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Interlaboratory validation of oxidation-index measurement methods for UHMWPE after long-term shelf aging.

An international oxidation index standard would greatly benefit the orthopedic community by providing a universal scale for reporting oxidation data of ultra-high molecular weight polyethylene (UHMWPE). We investigated whether severe oxidation associated with long-term shelf aging affects the repeatability and reproducibility of area-based oxidation index measurement techniques based on normalization with the use of 1370- or 2022-cm(-1) infrared (IR) absorption reference peaks. Because an oxidation index is expected to be independent of sample thickness, subsurface oxidation was examined with the use of both 100- and 200-microm-thick sections from tibial components (compression-molded GUR 1120, gamma irradiated in air) that were shelf aged for up to 11.5 years. Eight institutions in the United States and Europe participated in the present study, which was administered in accordance with ASTM E691. On average, the 100-microm-thick samples were associated with significantly greater interlaboratory relative standard uncertainty (40.3%) when compared with the 200-microm samples (21.8%, p = 0.002). In contrast, the intralaboratory relative standard uncertainty was not significantly affected by the sample thickness (p = 0.21). The oxidation index method did not significantly influence either the interlaboratory or intralaboratory relative standard uncertainty (p = 0.32 or 0.75, respectively). Our interlaboratory data suggest that with the suitable choice of specimen thickness (e.g., 200 microm) and either of the two optimal oxidation index methods, interlaboratory reproducibility of the most heavily oxidized regions in long-term shelf-aged components can be quantified with a relative standard uncertainty of 21% or less. Therefore, both the 1370-cm(-1) and the 2022-cm(-1) reference peaks appear equally suitable for use in defining a standard method for calculating an oxidation index for UHMWPE.

Artifacts↗

Novel topological index for research on structure-property relationships of complex organic compounds.

Based on bonding parameters such as Yang's Electronegative Force Gauge Y(i), electronic number of valence layer Z(i), number of combined hydrogen atoms h(i), number of bonding electron b(i), and quantum number such as the highest main quantum number of valence layer n(i), a novel atomic valence delta(i) (Y) is defined and a novel topological index (1)chi(Y) is derived from the atomic valence. The atomic valence is defined as delta(i) (Y) = (Z(i) - h(i))b(i)/n(i) (2)Y(i), while the topological index is expressed as (1)chi(Y) summation operator (i,j=1) (m) (delta(i) (Y)delta(j) (Y))(-1/2). Subsequently, the index (1)chi(Y) is utilized to study the structure-property relationships of complex organic compounds. The results of correlativity showed that the index is highly and extensively correlated with such properties as solubility of phenyl chlorides, gas chromatographic retention index of alkoxyl silanes, and toxicity of heterocyclic nitrogen-containing compounds. Moreover, predicted values are quite consistent with experimental ones when the index is employed to predict the partition coefficient (log P) of fatty alcohols, phenyl chlorides, and barbitals. Compared to the topological indices reported in the literature, the universality and reliability of (1)chi(Y) to the properties of complex organic compounds have been distinctively improved, and its calculating process is simple and convenient.

Journal Article↗

DNA ploidy and PCNA index in pancreatic lesions producing hyperinsulinemic hypoglycemia.

DNA nuclear content and PCNA index (proportion of PCNA reactive cells) have been studied by flow cytometry in eight pancreatic lesions producing hyperinsulinemic hypoglycemia to assess DNA ploidy and tumoral growth fraction. Adult nesidioblastosis had a diploid DNA index, two adenomas were near diploid, and four of the adenomas and the carcinoma were aneuploid. The median value of PCNA index (6.056% +/- 6.76) was significantly correlated (P < 0.05) with the mean tumor diameter (2.43 cm +/- 1.96). Tumors with a PCNA index < 6.056% showed a diameter less than the mean tumoral diameter and a benign clinical course. Tumors with PCNA index > 6.056% generally displayed a diameter bigger than the mean tumoral diameter, being associated with lymph node metastases in one case. The authors conclude that nuclear DNA and PCNA index cytometric studies are useful parameters to assess the biological behavior of pancreatic lesions producing hyperinsulinemic hypoglycemia.

