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Sample records for bispectral index values

  1. Lower Bispectral index values in psychiatric patients: A prospective, observational study

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    Venkatapura J Ramesh

    2014-01-01

    Full Text Available Background : Bispectral index score (BIS is a processed electroencephalographic parameter used to measure level of sedation in anaesthetised patients. In few studies of psychiatric patients undergoing electroconvulsive therapy (ECT, it was observed that the BIS values were lower at baseline. It is not clear from those studies whether the BIS values are really low. Also, it is not clear whether the lower values are related to the primary psychiatric illness or the due to the effect of ECT. Therefore, we studied the BIS values in psychiatric illnesses and compared them with the normal controls. Materials and Methods : BIS index was recorded in 237 patients with various psychiatric illness (Group P and 40 control patients without any psychiatric illness undergoing spinal surgery (Group C. BIS values were recorded in supine position before breakfast and before the morning doses of antipsychotic/benzodiazepine medications. It was recorded during resting state in all the subjects. Results : BIS values were lower in group P compared to control group (a mean of 89.8 ± 7.8 vs 95.7 ± 2.4, P < 0.0001. In the group P, the patients with psychosis and bipolar disorder had significantly lower BIS values than the patients with depression (P = 0.04. Conclusions : BIS values in psychiatric patients are lower than those in the control group. Psychotic and bipolar disorders are associated with significantly lower BIS values than the depression.

  2. Reduction in anaesthetic drug consumption is correlated with mean titrated intra-operative Bispectral Index values.

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    Ellerkmann, R.K.; Kreuer, S.; Wilhelm, W.; Ropcke, H.; Hoeft, A.; Bruhn, J.

    2006-01-01

    BACKGROUND: Several studies have shown a reduction in anaesthetic drug consumption with Bispectral Index (BIS) titration compared with standard clinical practice. However, the amount of reduction varied widely between 1% and 40%. We investigated the correlation between reduction in anaesthetic drug

  3. Bispectral Index Monitor

    Science.gov (United States)

    2004-01-01

    Executive Summary The objective of this analysis was to evaluate the effectiveness and cost-effectiveness of the bispectral index (BIS) monitor, a commercial device to assess the depth of anesthesia. Conventional methods to assess depth of consciousness, such as cardiovascular and pulmonary measures (e.g., heart rate, systolic/diastolic blood pressure, mean arterial pressure, respiratory rate, and level of oxygen in the blood), and clinical signs (e.g., perspiration, shedding of tears, and limb movement) are not reliable methods to evaluate the brain status of anesthetized patients. Recent progress in understanding the electrophysiology of the brain has led to the development of cerebral monitoring devices that identify changes in electrophysiologic brain activity during general anesthesia. The BIS monitor, derived from electroencephalogram (EEG) data, has been used as a statistical predictor of the level of hypnosis and has been proposed as a tool to reduce the risk of intraoperative awareness. Anesthesia that is too light can result in the recall of events or conversations that happen in the operation room. Patients have recalled explicit details of conversations that happened while under anesthesia. This awareness is frightening for patients and can lead to post-traumatic stress disorder. Conversely, anesthesia that is too deep can cause hemodynamic disturbances necessitating the use of vasoconstrictor agents, which constrict blood vessels, to maintain normal blood pressure and cardiac output. Overly deep anesthesia can also result in respiratory depression requiring respiratory assistance postoperatively. Monitoring the depth of anaesthesia should prevent intraoperative awareness and help to ensure that an exact dose of anaesthetic drugs is given to minimize adverse cardiovascular effects caused by overly large doses. Researchers have suggested that cerebral monitoring can be used to assess the depth of anesthesia, prevent awareness, and speed early recovery

  4. Sevoflurane decreases bispectral index values more than does halothane at equal MAC multiples.

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    Schwab, Hildebrand S; Seeberger, Manfred D; Eger, Edmond I; Kindler, Christoph H; Filipovic, Miodrag

    2004-12-01

    At the minimum alveolar concentration (MAC) of inhaled anesthetics, 50% of subjects move in response to noxious stimulation. Similarly, at MAC-awake, 50% of subjects respond appropriately to command. The bispectral index (BIS) nominally measures the effect of anesthetics on wakefulness or consciousness. We postulated that the use of halothane with a larger MAC-awake/MAC ratio than sevoflurane would produce higher BIS values at comparable levels of MAC. We studied 33 unpremedicated patients anesthetized by inhalation, 18 with sevoflurane and 15 with halothane. We measured BIS before and during anesthesia at 1 MAC, both before and after tracheal intubation facilitated by fentanyl and rocuronium and then at 1.5 MAC. BIS measurements were made after meeting steady-state conditions. No surgery was performed during this study. BIS values in awake patients did not differ between the sevoflurane and halothane groups (96 +/- 2 and 96 +/- 2, mean +/- sd, respectively). At 1 MAC without and with neuromuscular blockade and at 1.5 MAC, BIS values for patients anesthetized with halothane (54 +/- 7, 56 +/- 7, and 49 +/- 7, respectively) exceeded those for patients anesthetized with sevoflurane (34 +/- 6, 34 +/- 6, and 29 +/- 5, respectively) (P < 0.0001). This finding adds to other evidence indicating that BIS is drug specific.

  5. Index of consciousness and bispectral index values are interchangeable during normotension and hypotension but not during non pulsatile flow state during cardiac surgical procedures: a prospective study.

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    Chakravarthy, Murali; Holla, Srinivasa; Jawali, Vivek

    2010-04-01

    Awareness under anesthesia is an avoidable complication during general anesthesia. Anesthetic depth monitors assist anesthesiologists in providing appropriate levels of anesthesia. Index of consciousness monitoring is a recently introduced monitor in the array of anesthesia depth monitors. The objective of this study was to assess the interchangeability of bispectral index, which is already in clinical use and the recently introduced index of consciousness techniques. The other objective was to assess this interchangeability during normotension, hypotension and during pulseless state in patients undergoing coronary artery bypass graft surgery. This study is a prospective observational study, conducted in a tertiary referral hospital. Fifteen cardiac surgical patients undergoing off pump and conventional coronary artery bypass under cardiopulmonary bypass participated in the study. Bispectral index and index of consciousness monitoring were carried out simultaneously during various stages of consciousness, and assessed for interchangeability. Bland Altman plotting and 'mountain plot' were used to assess the interchangeability. Eleven in the cohort underwent off pump and the rest (n = 4) conventional coronary artery bypass surgery under cardiopulmonary bypass. A set of 887 data were obtained during the study period. The data were classified as those obtained during normotension, hypotension and pulseless state during cardiopulmonary bypass. 732 sets of data were obtained during normotension, 84 during hypotension and 71 during cardiopulmonary bypass. Overall interchangeability was good, suggested by low bias (0.96), high precision (0.54), r value of 0.7 and P value of consciousness values may be interchangeable. The interchangeability is better appreciated during normotension and hypotension but not during non pulsatile state of cardiopulmonary bypass.

  6. The use of Bispectral Index (BIS values as an indicator for sleep staging

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    Evangelia Nena

    2009-01-01

    Full Text Available SUMMARY. The aim of this study was to examine whether BIS values during sleep correspond to the different sleep stages, in order to assess BIS as an alternative means of sleep staging. Patients-Methods: The study was conducted on 23 patients who were examined concurrently with polysomnography (PSG for diagnosing sleep-disordered breathing and with BIS. Exclusion criteria were sleep duration <4 hours, sleep efficiency <80% on PSG and signal quality index (SQI <50% on BIS. Comparisons in recordings were performed. Results: The patients provided 806 different sleep periods. The mean BIS value was 93.6±4.8 in the wakeful state, and in sleep, according to each stage: 84±11.5 in stage 1, 75.4±13.2 in stage 2, 53.4±15.8 in slow wave sleep (SWS, and 81.5±13.3 during REM sleep. A significant difference was observed between BIS values in the wakeful state and stage 1 (p<0.005 and between stages 1 and 2 and SWS (p<0.001, but not between stage 1 and REM (p=0.102. Conclusion: BIS values decrease with sleep and remain low, with the exception of REM sleep, the BIS values in which overlap with those in stage 1, reducing the sensitivity of BIS in sleep staging. Pneumon 2009, 22(3:230-239.

  7. Comparison of equi-minimum alveolar concentration of sevoflurane and isoflurane on bispectral index values during both wash in and wash out phases: A prospective randomised study

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    Madhu Gupta

    2015-01-01

    Full Text Available Background and Aims: At equal minimum alveolar concentration (MAC, volatile agents may produce different bispectral index (BIS values especially at low BIS levels when the effect is volatile agent specific. The present study was performed to compare the BIS values produced by sevoflurane and isoflurane at equal MAC and thereby assessing which is a better hypnotic agent. Methods: Sixty American Society of Anaesthesiologists I and II patients undergoing elective mastoidectomy were divided into groups receiving either isoflurane or sevoflurane, and at equi-MAC. BIS value was measured during both wash in and wash out phase, keeping other parameters same. Statistical analysis was performed using the Friedman two-way analysis and Mann-Whitney U-test. A P < 0.05 was considered significant. Results: BIS value was significantly lower with sevoflurane at all MAC values as compared to isoflurane, except in the beginning and at MAC awake. However, both the drugs proved to be cardiostable. Conclusion: At equi-MAC sevoflurane produces lower BIS values during wash in as well as wash out phase as compared to isoflurane, reflecting probably an agent specific effect and a deficiency in BIS algorithm for certain agents and their interplay.

  8. Comparison of equi-minimum alveolar concentration of sevoflurane and isoflurane on bispectral index values during both wash in and wash out phases: A prospective randomised study.

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    Gupta, Madhu; Shri, Iti; Sakia, Prashant; Govil, Deepika

    2015-02-01

    At equal minimum alveolar concentration (MAC), volatile agents may produce different bispectral index (BIS) values especially at low BIS levels when the effect is volatile agent specific. The present study was performed to compare the BIS values produced by sevoflurane and isoflurane at equal MAC and thereby assessing which is a better hypnotic agent. Sixty American Society of Anaesthesiologists I and II patients undergoing elective mastoidectomy were divided into groups receiving either isoflurane or sevoflurane, and at equi-MAC. BIS value was measured during both wash in and wash out phase, keeping other parameters same. Statistical analysis was performed using the Friedman two-way analysis and Mann-Whitney U-test. A P MAC values as compared to isoflurane, except in the beginning and at MAC awake. However, both the drugs proved to be cardiostable. At equi-MAC sevoflurane produces lower BIS values during wash in as well as wash out phase as compared to isoflurane, reflecting probably an agent specific effect and a deficiency in BIS algorithm for certain agents and their interplay.

  9. Effect of nicardipine on haemodynamic and bispectral index changes following endotracheal intubation.

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    Kim, J H; Lee, Y S; Kim, W Y; Kim, H J; Chang, M S; Park, J Y; Shin, H W; Park, Y C

    2007-01-01

    We investigated the effect of IV nicardipine on haemodynamic and bispectral index responses to the induction of general anaesthesia and intubation. Forty patients were randomly allocated to two groups of 20 to receive normal saline or nicardipine 15 microg/kg IV 30 s after induction. Ninety seconds later, tracheal intubation was performed. Systolic blood pressure, heart rate and bispectral index were measured at baseline, 1 min after induction, pre-intubation, and every minute until 5 min after endotracheal intubation. Rate-pressure product values were calculated. In the nicardipine group, systolic blood pressure decreased compared with the control group, and heart rate increased comparedwith the control group. Bispectral index and rate-pressure product showed no differences between the two groups. In conclusion, the administration of 15 microg/kg nicardipine IV does not affect anaesthetic depth in response to the induction of general anaesthesia and intubation.

  10. Lidocaine does not prevent bispectral index increases in response to endotracheal intubation.

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    Kim, Woon-Young; Lee, Yoon-Sook; Ok, Se-Jin; Chang, Moon-Seok; Kim, Jae-Hwan; Park, Young-Cheol; Lim, Hye-Ja

    2006-01-01

    We investigated the effect of IV lidocaine on the hemodynamic and bispectral index responses to induction of general anesthesia and endotracheal intubation. Forty patients (ASA I) were randomly allocated into 2 groups of 20 to receive normal saline or lidocaine 1.5 mg/kg IV 30 s after induction. Ninety seconds later, endotracheal intubation was performed. Systolic blood pressure, heart rate, and bispectral index were measured at baseline, 1 min after induction, at preintubation, and every minute until 5 min after endotracheal intubation. Bispectral index at 1 min after induction and preintubation in the lidocaine group were significantly lower compared with the control group (P intubation in the control group compared with the baseline value (P endotracheal intubation.

  11. MONITORING DEPTH OF ANAESTHESIA USING PRST SCORE AND BISPECTRAL INDEX

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    Rahul

    2015-03-01

    Full Text Available BACKGROUND : Intraoperative awareness is a frightening experience for any patient for it has long term psychological consequences. Among the various tools available for monitoring depth of anaesthesia, Bispectral index monitoring (BIS is one of the recent and widely accepted techniques. AIMS AND OBJECTIVES : The present study was carried out to evaluate and correlate the efficacy of BIS monitoring along with PRST score in assessment of depth of anaesthesia. MATERIALS AND METHODS : A prospective clinical study was conducted on 160 patients undergoing surgery in various specialties, in the department of Anaesthesiology at Rajarajeswari Medical College and Hospital which included adult patients between the ages of 18 and 65 years and of ASA I/II posted for elective surgeries under general anaesthesia. Conditions and drugs likely to interfere with BIS values were excluded. Anaesthesia protocol was kept uniform. These patients were divided into two groups of 80 patients each by consecutive selection. In Group 1 - depth of anaesthesia was assessed by PRST score, in Group 2 - by BIS monitoring and PRST score. Statistical analysis was performed by descriptive statistics to calculate the mean and standard deviation, the t - test, χ² test s for calculating the materiality for establishing the results. RESULTS: We saw that the Bispectral index varied with various stages of anaesthesia, almost simultaneous changes in systolic, diastolic and mean arterial blood pressures occurred in both groups in T1 and T2. On intubation, both blood pressure and heart rate increased but BIS showed a very minimal increase, which was because of adequate depth of anaesthesia and analgesia . There was a statistically significant difference in PRST scores between the two groups. There was no incidence of awareness among our study population. CONCLUSION : Evaluation of intraoperative depth of anaesthesia is one of the major tasks of anaesthesiologist. In patients with higher

  12. Suxamethonium induces a prompt increase in the bispectral index.

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    Choi, Jong Bum; Na, Se Hee; Lee, Sook Young; Kim, Jong Yeop; Park, Sung Yong; Kim, Ji Eun; Hong, Seungbae; An, Jiwon; Park, Chung Hoon; Kim, Yong Chan; Park, Woo Young

    2017-04-01

    Upon inducting general anesthesia in the operating room, we have observed a prompt increase in the bispectral index (BIS) after the intravenous injection of suxamethonium. We hypothesized that the cause of this BIS increase is muscle hyperactivity owing to fasciculation. However, no reports have been published regarding this abrupt increase in the BIS upon the induction of general anesthesia by suxamethonium. To investigate the degree of change in the BIS in patients receiving anesthesia with suxamethonium, we performed a prospective observational study of 63 participants who underwent closed reduction for nasal bone fracture. Anesthesia was induced by the total intravenous administration of anesthetics and 1.5 mg kg of suxamethonium was injected intravenously upon achieving BIS between 45 and 55. Intubation was performed after fasciculation. Electromyograms and BIS values were recorded from the induction of suxamethonium until 15 minutes after intubation. The mean BIS values were 95.4, 48.5, and 69.3 before induction, before the intravenous injection of suxamethonium, and immediately after fasciculation, respectively. The BIS value immediately after fasciculation (69.3 ± 10.6) was significantly higher than the cutoff BIS value of 60 (P increase of the BIS to values over 60, none of the participants was awake during surgery. In conclusion, the administration of suxamethonium resulted in the postfasciculation increase of the BIS to an average value of 69.3 without affecting the patient's state of consciousness.

  13. IV ATP potentiates midazolam sedation as assessed by bispectral index.

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    Sakurai, Satoru; Fukunaga, Atsuo; Ichinohe, Tatsuya; Kaneko, Yuzuru

    2014-01-01

    In this study, by measuring bispectral index (BIS), we tested the hypothesis that intravenous adenosine 5'-triphosphate (ATP) infusion would deepen the level of midazolam-induced sedation. Ten healthy volunteers underwent 2 experiments with at least 2 weeks' interval: immediately after intravenous bolus administration of midazolam (0.04 mg/kg), they received continuous infusion of either ATP infusion (100 μg/kg/min) or placebo (saline) for 40 minutes in a double-blind, randomized, crossover manner. Changes in BIS values and responsiveness to verbal command as well as cardiorespiratory variables were observed throughout the study periods. Administration of midazolam alone reduced BIS value from control: 97 ± 1 to 68 ± 18 at 25 minutes, which was accompanied by significant cardiopulmonary depressant effects, while maintaining responsiveness to verbal command (consciousness) throughout the study period. Coadministration of ATP with midazolam further reduced BIS value to 51 ± 13, associated with complete loss of consciousness without adverse effect on the cardiorespiratory systems. We conclude that the addition of ATP infusion to midazolam significantly enhances midazolam sedation without disturbing cardiorespiratory functions.

  14. The Utility of Bispectral Index for Titration of Propofol Dosages and Recovery from Anaesthesia

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    Heena Parikh

    2012-08-01

    Full Text Available Background: The use of clinical signs may not be reliable to measure the hypnotic component of anaesthesia. Bispectral Index monitoring provides a direct measurement of the hypnotic effect of the anaesthetic agent used and it may have certain clinical advantages over clinical signs. Objective: This study consists of dose requirement of propofol with bispectral Index monitoring and without bispectral Index monitoring. Material and Methods: In the present study, 100 patients were randomly divided into two groups (50 in each group, one group received Standard dose of propofol while the other received propofol infusion with BIS monitoring. Results: Mean amount of propofol for induction used was 1.6 vs 2.24 mg/kg in bispectral index group and standard group respectively. The inference was that the induction dose of propofol by Bispectral index and by standard practice was statistically highly significant with P<0.001. Similarly mean amount of propofol for maintenance used was 5.70 vs 8.88 mg/kg/hr in bispectral index group and standard group respectively. The inference was that the maintenance dose of propofol by Bispectral index and by standard practice was statistically highly significant with P<0.001. Conclusion: Dose requirement of propofol was less and early recovery from anesthesia with bispectral Index monitoring. [Natl J of Med Res 2012; 2(4.000: 484-487

  15. A-line, bispectral index, and estimated effect-site concentrations: a prediction of clinical end-points of anesthesia.

    NARCIS (Netherlands)

    Kreuer, S.; Bruhn, J.; Larsen, R.; Buchinger, H.; Wilhelm, W.

    2006-01-01

    Autoregressive modeling with exogenous input of middle-latency auditory evoked potentials (A-Line AEP index, AAI) has been developed for monitoring depth of anesthesia. We investigated the prediction of recovery and dose-response relationship of desflurane and AAI or bispectral index (BIS) values.

  16. Patient state index vs bispectral index as measures of the electroencephalographic effects of propofol.

    NARCIS (Netherlands)

    Soehle, M.; Kuech, M.; Grube, M.; Wirz, S.; Kreuer, S.; Hoeft, A.; Bruhn, J.; Ellerkmann, R.K.

    2010-01-01

    BACKGROUND: The patient state index (PSI) and the bispectral index (BIS) quantify anaesthetic depth based on the EEG using different algorithms. We compared both indices with regard to the prediction of the depth of propofol anaesthesia. METHODS: In 17 patients, propofol was infused until burst supp

  17. Bispectral Index Monitoring: validity and utility in pediatric dentistry.

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    Goyal, Ashima; Mittal, Neeti; Mittal, Parteek; Gauba, K

    2014-01-01

    Reliable and safe provision of sedation and general anesthesia is dependent on continuous vigilance of patient's sedation depth. Failure to do so may result in unintended oversedation or undersedation. It is a common practice to observe sedation depth by applying subjective sedation scales and in case of general anesthesia, practitioner is dependent on vital sign assessment. The Bispectral Index System (BIS) is a recently introduced objective, quantitative, easy to use, and free from observer bias, and clinically useful tool to assess sedation depth and it precludes the need to stimulate the patient to assess his sedation level. The present article is an attempt to orient the readers towards utility and validity of BIS for sedation and general anesthesia in pediatric dentistry. In this article, we attempt to make the readers understand the principle of BIS, its variation across sedation continuum, its validity across different age groups and for a variety of sedative drugs.

  18. The effect of aging on bispectral index before and after sedation: a prospective study

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    Mahoori A

    2010-08-01

    Full Text Available "nBackground: The Bispectral Index (BIS is an EEG-derived value that measures the sedative and hypnotic component of the anesthetic state. The effects of age on the bispectral index have not been well documented. The objective of the present study was to determine the influence of age on hypnotic requirement and bispectral index in awake and in patients with sedation induced by midazolam. "n"nMethods: Eighty patients were enrolled in this prospective observational study. The patients in study group were aged more than 70 years, and the age in control group ranged 20-40 years. Baseline recording of BIS was taken in awake patients in two groups for few minutes. Five minutes after administration of 0.02 mg/kg IV midazolam the BIS value also was taken and recorded. "n"nResults: In the study group, patients had a mean base BIS 94±3 compared with 97.3±1 in the control group (p< 0.0001. Five minutes after administration of 0.02 mg/kg midazolam the value were 80.9±6 and 90.4±3 respectively (p< 0.0001. "n"nConclusion: When BIS is used as a monitor of hypnosis in the elderly, we recommend that a baseline recording be taken before induction for a few minutes to alert the anesthesia provider to the possibility of low initial values. Further studies are needed to verify if the recommended range of 50-60 of BIS during clinical anesthesia is also adequate in the elderly with low initial baseline BIS or if this range needs adjusting in view of reduced initial BIS value.

  19. Auditory information processing during adequate propofol anesthesia monitored by electroencephalogram bispectral index

    NARCIS (Netherlands)

    C. Kerssens (Chantal); J. Klein (Jan); A. van der Woerd; B. Bonke (Benno)

    2001-01-01

    textabstractMemory for intraoperative events may arise from inadequate anesthesia when the hypnotic state is not continuously monitored. Electroencephalogram bispectral index (BIS) enables monitoring of the hypnotic state and titration of anesthesia to an adequate level

  20. Auditory information processing during adequate propofol anesthesia monitored by electroencephalogram bispectral index

    NARCIS (Netherlands)

    C. Kerssens (Chantal); J. Klein (Jan); A. van der Woerd; B. Bonke (Benno)

    2001-01-01

    textabstractMemory for intraoperative events may arise from inadequate anesthesia when the hypnotic state is not continuously monitored. Electroencephalogram bispectral index (BIS) enables monitoring of the hypnotic state and titration of anesthesia to an adequate level

  1. Comparison of ocular microtremor and bispectral index during sevoflurane anaesthesia.

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    Kevin, L G; Cunningham, A J; Bolger, C

    2002-10-01

    A practical and reliable monitor of depth of anaesthesia would be a major advance on current clinical practice. None of the present monitors is both simple to use and accurate. Ocular microtremor (OMT) is a physiological tremor that is suppressed by propofol in a dose-dependent manner. We studied OMT during propofol induction and nitrous oxide-oxygen-sevoflurane maintenance of anaesthesia in 30 patients, and compared OMT with the bispectral index (BIS) as a predictor of response to verbal command. OMT was measured using the closed-eye piezoelectric strain-gauge technique. OMT and BIS were measured at specific times during the anaesthetic, including at loss of consciousness, at end-tidal sevoflurane 1 and 2%, and at emergence. OMT decreased significantly after induction, did not decrease as end-tidal sevoflurane was increased from 1 to 2%, and increased at emergence in all patients. By logistic regression, OMT was more sensitive and specific than BIS in distinguishing the awake from the anaesthetized state (OMT, 84.9 and 93.1% respectively; BIS, 75.7 and 69.0%). OMT is suppressed by sevoflurane and accurately predicts response to verbal command. OMT may be a useful monitor of depth of hypnosis.

  2. Evaluation of the electroencephalographic bispectral index during fentanyl-midazolam anaesthesia for cardiac surgery. Does it predict haemodynamic responses during endotracheal intubation and sternotomy?

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    Driessen, J J; Harbers, J B; van Egmond, J; Booij, L H

    1999-09-01

    The bispectral index, a value derived from the electroencephalogram, has been proposed as a measure of anaesthetic effect. The aim of the present study was to evaluate the bispectral index during midazolam-fentanyl anaesthesia for cardiac surgery for its possible role as a predictor of increases in systolic blood pressure during endotracheal intubation and sternotomy. After institutional approval 15 consenting patients, scheduled for elective cardiac surgery, were selected for the study. Anaesthesia was induced in all patients with a loading dose of fentanyl 7.5-10 micrograms kg-1, midazolam 0.15 mg kg-1 and pancuronium 0.1 mg kg-1. After a further bolus dose of fentanyl 10-12.5 micrograms kg-1 prior to the start of incision and sternotomy, maintenance infusion rates of fentanyl 4-6 micrograms kg-1 h-1 and midazolam 0.1 mg kg-1 h-1 were started and continued through surgery at the discretion of the anaesthetist and guided by the presenting clinical and haemodynamic responses. The control of anaesthesia was never based on the value of the bispectral index. The mean bispectral index value decreased from 95.7 (3.1) at base-line to 59.5 (12.0) after induction of anaesthesia and then remained below 70 throughout surgery. However, there was an important interindividual variability in bispectral index values despite standardized dosages of fentanyl and midazolam. There was no significant correlation between the bispectral index values in the pre-intubation and pre-incision period and the changes in systolic blood pressure during endotracheal intubation and sternotomy, respectively. In conclusion, the large intersubject variability in the bispectral index values should be investigated further in the light of the great variability in the clinical effects of midazolam and fentanyl. The lack of significant correlation between the bispectral index values and the haemodynamic responses suggest that the bispectral index, which is a helpful monitor of anaesthetic depth, is not a

  3. Effect of different doses of dezocine on degree of emergence agitation under bispectral index monitoring

    Institute of Scientific and Technical Information of China (English)

    Xing-Bao Liang; Zong-Rong Guo

    2016-01-01

    Objective:To analyze the effect of different doses of dezocine on degree of emergence agitation under bispectral index monitoring. Methods:A total of 196 cases who received general anesthesia in our hospital from September 2012 to December 2014 were selected as research subjects, bispectral index (BIS) monitoring was continuously conducted during anesthesia induction and extubation anesthesia recovery, and according to different methods of dezocine intervention, they were randomly divided into control group, D1 group, D2 group and D3 group, each group with 49 cases. Differences in levels of recovery time-related indexes, BIS values before dezocine administration (T0), sputum suction before extubation (T1), extubation time (T2) and 10 min after extubation (T3), hemodynamic indexes and stress indexes of all groups were compared. Results:Recovery time and extubation time of D2 group were shorter than those of control group, D1 group and D3 group, restlessness scale after extubation and VAS were lower than those of control group and D1 group, and Ramsay sedation scale was higher than that of control group and D1 group (P0.05);cortisol and blood glucose levels at T1, T2 and T3 points in time of D2 and D3 group were lower than those of other two groups (P0.05). Conclusions:0.1 mg/kg dezocine administration before end of operation can reduce emergence agitation without causing excessive sedation or prolonged extubation time, and it has active significance in stabilizing patients’ hemodynamic and stress levels in extubation period.

  4. 脑电双频指数监测对重症监护病房昏迷患者预后的评估%Study of estimating the prognosis of ICU patients with coma using Bispectral index value

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    高红梅; 路玲; 窦琳; 常文秀

    2013-01-01

    Objective To investigate the correlation between Bispectral index (BIS) value and the prognosis of patients with coma in ICU.Methods A total of 208 patients with coma in ICU were divided into 4 groups according to the BIS value.In group I,BIS value was 0 to 20; groupⅡ,BIS value 21 to 40; group Ⅲ,BIS value 41 to 60; and group Ⅳ,BIS value greater than 60.Comparison of the difference in BIS value with the differences in prognosis of patients with coma was carried out between four groups,and the prognosis of patients with coma was stratified into consciousness,coma,vegetative state,and brain death.Subsequently,the best cutoff score of BIS value calculated for determining the correlation between BIS and mental state was proposed.Results There are no significant differences in the age and APACHE Ⅱ scores between four groups (P > 0.05).It was inverse correlation between BIS value and mental state (r =-0.749,P =0.00).According to the ROC curve,as BIS value was greater than 42.5,there were higher sensitivity and specificity in Conscious-Coma patients.Conclusions BIS value is correlated with the prognosis of patients with coma in ICU,and BIS value can be a useful marker for estimating the prognosis of comatose patients.%目的 观察脑电双频指数(BIS)监测值与重症监护室(ICU)中昏迷患者预后的相关性,探讨通过BIS值评估ICU昏迷患者的预后的可行性.方法 回顾性将纳入的208例昏迷危重病患者根据所监测的BIS监测值分为四组:Ⅰ组,0~20;Ⅱ组,21 ~40;Ⅲ组,41~60;Ⅳ组,>60.分别用BIS值和神志预后(神志清楚-昏迷、植物状态、脑死亡状态)为目标,比较组间差异,计算各组BIS值与昏迷患者预后的相关性,寻找较准确评估昏迷患者预后的BIS临界值.结果 四组患者的年龄、APACHEⅡ评分采用单因素方差分析,差异无统计学意义(P>0.05),对BIS值与昏迷预后状态采用Spearman’s等级相关进行相关分析,结果呈负相关(r=-0.749,P

  5. Relationship of bispectral index to hemodynamic variables and alveolar concentration multiples of sevoflurane in puppies.

    Science.gov (United States)

    Morgaz, J; Granados, M M; Domínguez, J M; Navarrete, R; Galán, A; Fernández, J A; Gómez-Villamandos, R J

    2009-06-01

    The relationships between bispectral index (BIS), cardiovascular variables and minimum alveolar concentration (MAC) multiples of sevoflurane in puppies were determined. Five puppies were anesthetized with sevoflurane on two occasions. First, the individual sevoflurane MAC values were determined for each puppy. Secondly, dogs were anesthetized with sevoflurane at each of 5 MAC multiples, 0.75, 1, 1.25, 1.5 and 1.75 MAC administered in random order. Hemodynamic parameters and BIS data were collected for 20min. Somatic stimulus was then applied and the same parameters and data were collected for 6min. Correlation between BIS and end tidal sevoflurane and between BIS and hemodynamic parameters were studied. We found positive significant correlation in both cases. BIS is lower in puppies that in adults at the same alveolar anesthetic concentrations and sevoflurane appears to be a safe anesthetic in puppies.

  6. Bispectral Index in ICU: correlation with Ramsay Score on assessment of sedation level.

    Science.gov (United States)

    Mondello, Epifanio; Siliotti, Rossella; Noto, Giusi; Cuzzocrea, Elisabetta; Scollo, Giuseppe; Trimarchi, Giuseppe; Venuti, Francesco Saverio

    2002-07-01

    The assessment of sedation level in critically ill patient remains a challenge for the intensivists in order to avoid over- or under-sedation phenomena. Scoring systems commonly used still show some limitation; the introduction of Bispectral Index (an EEG parameter) could bring potential advantages in monitoring sedation. According to the reports, Bispectral Index correlates with levels of sedation on the Ramsay Scale. We report our personal experience in this topic. Twenty patients, diagnosed with chronic obstructive pulmonary disease (COPD), were involved in the study. For an optimal adaptation to respiratory prothesis, they were sedated (with Propofol by continuous infusion at an initial dose of 2 mg/kg/h, which could be modulated with steps of 0.5 mg/kg/h), in order to maintain a Ramsay score of 4-5. BIS value was continuously recorded, and manually calculated on a mean average of a minute during the measuring of Ramsay score (T0) and every 30' for 24 hours on par with Ramsay score. EEG, SpO2, non invasive arterial pressure, ventilatory module, ETCO2, FIO2 were also recorded. For the statistic analysis, Friedman test and Spearman coefficient were utilized. Values of p < 0.05 were considered significant. 980 observations were carried out. The variation range of Ramsay Score was between 2 and 6. BIS range varied from 34 to 98. Statistic analysis of the data obtained pointed out some significative correlations, particularly between Ramsay Score and BIS (p < 0.01), and between BIS and dosage of Propofol (p < 0.01). The results of the study are consistent with those found in the literature on this topic of study. In fact, this study demonstrates the utility of BIS to track levels of consciousness in ICU patients while still maintaining the use of the score systems to care for ICU patients.

  7. Closed loop control of sedation for colonoscopy using the Bispectral Index

    NARCIS (Netherlands)

    Leslie, K.; Absalom, A.; Kenny, G. N. C.

    Sixteen patients undergoing colonoscopy were sedated with propofol using a closed-loop control system guided by the Bispectral Index (BIS). Propofol administration, via a target-controlled infusion, was controlled by a proportional-integral-differential control algorithm. The median (range) propofol

  8. Electroconvulsive Therapy Under General Anesthesia With Cisatracurium, Laryngeal Mask Airways, and Bispectral Index.

    Science.gov (United States)

    Liu, Cai-Cai; Qian, Xiao-Yan; An, Jian-Xiong; Yu, Zeng-Lei; Wu, Jian-Ping; Wen, Hui; Cao, Zong-Xin; Wang, Yong; Fang, Qi-Wu; Williams, John P

    2016-03-01

    Electroconvulsive therapy (ECT) has dramatically reduced musculoskeletal complications when carried out with muscle relaxants under general anesthesia. However, seizure quality can be affected by the depth of anesthesia and choice of anesthetic agent. The purpose of this study was to describe a general anesthetic technique for ECT by using laryngeal mask, bispectral index (BIS), and muscle relaxant monitoring. Twenty-one patients, between ages 18 and 70 years (American Society of Anesthesiologists physical status I-III), who underwent a total of 89 sessions of ECT were examined in a retrospective study. Anesthesia was induced by use of propofol (1.0 mg/kg) followed by cisatracurium (0.2 mg/kg). The BIS, train-of-four, and end-tidal carbon dioxide were all monitored continuously. A laryngeal mask airway was used to maintain and protect the airway during the procedure. Electroconvulsive therapy stimuli were applied bilaterally when the train-of-four was assessed as being zero and BIS scores were 70. All patients then received 5 μg sufentanil and 2 mg midazolam, while titrated to maintain the BIS value at 40 to 50, before the muscle relaxation exhibited complete recovery. The mean duration of treatment process takes approximately 82.5 minutes. Mean (SD) seizure length was 58.8 (28.3) seconds, with 4.5% incidence of restimulation per treatment. Incidence of awareness was 0%. No patients exhibited delirium, nausea, vomiting, or myalgia in the postseizure phase. Bispectral index monitoring of the depth of anesthesia may have improved seizure quality, and awareness did not occur.

  9. Comparison of bispectral index and composite auditory evoked potential index for monitoring depth of hypnosis in children

    NARCIS (Netherlands)

    H.J.B. van Oud-Alblas; J.W.B. Peters (Jeroen); T.G. de Leeuw (Tom); D. Tibboel (Dick); J. Klein (Jan); F. Weber (Frank)

    2008-01-01

    textabstractBACKGROUND: In pediatric patients, the Bispectral Index (BIS), derived from the electroencephalogram, and the composite A-Line autoregressive index (cAAI), derived from auditory evoked potentials and the electroencephalogram, have been used as measurements of depth of hypnosis during

  10. Comparison of bispectral index and composite auditory evoked potential index for monitoring depth of hypnosis in children

    NARCIS (Netherlands)

    H.J.B. van Oud-Alblas; J.W.B. Peters (Jeroen); T.G. de Leeuw (Tom); D. Tibboel (Dick); J. Klein (Jan); F. Weber (Frank)

    2008-01-01

    textabstractBACKGROUND: In pediatric patients, the Bispectral Index (BIS), derived from the electroencephalogram, and the composite A-Line autoregressive index (cAAI), derived from auditory evoked potentials and the electroencephalogram, have been used as measurements of depth of hypnosis during ane

  11. Comparison of Intravenous Dexmedetomidine and Midazolam for Bispectral Index-Guided Sedation During Spinal Anesthesia.

    Science.gov (United States)

    Jo, Youn Yi; Lee, Dongchul; Jung, Wol Seon; Cho, Noo Ree; Kwak, Hyun Jeong

    2016-10-04

    BACKGROUND Despite the high frequency of hypotension during spinal anesthesia with proper sedation, no previous report has compared the hemodynamic effects of dexmedetomidine and midazolam sedation during spinal anesthesia. We compared the effects of bispectral index (BIS)-guided intravenous sedation using midazolam or dexmedetomidine on hemodynamics and recovery profiles in patients who underwent spinal anesthesia. MATERIAL AND METHODS One hundred and sixteen adult patients were randomly assigned to receive either midazolam (midazolam group; n=58) or dexmedetomidine (dexmedetomidine group; n=58) during spinal anesthesia. Systolic, diastolic, and mean arterial pressures; heart rates; peripheral oxygen saturations; and bispectral index scores were recorded during surgery, and Ramsay sedation scores and postanesthesia care unit (PACU) stay were monitored. RESULTS Hypotension occurred more frequently in the midazolam group (Pmidazolam sedation.

  12. Auditory information processing during adequate propofol anesthesia monitored by electroencephalogram bispectral index

    OpenAIRE

    Kerssens, Chantal; Klein, Jan; Woerd, A.; Bonke, Benno

    2001-01-01

    textabstractMemory for intraoperative events may arise from inadequate anesthesia when the hypnotic state is not continuously monitored. Electroencephalogram bispectral index (BIS) enables monitoring of the hypnotic state and titration of anesthesia to an adequate level (BIS 40 to 60). At this level, preserved memory function has been observed in trauma patients. We investigated memory formation in elective surgical outpatients during target-controlled propofol anesthesia supplemented with al...

  13. Effects of cardiopulmonary bypass on propofol pharmacokinetics and bispectral index during coronary surgery

    Directory of Open Access Journals (Sweden)

    Ricardo Antonio G. Barbosa

    2009-03-01

    Full Text Available PURPOSE: Cardiopulmonary bypass is known to alter propofol pharmacokinetics in patients undergoing cardiac surgery. However, few studies have evaluated the impact of these alterations on postoperative pharmacodynamics. This study was designed to test the hypothesis that changes in propofol pharmacokinetics increase hypnotic effects after cardiopulmonary bypass. METHODS: Twenty patients scheduled for on-pump coronary artery bypass graft (group, n=10 or off-pump coronary artery bypass graft (group, n=10 coronary artery bypass grafts were anesthetized with sufentanil and a propofol target controlled infusion (2.0 µg/mL. Depth of hypnosis was monitored using the bispectral index. Blood samples were collected from the induction of anesthesia up to 12 hours after the end of propofol infusion, at predetermined intervals. Plasma propofol concentrations were measured using high-performance liquid chromatography, followed by a non-compartmental propofol pharmacokinetic analysis. Data were analyzed using ANOVA, considering p<0.05 as significant. RESULTS: After cardiopulmonary bypass, despite similar plasma propofol concentrations in both groups, bispectral index values were lower in the on-pump coronary artery bypass graft group. Time to extubation after the end of propofol infusion was greater in the on-pump coronary artery bypass graft group (334 ± 117 vs. 216 ± 85 min, p = 0.04. Patients undergoing cardiopulmonary bypass had shorter biological (1.82 ± 0.5 vs. 3.67 ± 1.15h, p < 0.01 and terminal elimination (6.27 ± 1.29 vs. 10.5h ± 2.18, p < 0.01 half-life values, as well as higher total plasma clearance (28.36 ± 11.40 vs.18.29 ± 7.67 mL/kg/min, p = 0.03, compared to patients in the off-pump coronary artery bypass graft group. CONCLUSION: Aside from the increased sensitivity of the brain to anesthetics after cardiopulmonary bypass, changes in propofol pharmacokinetics may contribute to its central nervous system effects.

  14. [Effects of landiolol on cardiovascular responses, bispectral index and body movement during endotracheal intubation].

    Science.gov (United States)

    Kawano, Takashi; Eguchi, Satoru; Iseki, Akio; Oshita, Shuzo

    2005-06-01

    We investigated the effects of a novel highly cardioselective short-acting beta-blocker, landiolol, on cardiovascular response, bispectral index and body movement during endotracheal Forty ASA class 1 patients were randomly allocated into 2 groups, in a double-blind fashion; 1) 20 patients received landiolol 125 microg x kg(-1) x min(-1) for one minute followed by 40 microg x kg(-1) x min(-1) (landiolol group), and 2) 20 patients received saline (control group). Landiolol or saline was started 6 min after a target controlled infusion of propofol (effect-site concentration 4 microg x ml(-1)). The trachea was intubated 11 min after propofol infusion. Heart rate, mean arterial pressure, and bispectral index were recorded. In addition, the "isolated forearm" technique was used to detect body movement during endotracheal intubation. Maximum changes in heart rate (control; 48% versus landiolol; 19%), mean arterial pressure (51% versus 39%), and bispectral index (31% versus 12%) observed during endotracheal intubation were significantly less in the landiolol group. More patients in the control than in the landiolol group moved after endotracheal intubation (19 versus 11, Pendotracheal intubation.

  15. Vocal cord function and bispectral index in pediatric bronchoscopy patients emerging from propofol anesthesia.

    Science.gov (United States)

    Schroeck, Hedwig; Fecho, Karamarie; Abode, Kathleen; Bailey, Ann

    2010-05-01

    In children undergoing bronchoscopy for evaluation of stridor or respiratory symptoms, movement of the vocal cords is routinely assessed at the conclusion of flexible bronchoscopy with children still anesthetized. The effect of anesthesia on vocal cord function is not well described. This study aimed to characterize the relationship between depth of propofol anesthesia, as measured by Bispectral Index (BIS), and vocal cord movement in pediatric patients. Children between 6 months and 12 years of age presenting for diagnostic flexible bronchoscopy were enrolled in this prospective observational study. Anesthesia was maintained with a propofol infusion which was discontinued upon completion of the lower airway evaluation. An independent observer recorded the BIS score every 15 sec from discontinuation of propofol whereas the pulmonologist continued to observe vocal cord motion. BIS scores were also recorded for each observed clinical endpoint (paradoxical and normal vocal cord movement, complete vocal cord closure, and volitional movement). Data were analyzed for 47 subjects. The BIS values increased significantly from the conclusion of the lower airway evaluation with return of normal vocal cord movement, complete vocal cord closure, and volitional movement (P propofol anesthesia is related to decreasing anesthetic depth with complete vocal cord closure occurring at BIS values near those associated with volitional movement.

  16. Relationship of feline bispectral index to multiples of isoflurane minimum alveolar concentration.

    Science.gov (United States)

    Lamont, Leigh A; Greene, Stephen A; Grimm, Kurt A; Tranquilli, William J

    2005-06-01

    The study reported here was done to determine the relationship between bispectral index (BIS) values and minimum alveolar concentration (MAC) multiples of isoflurane in cats. Isoflurane MAC was determined using the tail-clamp method in eight domestic cats. Ten days later, the cats were anesthetized a second time with isoflurane at each of five MAC multiples administered in random order. Ventilation was controlled and, after a 20-min equilibration period at each MAC multiple of isoflurane, BIS data were collected for 5 min and the median BIS value calculated. Data from each isoflurane MAC multiple were compared using analysis of variance for repeated measures, and statistical significance was set at P MAC of isoflurane (mean +/- 1 standard deviation) was 1.8% +/- 0.2%. BIS values at 0.5 MAC could not be recorded due to spontaneous movement in all eight cats. BIS values at 2.0 MAC were confounded by burst suppression in seven of the eight cats. Over the range of 0.8 to 1.5 MAC, BIS values decreased significantly with increasing end-tidal isoflurane concentrations. Mean (+/- 1 standard deviation) BIS measurements were 32 +/- 3 at 0.8 MAC, 20 +/- 4 at 1.0 MAC, and 5 +/- 3 at 1.5 MAC. Therefore, BIS values are inversely and linearly related to end-tidal isoflurane concentrations in anesthetized cats. However, the consistently low BIS values recorded in this study suggest that clinical BIS endpoints used to titrate anesthetic agents in humans may not be applicable to cats.

  17. Nervus medianus evoked potentials and bispectral index during repeated transitions from consciousness to unconsciousness.

    Science.gov (United States)

    Rundshagen, I; Mast, J; Mueller, N; Pragst, F; Spies, C; Cortina, K

    2008-09-01

    We investigated the relationship between median nerve somatosensory evoked potentials (SSEPs) and the bispectral index (BIS) during alternating periods of consciousness and propofol-induced unconsciousness. Loss of consciousness (LOC) was repetitively induced by bolus injections of propofol in 24 patients undergoing elective surgery in spinal anaesthesia. SSEP and the BIS were recorded during LOC and recovery of consciousness (ROC). The level of consciousness was clinically assessed by the observer's assessment of alertness/sedation scale. Propofol venous plasma concentrations were measured simultaneously. At LOC, all SSEPs latency components were prolonged (P or = 45 ms were smaller (P=0.008) and the BIS values were lower (Plevels during ROC. Regression analyses revealed that the SSEP components (five latencies and five amplitudes) explained 33% of the variance when predicting ROC; the BIS explained 12%. The combination of SSEP and BIS explained 37% of variance in this patient sample. Propofol venous plasma concentration was 1.2 (0.8) microg ml(-1) during LOC and 0.4 (0.5) microg ml(-1) during ROC. The present results indicate the usefulness of combining variables of the evoked and spontaneous EEG to measure different levels of consciousness, because the SSEP provide additional information beyond the BIS. Inter-individual variability of all the EEG variables limits their predictive potency of ROC after propofol infusion.

  18. Bispectral index as a predictor of sedation depth during isoflurane or midazolam sedation in ICU patients.

    Science.gov (United States)

    Sackey, P V; Radell, P J; Granath, F; Martling, C R

    2007-06-01

    Bispectral index (BIS) is used for monitoring anaesthetic depth with inhaled anaesthetic agents in the operating room but has not been evaluated as a monitor of sedation depth in the intensive care unit (ICU) setting with these agents. If BIS could predict sedation depth in ICU patients, patient disturbances could be reduced and oversedation avoided. Twenty ventilator-dependent ICU patients aged 27 to 80 years were randomised to sedation with isoflurane via the AnaConDa or intravenous midazolam. BIS (A-2000 XP, version 3.12), electromyogram activity (EMG) and Signal Quality Index were measured continuously. Hourly clinical evaluation of sedation depth according to Bloomsbury Sedation Score (Bloomsbury) was performed. The median BIS value during a 10-minute interval prior to the clinical evaluation at the bedside was compared with Bloomsbury. Nurses performing the clinical sedation scoring were blinded to the BIS values. End-tidal isoflurane concentration was measured and compared with Bloomsbury. Correlation was poor between BIS and Bloomsbury in both groups (Spearman's rho 0.012 in the isoflurane group and -0.057 in the midazolam group). Strong correlation was found between BIS and EMG (Spearman's rho 0.74). Significant correlation was found between end-tidal isoflurane concentration and Bloomsbury (Spearman's rho 0.47). In conclusion, BIS XP does not reliably predict sedation depth as measured by clinical evaluation in non-paralysed ICU patients sedated with isoflurane or midazolam. EMG contributes significantly to BIS values in isoflurane or midazolam sedated, non-paralysed ICU patients. End-tidal isoflurane concentration appeared to be a better indicator of clinical sedation depth than BIS.

  19. Validation of the bispectral index as an indicator of anesthetic depth in Thoroughbred horses anesthetized with sevoflurane

    Science.gov (United States)

    TOKUSHIGE, Hirotaka; KAKIZAKI, Masashi; ODE, Hirotaka; OKANO, Atsushi; OKADA, Jun; KURODA, Taisuke; WAKUNO, Ai; OHTA, Minoru

    2016-01-01

    ABSTRACT To evaluate the bispectral index (BIS) as an indicator of anesthetic depth in Thoroughbred horses, BIS values were measured at multiple stages of sevoflurane anesthesia in five horses anesthetized with guaifenesin and thiopental following premedication with xylazine. There was no significant difference between the BIS values recorded at end-tidal sevoflurane concentrations of 2.8% (median 60 ranging from 47 to 68) and 3.5% (median 71 ranging from 49 to 82) in anesthetized horses. These BIS values during anesthesia were significantly lower (P<0.01) than those in awake horses (median 98 ranging from 98 to 98) or sedated horses (median 92 ranging from 80 to 93). During the recovery phase, the BIS values gradually increased over time but did not significantly increase until the horses showed movement. In conclusion, the BIS value could be useful as an indicator of awakening during the recovery period in horses, as previous reported. PMID:27974877

  20. Comparison of bispectral index and composite auditory evoked potential index for monitoring depth of hypnosis in children.

    Science.gov (United States)

    Blussé van Oud-Alblas, Heleen J; Peters, Jeroen W B; de Leeuw, Tom G; Tibboel, Dick; Klein, Jan; Weber, Frank

    2008-05-01

    In pediatric patients, the Bispectral Index (BIS), derived from the electroencephalogram, and the composite A-Line autoregressive index (cAAI), derived from auditory evoked potentials and the electroencephalogram, have been used as measurements of depth of hypnosis during anesthesia. The performance and reliability of BIS and cAAI in distinguishing different hypnotic states in children, as evaluated with the University of Michigan Sedation Scale, were compared. Thirty-nine children (aged 2-16 yr) scheduled to undergo elective inguinal hernia surgery were studied. For all patients, standardized anesthesia was used. Prediction probabilities of BIS and cAAI versus the University of Michigan Sedation Scale and sensitivity/specificity were calculated. Prediction probabilities for BIS and cAAI during induction were 0.84 for both and during emergence were 0.75 and 0.74, respectively. At loss of consciousness, the median BIS remained unaltered (94 to 90; not significant), whereas cAAI values decreased (60 to 43; P hypnosis in children. Both indices, however, showed considerable overlap for different clinical conditions.

  1. Can bispectral index or auditory evoked potential index predict implicit memory during propofol-induced sedation?

    Institute of Scientific and Technical Information of China (English)

    WANG Yun; YUE Yun; SUN Yong-hai; WU An-shi

    2006-01-01

    Background Some patients still suffer from implicit memory of intraoperative events under adequate depth of anaesthesia. The elimination of implicit memory should be a necessary aim of clinical general anaesthesia.However, implicit memory cannot be tested during anaesthesia yet. We propose bispectral index (BIS) and auditory evoked potential index (AEPI), as predictors of implicit memory during anaesthesia.Methods Thirty-six patients were equally divided into 3 groups according to the Observer's Assessment of Alertness/Sedation Score: A, level 3; B, level 2 ;and C, level 1. Every patient was given the first auditory stimulus before sedation. Then every patient received the second auditory stimulus after the target level of sedation had been reached. BIS and AEPI were monitored before and after the second auditory stimulus presentation. Four hours later, the inclusion test and exclusion test were performed on the ward using process dissociation procedure and the scores of implicit memory estimated.Results In groups A and B but not C, implicit memory estimates were statistically greater than zero (P<0.05).The implicit memory scores in group A did not differ significantly from those in group B (P>0.05). Implicit memory scores correlated with BIS and AEPI (P<0.01). The area under ROC curve is BIS> AEPI. The 95% cutoff points of BIS and AEPI for predicting implicit memory are 47 and 28, respectively.Conclusions Implicit memory does not disappear until the depth of sedation increases to level 1 of OAA/S score. Implicit memory scores correlate well with BIS and AEPI during sedation. BIS is a better index for predicting implicit memory than AEPI during propofol induced sedation.

  2. Utility of Bispectral Index (BIS) monotoring during general anesthesia

    OpenAIRE

    Lindholm, Maj-Lis

    2009-01-01

    p>The possibility to objectively measure effects from anesthetics on the level of consciousness has since long been desired. General anesthetics cause changes in brain electrical activity, seen as changes in the electroencephalogram (EEG). Devices utilizing processed EEG for pseudo-quantification of anesthetic depth have been available for more than ten years. These monitors display the anesthetic, or rather, hypnotic depth as an index number. In this thesis, some aspects ...

  3. Evaluation of the Adequacy of General Anesthesia in Cesarean Section by Bispectral Index

    Directory of Open Access Journals (Sweden)

    Sayed Mohammad Reza Hadavi

    2013-09-01

    Full Text Available Background: Awareness and recall, though not common, are the major hazards of general anesthesia, especially in Cesarean section (C/S because of the absence of benzodiazepine and opioids for a significant time during anesthesia. In this study, the Bispectral Index (BIS, end-tidal isoflurane, and hemodynamic parameters were examined to evaluate the depth of the routine general anesthetic technique in C/S. Methods: This study was carried out on 60 parturient patients undergoing elective C/S. A standardized anesthetic technique was applied: induction with Thiopental (4-5 mg/kg and Succinylcholine (1.5-2 mg/kg as well as maintenance with O2, N2O, and isoflurane. Electrocardiogram, heart rate, blood pressure, Spo2, end-tidal isoflurane concentration, BIS, and any clinical signs of inadequate depth of anesthesia such as movement, sweating, lacrimation, coughing, and jerking were continuously monitored and recorded at 16 fixed time points during anesthesia. Results: A median BIS of less than 70 (range: 42-68 was obtained on all occasions during surgery; however, at each milestone, at least 20% of the patients had BIS values above 60. Hemodynamic parameters increased significantly in some patients, especially during laryngoscopy and intubation. No patient experienced recall or awareness. Conclusion: The currently used general anesthetic technique in our center appears inadequate in some milestones to reliably produce BIS values less than 60, which are associated with lower risk of awareness. Therefore, with respect to such desirable outcomes as good Apgar and clinical status in neonates, we would recommend the application of this method (if confirmed by further studies through larger dosages of anesthetic agents.

  4. [EEG bispectral index as an indicator of the electrical activity of the central nervous system in children during anesthetic maintenance and intensive care].

    Science.gov (United States)

    Lazarev, V V; Subbotin, V V

    2009-01-01

    The paper presents different investigators' data on the use of the bispectral (BIS) index in children during anesthetic maintenance and intensive care. The most of publications deal with the use of the BIS index during anesthesia with sevoflurane, which shows its high efficiency in estimating the depth of sleep. There are positive aspects in the use of the BIS index in the evaluation of sedative tolerance and central nervous system function, when brain death is diagnosed, cerebral oxygenation adequateness, etc. Data are given on the ambiguity of BIS index values in infants less than a year of age.

  5. Comparison of the ability of wavelet index and bispectral index for reflecting regain of consciousness in patients undergone surgery

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xiao-tong; CHENG Hao; XIONG Wei; WANG Bao-guo

    2010-01-01

    Background Wavelet index (WLI) is a new parameter for monitoring depth of anesthesia based on Wavelet analysis.We observed the change of WLI and bispectral index (BIS) in patients regain of consciousness (ROC) in the absence of frontalis electromyographic (EMG) interference. The aim of this study was to compare the ability of WLI and BIS for reflecting ROC in patients undergone surgery.Methods Twelve patients who were scheduled for maxillofacial surgeries were enrolled in the study. BIS and WLI values were monitored continually. After being given midazolam and remifentanil, patients were asked to squeeze the investigator's hand ever 30 seconds. Patients were continuously given propofol until loss of consciousness (LOC1).Tunstall's isolated forearm technique was used to test the surgical consciousness in patients. After total muscle relaxation,endotracheal intubations were performed, and the patients were connected to a ventilator. Then, propofol was withdrawn until the patients showed regain of consciousness (ROC1) and an awareness reaction. After the command test, patients were readministered with propofol until loss of consciousness (LOC2). After surgery, all of the sedatives were withdrawn,and the patients were let to regain consciousness (ROC2).Results The BIS values of twelve patients at ROC1 after using muscle relaxant were much lower than those at LOC1 and ROC2 without using muscle relaxant, showing statistical significance (P <0.05). Meanwhile, the WLI values of twelve patients at ROC1 after using muscle relaxant were much higher than those at LOC1 and equal to ROC2 without using muscle relaxant, showing statistical significances (P <0.05) between ROC1 and LOC1.Conclusions This study showed that under muscle relaxation or facial paralysis, when there is no EMG signal, BIS can not accurately reflect regain of consciousness in surgical patients, but WLI can reflect it accurately. So WLI may have advantages for reflecting state of consciousness in surgical

  6. Prediction of Bispectral Index during Target-controlled Infusion of Propofol and Remifentanil: A Deep Learning Approach.

    Science.gov (United States)

    Lee, Hyung-Chul; Ryu, Ho-Geol; Chung, Eun-Jin; Jung, Chul-Woo

    2017-09-27

    The discrepancy between predicted effect-site concentration and measured bispectral index is problematic during intravenous anesthesia with target-controlled infusion of propofol and remifentanil. We hypothesized that bispectral index during total intravenous anesthesia would be more accurately predicted by a deep learning approach. Long short-term memory and the feed-forward neural network were sequenced to simulate the pharmacokinetic and pharmacodynamic parts of an empirical model, respectively, to predict intraoperative bispectral index during combined use of propofol and remifentanil. Inputs of long short-term memory were infusion histories of propofol and remifentanil, which were retrieved from target-controlled infusion pumps for 1,800 s at 10-s intervals. Inputs of the feed-forward network were the outputs of long short-term memory and demographic data such as age, sex, weight, and height. The final output of the feed-forward network was the bispectral index. The performance of bispectral index prediction was compared between the deep learning model and previously reported response surface model. The model hyperparameters comprised 8 memory cells in the long short-term memory layer and 16 nodes in the hidden layer of the feed-forward network. The model training and testing were performed with separate data sets of 131 and 100 cases. The concordance correlation coefficient (95% CI) were 0.561 (0.560 to 0.562) in the deep learning model, which was significantly larger than that in the response surface model (0.265 [0.263 to 0.266], P deep learning model-predicted bispectral index during target-controlled infusion of propofol and remifentanil more accurately compared to the traditional model. The deep learning approach in anesthetic pharmacology seems promising because of its excellent performance and extensibility.

  7. Bispectral index monitoring for conscious sedation in intervention: better, safer, faster

    Energy Technology Data Exchange (ETDEWEB)

    Bell, J.K.; Laasch, H.-U.; Wilbraham, L.; England, R.E.; Morris, J.A.; Martin, D.F. E-mail: derrick.martin@smtr.nhs.uk

    2004-12-01

    AIM: The aim of this study was to compare subjective (Ramsay sedation score, RSS) with objective electroencephalogram-based bispectral index (BIS) assessment, and to validate the appropriate BIS range for measurement of conscious sedation in interventional procedures. MATERIALS AND METHODS: One hundred patients undergoing sedo-analgesia (midazolam and fentanyl) for interventional gastrointestinal procedures were divided into two groups. In group A (n=30) sedation was guided by the RSS with the operator blinded to the BIS recording. In group B (n=70) the operator titrated intravenous sedation to maintain an optimal BIS, predetermined from the results in group A. Recovery time, procedure duration, physiological parameters and unplanned events were recorded in both groups. RESULTS: There was a significant correlation between the BIS and RSS (p<0.001). BIS values of 87.2 and 80.9 corresponded to an RSS of 3 and 4, respectively. The optimal BIS level was defined as 80-85. Fifty-seven point five percent of readings were within this range in group B compared with 26.5% in group A (p<0.001). Sedation approaching general anaesthesia (BIS<60) occurred in 5.5% of patients in group A but not in group B. Mean recovery time, duration of procedure, midazolam and fentanyl doses were significantly reduced in group B. Unplanned events were reduced from 27 to 17%, but this was not statistically significant (p=0.29). CONCLUSION: BIS monitoring enables more effective titration of sedatives to maintain a suitable level of consciousness, whilst reducing procedure time. The BIS offers an objective, safe and reliable measure of sedation, without disturbing either patient or operator. BIS monitoring raises the standard of patient care, and in our view, should be used to augment standard assessment.

  8. Monitoring sleep depth: analysis of bispectral index (BIS) based on polysomnographic recordings and sleep deprivation.

    Science.gov (United States)

    Giménez, Sandra; Romero, Sergio; Alonso, Joan Francesc; Mañanas, Miguel Ángel; Pujol, Anna; Baxarias, Pilar; Antonijoan, Rosa Maria

    2017-02-01

    The assessment and management of sleep are increasingly recommended in the clinical practice. Polysomnography (PSG) is considered the gold standard test to monitor sleep objectively, but some practical and technical constraints exist due to environmental and patient considerations. Bispectral index (BIS) monitoring is commonly used in clinical practice for guiding anesthetic administration and provides an index based on relationships between EEG components. Due to similarities in EEG synchronization between anesthesia and sleep, several studies have assessed BIS as a sleep monitor with contradictory results. The aim of this study was to evaluate objectively both the feasibility and reliability of BIS for sleep monitoring through a robust methodology, which included full PSG recordings at a baseline situation and after 40 h of sleep deprivation. Results confirmed that the BIS index was highly correlated with the hypnogram (0.89 ± 0.02), showing a progressive decrease as sleep deepened, and an increase during REM sleep (awake: 91.77 ± 8.42; stage N1: 83.95 ± 11.05; stage N2: 71.71 ± 11.99; stage N3: 42.41 ± 9.14; REM: 80.11 ± 8.73). Mean and median BIS values were lower in the post-deprivation night than in the baseline night, showing statistical differences for the slow wave sleep (baseline: 42.41 ± 9.14 vs. post-deprivation: 39.49 ± 10.27; p = 0.02). BIS scores were able to discriminate properly between deep (N3) and light (N1, N2) sleep. BIS values during REM overlapped those of other sleep stages, although EMG activity provided by the BIS monitor could help to identify REM sleep if needed. In conclusion, BIS monitors could provide a useful measure of sleep depth in especially particular situations such as intensive care units, and they could be used as an alternative for sleep monitoring in order to reduce PSG-derived costs and to increase capacity in ambulatory care.

