Performance of Fukuda Stepping Test as a Function of the Severity of Caloric Weakness in Chronic Dizzy Patients

2012 ◽  
Vol 23 (08) ◽  
pp. 616-622 ◽  
Author(s):  
Julie A. Honaker ◽  
Neil T. Shepard
Keyword(s):  
Test Performance ◽  
Gold Standard ◽  
Low Cost ◽  
Cost Evaluation ◽  
Caloric Irrigation ◽  
Canal Paresis ◽  
Technical Report ◽  
Vestibular Pathology ◽  
Vestibulospinal Reflex ◽  
Turn Direction

Background: The purpose of the Fukuda Stepping Test (FST) is to measure asymmetrical vestibulospinal reflex tone resulting from labyrinthine dysfunction. The FST is a low cost evaluation for dizzy patients; however, when compared with gold standard caloric irrigation unilateral weakness (UW) value ≥25%, the FST has not been shown to be a sensitive tool for identifying unilateral vestibular hypofunction. Purpose: The purpose of this technical report is to further evaluate the clinical utility of FST with and without headshake as a function of increased caloric asymmetry for individuals with unilateral peripheral vestibular pathology. Research Design: Retrospective review of FST results with and without head shaking component as compared to gold standard, caloric irrigation UW outcome values at four severity levels: 0–24% UW (normal caloric value); 25–50% UW (mild caloric UW); 51–75% UW (moderate caloric UW); 76–100% UW (severe caloric UW). Study Sample: 736 chronic (≥8 wk symptom complaints) dizzy patients. Results: Standard FST and FST following a head shake task are insensitive to detecting mild to moderate peripheral vestibular paresis. Increased test performance was observed for patients with severe canal paresis (>76% UW); however, continued inconsistencies were found in turn direction toward the severe unilateral vestibular dysfunction. Conclusions: Overall, the FST provides little benefit to clinicians when used in the vestibular bedside examination.

Characterization of a Polymeric Membrane for the Separation of Hydrogen in a Mixture with CO2

2016 ◽  
Vol 9 (1) ◽  
pp. 126-136 ◽  
Author(s):  
Dionisio H. Malagón-Romero ◽  
Alexander Ladino ◽  
Nataly Ortiz ◽  
Liliana P. Green
Keyword(s):  
Carbon Dioxide ◽  
Hydrogen Production ◽  
Test Performance ◽  
Low Cost ◽  
Time Lag ◽  
Polymeric Membrane ◽  
Biological Processes ◽  
Scanning Calorimetry ◽  
Environmentally Sustainable ◽  
Production Of Hydrogen

Hydrogen is expected to play an important role as a clean, reliable and renewable energy source. A key challenge is the production of hydrogen in an economically and environmentally sustainable way on an industrial scale. One promising method of hydrogen production is via biological processes using agricultural resources, where the hydrogen is found to be mixed with other gases, such as carbon dioxide. Thus, to separate hydrogen from the mixture, it is challenging to implement and evaluate a simple, low cost, reliable and efficient separation process. So, the aim of this work was to develop a polymeric membrane for hydrogen separation. The developed membranes were made of polysulfone via phase inversion by a controlled evaporation method with 5 wt % and 10 wt % of polysulfone resulting in thicknesses of 132 and 239 micrometers, respectively. Membrane characterization was performed using scanning electron microscopy (SEM), differential scanning calorimetry (DSC), atomic force microscopy (AFM), and ASTM D882 tensile test. Performance was characterized using a 23 factorial experiment using the time lag method, comparing the results with those from gas chromatography (GC). As a result, developed membranes exhibited dense microstructures, low values of RMS roughness, and glass transition temperatures of approximately 191.75 °C and 190.43 °C for the 5 wt % and 10 wt % membranes, respectively. Performance results for the given membranes showed a hydrogen selectivity of 8.20 for an evaluated gas mixture 54% hydrogen and 46% carbon dioxide. According to selectivity achieved, H2 separation from carbon dioxide is feasible with possibilities of scalability. These results are important for consolidating hydrogen production from biological processes.