Adenoma↗

A morphology index based on sonographic findings in ovarian cancer.

A morphology index based on morphologic characteristics of ovarian tumors was developed. Specific categories included tumor volume, wall structure, and septal structure. A point scale (0-4) was developed within each category with the total points per evaluation varying from 0-12. Sonograms on 121 patients undergoing exploratory laparotomy for ovarian masses were evaluated using this index. Eighty ovarian tumors had a morphology index score < 5, and all were benign (negative predictive value, 1.000). In postmenopausal patients, a morphology index score > or = 5 had a positive predictive value for malignancy of 0.45. All ovarian malignancies had significant abnormalities in wall structure and all had a total volume in excess of 10 cm3. The findings of the present investigation indicate that the morphology index is a cost effective adjuvant method which significantly increases the specificity and positive predictive value of transvaginal sonography. The routine application of a morphology index to screening sonography should decrease the amount of diagnostic surgery performed in order to detect each case of ovarian cancer.

Adolescent↗

Involvement of RNA2-encoded proteins in the specific transmission of Grapevine fanleaf virus by its nematode vector Xiphinema index.

The nepovirus Grapevine fanleaf virus (GFLV) is specifically transmitted by the nematode Xiphinema index. To identify the RNA2-encoded proteins involved in X. index-mediated spread of GFLV, chimeric RNA2 constructs were engineered by replacing the 2A, 2B(MP), and/or 2C(CP) sequences of GFLV with their counterparts in Arabis mosaic virus (ArMV), a closely related nepovirus which is transmitted by Xiphinema diversicaudatum but not by X. index. Among the recombinant viruses obtained from transcripts of GFLV RNA1 and chimeric RNA2, only those which contained the 2C(CP) gene (504 aa) and 2B(MP) contiguous 9 C-terminal residues of GFLV were transmitted by X. index as efficiently as natural and synthetic wild-type GFLV, regardless of the origin of the 2A and 2B(MP) genes. As expected, ArMV was not transmitted probably because it is not retained by X. index. These results indicate that the determinants responsible for the specific spread of GFLV by X. index are located within the 513 C-terminal residues of the polyprotein encoded by RNA2.

Animals↗

A composite index of lead effects. Comparative study of four occupational groups with different levels of lead absorption.

Biological indicators of lead effects on the central nervous system (CNS), hematogenous bone marrow, and kidney function as measured by performance tests, hemoglobin (Hgb) and BUN levels respectively were combined in an integrative index (INDEX). Such an index was calculated by removing age effects in measures of performance and kidney function and then transforming all the variables to Z (standard) units. The relationships between INDEX and biological indicators of lead exposure and absorption (Pb-B and ZPP) were studied in four groups: 191 non-lead exposed males (control group), 169 copper smelter workers, 133 autobody shop workers and 87 secondary lead smelter workers. We found that: 1) the magnitude of the correlation coefficient between INDEX and ZPP was much higher than were the correlations between the various single indicators of lead effects (performance test scores, Hgb, and BUN); and 2) the magnitude of the correlation coefficients was related to the degree of lead exposure and absorption (as reflected in distribution patterns of Pb-B and ZPP) in each group. The concept of an integrative index of biological effects of lead is important for the evaluation of early manifestations of lead toxicity and also for the correct assessment of adverse health effects of lesser intensity than those characteristic for the classic picture of overt lead poisoning.

Adult↗

Relationship between chemical and physical indexes and column and HPSE chromatography methods for evaluating frying oil.

