (CBCL). The latter was evaluated as a potential screening tool for PTSD using (i) the CBCL-PTSD subscale and (ii) an alternative subscale consisting of a psychometrically guided selection of items with an appropriate correlation to PTSD and a sufficient prevalence (presence in more than 20% of the cases with PTSD). For both tools we calculated sensitivity, specificity, and a receiver operating characteristic (ROC) curve. Depending on the sum score of the items, the 20-item CBCL-PTSD subscale as used in previous studies yielded a maximal sensitivity of 85% and specificity of 76%. The psychometrically guided item selection resulted in a sensitivity of 85% and a specificity of 83%. The areas under the ROC curves were the same for both tools (0.9). Both subscales may be suitable as screening instrument for PTSD in refugee children, as they reveal a high sensitivity and specificity.

scholarly journals Evaluation of HiCrome KPC Agar for the Screening of Carbapenem-Resistant Enterobacterales Colonization in the ICU Setting of a Tertiary Care Hospital

2021 ◽  
Author(s):  
Ashoka Mahapatra ◽  
K Nikitha ◽  
Sutapa Rath ◽  
Bijayini Behera ◽  
Kavita Gupta
Keyword(s):  
Tertiary Care ◽  
High Sensitivity ◽  
Care Hospital ◽  
Predictive Values ◽  
Klebsiella Pneumoniae Carbapenemase ◽  
Carbapenem Resistant ◽  
Rectal Swabs ◽  
Control And Prevention ◽  
Indian Setting ◽  
Sensitivity Specificity

Abstract Background Spread of carbapenem-resistant Enterobacterales (CRE) is a significant concern in intensive care unit (ICU) settings. Approaches to routine screening for CRE colonization in all ICU patients vary depending on institutional epidemiology and resources. The present study was aimed to evaluate the performance of HiCrome Klebsiella pneumoniae carbapenemase (KPC) agar for the detection of CRE colonization in ICU settings taking the Centers for Disease Control and Prevention (CDC) recommended method as reference. Methods Two-hundred and eighty rectal swabs (duplicate) from 140 patients were subjected to CRE detection in HiCrome KPC agar and MacConkey agar (CDC criteria). Results Using CDC method, total 41 CRE isolates were recovered comprising of 29 E scherichia coli, 11 Klebsiella, and 1 Enterobacter spp. On the other hand, 49 isolates of CRE recovered from 140 rectal swabs using HiCrome KPC agar, out of which 33 were E. coli, 15 Klebsiella, and 1 Enterobacter sp. Statistical Analysis Sensitivity, specificity, negative, and positive predictive values of CRE screening by HiCrome KPC agar were found to be 100% (91.4–100), 91.9% (84.8–95.8), 83.6% (70.9–91.4), and 100% (95.9–100), respectively, taking the CDC recommended method as reference. Conclusion HiCrome KPC agar has high sensitivity in screening CRE colonization. Further studies are needed to establish its applicability for detecting the predominant circulating carbapenemases in the Indian setting.

scholarly journals Sensitivity, specificity, and accuracy of a liquid biopsy approach utilizing molecular amplification pools

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jessica Garcia ◽  
Nick Kamps-Hughes ◽  
Florence Geiguer ◽  
Sébastien Couraud ◽  
Brice Sarver ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Clinical Setting ◽  
High Sensitivity ◽  
Sequencing Error ◽  
Lung Cancer Patients ◽  
Mutation Discovery ◽  
Sensitivity Specificity ◽  
Next Generation Sequencing Ngs ◽  
Digital Polymerase Chain Reaction

AbstractCirculating cell-free DNA (cfDNA) has the potential to be a specific biomarker for the therapeutic management of lung cancer patients. Here, a new sequencing error-reduction method based on molecular amplification pools (MAPs) was utilized to analyze cfDNA in lung cancer patients. We determined the accuracy of MAPs plasma sequencing with respect to droplet digital polymerase chain reaction assays (ddPCR), and tested whether actionable mutation discovery is improved by next-generation sequencing (NGS) in a clinical setting. This study reports data from 356 lung cancer patients receiving plasma testing as part of routine clinical management. Sequencing of cfDNA via MAPs had a sensitivity of 98.5% and specificity 98.9%. The ddPCR assay was used as the reference, since it is an established, accurate assay that can be performed contemporaneously on the same plasma sample. MAPs sequencing detected somatic variants in 261 of 356 samples (73%). Non-actionable clonal hematopoiesis-associated variants were identified via sequencing in 21% of samples. The accuracy of this cfDNA sequencing approach was similar to that of ddPCR assays in a clinical setting, down to an allele frequency of 0.1%. Due to broader coverage and high sensitivity for insertions and deletions, sequencing via MAPs afforded important detection of additional actionable mutations.