scholarly journals A set of simple methods for detection and extraction of laminarinase

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ananthamurthy Koteshwara ◽  
Nancy V. Philip ◽  
Jesil Mathew Aranjani ◽  
Raghu Chandrashekhar Hariharapura ◽  
Subrahmanyam Volety Mallikarjuna
Keyword(s):  
Ammonium Sulfate ◽  
Ammonium Sulphate ◽  
Gold Standard ◽  
Direct Detection ◽  
Low Cost ◽  
Direct Analysis ◽  
Reducing Sugar ◽  
Ammonium Sulfate Precipitation ◽  
Simple Method ◽  
Functional Step

AbstractA carefully designed ammonium sulfate precipitation will simplify extraction of proteins and is considered to be a gold standard among various precipitation methods. Therefore, optimization of ammonium sulfate precipitation can be an important functional step in protein purification. The presence of high amounts of ammonium sulphate precludes direct detection of many enzymatically active proteins including reducing sugar assays (e.g. Nelson-Somogyi, Reissig and 3,5-dinitrosalicylic acid methods) for assessing carbohydrases (e.g. laminarinase (β (1–3)-glucanohydrolase), cellulases and chitinases). In this study, a simple method was developed using laminarin infused agarose plate for the direct analysis of the ammonium sulphate precipitates from Streptomyces rimosus AFM-1. The developed method is simple and convenient that can give accurate results even in presence of ammonium sulfate in the crude precipitates. Laminarin is a translucent substrate requiring the use of a stain to visualize the zones of hydrolysis in a plate assay. A very low-cost and locally available fluorescent optical fabric brightener Tinopal CBS-X has been used as a stain to detect the zones of hydrolysis. We also report simple methods to prepare colloidal chitin and cell free supernatant in this manuscript.

scholarly journals Investigation of the rapid immunochromatographic test performance in the diagnosis of syphilis; comparison of four serological methods

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Huseyin Agah Terzi ◽  
Ozlem Aydemir ◽  
Engin Karakece ◽  
Huseyin Hatipoglu ◽  
Mehmet Olmez ◽  
...  
Keyword(s):  
Test Performance ◽  
Gold Standard ◽  
Treponema Pallidum ◽  
Rapid Test ◽  
Immunochromatographic Test ◽  
Rapid Plasma Reagin ◽  
Serum Samples ◽  
Hemagglutination Assay ◽  
Predictive Values ◽  
Sensitivity Specificity

AbstractObjectivesTo test the performance of the newly available rapid test for syphilis, we compared it with Treponema pallidum hemagglutination assay (TPHA). Additionally, we investigated the performance of rapid plasma reagin (RPR) and chemiluminescence microparticle immunoassays (CMIA) at our laboratory using TPHA as a gold standard.MethodsThe serum samples of 595 patients with the pre-diagnosis of syphilis were studied by four serological methods. The sensitivity, specificity, and predictive values of RPR, CMIA, and syphilis rapid test were assessed by utilizing TPHA as a gold standard for the diagnosis of syphilis.ResultsOf the patients, 6.2% (37/595) had positive RPR, 5.5% (33/595) had positive CMIA, 5.5% (33/595) had a positive rapid immunochromatographic method and 5% (30/595) had positive TPHA. When TPHA results were taken as the reference, the sensitivity of the rapid test for syphilis was 100%, the specificity was 99.5%, PPV was 90.9%, and NPV was 100.0%.ConclusionsIt was observed that the rapid test for syphilis used in the study was quite successful, its cost was appropriate, and the test was very fast and easy to apply. At the same time, the agreement between syphilis rapid test and TPHA was found to be excellent.

scholarly journals A20 DIAGNOSTIC ACCURACY OF A LOW COST, WIDELY AVAILABLE TEST STRIP FOR PREDICTING A POSITIVE FECAL CALPROTECTIN TEST