Standard chemical and physical indexes, such as color index, acid value, and K270 were compared with the polar content and the specific thermoxidative and hydrolytic compounds originated during 75 potato fryings with sunflower oil. The color index, acid value, K270 and total polar content showed a significant increase (p < 0.05) after the first 30 fryings, followed by a tendency of the last three indexes to reach a near-steady state. Triglyceride polymers and triglyceride dimers showed a significant increase (p < 0.05) after 30 fryings, while the oxidized triglycerides were not increased significantly after 30 fryings. The amount of diglycerides and free fatty acids related to hydrolytic alteration did not change significantly throughout the frying operations. The significant correlations between acid value and total polar content, triglyceride dimers, triglycerides polymers and oxidized triglycerides, or between color index and polar content and triglyceride polymers or between K270 and triglyceride polymers indicate that these simple and standard methods can be applied and they are as useful as more specific methods of evaluation in the monitoring of frying operations, provided that initial values of all of these indexes are available.

Color↗

Hepatitis C virus infection among sexually promiscuous groups and the heterosexual partners of hepatitis C virus infected index cases.

To define the role of sexual transmission in the spread of hepatitis C virus (HCV) infection, a seroprevalence study of antibodies against HCV was performed in populations at high risk for sexually transmitted diseases. Subjects included 310 female prostitutes, 88 clients of prostitutes, 168 homosexual men and 147 stable heterosexual partners of index cases reactive for anti-HCV (98 of whom were partners of drug addicts coinfected with HCV and human immunodeficiency virus [HIV]). All subjects denied prior transfusion or intravenous drug use. Controls were 400 voluntary blood donors selected randomly from first-time donors. The prevalence of anti-HCV by enzyme immunoassay, confirmed by a second-generation recombinant immunoblot assay, was 6.4% in prostitutes, 6.8% in clients of prostitutes, 4.2% in homosexual men, 7.4% in heterosexual partners of index cases and 1.2% in random donors. However, the anti-HCV prevalence in stable heterosexual partners of HCV-positive/HIV-positive index cases was 2.2 times higher than in stable heterosexual partners of index cases reactive for anti-HCV only (9.2% vs. 4.1%), and sexual partners of index cases coinfected with HCV and HIV were almost three times more likely to be infected with HIV than with HCV (25.5% vs. 9.2%). These data suggest that HCV infection may be sexually transmitted but with low efficiency and that this efficiency could be increased in the presence of coexistent HIV infection in the index case.

Adolescent↗

Fatigue rate index as a new measurement of external sphincter function.

PURPOSE: Assessment of sustained voluntary contraction of the external sphincter is helpful in evaluating the patient who has a defecation disorder on presentation. A new index of external sphincter function is described. METHOD: A prospective registry of patients referred for computerized anal manometry using standard protocols was reviewed. Patients were grouped by primary symptoms; those with overlapping complaints were excluded. The rate of fatigue, defined as the change in stationary squeeze over a 40-second period of voluntary contraction, was calculated by linear regression analysis. Fatigue rate index, a calculated measure of time necessary for the external sphincter to become completely fatigued, was determined to permit comparison of external sphincter fatigue in patients with different complaints. RESULTS: Twenty-six healthy volunteers (15 women; mean age, 45 years), 33 patients with a primary complaint of anal seepage (13 women; mean age, 53 years), 75 patients with gross incontinence (61 women; mean age, 53 years), and 49 patients with severe constipation (41 women; mean age, 45 years) were evaluated. Mean resting and squeeze pressures were 55 mmHg and 107 mmHg for volunteers, 37 mmHg and 97 mmHg for patients with seepage, 30 mmHg and 49 mmHg for incontinent patients, and 56 mmHg and 93 mmHg for constipated patients. Pudendal neuropathy, as evidenced by a prolonged pudendal nerve terminal motor latency (> 2.4 ms), was identified in 13 percent of volunteers, 32 percent of patients with seepage, 54 percent of incontinent patients, and 38 percent of constipated patients. Mean fatigue rate index was 3.3 minutes for volunteers, 2.3 minutes for seepage patients, 1.5 minutes for incontinent patients, and 2.8 minutes for constipated patients. Compared with volunteers and patients with seepage, the incontinent patients had a significantly shorter fatigue rate index (P < 0.05; Student's t-test), which was independent of the variations in resting pressure (P < 0.05; two-way analysis of variance). CONCLUSION: The external anal sphincter is normally subject to fatigue. Patients with worsening degrees of incontinence have a predictably lower fatigue rate index. Fatigue rate index is a simple measure of external sphincter integrity, which may be used in assessment of sphincter function and future treatment protocols.

