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PubMed2006

Refinement and reduction of the Impact of Psoriasis Questionnaire: classical test theory vs. Rasch analysis.

BACKGROUND: Quality of life instruments are increasingly important in assessing disease severity. However, some of these measurements have been developed on a more or less ad hoc basis. Although not well standardized, psychometric analyses can be used to retest, refine and shorten existing quality of life instruments. OBJECTIVES: To psychometrically test and refine the Impact of Psoriasis Questionnaire (IPSO) and to compare the results of two different statistical approaches. PATIENTS AND METHODS: Among 792 psoriasis patients who were included in the PUVA Follow-up Study, we used classical test theory (CTT) and Rasch analysis to test and optimize the IPSO. Thereafter, two shortened versions of the IPSO derived from these models were compared. RESULTS: CTT analyses of the original IPSO demonstrated suboptimal item performance for six of 16 items and inappropriate subscaling. In contrast to the original four subscales, factor analysis of the CTT version yielded three subscales (mental functioning, mental wellbeing and stigmatization). The Rasch approach, which included ordering of thresholds, differential item functioning and item fit, resulted in a unidimensional 11-item questionnaire. Although the two new versions of the IPSO shared only six items, both reflected the original IPSO well. However, several arguments such as lower correlation coefficients, higher Cronbach's alpha, ordered thresholds, unidimensionality and fewer differences among subgroups of patients suggested that the Rasch version of the IPSO may be the preferred instrument to use. CONCLUSIONS: The IPSO can be improved and shortened and the Rasch-reduced version of this instrument is likely to assess the psychosocial impact of moderate to severe psoriasis on patients' lives best because it is a short, reliable and unidimensional measurement.

Adult↗
PubMed2003

Expression of conditional fear with and without awareness.

Conditional responding during simple Pavlovian conditioning is often characterized as a form of implicit memory. The extent to which this type of associative learning is independent of awareness is an issue of continuing debate. Previous studies have demonstrated conditioning in the absence of awareness. However, their results have been questioned based on methodological concerns with postexperimental questionnaires. In the present study, skin conductance response (SCR) and unconditioned stimulus (UCS) expectancy were measured concurrently as participants were exposed to a differential delay fear conditioning procedure in which one tone (CS+) predicted a loud white noise, whereas a second tone (CS-) was presented alone. UCS predictability was varied on a trial-by-trial basis by presenting conditioned stimuli (CSs) at volumes just above or below the perceptual threshold. Differential UCS expectancy (awareness) was observed only on perceived trials, whereas differential SCR developed on both perceived and unperceived trials. Although perceived stimuli elicited larger SCRs, the magnitude of conditioning, indexed by differential conditioned response expression (conditioned SCR to CS+ minus the SCR to CS-), was not influenced by stimulus perception. These data indicate that conditional fear can be expressed when individuals are unaware of fear-eliciting stimuli and suggest that the degree of conditioning is independent of awareness during differential Pavlovian fear conditioning.

Adult↗
PubMed1975

[Audiological observations of a patient with auditory agnosia].

A case is reported in which a patient was become unable to identify all kinds of auditory material, including speech, despite only subnormal audiometric thresholds (i.e. "auditory agnosia"). The following audiological disorders were shown: some fragility in the perception of brief sound stimuli, difficulties to apprehending prolonged series of stimuli (rhythms), defective sound localization, an increase in the homolateral and in the contralateral effects of masking sounds. On the other hand, differential thresholds for frequency and for intensity, as well as fusion thresholds, were little affected, or unaffected. A complete dissociation appeared between the auditory evoked potentials and the audiometric thresholds; a year after the first examination, and the following years, the auditory potentials were largely reduced, or even have elapsed for one ear, while the audiometric thresholds seem to remain nearly the same.

Agnosia↗
PubMed1989

[The effect of a high-frequency electromagnetic field (2.45 GHz) on perceptual processes, psychological performance and well-being].