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 210-212
Author(s):  
R Trasolini ◽  
S Wong ◽  
B Salh
Keyword(s):  
Sample Size ◽  
Likelihood Ratio ◽  
Gold Standard ◽  
Low Cost ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Rapid Test ◽  
Test Strip ◽  
Fecal Calprotectin ◽  
Type I

Abstract Background Fecal calprotectin is a non-invasive test of colonic inflammation used for monitoring inflammatory bowel disease activity and for risk stratifying non-specific colonic symptoms. Calprotectin is a leukocyte specific enzyme. A similar test, leukocyte esterase is used to detect leukocytes in urine and is widely available as a low-cost point-of-care test strip. We hypothesize that an unmodified version of the urine test strip would be highly accurate in predicting a positive fecal calprotectin test in a real world sample of patients. Aims To explore a low cost, rapid alternative to the fecal calprotectin test Methods All inpatient and outpatient stool samples tested for calprotectin by the Vancouver General Hospital laboratory from February 2020 to November 2020 were included prospectively. Samples were simultaneously tested for fecal leukocyte esterase using an unmodified Roche Cobas Chemstrip urinalysis test strip by central lab personnel. An identical aliquot was sent to LifeLabs for calprotectin as per standard protocol. All samples were suspended in buffer using established laboratory protocols prior to testing. Fecal leukocyte esterase results were reported as 0–4+ based on visual interpretation, calprotectin results were reported as mcg/g of stool. REB review and approval was obtained prior to data collection. Sensitivity, Specificity and AUROC were calculated using Microsoft Excel and JROCFIT. Results 26 samples were collected. Using a fecal calprotectin greater than 120 mcg/g as a gold standard an AUROC of 0.89 (SE= .06) was calculated. A leukocyte esterase reading of 2+ or greater had the best test characteristics based on ROC curve analysis. Using this cutoff, 21/26 samples were concordant, giving an accuracy of 80.8%, sensitivity of 90.9% and specificity of 73.3%. Positive likelihood ratio was 8.07 and negative likelihood ratio was 0.29. Assuming an AUROC of 0.8, the sample size N=26 is 90% powered (β=0.9) to predict the true AUROC within 0.1 with a type I error rate of .05 (α<.05). Conclusions This study suggests application of a prepared stool sample to a urinalysis test strip gives a result highly predictive of a positive fecal calprotectin test. Further results are being collected prospectively to improve the robustness of these preliminary data. Secondary outcomes including comparison to endoscopy and biopsy results where available are planned if an adequate sample size can be accrued. Future studies justifying independent clinical use of leukocyte esterase would require a common gold standard comparator such as endoscopy. Fecal calprotectin testing is not universally insured and is not available as a rapid test strip. Use of fecal leukocyte esterase may reduce costs and shorten time to results if proven to be independently reliable. Funding Agencies None

Could a low-cost audio-visual link be useful in rheumatology?

2000 ◽  
Vol 6 (1_suppl) ◽  
pp. 35-37 ◽  
Author(s):  
L E Graham ◽  
S Mcgimpsey ◽  
S Wright ◽  
G Mcclean ◽  
J Carser ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Gold Standard ◽  
Junior Doctor ◽  
Low Cost ◽  
Clinical Signs ◽  
Final Diagnosis ◽  
Provisional Diagnosis ◽  
Face To Face ◽  
Significant Difference ◽  
Small Joint

We have investigated prospectively the diagnostic accuracy, specialist satisfaction and patient–specialist rapport of a low-cost audio-visual link between a junior doctor with a patient and a consultant rheumatologist. Using a telephone link and subsequently a video-phone link, 20 patients, with various rheumatological problems, were presented by a junior doctor to the consultant rheumatologist for provisional diagnosis. All patients were then seen face to face by the consultant, when a final diagnosis was made. An independent consultant rheumatologist made a ‘gold standard’ diagnosis. Thirty-five per cent of diagnoses were made correctly over the telephone and 40% over the video-phone – there was no significant difference in the diagnostic accuracy between these two methods of communication. Rapport over the video-phone was universally poor. Where it was important, clinical signs could not be visualized over the video-phone and in more than 85% of cases small joint swellings could not be seen clearly.