Anal Canal↗

Creating an aggregate outcome index: cost-effectiveness analysis of substance abuse treatment.

This article proposes a method of calculating a practical index of improvement for conducting a cost-effectiveness analysis of substance abuse treatment. While the methodology of cost-effectiveness analysis necessitates the use of a single outcome measure, substance abuse treatment can produce multiple, important outcomes that must be considered in policy decisions about funding and alternative treatments. Thus, there is a need to aggregate the variety of outcomes from substance abuse treatment into a single index. The proposed index is a preference-weighted sum of outcomes using data from the Addiction Severity Index. The methodology and use of the index for conducting a cost-effectiveness analysis are illustrated using Addiction Severity Index data from a controlled quasi-experimental field study of case management.

Cost-Benefit Analysis↗

Prognostic significance of the bromodeoxyuridine labeling index in primary colorectal carcinoma.

The bromodeoxyuridine (BrdU) labeling index was determined in 40 primary colorectal carcinomas by DNA flow cytometry using a BrdU-specific monoclonal antibody. The labeling index, or the fraction of cells in the S-phase of the cell cycle, ranged from 12% to 52%, with a mean of 28% (SEM, 2%). The labeling index in 19 patients was over 30%, which was termed a higher labeling index. There was no significant difference in the labeling index based on the clinical stage of the disease. During the 5-year follow-up after the apparently curative resection, 14 patients died of the disease, 1 died of an unrelated cause, 1 is alive with a recurrence of the disease, and 24 are alive without the disease. The higher labeling index was thus associated with a significantly poorer patient survival (P = 0.03 based on the generalized Wilcoxon test). The present study therefore disclosed that the S-phase fraction of tumor cells thus determined had prognostic significance in primary colorectal carcinoma.

Adult↗

Relation of cerebral tissue oxygenation index to central venous oxygen saturation in children.

OBJECTIVE: To evaluate the relationship between the cerebral tissue oxygenation index measured by near-infrared spectroscopy and central venous oxygen saturation (SvO2) after corrective surgery of congenital heart defects in children. DESIGN: Prospective observational clinical study. SETTING: A tertiary neonatal and paediatric intensive care unit for paediatric cardiology. PATIENTS: Neonates and children consecutively admitted to the paediatric cardiology intensive care unit after corrective surgery of non-cyanotic congenital heart defects. MEASUREMENTS AND RESULTS: Forty-three children were studied. Cerebral tissue oxygenation index, measured non-invasively by near-infrared spectroscopy, was compared to SvO2, measured by a catheter placed in the right atrium, and to haemodynamic and respiratory parameters. Pearson's correlation coefficients and p values were calculated. Simultaneously measured values for SvO2 (62.2+/-9.8%, 39.8-80.4%) and cerebral tissue oxygenation index (56.7+/-8.8%, 35.8-71.2%) showed a significant correlation ( r=0.52, p<0.001). CONCLUSION: Cerebral tissue oxygenation index and SvO2 are not interchangeable parameters, but cerebral tissue oxygenation index reflects the haemodynamic influence on cerebral oxygenation after cardiovascular surgery. Further work is necessary to confirm the clinical role of continuous non-invasive measurement of cerebral tissue oxygenation index with regard to the variations of global systemic oxygen consumption after cardiac surgery in children.

Adolescent↗

The effect of a fatiguing exercise by the index finger on single- and multi-finger force production tasks.