  9. Effect of rocuronium on the bispectral index under anesthesia and tracheal intubation

    Science.gov (United States)

    Yue, Hui; Han, Jinyu; Liu, Ling; Wang, Kaiyuan; Li, Jincheng

    2016-01-01

    The aim of the present study was to investigate the effect of various doses of rocuronium on bispectral index (BIS) responses to propofol induction and tracheal intubation, as well as the role of the non-depolarization muscle relaxant rocuronium on the depth of sedation. A total of 72 patients (American Society of Anesthesiologists physical status I–II) were anaesthetized with propofol using a target-controlled infusion, and randomly divided into two sedation level groups (n=36). The patients were divided into 2 groups according to the BIS value: A normal sedation group (group 1), with a stable BIS value at 40–60, and a deep sedation group (group 2), with a BIS value <20 or with burst suppression. Each group was randomly divided into 4 subgroups A-D (n=9) according to the various doses of rocuronium (0.3, 0.6, 0.9 and 1.2 mg/kg). Tracheal intubation was performed after 2 min of rocuronium administration. BIS, electromyography (EMG), heart rate (HR) and mean arterial pressure (MAP) were recorded continuously and averaged over 1 min during baseline (T1), steady state (T2), 2 min after rocuronium infusion (T3), and 0, 2 and 5 min after tracheal intubation. The results demonstrated that HR and MAP decreased significantly at T2 and T3 compared with T1. Following tracheal intubation (L0), HR and MAP significantly increased compared with T2 and T3, and returned to levels similar to those prior to intubation after 5 min. In group 1C and 1D, BIS was significantly decreased at T3 compared with T2; BIS was significantly increased at L0 compared with T3 in group 1A and 1B. EMG at earlier stages of anesthesia was significantly higher compared with other points, and was significantly increased at L0 compared with T3 in group 1A and 1B. These results demonstrated that BIS response may be associated with the dosage of rocuronium in the normal sedation group, although no association was observed with the deep sedation group. Tracheal intubation resulted in marked hemodynamic

  10. The effects of bispectral index monitoring on hemodynamics and recovery profile in developmentally delayed pediatric patients undergoing dental surgery.

    Science.gov (United States)

    Sargin, Mehmet; Uluer, Mehmet Selcuk; Ozmen, Sadık

    2015-09-01

    General anesthesia is often preferred for dental surgery or rehabilitation in developmentally delayed pediatric patients. Bispectral index monitoring is used to monitor the depth of anesthesia and to ensure early recovery. However, studies on the topic in developmentally delayed pediatric patients are limited. To evaluate the effects of Bispectral Index Scale (BIS) on hemodynamics and recovery profile in developmentally delayed pediatric patients undergoing dental surgery. Forty children between the ages of 6-16 years were studied in this prospective and randomized study. The children were randomized into two groups. In Group 1 (n = 20), general anesthesia was maintained with 1-2 minimum alveolar concentration (MAC) of sevoflurane in oxygen by standard practice. In Group 2 (n = 20), the depth of anesthesia was monitored by BIS. BIS values were continuously recorded from awake status to tracheal extubation. The duration of the surgical procedure, anesthesia, postanesthesia care unit (PACU) stay was noted. To evaluate recovery profile, time to spontaneous ventilation, extubation, open eyes, and PACU discharge were also noted. There were significant differences between recovery times and Non-communicating Children's Pain Checklist - Postoperative Version (NCCPC-PV) scores of two groups. Time to spontaneous ventilation [Difference in means (95% CI); 3.17 (1.79-4.54) P < 0.001], extubation [Difference in means (95% CI); 3.13 (1.66-4.60) P < 0.001], open eyes [Difference in means (95% CI); 3.97 (2.34-5.59) P < 0.001], and PACU stay time [Difference in means (95% CI); 23.55 (18.08-29.01) P < 0.001] were significantly shorter in Group 2. In conclusion, results suggest that routine BIS monitoring may be beneficial due to its favorable effects on the recovery profile in developmentally delayed pediatric patients. © 2015 John Wiley & Sons Ltd.

  11. Protocol for the "Michigan Awareness Control Study": A prospective, randomized, controlled trial comparing electronic alerts based on bispectral index monitoring or minimum alveolar concentration for the prevention of intraoperative awareness

    Directory of Open Access Journals (Sweden)

    Avidan Michael S

    2009-11-01

    Full Text Available Abstract Background The incidence of intraoperative awareness with explicit recall is 1-2/1000 cases in the United States. The Bispectral Index monitor is an electroencephalographic method of assessing anesthetic depth that has been shown in one prospective study to reduce the incidence of awareness in the high-risk population. In the B-Aware trial, the number needed to treat in order to prevent one case of awareness in the high-risk population was 138. Since the number needed to treat and the associated cost of treatment would be much higher in the general population, the efficacy of the Bispectral Index monitor in preventing awareness in all anesthetized patients needs to be clearly established. This is especially true given the findings of the B-Unaware trial, which demonstrated no significant difference between protocols based on the Bispectral Index monitor or minimum alveolar concentration for the reduction of awareness in high risk patients. Methods/Design To evaluate efficacy in the general population, we are conducting a prospective, randomized, controlled trial comparing the Bispectral Index monitor to a non-electroencephalographic gauge of anesthetic depth. The total recruitment for the study is targeted for 30,000 patients at both low and high risk for awareness. We have developed a novel algorithm that is capable of real-time analysis of our electronic perioperative information system. In one arm of the study, anesthesia providers will receive an electronic page if the Bispectral Index value is >60. In the other arm of the study, anesthesia providers will receive a page if the age-adjusted minimum alveolar concentration is Discussion Awareness during general anesthesia is a persistent problem and the role of the Bispectral Index monitor in its prevention is still unclear. The Michigan Awareness Control Study is the largest prospective trial of awareness prevention ever conducted. Trial Registration Clinical Trial NCT00689091

  12. BIS在氯胺酮联合咪达唑仑小儿麻醉深度中的监测价值评价%Evaluation on monitoring value of bispectral index in pediatric anesthesia depth of ketamine combined with midazolam

    Institute of Scientific and Technical Information of China (English)

    蔡军; 武玉清; 周成华; 周策; 陆富钊; 李鑫; 黄鹂; 李伟; 张永; 陈虎

    2012-01-01

    Objective To evaluate the value of bispectral index (BIS) monitor in pedo-oblique inguinal hernia operation through anesthesia by ketamine combined with midazolam . Methods Forty 2-to 6-year-old child patients undergoing pedo-oblique inguinal hernia surgery in 2011 were randomly divided into 2 groups; BIS group (B, n=20) and control group (C, n=20). In group B , we controlled the dosage of ketamine and midazolam by BIS monitor (78±5). In group C, we controlled the dosage of ketamine and midazolam by observation of haemodynamic reaction , respiratory rate and boby movement. Results Compared to group C , there is less haemodynamic fluctuation and shorter analepsia time and better sedation in group B. Conclusion BIS monitor could control the depth of anesthesia , shorten analepsia time by continuous and objective monitoring in pedo-oblique inguinal hernia operation , which results in better sedation in surgery and enhancementof pedo-patient comfort and safety.%目的 探讨脑电双频指数(bispectral index,BIS)在氯胺酮联合咪达唑仑进行小儿腹股沟斜疝手术麻醉深度监测中的应用价值.方法 选择择期行腹股沟斜疝手术的患儿40例,年龄2~6岁,ASAⅠ~Ⅱ级,随机分成 BIS监测组(B组)和对照组(C组).B组 (20例) 通过术中监测BIS数值,调整氯胺酮和咪达唑仑剂量使其维持在78±5;C组根据术中患儿的血流动力学反应、呼吸频率改变和出现体动反应来调整氯胺酮和咪达唑仑用量大小.结果 同C组相比,B组患儿镇静充分,血流动力学波动较小,术后苏醒时间缩短,有统计学意义(P<0.05).结论 应用BIS能连续、客观地监测并控制氯胺酮联合咪达唑仑进行小儿腹股沟斜疝手术的麻醉深度,缩短术后苏醒时间,有利于术中镇静及增强患儿的舒适感和安全性.

  13. Clinical vs. bispectral index-guided propofol induction of anesthesia: A comparative study

    Directory of Open Access Journals (Sweden)

    Snehdeep Arya

    2013-01-01

    Full Text Available Background: Clinically optimized focusing of drug administration to specific need of patient with bispectral index (BIS monitoring results in reduced dose and faster recovery of consciousness. This study was planned with an aim to study and compare the conventional clinical end point or BIS on the requirement of dosage of propofol, hemodynamic effects, and BIS alterations following propofol induction. Methods: 70 patients, ASA I and II, 20-60 years undergoing elective surgical procedure under general anesthesia with endotracheal intubation were selected and divided into two groups. Group A received (inj. fentanyl (2 μg/kg, followed 3 min later by inj. propofol at the rate of 30 mg/kg/hr infusion till the loss of response to verbal command while group B received inj. fentanyl (2 μg/kg, followed 3 min later by inj. propofol at the rate of 30 mg/kg/hr infusion. The end point of hypnosis was when the BIS value was sustained for 1 min at 48±2. The patients were intubated. Total induction dose of propofol was noted in each group. The value of BIS and hemodynamic parameters (heart rate, systolic/diastolic blood pressure were noted at the time of loss of consciousness, at the time of intubation, and 1 min after intubation, thereafter every minute for first 10 min and thereafter every 10 min till end of surgery. Any involuntary muscle activity such as jerky movements, dystonic posturing, and opisthotonos were also recorded. Results: The mean dose of propofol used in groups A and B were 1.85±0.48 mg/kg and 1.79±0.41 mg/kg, respectively. The dosage used in group B were less but not clinically significant (P=0.575. On comparing the dosage of propofol in males among the groups there was a significantly lower dosage of propofol required in group B (2.06±0.45 mg/kg and 1.83±0.32 mg/kg, respectively, P=0.016. This decrease however was not seen in female patients dosage being 1.65±0.44 mg/kg and 1.75±0.49 mg/kg, respectively (P=0.372. The hemodynamic

  14. The use of the bispectral index in the detection of pain in mechanically ventilated adults in the intensive care unit: A review of the literature

    Science.gov (United States)

    Coleman, Robin Marie; Tousignant-Laflamme, Yannick; Ouellet, Paul; Parenteau-Goudreault, Élizabeth; Cogan, Jennifer; Bourgault, Patricia

    2015-01-01

    BACKGROUND: Pain assessment is an immense challenge for clinicians, especially in the context of the intensive care unit, where the patient is often unable to communicate verbally. Several methods of pain assessment have been proposed to assess pain in this environment. These include both behavioural observation scales and evaluation of physiological measurements such as heart rate and blood pressure. Although numerous validation studies pertaining to behavioural observation scales have been published, several limitations associated with using these measures for pain assessment remain. Over the past few years, researchers have been interested in the use of the bispectral index monitoring system as a proxy for the evaluation of encephalography readings to assess the level of anesthesia and, potentially, analgesia. OBJECTIVES: To synthesize the main studies exploring the use of the bispectral index monitoring system for pain assessment, to guide future research in adults under sedation in the intensive care unit. METHOD: The EMBASE, Medline, CINAHL and PsycINFO databases were searched for studies published between 1996 and 2013 that evaluated the use of the bispectral index in assessing pain. RESULTS: Most studies conclude that nociceptive stimulation causes a significant increase in the bispectral index and revealed the importance of controlling certain confounding variables such as the level of sedation. DISCUSSION: Further studies are needed to clearly demonstrate the relationship between nociceptive stimuli and the bispectral index, as well as the specificity of the bispectral index in detecting pain. PMID:25050877

  15. Bispectral index detects intraoperative cerebral ischaemia during balloon assisted cerebral aneurysm coiling [v2; ref status: indexed, http://f1000r.es/2xs

    Directory of Open Access Journals (Sweden)

    Zoe Harclerode

    2014-02-01

    Full Text Available Bispectral index (BIS is a monitoring modality designed and used for monitoring depth of anaesthesia. We wish to report a case where BIS monitoring may have alerted us to a potential adverse neurological event during angiographic coiling of a cerebral aneurysm.

  16. Effect of a single dose of esmolol on the bispectral index to endotracheal intubation during desflurane anesthesia.

    Science.gov (United States)

    Choi, Eun Mi; Min, Kyeong Tae; Lee, Jeong Rim; Lee, Tai Kyung; Choi, Seung Ho

    2013-05-01

    In this prospective, randomized, double-blind, placebo-controlled trial, we investigated the effect of a single dose of esmolol on the bispectral index (BIS) to endotracheal intubation during desflurane anesthesia. After induction of anesthesia, 60 patients were mask-ventilated with desflurane (end-tidal 1 minimum alveolar concentration) for 5 min and then received either normal saline, esmolol 0.5 or 1 mg/kg, 1 min prior to intubation (control, esmolol-0.5 and esmolol-1 groups, n = 20/group). BIS, mean arterial pressure, and heart rate were measured prior to anesthesia induction and esmolol administration, immediately preceding intubation (time point 0), and every minute for 5 min after intubation (time point 1 to 5). At time point 0, 1 and 5, 5 ml of arterial blood was taken to measure plasma concentrations of norepinephrine and epinephrine. BIS increased significantly at 1 min after intubation when compared with pre-intubation values in all groups. Both mean arterial pressure and heart rate increased significantly 1 min after intubation when compared with preintubation values for all groups. Plasma epinephrine concentrations did not increase significantly after tracheal intubation in any of the groups. Norepinephrine increased at 1 min after intubation when compared with the preintubation values in the esmolol groups (P endotracheal intubation during desflurane anesthesia.

  17. Bispectral index monitoring as an adjunct to nurse-administered combined sedation during endoscopic retrograde cholangiopancreatography

    Institute of Scientific and Technical Information of China (English)

    Se Young Jang; Hyun Gu Park; Min Kyu Jung; Chang Min Cho; Soo Young Park; Seong Woo Jeon; Won Young Tak

    2012-01-01

    AIM:TO determine whether bispectral index (BIS)monitoring is useful for propofol administration for deep sedation during endoscopic retrograde cholangiopancreatography (ERCP).METHODS:Fifty-nine consecutive patients with a variety of reasons for ERCP who underwent the procedure at least twice between 1 July 2010 and 30 November 2010.This was a randomized cross-over study,in which each patient underwent ERCP twice,once with BIS monitoring and once with control monitoring.Whether BIS monitoring was done during the first or second ERCP procedure was random.Patients were intermittently administered a mixed regimen including midazolam,pethidine,and propofol by trained nurses.The nurse used a routine practice to monitor sedation using the Modified Observer's Assessment of Alertness/Sedation (MOAA/S) scale or the BIS monitoring.The total amount of midazolam and propofol used and serious side effects were compared between the BIS and control groups.RESULTS:The mean total propofol dose administered was 53.1 ± 32.2 mg in the BIS group and 54.9± 30.8 mg in the control group (P =0.673).The individual propofol dose received per minute during the ERCP procedure was 2.90 ± 1.83 mg/min in the BIS group and 3.44 ± 2.04 mg in the control group (P =0.103).The median value of the MOAA/S score during the maintenance phase of sedation was comparable for the two groups.The mean BIS values throughout the procedure (from insertion to removal of the endoscope) were 76.5 ± 8.7 for all 59 patients in using the BIS monitor.No significant differences in the frequency of < 80% oxygen saturation,hypotension (< 80 mmHg),or bradycardia (< 50 beats/min) were observed between the two study groups.Four cases of poor cooperation occurred,in which the procedure should be stopped to add the propofol dose.After adding the propofol,the procedure could be conducted successfully (one case in the BIS group,three cases in the control group).The endoscopist rated patient sedation as excellent for

  18. Bispectral index for monitoring anesthetic depth in patients with severe burns receiving target-controlled infusion of remifentanil and propofol.

    Science.gov (United States)

    Guo, Z G; Jia, X P; Wang, X Y; Li, P; Su, X J; Hao, J H

    2015-07-13

    This study evaluated the feasibility and effectiveness of using the bispectral index (BIS) to monitor anesthetic depth in patients with severe burns receiving intravenous target-controlled infusion (TCI) of remifentanil and propofol. We randomly assigned 80 patients undergoing elective escharectomy (depth in patients with severe burns receiving TCI of remifentanil and propofol during the perioperative period reduces propofol consumption and shortens the consciousness recovery time in patients.

  19. Changes to the bispectral index and regional cerebral blood flow in a sedative state, caused by midazolam administration

    OpenAIRE

    池田, 淳子; イケダ, ジュンコ; Junko, IKEDA

    2006-01-01

    Psychosedation, as used in the field of dentistry, is intended to provide trouble-free dental care while maintaining a proper level of sedation. One drug used in psychosedation is midazolam, which is known to have a strong amnestic effect. In the current research, I sought to clarify whether the bispectral index (BIS) using EEC analysis can be used for assessment of optimal sedation in psychosedation, and what effects midazolam has on the cerebrum's mechanism of memory. The subjects were 17 h...

  20. Comparison of bispectral index value induced by etomidate and propofol at same pharmacodynamics index%同等药效学指标下依托咪酯与丙泊酚脑电双频指数值的比较

    Institute of Scientific and Technical Information of China (English)

    马新刚; 刘芳; 岳云

    2009-01-01

    目的 研究靶控输注(target controlled infusion,TCI)依托咪酯使50%手术患者意识消失时血浆和效应室靶浓度(EC50)与脑电双频谱指数(bispectral index,BIS).同时比较达到相同的药效学指标(意识消失EC50)时,依托咪酯与丙泊酚的BIS值有无差异.方法 选择年龄18岁~64岁,ASA Ⅰ~Ⅱ的患者,不用任何术前药.靶控输注依托咪酯,以血浆靶浓度0.25 mg/L为起点,达到预期血浆靶浓度后每30秒递增0.03 mg/L,直至患者意识消失为止.采用概率单位回归分析方法计算患者意识消失时依托咪酯的血浆靶浓度和效应室靶浓度的EC05、EC50和EC95及其对应的BIS值.将所得BIS值与我们以前报道的丙泊酚意识消失时的BIS值进行比较.结果 择期手术患者TCI依托咪酯意识消失时的血浆靶浓度EC05、EC50和EC95分别是0.46 mg/L、0.59 ms/L、0.71 mg/L;效应室靶浓度的EC05、EC50和EC95分别是0.37 mg/L、0.51 mg/L、0.64 mg/L;5%、50%和95%患者意识消失时BIS分别是56、44、31.达到相同的药效学指标时(意识消失EC50),依托咪酯组的BIS值(44.50±9.96)明显低于丙泊酚组(57.93±11.28)(P<0.01).结论 择期手术患者TCI依托咪酯意识消失时血浆和效应室靶浓度EC50为0.59 mg/L和0.51 mg/L;依托咪酯组意识消失EC50的BIS值明显低于丙泊酚组.%Objective To measure the predicted plasma and effect-site EC50 and bispeetral index(BIS) of etomidate delivered with TCI,and to compare the difference in BIS value induced by etomidate and propofol at same pharmacodynamics index (EC50 of losing consciousness).Methods Forty seven patients scheduled for surgery were anesthetized with etomidate using TCI.TCL started to get a predicted plasma etomidate concentration of 0.25 mg/L,and increased by 0.03 mg/L every 30 s until patients lost their consciousness.A quantal response model(probit analysis) was used to calculate the predict plasma and effect-site EC50,EC50 and EC95 of etomidate,and the

  1. Comparison of dexmedetomidine and midazolam for conscious sedation in dental surgery monitored by bispectral index.

    Science.gov (United States)

    Fan, Tai Weng Victor; Ti, Lian Kah; Islam, Intekhab

    2013-07-01

    Although various sedative drugs in different regimens and given by different delivery routes have been used for conscious sedation, the ideal agent and regimen remain to be established. This study was designed to compare the efficacy (sedation, anxiolysis, analgesia, operating conditions, and patients' satisfaction) and safety of midazolam and dexmedetomidine as sedatives for dental procedures in a randomised, double-blind study in third molar and dental implant surgery. Sixty healthy patients who were American Society of Anesthesiologists (ASA) group I or II were enrolled and we recorded their personal details, the amount of drug used, their degree of satisfaction, duration of operation, and haemodynamic and respiratory variables. The two groups were comparable. The amount of local anaesthetic (p=0.11) and the duration of operation did not differ significantly (p=0.32). The patients in the dexmedetomidine group had a slower heart rate, lower systolic and diastolic pressure, and cooperated better. There were no significant differences in their respiratory rates, bispectral index, and total volume of drugs used. We conclude that dexmedetomidine works as well as midazolam for outpatient dental procedures and can be used as an alternative to midazolam.

  2. Benefit of general anesthesia monitored by bispectral index compared with monitoring guided only by clinical parameters. Systematic review and meta-analysis.

    Science.gov (United States)

    Oliveira, Carlos Rogério Degrandi; Bernardo, Wanderley Marques; Nunes, Victor Moisés

    The bispectral index parameter is used to guide the titration of general anesthesia; however, many studies have shown conflicting results regarding the benefits of bispectral index monitoring. The objective of this systematic review with meta-analysis is to evaluate the clinical impact of monitoring with the bispectral index parameter. The search for evidence in scientific information sources was conducted during December 2013 to January 2015, the following primary databases: Medline/PubMed, LILACS, Cochrane, CINAHL, Ovid, SCOPUS and TESES. The criteria for inclusion in the study were randomized controlled trials, comparing general anesthesia monitored, with bispectral index parameter with anesthesia guided solely by clinical parameters, and patients aged over 18 years. The criteria for exclusion were studies involving anesthesia or sedation for diagnostic procedures, and intraoperative wake-up test for surgery of the spine. The use of monitoring with the bispectral index has shown benefits reducing time to extubation, orientation in time and place, and discharge from both the operating room and post anesthetic care unit. The risk of nausea and vomiting after surgery was reduced by 12% in patients monitored with bispectral index. Occurred a reduction of 3% in the risk of cognitive impairment postoperatively at 3 months postoperatively and 6% reduction in the risk of postoperative delirium in patients monitored with bispectral index. Furthermore, the risk of intraoperative memory has been reduced by 1%. Clinically, anesthesia monitoring with the BIS can be justified because it allows advantages from reducing the recovery time after waking, mainly by reducing the administration of general anesthetics as well as the risk of adverse events. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  3. [Benefit of general anesthesia monitored by bispectral index compared with monitoring guided only by clinical parameters. Systematic review and meta-analysis].

    Science.gov (United States)

    Oliveira, Carlos Rogério Degrandi; Bernardo, Wanderley Marques; Nunes, Victor Moisés

    The bispectral index parameter is used to guide the titration of general anesthesia; however, many studies have shown conflicting results regarding the benefits of bispectral index monitoring. The objective of this systematic review with meta-analysis is to evaluate the clinical impact of monitoring with the bispectral index parameter. The search for evidence in scientific information sources was conducted during December 2013 to January 2015, the following primary databases: Medline/PubMed, LILACS, Cochrane, CINAHL, Ovid, SCOPUS and TESES. The criteria for inclusion in the study were randomized controlled trials, comparing general anesthesia monitored, with bispectral index parameter with anesthesia guided solely by clinical parameters, and patients aged over 18 years. The criteria for exclusion were studies involving anesthesia or sedation for diagnostic procedures, and intraoperative wake-up test for surgery of the spine. The use of monitoring with the bispectral index has shown benefits reducing time to extubation, orientation in time and place, and discharge from both the operating room and post anesthetic care unit. The risk of nausea and vomiting after surgery was reduced by 12% in patients monitored with bispectral index. Occurred a reduction of 3% in the risk of cognitive impairment postoperatively at 3 months postoperatively and 6% reduction in the risk of postoperative delirium in patients monitored with bispectral index. Furthermore, the risk of intraoperative memory has been reduced by 1%. Clinically, anesthesia monitoring with the BIS can be justified because it allows advantages from reducing the recovery time after waking, mainly by reducing the administration of general anesthetics as well as the risk of adverse events. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  4. Comparative effects of propofol, landiolol, and nicardipine on hemodynamic and bispectral index responses to endotracheal intubation: a prospective, randomized, double-blinded study.

    Science.gov (United States)

    Miyazaki, Masumi; Kadoi, Yuji; Takashi, Sudo; Sawano, Yukari; Shimada, Hitoshi

    2008-06-01

    To examine the comparative effects of propofol, landiolol, and nicardipine on hemodynamic responses and bispectral index (BIS) changes to endotracheal intubation. Operating room of a university-affiliated general hospital. 27 ASA physical status I and II patients who were scheduled to undergo elective general surgical, urological, or gynecological procedures with general anesthesia. Prospective, randomized, double-blinded study. Patients were divided into three groups as follows: Group 1 received propofol, 1 mg/kg; Group 2 received landiolol, 0.1 mg/kg; and Group 3 received nicardipine, 1 mg. After baseline measurements were recorded, anesthesia was induced with propofol, fentanyl, and vecuronium. Patients' lungs were ventilated with 100% oxygen for 120 seconds, at which time one of one of the study drugs was administered. Laryngoscopy and tracheal intubation were performed 4 minutes after anesthetic induction. Cardiac index (CI) and stroke volume index (SVI) were monitored continuously. Bispectral index was also monitored continuously from 5 minutes after tracheal intubation. Heart rate values in Group 3 increased 30 seconds after intubation; this increase lasted for 1 minute after intubation. Systolic blood pressure in all three groups decreased after induction of anesthesia and before tracheal intubation, and values returned closer to baseline values 30 seconds after intubation. In the propofol group, CI and SVI decreased after administration of additional propofol, lasting for 30 seconds after intubation. The BIS values rapidly decreased after induction of anesthesia, with no intergroup differences noted in BIS values (propofol group, 39+/-7; landiolol group, 44+/-14; nicardipine group, 41+/-9). However, BIS was significantly lower in the propofol group than in the other two groups from 30 seconds to 5 minutes after intubation. Landiolol, 0.1 mg/kg, before intubation provides effective hemodynamic stability in the postintubation period.

  5. Optimization of Deep Sedation with Spontaneous Respiration for Therapeutic Endoscopy Combining Propofol and Bispectral Index Monitoring

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    Kohei Matsumoto

    2015-01-01

    Full Text Available Background/Aims. This study aimed to establish optimal propofol anesthesia for therapeutic endoscopy, which has not been established. Methodology. We retrospectively investigated data on 89 patients who underwent upper-GI endoscopic submucosal dissection or endoscopic mucosal resection under anesthesia with propofol. Examined doses of propofol were changed according to efficacy and/or adverse events and classified into 5 periods. A bispectral index (BIS monitor was used at Period 5 to decrease the incidence of adverse events caused by oversedation. The initial dose of propofol was administered after bolus injection of pethidine hydrochloride (0.5 mg/kg, and 1.0 mL of propofol was added every minute until the patients fell asleep. Continuous and bolus infusion were performed to maintain sedation. When the patient moved or an adverse event occurred, the maintenance dose examined was increased or decreased by 5 mL/h regardless of body weight. Results. Dose combinations (introduction : maintenance and patient numbers for each period were as follows: Period 1 (n=27, 0.5 mg/kg : 5 mg/kg/h; Period 2 (n=11, 0.33 mg/kg : 3.3 mg/kg/h; Period 3 (n=7, 0.5 mg/kg : 3.3 mg/kg/h; Period 4 (n=14, 0.5 mg/kg : 2.5 mg/kg/h; Period 5 (n=30, 0.5 mg/kg : 2.5 mg/kg/h, using BIS monitor. During Period 5, an adverse event occurred in 10.0% of patients, which was lower than that for Periods 1–4. Conclusions. Period 5 propofol anesthesia with BIS protocol could be safe and useful for therapeutic endoscopy under deep sedation with spontaneous respiration.

  6. Bispectral index monitoring of a narcolepsy-cataplexy episode during regional anesthesia.

    Science.gov (United States)

    Dahaba, Ashraf A; Xu, Guo Xun; Liu, Qing Hai; Xue, Ji Xiu; Metzler, Helfried

    2009-02-01

    Narcolepsy or Gélineau syndrome is an extremely incapacitating chronic sleep disorder of unknown etiology that is characterized by uncontrollable attacks of deep sleep and is typically associated with cataplexy sudden loss of muscle tone. The Bispectral Index (BIS), an electroencephalographic-derived cerebral monitor, used for monitoring the effects of anesthetic/hypnotic drugs was shown to correlate to various conditions that could influence the eletroencephalogram. We assessed the utility of using BIS for monitoring a possible narcolepsy-cataplexy episode and whether a distinctive BIS profile might offer an early warning of an impending narcoleptic/cataplectic spell. We recorded both hemispheres, using two synchronized BIS-XP monitors, during a narcolepsy-cataplexy episode in a 57-yr-old male patient undergoing lower limb surgery under femoral nerve block regional anesthesia. The patient went through three stages: first a prodromal "intermittent low-vigilance" phase interrupted by high electromyographic activity. This was followed by a second "continuous low-vigilance" phase of BIS around 75 with low electromyographic activity, ending with a third "nonresponsive vigilance" phase of a full-blown narcolepsy-cataplexy episode of BIS around 45 with complete loss of muscle power. The purpose of presenting this report is to emphasize the fact that narcoleptic patients can still run the risk of loss of consciousness with atonia under regional anesthesia, and such an undesirable complication cannot be under-estimated. BIS monitoring is a simple method that could offer an early warning of an imminent episode, with its associated hazards, in patients with narcolepsy-cataplexy undergoing surgery under regional anesthesia.

  7. Feasibility of bispectral index-guided propofol infusion for flexible bronchoscopy sedation: a randomized controlled trial.

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    Yu-Lun Lo

    Full Text Available OBJECTIVES: There are safety issues associated with propofol use for flexible bronchoscopy (FB. The bispectral index (BIS correlates well with the level of consciousness. The aim of this study was to show that BIS-guided propofol infusion is safe and may provide better sedation, benefiting the patients and bronchoscopists. METHODS: After administering alfentanil bolus, 500 patients were randomized to either propofol infusion titrated to a BIS level of 65-75 (study group or incremental midazolam bolus based on clinical judgment to achieve moderate sedation. The primary endpoint was safety, while the secondary endpoints were recovery time, patient tolerance, and cooperation. RESULTS: The proportion of patients with hypoxemia or hypotensive events were not different in the 2 groups (study vs. control groups: 39.9% vs. 35.7%, p = 0.340; 7.4% vs. 4.4%, p = 0.159, respectively. The mean lowest blood pressure was lower in the study group. Logistic regression revealed male gender, higher American Society of Anesthesiologists physical status, and electrocautery were associated with hypoxemia, whereas lower propofol dose for induction was associated with hypotension in the study group. The study group had better global tolerance (p<0.001, less procedural interference by movement or cough (13.6% vs. 36.1%, p<0.001; 30.0% vs. 44.2%, p = 0.001, respectively, and shorter time to orientation and ambulation (11.7±10.2 min vs. 29.7±26.8 min, p<0.001; 30.0±18.2 min vs. 55.7±40.6 min, p<0.001, respectively compared to the control group. CONCLUSIONS: BIS-guided propofol infusion combined with alfentanil for FB sedation provides excellent patient tolerance, with fast recovery and less procedure interference. TRIAL REGISTRATION: ClinicalTrials. gov NCT00789815.

  8. Comparative study of Poincaré plot analysis using short electroencephalogram signals during anaesthesia with spectral edge frequency 95 and bispectral index.

    Science.gov (United States)

    Hayashi, K; Yamada, T; Sawa, T

    2015-03-01

    The return or Poincaré plot is a non-linear analytical approach in a two-dimensional plane, where a timed signal is plotted against itself after a time delay. Its scatter pattern reflects the randomness and variability in the signals. Quantification of a Poincaré plot of the electroencephalogram has potential to determine anaesthesia depth. We quantified the degree of dispersion (i.e. standard deviation, SD) along the diagonal line of the electroencephalogram-Poincaré plot (named as SD1/SD2), and compared SD1/SD2 values with spectral edge frequency 95 (SEF95) and bispectral index values. The regression analysis showed a tight linear regression equation with a coefficient of determination (R(2) ) value of 0.904 (p plot tightly correlates with SEF95, reflecting anaesthesia-dependent changes in electroencephalogram oscillation.

  9. Effect of a single dose of esmolol on the bispectral index to endotracheal intubation during desflurane anesthesia

    OpenAIRE

    Choi, Eun Mi; Min, Kyeong Tae; Lee, Jeong Rim; Lee, Tai Kyung; Choi, Seung Ho

    2013-01-01

    Background In this prospective, randomized, double-blind, placebo-controlled trial, we investigated the effect of a single dose of esmolol on the bispectral index (BIS) to endotracheal intubation during desflurane anesthesia. Methods After induction of anesthesia, 60 patients were mask-ventilated with desflurane (end-tidal 1 minimum alveolar concentration) for 5 min and then received either normal saline, esmolol 0.5 or 1 mg/kg, 1 min prior to intubation (control, esmolol-0.5 and esmolol-1 gr...

  10. Bispectral index monitoring in the management of sedation in an intensive care unit patient with locked-in syndrome.

    Science.gov (United States)

    Quraishi, Sadeq A; Blosser, Sandralee A; Cherry, Robert A

    2011-11-01

    Locked-in syndrome is an extremely rare neurological state caused by injury of the ventral pons. The syndrome is characterized by quadriplegia and anarthria with concomitant preservation of cortical function. When a reversible underlying pathological abnormality is identified and managed aggressively, meaningful recovery is possible. Because patients retain consciousness throughout their illness, a dependable method for titrating sedation may improve their quality of life. The case presented suggests that bispectral index monitoring may be a cost-effective and reliable method for managing sedation in patients with locked-in syndrome.

  11. BiSpectral Index (BIS monitoring may detect critical hypotension before automated non-invasive blood pressure (NIBP measurement during general anaesthesia; a case report. [v1; ref status: indexed, http://f1000r.es/2oi

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    Matthew M. J. Smith

    2014-01-01

    Full Text Available A patient undergoing general anaesthesia for neurosurgery exhibited an unexpected sudden decrease in the BiSpectral Index (BIS value to near-zero. This prompted the detection of profound hypotension using non-invasive blood pressure (NIBP measurement and expedited urgent assessment and treatment, with the patient making a full recovery. Widely regarded as a ‘depth of anaesthesia’ monitor, this case demonstrates the potential extra clinical benefit BIS may have in the detection of critical incidents such as anaphylaxis during general anaesthesia.

  12. The effect of atropine on the bispectral index response to endotracheal intubation during propofol and remifentanil anesthesia.

    Science.gov (United States)

    Kwak, Hyun Jeong; Moon, Bong Ki; Oh, Chang Keun; Chang, Young Jin; Kim, Hong Soon; Kim, Jong Yeop

    2013-04-01

    Atropine has been reported to increase the propofol requirements for the induction of anesthesia during continuous infusion of propofol. We investigated the influence of atropine on the bispectral index (BIS) response to endotracheal intubation during anesthetic induction with propofol and remifentanil target controlled infusion (TCI). Fifty-six patients aged 18-50 years undergoing general anesthesia, were enrolled. For induction of anesthesia, propofol TCI was set at a target effect-site concentration of 4.0 μg/ml. Two minutes later, remifentanil was started at an effect-site concentration of 4.0 ng/ml. Four minutes after the start of propofol TCI, patients received either atropine (10 μg/kg) or an equal volume of normal saline. Tracheal intubation was performed 10 min after anesthetic induction. Mean arterial pressure, HR, SpO2, and BIS were recorded during the 15 min-anesthesia induction. From 2 to 5 min after tracheal intubation, BIS was significantly higher in the atropine group than in the control group (p = 0.043, 0.033, 0.049, and 0.001, respectively). When compared with baseline values (immediately before intubation), BIS showed a significant increase at 1 min after intubation in both groups, without intergroup differences, whereas it decreased significantly from 4 to 5 min after intubation only in the control group. This study demonstrated that atropine maintained BIS increases in response to endotracheal intubation during anesthetic induction with propofol and remifentanil TCI, although the maximal response did not differ between the groups.

  13. Effects of Phenytoin Therapy on Bispectral Index and Haemodynamic Changes Following Induction and Tracheal Intubation

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    Parmod P Bithal

    2009-01-01

    Full Text Available Laryngoscopy and tracheal intubation (LTI increase blood pressure and heart rate (HR. Intensity of these changes is influenced by the anaesthetic depth assessed by the bispectral index (BIS. We determined the effect of phenytoin on anaesthetic depth and its influence on haemodynamics following LTI. Fifty patients of ASA grades I and II on oral phenytoin 200 to 300mg per day for more than one week were compared with 48 control patients. Standard anaesthesia technique was followed. BIS, non invasive mean blood pressure (MBP and HR were recorded 30, 60, 90 and 120 sec after LTI. Phenytoin group needed lesser thiopentone for induction, 5 mg (1.1 vs. 4.3 mg (0.7 [p=0.036]. BIS was significantly lower in the phenytoin group vs. the control 30, 60, 90 and 120 sec after LTI [43.1 (16.0 vs. 48.9 (14.9, p=0.068, 56.3 (16.7 vs. 64.3 (14.4, p=0.013, 59.8 (15.8 vs. 67.5 (12.1, p=0.008, 62.6 (14 vs. 68.9 (11.2, p=0.017, and 64.2 (11.3 vs. 69 (11.7, p=0.033], respectively. MBP was also lower in the phenytoin group 30, 60, 90 and 120 sec after LTI [112.8 mmHg (13.8, vs. 117.9 mmHg (18 p=0.013, 108.6 (12.8 vs. 117.5 (16 p=0.003, 106.1 mmHg (14.1 vs. 113.2 mmHg (14.9, p=0.017, 101.8 mmHg (13.8 vs. 109.5 mmHg (14.1, p=0.007], respectively. HR was lower in phenytoin group at 30 sec. (p=0.027, 60 sec (p=0.219, and again at 120 sec (p=0.022. Oral phenytoin therapy for over a week results in greater anaesthetic depth as observed using BIS, which also attenuated haemodynamic response of LTI.

  14. Quando o índice bispectral (BIS pode fornecer valores espúrios Cuando el índice bispectral (BIS puede suministrar valores falsos When the bispectral index (Bis can give false results

    Directory of Open Access Journals (Sweden)

    Leonardo Teixeira Domingues Duarte

    2009-02-01

    profundidad de la anestesia, reduce el aparecimiento del despertar y memoria intraoperatoria. Esa revisión tuvo el objetivo de presentar situaciones clínicas en que el BIS denota valores no verdaderos, que están falsamente elevados o reducidos, debido a condiciones del paciente o a acciones de anestésicos no previstos cuando se elaboró su algoritmo. CONTENIDO: Los valores del BIS pueden sufrir la alteración y el influjo en múltiples situaciones clínicas en que existen estándares anormales del EEG; efecto de diferentes anestésicos y otros fármacos no incluidos en la elaboración de su algoritmo; interferencia por equipos eléctricos; o debido a peculiaridades del monitor. CONCLUSIÓN: A pesar de que el algoritmo del BIS haya sufrido diversas alteraciones desde su primera versión, esas situaciones que determinan variaciones falsas de los valores del BIS, deben ser reconocidas por el anestesiólogo para evitar complicaciones, sean a causa de la sobredosis anestésica, o por subdosis que podrán causar el despertar y la memoria intraoperatoria.BACKGROUND AND OBJECTIVES: The bispectral index (BIS is a multifactorial parameter derived from the electroencephalogram (EEG, which allows monitoring of the hypnotic component of anesthesia. It was obtained from the algorithm based on the analysis of a large number of EEGs from volunteers and patients undergoing sedation and general anesthesia with different anesthetic agents. The use of BIS to monitor the depth of anesthesia reduces the incidence of intraoperative awakening and recall, among other benefits. The objective of this review was to present clinical situations in which the BIS gives false results, either elevated or decreased, due to conditions related to the patient or anesthetic actions unforeseen when the algorithm was elaborated. CONTENTS: The bispectral index can be altered and influenced in different clinical situations in which abnormal EEG patterns are present; the effects of different anesthetics and other

  15. Evaluation of entropy for monitoring the depth of anesthesia compared with bispectral index: a multicenter clinical trial

    Institute of Scientific and Technical Information of China (English)

    GAO Jian-dong; DING Qian; TAN Zhi-ming; ZHU Zhi-rong; YUE Yun; ZHAO Yu-jie; XU Chen-shi; ZHAO Jing; HUANG Yu-guang; WANG Tian-long; PEI Ling; WANG Jian; YAO Li-nong

    2012-01-01

    Background As a new electroencephalogram (EEG) signal processing technique for monitoring the depth of anesthesia,entropy consists of two indices:reaction entropy (RE) and state entropy (SE).Our study compared entropy with classical bispectral index (BIS) in reduction of myoelectrical interference and noxious stimuli with EEG signals.Methods Two hundred and eighty patients (ASA Ⅰ-Ⅱ,18-60 years old) undergoing scheduled surgeries from seven medical centers were enrolled.Anesthesia induction was managed with propofol via the target-controlled infusion (TCI)system.The results of BIS,RE,SE,mean arterial pressure (MAP) and heart rate (HR) were recorded before anesthesia induction,at the moment of unconsciousness,before and 2 minutes after administration of muscle relaxant,and before and one and three minutes after the tracheal intubation.Results The values of half maximum effective concentrations (EC50),5% effective concentrations (EC05) and 95% effective concentrations (EC95) of propofol effect-site concentration at the onset of unconsciousness were 1.2 (1.1-1.3μg/ml),2.5 (2.4-2.5 μg/ml) and 3.7 (3.7-3.8 μg/ml),while those of the predicted plasma propofol concentration were 2.8 (2.7-2.9 μg/ml),3.9 (3.8-3:9 μg/ml) and 4.9 (4.8-5.0 μg/ml),respectively.The values of BIS,SE and RE were 62,59 and 63 when 50% of patients lost consciousness,and 79,80,85 and 42,37,44,respectively,when 5% and 95% of patients were unconscious.The values of BIS,RE and SE dropped two minutes after the injection of muscle relaxant,but there were no significant differences between RE and SE.MAP and HR increased visibly,which indicated a reaction to tracheal intubation; the values of BIS,RE and SE,however,did not display any significant changes.Conclusions This large-sample multicentric study confirmed the values of RE and SE as approximating BIS value,at the onset of unconsciousness during propofol TCI anesthesia.After elimination of myoelectrical activation,all values of RE

  16. [Is there an appropriate bispectral index for upper gastrointestinal endoscopy in spontaneous breathing in the pediatric patient?].

    Science.gov (United States)

    Alados-Arboledas, F J; Millán-Bueno, M P; Expósito-Montes, J F; Arévalo-Garrido, A; Pérez-Parras, A; de la Cruz-Moreno, J

    2015-03-01

    The bispectral index (BIS) values that predict appropriate anesthetic level to perform an upper gastrointestinal endoscopy in spontaneous breathing are not well established in Pediatrics. The objective of this study is to determine whether it is possible to find an appropriate, less profound, BIS level in the pediatric patient that would enable an upper gastrointestinal endoscopy (UGE) to be performed in spontaneous breathing without causing gag reflex or motor response. A prospective study was designed and included 61 patients from 12-167 months old, and an ASAI-II who needed a diagnostic UGE. The study was conducted from October 2011 to March 2013. UGE performed with an anesthetic protocol using propofol. The vital signs measured were heart and respiratory rate, pulse oximetry, non-invasive blood pressure. The sedation level score (Ramsay scale) and BIS values were also measured. The first attempt was performed at BIS level 60-69, and this was not feasible, then the anesthetic was deepened and a second attempt made at BIS level 50-59. If this was still not possible a deeper anesthetic level was then achieved and a third attempt made at BIS level 45-49. Variables of interest were: effective BIS level (eBIS), BIS level at which UGE was performed without gag reflex or motor response; propofol total dose (mgkg(-1)), induction time (time from onset of sedation to effective start of UGE). A logistic regression analysis was performed to obtain an equation to estimate the possibility of UGE success. The distribution of the patient was: male 40%, female 60%, with 11 (18%) patients under 36 months. The statistical values are expressed as mean and standard deviation, with following results; age (months): 95.9±45.86; weight (kg): 30.5±14.68; effective BIS: 56.41±4.63; induction time (minutes): 11.07±2.69; total propofol dose (per kg): 4.86±1.21. An additional intra-procedure propofol bolus was given in 38 patients (62%), with 7/38 of them (18%) due to movement, and 31

  17. Evaluation of entropy and bispectral index values for monitoring depth of sevoflurane anesthesia in children with cerebral palsy%熵指数和脑电双频指数用于脑瘫患儿七氟醚麻醉时镇静深度监测的评价

    Institute of Scientific and Technical Information of China (English)

    周丽萍; 贾乃光; 张亚军

    2012-01-01

    目的:通过熵指数和脑电双频指数(BIS)在脑瘫患儿七氟醚麻醉时与镇静深度的相关性和预测作用,评价熵指数和BIS用于脑瘫患儿镇静程度监测的准确性.方法:选择ASA Ⅰ或Ⅱ级、5~15岁择期在全身麻醉下行选择性周围神经缩窄术的脑瘫患儿25例.经面罩吸入5%七氟醚和N2O/O2:70%/30%.记录清醒时改良警觉/镇静评分(mOAAS)各阶段的反应熵(RE)、状态熵(SE) 、BIS、无创血压(NIBP)、平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SPO2).RE、SE、BIS与mOAAS评分的关系采用Spearman's等级相关进行分析.计算RE、SE、BIS、MAP、HR、SPO2对镇静深度的预测概率.结果:脑瘫患儿RE、SE 、BIS与mOAAS评分密切相关,明显优于MAP、HR、SPO2.RE、SE、BIS对镇静深度的预测概率(Pk)值明显高于MAP、HR、SPO2(P<0.01).结论:RE、SE、BIS均可以在脑瘫患儿七氟醚-笑气麻醉中反应镇静深度.%Objective:To evaluate the accuracy of entropy and bispectral index (BIS)for monitoring depth of sevoflurane anesthesia in children with cerebral palsy .Methods:Twenty-five ASA I or II children aged 5-15 years undergoing elective surgery of peripheral neurotomy were enrolled in this study.Anesthesia were induced with 5% sevoflurane and 70% nitrous oxide in oxygen,Rresponse entropy(RE),state entropy(SE),BIS,non-invasive blood pressure (NIBP) t mean artery pressure (MAP), heart rate(HR)and pulse oxygen saturation (SPO2) values in awake and each stage of mOAAS (modified Observer's Assessment of Alertness/Sedation score)were recorded during the induction of anesthesia.The correlation between the different electroencephalographic indices (SE,RE and BIS) and mOAA/S were calculated by nonparainetric Spearman's rank-correlation analysis and analyzed with prediction probability (Pk).Results:RE,SE and BIS were significantly better correlated with mOAA/S score than MAP,HR and SPO2 in children with cerebral palsy,The Pk values of RE,SE and

  18. The Entropy Module and Bispectral Index as guidance for propofol-remifentanil anaesthesia in combination with regional anaesthesia compared with a standard clinical practice group.

    NARCIS (Netherlands)

    Ellerkmann, R.K.; Soehle, M.; Riese, G.; Zinserling, J.; Wirz, S.; Hoeft, A.; Bruhn, J.

    2010-01-01

    This study was designed to investigate the impact of the Entropy Module and Bispectral Index (BIS) monitoring on drug consumption and recovery times compared with standard anaesthetic practice in patients undergoing orthopaedic surgery using a combination of regional and general anaesthesia as perfo

  19. The Entropy Module and Bispectral Index as guidance for propofol-remifentanil anaesthesia in combination with regional anaesthesia compared with a standard clinical practice group.

    NARCIS (Netherlands)

    Ellerkmann, R.K.; Soehle, M.; Riese, G.; Zinserling, J.; Wirz, S.; Hoeft, A.; Bruhn, J.

    2010-01-01

    This study was designed to investigate the impact of the Entropy Module and Bispectral Index (BIS) monitoring on drug consumption and recovery times compared with standard anaesthetic practice in patients undergoing orthopaedic surgery using a combination of regional and general anaesthesia as perfo

  20. The accuracy and clinical feasibility of a new Bayesian-based closed-loop control system for propofol administration using the bispectral index as a controlled variable

    NARCIS (Netherlands)

    De Smet, Tom; Struys, Michel M. R. F.; Neckebroek, Martine M.; Van den Hauwe, Kristof; Bonte, Sjoert; Mortier, Eric P.

    2008-01-01

    BACKGROUND: Closed-loop control of the hypnotic component of anesthesia has been proposed in an attempt to optimize drug delivery. Here, we introduce a newly developed Bayesian-based, patient-individualized, model-based, adaptive control method for bispectral index (BIS) guided propofol infusion

  1. Bispectral index monitoring prevent awareness during total intravenous anesthesia: a prospective, randomized,double-blinded, multi-center controlled trial

    Institute of Scientific and Technical Information of China (English)

    ZHANG Chen; GUO Jian-rong; JIN Yao-jun; WU Gang; YUAN Wei; YUAN Zhi-guo; YUE Yun; XU Liang; MA Ya-qun; SUN Yan-xia; LI Yan-hong; ZHANG Liang; FENG Chun-sheng; LUO Bing; ZHAO Zhen-long

    2011-01-01

    Background Awareness is a serious complication of general anesthesia.In China,the incidence of intraoperative awareness was 1% in patients undergoing total intravenous anesthesia (TIVA).In this study,we compared the incidence of awareness between Bispectral index (BIS)-guided and routine TIVA protocol and evaluated the effect of BIS on preventing awareness.Methods A prospective,randomized,double-blinded,multicenter controlled trial was performed.Patients (≥18 years of age) undergoing TIVA were randomly divided into BIS-guided group (Group A,BIS was monitored and recommended to maintain between 40-60) and control group (Group B,BIS was monitored but the screen was covered).The intraoperative BIS values were downloaded and the BIS trends of confirmed awareness cases were analyzed to determine whether light anesthesia existed.Results Of the total 5228 patients,2919 patients were assigned to Group A and 2309 to Group B.Four cases of confirmed awareness (0.14%) were reported in the BIS-guided group and 15 (0.65%) in the control group (P=0.002,OR=0.21,95% confidence intervals:0.07-0.63).The incidence of possible awareness (0.14% vs.0.26%,P=0.485) and dreaming (3.1% vs.3.1%,P=0.986) was comparable between BIS-guided group and the control group.Among the 19 confirmed awareness cases,intraoperative BIS trends of six cases were downloaded and identified.Five of them showed signs of light anesthesia as BIS >60 and lasted 19-106 minutes,whereas one case had a stable BIS trend and the values were within 60 during the operation.Another five awareness cases were reviewed for anesthesia procedures,of which improper light anesthesia were confirmed.Conclusions BIS-guided TIVA (BIS was recommended to maintain between 40-60) decreased the risk of awareness compared with routine TIVA.The main reason for awareness was light anesthesia.

  2. Observation of anesthesia depth in severe burn patients with target controlled infusion of propofol and remifentanil by bispectral index

    Directory of Open Access Journals (Sweden)

    Zheng-gang GUO

    2012-04-01

    Full Text Available Objective To evaluate the feasibility and efficiency of bispectral index (BIS for monitoring the anesthesia depth of severe burn patients with target controlled infusion (TCI of propofol and remifentanil. Methods A total of 80 severe burns patients undergoing eschar excision ( < 1week were randomly divided into BIS group (group A and control group (group B, with 40 cases assigned in each group. These patients were 18 years to 65 years old, ASAⅡ-Ⅲ. Their total burn surface areas (TBSA were from 31% to 50%, or 11% to 20% with three-degree burns. All patients received remifentanil and propofol for TCI intravenous anesthesia. The mean arterial pressure (MAP and heart rate (HR were determined at following time points, namely, entrance to the operation room, loss of consciousness, 2min after intubation, before surgery, 2, 15, and 30min after the start of surgery, end of surgery, eye opening, and period when Aldrete score reaching 9 points, as well as the target concentrations of remifentanil and propofol. The time frames from stoppage of drug infusion to eye opening and the period when Aldrete score reaching 9 points were also recorded. Results Compared with group B, the target concentrations of remifentanil (2.12±0.35ng/ml vs. 2.50±0.21ng/ml and propofol (2.54±0.22μg/ml vs. 2.86±0.31μg/ml were significantly lower in group A during anesthetic maintenance (P < 0.01. The time interval from stoppage of drug infusion to eye opening (7.90±0.58min vs. 8.35±0.66min and period when Aldrete score reaching 9 points (9.15±0.69min vs. 11.13±0.96min were significantly reduced in group A. The MAP of both groups from loss of consciousness at all time points, except 2min after intubation, was significantly lower than the basic values upon entrance into the operation room (P < 0.05. The HR at all time points were significantly lower compared with the basic data (P < 0.05. Conclusion BIS for monitoring the anesthetic depth of severe burns patients

  3. Cerebral state index during propofol anesthesia : A Comparison with the Bispectral Index and the A-Line ARX Index

    NARCIS (Netherlands)

    Jensen, EW; Litvan, H; Revuelta, M; Rodriguez, BE; Caminal, P; Martinez, P; Vereecke, H; Struys, MMRF

    2006-01-01

    Background: The objective of this study was to prospectively test the Cerebral State Index designed for measuring the depth of anesthesia. The Cerebral State Index is calculated using a fuzzy logic combination of four subparameters of the electroencephalographic signal. The performance of the Cerebr

  4. Relative reliability of the auditory evoked potential and Bispectral Index for monitoring sedation level in surgical intensive care patients.

    Science.gov (United States)

    Lu, C-H; Ou-Yang, H-Y; Man, K-M; Hsiao, P-C; Ho, S-T; Wong, C-S; Liaw, W-J

    2008-07-01

    Sedation is an important adjunct therapy for patients in the intensive care unit. The objective of the present study was to observe correlation between an established subjective measure, the Ramsay Sedation Scale, and two objective tools for monitoring critically ill patients: the Bispectral Index (BIS) and auditory evoked potential. Ninety patients undergoing major surgery scheduled for postoperative mechanical ventilation and continuous sedation with propofol and fentanyl were selected. Electrodes for determining BIS and auditory evoked potential were placed on the foreheads of all patients according to manufacturer's specifications at least six hours after patients' arrival at the intensive care unit. Ramsay Sedation Scale, BIS, signal quality index, composite A-line autoregressive index (AAI) and electromyographic activities were recorded every five minutes for 30 minutes. BIS and AAI showed good correlation amongst readings (r(s)=0.697, P Ramsay Sedation Scale (BIS, tau=-0.689; AAI, tau=-0.621; P Ramsay Sedation Scale. However, the BIS and auditory evoked potential monitors do not perform adequately as a substitute in the assessment of sedated intensive care unit patients. These monitors could be used as part of an integrated approach for the evaluation of those patients especially when the subjective scales do not work well in the setting of neuromuscular blockade or may not be sufficiently sensitive to evaluate very deep sedation.

  5. Comparative evaluation of bispectral index system after sedation with midazolam and propofol combined with remifentanil versus ketamine in uncooperative during dental procedures

    OpenAIRE

    Alireza Eshghi; Mehrnaz Mohammadpour; Nasser Kaviani; Dana Tahririan; Najmeh Akhlaghi

    2016-01-01

    Background: Proper analgesic agents should be used in combination with sedative agents. Remifentanil is a synthetic narcotic/analgesic agent with a short duration effect and decreases the risk of apnea during recovery. Bispectral index system (BIS) is a new noninvasive technique for the evaluation of the depth of sedation. The aim of present clinical trial was to evaluate and compare the efficacy of intravenous sedation with propofol/midazolam/remifentanil (PMR) in comparison to propofol/mida...

  6. A single dose of esmolol blunts the increase in bispectral index to tracheal intubation during sevoflurane but not desflurane anesthesia.

    Science.gov (United States)

    Choi, Seung Ho; Kim, Chang Seok; Kim, Jong Hoon; Kim, Bum Su; Kim, Eun Mi; Min, Kyeong Tae

    2009-07-01

    Activation of the peripheral nerve system by endotracheal intubation is accompanied by an increase in bispectral index (BIS). Esmolol produces a dose-dependent attenuation of the adrenergic response to endotracheal intubation. Desflurane increases sympathetic nerve activity and plasma norepinephrine relative to sevoflurane. The authors hypothesized that esmolol might blunt the BIS response to endotracheal intubation more during sevoflurane anesthesia than desflurane anesthesia. In this double blind, randomized study, after the induction of anesthesia, patients were mask-ventilated with either sevoflurane or desflurane (end-tidal 1 minimum alveolar concentration) and received normal saline or esmolol (0.5 mg/kg) 1 minute before intubation (sevoflurane-control, sevoflurane-esmolol, desflurane-control, and desflurane-esmolol groups, n=20/group). BIS, mean arterial pressure, and heart rate were measured before the induction of anesthesia (awake), before esmolol injection (time point -1), immediately before intubation (time point 0), and every minute for 5 minutes after tracheal intubation (time point 1 to 5). Compared with preintubation, esmolol attenuated the increase in BIS at 1 minute after intubation during sevoflurane anesthesia (5.1% for esmolol and 31.7% for control) but not during desflurane anesthesia (28.6% for esmolol and 30.8% for control). Mean arterial pressure and heart rate increased after intubation in all groups but the changes were greater in the control groups than the esmolol groups. In conclusion, a single dose of esmolol blunted the increase in BIS to tracheal intubation during sevoflurane but not desflurane anesthesia.

  7. Awareness of bispectral index monitoring system among the critical care nursing personnel in a tertiary care hospital of India

    Directory of Open Access Journals (Sweden)

    Shikha Thakur

    2011-01-01

    Full Text Available Background: Bispectral index monitoring system (BIS is one of the several systems used to measure the effects of anaesthetic and sedative drugs on the brain and to track changes in the patient′s level of sedation and hypnosis. BIS monitoring provides information clinically relevant to the adjustment of dosages of sedating medication. It can help the nursing personnel in preventing under- and over sedation among intensive care unit (ICU patients. Objective: The present study was conducted to assess the knowledge of nursing personnel working in the ICU regarding BIS. Methods: Fifty-four subjects participated in the study. A structured questionnaire was developed to assess the knowledge of the nursing personnel regarding BIS. Focus group discussions were held among the nursing personnel to know their views regarding BIS. Results: Mean age (years of the subjects was 30.7΁7.19 (21-47 years, with a female preponderance. Although the use of BIS in ICU is not common, majority (94.44% were aware of BIS and its purpose. 79.62% of the subjects knew about its implication in patient care. The mean knowledge score of the subjects was 11.87΁2.43 (maximum score being 15. Conclusion: There exists an awareness among the critical care nursing staff in our institution regarding BIS and its clinical implications. Its use in the critical care setting may benefit the patients in terms of providing optimal sedation.

  8. [The influence of intermittent hemodialysis (HD) on bispectral index (scale) (BIS) and serum propofol concentration under postoperative intravenous sedation].

    Science.gov (United States)

    Tatebayashi, Shigeru; Imai, Yuichiro; Ohgi, Kazuhiko; Tamaki, Shigehiro; Yamamoto, Kazuhiko; Takahashi, Masahiro; Kurehara, Koukichi; Furuya, Hitoshi; Kirita, Tadaaki

    2004-05-01

    We experienced a case of postoperative intravenous sedation with propofol during intermittent hemodialysis (HD), and investigated the correlation between the clinical sedation level based on bispectral index scale (BIS) together with Ramsay score, and the serum concentration of propofol. One adult oral cancer patient (carcinoma of the lower gingiva) with end-stage renal dysfunction needing HD was selected for this study. The day after operation, HD was commenced under intravenous sedation with propofol. Clinical sedation level was assessed using BIS and Ramsay score, and serum propofol concentrations were determined in arterial blood samples. Serum concentrations were measured every 15 times until 51 hours after operation. The initial dose of propofol was set at 3.5 mg x kg(-1) x h(-1) on the basis of clinical symptoms. According to BIS and Ramsay score, sedation level decreased lineally for 1 hour after commencement of HD. In contrast, serum propofol concentration incresed from 1.71 microg x ml(-1) to 2.21 microg x ml(-1). Total serum concentration of propofol was enhanced during HD because of dialytic dehydration, but, according to BIS and Ramsay scores, the possibility was suggested that the fraction of albmin-unbound propofol with pharmacological activities was eliminated or absorbed by membrane during HD.

  9. Comparison of recovery profiles of propofol AND sevoflurane anesthesia with bispectral index monitoring (BIS in general anesthesia

    Directory of Open Access Journals (Sweden)

    Mukesh Somvanshi

    2015-03-01

    Method: Fifty ASA physical status I-II patients of either sex, aged between 18 and 60 years were randomly divided into two groups to receive either propofol infusion (group P, n=25 or sevoflurane (group S, n=25. Cardiovascular parameters, SpO2 and bispectral index (BIS scores were recorded. Time to eye opening, hand squeezing and achieve modified Aldrete's Score and #8805; 9 and the incidence of complications were noted. Results: Early recovery times [eye opening, hand squeezing and achieve modified Aldrete's Score and #8805; 9] were significantly longer in group P (P 0.05. The incidence of post-operative nausea and vomiting was significantly higher in group S. Conclusions: The present study which adjusted propofol infusion rate and sevoflurane concentration according to BIS scores revealed that maintenance of anesthesia with sevoflurane is associated with faster recovery than anesthesia with propofol. Propofol resulted in a significantly lower incidence of postoperative nausea and vomiting. [Natl J Med Res 2015; 5(1.000: 52-56

  10. Early detection of brain death using the Bispectral Index (BIS) in patients treated by extracorporeal cardiopulmonary resuscitation (E-CPR) for refractory cardiac arrest.