Adaptation and Validation of the Mini-Addenbrooke’s Cognitive Examination in Dementia in Arabic Speakers in Egypt

2020 ◽  
Vol 49 (6) ◽  
pp. 611-616
Author(s):  
Tarik Qassem ◽  
Mohamed S. Khater ◽  
Tamer Emara ◽  
Doha Rasheedy ◽  
Heba M. Tawfik ◽  
...  
Keyword(s):  
Screening Tool ◽  
Characteristic Curve ◽  
High Sensitivity ◽  
Receiver Operator Characteristic Curve ◽  
Cutoff Score ◽  
Arabic Speakers ◽  
Dementia Patients ◽  
Significant Difference ◽  
Sensitivity Specificity ◽  
Addenbrooke’S Cognitive Examination

<b><i>Background:</i></b> The mini-Addenbrooke’s Cognitive Examination (m-ACE) is a brief cognitive battery that assesses 5 subdomains of cognition (attention, memory, verbal fluency, visuospatial abilities, and memory recall). It is scored out of 30 and can be administered in under 5 min providing a quick screening tool for assessment of cognition. <b><i>Objectives:</i></b> We aimed to adapt the m-ACE in Arabic speakers in Egypt and to validate it in dementia patients to provide cutoff scores. <b><i>Methods:</i></b> We included 37 patients with dementia (Alzheimer’s disease [<i>n</i> = 25], vascular dementia [<i>n</i> = 8], and dementia with Lewy body [<i>n</i> = 4]) and 43 controls. <b><i>Results:</i></b> There was a statistically significant difference (<i>p</i> &#x3c; 0.001) on the total m-ACE score between dementia patients (mean 10.54 and standard deviation [SD] 5.83) and controls (mean 24.02 and SD 2.75). There was also a statistically significant difference between dementia patients and controls on all sub-score domains of the m-ACE (<i>p</i> &#x3c; 0.05). Performance on the m-ACE significantly correlated with both the Mini-Mental State Examination (MMSE) and the Addenbrooke’s Cognitive Examination-III (ACE-III). Using a receiver operator characteristic curve, the optimal cutoff score for dementia on the m-ACE total score was found to be 18 (92% sensitivity, 95% specificity, and 94% accuracy). <b><i>Conclusions:</i></b> We adapted the m-ACE in Arabic speakers in Egypt and provided objective validation of it as a screening tool for dementia, with high sensitivity, specificity, and accuracy.

Do Maximum Flow-Volume Loops Collected During Maximum Exercise Test Alter the Main Cardiopulmonary Parameters?

CHEST Journal ◽  
2009 ◽  
Vol 135 (2) ◽  
pp. 425-433 ◽  
Author(s):  
Maurizio Bussotti ◽  
PierGiuseppe Agostoni ◽  
Alberto Durigato ◽  
Carlo Santoriello ◽  
Stefania Farina ◽  
...  
Keyword(s):  
Exercise Test ◽  
Maximum Flow ◽  
Flow Volume ◽  
Maximum Exercise

Implementing Cardiorespiratory Fitness as a Routine Measure in Health Care Settings

2021 ◽  
Vol 10 (2) ◽  
pp. 62-69
Author(s):  
Jonathan Myers ◽  
Robert Ross
Keyword(s):  
Health Care ◽  
Cardiorespiratory Fitness ◽  
Exercise Test ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Maximal Exercise Test ◽  
Health Care Settings ◽  
Biological Sex ◽  
Clinical Encounters ◽  
Routine Measure

ABSTRACT It is well established that cardiorespiratory fitness (CRF) is inversely associated with numerous morbidities independent of age, biological sex, race or ethnicity, and commonly obtained risk factors. More recent evidence also demonstrates that the addition of CRF to multivariable risk prediction algorithms used to estimate cardiovascular disease risk improves risk stratification. However, it is neither feasible nor appropriate to perform an exercise test to quantify CRF during most routine clinical encounters. A growing number of studies have suggested that CRF can be assessed pragmatically and reasonably accurately without performing a maximal exercise test. The concept that CRF can be substantially improved in response to regular exercise consistent with consensus recommendations underscores the recommendation that CRF should be a routine measure—a vital sign—across health care settings. Herein, we provide a brief, narrative overview of the evidence in support of this recommendation.

scholarly journals Mini-FLOTAC and McMaster egg counting method for detection of gastrointestinal parasites in small ruminants: a comparison study

2021 ◽  
Vol 15 (2) ◽  
pp. 119-124
Author(s):  
Osires Lustosa Vieira ◽  
Lucia Oliveira Macedo ◽  
Marcos Antônio Bezerra-Santos ◽  
Lucas Azevedo dos Santos ◽  
Carla Lopes de Mendonça ◽  
...  
Keyword(s):  
Animal Health ◽  
Small Ruminants ◽  
High Sensitivity ◽  
Gastrointestinal Parasites ◽  
Comparison Study ◽  
Helminth Eggs ◽  
Nematode Eggs ◽  
Proper Diagnosis ◽  
Flotac Technique ◽  
Sensitivity Specificity

The proper diagnosis of gastrointestinal parasites of small ruminants requires the development of multivalent techniques characterized by high sensitivity, specificity, precision, reproducibility, and the ability to quickly detect and monitor infections that pose risks to animal health. The aim of this study was to evaluate the performance of Mini-FLOTAC technique and McMaster egg counting (gold standard) in the detection of gastrointestinal parasites of goats and sheep. A total of 789 fecal samples were analyzed (401 of sheep and 388 of goats). From those, nematode eggs were detected in 80.86% (638/789), being 72.57% (291/401) from sheep and 89.43% (347/388) from goats. The Mini-FLOTAC technique presented a better performance to detect helminth eggs in both goats (88.40%; 343/388) and sheep (71.57%; 287/401) (?2 = 10.358; p < 0.0001). Kappa analysis revealed a weak concordance between techniques for goats (k = 0.342; p < 0.001) and sheep (k = 0.281; p < 0.001). Data herein reported suggests that the Mini-FLOTAC is a technique more sensitive than the McMaster egg counting, therefore its use might be adopted for the diagnosis of gastrointestinal infection in small ruminants.

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