We studied the effects of fatigue, induced by a 60-s maximal isometric force production with the index finger, on multi-finger coordination and force production by the other fingers of the hand. Finger forces were measured during single- and multi-finger maximal voluntary force production (MVC) at two sites, the middle of the distal or the middle of the proximal phalanges. Two fatiguing exercises involving force production by the index finger were used, one at the distal phalanx and the other at the proximal phalanx. The MVC of the index finger dropped by about 33% when it was produced at the site involved in the fatiguing exercise. In addition, large transfer effects of fatigue were observed across sites of force application and across fingers. Force deficit increased under fatigue, especially due to a drop in the recruitment of the index finger. Under fatigue, the index finger was less enslaved during force production by other fingers. During multi-finger tasks, the percentage of total force produced by the index finger was significantly reduced after the fatiguing exercise. The principle of minimization of secondary moments was violated under fatigue. We suggest that the most impaired (fatigued) finger shows less interaction with other fingers or, in other words, is being progressively removed from the multi-finger synergy. Some of the observed changes in finger coordination suggest effects of fatigue at a central (neural) level.

Adult↗

The kinetic basis of glomerular filtration rate measurement and new concepts of indexation to body size.

As measurement of glomerular filtration rate (GFR) is now generally the responsibility of departments of nuclear medicine, it is important for nuclear medicine physicians and scientists to understand the pharmacokinetics of the indicators and radiotracers that are used, generally known as filtration markers. The single-injection, non-steady state technique is almost universally used, departments varying in how many blood samples are taken: rarely multisample clearance, which does not assume a single compartment of tracer distribution, commonly clearance based on a limited number of blood samples between 2 and 4 h after injection, which assumes a single compartment of distribution, and often a single sample at a defined time point. The volume of distribution, V(d), of a filtration marker is close to extracellular fluid volume (ECFV). GFR and ECFV are both overestimated by the assumption of a single compartment by amounts that are functions of the rate of plasma clearance, Z. Residence time, T, of tracer in its V(d) is equal to V(d) divided by Z. Z and T can both be measured from a multisample clearance curve, whereupon V(d) is the product of Z and T. GFR is usually indexed to patient size by expressing it in relation to body surface area (BSA), which in turn is calculated from an equation based on the patient's height and weight. An equation in common use was described by Haycock et al. and is BSA=0.024265 x weight(0.5378) x height(0.3964). An alternative indexation variable is ECFV. GFR per unit ECFV is close to the rate constant, alpha(3), of the terminal exponential of the plasma clearance curve. It is in fact slightly higher than this rate constant by an amount that is a function of the rate constant itself. The discrepancy between GFR/ECFV and alpha(3) arises from the development of a concentration gradient between interstitial fluid and plasma, which in turn produces an extrarenal veno-arterial gradient throughout the body. Indexing GFR to ECFV not only has physiological attractions (especially in children) but is technically simple because it requires measurement only of alpha(3) (slope-only technique). A disadvantage, however, is a lack of robustness in comparison with the conventional slope/intercept method, which measures tracer dilution as well as alpha(3). Nevertheless, the advantages of indexation to ECFV can still be exploited by changing the constants of an equation of the Haycock type so that the equation becomes a predictor of ECFV rather than BSA. A recently described equation is ECFV=0.02154 x weight(0.6469) x height(0.7236). Indexation to ECFV abolishes differences that arise between children and adults when GFR is indexed to BSA.

Aging↗

Influence of posture change on intrarenal arterial resistive index measurement.

BACKGROUND: We investigated the influence of posture change on intrarenal arterial resistive index measurement in 80 subjects (38 male, 42 female). METHODS: Three interlobar arteries in the superior, middle, and inferior parts of the right kidney in each subject were examined by color Doppler ultrasound in two different positions (left lateral decubitus and supine). Based on the movement of the kidney caused by posture change, 23 subjects were classified as having a highly mobile kidney (group I) and the other 57 subjects were classified as not having a highly mobile kidney (group II). RESULTS: Fifty-eight kidneys (72.5%), 19 in group I (82.6%) and 39 in group II (68.4%), showed higher resistive index values in the lateral decubitus position than in the supine position. The influence of posture change on resistive index measurement was significant ( p < 0.001 for all subjects, p < 0.01 for group I, p < 0.05 for group II). The ranges of resistive index differences caused by posture change were 0-0.13 for group I and 0-0.11 for group II. The difference in resistive index caused by posture change was not significant between groups. CONCLUSION: Posture change is a potential confounding factor for intrarenal resistive index measurement.