    Science.gov (United States)

    Jouffroy, Romain; Lamhaut, Lionel; Guyard, Alexandra; Philippe, Pascal; An, Kim; Spaulding, Christian; Baud, Frédéric; Carli, Pierre; Vivien, Benoît

    2017-08-24

    Despite increasing use of extracorporeal cardiopulmonary resuscitation (E-CPR) for treatment of refractory cardiac arrest patients, prognosis remains dismal, often resulting in brain-death. However, clinical assessment of brain-death occurence is difficult in post-cardiac arrest patients, sedated, paralyzed, under mild therapeutic hypothermia (MTH). Our objective was to assess the usefulness of Bispectral-Index (BIS) monitoring at bedside for an early detection of brain-death occurrence in refractory cardiac arrest patients treated by E-CPR. This prospective study was performed in an intensive care unit of an university hospital. Forty-six patients suffering from refractory cardiac arrest treated by E-CPR were included. BIS was continuously recorded during ICU hospitalization. Clinical brain-death was confirmed when appropriate by EEG and/or cerebral CT angiography. Twenty-nine patients evolved into brain-death and had average BIS values under MTH and after rewarming (temperature ≥35°C) of 4 (0-47) and 0 (0-82), respectively. Among these, 11 (38%) entered into a procedure of organs donation. Among the 17 non-brain-dead patients, the average BIS values at admission and after rewarming were 39 (0-65) and 59 (22-82), respectively. Two patients had on admission a BIS value equal to zero and evolved to a poor prognostic (CPC 4) and died after care limitations. BIS values were significantly different between patients who developed brain death and those who did not. In both groups, no differences were observed between the AUCs of ROC curves for BIS values under MTH and after rewarming (respectively 0.86 vs 0.83, NS). Initial values of BIS could be used as an assessment tool for early detection of brain-death in refractory cardiac arrest patients treated by mild therapeutic hypothermia and E-CPR. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. The effect of different doses of esmolol on hemodynamic, bispectral index and movement response during orotracheal intubation: prospective, randomized, double-blind study

    Directory of Open Access Journals (Sweden)

    Mensure Yılmaz Çakırgöz

    2014-12-01

    Full Text Available Objective: A prospective, randomized and double-blind study was planned to identify the optimum dose of esmolol infusion to suppress the increase in bispectral index values and the movement and hemodynamic responses to tracheal intubation. Materials and methods: One hundred and twenty patients were randomly allocated to one of three groups in a double-blind fashion. 2.5 mg kg-1 propofol was administered for anesthesia induction. After loss of consciousness, and before administration of 0.6 mg kg-1 rocuronium, a tourniquet was applied to one arm and inflated to 50 mm Hg greater than systolic pressure. The patients were divided into 3 groups; 1 mg kg-1 h-1 esmolol was given as the loading dose and in Group Es50 50 μg kg-1 min-1, in Group Es150 150 μg kg-1 min-1, and in Group Es250 250 μg kg-1 min-1 esmolol infusion was started. Five minutes after the esmolol has been begun, the trachea was intubated; gross movement within the first minute after orotracheal intubation was recorded. Results: Incidence of movement response and the ΔBIS max values were comparable in Group Es250 and Group Es150, but these values were significantly higher in Group Es50 than in the other two groups. In all three groups in the 1st minute after tracheal intubation heart rate and mean arterial pressure were significantly higher compared to values from before intubation (p < 0.05. In the study period there was no significant difference between the groups in terms of heart rate and mean arterial pressure. Conclusion: In clinical practise we believe that after 1 mg kg-1 loading dose, 150 μg kg-1 min-1 iv esmolol dose is sufficient to suppress responses to tracheal intubation without increasing side effects.

  12. The Effects of Bispectral Index and Neuromuscular Blockade Monitoring on the Depth of Anaesthesia and Recovery in Cardiac Patients Under Desflurane Anaesthesia

    Science.gov (United States)

    Payas, Ayşe; Kaygusuz, Kenan; Düger, Cevdet; İsbir, Ahmet Cemil; Kol, İclal Özdemir; Gürsoy, Sinan; Mimaroğlu, Caner

    2013-01-01

    Objective In this study, we aimed to investigate the effects of bispectral index (BIS) and neuromuscular blockade monitoring on the depth of anaesthesia and recovery in cardiac patients, scheduled to undergo open cholecystectomy operation with desflurane anaesthesia. Methods After the approval of the Ethics Committee and consent from the patients, patients were randomly divided into two groups. All patients received standard induction drugs, and 4–6% desflurane was used for maintenance of anaesthesia. In Group I, the anaesthesiologist was blind to BIS, and end-tidal volatile agent concentration (ETVAC) of desflurane was titrated according to the patients’ hemodynamic changes. In Group II, ETVAC of desflurane was titrated to maintain BIS at 50–60. The hemodynamic data, BIS values, end-tidal volatile agent concentration (ETVAC) and train of four (TOF) values were recorded at pre-induction, post-induction, post-intubation, 1st and 5th minutes after surgical incision and then every 15 min. At the end of the operation, extubation time and the time to reach an Aldrete recovery score ≥9 were recorded in each group. Additionally, neuromuscular agent and narcotic agent doses were recorded. Results The BIS values were lower for Group I in all times, except pre- and post-induction times (p<0.05). ETVAC values of all times were lower for Group II (p<0.05). Conclusion The requirement of volatile agent, which was given according to BIS monitoring, was lower than in the standard technique, but it is considered not to affect the early extubation, recovery and neuromuscular agent requirement dependent on TOF monitoring. PMID:27366374

  13. Bispectral index dynamics during propofol hypnosis is similar in red-haired and dark-haired subjects.

    Science.gov (United States)

    Doufas, Anthony G; Orhan-Sungur, Mukadder; Komatsu, Ryu; Lauber, Rolf; Akca, Ozan; Shafer, Steven L; Sessler, Daniel I

    2013-02-01

    We have previously shown that red hair is associated with increased desflurane requirement for immobility, compared with dark hair. The effect of red hair on IV anesthetic requirement remains unknown. We tested the hypothesis that the propofol concentration in the effect site associated with half maximal electroencephalogram response, Ce50, is at least 50% higher in subjects with red hair. We modeled the propofol concentration versus electroencephalogram response relationship using a 2-step approach in 29 healthy dark- and red-haired volunteers receiving a propofol infusion to produce loss of consciousness. Bispectral Index (BIS) was the measure of drug effect. The parameters of a 3-compartment pharmacokinetic model were fit to measured arterial propofol concentrations. The relationship between effect-site propofol concentration (Ce) and BIS was characterized using a sigmoid Emax model. Model performance and accuracy of the estimated parameters were evaluated using accepted metrics and bootstrap resampling. The effect of hair color on the Ce50 for BIS response in the final model was assessed using a threshold of 6.63 (P<0.01) in reduction of -2 log likelihood. The influence of body weight on the model was also assessed. The inclusion of hair color as a model covariate did not improve either the pharmacokinetic or the pharmacodynamic model. A separate analysis for the dark- and red-haired subjects estimated a median (95% confidence interval) Ce50 BIS of 2.71 μg/mL (2.28-3.36 μg/mL) and 2.57 μg/mL (1.68-3.60 μg/mL), respectively. Body weight was a significant covariate for the CL1 and V1. Red hair phenotype does not affect the pharmacokinetics or pharmacodynamics of propofol.

  14. Relationship between type of brain injury with Bispectral Index monitoring in intubated ICU trauma patients

    Directory of Open Access Journals (Sweden)

    Omid Moradi Moghaddam

    2015-05-01

    Conclusion: Different kinds of acute traumatic cranial lesions with different prognosis may have different values in BIS monitoring. Presence or absence of frontal lobe injury, had no statistically significant correlations with BIS values.

  15. Effects of remifentanil on cardiovascular and bispectral index responses to endotracheal intubation in severe pre-eclamptic patients undergoing Caesarean delivery under general anaesthesia.

    Science.gov (United States)

    Yoo, K Y; Jeong, C W; Park, B Y; Kim, S J; Jeong, S T; Shin, M H; Lee, J

    2009-06-01

    We examined the effects of remifentanil on cardiovascular and bispectral index (BIS) responses to tracheal intubation and neonatal outcomes in pre-eclamptic patients undergoing Caesarean delivery under general anaesthesia. Forty-two women with severe pre-eclampsia were randomly assigned to receive either remifentanil 1 microg kg(-1) (n=21) or saline (n=21) over 30 s before induction of anaesthesia using thiopentone 4 mg kg(-1) and suxamethonium 1.5 mg kg(-1). Mean arterial pressure (MAP), heart rate (HR) and BIS values as well as plasma catecholamine concentrations were measured. Neonatal effects were assessed using Apgar scores and umbilical cord blood gas analysis. Induction with thiopentone caused a reduction in MAP and BIS in both remifentanil and control groups. Following the tracheal intubation MAP and HR increased in both groups, the magnitude of which was lower in the remifentanil group. BIS values also increased, of which magnitude did not differ between the groups. Norepinephrine concentrations increased significantly following the intubation in the control, while remained unaltered in the remifentanil group. The neonatal Apgar scores at 1 min were significantly lower in the remifentanil group than in the control. However, Apgar scores at 5 min, and umbilical artery and vein blood gas values were similar between the groups. These results suggest that a single bolus of 1 microg kg(-1) remifentanil effectively attenuates haemodynamic but not BIS responses to tracheal intubation in pre-eclamptic patients undergoing Caesarean delivery under general anaesthesia. However, its use was associated with maternal hypotension and neonatal respiratory depression requiring resuscitation.

  16. Comparative evaluation of bispectral index system after sedation with midazolam and propofol combined with remifentanil versus ketamine in uncooperative during dental procedures.

    Science.gov (United States)

    Eshghi, Alireza; Mohammadpour, Mehrnaz; Kaviani, Nasser; Tahririan, Dana; Akhlaghi, Najmeh

    2016-01-01

    Proper analgesic agents should be used in combination with sedative agents. Remifentanil is a synthetic narcotic/analgesic agent with a short duration effect and decreases the risk of apnea during recovery. Bispectral index system (BIS) is a new noninvasive technique for the evaluation of the depth of sedation. The aim of present clinical trial was to evaluate and compare the efficacy of intravenous sedation with propofol/midazolam/remifentanil (PMR) in comparison to propofol/midazolam/ketamine (PMK) for dental procedures in children 3-7 years of age. In this clinical trial, 32 healthy uncooperative children who were candidates for dental treatments under sedation were randomly divided into two groups. Intravenous sedation was induced with PMR in one group and with PMK in the other group. After injection and during procedure BIS index, heart rate and respiratory rate, blood pressure, and oxygen saturation was evaluated every 5 min. After the procedure, recovery time was measured. Data were analyzed with ANOVA, Friedman, Wilcoxon, and t-test. The BIS value was significantly low in ketamin group (P = 0.003) but respiratory rates and heart rates were same in both groups with no statistical difference (P = 0.884, P = 0.775). The recovery time was significantly shorter in remifentanil group (P = 0.008 and P = 0.003). It can be concluded that intravenous sedation technique with PMR combination induces effective and safe sedation, with less pain and more forgetfulness and a shorter recovery time for children 3-7 years of age during dental procedures.

  17. Comparative pharmacodynamic modeling using bispectral and narcotrend-index with and without a pharmacodynamic plateau during sevoflurane anesthesia.

    NARCIS (Netherlands)

    Kreuer, S.; Bruhn, J.; Walter, E.; Larsen, R.; Apfel, C.C.; Grundmann, U.; Biedler, A.; Wilhelm, W.

    2008-01-01

    BACKGROUND: We compared two pharmacodynamic models, one with and one without a plateau effect. Bispectral indices (BIS, Aspect Medical Systems, Natick, MA, version XP) and Narcotrend (NCT, MonitorTechnik, Bad Bramstedt, Germany, version 4.0) were used as an electroencephalographic measure of sevoflu

  18. Comparison of 1.5% lidocaine and 0.5% ropivacaine epidural anesthesia combined with propofol general anesthesia guided by bispectral index

    Institute of Scientific and Technical Information of China (English)

    XIANG Yan; LI Yu-hong

    2007-01-01

    Objective:To compare the effects of epidural anesthesia with 1.5% lidocaine and 0.5% ropivacaine on propofol requirements,the time to loss of consciousness (LOC),effect-site propofol concentrations,and the hemodynamic variables during induction of general anesthesia guided by bispectral index (BIS) were studied.Methods:Forty-five patients were divided into three groups to receive epidurally administered saline (Group S),1.5% (w/w) lidocaine (Group L),or 0.5% (w/w) ropivacaine (Group R).Propofol infusion was started to produce blood concentration of 4 μg/ml.Once the BIS value reached 40~50,endotracheal intubation was facilitated by 0.1 mg/kg vecuronium.Measurements included the time to LOC,effect-site propofol concentrations,total propofol dose,mean arterial blood pressure (MABP),and heart rate (HR) at different study time points.Results:During induction of anesthesia,both Groups L and R were similar for the time to LOC,effect-site propofol concentrations,total propofol dose,MABP,HR,and BIS.The total doses of propofol administered until 1 min post-intubation were significantly less in patients of Groups R and L compared with Group S.MABP and HR were significantly lower following propofol induction compared with baseline values in the three groups,or MABP was significantly increased following intubation as compared with that prior to intubation in Group S but not in Groups R and L while HR was significantly increased following intubation in the three groups.Conclusion:Epidural anesthesia with 1.5% lidocaine and 0.5% ropivacaine has similar effects on the time to LOC,effect-site propofol concentrations,total propofol dose,and the hemodynamic variables during induction of general anesthesia.

  19. [Anesthesia recovery comparison between remifentanil-propofol and remifentanil-desflurane guided by Bispectral Index(®) monitoring].

    Science.gov (United States)

    Rocha, Raphael Grossi; Almeida, Eduardo Giarola; Carneiro, Lara Moreira Mendes; Almeida, Natália Farias de; Boas, Walkíria Wingester Vilas; Gomez, Renato Santiago

    There is a strong demand for fast and predictable anesthesia recovery with few side effects. Choice of the hypnotic agent could impact on that. This study investigated the differences between recoveries after remifentanil-propofol and remifentanil-desflurane anesthesias guided by bispectral index (BIS(®)). Forty patients were randomly assigned into 2 groups according to the anesthesia technique applied: remifentanil-propofol (REM-PRO) and remifentanil-desflurane (REM-DES). After the discontinuation of the anesthetics, the times to extubation, to obey commands and to recover the airway protection reflex were recorted. In the post-anesthetic recovery room (PACU) it was recorded the occurrence of nausea and vomiting (PONV), scores of Ramsay sedation scale and of numeric pain scale (NPS), morphine dose and length of stay in the unit. Data from 38 patients were analyzed: 18 from REM-PRO and 20 from REM-DES group. Anesthesia times were similar (REM-PRO=193min, SD 79.9 vs. 175.7min, SD 87.9 REM-DES; p=0.5). REM-DES had shorter times than REM-PRO group: time to follow command (8.5min; SD 3.0 vs. 5.6min; SD 2.5; p=0.0) and extubation time (6.2 minutes; 3.1-8.5 vs. 9.5 minutes; 4.9-14.4; p=0.0). Times to recover airway protective reflex were similar: 16 patients from REM-PRO (88.9%) restored the airway protective reflex 2min after extubation vs. 17 from REM-DES (89.5%); and 2 patients from REM-PRO (11.1%) vs. 2 from REM-DES (10.5%) 6min after extubation, p=1. Ramsay sedation score, NPS, PONV incidents, morphine dose and PACU stay of length PACU were also similar. Remifentanil-desflurane-based anesthesia has a faster extubation time and to follow command than remifentanil-propofol-based anesthesia when both guided by BIS(®). Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  20. [Mechanism of the preventing of endotracheal intubation response with esmolol-the relationship between the plasma catecholamine level and bispectral index].

    Science.gov (United States)

    Jin, Yun yu; Yang, Lan; Zhu, Sai nan; Pan, Zhen Yu; Bai, Yu; Fan, Zhi yi

    2008-04-01

    To observe the relationship between the level of catecholamine in plasma with bispectral index during endotracheal intubation with propofol anesthesia in order to investigate the mechanism of the preventing of endotracheal intubation response with esmolol. Thirty patients were randomly allocated into two groups: control group (n=15) and esmolol group (n=15). The patients received esmolol 1amg/kg followed by 250 microg/(kgdmin) in esmolol group and saline in control group. Two minutes later, the patients received propofol 2amg/kg for induction. Bispectral index (BIS), systolic pressure (SP), diostolic pressure (DP), and heart rate (HR) were measured before endotracheal intubation and 3amin after intubation, at the same time 8a mL arteral blood was taken for the measurement of the concentrations of norephinephrine(NE) and ephinephrine(E) in plasma. The level of BIS(63.53+/-3.11), NE(2.016+/-0.681)and E(0.578+/-0.072)in control group 3 min after endotracheal intubation were increased significantly than those before intubation (Pendotracheal intubation . There were significant differences in the concentrations of NE(2.016+/-0.681)and E(0.578+/-0.072) in plasma 3 min after intubation between the two groups (Pintubation between the two groups(Pintubation than those before intubation (Pintubation than those before intubation. Esmolol can reduce the plasma concentrations of NE and E through preventing periopheal sympathetic nerve response to intubation and can reduce BIS arousal reactions after endotracheal intubation.

  1. Effect site concentrations of remifentanil maintaining cardiovascular homeostasis in response to surgical stimuli during bispectral index guided propofol anestesia in seriously obese patients.

    Science.gov (United States)

    Albertin, A; La Colla, G; La Colla, L; Bergonzi, P C; Deni, F; Moizo, E

    2006-11-01

    The aim of this prospective study was to determine the effect site concentrations of remifentanil maintaining cardiovascular homeostasis in response to surgical stimuli during bispectral index (BIS) guided propofol anesthesia in seriously obese patients. Twenty-two patients, female/male 15/7, ASA physical status II - III, aged 29-69 years, body mass index (BMI) 54.5+/-12, undergoing major open bariatric surgery, were enrolled to receive a propofol-remifentanil total intravenous anesthesia. All patients were intubated by using a flexible fiberoptic bronchoscopic technique facilitated by a target controlled effect site concentration of remifentanil set at 2.5 ng/mL. After endotracheal intubation, anesthesia was started with a target controlled infusion of propofol initially set at 6 microg/mL, then adjusted to maintain a BIS value between 40 and 50. The mean effect site concentration of remifentanil was recorded at different intervals time during surgery: skin incision-opening of peritoneum (T1), bowel resection (T2), cholecystojejunal anastomosis (T3), ileojejunal anastomosis (T4), closing of peritoneum (T5). The mean plasma concentrations of propofol required to maintain a BIS value between 40 and 50 were 4+/-0.55, 3.8+/-0.64, 3.8+/- 0.63, 3.8+/-0.65 and 3.8+/-0.63 microg/mL at T1, T2, T3, T4 and T5 interval time, respectively. The mean values of remifentanil target effect site concentration were 5.2+/-1.3, 7.7+/-1.7, 9.1+/-1.8, 9.7+/- 2.2 and 9.9+/-2.5 ng/mL at T1, T2, T3, T4 and T5 interval time. This study suggests that tolerance to remifentanil infusion is profound and develops very rapidly in morbidly obese patients submitted to open bariatric surgery during BIS guided propofol anesthesia. The administration of opiates during anesthesia based on target-controlled infusion should include corrections for the development of tolerance.

  2. A study of the effect of caudal epidural block on bispectral index targeted propofol requirement in children: A comparative study

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    Abhishek Banerjee

    2015-01-01

    Full Text Available Caudal epidural block is one of the most commonly performed neuraxial block techniques with reliable peri-operative and post-operative analgesia in pediatric patients. In our randomized, prospective, double-blinded, open level, parallel group study, we have established the effect of caudal epidural block on maintenance requirement of intravenous (IV propofol in targeted bispectral (BIS monitored patients. Context: Neuraxial anesthesia exhibits sedative properties that may reduce the requirement for general anesthesia. TIVA with propofol has been administered as an established method of maintaining general anesthesia in children. Caudal analgesia being a type of neuraxial block, also seems to reduce the requirement of sedative hypnotics in pediatric patients. Numerous studies show that for patients, administered with caudal epidural block, they require reduced intra-operative volatile inhalation anesthetics. In the present study, we have established the anesthetic sparing effect of Caudal Epidural Analgesia in children undergoing infra-umbilical surgical procedure and calculated the efficacy of propofol-infusion in maintaining adequate depth of anesthesia. Aims: (1 To study and compare the dose requirements of propofol using caudal epidural analgesia. (2 To calculate the efficacy of propofol as maintenance anesthetic agent in both groups and to compare hemodynamic stability of patients in both the techniques. Settings and Design: In our study, after administering general anesthesia to pediatric patients, we have administered caudal analgesia and IV analgesia to monitor the requirement of intra-operative propofol infusion using BIS monitor with a target value of 40-60 in both groups. Materials and Methods: 82 patients (aged between 3 and 6 years have been selected undergoing infra-umbilical surgery and randomly allocated into two groups containing 41 patients in each group. Both the groups group B and group A then intubated with glycopyrrolate, 2

  3. The Use of the Bispectral Index in the Detection of Pain in Mechanically Ventilated Adults in the Intensive Care Unit: A Review of the Literature

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    Robin Marie Coleman

    2015-01-01

    Full Text Available BACKGROUND: Pain assessment is an immense challenge for clinicians, especially in the context of the intensive care unit, where the patient is often unable to communicate verbally. Several methods of pain assessment have been proposed to assess pain in this environment. These include both behavioural observation scales and evaluation of physiological measurements such as heart rate and blood pressure. Although numerous validation studies pertaining to behavioural observation scales have been published, several limitations associated with using these measures for pain assessment remain. Over the past few years, researchers have been interested in the use of the bispectral index monitoring system as a proxy for the evaluation of encephalography readings to assess the level of anesthesia and, potentially, analgesia.

  4. Changes in the Bispectral Index in Response to Loss of Consciousness and No Somatic Movement to Nociceptive Stimuli in Elderly Patients

    Institute of Scientific and Technical Information of China (English)

    Ning Yang; Yun Yue; Jonathan Z Pan; Ming-Zhang Zuo; Yu Shi; Shu-Zhen Zhou; Wen-Ping Peng

    2016-01-01

    Background: Bispectral index (BIS) is considered very useful to guide anesthesia care in elderly patients, but its use is controversial for the evaluation of the adequacy of analgesia.This study compared the BIS changes in response to loss of consciousness (LOC) and loss of somatic response (LOS) to nociceptive stimuli between elderly and young patients receiving intravenous target-controlled infusion (TCI) of propofol and remifentanil.Methods: This study was performed on 52 elderly patients (aged 65-78 years) and 52 young patients (aged 25-58 years), American Society of Anesthesiologists physical status Ⅰ or Ⅱ.Anesthesia was induced with propofol administered by TCI.A standardized noxious electrical stimulus (transcutaneous electrical nerve stimulation, [TENS]) was applied (50 Hz, 80 mA, 0.25 ms pulses for 4 s) to the ulnar nerve at increasing remifentanil predicted effective-site concentration (Ce) until patients lost somatic response to TENS.Changes in awake, prestimulus, poststimulus BIS, heart rate, mean arterial pressure, pulse oxygen saturation, predicted plasma concentration, Ce of propofol, and remifentanil at both LOC and LOS clinical points were investigated.Results: BISLOC in elderly group was higher than that in young patient group (65.4 ± 9.7 vs.57.6 ± 12.3) (t =21.58, P < 0.0001) after TCI propofol, and the propofol Ce at LOC was 1.6 ± 0.3 μg/ml in elderly patients, which was significantly lower than that in young patients (2.3 ± 0.5 μg/ml) (t =7.474, P < 0.0001).As nociceptive stimulation induced BIS to increase, the mean of BIS maximum values after TENS was significantly higher than that before TENS in both age groups (t =8.902 and t =8.019, P < 0.0001).With increasing Ce of remifentanil until patients lost somatic response to TENS, BISLOS was the same as the BISLOC in elderly patients (65.6 ± 10.7 vs.65.4 ± 9.7), and there were no marked differences between elderly and young patient groups in BISawake, BISLOS, and Ce of

  5. Comparative study among acepromazine, chlorpromazine and methotrimeprazine in different doses, through bispectral index, term and pressure algimetry, in dogs / Estudo comparativo entre a acepromazina, clorpromazina e levomepromazina em diferentes doses, através do exame bispectral, termo e pressoalgimetria, em cães

    Directory of Open Access Journals (Sweden)

    Lidia Mitsuko Matsubara

    2009-12-01

    Full Text Available The study’s objective was to realize comparisons among different acepromazine, chlorpromazine and methotrimeprazine doses, evaluate parametric changes, test analgesia using press and term algimetry, and evaluate bispectral condition. 90 mongrel dogs were used, male and female, adult, weighting 10 to 15 Kg as a rule, distributed in 9 groups with 10 animals each. At first, second and third groups acepromazine was used at 0,1; 0,05 e 0,025 mg/Kg, respectively. At forth, fifth and sixth groups, chlorpromazine was used at 1,0; 0,5 and 0,25 mg/Kg, respectively. At seventh, eighth and ninth groups, methotrimeprazine at 1,0; 0,5 and 0,25 mg/Kg was used, respectively. All drugs were administered intravenously. Objects of study: heart rate (HR, non invasive blood pressure (SAP, MAP, DAP, respiratory rate (f, capnography (ETCO2, pulse oxymetry (SatO2, mouth and rectal temperature, bispectral index (BIS, electromyography (EMG%, press and term algimetry. Somatic analgesia was evaluated by animal’s response to nociceptives stimulus. We concluded that chlorpromazine had more hypotension. Dogs showed higher hypnosis level at chlorpromazine group, with evident myorelaxation. All groups showed analgesia to thermic and mechanic stimulus. Acepromazine group showed high duration to both pain stimuli. Bispectral index was shorten at chlorpromazine group at 1,0 mg/kg doses, showing higher hypnosis index, and acepromazine was the less depressing considering the bispectral index.Objetivou-se comparar, em diferentes doses, a acepromazina, a clorpromazina e a levomepromazina com relação às alterações paramétricas, à analgesia avaliada através da presso e termoalgimetria e a condição bispectral em 90 cães sem raça definida alocados em nove grupos. No primeiro, segundo e terceiro grupo foi empregada a acepromazina nas doses de 0,1; 0,05 e 0,025 mg/kg, respectivamente. No quarto, quinto e sexto grupo foi empregada a clorpromazina nas doses de 1,0; 0,5 e 0

  6. A prospective evaluation of the incidence of adverse events in nurse-administered moderate sedation guided by sedation scores or Bispectral Index.

    Science.gov (United States)

    Yang, Katie S; Habib, Ashraf S; Lu, Minyi; Branch, M S; Muir, Holly; Manberg, Paul; Sigl, Jeffrey C; Gan, Tong J

    2014-07-01

    Moderate sedation is routinely performed in patients undergoing minor therapeutic and diagnostic procedures outside the operating room. The level of sedation is often monitored by sedation nurses using clinical criteria, such as sedation scores. The Bispectral Index (BIS) is derived from changes in the electroencephalograph profile that may provide an objective measure of the level of sedation. In this prospective observational study, we investigated whether using BIS values to guide sedative drug administration influences the level of sedation and the incidence of adverse events compared with using Ramsay sedation scale (RSS) only in nurse-administered moderate sedation. We hypothesized that both depth of sedation and the incidence of adverse events related to oversedation would decrease when sedation nurses used BIS values to help guide sedative drug administration. Sedation care was provided by trained sedation nurses under the supervision of a physician performing the procedure. The sedation regimen was initiated with IV midazolam 1 to 2 mg and fentanyl 50 mcg or hydromorphone 0.2 mg. Additional small boluses of midazolam, fentanyl, or hydromorphone were administered to maintain an RSS of 2 to 3 (cooperative, oriented, and responding to verbal command). Propofol was not used. Information including patient demographics, type of procedure, medication administered, RSS, and rates of adverse events was recorded by the sedation nurses for each patient on a computer-readable form. The study was divided into 3 phases. In phase 1 (baseline, 6 months' duration), baseline data on sedation practice were prospectively collected. There was no change from standard of care for all patients except that each patient had a BIS sensor attached, but the monitor was covered and nurses were blinded to the BIS values. In phase 2 (training, 3 months), the sedation nurses received comprehensive education on the use of BIS to guide sedative drug administration, pharmacology of commonly

  7. Hemodynamics and bispectral index (BIS of dogs anesthetized with midazolam and ketamine associated with medetomidine or dexmedetomidine and submitted to ovariohysterectomy Avaliação hemodinâmica e do índice bispectral (BIS de cadelas anestesiadas com midazolam e cetamina associados à medetomidina ou dexmedetomidina e submetidas a ovário-salpingo-histerectomia

    Directory of Open Access Journals (Sweden)

    Fernando do Carmo Silva

    2010-04-01

    Full Text Available PURPOSE: To evaluate hemodynamics and bispectral index (BIS in bitches anesthetized with ketamine and midazolam in combination with dexmedetomidine or medetomidine and submitted to ovariohysterectomy. METHODS: Twenty bitches pretreated with levomedetomidine and buprenorphine were anesthetized with 5 mg.kg-1 ketamine and 0.2 mg.kg-1 midazolam i.v. Continuous infusion of 0.4 mg.kg-1.h-1 midazolam and 20 mg.kg-1.h-1 ketamine was initiated in combination with DEX (n=10: 20 µg.kg-1.h-1 dexmedetomidine or MED (n=10: 30 µg.kg-1.h-1 medetomidine over 30 minutes. A pharmacokinetic study provided dexmedetomidine plasma concentration, set to be 3.0 ng.mL-1. RESULTS: BIS decreased in both groups (P0.05, but heart rate decreased in both groups, as compared to control values (POBJETIVO: Verificar o comportamento hemodinâmico e o índice bispectral de cadelas anestesiadas com cetamina e midazolam associados à dexmedetomidina ou medetomidina. MÉTODOS: Vinte cadelas receberam pré-tratamento com levomepromazina e buprenorfina e foram anestesiadas com cetamina, 5 mg.kg-1 i.v., e midazolam, 0,2 mg.kg-1 i.v., seguidos da administração contínua de midazolam, 0,4 mg.kg-1.h-1, e cetamina, 20 mg.kg-1.h-1, associados, conforme o grupo, à: DEX (n=10: dexmedetomidina 20 µg.kg-1.h-1 ou MED (n=10: medetomidina 30 µg.kg-1.h-1, mantidos por 30 minutos. A dose de dexmedetomidina foi obtida por meio de estudo farmacocinético planejando-se concentração plasmática de 3,0 ng.mL-1. RESULTADOS: Os valores do BIS diminuíram em ambos os grupos (P0,05, sem a presença de efeitos adversos. CONCLUSÃO: A administração contínua de dexmedetomidina em concentração plasmática calculada de 3 ng.mL-1, em combinação com midazolam e cetamina, resulta em plano anestésico adequado para castração de cadelas, estabilidade hemodinâmica e despertar tranquilo, sem efeitos adversos.

  8. Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea.

    Science.gov (United States)

    Traxdorf, Maximilian; Tschaikowsky, Klaus; Scherl, Claudia; Bauer, Judith; Iro, Heinrich; Angerer, Florian

    2016-12-06

    The aim of this study was to establish a standardized protocol for drug-induced sleep endoscopy (DISE) to differentiate obstruction patterns in obstructive sleep apnea (OSA). Target-controlled infusion (TCI) of the sedative propofol was combined with real-time monitoring of the depth of sedation using bispectral analysis. In an observational study 57 patients (mean age 44.8 years, ± SD 10.5; mean apnea hypopnea Index (AHI) 30.8/hr, ± SD 21.6, mean BMI 28.2 kg/m(2), ± SD 5.3) underwent cardiorespiratory polysomnography followed by DISE with TCI and bispectral analysis. Sleep was induced solely by the intravenous infusion of propofol with a TCI-pump, with an initial target plasma level of 2.0 µg/ml. Under continuous monitoring of the patient's respiration, state of consciousness and value of the bispectral analysis, the target plasma propofol level was raised in steps of 0.2 µg/ml/2 min until the desired depth of sedation was reached. The mean value of the bispectral analysis at the target depth of sedation was determined and the obstruction patterns during DISE-TCI-bispectral analysis then classified according to the VOTE-system. Subsequently the results were analyzed according to polysomnographic and anthropometric data. The occurrence of multilevel obstruction sites across all degrees of severity of OSA clarifies the need for sleep endoscopy prior to upper airway surgery. The advantage of this technique is the reproducibility of the protocol even for heterogeneous groups of patients. In addition, the gradual controlled and standardized increase of the plasma level of propofol with real-time control of the bispectral index leads to a precisely controllable depth of sedation. The DISE-TCI-bispectral analysis procedure is a step towards a required reproducible protocol of sleep endoscopy - capable of standardization. However it is not yet known whether these observed obstruction patterns also correspond to findings in natural sleep.

  9. The Effect of Fentanyl on Bispectral Index (BIS) Values and Recall

    Science.gov (United States)

    2002-12-01

    M. (1997). Anesthesia for the patient with neurologic disease. Anesthesiology Clinics of North America , 15, 561. Bower, A., Ripepi, A., Dilger, J...sedation for third molar extractions. Journal of Oral and Maxillofacial Surgery , 58, 364- 368. Sebel, P., Lang, E., Rampil, I., White, P., Cork, R., Jopling...Education Clinic (founded the Nurse-Run Diabetes Clinic ) 1993-1994 Air Force Nurse Internship Program, Wright-Patterson AFB, Ohio Hi CURRICULUM VITAE Name

  10. Bispectral index score and observer′s assessment of awareness/sedation score may manifest divergence during onset of sedation: Study with midazolam and propofol

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    Dipanjan Bagchi

    2013-01-01

    Full Text Available Background: Correlation between the clinical and electroencephalogram-based monitoring has been documented sporadically during the onset of sedation. Propofol and midazolam have been studied individually using the observer′s assessment of awareness/sedation (OAA/S score and Bispectral index score (BIS. The present study was designed to compare the time to onset of sedation for propofol and midazolam using both BIS and OAA/S scores, and to find out any correlation. Methods: A total of 46 patients (18-60 years, either sex, American Society of Anesthesiologists (ASA I/II posted for infraumbilical surgeries under spinal anaesthesia were randomly allocated to receive either injection propofol 1 mg/kg bolus followed by infusion 3 mg/kg/h (Group P, n=23 or injection midazolam 0.05 mg/kg bolus followed by infusion 0.06 mg/kg/h (Group M, n=23. Spinal anaesthesia was given with 2.5 ml to 3.0 ml of 0.5% bupivacaine heavy. When sensory block reached T6 level, sedation was initiated. The time to reach BIS score 70 and time to achieve OAA/S score 3 from the start of study drug were noted. OAA/S score at BIS score 70 was noted. Data from 43 patients were analyzed using SPSS 12 for Windows. Results: Time to reach BIS score 70 using propofol was significantly lower than using the midazolam (P<0.05. Time to achieve OAA/S score 3 using propofol was comparable with midazolam (P=0.358. Conclusion: A divergence exists between the time to reach BIS score 70 and time to achieve OAA/S score 3 using midazolam, compared with propofol, during the onset of sedation.

  11. Optimal propofol induction dose in morbidly obese patients: A randomized controlled trial comparing the bispectral index and lean body weight scalar.

    Science.gov (United States)

    Subramani, Yamini; Riad, Waleed; Chung, Frances; Wong, Jean

    2017-05-01

    Propofol dosing based on total body weight (TBW) can lead to overdosing in morbidly obese (MO) patients. Our aim was to determine whether an induction dose of propofol based on a bispectral index (BIS) target is better for achieving loss of consciousness in MO patients than dosing based on lean body weight (LBW). Sixty MO patients with a body mass index (BMI) of ≥ 40 kg·m(-2) were randomized to either BIS- or LBW-based propofol dosing groups. Anesthesia was induced with a propofol infusion of 100 mg·kg(-1)·hr(-1) to an initial target endpoint of a BIS of 50 (BIS group) or until a precalculated dose of 2.6 mg·kg(-1) LBW based on the Janmahasatian equation was administered (LBW group). Induction was assessed using the observer's assessment alertness/sedation scale (OAA/S). If an OAA/S score of 0 was not achieved, infusions continued until it reached 0. The groups were compared for the primary outcome which was the difference in the propofol doses at the initial target endpoint. The median [interquartile range] OAA/S score at the initial target endpoint was lower in the BIS group than in the LBW group (0 [0-0] vs 1 [0-3], respectively; median difference 1, 95% confidence interval [CI] 0 to 3; P = 0.001). The number of patients requiring additional propofol doses was also higher for the LBW group [1 vs 18 patients, respectively; relative risk of requiring additional propofol 18; 95% CI 3 to 126; P = 0.001]. The mean (SD) propofol dose at the target endpoint was significantly lower in the LBW group than in the BIS group [164 (36) mg vs 225 (44) mg, respectively; mean difference 61 mg; 95% CI 41 to 83 mg; P = 0.002]. There was no difference between the two groups, however, regarding the total induction dose of propofol needed for the OAA/S to reach 0 (P = 0.07). The induction dose of propofol based on the BIS index was different from the induction dose based on LBW in MO patients. Patients in the LBW group required additional propofol to achieve an OAA/S of 0.

  12. Possible values of UV index in Serbia

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    Letić Milorad

    2008-01-01

    Full Text Available INTRODUCTION UV Index is an indicator of human exposure to solar ultraviolet (UV rays. The numerical values of the UV Index range from 1-11 and above. There are three levels of protection against UV radiation; low values of the UV Index - protection is not required, medium values of the UV Index - protection is recommended and high values of the UV Index - protection is obligatory. The value of the UV Index primarily depends on the elevation of the sun and total ozone column. OBJECTIVE The aim of the study is to determine the intervals of possible maximal annual values of the UV Index in Serbia in order to determine the necessary level of protection in a simple manner. METHOD For maximal and minimal expected values of total column ozone and for maximal elevation of the sun, the value of the UV Index was determined for each month in the Northern and Southern parts of Serbia. These values were compared with the forecast of the UV Index. RESULTS Maximal clear sky values of the UV Index in Serbia for altitudes up to 500m in May, June, July and August can be 9 or even 10, and not less than 5 or 6. During November, December, January and February the UV Index can be 4 at most. During March, April, September and October the expected values of the UV Index are maximally 7 and not less than 3. The forecast of the UV Index is within these limits in 98% of comparisons. CONCLUSION The described method of determination of possible UV Index values showed a high agreement with forecasts. The obtained results can be used for general recommendations in the protection against UV radiation.

  13. 脑电双频指数在儿科ICU镇静监测的临床应用价值%Sedation assessment by using bispectral index in the pediatric intensive care unit

    Institute of Scientific and Technical Information of China (English)

    滕国良; 姚军; 龚小慧; 张宇鸣

    2009-01-01

    目的 探讨脑电双频指数(BIS)在儿科ICU危重患儿镇静深度监测中的应用价值.方法 前瞻性收集我院PICU的42例6个月~13岁的危重患儿,以咪唑安定持续静脉滴注镇静治疗,在应用镇静剂后的10个时间段以Ramsay评分评价镇静深度的同时进行BIS监测,分析BIS与Ramsay评分在儿童危重症镇静评估的相关性及影响因素.结果 42例危重症患儿中共采集420对BIS与Ramsay对照数据,并做Spearman等级相关分析,BIS与Ramsay评分呈明显负相关(r=-0.8879,P0.05);BIS范围在55~80之间为危重症患儿合适的镇静分值.结论 BIS与Ramsay评分在危重症镇静深度评估中具有较好相关性.BIS监测具有操作简单、省时、连续性好等优点,可作为PICU患儿镇静深度判断的客观指标.%Objective To evaluate the applicability of bispectral index (BIS) in assessing sedation in pediatric intensive care unit. Methods Patients in pediatric ICU,aged six months to thirteen years and requi-ring sedation were given midazolam as sedative drug. The Ramsay score was assessed by physicians after mi-dazolam was given at ten time interval and these data were compared with the blinded BIS score. Results A total of 42 children were included in the study,420 valid paired observation of BIS values and Ramsay score were performed. According to Spearman's scale analysis, the correlation coefficient between BIS value and Ramsay score was -0.887 9 (P0.05). Conclusion BIS values cor-relate fairly well with the Ramsay scores in PICU patient. With the advantages such as simpleness, time-sav-ing,continuity and etc,BIS monitoring is a good objective tool for judging sedation depth of PICU patients.

  14. Comparison of C50 for Propofol-remifentanil Target-controlled Infusion and Bispectral Index at Loss of Consciousness and Response to Painful Stimulus in Elderly and Young Patients

    Institute of Scientific and Technical Information of China (English)

    Ning Yang; Ming-Zhang Zuo; Yun Yue; Yun Wang; Yu Shi; Xue-Na Zhang

    2015-01-01

    Background:In this prospective randomized study,we compared the predicted blood and effect-site C50 for propofol and remifentanil target-controlled infusion (TCI) and the bispectral index (BIS) values at loss of consciousness (LOC) and response to a standard noxious painful stimulus (LOS) in elderly and young patients,respectively.We hypothesized that the elderly patients will require lower target concentration of both propofol and remifentanil at above two clinical end-points.Methods:There were 80 American Society of Anesthesiologists (ASA) physical status Ⅰ Ⅱ unpremedicated patients enrolled in this study,they were divided into elderly group (age ≥65 years,n =40) and young group (aged 18-54 years,n =40).Propofol was initially given to a predicted blood concentration of 1.2 μg/ml and thereafter increased by 0.3 μg/ml every 30 s until Observer's Assessment of Alertness and Sedation score was 1.The propofol level was kept constant,and remifentanil was given to provide a predict blood concentration of 2.0 ng/ml,and then increased by 0.3 ng/ml every 30 s until loss of response to a tetanic stimulus.BIS (version 3.22,BIS Quattro sensor) was also recorded.Results:In elderly group,the propofol effect-site C50 at LOC of was 1.5 (1.4-1.6) μg/ml,was significantly lower than that of young group,which was 2.2 (2.1-2.3) μg/ml,the remifentanil effect-site C50 at LOS was 3.5 (3.3-3.7) ng/ml in elderly patients,was similar with 3.7 (3.6-3.8) ng/ml in young patients.Fifty percent of patients lost consciousness at a BIS value of 57.3 (56.4-58.1),was similar with that of young group,which was 55.2 (54.0-56.3).Conclusion:In elderly patients,the predicted blood and effect-site concentrations of propofol at LOC were lower than that of young patients.At same sedation status,predicted blood and effect-site concentrations of remifentanil required at LOS were similar in elderly and young patients.BIS were not affected by age.Low-propofol/high-opioid may be optional TCI strategy

  15. Glycemic Index values of some Jaffna fruits

    National Research Council Canada - National Science Library

    Selladurai Pirasath; Kulasingam Thayananthan; Sandrasekarampillai Balakumar; Vasanthy Arasaratnam

    2012-01-01

    .... This study aimed to evaluate the glycemic index (GI) values of fruits such as ‘Kathali’ (Yellow plantain), ‘Kappal’ (Golden plantain), and ‘Itharai’ (Green plantain) varieties of plantains, jack fruit and papaya...

  16. Glycemic Index values of some Jaffna fruits

    OpenAIRE

    Selladurai Pirasath; Kulasingam Thayananthan; Sandrasekarampillai Balakumar; Vasanthy Arasaratnam

    2012-01-01

    Background: The incidence of diabetes mellitus has recently increased in developing countries. Scientific data on glycemic index values of common meals is essential to modify the diets for diabetes mellitus patients. This study aimed to evaluate the glycemic index (GI) values of fruits such as ‘Kathali’ (Yellow plantain), ‘Kappal’ (Golden plantain), and ‘Itharai’ (Green plantain) varieties of plantains, jack fruit and papaya. The results will be helpful to physicians and the general public t...

  17. Protocol for the BAG-RECALL clinical trial: a prospective, multi-center, randomized, controlled trial to determine whether a bispectral index-guided protocol is superior to an anesthesia gas-guided protocol in reducing intraoperative awareness with explicit recall in high risk surgical patients

    OpenAIRE

    Villafranca Alex; Jacobsohn Eric; Glick David; Palanca Ben J; Avidan Michael S; O'Connor Michael; Mashour George A

    2009-01-01

    Abstract Background Awareness with explicit recall of intra-operative events is a rare and distressing complication that may lead to severe psychological symptoms. Candidate depth of anesthesia monitors have been developed, partly with the aim of preventing this complication. Despite conflicting results from clinical trials and the lack of incisive validation, such monitors have enjoyed widespread clinical adoption, in particular the bispectral index. The American Society of Anesthesiologists...

  18. Some Noncommutative Matrix Algebras Arising in the Bispectral Problem

    Science.gov (United States)

    Grünbaum, F. Alberto

    2014-07-01

    I revisit the so called ''bispectral problem'' introduced in a joint paper with Hans Duistermaat a long time ago, allowing now for the differential operators to have matrix coefficients and for the eigenfunctions, and one of the eigenvalues, to be matrix valued too. In the last example we go beyond this and allow both eigenvalues to be matrix valued.

  19. 脑电双频谱指数和 Narcotrend 监测临床应用新进展%The new advance in clinical application of bispectral index and Narcotrend monitoring

    Institute of Scientific and Technical Information of China (English)

    郝倩; 周莉; 刘保江; 吕洁萍

    2016-01-01

    Monitoring the depth of anesthesia has been a challenge in anesthetic research. For decades, adequacy of general anesthesia was estimated on the basis of unspecific clinical parameters, such as blood pressure, heart rate, sweating, tearing, eye movement, and many more. These traditional methods may vary from patient to patient depending on the type of surgery. And with the extent of time, these indicators may have fatigue phenomenon. In addition, the use of other drugs such as muscle relaxants and vasodilators make the analysis of these signs difficult and unreliable. Today, an increasing number of monitors reflect anesthetic effects on the main target organ of general anesthesia, the brain. These monitors record and process electroencephalogram or auditory evoked potentials, which can accurately reflect the changes in the physiological functions of the brain. At present, bispectral index (BIS) and Narcotrend monitors are commonly used for monitoring the hypnotic component of anesthesia during perioperative period. BIS is first applied to clinical, a large number of data proved the good correlation between the BIS value and sedation degree, which is its uniqueness. Narcotrend monitor is a new type of EEG monitoring system, compared with the BIS, the time delay for calculation is shorter and the electrode is cheaper. This article reviewed the application and progress of the two technologies.%麻醉深度的评估一直是麻醉研究领域的一个重要话题。传统的临床麻醉常根据临床体征调节麻醉深度,如血压、心率、出汗、流泪、眼球运动等。这些体征可能由于手术类型不同因人而异,且可能随麻醉和手术时间延长出现疲劳现象,加之现代麻醉术中骨骼肌松弛药和血管扩张剂的联合使用,使得全麻下的临床体征很难用来准确客观地评估麻醉深度。随着神经电生理技术迅猛发展,近年产生了许多定量脑电图和诱发电位指标,可更加精确

  20. Glycemic Index values of some Jaffna fruits

    Directory of Open Access Journals (Sweden)

    Selladurai Pirasath

    2012-02-01

    Full Text Available Background: The incidence of diabetes mellitus has recently increased in developing countries. Scientific data on glycemic index values of common meals is essential to modify the diets for diabetes mellitus patients. This study aimed to evaluate the glycemic index (GI values of fruits such as ‘Kathali’ (Yellow plantain, ‘Kappal’ (Golden plantain, and ‘Itharai’ (Green plantain varieties of plantains, jack fruit and papaya. The results will be helpful to physicians and the general public to decide the benefits ofthe consumption of fruits, particularly by diabetic and coronary heart disease patients.Methods: Healthy volunteers (20 Nos. of 21.05(±0.92 years, 53.90 (±9.36 kg body weights, 153.92 (±9.15 m heights, and 20.55 (±2.22 kgm-2body mass indexes were selected with their written consent. After overnight fasting, 75g glucose and each test fruit containing 75g digestible carbohydrate were administered at different instances and blood glucose levels were measured half hourly for two hours. The glycemic response and GI values were calculated and analyzed by Randomized Complete Block Design using SAS analytical package.Results: The mean GI values of the ‘Kathali’, ‘Kappal’, ‘Itharai’ varieties of plantains, jack fruit and papaya were 54.45 (±9.26, 50.43 (±5.79, 48.47 (±10.13, 65.36 (±8.00 and 34.80 (±12.78 % respectively. The GI value of papaya differed significantly (P<0.05 from other fruits. The GI value of ‘Itharai’ variety of plantain differed significantly (P<0.05 from other fruits except the ‘Kappal’ varietyof plantain.Conclusion: The three varieties of plantains and papaya were low GI fruits, and jack fruit was found to be an intermediate GI fruit. The presence of dietary fiber, esp. soluble fiber, reduces the glycemicresponse and glycemic index of foods.

  1. Establishment of pharmacodynamic model of sevoflurane in pediatric patients: bispectral index%患儿七氟醚药效学模型的建立:脑电双频谱指数

    Institute of Scientific and Technical Information of China (English)

    宋蕴安; 黄悦; 林琳; 张马忠; 牛静

    2013-01-01

    Objective To establish the pharmacodynamic model of sevoflurane with bispectral index (BIS) as the effective index in pediatric patients.Methods Thirteen ASA physical status Ⅰ or Ⅱ pediatric patients,aged 4-9 yr,weighing 12-39 kg,undergoing non-cardiac surgery,were selected in the study.The pediatric patients sequentially inhaled 1%,5 % and 1% sevoflurane via a face mask and each concentration was inhaled for 15 min.BIS value,HR,BP and SpO2 were automatically recorded every 10 s.Based on nonlinear mixed effect modeling,the population pharmacodynamic model of sevoflurane was established using NONMEM software.The effect of age on the pharmacodynamic parameters was evaluated using a stepwise forward addition then backward elimination modeling approach.The standard for model improvement was defined as a decrease in the value of the objective function by more than 3.84.Results Twelve pediatric patients,aged 4.0-8.5 yr,weighing 12.8-38.0 kg,with body height of 92-135 cm,were enrolled in this study and the data which were enrolled comprised 2964 effective concentration-time-BIS points.The model was not improved significantly with any covariates (age,body height,and body weight) introduced (P > 0.05).The estimated parameters of the final pharmacodynamic model of sevoflurane were as follows:ke0 =O.516/min ; EC50 (BIS50) =2.11% ; γ =2.46 ; E0 =74.6 ; EMAx =11.2.Conclusion The pharmacodynamic model of sevoflurane is successfully established with BIS as the effective index in pediatric patients,and the analysis for each parameter of the model indicates that the sensitivity to sevoflurane is lower,but the blood-brain equilibration time of the drug is shorter and the onset and recovery are faster in children than in adults.%目的 以脑电双频谱指数(BIS)为效应指标,建立患儿七氟醚药效学模型.方法 选择行非心脏手术患儿13例,年龄4-9岁,体重12~39 kg,ASA分级Ⅰ或Ⅱ级.患儿经面罩顺序吸入七氟醚1%、5%和1

  2. Normative values for the Foot Posture Index

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    Redmond Anthony C

    2008-07-01

    Full Text Available Abstract Background The Foot Posture Index (FPI is a validated method for quantifying standing foot posture, and is being used in a variety of clinical settings. There have however, been no normative data available to date for comparison and reference. This study aimed to establish normative FPI reference values. Methods Studies reporting FPI data were identified by searching online databases. Nine authors contributed anonymised versions of their original datasets comprising 1648 individual observations. The datasets included information relating to centre, age, gender, pathology (if relevant, FPI scores and body mass index (BMI where available. FPI total scores were transformed to interval logit scores as per the Rasch model and normal ranges were defined. Comparisons between groups employed t-tests or ANOVA models as appropriate and data were explored descriptively and graphically. Results The main analysis based on a normal healthy population (n = 619 confirmed that a slightly pronated foot posture is the normal position at rest (mean back transformed FPI raw score = +4. A 'U' shaped relationship existed for age, with minors and older adults exhibiting significantly higher FPI scores than the general adult population (F = 51.07, p t = -1.44, p = 0.149. No relationship was found between the FPI and BMI. Systematic differences from the adult normals were confirmed in patients with neurogenic and idiopathic cavus (F = 216.981, p Conclusion A set of population norms for children, adults and older people have been derived from a large sample. Foot posture is related to age and the presence of pathology, but not influenced by gender or BMI. The normative values identified may assist in classifying foot type for the purpose of research and clinical decision making.

  3. Comparação dos valores do índice bispectral em pacientes com paralisia cerebral em estado de vigília Comparación de los valores del índice bispectral en pacientes con parálisis cerebral en estado de vigilia Comparison of the bispectral index in awake patients with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Verônica Vieira da Costa

    2007-08-01

    study was to evaluate the efficacy of the awake EEG-BIS in patients with cerebral palsy (CP by comparing it with patients without neurological disorders (without CP. METHODS: Two groups of patients were evaluated: one composed of patients with the diagnosis of cerebral palsy, and the other with subjects without central nervous system (CNS disorders. The day before the surgery, hospitalized patients were connected to the EEG-BIS monitor and were asked to close their eyes. The values on the monitor were recorded at 10-minute intervals on a standard form, and the mean value for each patient was calculated. RESULTS: One hundred and eighty-eight patients of both genders, mean age of 10.07 ± 2.9 (CP and 10.21 ± 3.1 (without CP, were evaluated. The basal EEG-BIS of the PC group was 95.83 ± 5.142 and in the non-CP group was 96.56 ± 1.941, which did not demonstrate a statistically significant difference. CONCLUSIONS: The signals of the EEG are captured normally and the values of the awake EEG-BIS of CP patients are similar to that of non-CP patients.

  4. Regressão da anestesia geral em pacientes com paralisia cerebral: estudo comparativo utilizando o índice bispectral Regresión de la anestesia general en pacientes con parálisis cerebral: estudio comparativo utilizando el índice bispectral Regression of general anesthesia in patients with cerebral palsy: a comparative study using the bispectral index

    Directory of Open Access Journals (Sweden)

    Verônica Vieira da Costa

    2006-10-01

    pacientes del grupo control estaba en el estadio III de regresión anestésica, versus 29% del grupo con parálisis cerebral. A los treinta minutos, el 72% de los pacientes del grupo control estaba apto para recibir el alta, estadio IV de regresión anestésica, versus 41,9% de los pacientes con PC. CONCLUSIONES: Los pacientes con parálisis cerebral presentaron un regreso más lento de la conciencia en comparación con el grupo control.BACKGROUND AND OBJECTIVES: It has been said that patients with cerebral palsy (CP present a higher sensitivity to anesthetic agents, which may affect adversely the awakening from anesthesia. The objective of this study was to evaluate the recovery of patients with CP compared with patients without CNS disease. METHODS: The study population was composed of children ages 5 to 15, divided in two groups: those with a diagnosis of cerebral palsy and those without CNS disease. All of them underwent general anesthesia with sevoflurane associated with nitrous oxide and 50% oxygen. Besides the parameters commonly monitored, they also underwent EEG-BIS monitoring. Regression of general anesthesia during awakening from anesthesia, tracheal extubation, and the immediate postanesthetic period were evaluated according to the criteria adopted by Saraiva. The speed of elimination of the anesthetic agents was also evaluated, correlating it with the EEG-BIS values, and comparing the two groups of patients. Statistical analysis was done through exploratory analysis of the data and statistical testing comparing the means. The statistical difference was considered significant for values of p smaller or equal to 5%. RESULTS: Fifty-six patients were evaluated: 31 with CP and 25 without CNS disease. Both groups were homogenous regarding age and gender. Baseline EEG-BIS values for CP patients were smaller than those for the control group, and this difference was statistically significant (p = 0.04. During the first five minutes after discontinuation of sevoflurane

  5. Efficacy of Sedation Scheme Research in ICU by Using Bispectral Index Scores%脑电双频指数评分用于重症监护病房镇静方案调整的效果

    Institute of Scientific and Technical Information of China (English)

    陈亚芳; 葛称; 蔡福良; 沈正林

    2014-01-01

    目的:临床药师参与镇静方案研究,使镇静剂更加安全、合理地用于重症监护患者。方法选择18岁以上以治疗为目的进行有创机械通气重症监护病房( ICU )住院患者,利用脑电双频指数(BIS)数值调整其镇静剂,用量使镇静处于最佳水平,记录患者的生命体征、咪达唑仑总用量及平均日用量。结果咪达唑仑平均日用量与年龄呈负相关,与身高、体重、体表面积呈正相关,男性患者用量大于女性患者,60岁以上患者用量小于60岁以下患者。结论咪达唑仑应根据患者的年龄、性别、身高、体重给予个体化镇静。%Objective To make the sedative agents use in ICU patients more safe and more rational by the clinical pharmacists partici-pating in the sedative scheme research. Methods The ICU inpatients aged over 18 years old with injured mechanical ventilation were selected. The bispectral index ( BIS ) was adopted to adjust the sedative agent for making the dosage in the optimal level. The patient vi-tal signs,total amount and average daily dose of midazolam were recorded. Results The average daily dose of midazolam was negatively correlated with age and positively correlated with height,body weight and body surface area. The midazolam dose of the male patients was more than that of the female patients,the midazolam dose for the patients aged over 60 years old was less than that for the pa-tients aged less than 60 years old. Conclusion Midazolam sedation should be individualized according to the patient's age,gender, height and weight.

  6. Values Reflected in the Human Development Index

    Science.gov (United States)

    Lind, Niels

    2004-01-01

    The Human Development Index (HDI) implicitly defines "human development" and ranks countries accordingly. To elucidate the HDI's meaning of "human development," the paper examines the sensitivity of the HDI to changes in its components, namely social indicators of education, longevity and standard of living. The HDI is next compared with two…

  7. Kernel-type estimators for the extreme value index

    NARCIS (Netherlands)

    De Wolf, P.P.; Lopuhaa, H.P.; Groeneboom, P.

    2003-01-01

    A large part of the theory of extreme value index estimation is developed for positive extreme value indices. The best-known estimator of a positive extreme value index is probably the Hill estimator. This estimator belongs to the category of moment estimators, but can also be interpreted as a quasi

  8. Protocol for the BAG-RECALL clinical trial: a prospective, multi-center, randomized, controlled trial to determine whether a bispectral index-guided protocol is superior to an anesthesia gas-guided protocol in reducing intraoperative awareness with explicit recall in high risk surgical patients.

    Science.gov (United States)

    Avidan, Michael S; Palanca, Ben J; Glick, David; Jacobsohn, Eric; Villafranca, Alex; O'Connor, Michael; Mashour, George A

    2009-11-30

    Awareness with explicit recall of intra-operative events is a rare and distressing complication that may lead to severe psychological symptoms. Candidate depth of anesthesia monitors have been developed, partly with the aim of preventing this complication. Despite conflicting results from clinical trials and the lack of incisive validation, such monitors have enjoyed widespread clinical adoption, in particular the bispectral index. The American Society of Anesthesiologists has called for adequately powered and rigorously designed clinical trials to determine whether the use of such monitors decreases the incidence of awareness in various settings. The aim of this study is to determine with increased precision whether incorporating the bispectral index into a structured general anesthesia protocol decreases the incidence of awareness with explicit recall among a subset of surgical patients at increased risk for awareness and scheduled to receive an inhalation gas-based general anesthetic. BAG-RECALL is a multi-center, randomized, controlled clinical trial, in which 6,000 patients are being assigned to bispectral index-guided anesthesia (target range, 40 to 60) or end-tidal anesthetic gas-guided anesthesia (target range, 0.7 to 1.3 age-adjusted minimum alveolar concentration). Postoperatively, patients are being assessed for explicit recall at two intervals (0 to 72 hours, and 30 days after extubation). The primary outcome of the trial is awareness with explicit recall. Secondary outcomes include postoperative mortality, psychological symptoms, intensive care and hospital length of stay, average anesthetic gas administration, postoperative pain and nausea and vomiting, duration of stay in the recovery area, intra-operative dreaming, and postoperative delirium. This trial has been designed to complement two other clinical trials: B-Unaware and MACS (ClinicalTrials.gov numbers, NCT00281489 and NCT00689091). With the large patient numbers and complementary rigorous

  9. Protocol for the BAG-RECALL clinical trial: a prospective, multi-center, randomized, controlled trial to determine whether a bispectral index-guided protocol is superior to an anesthesia gas-guided protocol in reducing intraoperative awareness with explicit recall in high risk surgical patients

    Directory of Open Access Journals (Sweden)

    Villafranca Alex

    2009-11-01

    Full Text Available Abstract Background Awareness with explicit recall of intra-operative events is a rare and distressing complication that may lead to severe psychological symptoms. Candidate depth of anesthesia monitors have been developed, partly with the aim of preventing this complication. Despite conflicting results from clinical trials and the lack of incisive validation, such monitors have enjoyed widespread clinical adoption, in particular the bispectral index. The American Society of Anesthesiologists has called for adequately powered and rigorously designed clinical trials to determine whether the use of such monitors decreases the incidence of awareness in various settings. The aim of this study is to determine with increased precision whether incorporating the bispectral index into a structured general anesthesia protocol decreases the incidence of awareness with explicit recall among a subset of surgical patients at increased risk for awareness and scheduled to receive an inhalation gas-based general anesthetic. Methods/Design BAG-RECALL is a multi-center, randomized, controlled clinical trial, in which 6,000 patients are being assigned to bispectral index-guided anesthesia (target range, 40 to 60 or end-tidal anesthetic gas-guided anesthesia (target range, 0.7 to 1.3 age-adjusted minimum alveolar concentration. Postoperatively, patients are being assessed for explicit recall at two intervals (0 to 72 hours, and 30 days after extubation. The primary outcome of the trial is awareness with explicit recall. Secondary outcomes include postoperative mortality, psychological symptoms, intensive care and hospital length of stay, average anesthetic gas administration, postoperative pain and nausea and vomiting, duration of stay in the recovery area, intra-operative dreaming, and postoperative delirium. Discussion This trial has been designed to complement two other clinical trials: B-Unaware and MACS (ClinicalTrials.gov numbers, NCT00281489 and NCT00689091

  10. Influence of intravenous clonidine pretreatment on anesthetic requirements during bispectral EEG-guided sevoflurane anesthesia

    NARCIS (Netherlands)

    De Deyne, C; Struys, M; Heylen, R; De Jongh, R; Vander Laenen, M; Buyse, L; Deghislage, J; Rolly, G

    2000-01-01

    Study Objective: To assess the anaesthetic effects of clonidine during sevoflurane anaesthesia guided by the bispectral index (BIS), which is a processed EEG variable correlated with anaesthetic-hypnotic depth. Design: Placebo-controlled, double-blind clinical trial Settings: Elective laparoscopic s

  11. The Economic Value of Predicting Stock Index Returns and Volatility

    NARCIS (Netherlands)

    W.A. Marquering (Wessel); M.J.C.M. Verbeek (Marno)

    2001-01-01

    textabstractIn this paper, we analyze the economic value of predicting stock index returns as well as volatility. On the basis of simple linear models, estimated recursively, we produce genuine out-of-sample forecasts for the return on the S&P 500 index and its volatility. Using monthly data from

  12. The Economic Value of Predicting Stock Index Returns and Volatility

    NARCIS (Netherlands)

    Marquering, W.; Verbeek, M.J.C.M.

    2000-01-01

    In this paper, we analyze the economic value of predicting index returns as well as volatility. On the basis of fairly simple linear models, estimated recursively, we produce genuine out-of-sample forecasts for the return on the S&P 500 index and its volatility. Using monthly data from 1954-1998, we

  13. Adding Value to Scholarly Journals through a Citation Indexing System

    Science.gov (United States)

    Zainab, A. N.; Abrizah, A.; Raj, R. G.