scholarly journals DYSKIMOT: An ultra-low-cost inertial sensor to assess head’s rotational kinematics in adults during the Didren-Laser Test

2019 ◽  
Author(s):  
Renaud Hage ◽  
Christine Detrembleur ◽  
Frédéric Dierick ◽  
Laurent Pitance ◽  
Laurent Jojczyk ◽  
...  
Keyword(s):  
Time Series ◽  
Clinical Practice ◽  
Gold Standard ◽  
Inertial Sensor ◽  
Low Cost ◽  
Real Life ◽  
Optoelectronic System ◽  
Qualitative Level ◽  
Cervical Motion ◽  
Head Rotations

Various noninvasive measurement devices can be used to assess cervical motion. Size, complexity and cost of gold-standard systems make them not suited in clinical practice, and actually difficult to use outside dedicated laboratory. Nowadays, ultra-low-cost inertial measurement units are available but without any packaging nor user-friendly interface. DYSKIMOT is a home- designed, small-sized, motion sensor based on the latter technology, aiming at being used by clinicians in “real-life situations”. In the present study. DYSKIMOT was compared with a gold- standard optoelectronic system (Elite). Our goal was to evaluate the accuracy of DYSKIMOT in assessing the kinematics in fast head rotations. Kinematics was simultaneously recorded by the DYSKIMOT and Elite systems during the execution of the DidRen Laser test and performed by 15 participants and 9 patients. Kinematic variables were computed from the position, speed and acceleration time series. Two-way ANOVA, Passing-Bablok regressions and Dynamic Time Warping analysis showed good to excellent agreement between Elite and DYSKIMOT, both at the qualitative level of the time series shape and at the quantitative level of peculiar kinematical events’ measured values. In conclusion, DYSKIMOT sensor is as relevant as a gold-standard system to assess kinematical features during fast head rotations in participants and patients, demonstrating its usefulness in clinical practice or research in ecological environment.

Evaluating the ARF diagnosis calculator: A survey and content analysis. (Preprint)

2021 ◽  
Author(s):  
Elizabeth Fisher ◽  
Christian James ◽  
Diana Mosca ◽  
Bart J Currie ◽  
Anna P Ralph
Keyword(s):  
Health Service ◽  
Test Performance ◽  
Gold Standard ◽  
Online Survey ◽  
Clinical Laboratory ◽  
Diagnostic Process ◽  
Reference Ranges ◽  
Clinical Expertise ◽  
Structured Interviews ◽  
Support Tool

BACKGROUND Acute Rheumatic Fever (ARF) is a critically important condition for which there is no diagnostic test. Diagnosis requires the use of a set of criteria comprising clinical, laboratory, electrocardiographic and echocardiographic findings. The complexity of the algorithm and the fact that clinicians lack familiarity with ARF, make ARF diagnosis ideally suited to an electronic decision support tool. We developed an ARF Diagnosis Calculator to assist clinicians in diagnosing ARF and correctly assigning categories of ‘possible, ‘probable’ or ‘definite’ ARF. OBJECTIVE To evaluate the acceptability and accuracy of the ARF Diagnosis Calculator as perceived by clinicians in Northern Australia where ARF rates are high, and test performance against a ‘gold standard’. METHODS Three strategies were used to provide triangulation of data. Users of the calculator employed at Top End Health Service, Northern Territory, Australia were invited to participate in an online survey about the calculator, and clinicians with ARF expertise were invited to participate in semi-structured interviews. Qualitative data were analysed using inductive analysis. Performance of the calculator in correctly assigning a diagnosis of possible, probable or definite ARF, or not ARF, was assessed using clinical data from 35 patients presenting with suspected ARF. Diagnoses obtained from the calculator were compared using the Kappa statistic with those obtained from a panel of expert clinicians, considered the ‘gold standard’. Findings were shared with developers of the calculator and changes were incorporated. RESULTS Survey responses were available from 23 Top End Health Service medical practitioners, and interview data were available from five expert clinicians. Using a 6-point Likert scale, participants highly recommended the ARF Diagnosis Calculator (median score 6, IQR 1) and found it easy to use (median 5, IQR 1). Participants believed the calculator helped them diagnose ARF (median 5, IQR 1). Valued features included educational content and laboratory test reference ranges. Criticisms included: too many pop-up messages to be clicked through; that it is less helpful in remote areas which lack access to investigation results; and the need for more clarity about actively excluding alternative diagnoses to avoid false-positive ARF diagnoses. Importantly, clinicians with ARF expertise noted that electronic decision making is not a substitute for clinical experience. There was high agreement between the ARF Diagnosis Calculator and the ‘gold standard’ ARF diagnostic process (κ=0.767, 95% CI: 0.568-0.967). However, incorrect assignment of diagnosis occurred in 4/35 (11%) patients highlighting the greater accuracy of expert clinical input for ambiguous presentations. Sixteen changes were incorporated into a revised version of the calculator. CONCLUSIONS The ARF Diagnosis Calculator is an easy-to-use, accessible tool, but it does not replace clinical expertise. Effective resources to support clinicians in diagnosing and managing ARF are critically important for improving the quality of care of ARF.