Adult↗

Development of a bird integrity index: using bird assemblages as indicators of riparian condition.

We describe the development of a bird integrity index (BII) that uses bird assemblage information to assess human impacts on 13 stream reaches in the Willamette Valley, Oregon, USA. We used bird survey data to test 62 candidate metrics representing aspects of bird taxonomic richness, tolerance or intolerance to human disturbance, dietary preferences, foraging techniques, and nesting strategies that were affected positively or negatively by human activities. We evaluated the metric responsiveness by plotting each one against a measure of site disturbance that included aspects of land use/land cover, road density, riparian cover, and stream channel and substrate conditions. In addition, we eliminated imprecise and highly correlated (redundant) metrics, leaving 13 metrics for the final index. Individual metric scores ranged continuously from 0 to 10, and index scores were weighted to range from 0 to 100. Scores were calibrated using historical species information to set expectations for the number of species expected under minimally disturbed conditions. Site scores varied from 82 for the least disturbed stream reach to 8.5 for an urban site. We compared the bird integrity index site scores with the performance of other measures of biotic response developed during this study: a fish index of biointegrity (IBI) and two benthic macroinvertebrate metrics. The three assemblages agreed on the general level of disturbance; however, individual sites scored differently depending on specific indicator response to in-stream or riparian conditions. The bird integrity index appears to be a useful management and monitoring tool for assessing riparian integrity and communicating the results to the public. Used together with aquatic indicator response and watershed data, bird assemblage information contributes to a more complete picture of stream condition.

Animals↗

Application of a karst disturbance index in Hillsborough County, Florida.

Hillsborough County, Florida, is a karst region that is heavily urbanized, yet no study has been undertaken measuring the degree of human disturbance. Van Beynen and Townsend (2005) created a hierarchical and standardized disturbance index specifically designed for karst environments. To address the problem of determining human disturbance in the county, the above index was successfully applied and it was found that Hillsborough was highly disturbed (disturbance score of 0.69 of 1.0) because of its predominant urban and rural land use. Furthermore, the application of the index allowed for its refinement and the highlighting of environmental aspects in need of remediation such as soil compaction, deforestation, disturbance of archaeological sites, and the expanding urban footprint. Several minor issues arose during the application: the need for broader indicator descriptions that encompass a variety of scenarios, the need for a revised water quality indicator, inadequate data on sinkholes, and a lack of data for species richness and species population density. The utility of the index to resource managers arises from emphasizing certain areas of the environment that require immediate attention and determining temporal changes in environmental quality. Future application of the index requires potential retooling of the biota indicators, tightening of scoring descriptions for certain indicators, and further examination of the scale at which the index can be applied.

Environmental Monitoring↗

Evaluation of the applicability of the gastric carcinoma risk index for intestinal type cancer in Japanese patients infected with Helicobacter pylori.

The gastric carcinoma risk index is a histological criteria to Helicobacter pylori-infected patients with a high risk of gastric cancer. The aim of this study was to examine the applicability of this index for the intestinal-type gastric cancer in Japanese patients with H. pylori infection. In 55 patients with early intestinal-type gastric cancer and 69 control subjects, we calculated the gastric cancer risk index score by evaluating the grade of mononuclear cell (MNC) and polymorphonuclear cell (PMN) infiltration and the presence of intestinal metaplasia. The gastric cancer index score was significantly higher in patients with gastric cancer (P<0.01). The presence of intestinal metaplasia was significantly more frequent in cancer patients than in controls, while infiltration of MNCs or PMNs in the corpus was not different in the two groups. Within the gastric cancer risk index, the presence of intestinal metaplasia was the only criteria associated with the development of intestinal-type gastric cancer in Japan. The gastric cancer risk index may not be applicable to identify H. pylori-positive patients at high risk of developing intestinal-type gastric cancer in Japan.

Duodenal Neoplasms↗