    2013-01-01

    Purpose: The purpose of this paper is to relate the problems identified about scholarly journal publishing in Malaysia to establish motivation for the system development; to describe the design of MyCite, a Malaysian citation indexing system and to highlight the added value to journals and articles indexed through the generation of bibliometrics…

  14. Detection value of Th17 related indexes and platelet activation indexes in patients with liver cancer

    Institute of Scientific and Technical Information of China (English)

    Pai-Qiang Chen; Qiao-Li Jiang; Jun Li; Jing Zhang

    2017-01-01

    Objective:To study the detection value of Th17 related indexes and platelet activation indexes in the patients with liver cancer.Methods: A total of 59 patients with liver cancer in our hospital from July 2015 to June 2016 were selected as the observation group, 59 healthy persons of the same ages with physical examination were selected as the control group, then the serum Th17 related indexes and platelet activation indexes levels of two groups were detected and compared, then the serum Th17 related indexes and platelet activation indexes levels of observation group with different stages and types of liver cancer were compared too. Results:The serum Th17 related indexes and platelet activation indexes levels of observation group were all higher than those of control group, the serum Th17 related indexes and platelet activation indexes levels of observation group with different stages and types of liver cancer had obvious differences (allP<0.05).Conclusions: The Th17 related indexes and platelet activation indexes of patients with liver cancer show higher expression state, and the expression levels of patients with different stages and types of liver cancer have obvious differences too, so the clinical detection value of those indexes in the patients with liver cancer are higher.

  15. Clinical evaluation of midazolam intravenous sedation under bispectral index monitoring on romoval of anterior supernumerary teeth in children%咪达唑仑静脉注射对儿童埋伏多生牙拔除术中镇静效果的临床评价

    Institute of Scientific and Technical Information of China (English)

    关明; 王恩博; 刘宇; 崔念晖; 丁蓓; 张伟

    2012-01-01

    Objective: To evaluate the efficacy and safety of midazolam intravenous sedation plus local anaesthesia on removal of children' s anterior supernumerary teeth in dental clinic. Methods: A total of 41 ASA I children with anterior supernumerary teeth aged 6 to 14 were selected for removal surgery, anaesthesia was done by moderate sedation by midazolam intravenous titration plus local anaesthesia. Heart rate (HR) , blood pressure (BP) , pulse oxygen saturation rate (SpO2) , bispectral index (BIS) and Ramsay sedation score ( RSS) at different time points were recorded (5 min after patient is in operation room, at local anaesthesia injection, at incision, 10 min after incision and at the end of operation). After operation, the overall efficacy of sedation by Houpt rating scale was evaluated by surgeon, anaes-thesiologist and anaesthetic nurse. Results; Among the 41 children, 29 were male, 12 were female, mean age (9.76 ±2.46) years old; The average operation time was (23.83 ±9.98) min, total dose of midazolam was (2. 96 ±0. 92) mg with a dosage rate being (0. 084 ±0. 016) mg/kg. There was a positive correlation between age and total dose (r=0.69, P < 0.01) ; and a negative correlation between age and total dosage (r= -0. 37, P <0. 05). With the decreasing of age, probability for children to move or cry during local anaesthesia can increase, while with the increasing of age, probability for children to memorize the clicking of drill or hammer could increase. The correlation coefficient between RSS and BIS value was r = -0. 854 (P <0.01) , the median BIS value corresponded to RSS of 3 was 75. Pulse oxygen saturation rate was above 95% in all the cases. Conclusion: Sedation by midazolam intravenous titration is a safe and efficient method of anesthesia for removal of children' s anterior supernumerary teeth when BIS value is above 75.%目的:旨在评估咪达唑仑静脉镇静联合局部麻醉拔除儿童上颌理伏多生牙的镇静效果及共安全性.方法:选

  16. 脑电双频指数调控下的七氟烷吸入麻醉在小儿腹腔镜手术中的应用%The application of bispectral index control in sevoflurane anesthesia for pediatric laparoscopic surgery

    Institute of Scientific and Technical Information of China (English)

    毕林; 牟崇明; 卓庆亮; 刘江洪; 刘才堂

    2012-01-01

    Objective To study the feasibility of application of bispertral index ( BIS ) control in sevoflurane anesthesia in pediatrir laparosropir surgery. Methods Laparoscopic hernia repair had been performed in 80 children, they were equally divided into experimental group ( group Ⅰ ) and control group ( group Ⅱ ). Patients in group Ⅰ maintained BIS value at 40 - 60 through the regulation of end - tidal sevoflurane concentration ( Etsevo ) , and patients in group II were maintained with control Etsevo according to fluctuation of basic value ± 20% of blood pressure and heart rate. Hemodynamic changes, BIS value, Etsevo, extubation time and off - room time were recorded in patients of these two groups. Results The mean arterial pressure ( MAP ) and BIS value during anesthesia in group Ⅰ were higher than those of group Ⅱ ( P < 0. 05 ) , but Etsevo was lower than that of group Ⅱ ( P < 0. 05 ) in maintaining anesthesia. Extubation time and off - room time in group Ⅰ were less than those of group Ⅱ ( P <0. 05 ). Conclusion The application of bispectral index control in sevoflurane anesthesia for pediatrir laparoscopic surgery can reduce the dosage of sevoflurane and keep steady hemodynamics in children and improve the safety of anesthesia, so its application in laparoscopic surgery for children is safe and feasible.%目的 探讨脑电双频指数(BIS)调控下七氟烷吸入麻醉在小儿腹腔镜手术中的应用.方法 择期行腹腔镜手术的患儿80例,随机分为试验组(I组)和对照组(II组),每组40例.I组通过调控七氟烷呼气末浓度(Etsevo)维持BIS值在40~60,II组维持血压和心率在基础值的±20% 波动调控Etsevo,并监测BIS值.记录两组血流动力学变化、BIS值、ETsevo、拔管时间和离室时间.结果 I组麻醉过程中平均动脉压(MAP)和BIS值均高于II组(P<0.05);麻醉维持期I组ETsevo低于II组(P<0.05);I组拔管时间和离室时间都明显少于II组(P均<0.05).结论 BIS调控七氟烷

  17. Midazolam por via oral como medicação pré-anestésica em crianças e adolescentes com paralisia cerebral: estudo comparativo das variações do índice bispectral Midazolam por vía oral como medicación preanestésica en niños y adolescentes con parálisis cerebral: estudio comparativo de las variaciones del índice bispectral Oral midazolam as pre-anesthetic medication in children and teenagers with cerebral palsy: a comparative study on the variations of the bispectral index

    Directory of Open Access Journals (Sweden)

    Verônica Vieira da Costa

    2009-02-01

    grupo de pacientes que presentan una serie de particularidades, con alteraciones inclusive en la región de la acción del midazolam. El objetivo del estudio fue evaluar la acción del midazolam utilizado como medicación preanestésica sobre el índice bispectral (EEG-BIS de los pacientes con parálisis cerebral. MÉTODO: Se evaluaron dos grupos de pacientes: uno con diagnóstico de PC y el otro sin enfermedad del sistema nervioso central (SNC y periférico. Se registraron valores de EEG-BIS en la enfermería en la víspera de la operación y el día de la operación, 40 minutos después de la administración de 0,6 mg.kg-1 de midazolam por vía oral. Quedaron excluidos pacientes con historial de reacción paradoxal al midazolam y pacientes del grupo control que estuviesen usando otra medicación. RESULTADOS: Se estudiaron 77 pacientes de ambos sexos, entre 4 y 18 años de edad. No hubo diferencia entre los valores de EEG-BIS basal entre los grupos estudiados. Después del uso del midazolam hubo una reducción de los valores del EEG-BIS en los dos grupos estudiados, con diferencia estadística significativa en cada grupo. En la comparación entre los grupos no hubo diferencia estadística. CONCLUSIONES: El midazolam administrado como medicación preanestésica en la dosis de 0,6 mg.kg-1 redujo los valores basales del EEG-BIS sin caracterizar la hipnosis y sin diferencia estadística en los grupos estudiados.BACKGROUND AND OBJECTIVES: Midazolam is a benzodiazepine with hypnotic action widely used as pre-anesthetic medication in pediatric anesthesia. Children with cerebral palsy (CP also benefit from the use of midazolam, but its effects on this group of patients, who present several particularities, including changes at the site of action of midazolam, are still unknown. The objective of this study was to evaluate the effects of midazolam, when used as pre-anesthetic medication, on the bispectral index (EEG-BIS of patients with cerebral palsy. METHODS: Two groups of

  18. Effect of the nursing intervention and guiding significance of bispectral index monitoring in coma patients after hematoma clearance%护理干预对颅脑血肿清除术后昏迷患者的作用及脑电双频指数监测对其指导意义

    Institute of Scientific and Technical Information of China (English)

    林凡菊; 陈莉芳

    2016-01-01

    Objective:To explore the effects of the nursing intervention and guiding significance of bispectral index BIS monitoring in coma patients after hematoma clearance. Methods:Eighty coma patients after craniotomy operation in ICU were randomly divided into the control group and observation group(40 cases each group). Two groups were treated with symptomatic therapy and 24 h reaction level scale( BIS) monitoring. The control group were nursed with the route method, and the observation group were nursed with strengthening the respiratory tract and catheter management. The prognosis condition, BIS value and respirator use time in different prognosis patients between two groups were compared. The correlation of BIS value with GCS score and RLS classification were analyzed. Results:All patients were followed up for half a year, the number of cases with good prognosis in observation group were significantly higher than that in control group(P <0. 01). Among the observation group,the BIS value and respirator use time in patients with good prognosis were significantly higher and less than those in patient with poor prognosis,respectively(P<0. 01). The correlation analysis showed that the BIS value was positive correlation with GCS score,and negative correlation with RLS classification (P<0. 05). Conclusions:The effective nursing intervention can significantly improve the prognosis,and reduce the mortality. The BIS monitoring can effectively reflect the degree of cerebral dysfunction and prognosis of patients.%目的::探讨护理干预措施对ICU血肿清除术后昏迷患者作用及脑电双频指数( BIS)监测对其指导意义。方法:行开颅手术后仍昏迷而送ICU监护患者80例,随机分为对照组和观察组,各40例。2组患者术后均给予对症治疗并进行24 h BIS监测,对照组患者给予常规护理,观察组患者进行加强呼吸道、导管管理等护理干预措施。比较2组患者预后情况,不同预后患者BIS值和呼吸

  19. International Tables of Glycemic Index and Glycemic Load Values: 2008

    OpenAIRE

    Atkinson, Fiona S.; Foster-Powell, Kaye; Brand-Miller, Jennie C.

    2008-01-01

    OBJECTIVE—To systematically tabulate published and unpublished sources of reliable glycemic index (GI) values. RESEARCH DESIGN AND METHODS—A literature search identified 205 articles published between 1981 and 2007. Unpublished data were also included where the data quality could be verified. The data were separated into two lists: the first representing more precise data derived from testing healthy subjects and the second primarily from individuals with impaired glucose metabolism. RESULTS—...

  20. Usefulness of bispectral monitoring of conscious sedation during endoscopic mucosal dissection

    Institute of Scientific and Technical Information of China (English)

    Kazunori Hata; Akira Andoh; Kiyoyuki Hayafuji; Atsuhiro Ogawa; Tamio Nakahara; Tomoyuki Tsujikawa; Yoshihide Fujiyama; Yasuharu Saito

    2009-01-01

    AIM: To assess the usefulness of bispectral index (BIS) monitoring in order to carry out endoscopic submucosal dissection (ESD) safely and with patients'satisfaction. METHODS: Three hundred sixty-six patients with an early-stage neoplasm of the digestive tract were enrolled. The BIS monitor (A-1050: Aspect medical systems/NIHON KOHDEN, Tokyo, Japan) was used. The appropriate sedative condition was set at 55 to 75 BIS levels (BIS value) during the endoscopic procedures.RESULTS: Among 366 cases, 13 were accompanied by adverse events during and/or after ESD. All episodes occurred in cases with BIS value between 56 and 65. Hypotension was observed in four cases, and bradycardia in six. Respiratory distress was observed in two cases with chronic pulmonary obstructive disease. All patients with adverse events were able to leave the hospital without extension of the hospitalization. CONCLUSION: BIS monitoring is useful to safely perform ESD. A BIS value of 70 to 75 is suitable for ESD.

  1. A NOVEL METHOD ON DESIGNING BISPECTRAL WINDOWS

    Institute of Scientific and Technical Information of China (English)

    YaoWenbing; YaoTianren; 等

    2002-01-01

    A novel method on designing bispectral windows is proposed in this letter.Com-pound functions based on a function with binary quadric form,starting from the symmetry characteristic of three-order moments are used as the 2-D window functions.Two approaches on how to find the expressions of the compound functions are discussed in detail.One is to approxi-mate the compound function after being Taylor expanded under the MinimumMean Square Error (MMSE)criteria.Another is to compound the hyperbolic secant function and the binary quadric function directly.According to theoretical analysis,the first type new windows have been proved as slightly better than the conventional ones,the second type new windows are much better than the conventional ones ,and the bispectral estimation mean square error approximates to 0.

  2. Prediction of endotracheal intubation outcome in opioid-poisoned patients: A clinical approach to bispectral monitoring

    OpenAIRE

    Eizadi-Mood, Nastaran; Yaraghi, Ahmad; Alikhasi, Mahsa; Jabalameli, Mitra; Farsaei, Shadi; Sabzghabaee, Ali Mohammad

    2014-01-01

    BACKGROUND: Some opioid-poisoned patients do not respond appropriately to naloxone; consequently, intubation is required. Although various measures have been used to evaluate the level of consciousness of poisoned patients, no study has assessed the role of the bispectral index (BIS) to ascertain the depth of anesthesia in opioid-poisoned patients who require endotracheal intubation. OBJECTIVE: To compare BIS scores between opioid-poisoned patients with and without intubation, and to determin...

  3. Bispectral Index as an Indicator of Cerebral Hypoperfusion During Off Pump Coronary Artery Bypass Grafting%脑电双频指数作为脑灌注不足指标在非体外循环下冠状动脉旁路移植术中的应用

    Institute of Scientific and Technical Information of China (English)

    Thomas M. Hemmerling; Jean-Fran(c)ois Olivier; Fadi Basile; Nien Le; Ignatio Prieto; 徐静

    2006-01-01

    非体外循环下冠状动脉旁路移植术(off-pump coronary artery bypass grafting,OPCAB)中常发生心动过缓和低血压.本文报道一例58岁行冠脉左回旋支远端吻合时并发可逆性脑灌注不足的病例.术中行远端吻合时,该患者的脑电双频指数(bispectral index,BIS)从45~50骤降至0.术后在手术室内拔除气管导管即刻的神经系统功能评估正常,无神经系统后遗症.术后恢复顺利,于术后第5天出院.OPCAB术中可能并发脑灌注不足,BIS可用于监测OPCAB术中脑灌注不足的发生.

  4. Estimation of the tail index for lattice-valued sequences

    DEFF Research Database (Denmark)

    Matsui, Muneya; Mikosch, Thomas Valentin; Tafakori, Laleh

    2013-01-01

    If one applies the Hill, Pickands or Dekkers–Einmahl–de Haan estimators of the tail index of a distribution to data which are rounded off one often observes that these estimators oscillate strongly as a function of the number k of order statistics involved.We study this phenomenon in the case of ...... of a Pareto distribution. We provide formulas for the expected value and variance of the Hill estimator and give bounds on k when the central limit theorem is still applicable. We illustrate the theory by using simulated and real-life data....

  5. A study of bispectral index monitoring in assessing the depth of sedation of patients under mechanical ventilation%脑电双频指数监测对机械通气患者镇静深度评估的研究

    Institute of Scientific and Technical Information of China (English)

    李孝锦; 康焰; 张川

    2009-01-01

    Objective To investigate the correlation between subjective scoring and bispectral index (BIS) monitoring, and to study the feasibility of BIS monitor in assessing the depth of sedation for mechanically ventilated patients. Methods A prospective randomized controlled trial was conducted. The sedation target was sedation-agitation scale (SAS) 3 - 4. A total of 83 patients in the intensive care unit were assigned to receive the sedation based on BIS monitor (42 eaese) or the sedation based on subjective scale SAS (41 eases). The parameters of respiration, circulation, and the depth of sedation (BIS, SAS, Ramsay) were recorded. The difference between the two groups was compared. The correlation index and significance were calculated. Results A total of 83 patients of two groups reached the sedation target. Statistically significant difference was found between two groups in respiratory rate, fraction of inspiratory oxygen, and pulse saturation of oxygen before and after sedation (all P0.05).所有患者镇静后呼吸频率、吸入氧浓度较镇静前显著下降,脉搏血氧饱和度显著升高,差异均有统计学意义(P均<0.05);BIS值与主观评分间相关性良好,其中BIS与SAS评分呈显著正相关(r=0.626,P<0.05),与Ramsay评分呈显著负相关(r=-0.650,P<0.05),SAS与Ramsay评分呈显著负相关(r=0.908,P<0.05).结论 用BIS监测评估机械通气患者镇静深度简单方便、同步有效,是评价ICU机械通气患者镇静深度的良好客观指标.

  6. Determination of glycemic index value of Naturo fruit bars.

    Science.gov (United States)

    Reddy, K Kodanda Rami; Raju, I Naga; Giriprasad, B; Lakshminarayanan, G; Sekhar, R Chandra; Reddy, C Damodar

    2009-11-01

    The glycemic response to Naturo fruit bar that is commercially available in India was determined against a glucose sta dard in a non-blind, repeated measure, crossover design trial. Eleven healthy subjects (mean age 37.3 (SD 5.5) years and mean BMI 213 (SD 36) kg/m2) were recruited to the study. Subjects were given Naturo fruit bar and a standard food (glucose), on separate occasions, each containing 50 grams carbohydrate. Blood glucose was determined after overnight fasting (0 hours) and at 30, 60, 90 and 120 min after the consumption of each test food. For Naturo fruit bar, the glycemic index (GI) value was calculated geometrically by expressing the incremental area under the blood glucose curve (iAUC) as a percentage of each subject's average iAUC for the standard food. The GI value of Naturo fruit bar was found to be 38.50. As per the Food and Agriculture Organization, GI cut-off values are as follows: low 70. Therefore Naturo fruit bar could be classified under low glycemic food/nutrient. Considering the widespread consumption of fruits/bars in India, this information is valuable for people who prefer to use low glycemic food which offer many beneficial effects because their consumption significantly reduces the GI of the diets of the Indian population.

  7. Glycaemic index values in the Finnish food composition database: an approach to standardised value documentation.

    Science.gov (United States)

    Kaartinen, N E; Similä, M E; Pakkala, H; Korhonen, T; Männistö, S; Valsta, L M

    2010-11-01

    The glycaemic index (GI) is used to describe the blood glucose-raising potential of carbohydrate-containing foods. Only a few descriptions of the addition of GI values to national food composition databases (FCDBs) exist. We tested whether the value documentation framework established within the European Food Information Resource (EuroFIR) Network could be used for GI values when adding them to the Finnish FCDB. The list of foods requiring GI values was based on the National FINDIET 2007 Survey data and extended with foods encoded in a food-frequency questionnaire used in other nationally representative studies. The minimum quality of GI measurements was verified when gathering values from various sources, using earlier defined criteria. If a measured GI value for a food was directly available, or could be imputed or estimated, the value was added to the Finnish FCDB and documented using core standard vocabularies of EuroFIR. The GI values of composite foods were calculated using recipe calculation software. A total of 2210 foods required a GI value. GI values for 1322 foods were available and added to the FCDB. The remaining 888 foods were composite foods and received a GI value through recipe calculation. The standard vocabularies describing the origin of the GI values, the methods used in their derivation and their qualitative characteristics were suitable for GI values. GI values can be added to FCDBs and documented using terms similar to those used for traditional food composition data. Standardised value documentation may provide transparency for GI database compilation processes.

  8. The Comparative Study of Entropy and Bispectral Indexes on Monitoring the Depth of Anaesthesia for the Elderly Patients%脑电双频指数和熵指数监测老年患者麻醉深度的比较

    Institute of Scientific and Technical Information of China (English)

    于帅; 林财珠

    2015-01-01

    目的:研究脑电双频指数和熵指数在老年患者硬膜外复合丙泊酚靶控静脉全麻中麻醉深度监测的可行性、准确性,并比较其优越性。方法选取择期行根治性全胃切除术的老年胃癌患者40例,均采用硬膜外复合丙泊酚靶控输注静脉全麻的麻醉方法,记录不同时间节点患者的心率(HR)、平均动脉压(MAP)、脑电双频指数(BIS)、反应熵(RE)、状态熵(SE)及停药后苏醒时间、拔管时间、手术时间、丙泊酚总用量、术中知晓的发生与否。结果应用阶梯式靶控输注丙泊酚诱导、术中维持及停药后BIS和RE、SE均随着意识变化而变化,2组之间差别无统计学意义。结论老年患者上腹部手术中施行硬膜外复合丙泊酚靶控输注静脉全麻时,BIS和RE、SE均可准确反映其麻醉深度。%Objective To compare the differences between entropy and bispectral indexes on mo‐nitoring the depth of anaesthesia for the elderly patients during the target‐controlled infusion (TCI) of propofol general anesthesia . Methods Fourty elderly patients undergoing elective abdominal surgery were studied . Anaesthesia was induced with epidural anesthesia combined with the target‐controlled infu‐sion (TCI) of propofol general anesthesia . Recording HR ,MAP ,BIS ,RE ,SE at different time ,also the emergence time and extubation time after discontinuation ,total operating time ,total dose of propofol ,and occurrence of the perioperative awareness . Results When applying ladder‐type target‐controlled infusion of propofol ,BIS and RE ,SE all changed with the conscious during induction ,maintenance and discontinua‐tion of propofol . There was no statistic difference between two groups . Conclusion In elderly patients with upper abdominal surgery in the implementation of epidural composite propofol target‐controlled infu‐sion w hen general anesthesia ,BIS and RE ,SE may reflect the depth of

  9. Evaluation of bispectral LIDAR data for urban vegetation mapping

    Science.gov (United States)

    Nabucet, Jean; Hubert-Moy, Laurence; Corpetti, Thomas; Launeau, Patrick; Lague, Dimitri; Michon, Cyril; Quenol, Herve

    2016-10-01

    Because of the large increase of urban population in the last decades, the question of sustainable development in urban areas is crucial. In this context, vegetation plays a significant role in urban planning, environmental protecting, and sustainable development policy making, heating and cooling requirements of buildings, displacement of animals dispersion, concentration of pollutants, and well-being. In numerous cities, vegetation is limited to public areas using GPS surveys or aerial remote sensing data. Recently, very high-resolution sensors as Light Detection and Ranging (LiDAR) data have permitted significant improvements in vegetation mapping in urban areas. This paper presents an evaluation of a new generation of airborne LIDAR bi-spectral discrete point (Optech titan) for mapping and characterizing urban vegetation. The methodology is based on a four-step approach: 1) the analysis of the quality of data in order to estimate noise between the green and near-infrared LIDAR point clouds; 2) this enables to remove the topographic effects and 3) a first classification, devoted to the elimination of the non-vegetation class, is performed based on the intensity value of the two channels; finally, in 4), the tree coverage is classified into seven categories of strata combination. To this end specific descriptors related to the organization of the point clouds are used. These first results show that compared to monospectral LiDAR data, bi-spectral LiDAR enables to improve significantly both the extraction and the characterization of urban objects. This reveals new perspectives for mapping and characterizing urban patterns and other complex structures.

  10. The effect of preventing awareness during total intravenous anesthesia by bispectral index monitoring:a prospective, randomized, double-blinded, multicentre controlled trial%BIS监测预防全凭静脉麻醉下术中知晓的多中心研究

    Institute of Scientific and Technical Information of China (English)

    吴奇伟; 张忱; 胥亮; 吴安石; 岳云; 柳娟

    2014-01-01

    Objective To evaluate the efficacy of bispectral index (BIS) monitoring on preventing awareness in pa-tients undergoing total intravenous anesthesia (TIVA), and determine the reasons for awareness by analyzing the intra-oper-ative BIS values of awareness cases. Methods This study was a prospective, randomized, double-blinded, multicentre controlled trial. Patients (≥16 years old) undergoing TIVA were randomly assigned to BIS-guided group (Group A, monitored and maintained BIS between 40~60 intra-operatively) and the control group (Group B, monitored BIS but the screen was covered). Blinded observer interviewed the patients for awareness at the 1st and 4th day after surgery. An inde-pendent evaluating committee assessed the results and identified the confirmed or possible awareness cases. The intraoper-ative BIS values were downloaded and the BIS trends of confirmed awareness cases were analyzed to determine whether in-adequate anesthesia existed. The primary outcome of the study was the incidence of confirmed awareness. Results Of the total 5 228 cases, 2 919 patients in the BIS group and 2 309 in the control group were included in the statistical analysis. Four confirmed awareness (0.14%) were reported in the BIS group and 15 confirmed awareness (0.65%) in the control group (P=0.002, OR=0.21, 95%CI:0.07~0.63), BIS-guided TIVA reduced the incidence of awareness by 78%. The inci-dences of possible awareness (0.14% vs. 0.26%, P= 0.485) and dreaming (3.1% vs. 3.1%, P= 0.986) were comparable between the BIS-guided group and the control group. Among the total 19 confirmed awareness patients, BIS trend of 8 cases (3 cases in Group A and 5 cases in Group B) was unavailable. Apart from these cases, 6 cases were identified to have intra-operative BIS trends, 5 of whom (4 cases in Group B, 1 case in Group A) showed BIS>60 and lasted for 19~106 min, whereas BIS trend in the other 1 case (Group B) was stable and BIS values were within 60 during the operation. Another 5

  11. Prediction of endotracheal intubation outcome in opioid-poisoned patients: A clinical approach to bispectral monitoring.

    Science.gov (United States)

    Eizadi-Mood, Nastaran; Yaraghi, Ahmad; Alikhasi, Mahsa; Jabalameli, Mitra; Farsaei, Shadi; Sabzghabaee, Ali Mohammad

    2014-01-01

    Some opioid-poisoned patients do not respond appropriately to naloxone; consequently, intubation is required. Although various measures have been used to evaluate the level of consciousness of poisoned patients, no study has assessed the role of the bispectral index (BIS) to ascertain the depth of anesthesia in opioid-poisoned patients who require endotracheal intubation. To compare BIS scores between opioid-poisoned patients with and without intubation, and to determine the BIS cut-off point for endotracheal intubation in these patients. In the present cross-sectional study, conducted in an Iranian university referral hospital for poisoning emergencies between 2012 and 2013, opioid-poisoned patients (n=41) were divided into two groups according to their requirement for endotracheal intubation. BIS analyses were performed at the time of admission and at the time of intubation for those who required it. In addition, electromyography and signal quality index were evaluated for all patients at the time of admission, and cardiorespiratory monitoring was performed during the hospitalization period. Using ROC curves, and sensitivity and specificity analyses, the optimal BIS cut-off point for prediction of intubation of these patients was determined. The optimal cut-off point for prediction of intubation was BIS ≤78, which had a sensitivity of 86.7% (95% CI 66.1 to 98.8) and specificity of 88.5% (95% CI 73.9% to 98.8%); the positive and negative predictive values were 81.2 % and 92%, respectively. BIS may be considered an acceptable index to determine the need for intubation in opioid-poisoned patients whose response to naloxone is inadequate.

  12. Bispectral Operators of Rank $1$ and Dual Isomonodromic Deformations

    CERN Document Server

    Harnad, J

    1996-01-01

    A comparison is made between bispectral operator pairs and dual pairs of isomonodromic deformation equations. Through examples, it is shown how operators belonging to rank one bispectral algebras may be viewed equivalently as defining 1-parameter families of rational first order differential operators with matricial coefficients on the Riemann sphere, whose monodromy is trivial. By interchanging the rôles of the two variables entering in the bispectral pair, a second 1-parameter family of operators with trivial monodromy is obtained, which may be viewed as the dual isomonodromic deformation system.

  13. Bispectral index-guided intraoperative sedation with dexmedetomidine and midazolam infusion in orthopaedic surgery of lower limbs%脑电双频指数引导下右美托咪啶和咪达唑仑用于下肢手术镇静的比较

    Institute of Scientific and Technical Information of China (English)

    赵一凡; 陈倩茹; 胡楚文; 曹铭辉

    2011-01-01

    Objective To compare and evaluate the effect and safety of dexmedetomidine(DEX) and midazolam sedation in lower limbs orthopaedic surgery. Methods Fifty-two patients undergoing lower limbs surgery were randomly assigned to group D (n=27,DEX, 0.5 μg·kg-1·h-1, loading dose 0.5 μg/kg) and group M(n=25, midazolam, 50 μg·kg-1·h-1, loading dose 30 μg/kg). An infusion was administered after mounting a bispectral index (BIS) monitor under combined spinal-epidural anesthesia. The target BIS level was≤85. An additional bolus dose of the study drug or cessation of the infusion was adjusted according to the BIS level, and the change should be recorded. Respiratory rates (RR), heart rate (HR), pulse oxygen saturation (SpO2), mean arterial blood pressure (MAP) were continually monitored. Sedation should be evaluated according to the Ramsay sedation scale(RSS) before the drug withdrawal. Results HR was lower in group D (72±7) bpm than that in group M (83±8) bpm (P0.05).两组的停药前RSS评分差异无统计学意义(P>0.05).D组有6例、M组有7例需要进行剂量调整.另外,M组有5例因舌后坠致SpO2下降需托下颌处理,D组无类似情况.结论 DEX用于骨科下肢手术镇静可引起HR减慢但对血压无明显影响;在相同的镇静程度下,DEX比咪达唑仑更有利丁维持呼吸道通畅,可能更适用于该类手术的镇静.

  14. Prediction of Bispectral index on state of consciousness of patients with colon cancer of different ages during Midazolam target controlled infusion%咪达唑仑靶控输注期间BIS对不同年龄结肠癌患者意识状态的预测

    Institute of Scientific and Technical Information of China (English)

    魏双江

    2012-01-01

    Objective To explore the prediction of bispectral index (BIS) and the influence of age on the state of consciousness of patients with colon cancer during Midazolam target controlled infusion (TCI). Methods Clinical data of 40 patients receiving colon cancer surgery under epidural anesthesia in our hospital from February 2004 to February 2010 were analyzed retrospectively. These patients were divided into the young group (40-64 years old, group A) and the elder group (65-85 years old, group B) by age, with 20 patients in each group. TCI was implemented stage by stage based on the target concentration (Ce) of Midazolam effect-site and the state of consciousness was evaluated using the observer's assessment of alertness/sedation (OAA/S) scale. The BIS values and hemodynamic parameters immediately prior to each scoring were recorded. The probability of BIS in predicting sedative depth was analyzed and used to evaluate the predictability of BIS on the sate of consciousness. Results With the increase of Midazolam Ce, BIS of the two groups of patients decreased gradually with the same changing trend. When patients lost consciousness, the BIS was (61.6±7.9) for group A and (72.9± 5.9) for group B, and the Ce was (69.8±8.9)μg/L for group A and (53.3±9.4) μg/L for group B. At the same sedation score (OAA/S4-1), the BIS of group B was significantly higher than that of group A (P 0.05); during TCI, the heart rate and pulse oximetry saturation had no significant changes. Compared to the basic values, when OAA/S score dropped below 2, the blood pressure decreased (P < 0.05). Conclusion During midazolam TCI, BIS can predict the changes of state of consciousness equally for young patients and elder patients.%目的 探讨咪达唑仑靶控输注(TCI)期间脑电双频谱指数(BIS)对结肠癌患者意识状态变化的预测及不同年龄对其的影响.方法 回顾性分析我院2004年2月~2010年2月收治入院的采用硬膜外麻醉下行结肠癌手术患者40

  15. 脑电双频指数用于重度烧伤患者瑞芬太尼复合丙泊酚靶控输注镇静深度的观察%Observation of anesthesia depth in severe burn patients with target controlled infusion of propofol and remifentanil by bispectral index

    Institute of Scientific and Technical Information of China (English)

    郭正纲; 郝建华; 贾晓鹏; 祈喆

    2012-01-01

    Objective To evaluate the feasibility and efficiency of bispectral index (BIS) for monitoring the anesthesia depth of severe burn patients with target controlled infusion (TCI) of propofol and remifentanil. Methods A total of 80 severe burns patients undergoing eschar excision (values upon entrance into the operation room (P<0.05). The HR at all time points were significantly lower compared with the basic data (P<0.05). Conclusion BIS for monitoring the anesthetic depth of severe burns patients

  16. A Delphi Study Using Value-Focused Thinking for United States Air Force Mission Dependency Index Values

    Science.gov (United States)

    2015-03-26

    Keeney, R. L. (1992). Value-Focused Thinking : A Path to Creative Decisionmaking. Cambridge: Harvard University Press. Keeney, R. L. (1996). Value...the Role of Value-Focused Thinking in Idea Management. Creativity and Innovation Management, 196-206. Shoviak, M. J. (2001). Decision Analysis...A DELPHI STUDY USING VALUE-FOCUSED THINKING FOR UNITED STATES AIR FORCE MISSION DEPENDENCY INDEX

  17. Habitat similarity index (HSI) values for greater sage-grouse across their western range.

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — Habitat similarity index (HSI) values for greater sage-grouse across their western range. HSI values represent the relationship of environmental values at map...

  18. Effect of propofol combined with remifentanil infusion on bispectral index in patients with essential hypertension%丙泊酚复合瑞芬太尼靶控输注对高血压患者脑电双频指数的影响

    Institute of Scientific and Technical Information of China (English)

    周玉军

    2016-01-01

    Objective: To study the effects of propofol compound fentanyl target controlled infusion on bispectral index (BIS) in hypertension patients.Methods: Selected 105 hypertension patients with propofol compound fentanyl target controlled infusion anesthesia from January 2015 to March 2016 in our hospital, divided the patients into three groups according to the fentanyl concentration of target controlled infusion, concentration of 2.0 ng/mL for group I, 3.0 ng/mL for group II, and 4.0 ng/mL for group III, and target concentrations of propofol in three groups were all 4 μg/mL, each group of 35 patients. Compared the mean arterial pressure, heart rate at each time point and the change of the electrical double frequency index in the home 5 min (T0), before intubation (T1), 1 min atfer intubation (T2), 3 min atfer intubation (T3) and 5 min atfer intubation (T4) among three groups of patients, and compared their waking time.Results: hTe mean arterial pressure and heart rate of T2, T3 time point in group I were signiifcantly higher than that of T1 time points; in group II, mean arterial pressure and heart rate of T2 time were signiifcantly higher than that of T1 time points, the differences were statistically signiifcant (P<0.05); at T2, T3, and T4 point, the brain electrical double-frequency index in group III was obviously lower than that of group I and II, the difference was statistically signiifcant (P<0.05); waking time in group III was obviously longer than that of group I, II, the difference was statistically signiifcant (P<0.05).Conclusion: Using propofol compound fentanyl target controlled infusion to anesthetize hypertension patients, the bispectral index will decrease with the concentration of fentanyl, reduce intubation stress reaction, and maintain stable hemodynamics.%目的:研究丙泊酚复合瑞芬太尼靶控输注对高血压患者脑电双频指数的影响。方法:选择2015年1月至2016年3月在我院行丙泊酚复合瑞芬太尼靶控

  19. 脑电双频指数监测在老年患者麻醉苏醒中的作用%Bispectral index monitoring improves early recovery of elderly patients under sevoflurane anesthesia

    Institute of Scientific and Technical Information of China (English)

    周惠丹; 方军; 付霜; 连燕虹

    2011-01-01

    目的 研究脑电双频指数(BIS)指导七氟醚吸入对老年患者麻醉苏醒的影响.方法 择期行下腹部手术的老年患者44例,ASAⅠ~Ⅱ级,随机数字表法分为BIS组(B组)和对照组(D组),每组22例.D组由麻醉医生根据临床经验调节术中七氟醚的吸入浓度;B组术中维持BIS值在45~55,术毕前10min维持在56~70.记录麻醉诱导前、手术期间和拔管时的BIS值、七氟醚设定浓度和呼气末浓度;苏醒时间、拔管时间、OAA /S评分达到5分的时间.结果 与D组相比,B组术中七氟醚用量减少20%,手术期间的BIS升高、呼气末七氟醚浓度降低,手术结束时呼气末七氟醚浓度降低,苏醒时间、拔管时间、OAA /S评分达到5分的时间缩短.结论 BIS指导吸入七氟醚能加快老年患者腹部手术的麻醉苏醒,提高苏醒质量,并可减少术中七氟醚的用量.%Objective To evaluate the application of BIS monitoring during sevoflurane anesthesia in elderly patients undergoing intra- abdominal surgery. Methods Forty- four ASA Ⅰ or Ⅱ patients aged over 60 undergoing intra- abdominal surgery were randomized dMded into two groups with 22 cases each: BIS group and control group. In BIS group sevoflurane was titrated to keep BIS values 45- 55 during operation; and the BIS value was increased to 56- 70 at 10 min before the end of operation. In control group the depth of anesthesia was maintained based on the clinical experience of anesthesiologist. The BIS values and the end- tidal sevoflurane concentration before and during anesthesia and at extubation, recovery time, extubation time and the time OAA/S score to 5 were recorded and compared between the two groups. The mini- mental state examination (MMSE) was used before and at 1,2,12 and 24h affer surgery. Results The total amount of sevoflurane consumed was 20% less, the average BIS value s were higher and end- tidal sevoflurane concentration was lower in BIS group than those in control group. The

  20. 脑电双频谱指数和脑电熵指数监测全麻患者镇痛水平的评价%Can bispectral index and entropy be used as mesgures of level of analgesia during general anesthesia?

    Institute of Scientific and Technical Information of China (English)

    权翔; 叶铁虎; 王俏杰; 郝绒绒

    2008-01-01

    bispectral index(BIS)and entropy as measures of level of analgesia during general anesthesia.Methods After hospital ethics committee approval and written informed consent,26 ASA Ⅰ or Ⅱ patients aged 18-64 yr weighing 50-90 kg undergoing elective abdominal operation under general anesthesia were randomly allocated to one of 2 groups(n=13 each):experiment group (L)and control group(S).Epidural catheter was phced into epidural space at T9,10 interspace in both groups.Epidural placement was confirmed by a test dose of 1% lidocaine 5 ml and then a mixture of 1% lidocaine + 0.5% ropivaeaine 5-10 ml Was given epidurally in experiment group.The incision was within the sensory block area.While in control group equal volume of normal saline(NS)was given instead of lidocaine and ropivacaine.ECG,BP,HR,SpO2,BIS(Aspect,USA)and entropy[response entropy(RE),state entropy(SE)](Datex-Ohmeda.Finland)Were continuously monitored.General anesthesia was induced with TCI of propofol(initial target plasma concentration 4μg/ml)and TCI of remifentanil(target effect-site concentration 2 ng/ml).The target concentration of propofol was progressively increased until BIS value reached 40-50.Tracheal intubation was facilitated with rocuronium 0.9 mg/kg.After intubation remifentanil infusion was discontinued in experiment group but was continued(target effect site concentration 2 ng/ml)in control group.Skin incision was made about 20 min after tracbeal intubafion.BIS,RE,SE,BP(SP,DP,MAP)and HR were recorded every minute for 3 min before(baseline)until 6 min after skin incision.The surgeons were asked to wait for 2 min after skin incision without doing anything including electrocautery.Results At 1 min after skin incision,BIS,the difference between RE and SE(RE-SE)and BP were significandy increased as compared with the baseline in control group;while in experiment group there was no significant change in BIS,RE-SE and BP.When electrocantery was employed BIS,RE and RE-SE were significantly increased as

  1. A comparison of bispectral index and sedation-agitation scale in guiding sedation therapy: a randomized controlled study in patients undergoing short-term mechanical ventilation%脑电双频指数与镇静-躁动评分指导短期机械通气患者镇静治疗的随机对照研究

    Institute of Scientific and Technical Information of China (English)

    赵栋; 许媛; 何伟; 李彤; 何茵

    2011-01-01

    目的 比较脑电双频指数(BIS)实时监测和镇静-躁动评分(SAS)在重症监护病房(ICU)短期机械通气患者镇静治疗实施过程中的可行性.方法 选择ICU中18~60岁外科手术后需持续机械通气(>12 h)患者105例,按信封法随机分为BIS组(42例)和SAS组(63例),分别依据BIS和SAS评估镇静深度.两组均给予芬太尼镇痛,丙泊酚和咪唑安定联合镇静,每小时根据镇静深度评估调节镇静药物泵入剂量(BIS组目标值为50~70,SAS组目标为3~4级).入ICU后次日晨6时停用镇静及镇痛药物,每小时记录镇静深度(BIS值或SAS分级)、镇静持续时间、觉醒时间、机械通气时间、单位时间内咪唑安定和丙泊酚用量及累计总量,以及吸痰后躁动发生率、镇静期间气管导管耐受率和疼痛耐受率、拔管后谵妄发生率.结果 BIS组单位时间内眯唑安定和丙泊酚用量均高于SAS组[咪唑安定(mg·kg-1·h-1):0.10±0.02比0.09±0.02,丙泊酚(mg·kg-1·h-1):0.95±0.23比0.86±0.20,均P<0.05],总体镇静达标时段(Dt,以1 h为1个时段)以及前3个时段(D1、D2、D3)的镇静达标率均明显高于SAS组[Dt:75.2%(507)比52.8%(421),D1:78.6%(33)比22.2%(14),D2:88.1%(37)比20.6%(13),D3:81.0%(34)比31.7%(20),均P<0.01],觉醒时间(min)明显短于SAS组[0(0,20)比15(0,47),P<0.05];BIS组和SAS组患者急性生理学与慢性健康状况评分系统Ⅱ(APACHE Ⅱ)评分(分:3.57±2.60比4.19±2.30)、机械通气时间[h:16.5(14.5,19.0)比17.0(15.0,19.0)]、镇静持续时间[h:14.0(12.9,17.1)比16.0(13.0,18.0)]及吸痰后躁动发生率(81.0%比79.4%)、镇静期间气管导管耐受率(71.4%比74.6%)和疼痛耐受率(92.8%比93.6%)、拔管后谵妄发生率(4.8%比1.6%)等差异均无统计学意义(均P>0.05).结论 与SAS比较,BIS在指导ICU短期机械通气患者的镇静治疗中,对镇静深度调控具有更好的可操作性.%Objective To compare the value of bispectral index (BIS) monitoring and

  2. Discussion of the indexes of nonoutburst coal seam upgrade and its corresponding critical values

    Institute of Scientific and Technical Information of China (English)

    WEI dian-ping; LIU Yan-wei; LIU Ming-ju; MENG Lei

    2009-01-01

    In view of the measurement difficulties of indexes recommended by the 50 Items Experience of Coal Mine Gas Prevention in the process of the nonoutburst coal seam upgrade, this paper took the No.8 coal seam of Huainan Mining Group as research object. Discussed the suitability of indexes and corresponding critical values, put forward method in determining the indexes and its critical values by analysis and investigation of the gas geological condition and the-spot tracking near position where an outburst occurred combined with laboratory experiment, and established the indexes and its critical values of nonoutburst coal seam upgrade in No.8 coal seam of Huainan Mining Group. The results show that it is suitable to take gas content and tectonic soft coal thickness easily to gain in routine production as primary upgrade indexes that its critical values are 7.5 m3/t and 0.8 m, respectively. In addition, takefvalue and Ap value as auxiliary indexes.

  3. 脑电双频指数监测与靶控输注丙泊酚联合小剂量舒芬太尼在无痛胃肠镜检查麻醉中的应用%Study on the application of target-controlled infusion of propofol combined with small-dosage sufentanil guided by bispectral index in ;painless gastrointestinal endoscopy

    Institute of Scientific and Technical Information of China (English)

    侯海军; 柯敬东; 刘英; 刘缚鲲; 田鸣

    2015-01-01

    目的:探讨运用脑电双频指数( BIS)监测,获取靶控输注( TCI)丙泊酚复合小剂量舒芬太尼对无痛胃肠镜检查麻醉深度的指导意义。方法将300例接受无痛胃肠镜患者随机分为三组:BIS监测TCI丙泊酚复合小剂量舒芬太尼组(A组,n=100)、BIS监测TCI丙泊酚组(B组,n=100)、单纯TCI丙泊酚组(C组,n=100)。根据血流动力学及BIS值调整丙泊酚的靶浓度。观察血压、心率、呼吸的变化,记录手术时间、术中体动次数、苏醒时间、镇静评分、定向力恢复及其术后的不良反应。结果300例患者麻醉效果满意,术后均恢复良好,其中丙泊酚用量、苏醒时间和定向率恢复时间C组﹥B组﹥A组,A组术中呼吸抑制以及体动发生率以及明显低于C组( P ﹤0.01或P ﹤0.05)。三组术中呛咳发生率无显著差异,三组患者均未见术中知晓。结论 BIS监测TCI丙泊酚复合小剂量舒芬太尼用于无痛胃肠镜检查能减少丙泊酚用量,且可以达到合理的麻醉深度,保证术后麻醉快速苏醒。%Objective To explore the efficacy of bispectral index( BIS)monitoring on the depth of anesthesia in patients undergoing painless gastrointestinal endoscopy with target-controlled infusion( TCI)of propofol combined with small-dosage of sufentanil. Methods A to-tal of 300 patients performed with painless gastrointestinal endoscopy were randomly divided into 3 groups:group A( TCI of propofol combined with small-dosage of sufentanil guided by BIS ),group B( TCI of propofol guided by BIS)and group C( TCI of propofol). The target concentration was adjusted according to BIS monitoring numerical value and hemodynamic variables. Blood pressure,heart rate( HR),respiratory rate( RR), operating time,body involuntary movement during operation,postoperative waking time,sedation scores,recovery time of orientation and postoper-ative complications were analyzed. Results All patients

  4. Capnography and the Bispectral Index—Their Role in Pediatric Sedation: A Brief Review

    Directory of Open Access Journals (Sweden)

    Maria Sammartino

    2010-01-01

    Full Text Available Sedation in children is increasingly emerging as a minimally invasive technique that may be associated with local anaesthesia or diagnostic and therapeutic procedures which do not necessarily require general anaesthesia. Standard monitoring requirements are not sufficient to ensure an effective control of pulmonary ventilation and deep sedation. Capnography in pediatric sedation assesses the effect of different drugs on the occurrence of respiratory failure and records early indicators of respiratory impairment. The Bispectral index (BIS allows the reduction of dose requirements of anaesthetic drugs, the reduction in the time to extubation and eye opening, and the reduction in the time to discharge. In the field of pediatric sedation, capnography should be recommended to prevent respiratory complications, particularly in spontaneous ventilation. The use of the BIS index, however, needs further investigation due to a lack of evidence, especially in infants. In this paper, we will investigate the role of capnography and the BIS index in improving monitoring standards in pediatric sedation.

  5. Tradeoffs between Price and Quality: How a Value Index Affects Preference Formation.

    Science.gov (United States)

    Creyer, Elizabeth H.; Ross, William T., Jr.

    1997-01-01

    Some of a group of 143 consumers were given a choice between higher-priced, higher-quality items and items with lower price and quality but higher value index (benefit/cost tradeoff); others were given price and quality information only. Consumers were more likely to choose lower-priced, higher-value options when the index information was…

  6. Elk Distributions Relative to Spring Normalized Difference Vegetation Index Values

    Directory of Open Access Journals (Sweden)

    Samuel T. Smallidge

    2010-01-01

    Full Text Available Rocky Mountain elk (Cervus elaphus that winter near San Antonio Mountain in northern New Mexico provide important recreational and economic benefits while creating management challenges related to temporospatial variation in their spring movements. Our objective was to examine spring distributions of elk in relation to vegetative emergence as it progresses across the landscape as measured by remote sensing. Spring distributions of elk were closely associated with greater photosynthetic activity of spring vegetation in 2 of 3 years as determined using NDVI values derived from AVHRR datasets. Observed elk locations were up to 271% greater than expected in the category representing the most photosynthetic activity. This association was not observed when analyses at a finer geographic scale were conducted. Managers facing challenges involving human-wildlife interactions and land-use issues should consider environmental conditions that may influence variation in elk association with greener portions of the landscape.

  7. The Relationship Between CSR and Profitability to Firm Value in SRI-KEHATI Index

    Directory of Open Access Journals (Sweden)

    Widuri Kurniasari

    2015-03-01

    Full Text Available This study aims to investigate the relationship between Corporate Social Responsibility (CSR, Profitability to Firm Value. The samples are all manufacturer companies that listed in SRI-KEHATI Index by using control samples (manufacturers company not listed in SRI-KEHATI Index. This study is empirically examined between CSR disclosure (environment, energy, health and safety, product, and community services, profitability (ROA and firm value. For company that listed in Sri Kehati Index, this study found no significant relationship between CSR to firm value but there were positive significant relationship between profitability to firm value.

  8. Association between fat mass index and fat-free mass index values and cardiovascular risk in adolescents

    Directory of Open Access Journals (Sweden)

    Patrícia Morais de Oliveira

    2016-03-01

    Full Text Available Abstract Objective: To describe the association between fat mass index and fat-free mass index values and factors associated with cardiovascular risk in adolescents in the city of Juiz de Fora, Minas Gerais. Methods: Cross-sectional study was with 403 adolescents aged 10–14 years, from public and private schools. Anthropometric, clinical, and biochemical measurements were obtained, as well as self-reported time spent performing physical exercises, sedentary activities and sexual maturation stage. Results: Regarding the nutritional status, 66.5% of the adolescents had normal weight, 19.9% were overweight and 10.2% were obese. For both genders, the fat mass index was higher in adolescents who had high serum triglycerides, body mass index and waist circumference. Conclusions: Adolescents who had anthropometric, clinical and biochemical characteristics considered to be at risk for the development of cardiovascular disease had higher values of fat mass index. Different methodologies for the assessment of body composition make health promotion and disease prevention more effective.

  9. Equality of Shapley value and fair proportion index in phylogenetic trees.

    Science.gov (United States)

    Fuchs, Michael; Jin, Emma Yu

    2015-11-01

    The Shapley value and the fair proportion index of phylogenetic trees have been introduced recently for the purpose of making conservation decisions in genetics. Moreover, also very recently, Hartmann (J Math Biol 67:1163-1170, 2013) has presented data which shows that there is a strong correlation between a slightly modified version of the Shapley value (which we call the modified Shapley value) and the fair proportion index. He gave an explanation of this correlation by showing that the contribution of both indices to an edge of the tree becomes identical as the number of taxa tends to infinity. In this note, we show that the Shapley value and the fair proportion index are in fact the same. Moreover, we also consider the modified Shapley value and show that its covariance with the fair proportion index in random phylogenetic trees under the Yule-Harding model and uniform model is indeed close to one.

  10. Normalized mean shapes and reference index values for computerized quantitative assessment indices of chest wall deformities

    Science.gov (United States)

    Kim, Ho Chul; Park, Man Sik; Lee, Seong Keon; Nam, Ki Chang; Park, Hyung Joo; Kim, Min Gi; Song, Jae-Jun; Choi, Hyuk

    2015-11-01

    We previously proposed a computerized index (eccentricity index [EI]) for chest-wall deformity measurements, such as pectus excavatum. We sought to define mean shapes based on normal chest walls and to propose for computerized index reference values of that are used in the quantitative analysis of the severity of chest-wall deformities. A total of 584 patients were classified into 18 groups, and a database of their chest-wall computed tomography (CT) scan images was constructed. The boundaries of the chest wall were extracted by using a segmentation algorithm, and the mean shapes were subsequently developed. The reference index values were calculated from the developed mean shapes. Reference index values for the EI were compared with a conventional index, the Haller index (HI). A close association has been shown between the two indices in multiple subjects (r = 0.974, P < 0.001). The newly developed mean shapes and reference index values supply both reliability and objectivity to the diagnosis, analysis, and treatment of chest-wall deformities. They promise to be highly useful in clinical settings.

  11. Adjusting Quality index Log Values to Represent Local and Regional Commercial Sawlog Product Values

    Science.gov (United States)

    Orris D. McCauley; Joseph J. Mendel; Joseph J. Mendel

    1969-01-01

    The primary purpose of this paper is not only to report the results of a comparative analysis as to how well the Q.I. method predicts log product values when compared to commercial sawmill log output values, but also to develop a methodology which will facilitate the comparison and provide the adjustments needed by the sawmill operator.

  12. ارزیابی سطح ارامبخشی در بیماران بحرانی و بدحال تحت تنفس مکانیکال: ایا بین دو روش bispectral index و Richmond agitation –sedation scale ارتباطی وجود دارد؟ Assessment of sedation level in critically ill mechanically ventilated patients: Is bispectral index correlated with Richmond agitation–sedation scale?

    Directory of Open Access Journals (Sweden)

    Seyed Jalal Hashemi

    2008-08-01

    لوم پزشكي اصفهان#استادیار گروه امار زیستی دانشگاه علوم پزشكي اصفهان##عضو هیِِئت علمی دانشکده پرستاری ومامایی دانشگاه علوم پزشكي اصفهان###مسئول پرستاری بخش مراقبت ویزه مرکزی بیمارستان الزهرا(س اصفهان

    • BACKGROUND: The intensivist should be avoided over or under sedation in mechanically ventilated patients. There are controversies in validity of bispectral index (BIS in the management of intensive care unit (ICU patients. The aim of this study was to evaluate sedation level in sedated and mechanically ventilated patients in our ICU using BIS and Richmond agitation–sedation scale (RASS, as a valid tool and to determine the correlation between these two methods of evaluation.
    • METHODS: Following the institutional research committee approval, we prospectively determined the sedation level in 33 patients aged 20-75 years who were mechanically ventilated and sedated routinely using intravenous diazepam (0.05 – 0.1 mg/kg/6 hr combined with intravenous morphine (0.05 – 0.1 mg/kg/6 hr in central ICU of Al-Zahra hospital. In each patient, we assessed BIS (0 to 100 values and also RASS (-5 to +4 twice a day, two hours after receiving systemicsedation in the morning and evening during mechanical ventilation period. Appropriate sedation score was considered -2 and -3 on RASS and 70 to 80 in BIS. Lower or

    • Comparison of the prevalence index and average wetland values for identification of wetland vegetation

      Energy Technology Data Exchange (ETDEWEB)

      Zimmerman, R.E.; Shem, L.M.; Gowdy, M.J. [Argonne National Lab., IL (United States); Van Dyke, G.D. [Trinity Christian Coll., Palos Heights, IL (United States); Hackney, C.T. [North Carolina Univ., Wilmington, NC (United States)

      1992-07-01

      Prevalence index values (FICWD, 1989) and average wetland values for all species present were compared for three wetland gas pipeline rights-of-way (ROWS) and adjacent natural areas. The similarities in results using these two indicator values suggest that an average wetland value may offer a simpler, less time-consuming method of evaluating the vegetation of a study site as an indication of wetness. Both PIVs and AWVs, are presented for the ROWs and the adjacent natural area at each site.

    • Accuracy of the Composite Variability Index as a Measure of the Balance Between Nociception and, Antinociception During Anesthesia

      NARCIS (Netherlands)

      Sahinovic, Marko; Eleveld, Douglas J.; Kalmar, Alain F.; Heeremans, Eleonora H.; De Smet, Tom; Seshagiri, Chandran V.; Absalom, Anthony R.; Vereecke, Hugo E. M.; Struys, Michel M. R. F.

      BACKGROUND: The Composite Variability Index (CVI), derived from the electroencephalogram, was developed to assess the antinociception-nociception balance, whereas the Bispectral Index (BIS) was developed to assess the hypnotic state during anesthesia. We studied the relationships between these

    • Experimental and forecasted values of the ultraviolet index in southwestern Spain

      Science.gov (United States)

      Antón, M.; Serrano, A.; Cancillo, M. L.; GarcíA, J. A.

      2009-03-01

      The ultraviolet (UV) index is a standard vehicle for informing the public about the magnitude of the UV radiation reaching the Earth's surface and its potential harmful effects over the human health. The first objective of this article is to analyze experimental values of the UV index in three stations located in southwestern Spain during five years (2001-2005). The study reports reliable fundamental statistical parameters, which can serve as relevant values for comparison with other regions and model results. The results show a great influence of the astronomical factors in the seasonal evolution of the daily UV index showing higher values in late spring and summer. Thus high erythemal risk values of the UV index (between 7 and 9) occur in 41.6% of the total cases in Badajoz, 41.4% in Cáceres, and 36.6% in Plasencia. These high percentages remark the great interest in reporting values of the UV index in the area of study. Besides the seasonal evolution, cloudiness appears as the main attenuation factor at short-term scales. Thus spring and autumn presented the highest dispersion because of their great variability in sky conditions. Also, changes in skewness and kurtosis are mainly related to the variability in cloudiness and particularly to the difference between the cloudless summer and the rest of the year. The second objective of the present article is to compare the values of daily UV index as calculated by different approaches: 30-min average, 10-min average, and 1-min average daily maximum erythemal irradiance, and value at solar noon. The results show that although the indices obtained by the different approaches are very similar for cloud-free days, they show interesting differences for cloudy days. Finally, this paper aims to compare the UV index measured at the mentioned three locations, with the UV index forecasted using the SBDART radiative transfer code and values of total ozone provided by TOMS. The predictions are always calculated assuming cloud

    • Assessing the Added Value of Dynamical Downscaling Using the Standardized Precipitation Index

      Science.gov (United States)

      In this study, the Standardized Precipitation Index (SPI) is used to ascertain the added value of dynamical downscaling over the contiguous United States. WRF is used as a regional climate model (RCM) to dynamically downscale reanalysis fields to compare values of SPI over drough...

    • B-valued martingale spaces with small index and atomic decompositions

      Institute of Scientific and Technical Information of China (English)

      刘培德; 于林

      2001-01-01

      Some atomic decomposition theorems for Banach-space-valued martingales are established. Using them, the embedding relationships between martingale spaces with small index are discussed. The results obtained here are connected closely with the p-uniform smoothness and q-uniform convexity of Banach space in which the martingales take values.

    • Assessing the Added Value of Dynamical Downscaling Using the Standardized Precipitation Index

      Science.gov (United States)

      In this study, the Standardized Precipitation Index (SPI) is used to ascertain the added value of dynamical downscaling over the contiguous United States. WRF is used as a regional climate model (RCM) to dynamically downscale reanalysis fields to compare values of SPI over drough...

    • Nonlinear damage detection in composite structures using bispectral analysis

      Science.gov (United States)

      Ciampa, Francesco; Pickering, Simon; Scarselli, Gennaro; Meo, Michele

      2014-03-01

      Literature offers a quantitative number of diagnostic methods that can continuously provide detailed information of the material defects and damages in aerospace and civil engineering applications. Indeed, low velocity impact damages can considerably degrade the integrity of structural components and, if not detected, they can result in catastrophic failure conditions. This paper presents a nonlinear Structural Health Monitoring (SHM) method, based on ultrasonic guided waves (GW), for the detection of the nonlinear signature in a damaged composite structure. The proposed technique, based on a bispectral analysis of ultrasonic input waveforms, allows for the evaluation of the nonlinear response due to the presence of cracks and delaminations. Indeed, such a methodology was used to characterize the nonlinear behaviour of the structure, by exploiting the frequency mixing of the original waveform acquired from a sparse array of sensors. The robustness of bispectral analysis was experimentally demonstrated on a damaged carbon fibre reinforce plastic (CFRP) composite panel, and the nonlinear source was retrieved with a high level of accuracy. Unlike other linear and nonlinear ultrasonic methods for damage detection, this methodology does not require any baseline with the undamaged structure for the evaluation of the nonlinear source, nor a priori knowledge of the mechanical properties of the specimen. Moreover, bispectral analysis can be considered as a nonlinear elastic wave spectroscopy (NEWS) technique for materials showing either classical or non-classical nonlinear behaviour.

    • C*-Algebra approach to the index theory of boundary value problems

      CERN Document Server

      Melo, Severino; Schick, Thomas

      2012-01-01

      Boutet de Monvel's calculus provides a pseudodifferential framework which encompasses the classical differential boundary value problems. In an extension of the concept of Lopatinski and Shapiro, it associates to each operator two symbols: a pseudodifferential principal symbol, which is a bundle homomorphism, and an operator-valued boundary symbol. Ellipticity requires the invertibility of both. If the underlying manifold is compact, elliptic elements define Fredholm operators. Boutet de Monvel showed how then the index can be computed in topological terms. The crucial observation is that elliptic operators can be mapped to compactly supported $K$-theory classes on the cotangent bundle over the interior of the manifold. The Atiyah-Singer topological index map, applied to this class, then furnishes the index of the operator. Based on this result, Fedosov, Rempel-Schulze and Grubb have given index formulas in terms of the symbols. In this paper we survey previous work how C*-algebra K-theory can be used to give...

  1. Optimizing the level of branch concentration with marginal values of Herfindahl-Hirschman index

    OpenAIRE

    V. Sukhoteplyy

    2010-01-01

    Striving of Ukraine for the European Union assumes, among other things, the sound understanding of the Herfindahl-Hirschman Index (HHI) methodology in defining the level of the competition in an industry. Modeling of an industry structure using predefined values of HHI and the concept of the Index of Competitive Potential of Industry (ICPI) has shown that the traditional use of the HHI criterion with-out the explicit consideration of the number of firms in an industry can results in ambiguous...