In a sample of 8 male subjects the effect of an ultra-highfrequency electromagnetic field (f = 2.45 GHz) with power densities of 1,000, 500 and 100 microW/cm2 was investigated. As parameters were used the perceptional threshold in a tachistoscopic perceptional test, the total time from the numbersearch-test and the sum of acute symptoms and complaints measured by a special questionnaire. At the highest field intensity on the one side increases of the total times and of the sum of complaints occurred. The differential threshold increased distinctly under 500 microW/cm2 exposure, whereas the total times and the sum of symptoms were not affected. At the lowest power density no differences between exposure and nonexposure conditions have been found. The intraindividual variability was considerable.

Adult↗
PubMed1990

Correlation between in vivo hemolysis and the amount of red cell-bound IgG measured by flow cytometry.

A flow cytometry method was used to compare the amount of red cell (RBC)-bound IgG in 73 patients with and without immune hemolytic anemia (IHA). The positive results in 10 of the direct antiglobulin tests (DATs) were idiopathic, and those in 25 were due to methyldopa therapy; 38 of the 73 DAT-positive patients were babies born to women with IgG alloantibodies of potential clinical significance. Normal blood donors with (n = 30) and without (n = 121) positive DATs were also tested. RBCs that had been strongly sensitized (4+ indirect antiglobulin test) in vitro with different quantities of IgG anti-D, but that had similar antiglobulin test (AGT) titration scores, could easily be differentiated by flow cytometry. The mean percent fluorescence of RBCs, incubated with fluorescein-labeled anti-IgG, from neonatal patients with IHA was higher than that of RBCs from those without IHA, but there was no statistical difference in the other groups. There was considerable overlap in the respective ranges of percent fluorescence of RBCs from patients with and without IHA in all groups. It was not possible to define a clear quantitative threshold differentiating patients with IHA from those without. Although flow cytometry was more precise and reproducible than standard serology (e.g., AGT titration scores), correlations of the amount of RBC-bound IgG and in vivo hemolysis were similar.

Anemia, Hemolytic, Autoimmune↗
PubMed1994

Violent and destructive behavior among the severely mentally ill in rural areas: evidence from Arkansas' community mental health system.

A comparison of rates of violence among admissions to the Arkansas State Hospital system between urban and rural areas tested the hypothesis that thresholds for admission to the hospital were greater in rural than in urban areas. Data on violent and destructive behavior were recorded from the medical records of 609 patients. Logistic regression was used to model the presence or absence of violent behavior in urban and rural admissions controlling for selected demographic and clinical characteristics. Results indicated that rural patients showed increased likelihood of violent and destructive behavior prior to admission supporting the hypothesis that barriers to mental health services in rural areas may be creating differential thresholds of service access and utilization. The increased rate of violence was particularly evident in those using substances prior to admission in rural areas suggesting that community management of the violent, substance abusing patient may be particularly difficult for rural areas.

Adult↗
PubMedDate not supplied

[Course of the audiometric threshold in relation to the age in chronic acoustic trauma].

Until now the relationship between auditory threshold and age has been evaluated in normal subjects only. In this study the Author reports results obtained in a cross-sectional study on 416 subjects suffering from noise-induced hearing loss who were exposed to noise for 10 years at least. The results show that hearing loss over time was more correlated to age than to noise exposure. Moreover, the evolution of hearing loss over time had a linear shape while in noise-induced hearing loss evolution has a logarithmic shape and in presbyacusis it has an exponential shape. The differential threshold between 30 and 60 years obtained by applying the linear regression model was, at higher frequencies, significantly reduced compared to normal subjects. These results suggest that threshold values related to age obtained in normal subjects can not be applied in subjects affected by noise-induced hearing loss.

Adult↗
PubMed2005

Accuracy of popular automatic QT interval algorithms assessed by a 'gold standard' and comparison with a Novel method: computer simulation study.