STUDY ON EFFICACY OF ULTRASOUND AND FOB IN CONFIRMING THE PLACEMENT OF LARYNGEAL MASK AIRWAY

2021 ◽  
pp. 48-49
Author(s):  
Ganga Nagalakshmi ◽  
Subha J.
Keyword(s):  
Test Performance ◽  
Predictive Value ◽  
Gold Standard ◽  
Linear Structure ◽  
Invasive Technique ◽  
Non Invasive ◽  
Optimal Depth ◽  
Correct Placement ◽  
Linear Probe ◽  
Standard Tool

Ultrasound is a safe and non invasive technique for assessing the airway . In this observational study, 60 patients belonging to ASAClasses I and II scheduled for elective general surgery without any airway abnormality were included. Squared wave of capnogramTransverse neck ultrasound was performed using linear probe (8- 13Hz) started from hyoid bone (hyperechoic supercial inverted Ushaped linear structure)probe moved caudally with slight cephalad angle visualization of vocal cord & arytenoids. The Ultrasound arytenoid grade had a signicant correlation with LMA rotation grade.The incidence of LMAMalposition by ultrasound was found to be 80% .With regard to the test performance ,US was found to have a sensitivity of 92%,with a positive predictive value of 94% to detect the LMA rotation of any number of degrees. The specicity was 62% with a negative predictive value of 55%. FOB Examination is the gold standard tool for conrmation of the correct placement of LMA. ,we evaluated USG as a tool to conrm the placement comparing with the FOB examinationThe FOB examination is invasive & interrupts the ventilation during procedure. It cannot be done frequently intra-operatively compromising ventilation. These problems can be overcome by using ultrasound.USG detects the rotation of LMAeven if it is positioned at optimal depth thereby predicting the chance of dislodgement during the course of surgery.

Technical Note: A two-degree-of-freedom ambulance stretcher suspension: Part 3: Laboratory and road test performance

1998 ◽  
Vol 212 (5) ◽  
pp. 401-407 ◽  
Author(s):  
R. J. Henderson ◽  
J. K. Raine
Keyword(s):  
Test Performance ◽  
Natural Frequencies ◽  
Low Cost ◽  
Mechanical Systems ◽  
Technical Note ◽  
Suspension System ◽  
Degree Of Freedom ◽  
Road Test ◽  
Pneumatic Suspension ◽  
Two Degree Of Freedom

Parts 1 and 2 of this paper gave a design overview and described the dynamics of a prototype two-degree-of-freedom pneumatic suspension for an ambulance stretcher. This concluding part briefly reviews laboratory shaker table and ambulance road test performance of the suspension with passive pneumatic damping. The suspension system is found to offer compact low-cost isolation with lower natural frequencies than achieved in earlier mechanical systems.

Sign in / Sign up

Export Citation Format

Share Document