  2. Efeitos de diferentes frações inspiradas de oxigênio no índice biespectral em cães submetidos à infusão contínua de propofol Effects of several inspired oxygen fractions on the bispectral index in dogs submitted to continuous infusion of propofol

    Directory of Open Access Journals (Sweden)

    P.C.F. Lopes

    2008-04-01

    Full Text Available Avaliaram-se os efeitos do fornecimento de diferentes frações inspiradas de oxigênio (FiO2 sobre o índice biespectral (BIS em cães submetidos a infusão contínua de propofol e mantidos em ventilação espontânea. Oito cães foram submetidos a cinco anestesias, diferenciando-se uma da outra pela FiO2 fornecida. Formaram-se cinco grupos denominados G100 (FiO2 = 1; G80 (FiO2 = 0,8; G60 (FiO2 = 0,6; G40 (FiO2 = 0,4 e G20 (FiO2 = 0,21. Os animais foram induzidos à anestesia com propofol na dose necessária para intubação, e, ato contínuo, iniciaram-se a infusão do fármaco e o fornecimento de oxigênio, conforme a FiO2 determinada para cada grupo. As primeiras mensurações (M0 foram efetuadas 30 minutos após o início da infusão do anestésico e, depois, em intervalos de 15 minutos (M15, M30, M45 e M60. A pressão parcial de oxigênio no sangue arterial (PaO2 variou conforme a FiO2, ou seja, quanto maior a FiO2, maior foi a PaO2. Para a pressão parcial de dióxido de carbono no sangue arterial (PaCO2, foram registradas diferenças em M30, no qual G100 foi maior que G20. Não foram observadas diferenças significativas nas variáveis estudadas do BIS. Os intervalos de médias registrados para o BIS foram, para G100, de 68 a 62; G80, de 71 a 58; G60, de 72 a 62; G40, de 76 a 68; e G20, de 77 a 68. Conclui-se que as variáveis relacionadas ao BIS não são afetadas pelo emprego de diferentes FiO2, e sugere-se que o monitoramento pelo BIS foi capaz de detectar alterações no equilíbrio do fluxo sangüíneo cerebral, oriundas das alterações ocasionadas na dinâmica respiratória pelo emprego de diferentes frações inspiradas de oxigênio.The effects of several inspired oxygen fractions (FiO2 on the bispectral index in spontaneously breathing dogs submitted to continuous infusion of propofol were evaluated. Eight adult mongrel dogs were used. Each animal was submitted to five anesthesias. In each procedure, the patient was allowed to

  3. Effect of sevoflurane titration anesthesia on recovery time in bispectral index monitoring laparoscopic cholecystectomy%七氟烷减量法对行腹腔镜下胆囊切除术患者苏醒时间的影响

    Institute of Scientific and Technical Information of China (English)

    李华; 孙波; 佘高明; 谢红; 王琛

    2012-01-01

    Objective To study the effect of sevoflurane titration anesthesia on recovery time in bispectral index (BIS) monitoring laparoscopic cholecystectomy. Methods Forty-five patients (American Society of Anesthesiologists [ASA] Ⅰ - Ⅱ level) underwent laparoscopic cholecystectomy and were randomly divided into 3 groups (n = 15). The patients in group I stopped inhaling sevoflurane after skin closure and oxygen flow increased to 10 L/min. The patients in group Ⅱ stop inhaling sevoflurane after peritoneal suture, oxygen flow increased to 10 L/min, and propofol (0.5 mg/kg) was intravenously injected. For group 1, sevoflurane decreased to 0.5 minimum alveolar concentration (MAC) at the end of peritoneal closure and was stopped after skin closure, and oxygen flow increased to 10 L/min. The recovery time (from finishing skin closure to opening eyes under orders), the time of BIS being 90, and vital signs (mean arterial pressure [MAP], heart rate [HR], pulse, saturation of blood oxygen [SpO2], and carbon dioxide of end expiration [pstCO2]) were recorded. Results The recovery time and the time of BIS being 90 in groups Ⅱ and Ⅲ were significantly shorter than those in group Ⅰ (all P0. 05). Conclusion Sevoflurane titration anesthesia can reduce the impact of combined drug use, shorten the recovery time after surgery and keep the recovery quality in laparoscopic cholecystectomy.%目的 观察七氟烷减量法对行腹腔镜下胆囊切除术患者苏醒时间的影响.方法 45例美国麻醉医师学会(ASA)分级Ⅰ~Ⅱ级、行择期腹腔镜胆囊切除术患者,随机分为3组,每组15例:Ⅰ组,皮肤缝合结束时停止吸入七氟烷,增加氧流量至10 L/min;Ⅱ组,腹膜缝合结束时停止吸入七氟烷,增加氧流量至10 L/min,静脉注射丙泊酚0.5 mg/kg;Ⅲ组,关闭腹膜即刻,降低七氟烷浓度至0.5最低肺泡有效浓度(MAC),缝合皮肤结束时停止吸人七氟烷,增加氧流量至10 L/min.观察苏醒时间(自皮肤缝合结束

  4. Ação do anticonvulsivante isolado e associado ao midazolam como medicação pré-anestésica sobre o índice bispectral (BIS em pacientes com paralisa cerebral Acción del antiepiléptico aislado y asociado al midazolam como medicación preanestésica sobre el índice bispectral (BIS en pacientes con parálisis cerebral Effect of isolated anticonvulsant drug use and associated to midazolam as pre-anesthetic medication on the bispectral index (BIS in patients with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Verônica Vieira da Costa

    2010-06-01

    -anesthetic drug on the BIS of patients with CP undergoing chronic treatment with anticonvulsant agents. METHOD: Three groups of patients were assessed: CP without anticonvulsant treatment, CP undergoing treatment with anticonvulsant and a group with no disease and no medication use (control group. On the day before the surgery, with the patients conscious and in dorsal decubitus, the BIS monitor was placed and the basal BIS values were recorded. On the following day, 40 minutes before the surgery, the patients received 0.6 mg.kg-1 of midazolam orally. Before the start of the anesthetic procedure, the same procedure for BIS recording was carried out after midazolam administration. RESULTS: A total of 107 patients were studied - 39 patients from the Control Group (CG and 68 with a diagnosis of CP. Among these, 17 used anticonvulsant drugs. Regarding the mean BIS value after the midazolam administration, there was no difference between patients from the CG and those in the CP group that did not take anticonvulsant drugs, whereas the ones who took anticonvulsants exhibited a difference (p = 0.003. The possibility of decrease in the BIS after midazolam use increases according to the number of anticonvulsant drugs used by the patient. CONCLUSIONS: The chronic use of anticonvulsants associated to oral midazolam as pre-anesthetic medication can lead to the decrease in the BIS values, which configures deep level of hypnosis.

  5. Composite chiral metamaterials with negative refractive index and high values of the figure of merit.

    Science.gov (United States)

    Li, Zhaofeng; Alici, Kamil Boratay; Caglayan, Humeyra; Kafesaki, Maria; Soukoulis, Costas M; Ozbay, Ekmel

    2012-03-12

    A composite chiral metamaterial (CCMM) is designed and studied both numerically and experimentally. The CCMM is constructed by the combination of a continuous metallic wires structure and a purely chiral metamaterial (CMM) that consists of conjugated Rosettes. For the CMM, only very small, useful bands of negative index can be obtained for circularly polarized waves. These bands are all above the chiral resonance frequencies because of the high value of the effective parameter of relative permittivity ε. After the addition of the continuous metallic wires, which provide negative permittivity, the high value of ε can be partially compensated. Thus, a negative index band for the left circularly polarized wave that is below the chiral resonance frequency is obtained for the CCMM. At the same time, a negative index band for the right circularly polarized wave that is above the chiral resonance frequency is also obtained. Furthermore, both negative index bands correspond to the transmission peaks and have high values of the figure of merit. Therefore, the CCMM design that is proposed here is more suitable than the CMM for the construction of chiral metamaterials with a negative index.

  6. Comparison of Haller index values calculated with chest radiographs versus CT for pectus excavatum evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Khanna, Geetika; Jaju, Alok; Don, Steven; Hildebolt, Charles F. [Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Keys, Tim [Medical Physics Services Ltd., St Louis, MO (United States)

    2010-11-15

    Pectus excavatum is a common chest wall anomaly in children. Pre-operative imaging for pectus excavatum is performed with CT, which is used to calculate the Haller index to determine the severity of pectus excavatum. To determine the correlation between Haller index values calculated with two-view chest radiographs and those calculated with CT and to determine, with CT as the reference standard, the diagnostic performance of radiographic Haller index for identifying cases that meet imaging criteria for surgical correction of pectus excavatum. For the period 2001-2009, our radiology information system was searched to identify all children who had undergone CT for Haller index calculation. Children who had also undergone two-view chest radiography (CXR) within 6 months of the CT were included in this retrospective study. Two radiologists independently calculated CT Haller index and radiographic Haller index. Data distributions were tested for normality with the Shapiro-Wilk W test. The associations between CT Haller index and radiographic Haller index were determined with the Spearman coefficient of rank correlation. Differences between CT Haller index and radiographic Haller index were tested with the Wilcoxon signed rank test. Haller index values were dichotomized into positive (>3.2) and negative ({<=}3.2) cases. Using CT as the reference standard, the sensitivity, specificity, and accuracy of radiographic Haller index in identifying children who meet imaging criteria for surgery were calculated. CT and CXR for evaluation of pectus excavatum were available for 32 children (25 male; median age 14.5 years). With CT, the median Haller indices for observers 1 and 2 were 3.4 and 3.5 and with CXR 3.5 and 3.5. There were statistically significant correlations between the radiographic Haller index and CT Haller index estimated by the two observers [Spearman correlation coefficient (95% confidence interval) for observer 1 = 0.71 (0.48-0.85, P < 0.01) and for observer 2 = 0

  7. A proposed selection index for feedlot profitability based on estimated breeding values.

    Science.gov (United States)

    van der Westhuizen, R R; van der Westhuizen, J

    2009-04-22

    It is generally accepted that feed intake and growth (gain) are the most important economic components when calculating profitability in a growth test or feedlot. We developed a single post-weaning growth (feedlot) index based on the economic values of different components. Variance components, heritabilities and genetic correlations for and between initial weight (IW), final weight (FW), feed intake (FI), and shoulder height (SHD) were estimated by multitrait restricted maximum likelihood procedures. The estimated breeding values (EBVs) and the economic values for IW, FW and FI were used in a selection index to estimate a post-weaning or feedlot profitability value. Heritabilities for IW, FW, FI, and SHD were 0.41, 0.40, 0.33, and 0.51, respectively. The highest genetic correlations were 0.78 (between IW and FW) and 0.70 (between FI and FW). EBVs were used in a selection index to calculate a single economical value for each animal. This economic value is an indication of the gross profitability value or the gross test value (GTV) of the animal in a post-weaning growth test. GTVs varied between -R192.17 and R231.38 with an average of R9.31 and a standard deviation of R39.96. The Pearson correlations between EBVs (for production and efficiency traits) and GTV ranged from -0.51 to 0.68. The lowest correlation (closest to zero) was 0.26 between the Kleiber ratio and GTV. Correlations of 0.68 and -0.51 were estimated between average daily gain and GTV and feed conversion ratio and GTV, respectively. These results showed that it is possible to select for GTV. The selection index can benefit feedlotting in selecting offspring of bulls with high GTVs to maximize profitability.

  8. Glycaemic and insulin responses, glycaemic index and insulinaemic index values of rice between three Asian ethnic groups.

    Science.gov (United States)

    Tan, V M H; Wu, T; Henry, C J; Lee, Y S

    2015-04-28

    Asians exhibit larger glycaemic response (GR) and insulin response (IR) than Caucasians, predisposing to an increased risk of type 2 diabetes mellitus (T2DM). We aimed to determine the GR and IR as well as the glycaemic index (GI) and insulinaemic index (II) of two rice varieties among three ethnic groups in Singapore. A total of seventy-five healthy males (twenty-five Chinese, twenty-five Malay and twenty-five Asian-Indians) were served the available equivalent carbohydrate amounts (50 g) of test foods (Jasmine rice and Basmati rice) and a reference food (glucose) on separate occasions. Postprandial blood glucose and plasma insulin concentrations were measured at fasting ( -5 and 0 min) and at 15, 30, 45, 60, 90 and 120 min after food consumption. Using the trapezoidal rule, GR, IR, GI and II values were determined. The GR did not differ between ethnic groups for Jasmine rice and Basmati rice. The IR was consistently higher for Jasmine rice (P=0·002) and Basmati rice (P=0·002) among Asian-Indians, probably due to compensatory hyperinsulinaemia to maintain normoglycaemia. The GI and II of both rice varieties did not differ significantly between ethnicities. The overall mean GI for Jasmine rice and Basmati rice were 91 (sd 21) and 59 (sd 15), respectively. The overall mean II for Jasmine rice was 76 (sd 26) and for Basmati rice was 57 (sd 24). We conclude that the GI values presented for Jasmine rice and Basmati rice were applicable to all three ethnic groups in Singapore. Future studies should include deriving the II for greater clinical utility in the prevention and management of T2DM.

  9. Has dental caries prevalence some connection with caries index values in adults?

    Science.gov (United States)

    Larmas, M

    2010-01-01

    DMF index values have been used for 70 years and were originally meant to describe both dental status and treatment need in elementary school children. Since then its application to caries experience and severity determination has expanded. Today, WHO has standardized its use in oral health surveys in describing past and present caries experience in adults and the elderly as well. This expansion to all age cohorts creates some problems if the index is limited to dental caries, which can be easily avoided when individual values are not combined. This has been performed in some of the 7,187 DMF index publications included in PubMed. The high number of scientific articles using this index underlines its leading role in the present epidemiological caries research. On the other hand, WHO uses different determinations for clinical dental caries and missing teeth in ICD-10, the 10th revision of International Classification of Diseases, which does not include dental restorations. Combining the individual parameters of Oral Health Surveys and diseases of ICD-10, and analyzing the mean value of each parameter separately, will give a precise picture of dental health at different ages. Copyright 2010 S. Karger AG, Basel.

  10. Bi-spectral extraction through elliptic neutron guides

    Energy Technology Data Exchange (ETDEWEB)

    Jacobsen, Henrik, E-mail: hjacobse@fys.ku.dk [Nanoscience center and eScience center, Niels Bohr Institute, University of Copenhagen (Denmark); ESS design update program (Denmark); Lieutenant, Klaus; Zendler, Carolin [Helmholtz-Zentrum Berlin, Hahn-Meitner-Platz 1, D-14109 Berlin (Germany); ESS design update program (Germany); Lefmann, Kim [Nanoscience center and eScience center, Niels Bohr Institute, University of Copenhagen (Denmark); ESS design update program (Denmark)

    2013-07-21

    In this paper we present the results of investigating a suggested guide extraction system utilizing both a thermal and a cold moderator at the same time, the so-called bi-spectral extraction. Here, the thermal moderator has line of sight to the sample position, and the neutrons from the cold source are reflected by a supermirror towards the sample. The work is motivated by the construction of the European Spallation Source (ESS) but the results are general and can be used at any neutron source. Due to the long pulse structure, most instruments at ESS will be long, often exceeding 50 m from moderator to detector. We therefore investigate the performance of bi-spectral extraction for instrument lengths of 30 m, 56 m, 81 m and 156 m. In all these cases, our results show that we can utilize both moderators (and thus high intensity in a wide wavelength band) in the same instrument at a cost of flux of 5–30% for neutrons with wavelength larger than 1 Å. In general, the divergence distribution is smooth at the sample position for all wavelengths. -- Highlights: • We simulate bi-spectral neutron beam extraction through elliptic guides. • Two independent ray-tracing tools (McStas and VITESS) give similar results. • Brilliance transfers of 70–95% for λ>1Å are achieved for guide lengths of 30–156 m. • The beam profile is smooth at the sample position. • The simulations are performed with ESS in mind, but have general validity.

  11. Identification of RESNET HERS Index Values Corresponding to Minimal Complicance with the IECC Performance Path

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, Zachary T.; Mendon, Vrushali V.

    2014-05-01

    This analysis provides a limited evaluation of the relationship between the Residential Energy Services Network (RESNET) Home Energy Rating System (HERS) Index and the simulation-based performance approach used in the 2012 International Energy Conservation Code (IECC). Not all differences between the approaches are analyzed here; only a subset of the distinctions considered likely to result in quantifiable differences in the outcomes of the two approaches or otherwise believed to be of interest to code developers and policy makers are considered. This analysis evaluates, for a single-family residence with various characteristics, the ranges of HERS Index values that would result in compliance with the 2012 IECC.

  12. Measuring daily Value-at-Risk of SSEC index: A new approach based on multifractal analysis and extreme value theory

    Science.gov (United States)

    Wei, Yu; Chen, Wang; Lin, Yu

    2013-05-01

    Recent studies in the econophysics literature reveal that price variability has fractal and multifractal characteristics not only in developed financial markets, but also in emerging markets. Taking high-frequency intraday quotes of the Shanghai Stock Exchange Component (SSEC) Index as example, this paper proposes a new method to measure daily Value-at-Risk (VaR) by combining the newly introduced multifractal volatility (MFV) model and the extreme value theory (EVT) method. Two VaR backtesting techniques are then employed to compare the performance of the model with that of a group of linear and nonlinear generalized autoregressive conditional heteroskedasticity (GARCH) models. The empirical results show the multifractal nature of price volatility in Chinese stock market. VaR measures based on the multifractal volatility model and EVT method outperform many GARCH-type models at high-risk levels.

  13. The equivalence of two phylogenetic biodiversity measures: the Shapley value and Fair Proportion index.

    Science.gov (United States)

    Hartmann, Klaas

    2013-11-01

    Most biodiversity conservation programs are forced to prioritise species in order to allocate their funding. This paper contains a mathematical proof that provides biological support for one common approach based on phylogenetic indices. Phylogenetic trees describe the evolutionary relationships between a group of taxa. Two indices for computing the distinctiveness of each taxon in a phylogenetic tree are considered here-the Shapley value and the Fair Proportion index. These indices provide a measure of the importance of each taxon for overall biodiversity and have been used to prioritise taxa for conservation. The Shapley value is the biodiversity contribution a taxon is expected to make if all taxa are equally likely to become extinct. This interpretation makes it appealing to use the Shapley value in biodiversity conservation applications. The Fair Proportion index lacks a convenient interpretation, however it is significantly easier to calculate and understand. It has been empirically observed that there is a high correlation between the two indices. This paper shows the mathematical basis for this correlation and proves that as the number of taxa increases, the indices become equivalent. Consequently in biodiversity prioritisation the simpler Fair Proportion index can be used whilst retaining the appealing interpretation of the Shapley value.

  14. Association between values of the Index IN 99 and the EVA indicator

    Directory of Open Access Journals (Sweden)

    Michaela Beranová

    2011-01-01

    Full Text Available The modern indicators of the performance of business entity are based on an economic conception of profit. It means that alternative costs and risks are taken into account in construction of these indicators. Moreover, the modern indicators would also enable to clearly and digestedly identify the links on each level of management, and therefore to support the value-based management. The one of these modern indicators is Economic Value Added. This indicator has been introduced by Stewart Stern & Co. in the early nineties. As some Czech authors state (e.g. Synek, 2007, domestic alternative of the EVA indicator are the IN indexes which has been developing since the middle of the nineties as overall indexes of company’s financial health especially because the indexes coming from abroad had not a good differentiation ability with regard to specifics of the Czech economic environment. The objective of this article is to define the relations between the values of EVA indicator and the values of the index IN 99 while the analysis is focused on agricultural companies of mixed farming. The authors base their work on differences in constructions of these two indicators and on ­differences in interpretations of their results. Primarily, basic correlation of values of these indicators has been observed. The calculation of Pearson correlation coefficient has been applied on the set of fifty business entities, and the calculated result of 0.669 shows relatively stronger linear dependence. Consequent test has verified a statistical significance of this dependence. Then in this article, the authors are focused on causations of this dependence which is rather strong in spite of a different logic of these two indicators. Other consequences of overall view on company’s economic performance are discussed in the article as well.

  15. Comparing the rankings obtained from two biodiversity indices: the Fair Proportion Index and the Shapley Value.

    Science.gov (United States)

    Wicke, Kristina; Fischer, Mareike

    2017-10-07

    The Shapley Value and the Fair Proportion Index of phylogenetic trees have been frequently discussed as prioritization tools in conservation biology. Both indices rank species according to their contribution to total phylogenetic diversity, allowing for a simple conservation criterion. While both indices have their specific advantages and drawbacks, it has recently been shown that both values are closely related. However, as different authors use different definitions of the Shapley Value, the specific degree of relatedness depends on the specific version of the Shapley Value - it ranges from a high correlation index to equality of the indices. In this note, we first give an overview of the different indices. Then we turn our attention to the mere ranking order provided by either of the indices. We compare the rankings obtained from different versions of the Shapley Value for a phylogenetic tree of European amphibians and illustrate their differences. We then undertake further analyses on simulated data and show that even though the chance of two rankings being exactly identical (when obtained from different versions of the Shapley Value) decreases with an increasing number of taxa, the distance between the two rankings converges to zero, i.e., the rankings are becoming more and more alike. Moreover, we introduce our freely available software package FairShapley, which was implemented in Perl and with which all calculations have been performed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Effect of imaging time on the values of the sacroiliac index

    Energy Technology Data Exchange (ETDEWEB)

    Dodig, D.; Domljan, Z.; Popovic, S.; Simonovic, I.

    1988-10-01

    Quantitative scintigraphy of the sacroiliac joints was performed in a group of normal subjects and a group of subjects with unilateral and bilateral sacroiliitis. The aim of the study was to determine whether the time intervals of imaging had any effect on the values of the sacroiliac index. Imaging was performed every 30 min up to 300 min and the indices were calculated at the time intervals mentioned. We found that the values of the sacroiliac index increased in the group of normal subjects until 150 min after the application of the radiopharmaceutical, and that in the group of subjects who had sacroiliitis they increased until 210 min. The results show that the time interval optimal to quantitative sacroiliac joint imaging is at least 3 1/2 h after administration of the radiopharmaceutical.

  17. New estimators of the extreme value index under random right censoring, for heavy-tailed distributions

    OpenAIRE

    Worms, Julien; Worms, Rym

    2014-01-01

    International audience; This paper presents new approaches for the estimation of the extreme value index in the framework of randomly censored (from the right) samples, based on the ideas of Kaplan-Meier integration and the synthetic data approach of S.Leurgans (1987). These ideas are developed here in the heavy tail case and for the adaptation of the Hill estimator, for which the consistency is proved under first order conditions. Simulations show good performance of the two approaches, with...

  18. PROGNOSTIC VALUE OF THE BASELINE VALUES OF SERUM TESTOSTERONE AND FREE ANDROGEN INDEX IN PATIENTS WITH PROSTATE CANCER

    Directory of Open Access Journals (Sweden)

    M. E. Grigoryev

    2012-01-01

    Full Text Available The growing incidence of prostate cancer (PC and its variable nature are an important problem today. PC is distinguished by its latent ability in many cases, which makes its screening difficult.Prostate-specific antigen (PSA is one of the most common tumor markers of PC, which are used for mass male screening. However, the detection rate of PC in men with normal PSA values is also very high. This promotes an active search for new markers and predictors of PC.The effect of androgens on hormonal carcinogenesis in the prostate suggests that the analysis of serum testosterone concentrations and free androgen index may be made in patients with low PSA levels in the early diagnosis and prognosis of PC.

  19. Glycaemic index and glycaemic load values of a selection of popular foods consumed in Hong Kong.

    Science.gov (United States)

    Lok, Kris Y; Chan, Ruth; Chan, Dicken; Li, Liz; Leung, Grace; Woo, Jean; Lightowler, Helen J; Henry, C Jeya K

    2010-02-01

    The objective of the present paper is to provide glycaemic index (GI) and glycaemic load (GL) values for a variety of foods that are commonly consumed in Hong Kong and expand on the international GI table of Chinese foods. Fasted healthy subjects were given 50 g of available carbohydrate servings of a glucose reference, which was tested twice, and test foods of various brands of noodles (n 5), instant cereals (n 3) and breads (n 2), which were tested once, on separate occasions. For each test food, tests were repeated in ten healthy subjects. Capillary blood glucose was measured via finger-prick samples in fasting subjects ( - 5, 0 min) and at 15, 30, 45, 60, 90 and 120 min after the consumption of each test food. The GI of each test food was calculated geometrically by expressing the incremental area under the blood glucose response curve (IAUC) of each test food as a percentage of each subject's average IAUC for the reference food. GL was calculated as the product of the test food's GI and the amount of available carbohydrate in a reference serving size. The majority of GI values of foods tested were medium (a GI value of 56-69) to high (a GI value of 70 or more) and compared well with previously published values. More importantly, our dataset provides GI values of ten foods previously untested and presents values for foods commonly consumed in Hong Kong.

  20. A Methodology to Estimate Ores Work Index Values, Using Miduk Copper Mine Sample

    Directory of Open Access Journals (Sweden)

    Mohammad Noaparast

    2012-12-01

    Full Text Available It is always attempted to reduce the costs of comminution in mineral processing plants. One of thedifficulties in size reduction section is not to be designed properly. The key factor to design size reductionunits such as crushers and grinding mills, is ore’s work index. The work index, wi, presents the oregrindability, and is used in Bond formula to calculate the required energy. Bond has defined a specificrelationship between some parameters which is applied to calculate wi, which are control screen, fineparticles produced, feed and product d80.In this research work, a high grade copper sample from Miduk copper concentrator was prepared, and itswork index values were experimentally estimated, using different control screens, 600, 425, 212, 150, 106and 75 microns. The obtained results from the tests showed two different behaviors in fine production.According to these two trends the required models were then defined to present the fine mass calculationusing control screen. In next step, an equation was presented in order to calculate Miduk copper ore workindex for any size. In addition to verify the model creditability, a test using 300 microns control screenwas performed and its result was compared with calculated ones using defined model, which showed agood fit. Finally the experimental and calculated values were compared and their relative error was equalto 4.11% which is an indication of good fit for the results.

  1. Economic values and expected effect of selection index for pathogen-specific mastitis under Danish conditions

    DEFF Research Database (Denmark)

    Sørensen, L P; Mark, T; Sørensen, M K

    2010-01-01

    The objectives of this study were 1) to estimate costs related to 5 different pathogen-specific mastitis traits (susceptibility to different pathogens causing mastitis in dairy cattle) and unspecific mastitis, and 2) to compare selection differentials for an udder health index consisting of 5...... different pathogen-specific mastitis traits and lactation average somatic cell count from 5 to 170 d after first calving (LASCC170) with another index consisting of 1 unspecific mastitis trait and LASCC170. Economic values were estimated for mastitis caused by Staphylococcus aureus, Streptococcus...... dysgalactiae, Escherichia coli, coagulase-negative staphylococci, and Streptococcus uberis using a stochastic simulation model (SimHerd IV). Mastitis incidences for SimHerd IV were from incidences of mastitis treatments in primiparous Danish Holstein cows calving in 2007. Estimated costs ranged from €149...

  2. Mother and Infant Body Mass Index, Breast Milk Leptin and Their Serum Leptin Values

    Science.gov (United States)

    Savino, Francesco; Sardo, Allegra; Rossi, Lorenza; Benetti, Stefania; Savino, Andrea; Silvestro, Leandra

    2016-01-01

    Purpose: This study investigates correlations between mother and infant Body Mass Index (BMI), their serum leptin values and breast milk leptin concentration in early infancy. Subjects and Methods: We determined serum leptin values in 58 healthy infants and leptin values in their mothers’ breast milk, using radioimmunoassay (RIA). Infant and maternal anthropometrics were measured. Results: Median leptin concentration was 3.9 ng/mL (interquartile range (IQR): 2.75) in infant serum, 4.27 ng/mL (IQR: 5.62) in maternal serum and 0.89 ng/mL (IQR: 1.32) in breast milk. Median maternal BMI and weight were 24 kg/m2 (IQR: 4.41) and 64 kg (IQR: 15). Median infant BMI was 15.80 kg/cm2 (IQR: 4.02), while average weight was 5.130 kg (IQR: 1.627). Infants serum leptin values positively correlated with infants’ BMI (p = 0.001; r = 0.213) and breast milk leptin (p = 0.03; r = 0.285). Maternal serum leptin values positively correlated with maternal BMI (p = 0.000, r = 0.449) and breast milk leptin ones (p = 0.026; r = 0.322). Conclusion: Breast milk leptin and maternal BMI could influence infant serum leptin values. Further studies are needed to better elucidate the role of genetics and environment on infant leptin production and risk of obesity later in life. PMID:27338468

  3. Mother and Infant Body Mass Index, Breast Milk Leptin and Their Serum Leptin Values

    Directory of Open Access Journals (Sweden)

    Francesco Savino

    2016-06-01

    Full Text Available Purpose: This study investigates correlations between mother and infant Body Mass Index (BMI, their serum leptin values and breast milk leptin concentration in early infancy. Subjects and Methods: We determined serum leptin values in 58 healthy infants and leptin values in their mothers’ breast milk, using radioimmunoassay (RIA. Infant and maternal anthropometrics were measured. Results: Median leptin concentration was 3.9 ng/mL (interquartile range (IQR: 2.75 in infant serum, 4.27 ng/mL (IQR: 5.62 in maternal serum and 0.89 ng/mL (IQR: 1.32 in breast milk. Median maternal BMI and weight were 24 kg/m2 (IQR: 4.41 and 64 kg (IQR: 15. Median infant BMI was 15.80 kg/cm2 (IQR: 4.02, while average weight was 5.130 kg (IQR: 1.627. Infants serum leptin values positively correlated with infants’ BMI (p = 0.001; r = 0.213 and breast milk leptin (p = 0.03; r = 0.285. Maternal serum leptin values positively correlated with maternal BMI (p = 0.000, r = 0.449 and breast milk leptin ones (p = 0.026; r = 0.322. Conclusion: Breast milk leptin and maternal BMI could influence infant serum leptin values. Further studies are needed to better elucidate the role of genetics and environment on infant leptin production and risk of obesity later in life.

  4. Retrospective evaluation of exposure index (EI) values from plain radiographs reveals important considerations for quality improvement

    Energy Technology Data Exchange (ETDEWEB)

    Mothiram, Ursula; Brennan, Patrick C; Robinson, John; Lewis, Sarah J [Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Radiation Sciences, Faculty of Health Science, University of Sydney, Sydney (Australia); Moran, Bernadette [Department of Clinical Medicine, Trinity College Dublin, Dublin (Ireland); Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Radiation Sciences, Faculty of Health Science, University of Sydney, Sydney (Australia)

    2013-12-15

    Following X-ray exposure, radiographers receive immediate feedback on detector exposure in the form of the exposure index (EI). To identify whether radiographers are meeting manufacturer-recommended EI (MREI) ranges for routine chest, abdomen and pelvis X-ray examinations under a variety of conditions and to examine factors affecting the EI. Data on 5000 adult X-ray examinations including the following variables were collected: examination parameters, EI values, patient gender, date of birth, date and time of examination, grid usage and the presence of implant or prosthesis. Descriptive statistics were used to summarize each data set and the Mann–Whitney U test was used to determine significant differences, with P < 0.05 indicating significance for all tests. Most examinations demonstrated EI values that were outside the MREI ranges, with significantly higher median EI values recorded for female patient radiographs than those for male patients for all manufacturers, indicating higher detector exposures for all units except for Philips digital radiography (DR), where increased EI values indicate lower exposure (P = 0.01). Median EI values for out of hours radiography were also significantly higher compared with normal working hours for all technologies (P ≤ 0.02). Significantly higher median EI values were demonstrated for Philips DR chest X-rays without as compared to those with the employment of a grid (P = 0.03), while significantly lower median EI values were recorded for Carestream Health computed radiography (CR) chest X-rays when an implant or prosthesis was present (P = 0.02). Non-adherence to MREIs has been demonstrated with EI value discrepancies being dependent on patient gender, time/day of exposure, grid usage and the presence of an implant or prosthesis. Retrospective evaluation of EI databases is a valuable tool to assess the need of quality improvement in routine DR.

  5. Methodology for adding and amending glycaemic index values to a nutrition analysis package.

    LENUS (Irish Health Repository)

    Levis, Sharon P

    2011-04-01

    Since its introduction in 1981, the glycaemic index (GI) has been a useful tool for classifying the glycaemic effects of carbohydrate foods. Consumption of a low-GI diet has been associated with a reduced risk of developing CVD, diabetes mellitus and certain cancers. WISP (Tinuviel Software, Llanfechell, Anglesey, UK) is a nutrition software package used for the analysis of food intake records and 24 h recalls. Within its database, WISP contains the GI values of foods based on the International Tables 2002. The aim of the present study is to describe in detail a methodology for adding and amending GI values to the WISP database in a clinical or research setting, using data from the updated International Tables 2008.

  6. Effects of dietary restraint and body mass index on the relative reinforcing value of snack food.

    Science.gov (United States)

    Goldfield, Gary S; Lumb, Andrew

    2009-01-01

    The present study examined the independent and interactive association between dietary restraint, body mass index (BMI) and the relative reinforcing value of food. Four hundred and three introductory psychology students completed questionnaires assessing age, gender, BMI, hunger, smoking status, nicotine dependence, dietary restraint, hedonic ratings for snack food and fruits and vegetables and the relative reinforcing value of snack food and fruits and vegetables. In the overall sample, results indicated a dietary restraint x BMI interaction after controlling for age, hunger, nicotine dependence, and hedonics. However, when regression models were separated by gender, the BMI x restraint interaction emerged only for females and not for males. Findings suggest that BMI moderates the relationship between dietary restraint and snack food reinforcement in females only, such that restraint and snack food reinforcement are inversely correlated in females with lower BMI, but restraint is positively correlated with snack food reinforcement in females with higher BMI. Theoretical and clinical implications of these findings are discussed.

  7. The Andean Biotic Index (ABI): revised tolerance to pollution values for macroinvertebrate families and index performance evaluation.

    Science.gov (United States)

    Ríos-Touma, Blanca; Acosta, Raúl; Prat, Narcís

    2014-04-01

    Score-based biotic indices are widely used to evaluate the water quality of streams and rivers. Few adaptations of these indices have been done for South America because there is a lack of knowledge on macroinvertebrate taxonomy, distribution and tolerance to pollution in the region. Several areas in the Andes are densely populated and there is need for methods to assess the impact of increasing human pressures on aquatic ecosystems. Considering the unique ecological and geographical features of the Andes, macroinvertebrate indices used in other regions must be adapted with caution. Here we present a review of the literature on macroinvertebrate distribution and tolerance to pollution in Andean areas above 2,000 masl. Using these data, we propose an Andean Biotic Index (ABI), which is based on the BMWP index. In general, ABI includes fewer macroinvertebrate families than in other regions of the world where the BMWP index has been applied because altitude restricts the distribution of several families. Our review shows that in the high Andes, the tolerance of several macroinvertebrate families to pollution differs from those reported in other areas. We tested the ABI index in two basins in Ecuador and Peru, and compared it to other BMWP adaptations using the reference condition approach. The ABI index is extremely useful for detecting the general impairment of rivers but class quality boundaries should be defined independently for each basin because reference conditions may be different. The ABI is widely used in Ecuador and Peru, with high correlations with land-use pressures in several studies. The ABI index is an integral part of the new multimetric index designed for high Andean streams (IMEERA).

  8. The Andean Biotic Index (ABI: revised tolerance to pollution values for macroinvertebrate families and index performance evaluation

    Directory of Open Access Journals (Sweden)

    Blanca Ríos-Touma

    2014-04-01

    Full Text Available Score-based biotic indices are widely used to evaluate the water quality of streams and rivers. Few adaptations of these indices have been done for South America because there is a lack of knowledge on macroinvertebrate taxonomy, distribution and tolerance to pollution in the region. Several areas in the Andes are densely populated and there is need for methods to assess the impact of increasing human pressures on aquatic ecosystems. Considering the unique ecological and geographical features of the Andes, macroinvertebrate indices used in other regions must be adapted with caution. Here we present a review of the literature on macroinvertebrate distribution and tolerance to pollution in Andean areas above 2 000masl. Using these data, we propose an Andean Biotic Index (ABI, which is based on the BMWP index. In general, ABI includes fewer macroinvertebrate families than in other regions of the world where the BMWP index has been applied because altitude restricts the distribution of several families. Our review shows that in the high Andes, the tolerance of several macroinvertebrate families to pollution differs from those reported in other areas. We tested the ABI index in two basins in Ecuador and Peru, and compared it to other BMWP adaptations using the reference condition approach. The ABI index is extremely useful for detecting the general impairment of rivers but class quality boundaries should be defined independently for each basin because reference conditions may be different. The ABI is widely used in Ecuador and Peru, with high correlations with land-use pressures in several studies. The ABI index is an integral part of the new multimetric index designed for high Andean streams (IMEERA. Rev. Biol. Trop. 62 (Suppl. 2: 249-273. Epub 2014 April 01.

  9. The development of a value based pricing index for new drugs in metastatic colorectal cancer.

    Science.gov (United States)

    Dranitsaris, George; Truter, Ilse; Lubbe, Martie S

    2011-06-01

    Worldwide, prices for cancer drugs have been under downward pressure where several governments have mandated price cuts of branded products. A better alternative to government mandated price cuts would be to estimate a final price based on drug performance, cost effectiveness and a country's ability to pay. We developed a global pricing index for new cancer drugs in patients with metastatic colorectal cancer (mCRC) that encompasses all of these attributes. A pharmacoeconomic model was developed to simulate mCRC patients receiving chemotherapy plus a 'new drug' that improves survival by 1.4, 3 and 6months, respectively. Cost and utility data were obtained from cancer centres and oncology nurses (n=112) in Canada, Spain, India, South Africa and Malaysia. Multivariable analysis was then used to develop the pricing index, which considers survival benefit, per capita GDP and income dispersion (as measured by the Gini coefficient) as predictor variables. Higher survival benefits were associated with elevated drug prices, especially in higher income countries such as Canada. For Argentina with a per capita GDP of $15,000 and a Gini coefficient of 51, the index estimated that for a drug which provides a 4month survival benefit in mCRC, the value based price would be $US 630 per dose. In contrast, the same drug in a wealthier country like Norway (per capita GDP=$50,000) could command a price of $US 2,775 per dose. The application of this index to estimate a price based on cost effectiveness and the wealth of a nation would be important for opening dialogue between the key stakeholders and a better alternative to government mandated price cuts. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Temperature-humidity index values and their significance on the daily production of dairy cattle

    Directory of Open Access Journals (Sweden)

    Pero Mijić

    2011-03-01

    Full Text Available The objectives of this study were to determine the microclimatic conditions in stables in three climactic regions (East, Mediterranean, and Central of Croatia as well as to evaluate the effect of temperature-humidity index (THI values on the daily production of dairy cattle. With that purpose, 1675686 test-day records collected from January 2005 until April 2010 were extracted from HPA (Croatian Agricultural Agency database. For estimation of the effect of THI on daily production of dairy cows fixed-effect model that took into account the effects of lactation stage, breed, calving season, measuring season, and THI group (T1 - THI≤72; T2 - THI>72 was used. Model was applied to each class of parity (P1, P2, P3, P4 and P5 and region. During the analysed period, the highest monthly averages of ambient temperature were determined in Mediterranean region, the highest monthly averages of relative humidity were observed in Central region, while the highest monthly mean values of temperature-humidity index (THI were determined in Mediterranean region. Heat stress conditions indicated with mean daily values of THI>72 were determined during spring and summer season in all analysed regions. Absence of heat stress conditions during autumn and winter season also characterised all three regions. Highly significant (P<0.01 decrease of daily milk yield as well as of daily fat and protein content due to enhanced THI was observed in all cows regardless the parity class and in all three climatic regions. Furthermore, the most deteriorate effect of heat stress was observed in East region. During heat stress period, with the aim of minimization of the effects of heat stress, it is necessary to regulate management strategies in the dairy herd.

  11. Indexed

    CERN Document Server

    Hagy, Jessica

    2008-01-01

    Jessica Hagy is a different kind of thinker. She has an astonishing talent for visualizing relationships, capturing in pictures what is difficult for most of us to express in words. At indexed.blogspot.com, she posts charts, graphs, and Venn diagrams drawn on index cards that reveal in a simple and intuitive way the large and small truths of modern life. Praised throughout the blogosphere as “brilliant,” “incredibly creative,” and “comic genius,” Jessica turns her incisive, deadpan sense of humor on everything from office politics to relationships to religion. With new material along with some of Jessica’s greatest hits, this utterly unique book will thrill readers who demand humor that makes them both laugh and think.

  12. Assessment of network traffic congestion through Traffic Congestability Value (TCV: a new index

    Directory of Open Access Journals (Sweden)

    Patel Nilanchal

    2015-12-01

    Full Text Available Traffic congestion is a major and growing problem in urban areas across the globe. It reduces the effective spatial interaction between different locations. To mitigate traffic congestion, not only the actual status of different routes needs to be known but also it is imperative to determine network congestion in different spatial zones associated with distinct land use classes. In the present paper, a new formula is proposed to quantify traffic congestion in the different spatial zones of a study area characterized by distinct land use classes. The proposed formula is termed the Traffic Congestability Value (TCV. The formula considers three major influencing factors: congestion index value, pedestrian movement and road surface conditions; since these parameters are significantly related to land use in a region. The different traffic congestion parameters, i.e. travel time, average speed and the proportion of time stopped, were collected in real time. Lower values of TCV correspond to a higher degree of congestion in the respective spatial zones and vice-versa and the results were validated in the field. TCV differs from the previous approaches to quantifying traffic congestion since it focuses on the causes of network congestion while in previous works the focus was generally on link flow congestion.

  13. The Glycemic Index of Rice and Rice Products: A Review, and Table of GI Values.

    Science.gov (United States)

    Kaur, Bhupinder; Ranawana, Viren; Henry, Jeyakumar

    2016-01-01

    Rice is the principle staple and energy source for nearly half the world's population and therefore has significant nutrition and health implications. Rice is generally considered a high glycemic index (GI) food, however, this depends on varietal, compositional, processing, and accompaniment factors. Being a major contributor to the glycemic load in rice eating populations, there is increasing concern that the rising prevalence of insulin resistance is as a result of the consumption of large amounts of rice. Devising ways and means of reducing the glycemic impact of rice is therefore imperative. This review gathers studies examining the GI of rice and rice products and provides a critical overview of the current state of the art. A table collating published GI values for rice and rice products is also included.

  14. Evaluation of low-cost consumer-level mobile phone technology for measuring international roughness index (IRI) values

    National Research Council Canada - National Science Library

    Hanson, Trevor; Cameron, Coady; Hildebrand, Eric

    2014-01-01

    International roughness index (IRI) values were calculated from multi-step processing of accelerometer data collected using three smartphone devices in three consumer vehicles under 11 test scenarios on a 1000 m stretch of secondary...

  15. Part II: Should the h-index be modified? An analysis of the m-quotient, contemporary h-index, authorship value, and impact factor.

    Science.gov (United States)

    Khan, Nickalus R; Thompson, Clinton J; Taylor, Douglas R; Gabrick, Kyle S; Choudhri, Asim F; Boop, Frederick R; Klimo, Paul

    2013-12-01

    The widely accepted h-index depends on the citation analysis source and does not consider the authorship position, the journal's impact factor (IF), or the age of the paper or author. We investigated these factors in citation statistics of academic neurosurgeons. An uncorrected h-index and the m-quotient, which corrects for career length, were calculated by the use of Scopus and Google Scholar. In a subset of neurosurgeons, we computed the contemporary h-index (hc), which accounts for the age of the publications; the authorship value (AV), weighted by author position; and the journal IF. An "overall' average for AV and IF including most of an author's publications and an average for publications comprising the h-index ("h-index core") were calculated. When we used Google Scholar, the mean h-index was significantly greater than that calculated when we used Scopus (P = 0.0030). m-quotient and hc-index increased with academic rank, with an m-quotient >1 achieved by 69% of chairmen and 48% of professors. The effect of AV was greatest on the greater h-indices. The average IF for the h-index core was greater than the overall IF, which did not correlate with academic rank. Few neurosurgeons consistently publish in high-impact journals. Google Scholar tends to inflate the h-index. The m-quotient and hc-index allow comparisons of researchers across time. Although average journal IF did not differ significantly among neurosurgeons academic ranks, it should be noted for individuals who consistently publish in high-impact journals. We recommend the creation of individual bibliometric profiles to better compare the academic productivity of neurosurgeons. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. New Danish reference values for height, weight and body mass index of children aged 0-5 years

    DEFF Research Database (Denmark)

    Nielsen, A M; Olsen, E M; Juul, A

    2010-01-01

    To derive new reference values for height, weight and body mass index (BMI) of children aged 0-5 years in Denmark and to compare them with the national reference from the 1970s and the 2006 WHO standard.......To derive new reference values for height, weight and body mass index (BMI) of children aged 0-5 years in Denmark and to compare them with the national reference from the 1970s and the 2006 WHO standard....

  17. An Analysis of Stability Properties in Earned Value Managements Cost Performance Index and Earned Schedules Schedule Performance Index

    Science.gov (United States)

    2014-03-27

    is no assumption on the normality of the distribution ( Hogg and Craig, 1995: 498). This test compares the median of the two variables, or groups...For the test, we calculate the test statistic, U, using this formula ( Hogg and Craig, 1995: 522): is the number of Ys, and...greater than . The summation formula counts the total number of X values that are less than each value of Y ( Hogg and Craig, 1995: 522). We compare

  18. Environmentally Lean Production: The Development and Incorporation of an Environmental Impact Index into Value Stream Mapping

    Directory of Open Access Journals (Sweden)

    T. J. Roosen

    2013-01-01

    Full Text Available There is a need to include environmental waste alongside other lean wastes. Current concepts of environmental waste focus on the total production of waste from a plant. However waste is generated by individual processes within the production. Therefore focused management of waste requires engineers to know what and where waste is being generated. This is often simply not known with any accuracy. This work offer a solution by developing a method to integrate environmental waste into the lean method of Value Stream Mapping (VSM. Specifically it integrate corporate environmental standards with the VSM process, thereby permitting established lean improvement process to be focused at specific environmental improvement actions. Application of the method is demonstrated in a manufacturing setting, representing a variety of environmental impacts. The deployment is capable of being generalised to any number of environmental factors. It is able to represent a customised waste index for a particular industry. Several ways to represent the multidimensional environmental wastes were explored via industry focus group. The resulting method can be used by production staff to quantify environmental impacts at the level of the individual process and aggregated to report wastes for the whole value stream.

  19. Joint spatiotemporal variability of global sea surface temperatures and global Palmer drought severity index values

    Science.gov (United States)

    Apipattanavis, S.; McCabe, G.J.; Rajagopalan, B.; Gangopadhyay, S.

    2009-01-01

    Dominant modes of individual and joint variability in global sea surface temperatures (SST) and global Palmer drought severity index (PDSI) values for the twentieth century are identified through a multivariate frequency domain singular value decomposition. This analysis indicates that a secular trend and variability related to the El Niño–Southern Oscillation (ENSO) are the dominant modes of variance shared among the global datasets. For the SST data the secular trend corresponds to a positive trend in Indian Ocean and South Atlantic SSTs, and a negative trend in North Pacific and North Atlantic SSTs. The ENSO reconstruction shows a strong signal in the tropical Pacific, North Pacific, and Indian Ocean regions. For the PDSI data, the secular trend reconstruction shows high amplitudes over central Africa including the Sahel, whereas the regions with strong ENSO amplitudes in PDSI are the southwestern and northwestern United States, South Africa, northeastern Brazil, central Africa, the Indian subcontinent, and Australia. An additional significant frequency, multidecadal variability, is identified for the Northern Hemisphere. This multidecadal frequency appears to be related to the Atlantic multidecadal oscillation (AMO). The multidecadal frequency is statistically significant in the Northern Hemisphere SST data, but is statistically nonsignificant in the PDSI data.

  20. [Relationship between visual field index and visual field morphological stages of glaucoma and their diagnostic value].

    Science.gov (United States)

    Hou, X R; Qin, J Y; Ren, Z Q

    2017-02-11

    Objective: To investigate the rationality of visual field morphological stages of glaucoma, its relationship with visual field index and their diagnostic value. Methods: Retrospective series case study. Two hundred and seventy-four glaucoma patients and 100 normal control received visual field examination by Humphrey perimeter using standard automatic perimetry (SAP) program from March 2014 to September 2014. Glaucoma patients were graded into four stages according to characteristic morphological damage of visual field, distribution of mean defect (MD) and visual field index (VFI) of each stage were plotted and receiver operation characteristic curve (ROC) was used to explore its correlation with MD and VFI. The diagnostic value of MD and VFI was also compared. For the comparison of general data of subjects, categorical variables were compared using χ(2) test, numerical variables were compared using F test. MD and VFI were compared using ANOVA among stages according to visual field, followed by multiple comparisons using LSD method. The correlation between MD and VFI and different stages according to visual field defined their diagnostic value, and compared using area under the curve (AUC) of ROC. Results: No characteristic visual field damage was found in normal control group, and MD and VFI was (-0.06±1.24) dB and (99.15±0.76)%, respectively. Glaucomatous visual field damage was graded into early, medium, late and end stage according to morphological characteristic. MD for each stage were (-2.83±2.00) dB, (-9.70±3.68) dB, (-18.46±2.90) dB, and (-27.96±2.76) dB, respectively. VFI for each stage were (93.84±3.61)%, (75.16±10.85)%, (49.36±11.26)% and (17.65±10.59)%, respectively. MD and VFI of each stage of glaucomatous group and normal control group were all significantly different (F=1 165.53 and PAUC(MD) (Pvisual field damage to be graded into early, medium, late and end stage using Humphrey perimeter. Distribution of MD and VFI for each stage was

  1. Assessment value of quantitative indexes of pancreatic CT perfusion scanning for malignant degree of pancreatic cancer

    Institute of Scientific and Technical Information of China (English)

    Jiang-Xia Lei

    2016-01-01

    Objective:To analyze the assessment value of the quantitative indexes of pancreatic CT perfusion scanning for malignant degree of pancreatic cancer.Methods:A total of 58 patients with space-occupying pancreatic lesions were divided into 20 patients with pancreatic cancer and 38 patients with benign pancreatic lesions after pancreatic CT perfusion. Patients with pancreatic cancer received palliative surgery, and the cancer tissue and para-carcinoma tissue specimens were collected during operation. The differences in pancreatic CT perfusion scanning parameter values and serum tumor marker levels were compared between patients with pancreatic cancer and patients with benign pancreatic lesions, mRNA expression levels of malignant molecules in pancreatic cancer tissue and para-carcinoma tissue were further determined, and the correlation between pancreatic CT perfusion scanning parameter values and malignant degree of pancreatic cancer was analyzed.Results:CT perfusion scanning BF, BV and Per values of patients with pancreatic cancer were lower than those of patients with benign pancreatic lesions; serum CA19-9, CEA, CA125 and CA242 levels were higher than those of patients with benign pancreatic lesions (P<0.05); mRNA expression levels of Bcl-2, Bcl-xL andsurvivin in pancreatic cancer tissue samples were higher than those in para-carcinoma tissue samples, and mRNA expression levels ofP53 andBax were lower than those in para-carcinoma tissue samples (P<0.05); CT perfusion scanning parameters BF, BV and Per values of patients with pancreatic cancer were negatively correlated with CA19-9, CEA, CA125 and CA242 levels in serum as well as mRNA expression levels ofBcl-2, Bcl-xL and survivinin pancreatic cancer tissue, and positively correlated with mRNA expression levels ofP53andBaxin pancreatic cancer tissue (P<0.05).Conclusions:Pancreatic CT perfusion scanning is a reliable way to judge the malignant degree of pancreatic cancer and plays a positive role in guiding clinical

  2. Prognostic value of brachioradialis muscle oxygen saturation index and vascular occlusion test in septic shock patients.

    Science.gov (United States)

    Marín-Corral, J; Claverias, L; Bodí, M; Pascual, S; Dubin, A; Gea, J; Rodriguez, A

    2016-05-01

    To compare rSO2 (muscle oxygen saturation index) static and dynamic variables obtained by NIRS (Near Infrared Spectroscopy) in brachioradialis muscle of septic shock patients and its prognostic implications. Prospective and observational study. Intensive care unit. Septic shock patients and healthy volunteers. The probe of a NIRS device (INVOS 5100) was placed on the brachioradialis muscle during a vascular occlusion test (VOT). Baseline, minimum and maximum rSO2 values, deoxygenation rate (DeOx), reoxygenation slope (ReOx) and delta value. Septic shock patients (n=35) had lower baseline rSO2 (63.8±12.2 vs. 69.3±3.3%, p<0.05), slower DeOx (-0.54±0.31 vs. -0.91±0.35%/s, p=0.001), slower ReOx (2.67±2.17 vs. 9.46±3.5%/s, p<0.001) and lower delta (3.25±5.71 vs. 15.1±3.9%, p<0.001) when compared to healthy subjects (n=20). Among septic shock patients, non-survivors showed lower baseline rSO2 (57.0±9.6 vs. 69.8±11.3%, p=0.001), lower minimum rSO2 (36.0±12.8 vs. 51.3±14.8%, p<0.01) and lower maximum rSO2 values (60.6±10.6 vs. 73.3±11.2%, p<0.01). Baseline rSO2 was a good mortality predictor (AUC 0.79; 95%CI: 0.63-0.94, p<0.01). Dynamic parameters obtained with VOT did not improve the results. Septic shock patients present an important alteration of microcirculation that can be evaluated by NIRS with prognostic implications. Monitoring microvascular reactivity in the brachioradialis muscle using VOT with our device does not seem to improve the prognostic value of baseline rSO2. Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  3. The value of delta neutrophil index in young infants with febrile urinary tract infection

    Science.gov (United States)

    Lee, Jung Won; Kim, Seong Heon; Park, Se Jin; Lee, Keum Hwa; Park, Jae Hyon; Kronbichler, Andreas; Eisenhut, Michael; Kim, Ji Hong; Lee, Jong Wook; Shin, Jae Il

    2017-01-01

    Delta neutrophil index (DNI) is the fraction of circulating immature granulocytes, which reflects severe bacterial infections and septic condition but has not been studied in urinary tract infection (UTI). Here, we evaluated the value of DNI in predicting acute pyelonephritis (APN) or vesicoureteral reflux (VUR) using the data of 288 patients. Conventional inflammatory markers (white blood cell [WBC] count, erythrocyte sedimentation rate [ESR], C-reactive protein [CRP]), and DNI were measured. WBC, CRP, ESR and DNI were higher in APN than in lower UTI (p < 0.01). Multiple logistic-regression analyses showed that DNI was a predictive factor for areas of lack of uptake on dimercaptosuccinic acid (DMSA) scans (P < 0.01). The area under the receiver operating characteristic (AUC) was also high for DNI (0.622, 95% CI 0.558–0.687, P < 0.01) as well as for CRP (0.731, 95% CI 0.673–0.789, P < 0.01) for the prediction of DMSA defects. DNI demonstrated the highest area under the ROC curve for diagnosis of VUR (0.620, 95% CI 0.542–0.698, P < 0.01). To the best of our knowledge, this is a first study demonstrating that DNI can be used as a diagnostic marker to distinguish APN from lower UTI and function as a diagnostic marker indicative of VUR compared to other conventional markers. PMID:28169298

  4. Diagnostic value of bioelectrical impedance analysis versus body mass index for detection of obesity among students.

    Science.gov (United States)

    Heydari, Seyed-Taghi; Ayatollahi, Seyed-Mohammad-Taghi; Zare, Najaf

    2011-06-01

    Obesity is a common nutritional problem in both developed and developing countries. The aim of this study was to determine the prevalence of overweightness and obesity using both bioelectrical impedance analysis (BIA) and body mass index (BMI). In this cross-sectional study, 288 healthy college students were selected. Socio-economic status questionnaires were completed and subjects' anthropometric features were measured by a trained nurse. BMI was calculated and body fat mass (BFM) and body fat percent (BF%) were obtained using BIA method by hand-to-hand Omron BF-500 set. Mean age of the subjects was 21.1±1.7 years. Based on BMI, 2.6% of males and 2.2% of females were obese while 15.7% and 9.6% were diagnosed to be overweight respectively. The correlation between BMI values and BFM were 0.883 and 0.908 in males and females respectively (Pcollege students compared with Iranian general population, especially in females. Additionally, BIA method was shown to be closely correlated with and as much valuable as BMI in regard to detection of obesity.

  5. [Value of automated medical indexing of an image database and a digital radiological library].

    Science.gov (United States)

    Duvauferrier, R; Le Beux, P; Pouliquen, B; Seka, L P; Morcet, N; Rolland, Y

    1997-06-01

    We indexed the contents of a radiology server on the web to facilitate access to research documents and to link reference texts to images contained in radiology databases. Indexation also allows case reports to be transformed with no supplementary work into formats compatible with computer-assisted training. Indexation was performed automatically by ADM-Index, the aim being to identify the medical concepts expressed within each medical text. Two types of texts were indexed: medical imaging reference books (Edicerf) and case reports with illustrations and captions (Iconocerf). These documents are now available on a web server with HTML format for Edicerf and on an Oracle database for Iconocerf. When the user consults a chapter of a book or a case report, the indexed terms are displayed in the heading; all reference texts and case reports containing the indexed terms can then be called up instantaneously. The user can express his search in natural language. Indexation follows the same process allowing instantaneous recall of all reference texts and case reports where the same concept appears in the diagnosis or clinical context. By using the context of the case reports as the search index, all case reports involving a common medical concept can be found. The context is interpreted as a question. When the user responds to this question, ADM-Index compares this response with the answer furnished by the reference texts and case reports. Correct or erroneous responses can thus be identified, converting the system into a computer-assisted training tool.

  6. Index

    Directory of Open Access Journals (Sweden)

    Antonio Juan Sánchez

    2012-09-01

    Full Text Available The Advances in Distributed Computing and Artificial Intelligence Journal (ISSN: 2255-2863 is an open access journal that publishes articles which contribute new results associated with distributed computing and artificial intelligence, and their application in different areas. The artificial intelligence is changing our society. Its application in distributed environments, such as the Internet, electronic commerce, mobile communications, wireless devices, distributed computing and so on, is increasing and becoming and element of high added value and economic potential in industry and research. These technologies are changing constantly as a result of the large research and technical effort being undertaken in both universities and businesses. The exchange of ideas between scientists and technicians from both academic and business areas is essential to facilitate the development of systems that meet the demands of today's society.

  7. [The value of area strain imaging diastolic index for predicting left anterior descending severe stenosis].

    Science.gov (United States)

    Tan, Tuantuan; Zhou, Qing; Chen, Jinling; Song, Hongning; Guo, Juan; Guo, Ruiqiang

    2015-09-01

    To evaluate the value of locating and defining severe stenosis of left anterior descending (LAD) with area strain imaging diastolic indexes (ASI-DI) derived from three dimensional speckle tracking imaging (3D-STI). A total of 92 suspected coronary heart disease patients with left ventricular ejection fraction (LVEF) ≥ 50% and without regional wall motion abnormality, who underwent echocardiography before coronary angiography in our department from July 2012 to April 2014, were included in this retrospective study. Patients were divided into three groups by the level of LAD stenosis: severe stenosis group (≥ 75%, n = 36), mild to moderate stenosis group (1%-74%, n = 22) and control group (without coronary artery stenosis, n = 34). Global peak systolic area strain (GPSAS), global ASI-DI (GASI-DI), and ASI-DI of the regional myocardial segments with blood supplied by LAD were measured. Receiver operating curves (ROC) were obtained between ASI-DI and stenosis level of LAD to locate and to find out the optimal segment and cutoff values. There was no significant difference of GPSAS among serious stenosis group, mild and moderate stenosis group and control group ((-25.2 ± 6.2) % vs. (-20.3 ± 6.6) % vs. (-21.3 ± 8.6) %, P = 0.159). GASI-DI was significantly lower in severe stenosis group than in mild to moderate stenosis group and control group ((-34.3 ± 14.7) vs. (-48.1 ± 13.3) % vs. (-59.4 ± 12.2) %, both P stenosis group and control group (P = 0.217). The optimal cutoff values of ASI-DI were 40.3% and area under the curve (AUC) were 0.829 in the base anterior segment for detecting proximal severe stenosis of LAD (sensitivity 0.967, specificity 0.651), 38.3% and 0.843 in the middle anteroseptum for detecting mid-distal sever stenosis of LAD (sensitivity 0.967, specificity 0.651). Patients with severe LAD stenosis can be screened by ASI-DI among patients with LVEF ≥ 50% and without regional wall motion abnormality. The ASI-DI of base anterior segment and

  8. Index

    Directory of Open Access Journals (Sweden)

    Antonio Juan Sánchez

    2013-08-01

    Full Text Available The Advances in Distributed Computing and Artificial Intelligence Journal (ADCAIJ is an open access journal that publishes articles which contribute new results associated with distributed computing and artificial intelligence,and their application in different areas.The artificial intelligence is changing our society. Its application in distributed environments, such as the Internet, electronic commerce, mobile communications, wireless devices, distributed computing and so on, is increasing and becoming and element of high added value and economic potential in industry and research. These technologies are changing constantly as a result of the large research and technical effort being undertaken in both universities and businesses. The exchange of ideas between scientists and technicians from both academic and business areas is essential to facilitate the development of systems that meet the demands of today's society.We would like to thank all the contributing authors for their hard and highly valuable work. Their work has helped to contribute to the success of this special issue. Finally, the Editors wish to thank Scientific Committee of Advances in Distributed Computing and Artificial Intelligence Journal for the collaboration of this special issue, that notably contributes to improve the quality of the journal. We hope the reader will share our joy and find this special issue very useful.

  9. Index

    Directory of Open Access Journals (Sweden)

    Antonio Juan SÁNCHEZ

    2013-05-01

    Full Text Available The Advances in Distributed Computing and Artificial Intelligence Journal (ADCAIJ is an open access journal that publishes articles which contribute new results associated with distributed computing and artificial intelligence,and their application in different areas. The artificial intelligence is changing our society. Its application in distributed environments, such as the Internet, electronic commerce, mobile communications, wireless devices, distributed computing and so on, is increasing and becoming and element of high added value and economic potential in industry and research. These technologies are changing constantly as a result of the large research and technical effort being undertaken in both universities and businesses. The exchange of ideas between scientists and technicians from both academic and business areas is essential to facilitate the development of systems that meet the demands of today's society. We would like to thank all the contributing authors for their hard and highly valuable work. Their work has helped to contribute to the success of this special issue. Finally, the Editors wish to thank Scientific Committee of Advances in Distributed Computing and Artificial Intelligence Journal for the collaboration of this special issue, that notably contributes to improve the quality of the journal. We hope the reader will share our joy and find this special issue very useful.

  10. Application of variable anti-connectivity index to active sites. Modelling pK(a) values of aliphatic monocarboxylic acids.

    Science.gov (United States)

    Sčavničar, A; Balaban, A T; Pompe, M

    2013-01-01

    A partial distance-weighted variable anti-connectivity topological index was introduced for modelling pK(a) values of 31 aliphatic carboxylic acids and haloalkyl-carboxylic acids. The partial distance-weighted variable anti-connectivity index showed superior modelling capabilities compared with the index calculated from the complete graph, because it is capable of accounting correctly for the intramolecular interactions of unconnected vertices to specific bond strengths (active site), thereby improving the RMS(CV) error by about 30% (0.221 pK(a) units).