BACKGROUND: Accurate measurement of the QT interval is very important from a clinical and pharmaceutical drug safety screening perspective. Expert manual measurement is both imprecise and imperfectly reproducible, yet it is used as the reference standard to assess the accuracy of current automatic computer algorithms, which thus produce reproducible but incorrect measurements of the QT interval. There is a scientific imperative to evaluate the most commonly used algorithms with an accurate and objective 'gold standard' and investigate novel automatic algorithms if the commonly used algorithms are found to be deficient. METHODS: This study uses a validated computer simulation of 8 different noise contaminated ECG waveforms (with known QT intervals of 461 and 495 ms), generated from a cell array using Luo-Rudy membrane kinetics and the Crank-Nicholson method, as a reference standard to assess the accuracy of commonly used QT measurement algorithms. Each ECG contaminated with 39 mixtures of noise at 3 levels of intensity was first filtered then subjected to three threshold methods (T1, T2, T3), two T wave slope methods (S1, S2) and a Novel method. The reproducibility and accuracy of each algorithm was compared for each ECG. RESULTS: The coefficient of variation for methods T1, T2, T3, S1, S2 and Novel were 0.36, 0.23, 1.9, 0.93, 0.92 and 0.62 respectively. For ECGs of real QT interval 461 ms the methods T1, T2, T3, S1, S2 and Novel calculated the mean QT intervals(standard deviations) to be 379.4(1.29), 368.5(0.8), 401.3(8.4), 358.9(4.8), 381.5(4.6) and 464(4.9) ms respectively. For ECGs of real QT interval 495 ms the methods T1, T2, T3, S1, S2 and Novel calculated the mean QT intervals(standard deviations) to be 396.9(1.7), 387.2(0.97), 424.9(8.7), 386.7(2.2), 396.8(2.8) and 493(0.97) ms respectively. These results showed significant differences between means at >95% confidence level. Shifting ECG baselines caused large errors of QT interval with T1 and T2 but no error with Novel. CONCLUSION: The algorithms T2, T1 and Novel gave low coefficients of variation for QT measurement. The Novel technique gave the most accurate measurement of QT interval, T3 (a differential threshold method) was the next most accurate by a large margin. The objective and accurate 'gold standard' presented in this paper may be useful to assess new QT measurement algorithms. The Novel algorithm may prove to be more accurate and reliable method to measure the QT interval.

Algorithms↗
PubMed1984

Correlation between color vision scores and quantitative perimetry in suspected glaucoma.

The mean differential threshold, studied on the Octopus perimeter, and color vision, estimated by the Farnsworth-Munsell 100-Hue test, were studied in glaucoma suspects and patients with questionable early field defects. The results of both tests were significantly correlated. The color vision scores correlated with the central, paracentral, and midperipheral parts of the visual field. This result suggests that both functions are disturbed in glaucoma and that the disturbance may be present diffusely throughout the visual field.

Aged↗
PubMed1984

Light regulation of photosynthetic membrane structure, organization, and function.

The light environment during plant growth determines the structural and functional properties of higher plant chloroplasts, thus revealing a dynamically regulated developmental system. Pisum sativum plants growing under intermittent illumination showed chloroplasts with fully functional photosystem (PS) II and PSI reaction centers that lacked the peripheral chlorophyll (Ch1) a/b and Ch1 a light-harvesting complexes (LHC), respectively. The results suggest a light flux differential threshold regulation in the biosynthesis of the photosystem core and peripheral antenna complexes. Sun-adapted species and plants growing under far-red-depleted illumination showed grana stacks composed of few (3-5) thylakoids connected with long intergrana (stroma) thylakoids. They had a PSII /PSI reaction center ratio in the range 1.3-1.9. Shade-adapted species and plants growing under far-red-enriched illumination showed large grana stacks composed of several thylakoids, often extending across the entire chloroplast body, and short intergrana stroma thylakoids. They had a higher PSII /PSI reaction center ratio, in the range of 2.2-4.0. Thus, the relative extent of grana and stroma thylakoid formation corresponds with the relative amounts of PSII and PSI in the chloroplast, respectively. The structural and functional adaptation of the photosynthetic membrane system in response to the quality of illumination involves mainly a control on the rate of PSII and PSI complex biosynthesis.

Chlorophyll↗
PubMed1991

An informational approach to sensory adaptation.

Concepts from information theory can enhance our understanding of perceptual processes by providing a unified picture of the process of perception. A single equation is shown to embrace adaptation phenomena, stimulus-response relations, and differential thresholds. Sensory adaptation is regarded as representing a gain in information by the receptor. It is calculated that for constant stimuli in the form of step inputs, insects and arachnids obtain approximately the same amount of information per stimulus from their respective environments as do human beings.

Adaptation, Physiological↗
PubMed1992

Can people hear the pitch change on a variable-pitch pulse oximeter?

The introduction of the variable-pitch feature on pulse oximeters in 1983 by the Nellcor Corporation (Hayward, CA) allowed users to rapidly detect changes in oxygen saturation by listening for changes in the pitch of the tones emitted by the pulse oximeter. A few individuals have reported that they have been unable to detect a change in pitch when oxygen saturation changes. To these individuals, the variable-pitch feature of these pulse oximeters has not been beneficial. Using the pitches from one manufacturer of oximeters, we created a computer program to simulate the pitches that accompanied various oxygen saturations. The pitches were recorded onto a tape player and played for 75 volunteer subjects unfamiliar with the pitches of a variable-pitch pulse oximeter. Of our sample, 67% were able to detect a single change in pitch corresponding to a 1% fall in oxygen saturation, and 11% of the population could not detect a change in pitch until there was a change in pitch with every beat. We suggested four alternative designs that may prove beneficial to this group of individuals.

Acoustic Stimulation↗
PubMed2006

Comparison of absolute thresholds derived from an adaptive forced-choice procedure and from reaction probabilities and reaction times in a simple reaction time paradigm.

An understanding of the auditory system's operation requires knowledge of the mechanisms underlying thresholds. In this work we compare detection thresholds obtained with a three-interval-three-alternative forced-choice paradigm with reaction thresholds extracted from both reaction probabilities (RP) and reaction times (RT) in a simple RT paradigm from the same listeners under otherwise nearly identical experimental conditions. Detection thresholds, RP, and RT to auditory stimuli exhibited substantial variation from session to session. Most of the intersession variation in RP and RT could be accounted for by intersession variation in a listener's absolute sensitivity. The reaction thresholds extracted from RP were very similar, if not identical, to those extracted from RT. On the other hand, reaction thresholds were always higher than detection thresholds. The difference between the two thresholds can be considered as the additional amount of evidence required by each listener to react to a stimulus in an unforced design on top of that necessary for detection in the forced-choice design. This difference is inversely related to the listener's probability of producing false alarms. We found that RT, once corrected for some irreducible minimum RT, reflects the time at which a given stimulus reaches the listener's reaction threshold. This suggests that the relationships between simple RT and loudness (reported in the literature) are probably caused by a tight relationship between temporal summation at threshold and temporal summation of loudness.

Adult↗
PubMed2006

Stress sensitization and adolescent depressive severity as a function of childhood adversity: a link to anxiety disorders.

The goal of the present study was to determine whether exposure to adversity in childhood contributes to a differential threshold at which stressful life events provoke depressive reactions in adolescence. In addition, to address empirical and conceptual questions about stress effects, the moderating effect of anxiety disorder history was also explored. This examination was conducted in a sample of 816 children of depressed and nondepressed mothers, who were followed from birth to age 15. Information on adversities experienced in childhood was collected both from mothers during the first five years of their youth's life and from the youths themselves at age 15, and included information on the mother's relationship with her partner, maternal psychopathology, as well as youth-reported abuse. Results indicated that youths with both greater exposure to adversity in childhood and a history of an anxiety disorder displayed increased depressive severity following low levels of episodic stress compared to youths with only one or neither of these risk factors. The results are speculated to reflect the possibility that early anxiety disorders associated with exposure to adversity in childhood may be a marker of dysregulated stress responses, and may help to account for the comorbidity of depression and anxiety in some individuals.