  11. Value of the Doppler index of myocardial performance in the early phase of acute myocardial infarction

    DEFF Research Database (Denmark)

    Poulsen, S H; Jensen, S E; Tei, C

    2000-01-01

    Prospective assessment of a nongeometric Doppler-derived index of combined systolic and diastolic myocardial performance was performed in 64 patients with acute myocardial infarction (MI) within 1 hour after their arrival to the hospital and in 39 age-matched healthy subjects. The index is defined...

  12. Explanatory Value of the Ability Index as Assessed by Cardiologists and Patients with Congenital Heart Disease

    DEFF Research Database (Denmark)

    Schrader, Anne-Marie Voss; Lisby, Karen H; King, Catriona;

    2012-01-01

    Introduction. The Ability Index was developed to classify patients with congenital heart disease into four functional classes. Functional class is typically determined by the cardiologist, based on data from a clinical interview. The validity of the Ability Index as assessed by the patient has...

  13. 76 FR 30550 - Federal Management Regulation; Change in Consumer Price Index Minimal Value

    Science.gov (United States)

    2011-05-26

    ... ADMINISTRATION 41 CFR Part 102-42 RIN 3090-AJ12 Federal Management Regulation; Change in Consumer Price Index..., to reflect changes in the Consumer Price Index for the immediately preceding 3-year period. The... INFORMATION CONTACT: Mr. Robert Holcombe, Director, Asset Management Policy Division (202-501-3828...

  14. Tei index and neurohormonal activation in patients with incident heart failure: serial changes and prognostic value

    DEFF Research Database (Denmark)

    Mikkelsen, Kirsten Vilain; Møller, Jacob Eifer; Bie, Peter;

    2006-01-01

    Natriuretic peptides and Tei index are useful indices for risk stratification in advanced left ventricular dysfunction (LVD). Their role in early stages is less clear.......Natriuretic peptides and Tei index are useful indices for risk stratification in advanced left ventricular dysfunction (LVD). Their role in early stages is less clear....

  15. Prognostic value of an increase in post-exercise ankle-brachial index.

    Science.gov (United States)

    Hammad, Tarek A; Hiatt, William R; Gornik, Heather L; Shishehbor, Mehdi H

    2017-06-01

    Prior studies have assessed the prognostic value of a decrease, not an increase, of the post-exercise ankle-brachial index (ABI) among patients with normal resting results. Thus, we sought to evaluate the prognostic significance of an increase in post-exercise ABI among these patients. From a single center vascular laboratory database between September 2005 and January 2010, we retrospectively identified 1437 consecutive patients with a normal resting ABI (1.00-1.40) and available post-exercise results. We classified them into group 1 (normal subjects; post-exercise ABI drop ⩽ 20%, 58%) and group 2 (post-exercise ABI increase, 42%) after excluding those with an ABI drop > 20% (peripheral artery disease) as they had known disease ( n=192). The primary outcome was to assess the risk of ischemic events, defined as a composite of unadjudicated death, stroke, or myocardial infraction (MACE). Associations between groups and outcomes were examined using multivariable Cox proportional hazard and propensity analyses. Both groups had similar prevalence of cardiovascular comorbidities. In unadjusted analysis, group 2 was more likely to have MACE ( p = 0.001). After adjusting for all baseline characteristics, an increase in post-exercise ABI compared to normal subjects was associated with a higher MACE (adjusted HR: 1.70, 95% CI: 1.14-2.53; p=0.009). This association stayed statistically significant after propensity matching (adjusted HR: 1.80, 95% CI: 1.17-2.76; p=0.007). This hypothesis-generating analysis showed that an increase in post-exercise ABI appears to identify a population with a higher risk for MACE. A prospective study of this association and mechanisms of risk should be conducted.

  16. Recurrence Relations of the Multi-Indexed Orthogonal Polynomials : III

    CERN Document Server

    Odake, Satoru

    2015-01-01

    In a previous paper, we presented conjectures of the recurrence relations with constant coefficients for the multi-indexed orthogonal polynomials of Laguerre, Jacobi, Wilson and Askey-Wilson types. In this paper we present a proof for the Laguerre and Jacobi cases. Their bispectral properties are also discussed, which give a method to obtain the coefficients of the recurrence relations explicitly.

  17. Bispectral methods of signal processing applications in radar, telecommunications and digital image restoration

    CERN Document Server

    Totsky, Alexander V; Kravchenko, Victor F

    2015-01-01

    By studying applications in radar, telecommunications and digital image restoration, this monograph discusses signal processing techniques based on bispectral methods. Improved robustness against different forms of noise as well as preservation of phase information render this method a valuable alternative to common power-spectrum analysis used in radar object recognition, digital wireless communications, and jitter removal in images.

  18. Influence of enamel composite thickness on value, chroma and translucency of a high and a nonhigh refractive index resin composite.

    Science.gov (United States)

    Ferraris, Federico; Diamantopoulou, Sofia; Acunzo, Raffaele; Alcidi, Renato

    2014-01-01

    To evaluate the influence of thickness on the optical properties of two enamel shade composites, one with a high refractive index and one traditional. A medium value enamel shade was selected from the resin composites Enamel Plus HRi (UE2) and Enamel Plus HFO (GE2). Enamel Plus HRi is a high refractive index composite. Samples were fabricated in five different thicknesses: 0.3, 0.5, 1, 1.5 and 2 mm. Three specimens per material and thickness were fabricated. Three measurements per sample, over white, black and dentin composite background were generated with a spectrophotometer (Spectroshade Micro, MHT). Value, chroma, translucency and color differences (ΔE) of the specimens were calculated. RESULTS were analyzed by the Pearson correlation test, ANOVA and a post-hoc Tukey test. Increasing the thickness of the enamel layers decreased the translucency and the chroma of the substrate for both materials tested. For HRi the increase of the thickness resulted in an increase of the value, whereas for HFO it resulted in a reduction of the value. The two composites showed a significant difference in value for each thickness, but not in translucency and chroma. Color difference between them was perceptible in layers equal or higher than 0.5 mm. The high refractive index enamel (HRi) composite exhibits different optical behavior compared to the traditional one (HFO). HRi enamel composite behaves more like natural enamel as by increasing the thickness of the enamel layer, the value also increases.

  19. Aortic augmentation index: reference values in a large unselected population by means of the SphygmoCor device

    DEFF Research Database (Denmark)

    Janner, Julie; Godtfredsen, Nina S; Ladelund, Steen

    2010-01-01

    Arterial stiffness and pulse wave reflection are associated with cardiovascular disease (CVD). Pulse wave analyses (PWAs) allow the estimation of the central augmentation index (AIx), a measurement of pulse wave reflection. To understand the predictive role of AIx, reference values for AIx are ne...

  20. Value of oxygenation index in assessment of outcome of patients with acute respiratory distress syndrome treated by mechanical ventilator

    Institute of Scientific and Technical Information of China (English)

    乔莉

    2014-01-01

    Objective To determine the value of oxygenation index in assessing the outcome of mechanical ventilated patients with acute respiratory distress syndrome(ARDS).Methods From September 2008 to September 2013,patients meeting the Berlin definition of ARDS were evaluated in this retrospective study.Data included oxygenation

  1. Observed and simulated trophic index (TRIX) values for the Adriatic Sea basin

    Science.gov (United States)

    Fiori, Emanuela; Zavatarelli, Marco; Pinardi, Nadia; Mazziotti, Cristina; Ferrari, Carla Rita

    2016-09-01

    The main scope of the Marine Strategy Framework Directive is to achieve good environmental status (GES) of the EU's marine waters by 2020, in order to protect the marine environment more effectively. The trophic index (TRIX) was developed by Vollenweider in 1998 for the coastal area of Emilia-Romagna (northern Adriatic Sea) and was used by the Italian legislation to characterize the trophic state of coastal waters. We compared the TRIX index calculated from in situ data ("in situ TRIX") with the corresponding index simulated with a coupled physics and biogeochemical numerical model ("model TRIX") implemented in the overall Adriatic Sea. The comparison between in situ and simulated data was carried out for a data time series on the Emilia-Romagna coastal strip. This study shows the compatibility of the model with the in situ TRIX and the importance of the length of the time series in order to get robust index estimates. The model TRIX is finally calculated for the whole Adriatic Sea, showing trophic index differences across the Adriatic coastal areas.

  2. Economic values and expected effect of selection index for pathogen-specific mastitis under Danish conditions

    DEFF Research Database (Denmark)

    Sørensen, Lars Peter; Mark, Thomas; Sørensen, M.K.

    2010-01-01

    dysgalactiae, Escherichia coli, coagulase-negative staphylococci, and Streptococcus uberis using a stochastic simulation model (SimHerd IV). Mastitis incidences for SimHerd IV were from incidences of mastitis treatments in primiparous Danish Holstein cows calving in 2007. Estimated costs ranged from 149 euro...... goal was identical to selection index 3. Mastitis data from primiparous cows calving from 1998 to 2008 were used to estimate genetic parameters of the mastitis traits using linear models and AI-REML algorithm. These parameters were used for construction of the selection index equations...

  3. [Value of cardiopulmonary risk index in predicting postoperative short-term prognosis in patients with lung cancer].

    Science.gov (United States)

    Gu, Yueqing; Gao, Chengxin; Bai, Hao; Liao, Meilin

    2002-06-20

    To determine the value of preoperative cardiopulmonary risk index (CPRI) in predicting the short-term prognosis after lung resection in patients with lung cancer. Preoperative clinical data were used to generate a cardiac risk index (CRI) and a pulmonary risk index (PRI). And the value of cardiopulmonary risk index (CPRI) consisting of CRI and PRI in predicting postoperative prognosis was estimated in patients who underwent lung resection at Shanghai Chest Hospital in 1999. A total of 625 consecutive patients were studied. Postoperative complications occurred in 49 patients (7.8%), including 8 deaths within 30 days of operation. In the total group, CRI, PRI and CPRI scores ranged from 1 to 3, 0 to 5 and 1 to 7, respectively. There were 489 patients with CPRI CPRI≥4. Using CPRI≥4 as a threshold for predicting postoperative complications, the sensitivity, specificity and accuracy rate were 75.5%, 82.8% and 82.2% respectively. The preoperative CPRI is one of the important indexes in predicting the short-term postoperative prognosis for patients with lung cancer. However, it can not completely predict all of postoperative risks, and should be used together with other factors.

  4. The Cut-off Values of Triglycerides and Glucose Index for Metabolic Syndrome in American and Korean Adolescents.

    Science.gov (United States)

    Moon, Shinje; Park, Joon Sung; Ahn, Youhern

    2017-03-01

    The aim of this study was to establish ethnic- and gender-specific cut-off values of triglycerides and glucose index (TyG index) for clinical usefulness in a representative sample of Mexican American, Non-Hispanic White, Non-Hispanic Black, and Korean adolescents. The data were collected from datasets of the National Health and Nutrition Examination Survey between 1999 and 2012, and the Korean National Health and Nutrition Examination Survey between 2005 and 2013. Receiver operating characteristic curve analysis was used to find valid cut-off values of the TyG index for metabolic syndrome. The total number of eligible participants was 3,164 in the US and 4,873 in Korea. The optimal cut-off value with the Cook et al. definition revealed 8.55 in Mexican American, 8.55 in Non-Hispanic White, 8.35 in Non-Hispanic Black, and 8.45 in Korean, respectively. The cut-off value with the de Ferranti et al. definition was 8.45, 8.45, 8.15, and 8.35, and the cut-off value with the International Diabetes Federation definition was 8.65, 8.65, 8.15, and 8.55, respectively. These findings may be clinically useful for evaluating insulin resistance for determining metabolic abnormalities in adolescents.

  5. How long the singular value decomposed entropy predicts the stock market? - Evidence from the Dow Jones Industrial Average Index

    Science.gov (United States)

    Gu, Rongbao; Shao, Yanmin

    2016-07-01

    In this paper, a new concept of multi-scales singular value decomposition entropy based on DCCA cross correlation analysis is proposed and its predictive power for the Dow Jones Industrial Average Index is studied. Using Granger causality analysis with different time scales, it is found that, the singular value decomposition entropy has predictive power for the Dow Jones Industrial Average Index for period less than one month, but not for more than one month. This shows how long the singular value decomposition entropy predicts the stock market that extends Caraiani's result obtained in Caraiani (2014). On the other hand, the result also shows an essential characteristic of stock market as a chaotic dynamic system.

  6. PHYSICAL ACTIVITY INDEX FOR CHILDREN: A COMPARISON OF LITERATURE VALUES AND EPA'S CHAD

    Science.gov (United States)

    The physical activity index (PAI) is a measure of an individual's energy expenditure level (and thus oxygen consumption) calculated as a time-weighted average of metabolic equivalents (METS) over the individual's activities. Many exposure models rely upon EPA's CHAD data base to ...

  7. Reference Values of the Pain Disability Index in Patients With Painful Musculoskeletal and Spinal Disorders

    NARCIS (Netherlands)

    Soer, Remko; Koke, Albere J. A.; Speijer, Bert L. G. N.; Vroomen, Patrick C. A. J.; Smeets, Rob J. E. M.; Coppes, Maarten H.; Reneman, Michiel F.; Gross, Douglas P.

    2015-01-01

    Study Design. Cross-sectional study. Objective. To examine reference data for the Pain Disability Index (PDI) in Dutch and Canadian patient samples with a variety of musculoskeletal pain disorders and to test which potential factors are independently associated with the PDI score. Summary of Backgro

  8. The predictive value of the foot posture index on dynamic function

    DEFF Research Database (Denmark)

    Nielsen, R.G.; Ratleff, M.; Kersting, Uwe G.

    2008-01-01

    Keenan et. al. identified the six-item version of the Foot Posture Index (FPI) as a valid, simple and clinically useful tool. The model combines measures of the standing foot posture in multiple planes and anatomical segments. It provides an alternative to existing static clinical measures when...

  9. The Predictive Value of the Foot Posture Index on Dynamic Function

    DEFF Research Database (Denmark)

    Nielsen, R.G.; Rathleff, M.; Kersting, Uwe G.

    Keenan et. al. identified the six-item version of the Foot Posture Index (FPI) as a valid, simple and clinically useful tool. The model combines measures of the standing foot posture in multiple planes and anatomical segments. It provides an alternative to existing static clinical measures when...

  10. Cardiorespiratory fitness and body mass index values in 9-year-old rural Norwegian children

    DEFF Research Database (Denmark)

    Resaland, G K; Mamen, A; Anderssen, S A

    2009-01-01

    and 16.8% of the girls were classified as overweight, and 1.6% of the boys and 6.9% of the girls as obese. Mean age, body mass, height and Ponderal index were not significantly different between sexes. Girls had a higher BMI than boys (p = 0.05). CONCLUSION: Compared to earlier Norwegian studies...

  11. Diagnostic value of [-2]proPSA and PHI index (review of literature

    Directory of Open Access Journals (Sweden)

    A. V. Sidorenkov

    2014-01-01

    Full Text Available Measurement of blood prostate-specific antigen (PSA levels resulted in an increasing number of performed prostate biopsies and the lower age-adjusted PSA threshold led to a larger number of unnecessary prostate biopsies. Today prostate cancer (PC is identified in only 35% of the patients with a total PSA level of 4–10 ng/ml and PSA-negative PC occurs in 20–25%. Obviously, PSA as an independent marker has exhausted its diagnostic potentialities. The new PC markers presented in the literature indubitably deserve close attention and further investigation. The most promising markers also include [-2]proPSA and PHI index. According to the latest evidence available in the literature now, [-2]proPSA and PHI index are the best predictors of PC during both primary and secondary prostate biopsy. Some publications show it possible to use the PHI index in planning both primary and secondary prostate biopsies, by constructing risk normograms, in combination with other individual patient examination parameters, including those with the other latest biomarkers of PC. The use of [-2]proPSA and PHI index in everyday practice can assist in increasing the specificity of PC diagnosis and reducing the number of unnecessary prostate biopsies. The apparent importance of the diagnosis of PC at its early stages (including that using the PHI index made us investigate this topic. Despite a great number of printed papers dealing with this problem, their number continues to increase, but clear guides to make actions in this field are yet to be elaborated and a decision on each specific case is made individually.

  12. Diagnostic value of [-2]proPSA and PHI index (review of literature

    Directory of Open Access Journals (Sweden)

    A. V. Sidorenkov

    2014-12-01

    Full Text Available Measurement of blood prostate-specific antigen (PSA levels resulted in an increasing number of performed prostate biopsies and the lower age-adjusted PSA threshold led to a larger number of unnecessary prostate biopsies. Today prostate cancer (PC is identified in only 35% of the patients with a total PSA level of 4–10 ng/ml and PSA-negative PC occurs in 20–25%. Obviously, PSA as an independent marker has exhausted its diagnostic potentialities. The new PC markers presented in the literature indubitably deserve close attention and further investigation. The most promising markers also include [-2]proPSA and PHI index. According to the latest evidence available in the literature now, [-2]proPSA and PHI index are the best predictors of PC during both primary and secondary prostate biopsy. Some publications show it possible to use the PHI index in planning both primary and secondary prostate biopsies, by constructing risk normograms, in combination with other individual patient examination parameters, including those with the other latest biomarkers of PC. The use of [-2]proPSA and PHI index in everyday practice can assist in increasing the specificity of PC diagnosis and reducing the number of unnecessary prostate biopsies. The apparent importance of the diagnosis of PC at its early stages (including that using the PHI index made us investigate this topic. Despite a great number of printed papers dealing with this problem, their number continues to increase, but clear guides to make actions in this field are yet to be elaborated and a decision on each specific case is made individually.

  13. Implementation of transformed lenses in bed of nails reducing refractive index maximum value and sub-unity regions.

    Science.gov (United States)

    Prado, Daniel R; Osipov, Andrey V; Quevedo-Teruel, Oscar

    2015-03-15

    Transformation optics with quasi-conformal mapping is applied to design a Generalized Maxwell Fish-eye Lens (GMFEL) which can be used as a power splitter. The flattened focal line obtained as a result of the transformation allows the lens to adapt to planar antenna feeding systems. Moreover, sub-unity refraction index regions are reduced because of the space compression effect of the transformation, reducing the negative impact of removing those regions when implementing the lens. A technique to reduce the maximum value of the refractive index is presented to compensate for its increase because of the transformation. Finally, the lens is implemented with the bed of nails technology, employing a commercial dielectric slab to improve the range of the effective refractive index. The lens was simulated with a 3D full-wave simulator to validate the design, obtaining an original and feasible power splitter based on a dielectric lens.

  14. Exploring spatial change and gravity center movement for ecosystem services value using a spatially explicit ecosystem services value index and gravity model.

    Science.gov (United States)

    He, Yingbin; Chen, Youqi; Tang, Huajun; Yao, Yanmin; Yang, Peng; Chen, Zhongxin

    2011-04-01

    Spatially explicit ecosystem services valuation and change is a newly developing area of research in the field of ecology. Using the Beijing region as a study area, the authors have developed a spatially explicit ecosystem services value index and implemented this to quantify and spatially differentiate ecosystem services value at 1-km grid resolution. A gravity model was developed to trace spatial change in the total ecosystem services value of the Beijing study area from a holistic point of view. Study results show that the total value of ecosystem services for the study area decreased by 19.75% during the period 1996-2006 (3,226.2739 US$×10(6) in 1996, 2,589.0321 US$×10(6) in 2006). However, 27.63% of the total area of the Beijing study area increased in ecosystem services value. Spatial differences in ecosystem services values for both 1996 and 2006 are very clear. The center of gravity of total ecosystem services value for the study area moved 32.28 km northwestward over the 10 years due to intensive human intervention taking place in southeast Beijing. The authors suggest that policy-makers should pay greater attention to ecological protection under conditions of rapid socio-economic development and increase the area of green belt in the southeastern part of Beijing.

  15. Prognostic value of body mass index and waist circumference in patients with chronic heart failure (Spanish REDINSCOR Registry).

    Science.gov (United States)

    Puig, Teresa; Ferrero-Gregori, Andreu; Roig, Eulalia; Vazquez, Rafael; Gonzalez-Juanatey, Jose R; Pascual-Figal, Domingo; Delgado, Juan; Alonso-Pulpon, Luis; Borras, Xavier; Mendez, Ana; Cinca, Juan

    2014-02-01

    To analyze the association between higher body mass index and waist circumference, and the prognostic values of both indicators in total and cardiac mortality in patients with chronic heart failure. The study included 2254 patients who were followed up for 4 years. Obesity was classified as a body mass index ≥30 and overweight as a body mass index of 25.0-29.9. Central obesity was defined as waist circumference ≥88 cm for women and ≥102cm for men. Independent predictors of total and cardiac mortality were assessed in a multivariate Cox model adjusted for confounding variables. Obesity was present in 35% of patients, overweight in 43%, and central obesity in 60%. Body mass index and waist circumference were independent predictors of lower total mortality: hazard ratio=0.84 (P120cm. Mortality was significantly lower in patients with a high body mass index and waist circumference. The results also showed that this protection was lost when these indicators over a certain limit. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  16. [Values of the sperm deformity index, acrosome abnormity rate, and sperm DNA fragmentation index of optimized sperm in predicting IVF fertilization failure].

    Science.gov (United States)

    Jiang, Wei-jie; Jin, Fan; Zhou, Li-ming

    2016-02-01

    To investigate the values of the sperm deformity index (SDI), acrosome abnormity rate (AAR), and DNA fragmentation index (DFI) of optimized sperm in the prediction of fertilization failure (fertilization rate fertilization (IVF). We selected 695 cycles of conventional IVF for pure oviductal infertility in this study, including 603 cycles of normal fertilization and 92 cycles of fertilization failure. On the day of oocyte retrieval, we examined sperm morphology, acrosome morphology, and DNA fragmentation using the Diff-Quik, PSA-FITC and SCD methods. We established the joint predictor (JP) by logistic equation and analyzed the values of different parameters in predicting fertilization failure with the receiver operating characteristic (ROC) curve. The fertilization rate was negatively correlated with SDI (r = - 0.07; P = 0.03), AAR (r = -0.49; P fertilization group were 1.24 ± 0.20, (7.75 ± 2.28)%, and (7.87 ± 3.15)%, and those in the fertilization failure group were 1.42 ± 0.15, (12.02 ± 3.06)%, and (13.32 ± 4.13)%, respectively, all with statistically significant differences between the two groups (P fertilization failure ( OR = 2.68, 14.11, and 3.85; P = 0.01, fertilization failure were approximately 1.45, 10%, and 12%. The SDI, AAR and DFI of optimized sperm are closely associated with the fertilization rate, and all have the value for predicting fertilization failure in IVF. The AAR is more valuable than the other single predictors, but JP is more effective than the AAR.

  17. 脑电双频指数指导下调节七氟烷体积分数对患儿眼心反射抑制的影响%Effect of bispectral index-guided sevoflurane concentration change on oculocardiac reflex in pediatric patients

    Institute of Scientific and Technical Information of China (English)

    张忠; 刘凤梅; 周峰; 米志华; 黄鹤

    2011-01-01

    Objective To investigate whether bispectrial index (BlS)-guided sevoflurane concentration change can effectively suppress the oculocardiac reflex in pediatric patients receiving strabotomy. Methods Totally 52 congenital esotropia children were randomly divided into group A and B (each n = 26). All children were anesthetized with sevoflurane inhalation. The BIS was maintained at about 40 in group A and about 60 in group B. The following indicators, including pulse oxyhemoglobin saturation (SpO2). Blood pressure (BP), electrocardiogram and end-tidal pressure of carbon dioxide (petCO2), were monitored during the operation. The incidences of oculocardiac reflex and related sevoflurane concentration were recorded. Results All the other physical data were within normal range except for the heart rate. The incidence of oculocardiac reflex was 11.6% (3/26) in group A, which was significantly lower than that in group B (34. 9% [9/26], P<0.05). The mean sevoflurane concentration was 0. 021 ± 0. 003 in group A, which was significantly higher than that in group B (0.015±0.005, P<0.05). Conclusion Compared with the adjusted seveflurane concentration guided by BIS = 60±2, that guided by BIS = 40± 1 can reduce the incidence of oculocardiac reflex in congenital crosseye children receiving strabotomy. (Shanghai Med J, 2011, 34: 601-603)%目的 探讨脑电双频指数(BIS)指导下调节七氟烷体积分数能否有效抑制行斜视手术时患儿的眼心反射.方法 52例行手术治疗的先天性斜视患儿被随机分为A、B两组,分别维持BIS值为40(A组)和60(B组)左右,两组均采用吸入七氟烷行全身麻醉,术中监测脉搏血氧饱和度(SpO2)、血压(BP)、心电图(ECG)、呼吸末二氧化碳分压(pet CO2),记录眼心反射的发生率及呼气末七氟烷体积分数.结果 A组的眼心反射发生率为11.6%(3/26),显著低于B组的34.9%(9/26,P<0.05).A组的呼气末七氟烷体积分数为0.021±0.003,显著高于B组的0

  18. The Predictive Value of Integrated Pulmonary Index after Off-Pump Coronary Artery Bypass Grafting: A Prospective Observational Study

    Directory of Open Access Journals (Sweden)

    Evgenia V. Fot

    2017-08-01

    Full Text Available BackgroundThe early warning scores may increase the safety of perioperative period. The objective of this study was to assess the diagnostic and predictive role of Integrated Pulmonary Index (IPI after off-pump coronary artery bypass grafting (OPCAB.Materials and MethodsForty adult patients undergoing elective OPCAB were enrolled into a single-center prospective observational study. We assessed respiratory function using IPI that includes oxygen saturation, end-tidal CO2, respiratory rate, and pulse rate. In addition, we evaluated blood gas analyses and hemodynamics, including ECG, invasive arterial pressure, and cardiac index. The measurements were performed after transfer to the intensive care unit, after spontaneous breathing trial and at 2, 6, 12, and 18 h after extubation.Results and DiscussionThe value of IPI registered during respiratory support correlated weakly with cardiac index (rho = 0.4; p = 0.04 and ScvO2 (rho = 0.4, p = 0.02. After extubation, IPI values decreased significantly, achieving a minimum by 18 h. The IPI value ≤9 at 6 h after extubation was a predictor of complicated early postoperative period (AUC = 0.71; p = 0.04 observed in 13 patients.ConclusionIn off-pump coronary surgery, the IPI decreases significantly after tracheal extubation and may predict postoperative complications.

  19. The Culture and Development Index (CDI: Measuring Values and Attitudes Associated With Development In Selected Asian and Latin American Countries

    Directory of Open Access Journals (Sweden)

    Joseph I. B. Gonzales

    2011-06-01

    Full Text Available Analyzing data gathered in five waves in the period 1981–2005 for up to 97 societies (most of which are independent countries, the World Values Survey Organization (WVSO identified two orthogonal factors, Traditional/Secular-Rational Values, and Survival/Self-Expression Values, that account for up to 70 percent of cross-cultural variation worldwide. However, one weakness of the two-factor construct is that it overlooks regional or local patterns in values and attitudes that may be vitally related to development. Alternatively, the Culture and Development Index (CDI and the closely related Culture and Corruption Index (CCI are constructed for selected South and Southeast Asian, Latin American, and East Asian countries to account for cross-cultural variation in terms of a different set of orthogonal factors, some of which are strongly associated with leading measures of development and of corruption. Both CDI and CCI reveal patterns of value and attitudinal change relevant to promoting development and to mitigating corruption.

  20. Evaluation value of coronary CTA for coronary plaque features and its correlation with platelet function and serum biochemical indexes

    Institute of Scientific and Technical Information of China (English)

    Jin-Xia Yang

    2017-01-01

    Objective:To analyze the evaluation value of coronary CT angiography for coronary plaque features and its correlation with platelet function and serum biochemical indexes.Methods:A total of 450 patients with coronary heart disease were divided into calcified plaque group (CT value≥130HU) (n=117), soft plaque group (CT value≤60HU) (n=150) and mixed plaque group (CT value 60-130HU) (n=183) by coronary CT angiography (CTA), and 100 healthy subjects who received physical examination in our hospital during the same period were selected as control group. Differences in platelet function and serum biochemical indexes were compared among four groups of patients, and the judgment value of atheromatous plaque CT value from CTA for the severity of coronary heart disease was analyzed.Results: Platelet function parameters MPV, TEG-MA, P-selectin, PDGF-BB and vWF levels in peripheral blood of soft plaque group were higher than those of the other three groups; inflammatory factors CRP, IL-6, IL-12, IL-18 and IL-23 content in serum were higher than those of the other three groups; chemokines MCP-1, CXCL16, Fractalkine and RANTES content in serum were higher than those of the other three groups; adipocytokines Leptin and RBP4 content in serum were higher than those of the other three groups while SFRP5 content was lower than those of the other three groups. Atheromatous plaque CT value in patients with coronary heart disease was directly correlated with platelet function and the content of serum biochemical indexes. Conclusions: Coronary CTA can accurately assess coronary atheromatous plaque features, and can also be a reliable noninvasive method to judge coronary heart disease severity, treatment prognosis and so on.

  1. The Predictive Value of the Foot Posture Index on Dynamic Function

    DEFF Research Database (Denmark)

    Mølgaard, Carsten Møller; Olesen Gammelgaard, Christian; Nielsen, R. G.;

    2008-01-01

    Keenan et. al. identified the six-item version of the Foot Posture Index (FPI) as a valid, simple and clinically useful tool. The model combines measures of the standing foot posture in multiple planes and anatomical segments. It provides an alternative to existing static clinical measures when...... dynamic measures are not feasible. Redmond et. al. found the model able to predict 41% of the variation in the complex rotation of the ankle joint, representing inversion/eversion, during midstance of walking. To our knowledge no studies have been published on the relationship between FPI and the movement...... of the midfoot during walking. The purpose of this study was to investigate the use of FPI classification as a predictor for dynamic midfoot kinematics during walking....

  2. The predictive value of the foot posture index on dynamic function

    DEFF Research Database (Denmark)

    Nielsen, Rasmus Gottschalk N; Rathleff, M; Kersting, U G;

    2008-01-01

    Keenan et. al. identified the six-item version of the Foot Posture Index (FPI) as a valid, simple and clinically useful tool. The model combines measures of the standing foot posture in multiple planes and anatomical segments. It provides an alternative to existing static clinical measures when...... dynamic measures are not feasible. Redmond et. al. found the model able to predict 41% of the variation in the complex rotation of the ankle joint, representing inversion/eversion, during midstance of walking. To our knowledge no studies have been published on the relationship between FPI and the movement...... of the midfoot during walking. The purpose of this study was to investigate the use of FPI classification as a predictor for dynamic midfoot kinematics during walking....

  3. The predictive value of the foot posture index on dynamic function

    DEFF Research Database (Denmark)

    Nielsen, Rasmus Gottschalk; Rathleff, Michael Skovdal; Kersting, U G;

    2008-01-01

    dynamic measures are not feasible. Redmond et. al. found the model able to predict 41% of the variation in the complex rotation of the ankle joint, representing inversion/eversion, during midstance of walking. To our knowledge no studies have been published on the relationship between FPI and the movement...... of the midfoot during walking. The purpose of this study was to investigate the use of FPI classification as a predictor for dynamic midfoot kinematics during walking.......Keenan et. al. identified the six-item version of the Foot Posture Index (FPI) as a valid, simple and clinically useful tool. The model combines measures of the standing foot posture in multiple planes and anatomical segments. It provides an alternative to existing static clinical measures when...

  4. Correlation Between P-wave Velocity and Strength Index for Shale to Predict Uniaxial Compressive Strength Value

    Directory of Open Access Journals (Sweden)

    Awang H.

    2017-01-01

    Full Text Available Seismic refraction survey is a non destructive method used in site investigation to identify the seismic velocity subsurface strata. Although it is widely known, the reliability of the result is still doubtable for some reason as well as due to an engineer’s ignorant, which insist on using conventional method rather than new advanced method causing the lack of usage in geophysical method for testing. This study aims to produce a correlation between P-wave velocity value and point load strength index value for shale. Both field and laboratory tests were carried out. In order to obtain the P-wave value, seismic refraction method was conducted as a field test at Precint 4, Putrajaya, Malaysia to achieve the Pwave velocity value of the shale bed. Ten samples of shale were collected from the field and laboratory tests were conducted. The tests are divided into three sections, namely non-destructive laboratory test, physical properties test and mechanical properties test. Ultrasonic Velocity Test via PUNDIT test was conducted as non-destructive laboratory test to acknowledge the P-wave velocity value in laboratory. Both field and laboratory P-wave velocity value were then compared and the result delivers are reliable due to it is within the range. For physical properties test, the rock density and porosity were acknowledged. Meanwhile, Point Load Test was conducted as mechanical properties. Correlation for both Pwave velocity value and point load strength value were achieved via producing an empirical relationship as the end result. Prediction of uniaxial compressive strength (UCS value was made via converting the point load strength value to UCS value using a correlation. By acknowledging this empirical relationship, it shows that geophysical methods are able to produce a reliable result. Hence more and widely used of geophysical method will be profound in the future.

  5. Annual Equivalent Value, Benefit Cost Ratio, and Composite Performance Index as Valuation Appraisal Support of Teakwood Plantation

    Directory of Open Access Journals (Sweden)

    Sugiharto Soeleman

    2014-04-01

    Full Text Available Teak (Tectona grandis L.f is a premium high-value hardwood species being viewed as the most preferred species for investment opportunity. Recently, there has been a gradual move away from state control of teakwood plantation toward the participation of private enterprises. Several enterprises offer investment opportunity of teakwood plantation in which one of the main selling points being offered is a quick harvesting schedule. A quick harvesting time, however, might not provide the best outcome to the investors. This research exercise and compare the valuation appraisal of different harvesting schedules. The research focused on project planning, enterprise budget, financial projection, and valuation measurements to arrive at overall appraisal. To avoid any possible bias of individual investor's preference on common valuation criteria such as total investment, net cash flow (NCF, net present value (NPV, internal rate of return (IRR, profit on investment (P/I, and payback period (PBP, 3 otherS criteria namely benefit cost ratio (BCR, annual equivalent value (AEV, and composite performance index (CPI have been applied to arrive at a more fair valuation. It is concluded that the longer the harvesting schedule, the better valuation outcome could be achieved, and therefore, investors should critically review any investment proposal in accordance to their preference on valuation criteria. Keywords : annual equivalent value, benefit cost ratio, composite performance index, valuation appraisal

  6. Normal values of posterior antebrachial cutaneous nerve conduction study related to age, gender, height, and body mass index.

    Science.gov (United States)

    Sajadi, Simin; Mansoori, Korosh; Raissi, Gholam R; Emami Razavi, Seyede Z; Ghajarzadeh, Mahsa

    2014-12-01

    Recent studies have proposed posterior antebrachial cutaneous (PABC) nerve could help in interpretation of some conditions in upper limb electrodiagnostic study. This study aimed to establish these normal values and to assess the effect of sex, age, height, and body mass index on these normal values. Eligible participants were 84 healthy adult people aged between 22 and 75 years who underwent PABC nerve conduction studies. The mean ± SD values of the base-to-peak amplitude, peak latency, and nerve conduction velocity of all participants were 10.95 ± 2.90 μV, 2.08 ± 0.20 milliseconds, and 57.85 ± 7.83 m/second, respectively. There was a significant positive correlation between the subjects' age and the PABC onset latency, peak latency, and nerve conduction velocity (r = 0.64, P < 0.001; r = 0.6, P < 0.001; and r = 0.44, P < 0.001, respectively). A significant negative correlation was observed between age and base-to-peak amplitude and peak-to-peak amplitude of participants, as well (r = -0.38, r = -0.41, P < 0.001, respectively). The correlation of body mass index with base-to-peak amplitude and peak-to-peak amplitude were r = -0.36, P < 0.001 and r = -0.40, P < 0.001, respectively. This study has established normal values for PABC nerve conduction studies. Furthermore, age and body mass index must be taken into account for making diagnostic conclusion in PABC nerve conduction studies.

  7. Utilization of kidneys with similar kidney donor risk index values from standard versus expanded criteria donors.

    Science.gov (United States)

    Woodside, K J; Merion, R M; Leichtman, A B; de los Santos, R; Arrington, C J; Rao, P S; Sung, R S

    2012-08-01

    With the shortage of standard criteria donor (SCD) kidneys, efficient expanded criteria donor (ECD) kidney utilization has become more vital. We investigated the effects of the ECD label on kidney recovery, utilization and outcomes. Using data from the Scientific Registry of Transplant Recipients from November 2002 to May 2010, we determined recovery and transplant rates, and modeled discard risk, for kidneys within a range of kidney donor risk index (KDRI) 1.4-2.1 that included both SCD and ECD kidneys. To further compare similar quality kidneys, these kidneys were again divided into three KDRI intervals. Overall, ECD kidneys had higher recovery rates, but lower transplant rates. However, within each KDRI interval, SCD and ECD kidneys were transplanted at similar rates. Overall, there was increased risk for discard for biopsied kidneys. SCD kidneys in the lower two KDRI intervals had the highest risk of discard if biopsied. Pumped kidneys had a lower risk of discard, which was modulated by KDRI for SCD kidneys but not ECD kidneys. Although overall ECD graft survival was worse than SCD, there were no differences within individual KDRI intervals. Thus, ECD designation adversely affects neither utilization nor outcomes beyond that predicted by KDRI.

  8. Comparison of regional index flood estimation procedures based on the extreme value type I distribution

    DEFF Research Database (Denmark)

    Kjeldsen, Thomas Rodding; Rosbjerg, Dan

    2002-01-01

    A comparison of different methods for estimating T-year events is presented, all based on the Extreme Value Type I distribution. Series of annual maximum flood from ten gauging stations at the New Zealand South island have been used. Different methods of predicting the 100-year event...... considered applying either a log-linear relationship between at-site mean annual flood and catchment characteristics or a direct log-linear relationship between 100-year events and catchment characteristics. Comparison of the results shows that the existence of at-site measurements significantly diminishes...

  9. Value of waist circumference, body mass index and hyperinsulinaemia in identifying metabolic syndrome

    Institute of Scientific and Technical Information of China (English)

    Hui TIAN; Jingfang SUN; Changyu PAN; Juming LU; Jingtao DOU; Fangling MA; Xiaoman ZHOU; Fusheng FANG; Yinghong SHAO; Chunlin LI; Jian LI; Xiutang CAO; Shuangtong YAN; Wenwen ZHONG; Yanyan LI

    2008-01-01

    To investigate the significance of waist circum-ference (WC), body mass index (BMI) and hyperinsuli-naemia A (Hlns) in evaluating metabolic syndrome (MS). Clinical data from middle-aged and senile indivi-duals (middle-senile group) who received glucose tol-erance test after diabetes mellitus screening and a group of subjects who received annual oral glucose tolerance test (OGTT) for diabetes mellitus screening (adult group) were collected. Data were collected by use of special mes-sengers, input into a computer data base and analyzed using SAS 5.0 software by expert staff. Abnormal WC and BMI were determined according to International Diabetes Federation (IDF) and Chinese Diabetes Society (CDS) criteria. Hlns was ascertained if fasting insulin (Fins)≥15 mU/L, and/or 2-hour insulin after a glucose challenge was (2hPIns)≥80 mU/L. Abnorma-lities in WC, BMI and Hlns were all found to be risk factors for abnormal glucose metabolism, hypertension and dyslipidemia. In the middle-senile group, the abnor-mality rate of WC and Hlns as well as the overall insulin level were significantly higher than those in the adult group. The abnormality rate of BMI was higher in the adult group, and HIns was mostly seen in impaired glu-cose test (IGT) and normal glucose test (NGT). The con-cordance rate of WC and BMI diagnostic criteria for evaluating obesity in the middle-senile and adult groups were 77.5% and 74.3%, respectively. When only the WC criterion was used for evaluating the existence of insulin resistance, there was a 28.2% missed diagnosis rate for MS patients. WC, BMI and Hlns were all risk factors for abnormal glucose metabolism, hypertension and dyslipi-demia. There was differing prevalence in the different populations. The combination of WC, BMI and Hlnsmight be more helpful in identifying MS at early stage.

  10. The prognostic value of tip-to-apex distance (TAD index) in intertrochanteric fractures fixed by dynamic hip screw.

    Science.gov (United States)

    Sedighi, Ali; Sales, Jafar Ganjpour; Alavi, Sahar

    2012-11-01

    Intertrochanteric fractures (ITFs) are the most common type of fractures requiring surgical intervention. They also have the highest surgical mortality among orthopedic operations. Among the many different techniques used for fixation of this type of fracture, use of the Dynamic Hip Screw (DHS) has gained wide acceptance. This current study was designed to assess positive predictive value of tip-to-apex distance (TAD) index in the prognosis of patients treated with DHS. The study was designed according to a descriptive-analytic protocol, made up of 100 cases of ITFs caused by falling, treated in the Shohada Orthopedic Center, Tabriz, Iran. All patients underwent lateral and antero-posterior hip X-ray to measure TAD index. The cohort was followed for three months after DHS placement. Of a total of 100 cases (53 male, 47 female) with a mean age of 76.7 years (range 29-100 years), 43% had grade 4, 29% grade 3, 21% grade 5, 5% grade 2 and 2% grade 6 osteoporosis. The screw position was postero-inferior in 57%, central in 40% and superior in 3% of patients. Minimum and maximum TAD index were 20 and 28 mm, respectively. Mean TAD was 23.5 mm. There were no post-operative complications in 84% of cases. Screw failure was the most common complication in the remaining 16% of patients. The study shows a statistically significant correlation between TAD index and cut-off rate in patients with intertrochanteric fractures of femoral bone treated by DHS. This validates the use of TAD index in determining the prognosis of patients treated by DHS.

  11. Comparative study of implicit memory during bispectral index guided total intravenous anesthesia versus sevoflurane inhalation anesthesia

    OpenAIRE

    Ahmed M. Elbadawy; Ahmed M. Khidr; Alia Adel Saleh

    2015-01-01

    Background: Several studies that investigate the implicit memory under general anesthesia revealed conflicting results. Limitations may be due to failure to control depth of anesthesia. This prospective randomized study was designed to compare the implicit memory during total intravenous versus inhalational anesthesia. Method: Fourty patients ASA I and II undergoing orthopedic procedures under BIS-guided (40–60) general anesthesia were tested for implicit memory of previously introduced au...

  12. [Transient increase of bispectral index in a patient with bronchoconstriction after endotracheal intubation].

    Science.gov (United States)

    Hidano, Gumi; Nagata, Osamu; Narushima, Mitsuhiro; Ozaki, Makoto

    2004-01-01

    A 62-year-old woman (148 cm, 48.5 kg) with a history of bronchial asthma underwent an emergency appendectomy. Ten days before the operation she developed symptoms of wheezing while under asthma medication. An endotracheal tube (7 mm) was inserted after the induction of general anesthesia with intravenous injection of fentanyl 100 micrograms, propofol 100 mg and vecuronium 10 mg under Sellick's maneuver. Anesthesia was maintained with 1% sevoflurane with oxygen 6l-min-1 just after intubation, but bilateral lung sound soon became weaker and ventilation difficult. Based on a diagnosis of bronchoconstriction, we started hyperventilation with 3% sevoflurane. Ventilation returned to normal after about 5 minutes. Percutaneous O2 saturation was maintained at 100% during this episode, but the BIS transiently rose to 82. Anesthesia was maintained with 2% sevoflurane and 50% nitrous oxide balanced with oxygen, and 250 mg aminophylline was administered. Upon completion of the operation, the endotracheal tube was removed without any events. The patient gave no sign of awareness during the operation. When severe bronchoconstriction prevents the absorption of anesthetics from the lung alveoli, additional intravenous anesthetics should be administered to maintain stable amnesia.

  13. The bilateral bispectral and the composite variability indexes during anesthesia for unilateral surgical procedure

    Directory of Open Access Journals (Sweden)

    Pedro Lopes-Pimentel

    2017-01-01

    Conclusions: Our results indicate that the large interindividual variability of BIS and CVI limits their usefulness. We found differences between the left and right measurements in a right-handed series of patients during surgical stimuli though they were not clinically relevant.

  14. B-valued martingale spaces with small index and atomic decompositions

    Institute of Scientific and Technical Information of China (English)

    LlU; Peide(

    2001-01-01

    [1]Pisier, G., Martingales à Valeurs Dans les Espaces Uniformement Convexes, Handwritten Mimeographed Notes, Ecole Polytechnique, Paris, June, 1974.[2]Woyczynski, W. A., Geometry and martingales in Banach spaces, Lecture Notes in Mathematics, Berlin: Springer-Verlag,1975, 472: 229-275.[3]Liu, P. D., Martingale spaces and the geometric property of banach Spaces, Science in China (in Chinese), Ser. A, 1990,(7): 694-704.[4]Coifman, R. R. , A real variable characterization of HP, Studia Math., 1974, 51: 269-274.[5]Herz, C. S. , Hp-spaces of martingales, 0 < p ≤ 1, Z Wahrs Verw Geb, 1974, 28: 189-205.[6]Bermard, A., Muisonneuve, B., Decomposition Atomique de Martingale de la Class H, Lecture Notes in Mathematics,Berlin: Springer-Verlag, 1977, 581: 303-323.[7]Weisz, F., Martingale Hardy space and their applications in Fourier analysis, Lecture Notes in Mathematics, Vol. 1568,Berlin: Springer-Verlag, 1994[8]Liu, P. D. , Hou, Y. L. , Atomic decompositions for B-valued martingales, Science in China (in Chinese), Ser. A, 1998,28(10): 884-892.[9]Kwapien, S. , Isomorphic characterizations of inner product spaces by orthogonal series with vector valued coefficients, Studia Math., 1972, 44: 583-595.

  15. Use of a seagrass residency index to apportion commercial fishery landing values and recreation fisheries expenditure to seagrass habitat service.

    Science.gov (United States)

    Jackson, Emma L; Rees, Siân E; Wilding, Catherine; Attrill, Martin J

    2015-06-01

    Where they dominate coastlines, seagrass beds are thought to have a fundamental role in maintaining populations of exploited species. Thus, Mediterranean seagrass beds are afforded protection, yet no attempt to determine the contribution of these areas to both commercial fisheries landings and recreational fisheries expenditure has been made. There is evidence that seagrass extent continues to decline, but there is little understanding of the potential impacts of this decline. We used a seagrass residency index, that was trait and evidence based, to estimate the proportion of Mediterranean commercial fishery landings values and recreation fisheries total expenditure that can be attributed to seagrass during different life stages. The index was calculated as a weighted sum of the averages of the estimated residence time in seagrass (compared with other habitats) at each life stage of the fishery species found in seagrass. Seagrass-associated species were estimated to contribute 30%-40% to the value of commercial fisheries landings and approximately 29% to recreational fisheries expenditure. These species predominantly rely on seagrass to survive juvenile stages. Seagrass beds had an estimated direct annual contribution during residency of €58-91 million (4% of commercial landing values) and €112 million (6% of recreation expenditure) to commercial and recreational fisheries, respectively, despite covering seagrass degradation associated with ineffective management of seagrass beds and that policy to manage both fisheries and seagrass beds should take into account the socioeconomic implications of seagrass loss to recreational and commercial fisheries.

  16. [Value of detection of pentraxins 3 value combined with measurement of vascular lung water index in prognosis of patients with sepsis].

    Science.gov (United States)

    Sun, Rongqing; Wang, Kai; Li, Feifei; Yang, Hongfu; Sun, Xiaoge

    2015-01-01

    To evaluate prognostic value of pentraxin3 ( PTX3 ) content combining with extravascular lung water index ( EVLWI ) in patients with sepsis. A retrospective analysis of complete clinical data of septic patients admitted to Department of Critical Care Medicine of the First Affiliated Hospital of Zhengzhou University from February 2013 to February 2014 was conducted. These patients were divided into two groups, survival group and death group, according to the outcome on the 28th day. Pulse index continuous cardiac output ( PiCCO ) was used to record the levels of EVLWI on the 1st, 2nd and 3rd day of intensive care unit ( ICU ) admission. The plasma level of PTX3 was measured simultaneously by enzyme-linked immunosorbent assay ( ELISA ). At the same time, acute physiology and chronic health evaluation II ( APACHEII) score and sequential organ failure assessment ( SOFA ) were calculated. Correlation analysis between plasma PTX3 and EVLWI values was performed, receiver operating characteristic curve ( ROC ) was drawn, and the prognostic value of each parameter was assessed finally. A total of 74 septic patients were enrolled, with 41 cases in the survival group and 33 cases in the non-survival group. Blood lactate, APACHEII, SOFA scores in the non-survival group were significantly higher than those of the survival group at ICU admission, and the length of ICU stay was significantly shorter than that of the survival group, while differences of the other clinical characteristics between two groups were not statistically significant. The plasma PTX3 level gradually declined with time in both groups, and plasma PTX3 at 1, 2, 3 days after ICU admission in non-survival group were significantly higher than those in survival group [ PTX3 ( μg/L ) at 1 day: 46.3±10.5 vs. 19.4±6.5, t = -13.486, P = 0.000; 2 days: 34.8±10.7 vs. 17.7±8.4, t = -8.284, P = 0.000; 3 days: 23.9±11.2 vs. 15.6±7.9, t = -5.036, P = 0.000 ]. EVLWI gradually declined in survival group, but increased

  17. Value of the lumbar lordotic angle taken from CT scanogram as an index of back pain

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Hea Sang; Kim, Guk Hee; Kim, Dae Young [Kangnam General Hospital Public Corporation, Seoul (Korea, Republic of)

    1986-10-15

    'Normal' spinal posture is generally accepted as moderate lordosis of the cervical and the lumbar sections of spine and moderate kyphosis of the thoracic and sacrococcygeal sections. Among these normal range of the lumbar lordosis is less well defined. CT is very useful method to identified the bony structure and adjacent soft tissue of the spine, so it is very available method to detect accurate lumbar lordotic angle by using lateral Scanogram. Analysis and comparison of lumbar lordotic angles, crossing angle are drawn each parallel line to the superior end plate of body of 1st. lumbar vertebra and to the inferior end plate of the 5th. lumbar vertebra, in 174 cases with backache and 50 cases normal groups at Kangnam General Hospital Public Corporation, from Aug. 1985 to Jul 1986. Male and female were almostly same affected in backache group (1.1:1). And most lumbar lordotic angles were 10 to 40 between all backache age group. On backache group, over all mean lumbar lordotic angles were 24.7+-8.9 but no significant difference at mean value of the each diseases, such as HIVD, Degenerative Spondylosis or No Remarkable Findings group. On control group, over all mean ones were 29.2+-8.0. So, significant difference of lumbar lordotic angle between backache and control group, and most difference is at 5th. decade group (p 0.01).

  18. Determinants of the inclusion in the BM&FBOVESPA Corporate Sustainability Index and its relationship with firm value

    Directory of Open Access Journals (Sweden)

    Lélis Pedro Andrade

    2013-07-01

    Full Text Available The aim of this study was to identify the variables that influence the firms inclusion in the BM&FBOVESPA Corporate Sustainability Index (CSI, and if such membership is correlated with the firm market value in the Brazilian market. We collected annual data of firms for the period 2006 to 2011. The methodology included the use of methods such as regression analysis type logit and panel data models. The results showed that companies that have joined the ISE have characteristics distinct from those who did not opt for membership. Firms with larger size, higher profitability and sectors considered high environmental impact are more likely to be classified in the ISE. When examined whether inclusion in the CSI has relation with the metric firm value, the results did not reject the hypothesis of positive relationship, even during the financial crisis of 2008, however, found evidence of a negative relationship in the post-crisis period.

  19. Effect of macronutrients and fiber on postprandial glycemic responses and meal glycemic index and glycemic load value determinations.

    Science.gov (United States)

    Meng, Huicui; Matthan, Nirupa R; Ausman, Lynne M; Lichtenstein, Alice H

    2017-02-15

    Background: The potential confounding effect of different amounts and proportions of macronutrients across eating patterns on meal or dietary glycemic index (GI) and glycemic load (GL) value determinations has remained partially unaddressed.Objective: The study aimed to determine the effects of different amounts of macronutrients and fiber on measured meal GI and GL values.Design: Four studies were conducted during which participants [n = 20-22; women: 50%; age: 50-80 y; body mass index (in kg/m(2)): 25-30)] received food challenges containing different amounts of the variable nutrient in a random order. Added to the standard 50 g available carbohydrate from white bread was 12.5, 25, or 50 g carbohydrate; 12.5, 25, or 50 g protein; and 5.6, 11.1, or 22.2 g fat from rice cereal, tuna, and unsalted butter, respectively, and 4.8 or 9.6 g fiber from oat cereal. Arterialized venous blood was sampled for 2 h, and measured meal GI and GL and insulin index (II) values were calculated by using the incremental area under the curve (AUCi) method.Results: Adding carbohydrate to the standard white-bread challenge increased glucose AUCi (P < 0.0001), measured meal GI (P = 0.0066), and mean GL (P < 0.0001). Adding protein (50 g only) decreased glucose AUCi (P = 0.0026), measured meal GI (P = 0.0139), and meal GL (P = 0.0140). Adding fat or fiber had no significant effect on these variables. Adding carbohydrate (50 g), protein (50 g), and fat (11.1 g) increased the insulin AUCi or II; fiber had no effect.Conclusions: These data indicate that uncertainty in the determination of meal GI and GL values is introduced when carbohydrate-containing foods are consumed concurrently with protein (equal amount of carbohydrate challenge) but not with carbohydrate-, fat-, or fiber-containing foods. Future studies are needed to evaluate whether this uncertainty also influences the prediction of average dietary GI and GL values for eating patterns. This trial was registered at clinicaltrials

  20. An Evaluation of the Usefulness of Stroke Index Values in the Swimming Training of People with Disabilities

    Directory of Open Access Journals (Sweden)

    Seidel Wojciech

    2016-09-01

    Full Text Available Introduction. When evaluating the swimming technique of people with disabilities, a particularly important factor, besides physiological aspects, is the efficiency of the effort expended. This suggests that assessing and monitoring the effectiveness of swimming should be a regular part of training for swimmers with disabilities. Therefore, it seems important to distinguish how changes occur in the parameters that determine the effectiveness of swimming. This is especially true of anaerobic lactic exercise as the lactic acid concentration in the blood increases significantly. The aim of this study was to evaluate the usefulness of calculating velocity and the stroke index in the swimming training of people with disabilities, along with the progressive fatigue of a high-intensity interval training workout. Material and methods. The sample comprised 12 elite competitors with a disability. The experiment consisted in swimming sequential distances of 48 m, 50 m, 52 m, and 54 m at maximum intensity. Competitors performed four sets of four repetitions with a 75-second interval between repetitions and 15 minutes of active resting between sets. All sets were recorded using five digital cameras with a frequency of 50 frames per second. The recorded material was analysed with the use of motion analysis software, and the stroke index was calculated. Results. There was found to be no significant change in the average swimming velocity during each set and corresponding repetition, which means that the participants were able to tolerate the training intensity. Also, the stroke index did not change to a statistically significant degree in either of the subsequent sets or the subsequent repetitions (p < 0.05. Conclusions. We conclude that analysing the value of the swimming stroke index for people with disabilities can be a diagnostic method for assessing the effectiveness of high-intensity interval training.

  1. Cut-off values of blood mercury concentration in relation to increased body mass index and waist circumference in Koreans.

    Science.gov (United States)

    Bae, Suhyun; Park, Soo-Jung; Yeum, Kyung-Jin; Choi, Beomhee; Kim, Young-Sang; Joo, Nam-Seok

    2016-04-01

    Blood mercury (methyl-mercury) from environmental exposure may be related to inflammation in our body. We investigated the cut-off values of blood mercury concentration in relation to increased body mass index (BMI) and waist circumference. On the basis of data obtained from the Korea National Health and Nutrition Examination Survey (KNHANES, 2008-2012), 11,159 subjects (5543 males and 5616 females) were analyzed cross-sectionally. Partial correlation, linear regression, and analysis of covariance (according to the mercury quartile) tests were performed to evaluate the relationship between blood mercury and BMI or waist circumference. In addition, we determined the cut-off values of blood mercury concentration in relation to increased BMI and waist circumference in both genders. Mean values of blood mercury concentration were 5.07 ± 0.07 μg/L in males and 3.59 ± 0.04 μg/L in females. After log transformation of blood mercury, significant (p waist circumference. BMI and waist circumference showed a significant and gradual increase as mercury quartile increased in both genders. Blood mercury concentration was weakly but significantly (p waist circumference. Cut-off values of blood mercury concentration correlated with increased BMI and waist circumference were around 3.95 μg/L in males and 3.40 μg/L in females.

  2. Higher Environmental Relative Moldiness Index (ERMI) Values Measured in Homes of Asthmatic Children in Boston, Kansas City, and San Diego

    Science.gov (United States)

    Vesper, Stephen; Barnes, Charles; Ciaccio, Christina E.; Johanns, Alan; Kennedy, Kevin; Murphy, Johnna S.; Nunez-Alvarez, Arcela; Sandel, Megan T.; Cox, David; Dewalt, Gary; Ashley, Peter J.

    2013-01-01

    Objective Mold in water-damaged homes has been linked to asthma. Our objective was to test a new metric to quantify mold exposures in asthmatic children’s homes in three widely dispersed cities in the United States. Methods The Environmental Relative Moldiness Index (ERMI) metric was created by the US Environmental Protection Agency, with assistance by the Department of Housing and Urban Development (HUD), to quantify mold contamination in US homes. The ERMI values in homes of asthmatic children were determined for the three widely dispersed cities of Boston, Kansas City, and San Diego. Results Asthmatic children in Boston (n = 76), Kansas City (n = 60), and San Diego (n = 93) were found to be living in homes with significantly higher ERMI values than were found in homes randomly selected during the 2006 HUD American Healthy Homes Survey (AHHS) from the same geographic areas (n = 34, 22, and 28, respectively). Taken together, the average ERMI value in the homes with an asthmatic child was 8.73 compared to 3.87 for the AHHS homes. In addition, Kansas City homes of children with “Mild, Moderate, or Severe Persistent Asthma” had average ERMI value of 12.4 compared to 7.9 for homes of children with only “Mild Intermittent Asthma.” Aspergillus niger was the only mold of the 36 tested which was measured in significantly greater concentration in the homes of asthmatic children in all three cities. Conclusion High ERMI values were associated with homes of asthmatic children in three widely dispersed cities in the United States. PMID:23137280

  3. Annual Equivalent Value, Benefit Cost Ratio, and Composite Performance Index as Valuation Appraisal Support of Teakwood Plantation

    Directory of Open Access Journals (Sweden)

    Sugiharto Soeleman

    2014-04-01

    Full Text Available Teak (Tectona grandis L.f is a premium high-value hardwood species being viewed as the most preferred species for investment opportunity. Recently, there has been a gradual move away from state control of teakwood plantation toward the participation of private enterprises. Several enterprises offer investment opportunity of teakwood plantation in which one of the main selling points being offered is a quick harvesting schedule. A quick harvesting time, however, might not provide the best outcome to the investors. This research exercise and compare the valuation appraisal of different harvesting schedules. The research focused on project planning, enterprise budget, financial projection, and valuation measurements to arrive at overall appraisal. To avoid any possible bias of individual investor's preference on common valuation criteria such as total investment, net cash flow (NCF, net present value (NPV, internal rate of return (IRR, profit on investment (P/I, and payback period (PBP, 3 otherS criteria namely benefit cost ratio (BCR, annual equivalent value (AEV, and composite performance index (CPI have been applied to arrive at a more fair valuation. It is concluded that the longer the harvesting schedule, the better valuation outcome could be achieved, and therefore, investors should critically review any investment proposal in accordance to their preference on valuation criteria.

  4. Estimation of accuracies and expected genetic change from selection for selection indexes that use multiple-trait predictions of breeding values.

    Science.gov (United States)

    Barwick, S A; Tier, B; Swan, A A; Henzell, A L

    2013-10-01

    Procedures are described for estimating selection index accuracies for individual animals and expected genetic change from selection for the general case where indexes of EBVs predict an aggregate breeding objective of traits that may or may not have been measured. Index accuracies for the breeding objective are shown to take an important general form, being able to be expressed as the product of the accuracy of the index function of true breeding values and the accuracy with which that function predicts the breeding objective. When the accuracies of the individual EBVs of the index are known, prediction error variances (PEVs) and covariances (PECs) for the EBVs within animal are able to be well approximated, and index accuracies and expected genetic change from selection estimated with high accuracy. The procedures are suited to routine use in estimating index accuracies in genetic evaluation, and for providing important information, without additional modelling, on the directions in which a population will move under selection.

  5. The Dynamic Relationship Between End-Tidal Sevoflurane Concentrations, Bispectral Index, and Cerebral State Index in Children

    NARCIS (Netherlands)

    Fuentes, Ricardo; Cortinez, Luis I.; Struys, Michel M. R. F.; Delfino, Alejandro; Munoz, Hernan

    2008-01-01

    BACKGROUND: To guide anesthetic administration with electroencephalogram monitors in children, an adequate characterization of the anesthetic effect measured by these monitors in this population is needed. We sought to quantify and compare the dynamic profile of sevoflurane's effect measured with th

  6. Accuracy of cut-off value by measurement of third molar index: Study of a Colombian sample.

    Science.gov (United States)

    De Luca, Stefano; Aguilar, Lina; Rivera, Marcela; Palacio, Luz Andrea Velandia; Riccomi, Giulia; Bestetti, Fiorella; Cameriere, Roberto

    2016-04-01

    The aim of this cross-sectional study was to test the accuracy of cut-off value of 0.08 by measurement of third molar index (I3M) in assessing legal adult age of 18 years in a sample of Colombian children and young adults. Digital orthopantomographs of 288 Colombian children and young adults (163 girls and 125 boys), aged between 13 and 22 years, were analysed. Concordance correlation coefficient (ρc) and κ statistics (Cohen's Kappa coefficient) showed that repeatability and reproducibility are high for both intra- and inter-observer error. κ statistics for intra- and inter-observer agreement in decision on adult or minor was 0.913 and 0.877, respectively. Age distribution gradually decreases as I3M increases in both girls and boys. For girls, the sensitivity test was 95.1% (95% CI 87.1%-95%) and specificity was 93.8% (95% CI 87.1%-98.8%). The proportion of correctly classified individuals was 95.1%. For boys, the sensitivity test was 91.7% (95% CI 85.1%-96.8%) and specificity was 90.6% (95% CI 82.1%-97.8%). The proportion of correctly classified individuals was 89.7%. The cut-off value of 0.08 is highly useful to determine if a subject is 18 years of age or older or not.

  7. Accuracy of a cut-off value based on the third molar index: Validation in an Australian population.

    Science.gov (United States)

    Franklin, Daniel; Karkhanis, Shalmira; Flavel, Ambika; Collini, Federica; DeLuca, Stefano; Cameriere, Roberto

    2016-09-01

    According to Recommendation N°196 of the Australian Law Reform Commission (ALRC), the age at which a child reaches adulthood for the purposes of criminal law should be 18 years in all Australian jurisdictions. With specific reference to age at majority, the only tooth with development spanning adolescence (and thus the legally relevant 18 years of age) is the third molar, which limits the number of methods that can be applied from those available in the published literature. The aim of the present study is to test the accuracy of the third molar index (I3M=0.08), based on the correlation between chronological age and normalized measures of the open apices and height of the third mandibular molar, in order to assess the legal adult age of 18 years. Digital orthopantomographs of 143 living Australian subjects (72 boys and 71 girls) are analyzed. The results demonstrate that the sensitivity is 0.90 in boys and 0.90 in girls; associated specificity values are 0.85 and 0.87 respectively. We conclude that the cut-off value of I3M=0.08 is statistically robust and thus valid for forensic application in an Australian population.

  8. Spectral and bispectral feature-extraction neural networks for texture classification

    Science.gov (United States)

    Kameyama, Keisuke; Kosugi, Yukio

    1997-10-01

    A neural network model (Kernel Modifying Neural Network: KM Net) specialized for image texture classification, which unifies the filtering kernels for feature extraction and the layered network classifier, will be introduced. The KM Net consists of a layer of convolution kernels that are constrained to be 2D Gabor filters to guarantee efficient spectral feature localization. The KM Net enables an automated feature extraction in multi-channel texture classification through simultaneous modification of the Gabor kernel parameters (central frequency and bandwidth) and the connection weights of the subsequent classifier layers by a backpropagation-based training rule. The capability of the model and its training rule was verified via segmentation of common texture mosaic images. In comparison with the conventional multi-channel filtering method which uses numerous filters to cover the spatial frequency domain, the proposed strategy can greatly reduce the computational cost both in feature extraction and classification. Since the adaptive Gabor filtering scheme is also applicable to band selection in moment spectra of higher orders, the network model was extended for adaptive bispectral filtering for extraction of the phase relation among the frequency components. The ability of this Bispectral KM Net was demonstrated in the discrimination of visually discriminable synthetic textures with identical local power spectral distributions.

  9. [Clinical application value of prognostic nutritional index for predicting survival in patients with advanced non-small cell lung cancer].

    Science.gov (United States)

    Xu, W J; Kang, Y M; Zhou, L; Chen, F F; Song, Y H; Zhang, C Q

    2017-02-23

    Objective: To explore the clinical application value of prognostic nutritional index(PNI) for predicting overall survival(OS) in patients with advanced non-small cell lung cancer (NSCLC). Methods: 123 patients with histologically confirmed non-small cell lung cancer were enrolled in this study, and their clinical and laboratory data were reviewed. The PNI was calculated as 10×serum albumin value+ 5×total lymphocyte countin peripheral blood.Univariate and multivariate analyses were used to identify the potential prognostic factors for advanced NSCLC. Results: PNI of the 123 NSCLC patients was 46.24±6.56. PNI was significantly associated with age, weight loss and pleural effusion (P0.05). The median OS of the 123 patients was 19.5 months. The median OS in the higher PNI group (PNI≥46.24) and lower PNI group(PNI<46.24) were 25.2 months and 16.4 months, respectively.The 1-year survival rates were 80.6% and 63.9%, and 2-year survival rates were 54.8% and 19.6%, respectively (P<0.01). Univariate analysis showed that PNI, age, dyspnea, and weight loss were related to the OS of the advanced NSCLC patients (P<0.05). Multivariate analysis identified PNI as an independent prognostic factor for OS of advanced NSCLC (P<0.001). Conclusion: PNI can be easily calculated, and may be used as a relatively new prognostic indicator for advanced NSCLC in clinical practice.

  10. RDW value for assessment of the severity of acute coronary syndrome and its correlation with serum indexes

    Institute of Scientific and Technical Information of China (English)

    Guo-Dong Cheng

    2016-01-01

    Objective:To study the RDW value for assessment of the severity of acute coronary syndrome and its correlation with serum indexes.Methods: A total of 80 cases of patients diagnosed with acute coronary syndrome (ACS) in Department of Cardiology of our hospital as well as 80 cases of healthy subjects receiving physical examination in Physical Examination Center of our hospital were selected for study, and serum was collected to detect RDW levels as well as the contents of inflammatory factors, myocardial ischemia molecules and endothelial protection molecules in serum.Results:RDW of ACS patients was significantly higher than that of healthy subjects, RDW of NSTEMI patients and STEMI patients were higher than that of UAP patients, and RDW of STEMI patients was higher than that of NSTEMI patients; the higher the RDW levels, the lower the serum IL-37, CTRP9, Ghrelin, AMPK, AdipoR1, eNOS and NO contents, showing the trend of Q1>Q2>Q3>Q4; the higher the serum sTWEAK, sCD40L, CCR7, CCL21, CK-MB, cTnT, IMA, GDF-15, ox-LDL and LOX-1 contents, showing the trend of Q1

  11. The Prognostic Value of the Charlson's Comorbidity Index in Patients with Prolonged Acute Mechanical Ventilation: A Single Center Experience

    Science.gov (United States)

    Song, Seung Eon; Lee, Sang Hee; Jo, Eun-Jung; Eom, Jung Seop; Mok, Jeong Ha; Kim, Mi-Hyun; Kim, Ki Uk; Lee, Min Ki

    2016-01-01

    Background The aim of our study was to evaluate the prognostic value of Charlson's weighted index of comorbidities (WIC) in patients with prolonged acute mechanical ventilation (PAMV, ventilator care ≥96 hours). Methods We retrospectively enrolled 299 Korean PAMV patients who were admitted in a medical intensive care unit (ICU) of a university-affiliated tertiary care hospital between 2008 and 2013. Survivors were defined as patients who survived for 60 days after ICU admission. Results The patients' mean age was 65.1±14.1 years and 70.6% were male. The mean ICU and hospital length of stay was 21.9±19.7 and 39.4±39.1 days, respectively. In addition, the 60-day mortality rate after ICU admission was 35.5%. The mean WIC was 2.3±1.8, with significant differences between nonsurvivors and survivors (2.7±2.1 vs. 2.1±1.7, pday survival, WIC ≥5 had statistically lower survival than WIC day mortality in PAMV patients.

  12. Accuracy of different cutoff points of body mass index to identify overweight according to body fat values estimated by DEXA.

    Science.gov (United States)

    Anzolin, Caroline Cristina; Silva, Diego Augusto Santos; Zanuto, Edner Fernando; Cayres, Suziane Ungari; Codogno, Jamile Sanches; Costa Junior, Paulo; Machado, Dalmo Roberto Lopes; Christofaro, Diego Giulliano Destro

    To evaluate the sensitivity and specificity of different cutoff points of body mass index for predicting overweight/obesity according to body fat values estimated by DEXA among Brazilian adolescents. Cross-sectional study including 229 male adolescents aged 10-15 years, in which body adiposity and anthropometric measures were assessed. Nutritional status was classified by BMI according to cutoff points described in scientific literature. Moderate agreements were observed between body fat estimated by DEXA and cutoffs proposed by Cole et al. (K=0.61), Conde and Monteiro (K=0.65), Must et al. (K=0.61) and WHO (K=0.63). The BMI in continuous form showed good agreement with the Dexa (ICC=0.72). The highest sensitivity was observed for cutoff by Conde and Monteiro (0.74 [0.62, 0.84]) and the highest specificity by Cole et al. (0.98 [0.94, 0.99]). For the areas under the ROC curve of cutoff points analyzed, significant difference comparing the cutoff points by Cole et al. and Conde and Monteiro (0.0449 [0.00294, 0.0927]) was observed. The cutoff proposed by Conde and Monteiro was more sensitive in identifying overweight and obesity when compared to the reference method, and the cutoff proposed by Cole et al. presented the highest specificity for such outcomes. Copyright © 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  13. An empirical evaluation of Value-at-Risk: The case of the Belgrade Stock Exchange index - BELEX15

    Directory of Open Access Journals (Sweden)

    Đaković Vladimir

    2012-03-01

    Full Text Available The subject of the research is to test and analyze VaR (Value-at-Risk methods of market risk management on the financial market of the Republic of Serbia. Thus, concrete research is conducted in the period 2005 - 2011, with the goal of VaR methods performance assessment on the Serbian financial market. The tested VaR methods are Historical simulation (HS and Delta normal VaR with 95% and 99% confidence level for 50, 100, 200 and 250 days. BELEX15 stock index of the Belgrade Stock Exchange, which comprises of 15 most liquid securities of the Serbian financial market, is used as a benchmark indicator of the conditions on the Serbian financial market. The goals which are intended for achieving in the research are focused to Historical simulation (HS and Delta normal VaR performance assessment on, according to many criteria, 'specific'-transitory financial market of the Republic of Serbia. The basic goal of the research is to come to concrete, practically tested, knowledge about the possibility and performance of VaR methods application on the financial market of the Republic of Serbia in function of investment decisions optimizing. Research results point to the necessity of VaR methods application in market risk management on the financial market of the Republic of Serbia.

  14. Glycaemic index values and physicochemical properties of five brown rice varieties cooked by different domestic cooking methods

    Directory of Open Access Journals (Sweden)

    Madan Kumar Chapagai

    2016-08-01

    Full Text Available Background: The prevalence of diabetes has increased dramatically in recent decades in the regions where people excessively consume white rice. Due to higher nutritional values and bioactive components, low to medium glycaemic index (GI brown rice could be a potential alternative to white rice in these regions. Methods: Five varieties, Chiang (CH, Sungyod (SY, Lepnok (LP from Thailand, Long grain specialty 1 (LS 1 and Long grain specialty 2 (LS 2 from Malaysia were tested for GI. Ten test foods were prepared from 5 varieties by 2 cooking techniques (pressure cooker, PC and rice cooker, RC. Overnight fasted 10 healthy subjects were fed with 25 g glucose as a reference food (RF on 3 occasions and amount equivalent to 25 g available carbohydrate portion of test food (TF on 1 occasion in separate days. Fasting and post-prandial capillary blood glucose was measured via finger-prick methods at 0, 15, 30, 45, 60, 90 and 120 min, and the incremental area under curve (iAUC was determined. The GI of each TF was calculated as percentage of incremental area under curve (iAUC of TF over RF. Results: The mean GI values of SY (72 – 81, high, CH and LP (59 – 65, medium and LS 1 and LS 2 (64 – 73, medium to high for cooking were discovered by PC and RC methods. The GI did not vary significantly (p>0.05 among varieties as well as between cooking methods. GI showed a significant negative correlation with the amylose content (r = –0.70, p<0.05 and significant positive correlation with cold peak viscosity (r = 0.80, p<0.01. Conclusions: All five rice varieties irrespectively of the cooking method used are classified as medium to high GI foods. Medium GI varieties could have potential of being used in diabetic diet. Cooking methods did not significantly alter the glycaemic characteristics of the studied varieties. Amylose content and pasting properties can be used for predicting GI of brown rice. It is urgent to explore low GI brown rice varieties in these

  15. Neutronic analysis of the bi-spectral moderator such as that proposed for ESS

    Energy Technology Data Exchange (ETDEWEB)

    Magán, M., E-mail: miguel.magan@essbilbao.org [ESS-BILBAO, Parque Tecnológico Bizkaia, Laida Bidea, Edificio 207 B Planta Baja, 48160 Derio (Spain); Instituto de Fusión Nuclear – UPM, ETS Ingenieros Industriales, C José Gutiérrez Abascal, 2, 28006 Madrid (Spain); Sordo, F. [ESS-BILBAO, Parque Tecnológico Bizkaia, Laida Bidea, Edificio 207 B Planta Baja, 48160 Derio (Spain); Instituto de Fusión Nuclear – UPM, ETS Ingenieros Industriales, C José Gutiérrez Abascal, 2, 28006 Madrid (Spain); Zanini, L. [European Spallation Source ESS AB, Box 176, 22100 Lund (Sweden); Terrón, S.; Ghiglino, A.; Martínez, F.; Vicente, J.P. de; Vivanco, R. [ESS-BILBAO, Parque Tecnológico Bizkaia, Laida Bidea, Edificio 207 B Planta Baja, 48160 Derio (Spain); Instituto de Fusión Nuclear – UPM, ETS Ingenieros Industriales, C José Gutiérrez Abascal, 2, 28006 Madrid (Spain); Perlado, J.M. [Instituto de Fusión Nuclear – UPM, ETS Ingenieros Industriales, C José Gutiérrez Abascal, 2, 28006 Madrid (Spain); Bermejo, F.J. [ESS-BILBAO, Parque Tecnológico Bizkaia, Laida Bidea, Edificio 207 B Planta Baja, 48160 Derio (Spain); Instituto de Estructura de la Materia, IEM-CSIC, Consejo Superior de Investigaciones Científicas, Serrano 123, 28006 Madrid (Spain); Mezei, F. [European Spallation Source ESS AB, Box 176, 22100 Lund (Sweden); Muhrer, G. [Lujan Neutron Scattering Center, LANSCE Los Alamos National Laboratory, Los Alamos, NM 87545 (United States)

    2013-11-21

    This paper reports on design studies concerning a moderator concept which aims to maximize the time averaged flux. The idea is to provide neutron spectra showing two clear maxima, with peaks at (∼1Å) and (∼2.5Å) arising from leakage from both cryogenic and thermal moderators. Such a concept known as a bi-spectral moderator (Mezei, 2006 [1]) while proven on a reactor source has only been examined for the ESS 2003 proposal. Filges et al. (2003 [2]), which featured a different design than the current ESS. This paper thus reports on a baseline design for such a moderator concept and shows that it can provide substantial gains in count rates for those applications not requiring high resolution in time-of-flight.

  16. Assessment value of blood flow velocity and resistance index detection by transvaginal color Doppler ultrasound on effect of neoadjuvant chemotherapy for ovarian cancer

    Institute of Scientific and Technical Information of China (English)

    You-Bin Fan

    2016-01-01

    Objective:To analyze the assessment value of blood flow velocity and resistance index detection by transvaginal color Doppler ultrasound on effect of neoadjuvant chemotherapy for ovarian cancer.Methods:A total of 78 cases of ovarian cancer patients receiving treatment in our hospital from September 2012 to May 2014 were included for study, all patients received neoadjuvant chemotherapy, and before and after treatment, transvaginal color Doppler ultrasound (TVCDU) was used to record resistance index (RI) and pulsatility index (PI), the expression levels of serum tumor markers, illness-related indicators and apoptosis-related factors in circulating blood were detected, and the correlation between TVCDU monitoring indexes and ovarian cancer-related indicators was further analyzed.Results: PI value (1.13±0.12) and RI value (0.65±0.05) of ovarian cancer patients after treatment were significantly higher than PI value (0.72±0.06) and RI value (0.32±0.03) of ovarian cancer patients before treatment; serum HE4, CA153, CA125 and毬-HCG levels of ovarian cancer patients after treatment were lower than those before treatment; serum MSLN, CCL-18, FS, CL and Hpa levels of ovarian cancer patients after treatment were lower than those before treatment; after ovarian cancer patients received neoadjuvant chemotherapy, ADM, HIF-1毩, PCNA and bcl-2 gene expression levels were lower than those before treatment; RI and PI values of ovarian cancer patients were inversely proportional to the expression levels of HE4, CA153, CA125,毬-HCG, MSLN, CCL-18, FS, CL, Hpa, ADM, HIF-1毩, PCNA and bcl-2. Conclusion:Blood flow velocity and resistance index detection by transvaginal color Doppler ultrasound can be used as a highly efficient means to evaluate the effect of neoadjuvant chemotherapy for ovarian cancer, and it has positive significance in judging disease severity, guiding treatment and other aspects.

  17. A brief history of space and time: the scope-year index as a patent value indicator based on families and renewals

    OpenAIRE

    2007-01-01

    The renewal of patents and their geographical scope for protection constitute two essential dimensions in a patent’s life, and probably the most frequently used patent value indicators. The intertwining of these dimensions (the geographical scope of protection may vary over time) makes their analysis complex, as any measure along one dimension requires an arbitrary choice on the second. This paper proposes a new indicator of patent value, the Scope-Year index, combining the two dimensions. Th...

  18. 指标变换值表示的空气质量评价的普适指数公式%Universal Index Formulae of Air Quality Evaluation by Transformed Values of Indexes

    Institute of Scientific and Technical Information of China (English)

    李祚泳; 张正健; 汪嘉杨

    2012-01-01

    为了建立形式简单、普适通用的空气质量评价的普适指数公式,适当设定空气指标的参照值和指标值的变换式,使不同指标的同级标准值经变换后的标准变换值差异不大,而标准变换值的对数值的差异更小,从而可以认为用变换值表示的不同指标皆与某个指标“等效”.因此,用变换值表示的不同指标的某种类型的空气质量评价的指数公式都可以用该“等效”指标相应的空气质量评价指数公式代替.在满足一定的优化目标准则条件下,采用猴王免疫进化算法对公式中的参数进行迭代优化,分别得到优化后对基于空气质量标准(GB3095-1996)的7项空气指标皆适用的对数型幂函数、韦伯-费希纳定律、Γ型分布函数、污染危害S型函数、加权加和型幂函数及参数化组合算子等6个空气质量评价的普适指数公式.对公式的可靠性进行了理论分析,对其实用性进行了效果检验,其评价结果与其他方法评价结果基本一致,并与实际相符合.结果表明:空气质量评价的多种形式的普适指数公式皆具有形式简洁、计算简便和普适通用的特点.%To establish the index formulae which are simple in forms and universal as well as common suited to air quality evaluation, proper reference values and transformed formulae are set for each index respectively. Based on normalized transformation of indexes, the differences of transformed values, especially logarithmic transformed values, for the same grade standard values of different indexes would become relatively small. Thus different indexes with normalized values are equivalent to a certain normalized index. Various index formulae with normalized values for air quality evaluation could be taken the place of corresponding air quality index formulae of equivalent indices. Meanwhile universal parameters in each formula are optimized, repeatedly by monkey -king immune evolutionary algorithm

  19. Association between the Hygiene Index Values of Live Fresh Aquatic Products and Food-Borne Diarrhea in the Population of the Ningbo Area in China

    Directory of Open Access Journals (Sweden)

    Lijun Zhang

    2015-08-01

    Full Text Available To investigate the association of the hygiene index values of live fresh aquatic products and food-borne diarrhea in the population of the Ningbo area in China. Volatile basic nitrogen (VBN, histamine (HIS, indole, tetrodotoxin (TTX, and paralytic, neurotoxic, amnesic and diarrhetic shellfish poisons (PSP, NSP, ASP, and DSP, respectively in the samples of live fresh aquatic products and food-borne diarrhea cases in six studied districts were analyzed. Results indicate that the incidence rate of food-borne diarrhea is related to the hygiene index values. Aside from VBN, the main risk factors related to food-borne diarrhea in edible aquatic products include DSP (in marine fish, shrimp, and other shellfishes, NSP, and ASP (in marine shrimp and crab. Hygiene index values among different species were significantly different. No significant difference in the monitoring index values was found among the six different studied districts. The reported cases of food-borne diarrhea were positively associated with VBN and DSP in aquatic products in Haishu, Jiangbei, Zhenhai, and Beilun, as well as VBN and NSP in aquatic products in Jiangdong and Yinzhou. In conclusion, VBN, DSP, NSP, and ASP are important risk factors for the occurring of food-borne diarrhea in the population of the Ningbo area in China.

  20. Values of functional indexes in assessment of efficacy of osteoarthritis treatment with Chondrolon and Zel T in polyclinic

    Directory of Open Access Journals (Sweden)

    O Y Maiko

    2009-01-01

    Full Text Available Objective. To study change of knee joints functional disability in pts with predominantly I-II stage of knee osteoarthritis (OA with clinical tests and WOMAC index for assessment of efficacy of treatment with Chondrolon and Zel T in polyclinic. Material and methods. 70 pts with I and II stage of OA according to Kellgren-Lawrence aged from 40 to 67 years were included. They were divided in 2 groups (30 pts in group I and40 pts in group II. Group I pts were treated with Chondrolon and group II pts – with Zel T. Treatment efficacy was assessed with WOMAC index, functional Lequesne index, pain on VAS at rest and at movement, knee mobility, time of walking for 30 m and walking stairs. Results. Positive changes of all parameters were revealed in both groups: significant improvement of pain on VAS, functional tests, Lequesne index, WOMAC scales was achieved. During treatment with Zel T improvement of the efficacy measures increased slower, mainly after 12 weeks of treatment (during treatment with Chondrolon – after8 weeks. Both drugs provided functional improvement assessed by WOMAC index butChondrolon was more effective. Conclusion. Chondrolon and Zel T can be used for treatment of OA at I or II stage with moderate knee joints functional disability. Course of treatment with Zel T should be continued not less than 3 months and with Chondrolon – 2 months.

  1. Metacarpal index by digital X-ray radiogrammetry: normative reference values and comparison with dual X-ray absorptiometry

    DEFF Research Database (Denmark)

    Hyldstrup, Lars; Nielsen, S P

    2001-01-01

    Metacarpal index (MCI), the combined cortical midmetacarpal thickness divided by the outer mid-metacarpal diameter, fell into oblivion when dual photon absorptiometry was introduced a quarter of a century ago. Modern PC-based digital X-ray diameter measurements offers a unique opportunity...

  2. The Effect of Financial Performance and Environmental Performance on Firm Value with Islamic Social Reporting (ISR Disclosure as Intervening Variable in Companies Listed at Jakarta Islamic Index (JII

    Directory of Open Access Journals (Sweden)

    Ratri Rahma Frida

    2017-01-01

    Full Text Available This study examined how far ISR disclosure as the intervening variable could mediate the effect of financial performance and environmental performance on the firm value. The subjects of this study were the companies listed in Jakarta Islamic Index (JII in 2012-2014. The samples of the study were sixty companies chosen by purposive sampling method, and the analytical technic used path analysis. The results of this study proved that: (1 financial performance had positive effect to the firm value, (2 environmental performance had no effect to the firm value, (3 financial performance had positive effect to the ISR disclosure, (4 environmental performance had positive effect to the ISR disclosure, (5 ISR disclosure had positive effect to the firm value, (6 ISR disclosure could mediate the effect of financial and environmental performances on the firm value.

  3. Isoflurane and sevoflurane decrease entropy indices more than halothane at equal MAC values.

    Science.gov (United States)

    Prabhakar, Hemanshu; Ali, Zulfiqar; Bithal, Parmod K; Rath, Girija P; Singh, Deepak; Dash, Hari H

    2009-01-01

    Recently, bispectral index (BIS) values were demonstrated to be different for various anesthetics as a result of differential effects on electroencephalographic (EEG) signals. Entropy is similar to the BIS monitor, as both process raw EEG to derive a number. We hypothesized that entropy may also be anesthetic agent-specific. Thirty adult patients undergoing spinal surgery were randomized to receive halothane, isoflurane, or sevoflurane. Entropy indices were recorded at various minimum alveolar concentration (MAC) values-0.5, 0.75, 1.0 and 1.5-both during wash-in and wash-out of the agent. Heart rate (HR), mean arterial blood pressure (MAP), response entropy (RE), and state entropy (SE) were noted. Statistical analysis was done using a one-way analysis-ofvariance test. P values less than 0.05 were considered significant. Ten patients in each group completed the study. The demographics and baseline values of HR, MAP, RE, and SE were comparable in all three groups. During the study period, for a given MAC value, both RE and SE remained low in the isoflurane and sevoflurane groups compared to the halothane group. For a given MAC, the RE and SE were comparable during wash-in and wash-out phases. Halothane produced higher entropy values as compared to isoflurane and sevoflurane at equivalent MAC levels.

  4. 指标变换值表示的水安全评价的普适指数公式%Universal index formulae represented with index transformed value for water security evaluation

    Institute of Scientific and Technical Information of China (English)

    李祚泳; 张正健; 汪嘉杨; 余春雪

    2012-01-01

    适当设定水安全指标的参照值和指标值的变换式,并对各指标值进行了变换,使得以变换值表示的不同指标皆“等效”于一个规范指标,从而不同指标的水安全评价指数公式皆可以用该“等效”指标相应的指数公式替代。在满足设定的优化准则条件下,采用猴王免疫进化算法对公式进行优化,分别得到优化后对23项水安全指标皆适用的5个水安全评价的普适指数公式。对所获公式的可靠性进行理论分析以及对其实用性进行效果检验后,其评价结果与其他方法评价结果相一致,并与实际相符合。结果表明:水安全评价的多种形式的普适指数公式皆具有形式简洁、计算简便和普适通用的特点。%In order to establish the universal and general index formulae suited to water security evaluations, based on the set of proper reference values and transformed formulae as well as the transformation for each index value respectively, the various index formulae represented with normalized values for water security evaluation could be taken the place of the corresponding water security index formulae of equivalent indices. Meanwhile universal parameters in each formula were optimized, repeatedly, by monkey-king immune evolutionary algorithm under the conditions of meeting the optimization rule. The optimized universal index formulae are suitable to 23 indices items for water security evaluation. Furthermore, the reliability analyses of formulae were made for the uncertainties of parameters in optimized formulae. At the same time, the formulae were applied in some cases for verification, the evaluation results are coincident with those obtained from other evaluation methods, and also correspond with the actual conditions. It is show that the various universal index formulae for water security evaluation have the characteristics of simplicity in form, simple for calculation, as well as universality

  5. Significance and clinical value of the transitional zone volume (TZV or index (TZI in assessing the degree of lower urinary tract obstruction: Revisited

    Directory of Open Access Journals (Sweden)

    M. El Ghoneimy

    2017-03-01

    Conclusion: Estimating the transition zone volume during TRUS is a reasonable way to obtain the required information about the TZI. Calculating the TZI could not be directly correlated with any of the different parameters, making the clinical value of such an index questionable. The observation that the obstructed and the retention groups both had a TZI above 0.5 deserves further research that can help in the classification of patients into obstructed and non-obstructed.

  6. Nonexistence and Existence of Multiple Positive Solutions for Superlinear Three-point Boundary Value Problems via Index Theory

    Institute of Scientific and Technical Information of China (English)

    Bao-qiang Yan; Donal O'Regan; Ravi P.Agarwal

    2008-01-01

    This paper discusses both the nonexistence of positive solutions for second-order three-point bound ary value problems when the nonlinear term f(t,x,y) is superlinear in y at y=0 and the existence of multiple positive solutions for second-order three-point boundary value problems when the nonlinear term f(t,x,y) is superlinear in x at +∞.

  7. Production Efficiency of Cocoon Shell of Silkworm, Bombyx mori L. (Bombycidae: Lepidoptera, as an Index for Evaluating the Nutritive Value of Mulberry, Morus sp. (Moraceae, Varieties

    Directory of Open Access Journals (Sweden)

    Jalaja Suresh Kumar

    2011-01-01

    Full Text Available The nutritional efficiency of mulberry leaves consumed by silkworms, Bombyx mori L., is usually evaluated in terms of the proportion of cocoon shell weight to the amount of food ingested. The production efficiency of cocoon shell is generally used to identify the superiority of a mulberry variety for silkworm rearing. In this study the production efficiency of cocoon shell was used as an index for evaluating the nutritive value of different mulberry varieties of India. Among the varieties, V-1, having highest production efficiency of cocoon shell with less amount of food ingested and highest digestibility, is regarded as the best suitable variety with nutritive values ideal for silkworm rearing.

  8. Multimethod approach to measuring values in a school context: exploring the association between Congruence — Discrepancy Index (CO DI and task commitment

    Directory of Open Access Journals (Sweden)

    Podolskiy, Dmitry A.

    2013-06-01

    Full Text Available There are considerable differences among the value hierarchies revealed by different methods of measurement. The quantitative measure of such a difference can be referred as the Congruence-Discrepancy Index (CODI. The more congruent the results of different methods are, the higher the CODI is. In the present study I compared value hierarchies obtained by the Schwartz Value Survey and an original instrument based on the constant-sum scale in two samples of adolescents (those in special schools for at-risk adolescents and those in ordinary secondary schools. The results show that the CODI for ordinary school students is significantly higher than that for adolescents recruited from special schools. A significant correlation between the CODI and school engagement was revealed for the ordinary school sample. The possibilities of using the CODI in value research are discussed.

  9. AP Index

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Planetary Amplitude index - Bartels 1951. The a-index ranges from 0 to 400 and represents a K-value converted to a linear scale in gammas (nanoTeslas)--a scale that...

  10. EEG entropy values during isoflurane, sevoflurane and halothane anesthesia with and without nitrous oxide.

    Science.gov (United States)

    Prabhakar, Hemanshu; Ali, Zulfiqar; Bithal, Parmod K; Singh, Gyaninder P; Laithangbam, Pradip K; Dash, Hari H

    2009-04-01

    We hypothesized that like bispectral index, entropy may be anesthetic agent specific. We carried out a study to assess the entropy values of different anesthetics at equi-minimal alveolar concentrations (MACs) with air and nitrous oxide as carrier gases. Thirty adult patients undergoing spine surgery were randomized to receive halothane, isoflurane, or sevoflurane, in 2 stages, (a) with air/oxygen mixture (2:1) and (b) in nitrous oxide/oxygen (2:1). Heart rate, mean arterial blood pressure, response entropy (RE), and state entropy (SE) were noted at 1.0 and 1.5 MACs for each agent. Statistical analysis was done using the 2-way analysis of variance followed by Bonferroni correction and Student t test for paired data. P value of less than 0.05 were considered significant. The demographics and baseline values of heart rate, mean arterial blood pressure, RE, and SE were comparable. Changing from air/oxygen as carrier gas to 66% nitrous oxide in oxygen resulted in significant increase in both RE and SE at 1.0 MAC for all the agents (Psevoflurane and isoflurane (P0.05). Again the values of RE and SE remained high for halothane as compared with isoflurane and sevoflurane. In conclusion, our data suggest a possibility of misinterpretation of anesthetic hypnosis when entropy values increase with addition of nitrous oxide to 1 MAC isoflurane and sevoflurane.

  11. Bi-spectral beam extraction in combination with a focusing feeder

    CERN Document Server

    Zendler, C; Nekrassov, D; Cussen, L D; Strobl, M

    2013-01-01

    Bi-spectral beam extraction combines neutrons from two different kind of moderators into one beamline, expanding the spectral range and thereby the utilization of an instrument. This idea can be realized by a mirror that reflects long wavelength neutrons from an off-axis colder moderator into a neutron guide aligned with another moderator emitting neutrons with shorter wavelengths which will be transmitted through the mirror. The mirror used in such systems is typically several meters long, which is a severe disadvantage because it reduces the possible length of a focusing device in design concepts requiring a narrow beam at a short distance from the source, as used in many instruments under development for the planned European Spallation Source (ESS). We propose a shortened extraction system consisting of several mirrors, and show that such an extraction system is better suited for combination with a feeder in an eye of the needle design, illustrated here in the context of a possible ESS imaging beamline.

  12. Reference values of serum transferrin receptor (sTfR) and sTfR/log ferritin index in healthy children.

    Science.gov (United States)

    Vázquez-López, María A; López-Ruzafa, Encarnación; Lendinez-Molinos, Francisco; Ortiz-Pérez, María; Ruiz-Tudela, Lucía; Martín-González, Manuel

    2016-03-01

    ABSTARCT The aims of this study were to determine appropriate reference ranges for serum transferrin receptor (sTfR) and sTfR/log ferritin (sTfR-F index) in healthy children and their relationship with iron parameters, erythropoiesis, and other conditions presented by the subject. A total of 902 children with normal iron status, aged 1-11 years, were included in a cross-sectional study. A physical examination was conducted and z-score of body mass index (zBMI) obtained. Complete blood count, iron biomarkers, erythropoietin, C-reactive protein, sTfR, and sTfR/log ferritin were determined. Linear multiple regression was applied to identify the factors that determined sTfR and sTfR-F index variability. Mean values for sTfR and sTfR-F index were 1.22 ± 0.28 mg/L (95% confidence interval [CI]: 1.2-1.23) and 0.87 ± 0.25 (95% CI: 0.85-0.88). The reference intervals (2.5th to 97.5th percentiles [P2.5-P97.5]) were 0.78-1.9 mg/L and 0.49-1.46, respectively. sTfR and sTfR-F values decreased with age (P <.03 and P <.0001, respectively). No changes were observed with sex. Changes in sTfR and sTfR-F index were consistent with ferritin and erythropoietin variations. Iron biomarkers, erythropoietin, and zBMI predicted 19% and 18.1% of the sTfR and sTfR-F index variability. The results provide reference ranges for sTfR and sTfR-F index in healthy children for clinical use in the assessment of body iron status. Both biomarkers are predicted by iron parameters, erythropoietin, and zBMI.

  13. P values are only an index to evidence: 20th- vs. 21st-century statistical science.

    Science.gov (United States)

    Burnham, K P; Anderson, D R

    2014-03-01

    Early statistical methods focused on pre-data probability statements (i.e., data as random variables) such as P values; these are not really inferences nor are P values evidential. Statistical science clung to these principles throughout much of the 20th century as a wide variety of methods were developed for special cases. Looking back, it is clear that the underlying paradigm (i.e., testing and P values) was weak. As Kuhn (1970) suggests, new paradigms have taken the place of earlier ones: this is a goal of good science. New methods have been developed and older methods extended and these allow proper measures of strength of evidence and multimodel inference. It is time to move forward with sound theory and practice for the difficult practical problems that lie ahead. Given data the useful foundation shifts to post-data probability statements such as model probabilities (Akaike weights) or related quantities such as odds ratios and likelihood intervals. These new methods allow formal inference from multiple models in the a prior set. These quantities are properly evidential. The past century was aimed at finding the "best" model and making inferences from it. The goal in the 21st century is to base inference on all the models weighted by their model probabilities (model averaging). Estimates of precision can include model selection uncertainty leading to variances conditional on the model set. The 21st century will be about the quantification of information, proper measures of evidence, and multi-model inference. Nelder (1999:261) concludes, "The most important task before us in developing statistical science is to demolish the P-value culture, which has taken root to a frightening extent in many areas of both pure and applied science and technology".

  14. The optimal cut-off value of the preoperative prognostic nutritional index for the survival differs according to the TNM stage in hepatocellular carcinoma.

    Science.gov (United States)

    Okamura, Yukiyasu; Sugiura, Teiichi; Ito, Takaaki; Yamamoto, Yusuke; Ashida, Ryo; Uesaka, Katsuhiko

    2017-08-01

    To establish the optimal cut-off value of the preoperative prognostic nutritional index (PNI) for prognosis according to the Tumor Node Metastasis (TNM) stage of hepatocellular carcinoma (HCC) after curative resection. This retrospective study reviewed the records of 375 patients. The optimal cut-off value of the PNI was established according to the TNM stage, and overall survival was compared between the low and high PNI groups. The optimal cut-off value of the PNI decreased with increasing TNM stage, with 52, 47, and 43 patients having stage I, II, and III HCC, respectively. A low preoperative PNI predicted a poorer overall survival than did a high PNI for stage I (P TNM stages and that the preoperative PNI is a favorable prognostic factor for stage I HCC.

  15. A comparative analysis of Serbia and the EU member states in the context of networked readiness index values

    Directory of Open Access Journals (Sweden)

    Soldić-Aleksić Jasna

    2015-01-01

    Full Text Available Nowadays it is generally accepted that information and communication technologies (ICT are important drivers and ‘enabling’ technologies that have a broad impact on many sectors of the economy and social life. Therefore, measuring the level of ICT development, their economic and social impact, and the country’s readiness to use them are of great importance. In this paper we present the conceptual framework of the Networked Readiness Index (NRI proposed by the World Economic Forum, and analyse the relative position of Serbia and its ‘distance’ from the EU member states in the domain of NRI indicator variables. For this purpose we have applied the Kohonen Self-Organizing Map (the SOM algorithm, which provides the visual image, as a virtual map, of observed countries and their groupings. The resulting SOM map indicates that in the complex NRI space, Serbia is located in a group of EU states that includes Romania, Croatia, Bulgaria, Cyprus, Greece, Italy, Poland, the Czech Republic, and the Slovak Republic. In comparison to other countries, this group shows the poorest performance in the NRI landscape. In addition, our empirical analysis points to the areas in which policy intervention can boost the impact of ICT on Serbian economic development and growth. [Projekat Ministarstva nauke Republike Srbije, br. 179005

  16. Prognostic value of body mass index and change in body weight in postoperative outcomes of lung cancer surgery.

    Science.gov (United States)

    Nakagawa, Tatsuo; Toyazaki, Toshiya; Chiba, Naohisa; Ueda, Yuichiro; Gotoh, Masashi

    2016-10-01

    Nutritional status is associated with an effect on oncological outcomes. However, the effect of nutritional status on postoperative survival in lung cancer has not been well studied. We retrospectively analysed and evaluated the effect of preoperative body mass index (BMI) and changes in body weight on postoperative outcomes of lung cancer surgery. A total of 1311 patients with non-small-cell lung cancer who underwent surgery between January 2001 and December 2011 were included in this study. Preoperative body weight at 4-12 weeks prior to surgery was obtained in 737 patients and the ratio of change in body weight was calculated. The patients were classified into four groups as follows: underweight (BMI obese (BMI ≥ 30). Postoperative survival curves of the BMI groups showed that the underweight group had a poorer prognosis than the other groups, especially for disease-free survival (DFS) (P = 0.03). Univariate and adjusted survival analyses using Cox's proportional hazards regression model showed that low BMI was a significantly poor prognostic factor in overall survival (OS) (P = 0.03 and P = 0.02, respectively) and DFS (P lung cancer. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  17. Value of body mass index in the diagnosis of obesity according to DEXA in well-controlled RA patients.

    Science.gov (United States)

    Tello-Winniczuk, Nina; Vega-Morales, David; García-Hernandez, Pedro A; Esquivel-Valerio, Jorge A; Garza-Elizondo, Mario A; Arana-Guajardo, Ana C

    Rheumatoid arthritis (RA) has an indirect effect on body composition. Body mass index (BMI) is not a valid predictor of body fat in RA patients. To evaluate the accuracy of BMI in identifying obesity diagnosed according to dual energy X-ray absorptiometry (DXA) in well-controlled RA patients. An observational, cross-sectional, descriptive, analytical study. We used 3 different cutoffs for obesity as determined by DXA: >35% total fat, >40% total fat, and >35% central fat mass (central obesity). One hundred one patients were included. We found that 35% total fat corresponded to a BMI of 24kg/m(2), with a sensitivity of 90% and specificity of 75% (area under the curve [AUC] 0.917); 40% total fat to a BMI of 25kg/m(2), with a sensitivity of 86% and specificity of 39% (AUC 0.822); and 35% central fat mass to a BMI of 22kg/m(2), with a sensitivity of 97% and specificity of 84% (AUC 0.951). Obesity according to DXA was underdiagnosed when the classic BMI cutoffs were used in well-controlled RA patients. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  18. EFFECTS OF PHYSICAL AND HEALTH EDUCATION ON THE VALUE OF BODY MASS INDEX OF PUPILS IN A THIRD GRADE OF ELEMENTARY SCHOOL

    Directory of Open Access Journals (Sweden)

    Dževad Džibrić

    2011-03-01

    Full Text Available One of the risk factors for the occurrence of cardiovascular disease is overweight. Body mass index presents approximate indicator of nutritional status. The aim of this research is to determine effects of physical and health education on the values of body mass index between initial and final measuring within three groups of male respondents, age of 8 ± 6 months. The research included 128 boys, divided in two experimental and one control group. According to obtained arithmetic mean results in applied variables in the beginning and at the end of implemented programs of physical education, as well as according to changes significance tested with T-test for dependent samples it is obvious that programs resulted with significant partial effects in experimental respondent groups

  19. Volatility forecasting and value-at-risk estimation in emerging markets: the case of the stock market index portfolio in South Africa

    Directory of Open Access Journals (Sweden)

    Lumengo Bonga-Bonga

    2011-04-01

    Full Text Available Accurate modelling of volatility is important as it relates to the forecasting of Value-at-Risk (VaR. The RiskMetrics model to forecast volatility is the benchmark in the financial sector. In an important regulatory innovation, the Basel Committee has proposed the use of an internal method for modelling VaR instead of the strict use of the benchmark model. The aim of this paper is to evaluate the performance of RiskMetrics in comparison to other models of volatility forecasting, such as some family classes of the Generalised Auto Regressive Conditional Heteroscedasticity models, in forecasting the VaR in emerging markets. This paper makes use of the stock market index portfolio, the All-Share Index, as a case study to evaluate the market risk in emerging markets. The paper underlines the importance of asymmetric behaviour for VaR forecasting in emerging markets’ economies.

  20. Metacarpal index by digital X-ray radiogrammetry: normative reference values and comparison with dual X-ray absorptiometry

    DEFF Research Database (Denmark)

    Hyldstrup, Lars; Nielsen, S P

    2001-01-01

    database for women is presented. It has its maximum in the third decade, and a moderate biologic variation that seems to decline with age. It was found that DXR-MCI was independent of body weight and body surface area, whereas all DXA-BMD values were significantly dependent on them. Body height...... to individual metacarpal bone length. DXR-MCI correlated significantly with DXA-BMD at the sites measured, and particularly well with that of the distal radius (r = 0.67; p

  1. Centile curves and reference values for height, body mass, body mass index and waist circumference of Peruvian children and adolescents.

    Science.gov (United States)

    Bustamante, Alcibíades; Freitas, Duarte; Pan, Huiqi; Katzmarzyk, Peter T; Maia, José

    2015-03-09

    This study aimed to provide height, body mass, BMI and waist circumference (WC) growth centile charts for school-children, aged 4-17 years, from central Peru, and to compare Peruvian data with North-American and Argentinean references. The sample consisted of 8753 children and adolescents (4130 boys and 4623 girls) aged 4 to 17 years, from four Peruvian cities: Barranco, La Merced, San Ramón and Junín. Height, body mass and WC were measured according to standardized techniques. Centile curves for height, body mass, BMI and WC were obtained separately for boys and girls using the LMS method. Student t-tests were used to compare mean values. Overall boys have higher median heights than girls, and the 50th percentile for body mass increases curvilinearly from 4 years of age onwards. In boys, the BMI and WC 50th percentiles increase linearly and in girls, the increase presents a curvilinear pattern. Peruvian children are shorter, lighter and have higher BMI than their counterparts in the U.S. and Argentina; in contrast, age and sex-specific WC values are lower. Height, body mass and WC of Peruvian children increased with age and variability was higher at older ages. The growth patterns for height, body mass, BMI and WC among Peruvian children were similar to those observed in North-American and Argentinean peers.

  2. Centile Curves and Reference Values for Height, Body Mass, Body Mass Index and Waist Circumference of Peruvian Children and Adolescents

    Directory of Open Access Journals (Sweden)

    Alcibíades Bustamante

    2015-03-01

    Full Text Available This study aimed to provide height, body mass, BMI and waist circumference (WC growth centile charts for school-children, aged 4–17 years, from central Peru, and to compare Peruvian data with North-American and Argentinean references. The sample consisted of 8753 children and adolescents (4130 boys and 4623 girls aged 4 to 17 years, from four Peruvian cities: Barranco, La Merced, San Ramón and Junín. Height, body mass and WC were measured according to standardized techniques. Centile curves for height, body mass, BMI and WC were obtained separately for boys and girls using the LMS method. Student t-tests were used to compare mean values. Overall boys have higher median heights than girls, and the 50th percentile for body mass increases curvilinearly from 4 years of age onwards. In boys, the BMI and WC 50th percentiles increase linearly and in girls, the increase presents a curvilinear pattern. Peruvian children are shorter, lighter and have higher BMI than their counterparts in the U.S. and Argentina; in contrast, age and sex-specific WC values are lower. Height, body mass and WC of Peruvian children increased with age and variability was higher at older ages. The growth patterns for height, body mass, BMI and WC among Peruvian children were similar to those observed in North-American and Argentinean peers.

  3. Ecological Evaluation Index continuous formula (EEI-c application: a step forward for functional groups, the formula and reference condition values

    Directory of Open Access Journals (Sweden)

    S. ORFANIDIS

    2011-04-01

    Full Text Available The Ecological Evaluation Index continuous formula (EEI-c was designed to estimate the habitat- based ecological status of rocky coastal and sedimentary transitional waters using shallow benthic macrophyte communities as bioindicators. This study aimed to remedy the weaknesses of the currently used EEI methodology in: (1 ecological status groups (ESG, (2 the formula, and (3 reference condition values. A cluster analysis of twelve species traits was used to delineate ESGs. Two main clusters (ESG I, late-successional; ESG II, opportunistic were identified that were hierarchically divided into three and two sub-clusters, respectively: ESG I comprised thick perennial (IA, thick plastic (IB and shade-adapted plastic (IC coastal water species, and angiosperm plastic (IA, thick plastic (IB and shade-adapted plastic (IC transitional water species. ESG II comprised fleshy opportunistic (IIB and filamentous sheet-like opportunistic (IIA species both in coastal and transitional waters. To avoid discrete jumps at the boundaries between predefined ecological categories, a hyperbolic model that approximates the index values and expresses the ecosystem status in continuous numbers was developed. Seventy-four quantitative and destructive samples of the upper infralittoralCystoseira crinita and coastal lagoonRuppia cirrhosa communities from tentative pristine to less impacted sites in Greece verified 10 as an ‘ideal’ EEI-c reference condition value.

  4. Ecological Evaluation Index continuous formula (EEI-c application: a step forward for functional groups, the formula and reference condition values

    Directory of Open Access Journals (Sweden)

    S. ORFANIDIS

    2012-12-01

    Full Text Available The Ecological Evaluation Index continuous formula (EEI-c was designed to estimate the habitat- based ecological status of rocky coastal and sedimentary transitional waters using shallow benthic macrophyte communities as bioindicators. This study aimed to remedy the weaknesses of the currently used EEI methodology in: (1 ecological status groups (ESG, (2 the formula, and (3 reference condition values. A cluster analysis of twelve species traits was used to delineate ESGs. Two main clusters (ESG I, late-successional; ESG II, opportunistic were identified that were hierarchically divided into three and two sub-clusters, respectively: ESG I comprised thick perennial (IA, thick plastic (IB and shade-adapted plastic (IC coastal water species, and angiosperm plastic (IA, thick plastic (IB and shade-adapted plastic (IC transitional water species. ESG II comprised fleshy opportunistic (IIB and filamentous sheet-like opportunistic (IIA species both in coastal and transitional waters. To avoid discrete jumps at the boundaries between predefined ecological categories, a hyperbolic model that approximates the index values and expresses the ecosystem status in continuous numbers was developed. Seventy-four quantitative and destructive samples of the upper infralittoralCystoseira crinita and coastal lagoonRuppia cirrhosa communities from tentative pristine to less impacted sites in Greece verified 10 as an ‘ideal’ EEI-c reference condition value.

  5. Intravenous lidocaine infusion reduces bispectral index-guided requirements of propofol only during surgical stimulation(dagger)

    NARCIS (Netherlands)

    Hans, G. A.; Lauwick, S. M.; Kaba, A.; Bonhomme, V.; Struys, M. M. R. F.; Hans, P. C.; Lamy, M. L.; Joris, J. L.

    2010-01-01

    I.V. lidocaine reduces volatile anaesthetics requirements during surgery. We hypothesized that lidocaine would also reduce propofol requirements during i.v. anaesthesia. A randomized controlled study of 40 patients tested the effect of i.v. lidocaine (1.5 mg kg(-1) then 2 mg kg(-1) h(-1)) on propofo

  6. An Evaluation of Using Population Pharmacokinetic Models to Estimate Pharmacodynamic Parameters for Propofol and Bispectral Index in Children

    NARCIS (Netherlands)

    Coppens, Marc J.; Eleveld, Douglas J.; Proost, Johannes H.; Marks, Luc A. M.; Van Bocxlaer, Jan F. P.; Vereecke, Hugo; Absalom, Anthony R.; Struys, Michel M. R. F.

    Background: To study propofol pharmacodynamics in a clinical setting a pharmacokinetic model must be used to predict drug plasma concentrations. Some investigators use a population pharmacokinetic model from existing literature and minimize the pharmacodynamic objective function. The purpose of the

  7. Effects of bispectral index monitoring on isoflurane consumption and recovery profiles for anesthesia in an elderly asian population

    Directory of Open Access Journals (Sweden)

    Faraz Shafiq

    2012-01-01

    Conclusion: The use of BIS in an elderly Asian population resulted in 40% reduction of isoflurane usage. The patients having BIS monitoring awoke earlier and had better recovery profiles at the end of anesthesia.

  8. The risk factors for abnormal ankle-brachial index in type 2 diabetic patients and clinical predictive value for diabetic foot

    Institute of Scientific and Technical Information of China (English)

    张净

    2013-01-01

    Objective To investigate the prevalence of diabetic foot (DF) and the normal,high and low ankle brachial index (ABI) in type 2 diabetic patients and explore the risk factor for abnormal ABI and the clinical predictive value for DF.Methods A total of 2 681 type 2 diabetic patients who visited our hospital between January,2007and December,2009 were enrolled in the study.The clinical data were analyzed and the risk factors for abnormal ABI were determined by logistic regression analysis.Results ABI was normal (0.9-<1.3) in 2 362 cases

  9. Feasibility of closed-loop titration of propofol and remifentanil guided by the bispectral monitor in pediatric and adolescent patients: a prospective randomized study.

    Science.gov (United States)

    Orliaguet, Gilles A; Benabbes Lambert, Fatema; Chazot, Thierry; Glasman, Pauline; Fischler, Marc; Liu, Ngai

    2015-04-01

    This study was designed to assess the feasibility of dual closed-loop titration of propofol and remifentanil guided solely by the Bispectral Index (BIS) monitor in pediatric and adolescent patients during anesthesia. Children undergoing elective surgery in this single-blind randomized study were allocated into the closed-loop (auto) or manual (manual) group. Primary outcome was the percentage of time with the BIS in the range 40 to 60 (BIS40-60). Secondary outcomes were the percentage of deep (BISPropofol (2.4 [1.9 to 3.3] vs. 1.7 [1.2 to 2.8] mg/kg) and remifentanil (2.3 [2.0 to 3.0] vs. 2.5 [1.2 to 4.3] μg/kg) consumptions were similar in auto versus manual groups during induction, respectively. During maintenance, propofol consumption (8.2 [6.0 to 10.2] vs. 7.9 [7.2 to 9.1] mg kg h; P = 0.89) was similar between the two groups, but remifentanil consumption was greater in the auto group (0.39 [0.22 to 0.60] vs. 0.22 [0.17 to 0.32] μg kg min; P = 0.003). Perioperative adverse events and length of stay in the postanesthesia care unit were similar. Intraoperative automated control of hypnosis and analgesia guided by the BIS is clinically feasible in pediatric and adolescent patients and outperformed skilled manual control.

  10. The prognostic value of pre-operative serum tetranectin, CA-125 and a combined index in women with primary ovarian cancer

    DEFF Research Database (Denmark)

    Høgdall, Claus K; Nørgaard-Pedersen, Bent; Mogensen, Ole

    2002-01-01

    no significant value was found for CA125 by univariate statistics. In the Cox analyses, FIGO stage was the strongest and TN the second most prognostic variable, followed by age. CA125, Index1 and tumor types were of no prognostic value. The strongest prognostic value for TN was found at the cut-off level 8.2 mg...... cancer. Evaluation was by univariate life-tables analyses and the multivariate Cox analysis. In the Cox analyses, the variables were tested respectively in actual values and as dichotomy variables with different cut-off levels: 6.7, 7.3 and 8.2 mg/l for TN, 35, 65, 100 and 165 U/ml for CA125. RESULTS......: In stages I+II only CA125 was found to be significantly prognostic, whereas TN was of no prognostic value by univariate statistics. For stages III+IV patients significantly better survivals were found for patients with TN levels above the respective cut-offs compared to patients with low TN levels, whereas...

  11. 制造业价值链绩效评价指标研究%The Study on Evaluation Index of the Value Chain of the Manufacturing

    Institute of Scientific and Technical Information of China (English)

    关永娟; 罗晓光; 郑小丽

    2014-01-01

    In order to make the development of the value chain of the manufacturing healthily, facilitate the formation of the sustained competitive advantage for every enterprises on the chain and maximize the value of the customers, the paper begins with the concept of the performance evaluation of the value chain of the manufacturing, and finally points out the evaluation index of the value chain of manufacturing from analyzing the six main factors that can affect the performance evaluation of the value chain of the manufacturing.%为了能够使制造业价值链健康发展,以利于各个节点企业形成持续的竞争优势,实现顾客价值最大化,文章从制造业价值链绩效评价的概念出发,通过对制造业价值链绩效评价的六个主要影响因素的分析,得出制造业价值链的评价指标。

  12. Glycemic Responses, Glycemic Index, and Glycemic Load Values of Some Street Foods Prepared from Plantain (Musa spp., AAB Genome in Côte d’Ivoire

    Directory of Open Access Journals (Sweden)

    Camille Adam Kouamé

    2017-09-01

    Full Text Available The glycemic index (GI and glycemic load (GL of four culinary preferences including five local street dishes prepared from three varieties of plantain at different maturity stages was determined. The GI was obtained following ISO/FDI 26642:2010 protocol, and the GL was calculated from test foods’ GI, considering the amount of available carbohydrate in the traditional portion size. GI values were 44 for Klaclo (with Ameletiha variety at all black stage, 39 for Aloco (with Agnrin variety at full yellow stage, 39 for Aloco (with Agnrin variety at full yellow with black spots stage; 45 for Chips (with Ameletiha variety at green stage and 89 for Banane braisée (with Afoto variety at light green stage. GI values were inversely correlated with the total sugar and carbohydrate in foods (p < 0.01, and no relationship existed between the GI values and the amount of protein (p = 0.89. Except for Chips (GL = 12, the GLs of the others foods were high (GL > 20. Contrary to Banane braisée, the consumption of Klaclo, Aloco, and Chips may promote the control of postprandial glucose response. Data provides the first GI published values of plantain-based foods commonly consumed in the urban area of Abidjan (Côte d’Ivoire.

  13. Extreme value theory applied to the standardized precipitation index - doi: 10.4025/actascitechnol.v36i1.17475

    Directory of Open Access Journals (Sweden)

    Gabriel Constantino Blain

    2014-01-01

    Full Text Available The Standardized Precipitation Index (SPI is a mathematical algorithm developed for detecting and characterizing precipitation departures with regard to an expected regional climate condition. Thus, this study aimed to verify the possibility of using the time-independent general extreme value distribution (GEV for modeling the probability of occurrence of both SPI annual maxima (the maximum monthly SPI value; SPImax and SPI annual minima (the minimum monthly SPI value; SPImim obtained from the weather station of Campinas, State of São Paulo, Brazil (1891-2011 and to evaluate the presence of trends, temporal persistence and periodical components in these two datasets. The goodness-of-fit tests used in this study quantify the agreement between the empirical cumulative distribution and the GEV cumulative function. Our results have indicated that such parametric function can be used to assess the probability of occurrence of SPImin and SPImax values. No significant serial correlation and no trend were detected in both series. For the SPImim, the wavelet analysis has detected a dominant mode in the 4-8 year band. Future studies should focus on the development of a GEV model capable of accounting for such feature. No dominant mode was found for the annual monthly SPI maximums.

  14. Association of the Nonalcoholic Hepatic Steatosis and Its Degrees With the Values of Liver Enzymes and Homeostasis Model Assessment-Insulin Resistance Index

    Science.gov (United States)

    Cruz, Mario Augusto Ferreira; Cruz, Josilda Ferreira; Macena, Larissa Baracho; de Santana, Demetrius Silva; Oliveira, Cristiane Costa da Cunha; Lima, Sonia Oliveira; Franca, Alex Vianey Callado

    2015-01-01

    Background Nonalcoholic fatty liver disease (NAFLD) is among the most common chronic diseases of the modern world with a wide variety of factors including genetic, environmental and metabolic. The aim of this study was to verify the association between the degrees of hepatic steatosis at the abdominal ultrasound and the values of aminotransferases (aspartate aminotransferase (AST) and alanine transferase (ALT)), gamma glutamyl transpeptidase (GGT) and homeostasis model assessment-insulin resistance (HOMA-IR) index. Methods A prospective, descriptive survey study, using a quantitative analytical examination, was conducted from July 2013 to July 2014. In the statistical analysis, values were expressed as median, first and third quartiles. We used the nonparametric Kruskal-Wallis test to compare the medians between the degrees of steatosis, adopted a statistical significance of 5% (P ≤ 0.05) and used the statistical program SPSS 22.0. Results We diagnosed 233/800 (29.1%) patients with hepatic steatosis on routine ultrasound, and 65.7% were female. Regarding degrees, 119 had grade 1 (51.0%), 94 grade 2 (40.4%) and 20 grade 3 (8.6%). The median age of the patients with grade 1, 2 or 3 did not vary significantly (P > 0.05). The median body mass index (BMI), although clinically important because of its elevation, did not differ significantly (P > 0.05). ALT levels increased as the degree of hepatic steatosis has advanced as well as the levels of AST, GGT and HOMA-IR. AST values showed a greater association with the severity of fatty liver (P = 0.0001) than the ALT (P = 0.001). Conclusions ALT, AST, GGT and HOMA-IR are associated to the degrees of hepatic steatosis on ultrasound and can help in the selection of patients for the liver histological evaluation. PMID:27785306

  15. Waist circumference values equivalent to body mass index points for predicting absolute cardiovascular disease risks among adults in an Aboriginal community: a prospective cohort study.

    Science.gov (United States)

    Adegbija, Odewumi; Hoy, Wendy E; Wang, Zhiqiang

    2015-11-13

    There have been suggestions that currently recommended waist circumference (WC) cut-off points for Australians of European origin may not be applicable to Aboriginal people who have different body habitus profiles. We aimed to generate equivalent WC values that correspond to body mass index (BMI) points for identifying absolute cardiovascular disease (CVD) risks. Prospective cohort study. An Aboriginal community in Australia's Northern Territory. From 1992 to 1998, 920 adults without CVD, with age, WC and BMI measurements were followed-up for up to 20 years. Incident CVD, coronary artery disease (CAD) and heart failure (HF) events during the follow-up period ascertained from hospitalisation data. We generated WC values with 10-year absolute risks equivalent for the development of CVD as BMI values (20-34 kg/m(2)) using the Weibull accelerated time-failure model. There were 211 incident cases of CVD over 13,669 person-years of follow-up. At the average age of 35 years, WC values with absolute CVD, CAD and HF risks equivalent to BMI of 25 kg/m(2) were 91.5, 91.8 and 91.7 cm, respectively, for males, and corresponding WC values were 92.5, 92.7 and 93 cm for females. WC values with equal absolute CVD, CAD and HF risks to BMI of 30 kg/m(2) were 101.7, 103.1 and 102.6 cm, respectively, for males, and corresponding values were 99.2, 101.6 and 101.5 cm for females. Association between WC and CVD did not depend on gender (p=0.54). WC ranging from 91 to 93 cm was equivalent to BMI 25 kg/m(2) for overweight, and 99 to 103 cm was equivalent to BMI of 30 kg/m(2) for obesity in terms of predicting 10-year absolute CVD risk. Replicating the absolute risk method in other Aboriginal communities will further validate the WC values generated for future development of WC cut-off points for Aboriginal people. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  16. Value of Computerized Tomography Enterography in Predicting Crohn’s Disease Activity: Correlation with Crohn’s Disease Activity Index and C-Reactive Protein

    Science.gov (United States)

    Park, Eun Kyung; Han, Na Yeon; Park, Beom Jin; Sung, Deuk Jae; Cho, Sung Beom; Jeen, Yoon Tae; Keum, Bora; Kim, Min Ju

    2016-01-01

    Background The accurate evaluation of Crohn’s disease activity is important for the treatment of the disease and for monitoring the response. Computerized tomography (CT) enterography is a useful imaging modality that reflects enteric inflammation, as well as extramural complications. Objectives The aim of this study was to evaluate the correlation between CT enterographic (CTE) findings of active Crohn’s disease and the Crohn’s disease activity index (CDAI) and C-reactive protein (CRP). Patients and Methods Fifty CT enterographies of 39 patients with Crohn’s disease in the small bowel were used in our study. The CDAI was assessed through clinical and laboratory variables. Multiple CT parameters, including mural hyperenhancement, mural thickness, mural stratification, comb sign, and mesenteric fat attenuation, were evaluated with a four-point scale. The presence or absence of enhanced lymph nodes, fibrofatty proliferation, sinus or fistula, abscess, and stricture were also assessed. Two gastrointestinal radiologists independently reviewed all CT images, and inter-observer agreement was examined. Correlations between CT findings, CRP, and CDAI were assessed using Spearman’s rank correlation and logistic regression analysis. To assess the predictive accuracy of the model, a receiver-operating characteristic curve analysis for the sum of CT enterographic scores was used. Results Mural hyperenhancement, mural thickness, comb sign, mesenteric fat density, and fibrofatty proliferation were significantly correlated with CDAI and CRP (P < 0.05). The binary logistic regression model demonstrated that mesenteric fat density, mural stratification, and the presence of enhanced lymph nodes (P < 0.05) had an influence on CDAI severity. The area under the receiver operating characteristic curve (AUROC) of the CTE index for predicting disease activity was 0.85. Using a cut-off value of 8, the sensitivity and negative predictive values were 95% and 94%, respectively

  17. Valor preditivo do "Clinical Risk Index for Babies" para o risco de mortalidade neonatal Predictive value of the "Clinical Risk Index for Babies" for the risk of neonatal death

    Directory of Open Access Journals (Sweden)

    Oscar T. Matsuoka

    1998-12-01

    Full Text Available OBJETIVO: Comparar o valor preditivo do CRIB (Clinical Risk Index for Babies para o risco de mortalidade neonatal ao peso de nascimento (PN e idade gestacional (IG. MÉTODO: Numa coorte prospectiva foram estudados, durante o ano de 1996, 71 recém-nascidos admitidos na unidade de terapia intensiva, com PN 10 foi de 100%. CONCLUSÕES: O escore de CRIB > 10 correspondeu a maiores especificidade e valor preditivo positivo em relação aos demais parâmetros. A área determinada pela "receiver operating characteristic" relativa ao CRIB também foi superior. O CRIB mostrou-se um marcador mais acurado na previsão de risco de mortalidade quando comparado ao PN ou IG isoladamente.OBJECTIVE: Several indicators, mainly birthweight and gestational age, have been used to predict the mortality risk in neonatal intensive care units. In order to assess the potential value of CRIB in predicting neonatal mortality, the score was used over the first 12 hours of life of the newborns admitted to this unit, during the year of 1996. METHOD: The inclusion criteria consisted of all infants without inevitably lethal congenital malformations, birthweight below 1,500g and/or gestational age less than 31 weeks. Newborn children who died within 12 hours after delivery were excluded. The CRIB score covers birth weight, gestational age, the presence of congenital malformations (not inevitably lethal and three indexes of physiological status during first 12 hours after birth - maximum and minimum appropriate fraction of inspired oxygen and maximum (most acidotic base excess. RESULTS: In a prospective cohort, seventy one newborn children were studied. The birthweight (average was 1,119 ± 275.6 g, gestational age 30 weeks 4/7 ±2 weeks 3/7; male (57%; Apgar 1° min. score <=3 ( 36.2% and Apgar 5° min. score < 5 (5.8%. The mortality rate was 29.6% (gold standard. But mortality rate by birthweight less than 1,000 gr. or gestational age lower than 29 weeks was 60.0% and for the

  18. Reconstructing Atmospheric CO2 Through The Paleocene-Eocene Thermal Maximum Using Stomatal Index and Stomatal Density Values From Ginkgo adiantoides

    Science.gov (United States)

    Barclay, R. S.; Wing, S. L.