Adaptation, Psychological↗
PubMed2004

Weaning from long-term mechanical ventilation: a nonpulmonary weaning index.

OBJECTIVE: Despite the extensive investigations in the area of weaning, clinicians are still struggling with the question of when to begin the process of weaning. Clinical weaning indices designed to predict the weaning potential are most frequently based on pulmonary factors. However, many physiological, respiratory, and mechanical factors also have impact on weaning, but are often overlooked. We suggest a new "nonpulmonary weaning index" (NPWI), which assesses the influence of factors such as blood albumin and total blood protein on the weaning success. METHODS: We assess the information value of 17 clinical and paraclinical indices in a retrospective study covering 151 patients on a long-term (at least 7 days) mechanical ventilation. The most informative of those 17 indices are used in the formulation of NPWI. Its threshold differentiates the successful from the unsuccessful weaning trials. RESULTS: From all 17 indices the most significant are: total blood protein, blood albumin, PaO2, hematocrit, lactate, the ratio PaO2/FiO2, hemoglobine, and RUE. The proposed index uses only two of them: blood albumin and total blood protein. It is easily calculated and can easily be tracked in time. It has high sensitivity and specificity. CONCLUSIONS: The results of this study suggest that in the decision whether to attempt weaning from long-term mechanical ventilation, more attention should be paid to the nonpulmonary factors.

Adolescent↗
PubMed1976

Metabolism of testosterone by the epididymis and ventral prostate of rat and its inhibition by cyproterone acetate.

The metabolism of 3H-testosterone by the epididymis and accessory organs of adult male rats exposed continuously to microdoses of cyproterone acetate from subcutaneous capsules were studied. The major metabolite of 3H-testosterone in the epididymis, vas deferens and ventral prostate of control rat was dihydrotestosterone while the formation of androstanediol by these tissues was low. The highest percentage of DHT was formed by the ventral prostate and cauda epididymis. In rats exposed to cyproterone acetate for four months, the conversion of testosterone to DHT was inhibited in all the tissues but maximally in the ventral prostate and cauda epididymis. In these rats, the secretory function of the ventral prostate was normal while that of the epididymis was markedly decreased. These data are discussed based on the differential thresholds of androgens required to regulate the functions of the accessory organs.

Animals↗
PubMed1986

A comparative study of successive and simultaneous methods in colour discrimination.

Simultaneous and successive methods of comparison of stimuli are studied by comparing experimental results of colour discrimination experiments. In this way, colour differential thresholds for two normal observers and four different stimuli were measured by the two methods. In most cases, the capacity to discriminate colour decreased when the successive method was used, although no differences were found in qualitative aspects of discrimination. These results differ somewhat from previous reports in this field, probably because of experimental differences in the method of obtaining the thresholds.

Color Perception↗
PubMed1986

Rat strain differences in the acquisition of hippocampal self-stimulation.

The rate of acquisition of lever-pressing for electrical stimulation of the hippocampus (HPC) was compared in two strains of rat: barrier-sustained Wistar and Sprague-Dawley. Sprague-Dawley rats initially bar-pressed at very low rates and took a median of 11 days to self-stimulate, according to the criterion used. Wistar rats all reached the same criterion in the first test session. Differential sensitivity to the activating effects of stimulation as an explanation for this difference was ruled out by the observation that both strains decreased response rates at the same rate and to the same level if stimulation was made non-contingent on lever-pressing. Differential threshold for reward was ruled out by the observation that rate-intensity curves yielded the same threshold currents and peak rates in both strains. Finally, it was shown that the rate of development of kindled seizures in the two strains of rats is different: Wistars kindle to full seizures faster than do Sprague-Dawleys. The relationship between the quicker onset of self-stimulation and of kindled seizures in Wistars is discussed.

Animals↗