    2013-12-01

    The Paleocene-Eocene Thermal Maximum (PETM) was a geologically brief interval of intense global warming 56 million years ago. It is arguably the best geological analog for a worst-case scenario of anthropogenic carbon emissions. The PETM is marked by a ~4-6‰ negative carbon isotope excursion (CIE) and extensive marine carbonate dissolution, which together are powerful evidence for a massive addition of carbon to the oceans and atmosphere. In spite of broad agreement that the PETM reflects a large carbon cycle perturbation, atmospheric concentrations of CO2 (pCO2) during the event are not well constrained. The goal of this study is to produce a high resolution reconstruction of pCO2 using stomatal frequency proxies (both stomatal index and stomatal density) before, during, and after the PETM. These proxies rely upon a genetically controlled mechanism whereby plants decrease the proportion of gas-exchange pores (stomata) in response to increased pCO2. Terrestrial sections in the Bighorn Basin, Wyoming, contain macrofossil plants with cuticle immediately bracketing the PETM, as well as dispersed plant cuticle from within the body of the CIE. These fossils allow for the first stomatal-based reconstruction of pCO2 near the Paleocene-Eocene boundary; we also use them to determine the relative timing of pCO2 change in relation to the CIE that defines the PETM. Preliminary results come from macrofossil specimens of Ginkgo adiantoides, collected from an ~200ka interval prior to the onset of the CIE (~230-30ka before), and just after the 'recovery interval' of the CIE. Stomatal index values decreased by 37% within an ~70ka time interval at least 100ka prior to the onset of the CIE. The decrease in stomatal index is interpreted as a significant increase in pCO2, and has a magnitude equivalent to the entire range of stomatal index adjustment observed in modern Ginkgo biloba during the anthropogenic CO2 rise during the last 150 years. The inferred CO2 increase prior to the

  19. [Analysis of postoperative complications in 256 non-small cell lung cancer patients and the value of cardiopulmonary risk index (CPRI)].

    Science.gov (United States)

    Su, Yanjun; Wang, Changli

    2005-10-20

    Pulmonectomy is the first priority in treatment of non-small cell lung cancer (NSCLC). The postoperative complication is the main factor which affects the efficacy of operation. The aim of this study is to analyze the incidences of postoperative complications in NSCLC patients and the value of modified cardiopulmonary risk index (CPRI) in predicting the short-term complication. Postoperative complications were analyzed in patients who underwent pulmonectomy in Tianjin Cancer Institute and Hospital from January 2004 to November 2004, and the value of modified Epstein CPRI in predicting the risk of pulmonectomy was estimated. A total of 256 consecutive patients were studied. Postoperative cardiopulmonary complications occurred in 86 patients (33.6%), hemathorax in 6 patients (2.3%) and other complications in 11 patients (4.3%). Postoperative cardiopulmonary complications occurred in 61 of the 67 patients with CPRI≥4, which was significantly more frequent than that in those with CPRI CPRI≥4 as a threshold for predicting postoperative complication, the sensitivity, specificity and accu- racy were 70.9%, 96.5% and 87.9% respectively. The main early postoperative complications are cardiopulmonary complications. CPRI shows significant importance in predicting the early postoperative prognosis for patients with NSCLC.

  20. Glycaemic index and load values tested in normoglycemic adults for five staple foodstuffs: pounded yam, pounded cassava-plantain, placali, attieke and maize meal stiff porridge.

    Science.gov (United States)

    Kouamé, Adam C; Kouassi, Kouakou N; N'dri, Yao D; Amani, N'guessan G

    2015-02-16

    There is currently an increased global interest in the published glycaemic index (GI) and glycaemic load (GL) values of foods. However, data on the GI and GL values of different varieties of foods within Côte d'Ivoire are very limited. The study therefore aimed at finding the GI and GL of the main food staples in Côte d'Ivoire. Following the International Standard Organisation's protocol (ISO/FDI 26642:2010), a selection of five staple foodstuffs were tested for their GI and GL. Fasted healthy subjects were given 50 g of available carbohydrate servings of a glucose reference, which was tested twice, and test foods which were tested once, on separate occasions. Excepted attieke (GI 63), the majority of foods tested have a high GI (GI>70). Attieke (agbodjama) had a high GL (GL 29) while placali (GL 17) and maize meal stiff porridge (GL 16) had medium GLs. The GLs of pounded cassava-plantain and pounded yam are 26 and 22. Consumption of attieke could minimize postprandial blood glucose spikes, in spite of high GL and potentially have benefit in the management and prevention of some chronic diseases.

  1. Glycaemic Index and Load Values Tested in Normoglycemic Adults for Five Staple Foodstuffs: Pounded Yam, Pounded Cassava-Plantain, Placali, Attieke and Maize Meal Stiff Porridge

    Directory of Open Access Journals (Sweden)

    Adam C. Kouamé

    2015-02-01

    Full Text Available There is currently an increased global interest in the published glycaemic index (GI and glycaemic load (GL values of foods. However, data on the GI and GL values of different varieties of foods within Côte d’Ivoire are very limited. The study therefore aimed at finding the GI and GL of the main food staples in Côte d’Ivoire. Following the International Standard Organisation’s protocol (ISO/FDI 26642:2010, a selection of five staple foodstuffs were tested for their GI and GL. Fasted healthy subjects were given 50 g of available carbohydrate servings of a glucose reference, which was tested twice, and test foods which were tested once, on separate occasions. Excepted attieke (GI 63, the majority of foods tested have a high GI (GI > 70. Attieke (agbodjama had a high GL (GL 29 while placali (GL 17 and maize meal stiff porridge (GL 16 had medium GLs. The GLs of pounded cassava-plantain and pounded yam are 26 and 22. Consumption of attieke could minimize postprandial blood glucose spikes, in spite of high GL and potentially have benefit in the management and prevention of some chronic diseases.

  2. INDEXING AND INDEX FUNDS

    Directory of Open Access Journals (Sweden)

    HAKAN SARITAŞ

    2013-06-01

    Full Text Available Proponents of the efficient market hypothesis believe that active portfolio management is largely wasted effort and unlikely to justify the expenses incurred. Therefore, they advocate a passive investment strategy that makes no attempt to outsmart the market. One common strategy for passive management is indexing where a fund is designed to replicate the performance of a broad-based index of stocks and bonds. Traditionally, indexing was used by institutional investors, but today, the use of index funds proliferated among individual investors. Over the years, both international and domestic index funds have disproportionately outperformed the market more than the actively managed funds have.

  3. Ultrasound analysis of gray-scale median value of carotid plaques is a useful reference index for cerebro-cardiovascular events in patients with type 2 diabetes.

    Science.gov (United States)

    Ariyoshi, Kyoko; Okuya, Shigeru; Kunitsugu, Ichiro; Matsunaga, Kimie; Nagao, Yuko; Nomiyama, Ryuta; Takeda, Komei; Tanizawa, Yukio

    2015-01-01

    Measurements of plaque echogenicity, the gray-scale median (GSM), were shown to correlate inversely with risk factors for cerebro-cardiovascular disease (CVD). The eicosapentaenoic acid (EPA)/arachidonic acid (AA) ratio is a potential predictor of CVD risk. In the present study, we assessed the usefulness of carotid plaque GSM values and EPA/AA ratios in atherosclerotic diabetics. A total of 84 type 2 diabetics with carotid artery plaques were enrolled. On admission, platelet aggregation and lipid profiles, including EPA and AA, were examined. Using ultrasound, mean intima media thickness and plaque score were measured in carotid arteries. Plaque echogenicity was evaluated using computer-assisted quantification of GSM. The patients were then further observed for approximately 3 years. Gray-scale median was found to be a good marker of CVD events. On multivariate logistic regression analysis, GSM <32 and plaque score ≥5 were significantly associated with past history and onset of CVD during the follow-up period, the odds ratios being 7.730 (P = 0.014) and 4.601 (P = 0.046), respectively. EPA/AA showed a significant correlation with GSM (P = 0.012) and high-density lipoprotein cholesterol (P = 0.039), and an inverse correlation with platelet aggregation (P = 0.046) and triglyceride (P = 0.020). Although most patients with CVD had both low GSM and low EPA/AA values, an association of EPA/AA with CVD events could not be statistically confirmed. The present results suggest the GSM value to be useful as a reference index for CVD events in high-risk atherosclerotic diabetics. Associations of the EPA/AA ratio with known CVD risk factors warrant a larger and more extensive study to show the usefulness of this parameter.

  4. Perioperative use of bispectral (BIS) monitor for a pressure ulcer patient with locked-in syndrome (LIS).

    Science.gov (United States)

    Yoo, Christine; Ayello, Elizabeth A; Robins, Bryan; Salamanca, Victor R; Bloom, Marc J; Linton, Patrick; Brem, Harold; O'Neill, Daniel K

    2014-10-01

    The bispectral (BIS) monitor uses brain electroencephalographic data to measure the depth of sedation and pharmacological response during anaesthetic procedures. In this case, the BIS monitor was used for another purpose, to demonstrate postoperatively to the nursing staff that a patient with history of locked-in syndrome (LIS), who underwent pressure ulcer debridement, had periods of wakefulness and apparent sensation, even with his eyes closed. Furthermore, as patients with LIS can feel pain, despite being unable to move, local block or general anaesthesia should be provided for sharp surgical debridement and other painful procedures. This use of the BIS has shown that as a general rule, the staff should treat the patient as though he might be awake and sensate even if he does not open his eyes or move his limbs. The goal of this study was to continuously monitor pain level and communicate these findings to the entire wound team, i.e. anaesthesiologists, surgeons and nurses.

  5. Perioperative Use of Bispectral Monitor (BIS) for a Pressure Ulcer patient with Lock-In Syndrome (LIS)

    Science.gov (United States)

    Yoo, Christine; Ayello, Elizabeth A.; Robins, Bryan; Salamanca, Victor R.; Bloom, Marc J.; Linton, Patrick; Brem, Harold; O'Neill, Daniel K.

    2013-01-01

    The bispectral (BIS) monitor uses brain electroencephalographic data to measure depth of sedation and pharmacological response during anesthetic procedures. In this case, the BIS monitor was used for another purpose, to demonstrate postoperatively to the nursing staff that a patient with history of locked-in syndrome (LIS), who underwent pressure ulcer debridement, had periods of wakefulness and apparent sensation, even with his eyes closed. Furthermore, as patients with LIS can feel pain, despite being unable to move, local block or general anesthesia should be provided for sharp surgical debridement and other painful procedures. This use of the BIS has shown that as a general rule, the staff should treat the patient as though he might be awake and sensate even if he does not open his eyes or move his limbs. Our goal was to continuously monitor pain level and communicate these findings to the entire wound team, ie anesthesiologists, surgeons, and nurses. PMID:25252146

  6. Varicella Zoster Virus Myelitis in Two Elderly Patients: Diagnostic Value of Nested Polymerase Chain Reaction Assay and Antibody Index for Cerebrospinal Fluid Specimens

    Directory of Open Access Journals (Sweden)

    Teruyuki Takahashi

    2013-04-01

    Full Text Available Background: Myelitis is one of the rarest neurological complications of the varicella zoster virus (VZV infection. Focal muscle weakness with or without sensory disturbance occurs in approximately 5% of the cases after acute VZV infection, with complete recovery in 50-70%. Case Presentation: This report describes two rare cases of elderly patients with VZV myelitis secondary to dermatomal zoster rash. Patient 1 was a 79-year-old woman who developed paraplegia, numbness and decreased sensation in the left arm and below thoracic (Th-10 after sacral zoster. Spinal cord MRI showed a high-signal-intensity lesion at the cervical spinal nerve 2 on a T2-weighted image. Patient 2 was a 73-year-old man who developed right flaccid leg weakness and urinary retention after right dorsal Th 5-8 zoster. Spinal cord MRI showed a high-signal-intensity lesion at Th 3-4 on a T2-weighted image. In both cases, although the conventional single polymerase chain reaction (PCR assays all showed negative results, the original nested PCR assay detected VZV DNA in the cerebrospinal fluid (CSF specimen collected on admission. In addition, the anti-VZV IgG antibody by enzyme immunoassay and antibody index were elevated in the CSF specimens during the clinical courses of both patients. On the basis of these findings, both patients were diagnosed with VZV myelitis and were treated with high-dose acyclovir and corticosteroid. This combined treatment was appropriate and effective for the improvement of their functional outcomes. Conclusion: The detection of VZV DNA in CSF by nested PCR assay and the evaluation of the antibody index to VZV had significant diagnostic value.

  7. Varicella zoster virus myelitis in two elderly patients: diagnostic value of nested polymerase chain reaction assay and antibody index for cerebrospinal fluid specimens.

    Science.gov (United States)

    Takahashi, Teruyuki; Tamura, Masato; Miki, Kenji; Yamaguchi, Mai; Kanno, Akira; Nunomura, Satoshi; Ra, Chisei; Tamiya, Takashi; Kamei, Satoshi; Takasu, Toshiaki

    2013-01-01

    Myelitis is one of the rarest neurological complications of the varicella zoster virus (VZV) infection. Focal muscle weakness with or without sensory disturbance occurs in approximately 5% of the cases after acute VZV infection, with complete recovery in 50-70%. This report describes two rare cases of elderly patients with VZV myelitis secondary to dermatomal zoster rash. Patient 1 was a 79-year-old woman who developed paraplegia, numbness and decreased sensation in the left arm and below thoracic (Th)-10 after sacral zoster. Spinal cord MRI showed a high-signal-intensity lesion at the cervical spinal nerve 2 on a T2-weighted image. Patient 2 was a 73-year-old man who developed right flaccid leg weakness and urinary retention after right dorsal Th 5-8 zoster. Spinal cord MRI showed a high-signal-intensity lesion at Th 3-4 on a T2-weighted image. In both cases, although the conventional single polymerase chain reaction (PCR) assays all showed negative results, the original nested PCR assay detected VZV DNA in the cerebrospinal fluid (CSF) specimen collected on admission. In addition, the anti-VZV IgG antibody by enzyme immunoassay and antibody index were elevated in the CSF specimens during the clinical courses of both patients. On the basis of these findings, both patients were diagnosed with VZV myelitis and were treated with high-dose acyclovir and corticosteroid. This combined treatment was appropriate and effective for the improvement of their functional outcomes. The detection of VZV DNA in CSF by nested PCR assay and the evaluation of the antibody index to VZV had significant diagnostic value.

  8. The assessment of health-related quality of life in relation to the body mass index value in the urban population of Belgrade

    Directory of Open Access Journals (Sweden)

    Milosevic Gorica

    2008-11-01

    Full Text Available Abstract Background The association between excess body weight, impairment of health and different co-morbidities is well recognized; however, little is known on how excess body weight may affect the quality of life in the general population. Our study investigates the relationship between perceived health-related quality of life (HRQL and body mass index (BMI in the urban population of Belgrade. Methods The research was conducted during 2005 on a sample of 5,000 subjects, with a response of 63.38%. The study sample was randomly selected and included men and women over 18 years of age, who resided at the same address over a period of 10 years. Data were collected by means of a questionnaire and nutritional status was categorized using the WHO classification. HRQL was measured using the SF-36 generic score. Logistic regression analysis was used to compare HRQL between subjects with normal weight and those with different BMI values; we monitored subject characteristics and potential co-morbidity. Results The prevalence of overweight males and females was 46.6% and 22.1%, respectively. The prevalence of obesity was 7.5% in males and 8.5% in females. All aspects of health, except mental, were impaired in males who were obese. The physical and mental wellbeing of overweight males was not significantly affected; all score values were similar to those in subjects with normal weight. By contrast, obese and overweight females had lower HRQL in all aspects of physical functioning, as well as in vitality, social functioning and role-emotional. Conclusion The results of our study show that, in the urban population of Belgrade, increased BMI has a much greater impact on physical rather than on mental health, irrespective of subject gender; the effects were particularly pronounced in obese individuals.

  9. The predictive value of ICD-10 diagnostic coding used to assess Charlson comorbidity index conditions in the population-based Danish National Registry of Patients

    Directory of Open Access Journals (Sweden)

    Lash Timothy L

    2011-05-01

    Full Text Available Abstract Background The Charlson comorbidity index is often used to control for confounding in research based on medical databases. There are few studies of the accuracy of the codes obtained from these databases. We examined the positive predictive value (PPV of the ICD-10 diagnostic coding in the Danish National Registry of Patients (NRP for the 19 Charlson conditions. Methods Among all hospitalizations in Northern Denmark between 1 January 1998 and 31 December 2007 with a first-listed diagnosis of a Charlson condition in the NRP, we selected 50 hospital contacts for each condition. We reviewed discharge summaries and medical records to verify the NRP diagnoses, and computed the PPV as the proportion of confirmed diagnoses. Results A total of 950 records were reviewed. The overall PPV for the 19 Charlson conditions was 98.0% (95% CI; 96.9, 98.8. The PPVs ranged from 82.0% (95% CI; 68.6%, 91.4% for diabetes with diabetic complications to 100% (one-sided 97.5% CI; 92.9%, 100% for congestive heart failure, peripheral vascular disease, chronic pulmonary disease, mild and severe liver disease, hemiplegia, renal disease, leukaemia, lymphoma, metastatic tumour, and AIDS. Conclusion The PPV of NRP coding of the Charlson conditions was consistently high.

  10. Comparison of the prognostic value of liver biopsy and FIB-4 index in patients coinfected with HIV and hepatitis C virus.

    Science.gov (United States)

    Berenguer, Juan; Zamora, Francisco X; Aldámiz-Echevarría, Teresa; Von Wichmann, Miguel A; Crespo, Manel; López-Aldeguer, José; Carrero, Ana; Montes, Marisa; Quereda, Carmen; Téllez, María J; Galindo, María J; Sanz, José; Santos, Ignacio; Guardiola, Josep M; Barros, Carlos; Ortega, Enrique; Pulido, Federico; Rubio, Rafael; Mallolas, Josep; Tural, Cristina; Jusdado, Juan J; Pérez, Gloria; Díez, Cristina; Álvarez-Pellicer, Julio; Esteban, Herminia; Bellón, José M; González-García, Juan

    2015-03-15

    We compared the prognostic value of liver biopsy (LB) and FIB-4 index in patients with human immunodeficiency virus (HIV)/hepatitis C virus (HCV) coinfection. We studied patients from the Grupo de Estudio del SIDA 3603 study cohort, in whom fibrosis was evaluated at baseline using both LB (Metavir score) and FIB-4 index. We assessed overall death (OD) and liver-related events (LREs), defined as decompensation or hepatocellular carcinoma, whichever occurred first. We used receiver operating characteristic (ROC) curves to determine the ability of LB and FIB-4 to predict outcomes. We also assessed the association between advanced fibrosis-LB (F3 or greater) or FIB-4 (≥3.25)-and outcomes using multivariate Cox regression analysis. The study sample comprised 903 patients (328 with sustained virologic response [SVR]). Baseline fibrosis by LB was as follows: F0, n = 71; F1, n = 242; F2, n = 236; F3, n = 236; F4, n = 118. Fibrosis by FIB-4 was as follows: ≤1, n = 148; >1 to <3.25, n = 597; ≥3.25, n = 158. After a median follow-up of 62 months, there were 46 deaths and 71 LREs. The area under the ROC curves for OD/LREs was 0.648 and 0.742 for LB and FIB-4, respectively (P = .006). Similar results were found for patients without SVR and for OD and LREs separately. The adjusted hazard ratios of OD or LRE were 1.740 (95% confidence interval [CI], 1.119-2.7.06; P = .014) for advanced fibrosis assessed by LB and 3.896 (95% CI, 2.463-6.160; P < .001) assessed by FIB-4. FIB-4 outperformed LB as a predictor of OD and LRE. These findings are of relevance for clinical practice and research and call into question the role of LB as a gold standard for assessing prognosis in HIV/HCV coinfection. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  11. Influence of Body Mass Index on the Prognostic Value of Tumor ¹⁸F-FDG Uptake in Stage I Non-Small Cell Lung Cancer.

    Science.gov (United States)

    Hyun, Seung Hyup; Lee, Kyung-Han; Choi, Joon Young; Kim, Byung-Tae; Kim, Jhingook; Zo, Jae Ill; Kim, Hojoong; Kwon, O Jung; Ahn, Hee Kyung

    2015-01-01

    The impact of host energy balance status on outcome of lung cancer has not been fully explored. It is also unknown if there is a potential modifying effect of body mass index (BMI) on tumor cell behavior in patients with early-stage non-small cell lung cancer (NSCLC). We therefore investigated the interactive effects of tumor [18F]-fluorodeoxyglucose (FDG) avidity and BMI. We investigated 1,197 patients with stage I NSCLC who underwent preoperative FDG positron emission tomography followed by curative resection. The primary outcome measure was disease-free survival (DFS). A multivariable Cox proportional hazards model was used to assess the potential independent effects of the prognostic variables. A stratified Cox regression analysis was also performed to assess the potential modifying effects of BMI on the relationship between tumor FDG uptake and patient survival. There were 145 tumor recurrences and 19 deaths during a median follow-up of 30 months. Tumor-related variables, including tumor size, maximum standardized uptake value (SUVmax), histologic cell type, differentiation, lymphovascular invasion, and visceral pleural invasion, did not differ significantly according to BMI status. In multivariable Cox regression analysis, overweight or obesity [hazard ratio (HR), 0.59; 95% CI, 0.43-0.81; P = 0.001] and tumor SUVmax (HR, 1.72; 95% CI, 1.43-2.07; P obese patients (HR, 2.61; 95% CI, 1.58-4.31; P obese patients. These results suggest that the host-tumor interaction between host energy balance status and tumor glucose metabolism plays an important role in the outcome of early-stage NSCLC.

  12. Influence of Body Mass Index on the Prognostic Value of Tumor ¹⁸F-FDG Uptake in Stage I Non-Small Cell Lung Cancer.

    Directory of Open Access Journals (Sweden)

    Seung Hyup Hyun

    Full Text Available The impact of host energy balance status on outcome of lung cancer has not been fully explored. It is also unknown if there is a potential modifying effect of body mass index (BMI on tumor cell behavior in patients with early-stage non-small cell lung cancer (NSCLC. We therefore investigated the interactive effects of tumor [18F]-fluorodeoxyglucose (FDG avidity and BMI.We investigated 1,197 patients with stage I NSCLC who underwent preoperative FDG positron emission tomography followed by curative resection. The primary outcome measure was disease-free survival (DFS. A multivariable Cox proportional hazards model was used to assess the potential independent effects of the prognostic variables. A stratified Cox regression analysis was also performed to assess the potential modifying effects of BMI on the relationship between tumor FDG uptake and patient survival.There were 145 tumor recurrences and 19 deaths during a median follow-up of 30 months. Tumor-related variables, including tumor size, maximum standardized uptake value (SUVmax, histologic cell type, differentiation, lymphovascular invasion, and visceral pleural invasion, did not differ significantly according to BMI status. In multivariable Cox regression analysis, overweight or obesity [hazard ratio (HR, 0.59; 95% CI, 0.43-0.81; P = 0.001] and tumor SUVmax (HR, 1.72; 95% CI, 1.43-2.07; P < 0.001 were significantly associated with DFS. There was a significant modifying effect of BMI (P for interaction < 0.001 in multivariable analysis. High tumor SUVmax was more strongly associated with worse DFS in normal weight patients (HR, 4.72; 95% CI, 2.77-8.06; P < 0.001 than in overweight or obese patients (HR, 2.61; 95% CI, 1.58-4.31; P < 0.001.Tumor FDG avidity is an independent predictor of DFS in patients with early-stage NSCLC and this prognostic value was strengthened in normal weight patients than in overweight or obese patients. These results suggest that the host-tumor interaction between

  13. Prognostic value of serum galactomannan index in critically ill patients with chronic obstructive pulmonary disease at risk of invasive pulmonary aspergillosis

    Institute of Scientific and Technical Information of China (English)

    He Hangyong; Li Qian; Chang Shuo; Ding Lin; Sun Bing; Li Fang; Zhan Qingyuan

    2014-01-01

    Background Critically ill chronic obstructive pulmonary disease (COPD) patients admitted to an intensive care unit (ICU) due to respiratory failure are at particularly high risk of Aspergillus infection.The serum galactomannan index (GMI) has proven to be one of the prognostic criteria for invasive pulmonary aspergillosis (IPA) in classical immunocompromised patients.However,the prognostic value of serum GMI in critically ill COPD patients needs evaluation.The purpose of this study is to investigate the prognostic value of serum GMI in patients with severe COPD.Methods In this single-center prospective cohort study,serum samples for GMI assay were collected twice a week from the first day of ICU admission to the day of the patients' discharge or death.Patients were divided into two groups according to their clinical outcome on the 28th day of their ICU admission.Univariate analysis and survival analysis were tested in these two groups.Results One hundred and fifty-three critically ill COPD patients were included and were divided into survival group (106 cases) and non-survival group (47 cases) according to their outcome.Univariate analysis showed that the highest GMI level during the first week after admission (GMI-high 1st week) was statistically different between the two groups.Independent prognostic factors for poor outcome in severe COPD patients were:GMI-high 1st week >0.5 (RR:4.04,95% CI:2.17-7.51) combined with accumulative dosage of corticosteroids >216 mg before the RICU admission (RR:2.25,95% CI:1.11-4.56) and clearance of creatinine (Ccr) <64.31 ml/min (RR:2.48,95% CI:1.22-5.07).Conclusions The positive GMI-high 1st week (>0.5) combined with an accumulative dosage of corticosteroids >216 mg before the ICU admission and a low Ccr may predicate a poor outcome of critically ill COPD patients.

  14. Diagnostic and prognostic values of the V-index, a novel ECG marker quantifying spatial heterogeneity of ventricular repolarization, in patients with symptoms suggestive of non-ST-elevation myocardial infarction.

    Science.gov (United States)

    Abächerli, Roger; Twerenbold, Raphael; Boeddinghaus, Jasper; Nestelberger, Thomas; Mächler, Patrick; Sassi, Roberto; Rivolta, Massimo W; Roonizi, Ebadollah Kheirati; Mainardi, Luca T; Kozhuharov, Nikola; Rubini Giménez, Maria; Wildi, Karin; Grimm, Karin; Sabti, Zaid; Hillinger, Petra; Puelacher, Christian; Strebel, Ivo; Cupa, Janosch; Badertscher, Patrick; Roux, Isabelle; Schmid, Ramun; Leber, Remo; Osswald, Stefan; Mueller, Christian; Reichlin, Tobias

    2017-06-01

    The V-index is an ECG marker quantifying spatial heterogeneity of ventricular repolarization. We prospectively assessed the diagnostic and prognostic values of the V-index in patients with suspected non-ST-elevation myocardial infarction (NSTEMI). We prospectively enrolled 497 patients presenting with suspected NSTEMI to the emergency department (ED). Digital 12-lead ECGs of five-minute duration were recorded at presentation. The V-index was automatically calculated in a blinded fashion. Patients with a QRS duration >120ms were ruled out from analysis. The final diagnosis was adjudicated by two independent cardiologists. The prognostic endpoint was all-cause mortality during 24months of follow-up. NSTEMI was the final diagnosis in 14% of patients. V-index levels were higher in patients with AMI compared to other causes of chest pain (median 23ms vs. 18ms, pV-index in addition to conventional ECG-criteria improved the diagnostic accuracy for the diagnosis of NSTEMI as quantified by area under the ROC curve from 0.66 to 0.73 (p=0.001) and the sensitivity of the ECG for AMI from 41% to 86% (pV-index (pV-index remained an independent predictor of death. The V-index, an ECG marker quantifying spatial heterogeneity of ventricular repolarization, significantly improves the accuracy and sensitivity of the ECG for the diagnosis of NSTEMI and independently predicts mortality during follow-up. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Comparison of relative oxycodone consumption in surgical pleth index-guided analgesia versus conventional analgesia during sevoflurane anesthesia

    Science.gov (United States)

    Won, Young Ju; Lim, Byung Gun; Lee, So Hyun; Park, Sangwoo; Kim, Heezoo; Lee, Il Ok; Kong, Myoung Hoon

    2016-01-01

    Abstract Background: The surgical pleth index (SPI) is proposed for titration of analgesic drugs during general anesthesia. Several reports have investigated the effect of SPI on the consumption of opioids including remifentanil, fentanyl, and sufentanil during anesthesia, but there are no reports about oxycodone. We aimed to investigate intravenous oxycodone consumption between SPI-guided analgesia and conventional analgesia practices during sevoflurane anesthesia in patients undergoing thyroidectomy. Methods: Forty-five patients undergoing elective thyroidectomy were randomly assigned to an SPI group (SPI-guided analgesia group, n = 23) or a control group (conventional analgesia group, n = 22). Anesthesia was maintained with sevoflurane to achieve bispectral index values between 40 and 60. In the SPI group, oxycodone 1 mg was administered intravenously at SPI values over 50; in the control group, oxycodone 1 mg was administered intravenously at the occurrence of tachycardia or hypertension event. Intraoperative oxycodone consumption and extubation time were recorded. The number of hemodynamic and somatic movement events was recorded, as were postoperative pain and recovery scores. Results: Patients’ characteristics were comparable between the groups. Intraoperative oxycodone consumption in the SPI group was significantly lower than the control group (3.5 ± 2.4 vs 5.1 ± 2.4 mg; P = 0.012). Extubation time was significantly shorter in the SPI group (10.6 ± 3.5 vs 13.4 ± 4.6 min; P = 0.026). Hemodynamic and somatic movement events during anesthesia were comparable between the groups, as were numeric rating scales for pain and modified Aldrete scores at postanesthesia care unit. Conclusions: SPI-guided analgesia reduces intravenous oxycodone consumption and extubation time compared with conventional analgesia based on clinical parameters during sevoflurane anesthesia in patients undergoing thyroidectomy. PMID:27583920

  16. Predictive Value of Combining the Ankle-Brachial Index and SYNTAX Score for the Prediction of Outcome After Percutaneous Coronary Intervention (from the SHINANO Registry).

    Science.gov (United States)

    Ueki, Yasushi; Miura, Takashi; Miyashita, Yusuke; Motoki, Hirohiko; Shimada, Kentaro; Kobayashi, Masanori; Nakajima, Hiroyuki; Kimura, Hikaru; Akanuma, Hiroshi; Mawatari, Eiichiro; Sato, Toshio; Hotta, Shoji; Kamiyoshi, Yuichi; Maruyama, Takuya; Watanabe, Noboru; Eisawa, Takayuki; Aso, Shinichi; Uchikawa, Shinichiro; Hashizume, Naoto; Sekimura, Noriyuki; Morita, Takehiro; Ebisawa, Soichiro; Izawa, Atsushi; Koyama, Jun; Ikeda, Uichi

    2016-01-15

    The Synergy Between PCI With TAXUS and Cardiac Surgery (SYNTAX) score is effective in predicting clinical outcome after percutaneous coronary intervention (PCI). However, its prediction ability is low because it reflects only the coronary characterization. We assessed the predictive value of combining the ankle-brachial index (ABI) and SYNTAX score to predict clinical outcomes after PCI. The ABI-SYNTAX score was calculated for 1,197 patients recruited from the Shinshu Prospective Multi-center Analysis for Elderly Patients with Coronary Artery Disease Undergoing Percutaneous Coronary Intervention (SHINANO) registry, a prospective, observational, multicenter cohort study in Japan. The primary end points were major adverse cardiovascular and cerebrovascular events (MACE; all-cause death, myocardial infarction, and stroke) in the first year after PCI. The ABI-SYNTAX score was calculated by categorizing and summing up the ABI and SYNTAX scores. ABI ≤ 0.49 was defined as 4, 0.5 to 0.69 as 3, 0.7 to 0.89 as 2, 0.9 to 1.09 as 1, and 1.1 to 1.5 as 0; an SYNTAX score ≤ 22 was defined as 0, 23 to 32 as 1, and ≥ 33 as 2. Patients were divided into low (0), moderate (1 to 2), and high (3 to 6) groups. The MACE rate was significantly higher in the high ABI-SYNTAX score group than in the lower 2 groups (low: 4.6% vs moderate: 7.0% vs high: 13.9%, p = 0.002). Multivariate regression analysis found that ABI-SYNTAX score independently predicted MACE (hazards ratio 1.25, 95% confidence interval 1.02 to 1.52, p = 0.029). The respective C-statistic for the ABI-SYNTAX and SYNTAX score for 1-year MACE was 0.60 and 0.55, respectively. In conclusion, combining the ABI and SYNTAX scores improved the prediction of 1-year adverse ischemic events compared with the SYNTAX score alone.

  17. Value of avidity index in diagnosis of herpes of IgG and polymerase chain reaction simplex 2 virus in pregnancy

    Institute of Scientific and Technical Information of China (English)

    Maysaa El Sayed Zaki

    2009-01-01

    Objective : The goal of the present study is to highlight the significance of the determination of IgG avidity to herpes simplex2virus( HSV2) compared to detection of viremia by polymerase chain reaction( PCR) in relation to recurrent abortions. Methods : Serum samples from pregnant patients with bad obstetric histories and control subjects were analyzed for quantitative determination of IgG specific for HSV2 by using ELISA with and without sample treatment with 8 M urea as protein-denaturing agents for measurement of avidity index ( AI). PCR was performed for samples to determine HSV2 viremia. Results : Regarding avidity index 11. 5% had avidity index = 100.0,11. 5% has avidity index = 47% and 76. 9% had avidity index > 60%. Control group had AI > 70% • There was statistically insignificant difference between OD of IgG in patients with viremia before urea treatment and after urea treatment compared to healthy control. Also there was statistically insignificant difference in OD before urea and after urea in patients with viremia. Conclusion : From this study we can conclude that viremia for HSV2 is common finding in patients with bad obstetric history. Low avidity immunoglobulin G was not common finding in those patients. This may be explain that even reactivation of latent HSV 2 infection is associated with fetal loss.

  18. The value of the different indexes of electrocardiogram in diagnosing high blood pressure with left ventricular hypertrophy%心电图不同指标对高血压病左室肥厚的诊断价值

    Institute of Scientific and Technical Information of China (English)

    严国平; 颜玉芳

    2009-01-01

    目的 探讨心电图(ECG)各指标对诊断高血压病左室肥厚(LVH)的价值.方法 根据超声心动图(UCG)报告,确定观察组(A组)高血压病伴LVH 55例及对照组(B组)高血压病不伴LVH 50例;测定ECG各指标数据并计算其敏感性.结果 ECG不同指标对诊断高血压病LVH的价值存在较大差异,其中QRS波群电压指标敏感性最高,肢体导联室壁激动时间(VAT)次之,余指标敏感性较低.结论 ECG不同指标在诊断高血压病LVH时的价值不同.%Objective To investigate the value of the different indexes of electrocardiogram (ECG) in diagnosing high blood pressure with left ventricular hypertrophy. Methods 55 cases of high blood pressure with left ventricular hy-pertrophy and 50 cases of high blood pressure without left ventricular hypertrophy by the investigation of ultrasonic cardio-gram(UCG) were studied. The figure and sensitivity of the different indexes of ECG were determined. Results There was obvious difference among each ECG index in the diagnosing value of high blood pressure with left ventricular hypertro-phy, QRS wave amplitude had the most sensitive value compared with others. Conclusion It was different for each ECG index in the value of diagnosing high blood pressure with left ventricular hypertrophy. In order to improve the diagnosing ac-curacy, it is important to understand the different diagnosing value of each ECG index.

  19. Determination of the supersaturation in the LiIO 3-HIO 3-H 2O system using a refractive index value at near saturation concentration

    Science.gov (United States)

    Lyutov, Lyudmil G.

    2009-09-01

    The exact determination of supersaturation is essential for the studies of crystal growth processes in solutions. Due to peculiarities in the solubility of LiIO 3, the refractive index of the solution is chosen as a measure of the supersaturation instead of undercooling. The experimental setup is based on a refractometer and a special setup to create supersaturation in the cuvette by means of successive evaporation of small amounts of solvent. The refractive index is measured at different solution concentrations and pH and the data are correlated as dependences of concentration and pH on the refractive index. The accuracy of the method and the adequacy of the model are discussed.

  20. Diagnostic value of the APRI index for liver fibrosis in a Chinese patients population with chronic hepatitis C acquired from blood transfusion

    Directory of Open Access Journals (Sweden)

    LEI Chengduo

    2013-05-01

    Full Text Available ObjectiveTo evaluate the diagnostic efficacy of various newly developed non-invasive fibrotic predictive models based on measurements of common biochemical indices in a group of ethnic Chinese patients with long-standing chronic hepatitis C (CHC infection acquired by transfusion. MethodsBetween July 2010 and June 2011, 120 of the monitored residents of Dingxi District of Gansu Province who had acquired hepatitis C infection via the regional practice of untested whole blood or plasma transfusion during the years of 1992-1995 were recruited for the current study. Each participant underwent liver biopsy for histological evaluation of liver fibrosis (S1-S4 progressive stages, from mild fibrosis to early cirrhosis. Each participant also provided serum samples for biochemical measurement of fibrotic indicators, including hyaluronic acid (HA, type Ⅲ procollagen protein (PCⅢ, laminin (LN, and type IV collagen (CⅣ. In addition, aspartate aminotransferase (AST, platelet count (PLT, alanine aminotransferase (ALT, prothrombin time (PT, and international normalized ratio (INR were measured to calculate the various non-invasive fibrotic predictive models: AST-to-PLT ratio index (APRI, the Sheth index (AST/ALT, the FibroQ index (10×[(age×AST×PT INR/(ALT×PLT], and the FIB-4 index ([age×AST/(PLT×ALT1/2]. Using the pathologic results as the reference standards, the diagnostic efficacies of these four non-invasive fibrotic predictive models were evaluated by Spearman’s rank correlation coefficient. Accuracies of the four were compared by constructing receiver operating characteristic (ROC curves and analyzing their sensitivities, specificities and area under the curves (AUCs. ResultsThe APRI, FibroQ and FIB-4 indexes, and the levels of PCⅢ, CⅣ, and HA increased in conjunction with progressive stages of liver fibrosis. However, only the APRI showed significant correlation to liver fibrosis stage (r=0.446, P<0.001. The APRI index also had

  1. Monthly values of the standardized precipitation index in the State of São Paulo, Brazil: trends and spectral features under the normality assumption

    Directory of Open Access Journals (Sweden)

    Gabriel Constantino Blain

    2012-01-01

    Full Text Available The aim of this study was to describe monthly series of the Standardized Precipitation Index obtained from four weather stations of the State of São Paulo, Brazil. The analyses were carried out by evaluating the normality assumption of the SPI distributions, the spectral features of these series and, the presence of climatic trends in these datasets. It was observed that the Pearson type III distribution was better than the gamma 2-parameter distribution in providing monthly SPI series closer to the normality assumption inherent to the use of this standardized index. The spectral analyses carried out in the time-frequency domain did not allow us to establish a dominant mode in the analyzed series. In general, the Mann-Kendall and the Pettitt tests indicated the presence of no significant trend in the SPI series. However, both trend tests have indicated that the temporal variability of this index, observed at the months of October over the last 60 years, cannot be seen as the result of a purely random process. This last inference is due to the concentration of decreasing trends, with a common beginning (1983/84 in the four locations of the study.

  2. Bispectral pairwise interacting source analysis for identifying systems of cross-frequency interacting brain sources from electroencephalographic or magnetoencephalographic signals

    Science.gov (United States)

    Chella, Federico; Pizzella, Vittorio; Zappasodi, Filippo; Nolte, Guido; Marzetti, Laura

    2016-05-01

    Brain cognitive functions arise through the coordinated activity of several brain regions, which actually form complex dynamical systems operating at multiple frequencies. These systems often consist of interacting subsystems, whose characterization is of importance for a complete understanding of the brain interaction processes. To address this issue, we present a technique, namely the bispectral pairwise interacting source analysis (biPISA), for analyzing systems of cross-frequency interacting brain sources when multichannel electroencephalographic (EEG) or magnetoencephalographic (MEG) data are available. Specifically, the biPISA makes it possible to identify one or many subsystems of cross-frequency interacting sources by decomposing the antisymmetric components of the cross-bispectra between EEG or MEG signals, based on the assumption that interactions are pairwise. Thanks to the properties of the antisymmetric components of the cross-bispectra, biPISA is also robust to spurious interactions arising from mixing artifacts, i.e., volume conduction or field spread, which always affect EEG or MEG functional connectivity estimates. This method is an extension of the pairwise interacting source analysis (PISA), which was originally introduced for investigating interactions at the same frequency, to the study of cross-frequency interactions. The effectiveness of this approach is demonstrated in simulations for up to three interacting source pairs and for real MEG recordings of spontaneous brain activity. Simulations show that the performances of biPISA in estimating the phase difference between the interacting sources are affected by the increasing level of noise rather than by the number of the interacting subsystems. The analysis of real MEG data reveals an interaction between two pairs of sources of central mu and beta rhythms, localizing in the proximity of the left and right central sulci.

  3. 基于废料削减的反应器网络综合—环境指标瞬时值%Reactor Network Synthesis for Waste Reduction Using Instantaneous Value of Environmental Index

    Institute of Scientific and Technical Information of China (English)

    陈启石; 冯霄

    2008-01-01

    Waste reduction is gaining importance as the preferred means of pollution prevention. Reactor networksynthesis is one of the key parts of chemical process synthesis. In this study, a geometric approach to reactor net-work synthesis for waste reduction is presented. The bases of the approach are potential environment impact (PEI)rate-law expression, PEI balance and the instantaneous value of environmental indexes. The instantaneous value can bederived using the PEI balance, PEI rate-law expression and the environmental indexes. The optimal reactor networkswith the minimum generation of potential environment impact are geometrically derived by comparing with areasof the corresponding regions. From the case study involving complex reactions, the approach does not involve solv-ing the complicated mathematical problem and can avoid the dimension limitation in the attainable region approach.

  4. Simpson-Golabi-Behmel syndrome type 1 in a 27-week macrosomic preterm newborn: the diagnostic value of rib malformations and index nail and finger hypoplasia.

    Science.gov (United States)

    Garavelli, Livia; Gargano, Giancarlo; Simonte, Graziella; Rosato, Simonetta; Wischmeijer, Anita; Melli, Nives; Braibanti, Silvia; Gelmini, Chiara; Forzano, Francesca; Pietrobono, Roberta; Pomponi, Maria Grazia; Andreucci, Elena; Toutain, Annick; Superti-Furga, Andrea; Neri, Giovanni

    2012-09-01

    The Simpson-Golabi-Behmel syndrome type 1 (SGBS1, OMIM #312870) is an X-linked overgrowth condition comprising abnormal facial appearance, supernumerary nipples, congenital heart defects, polydactyly, fingernail hypoplasia, increased risk of neonatal death and of neoplasia. It is caused by mutation/deletion of the GPC3 gene. We describe a macrosomic 27-week preterm newborn with SGBS1 who presents a novel GPC3 mutation and emphasize the phenotypic aspects which allow a correct diagnosis neonatally in particular the rib malformations, hypoplasia of index finger and of the same fingernail, and 2nd-3rd finger syndactyly.

  5. Indexing Images.

    Science.gov (United States)

    Rasmussen, Edie M.

    1997-01-01

    Focuses on access to digital image collections by means of manual and automatic indexing. Contains six sections: (1) Studies of Image Systems and their Use; (2) Approaches to Indexing Images; (3) Image Attributes; (4) Concept-Based Indexing; (5) Content-Based Indexing; and (6) Browsing in Image Retrieval. Contains 105 references. (AEF)

  6. Prognostic value of the apoptotic index analysed jointly with selected cell cycle regulators and proliferation markers in non-small cell lung cancer.

    Science.gov (United States)

    Dworakowska, Dorota; Jassem, Ewa; Jassem, Jacek; Karmoliński, Andrzej; Lapiński, Mariusz; Tomaszewski, Dariusz; Rzyman, Witold; Jaśkiewicz, Kazimierz; Sworczak, Krzysztof; Grossman, Ashley B

    2009-10-01

    In a previous small series of surgically treated non-small cell lung cancer patients (NSCLC), we found that higher apoptotic index (AI) negatively influenced survival (Dworakowska D, Jassem E, Jassem J, Karmolinski A, Dworakowski R, Wirth T, et al. Clinical significance of apoptotic index in non-small cell lung cancer: correlation with p53, mdm2, pRb and p21WAF1/CIP1 protein expression. J Cancer Res Clin Oncol 2005; 131:617-623.). In this study we attempted to verify our previous finding in larger group of 170 NSCLC cases, additionally correlating AI to selected cell cycle regulators as well as a proliferation marker. Apoptosis was assessed with the use of the TUNEL technique, whereas the expression of p53, pRb, mdm2, p21(WAF1/CIP1), cyclin D1 and PCNA were assessed immunohistochemically. The mean and the median AI was 12 and 8, respectively. The expression of p53, pRb, mdm2, p21(WAF1/CIP1) proteins and cyclin D1 was found in 47%, 71%, 37%, 65% and 40% of cases, respectively. The mean and the median PCNA labeling index (PCNA LI) was 34 and 35, respectively. AI was not correlated with any patient characteristic or other tumor markers. In uni- and multivariate analysis AI, analysed separately or jointly with cell cycle regulators and PCNA LI, did not influence disease-free or over-all survival. However, patients with "very high AI/very high PCNA LI" had a particularly poor prognosis (P=0.001). Patients with "very low AI/negative pRb" phenotype survived for a shorter time in comparison to others (P=0.04). In addition, patients with the highest PCNA LI had a worse outcome in comparison to patients with the lowest PCNA LI (P=0.04), especially those with concomitant p53 protein expression (P=0.026) or lacking pRb protein expression (P=0.04). This study demonstrates that joint analysis of several factors involved in apoptosis, proliferation and cell cycle regulation, but not AI alone, might provide additional prognostic information in NSCLC patients.

  7. Body mass index and other anthropometric parameters in patients with diffuse large B-cell lymphoma: physiopathological significance and predictive value in the immunochemotherapy era.

    Science.gov (United States)

    Sarkozy, Clémentine; Camus, Vincent; Tilly, Hervé; Salles, Gilles; Jardin, Fabrice

    2015-07-01

    Diffuse large B-cell lymphoma (DLBCL) is the most common form of aggressive non-Hodgkin lymphoma, accounting for 30-40% of newly diagnosed cases. Obesity is a well-defined risk factor for DLBCL. However, the impact of body mass index (BMI) on DLBCL prognosis is controversial. Recent studies suggest that skeletal muscle wasting (sarcopenia) or loss of fat mass can be detected by computed tomography (CT) images and is useful for predicting the clinical outcome in several types of cancer including DLBCL. Several hypotheses have been proposed to explain the differences in DLBCL outcome according to BMI or weight that include tolerance to treatment, inflammatory background and chemotherapy or rituximab metabolism. In this review, we summarize the available literature, addressing the impact and physiopathological relevance of simple anthropometric tools including BMI and tissue distribution measurements. We also discuss their relationship with other nutritional parameters and their potential role in the management of patients with DLBCL.

  8. The added value of cardiac index and pulse pressure variation monitoring to mean arterial pressure-guided volume therapy in moderate-risk abdominal surgery (COGUIDE): a pragmatic multicentre randomised controlled trial.

    Science.gov (United States)

    Stens, J; Hering, J-P; van der Hoeven, C W P; Boom, A; Traast, H S; Garmers, L E; Loer, S A; Boer, C

    2017-09-01

    There is disagreement regarding the benefits of goal-directed therapy in moderate-risk abdominal surgery. Therefore, we tested the hypothesis that the addition of non-invasive cardiac index and pulse pressure variation monitoring to mean arterial pressure-based goal-directed therapy would reduce the incidence of postoperative complications in patients having moderate-risk abdominal surgery. In this pragmatic multicentre randomised controlled trial, we randomly allocated 244 patients by envelope drawing in a 1:1 fashion, stratified per centre. All patients had mean arterial pressure, cardiac index and pulse pressure variation measured continuously. In one group, healthcare professionals were blinded to cardiac index and pulse pressure variation values and were asked to guide haemodynamic therapy only based on mean arterial pressure (control group). In the second group, cardiac index and pulse pressure variation values were displayed and kept within target ranges following a pre-defined algorithm (CI-PPV group). The primary endpoint was the incidence of postoperative complications within 30 days. One hundred and seventy-five patients were eligible for final analysis. Overall complication rates were similar (42/94 (44.7%) vs. 38/81 (46.9%) in the control and CI-PPV groups, respectively; p = 0.95). The CI-PPV group had lower mean (SD) pulse pressure variation values (9.5 (2.0)% vs. 11.9 (4.6)%; p = 0.003) and higher mean (SD) cardiac indices (2.76 (0.62) l min(-1) .m(-2) vs. 2.53 (0.66) l min(-1) .m(-2) ; p = 0.004) than the control group. In moderate-risk abdominal surgery, we observed no additional value of cardiac index and pulse pressure variation-guided haemodynamic therapy to mean arterial pressure-guided volume therapy with regard to postoperative complications. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

  9. Local verification and assignment of mean normal prothrombin time and International Sensitivity Index values across various instruments: recent experience and outcome from North America.

    Science.gov (United States)

    Tange, Julie I; Grill, Diane; Koch, Christopher D; Ybabez, Roxanne J; Krekelberg, Benjamin J; Fylling, Kara A; Wiese, Cynthia R; Baumann, Nikola A; Block, Darci R; Karon, Brad S; Chen, Dong; Pruthi, Rajiv K

    2014-02-01

    Warfarin dosing relies on accurate measurements of international normalized ratio (INR), which is calculated from the prothrombin time (PT), International Sensitivity Index international sensitivity index (ISI) of the thromboplastin, and the geometric mean of normal PT (MNPT). However, ISI assignments of certain reagent/instrument combinations are frequently unavailable, especially when the reagent and instrument are not from the same manufacturer. The effort to be in compliance with widely endorsed Clinical and Laboratory Standards Institute (CLSI) guidelines by locally verifying or assigning an ISI to an unsupported reagent/instrument combination is further hindered by the lack of US Food and Drug Administration (FDA)-approved certified plasmas designated for a particular reagent/instrument combination. The objectives of the study include development of a process to verify/assign ISI and MNPT of a single thromboplastin reagent from one manufacturer across multiple instruments including several from another manufacturer and across several campuses of a single institution, the Mayo Clinic. In this study, RecombiPlasTin 2G (R2G), was evaluated on the ACL TOP 700 (IL), STA-R Evolution, STA Compact, and STA Satellite. Random normal donor samples (n = 25) were used to verify/assign MNPT. A subset of the normal donors (n = 8) and 13 warfarin pools (INR range: 1.3-3.9), created from stable warfarin patient plasma, were used for ISI verification/assignment. The manufacturer's assigned ISI was first verified on the ACL TOP 700 (reference method), then assigned on three unsupported instruments using orthogonal regression analysis. The MNPT and manufacturer assigned ISI (11.0, 0.95) were verified on the ACL TOP 700 and subsequently assigned on the STA-R Evolution (11.6, 1.04); STA Compact (11.5, 1.02); and STA Satellite (10.9, 0.99). Linear correlations of the INR results from all the four instruments demonstrated an r2 > 0.99. This process provides a reproducible approach

  10. 顾客个人价值嵌入的顾客满意度指数扩展模型%Extended Customer Satisfaction Index Model Embedded Customer Personal Value Conception

    Institute of Scientific and Technical Information of China (English)

    李艺; 马钦海; 张跃先

    2011-01-01

    The paper tries to introduce the concept which reflects customers' terminal needs into the cause-and-effect line of the customer satisfaction index, and provides the extended Customer Satisfaction Index model embedded customer personal value conception. Through empirical research on the samples from restaurants and mobile services, the analysis shows that the extended model is confirmed, customer personal value has a significant influence on customer satisfaction, and perceived quality and perceived value are the factors which affect customer personal value. The results of the study deepen the understanding of the mechanism of forming customer satisfaction and can be used as a theoretical basis for service companies to choose suitable indexes in order to appraise the ability of fulfilling customer needs and economic performance.%本文尝试将反映消费终极目的的顾客个人价值概念引入顾客满意度指数模型,提出了嵌入顾客个人价值的顾客满意度指数扩展模型.基于餐饮业和移动通讯业样本进行实证研究,结果表明所提出的扩展模型得到验证,顾客个人价值对顾客满意具有显著的影响,感知服务质量和感知顾客价值是顾客个人价值的决定因素.本研究深化了对顾客满意形成机理的认识,为服务企业评价满足消费者需求能力和经济产出质量的指标提供了理论根据.

  11. Evaluation of an IgM/IgG sensitive enzyme immunoassay and the utility of index values for the screening of syphilis infection in a high-risk population.

    Science.gov (United States)

    Wong, Ernest H; Klausner, Jeffrey D; Caguin-Grygiel, Gloria; Madayag, Carmela; Barber, Kim O; Qiu, Julia S; Liska, Sally; Pandori, Mark W

    2011-06-01

    Increasing interest in the use of enzyme immunoassays (EIA) for syphilis screening has generated a considerable need for data on the performance of such tests. We compared the performance of 1 EIA, the TREP-SURE EIA to that of the Venereal Disease Research Laboratory (VDRL) and Treponema pallidum particle agglutination assay (TPPA) in the detection of infection with Treponema pallidum. In total, 674 specimens were tested by VDRL and EIA (356 VDRL-nonreactive and 318 VDRL-reactive). All specimens that were found to be reactive by either the VDRL or EIA were subsequently analyzed by TPPA. We found that the TREP-SURE EIA was marginally less sensitive than the VDRL test for screening, but was significantly more specific. All EIA-TPPA discordant specimens were analyzed by multiple tests, including Immunoglobulin M- and G-specific Western blots and an IgM-specific EIA. Signal-to-cutoff ratios (index values) generated by the TREP-SURE EIA were also investigated. It was found that these values may be instructive regarding the interpretation of test results, as they were found to correlate strongly with the probability of positivity on a TPPA assay. Specimens that reacted positively on the EIA with very high index values were found overwhelmingly to be reactive by TPPA, perhaps obviating the need for the testing of most EIA positive specimens with a secondary treponemal test. An IgM/IgG sensitive EIA would be an effective alternative to VDRL for syphilis screening. Using the EIA index values may provide additional, helpful information to the diagnostic process.

  12. [Estimation of the population attributable fraction due to obesity in hospital admissions for flu valued according to Body Mass Index (BMI) and CUN-BAE].

    Science.gov (United States)

    Dávila-Batista, V; Carriedo, D; Díez, F; Pueyo Bastida, A; Martínez Durán, B; Martin, V

    2017-05-11

    The obesity pandemic together with the influenza pandemic could lead to a significant burden of disease. The body mass index (BMI) does not discriminate obesity appropriately. The CUN-BAE has recently been used as an estimate of body fatness for Caucasians, including BMI, gender, and age. The aim of this study is to assess the population attributable fraction of hospital admissions due to influenza, due to the body fatness measured with the BMI, and the CUN-BAE. A multicentre study was conducted using matched case-controls. Cases were hospital admissions with the influenza confirmed by the RT-PCR method between 2009 and 2011. The risk of hospital admission and the population attribuible fraction were calculated using the BMI or the CUN-BAE for each adiposity category in a conditional logical regression analysis adjusted for confounding variables. The analyzes were estimated in the total sample, in unvaccinated people, and those less than 65 years-old. A total of 472 hospitalised cases and 493 controls were included in the study. Compared to normal weight, the aOR of influenza hospital admissions increases with each level of BMI (aOR=1.26; 2.06 and 11.64) and CUN-BAE (aOR=2.78; 4.29; 5.43 and 15.18). The population attributable fraction of influenza admissions using CUN-BAE is 3 times higher than that estimated with BMI (0,72 vs. 0,27), with the differences found being similar the non-vaccinated and under 65 year-olds. The BMI could be underestimating the burden of disease attributable to obesity in individuals hospitalised with influenza. There needs to be an appropriate assessment of the impact of obesity and vaccine recommendation criteria. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Semantic Text Indexing

    Directory of Open Access Journals (Sweden)

    Zbigniew Kaleta

    2014-01-01

    Full Text Available This article presents a specific issue of the semantic analysis of texts in natural language – text indexing and describes one field of its application (web browsing.The main part of this article describes the computer system assigning a set of semantic indexes (similar to keywords to a particular text. The indexing algorithm employs a semantic dictionary to find specific words in a text, that represent a text content. Furthermore it compares two given sets of semantic indexes to determine texts’ similarity (assigning numerical value. The article describes the semantic dictionary – a tool essentialto accomplish this task and its usefulness, main concepts of the algorithm and test results.

  14. Positive predictive value between medical-chart body-mass-index category and obesity versus codes in a claims-data warehouse.

    Science.gov (United States)

    Caplan, Eleanor O; Kamble, Pravin S; Harvey, Raymond A; Smolarz, B Gabriel; Renda, Andrew; Bouchard, Jonathan R; Huang, Joanna C

    2017-09-05

    To evaluate the positive predictive value of claims-based V85 codes for identifying individuals with varying degrees of BMI relative to their measured BMI obtained from medical record abstraction. This was a retrospective validation study utilizing administrative claims and medical chart data from 1 January 2009 to 31 August 2015. Randomly selected samples of patients enrolled in a Medicare Advantage Prescription Drug (MAPD) or commercial health plan and with a V85 claim were identified. The claims-based BMI category (underweight, normal weight, overweight, obese class I-III) was determined via corresponding V85 codes and compared to the BMI category derived from chart abstracted height, weight and/or BMI. The positive predictive values (PPVs) of the claims-based BMI categories were calculated with the corresponding 95% confidence intervals (CIs). The overall PPVs (95% CIs) in the MAPD and commercial samples were 90.3% (86.3%-94.4%) and 91.1% (87.3%-94.9%), respectively. In each BMI category, the PPVs (95% CIs) for the MAPD and commercial samples, respectively, were: underweight, 71.0% (55.0%-87.0%) and 75.9% (60.3%-91.4%); normal, 93.8% (85.4%-100%) and 87.8% (77.8%-97.8%); overweight, 97.4% (92.5%-100%) and 93.5% (84.9%-100%); obese class I, 96.9 (90.9%-100%) and 97.2% (91.9%-100%); obese class II, 97.0% (91.1%-100%) and 93.0% (85.4%-100%); and obese class III, 85.0% (73.3%-96.1%) and 97.1% (91.4%-100%). BMI categories derived from administrative claims, when available, can be used successfully particularly in the context of obesity research.

  15. Comparative evaluation of bispectral index system after sedation with midazolam and propofol combined with remifentanil versus ketamine in uncooperative during dental procedures

    Directory of Open Access Journals (Sweden)

    Alireza Eshghi

    2016-01-01

    Conclusion: It can be concluded that intravenous sedation technique with PMR combination induces effective and safe sedation, with less pain and more forgetfulness and a shorter recovery time for children 3-7 years of age during dental procedures.

  16. Perbandingan Kebutuhan Propofol dan Lama Bangun antara Kombinasi Propofol-Ketamin dan Propofol-Fentanil pada Pasien yang Dilakukan Kuretase yang Diukur dengan Bispectral Index (BIS

    Directory of Open Access Journals (Sweden)

    Wirawan Anggorotomo

    2015-12-01

    Full Text Available Adequate administration of safe, easy-to-obtain, and constantly available sedatives and analgesia, is needed for pain reduction throughout curettage procedures. The goal of this study was to examine differences in propofol requirements and emergence time between propofol-ketamine and propofol-fentanyl combinations in patients undergoing curettage. A single-blind randomized controlled trial study was performed on 60 patients who underwent curettage procedures. The patients were divided into two groups: propofol-ketamine (PK and propofol-fentanyl (PF. Blood pressure, pulse rate, respiration rate, and oxygen saturation and BIS data were analysed using a t-test and Mann-Whitney test. This study showed that propofol requirements differ significantly (p<0.001 between the two groups where in PK group where 4/30 subjects received additional propofol, compared to PF group 14/30 subjects received additional propofol. The wake up time for PK group was 25.75±2.47 minutes compared to 21.08±2.52 minutes for the PF group. The difference was statistically significant (p<0.001. The conclusions of this study are propofol requirements for PK group is less compared to PF group and the emergence time for PK group is longer compared to PF group.

  17. The response of bispectral index to laryngoscopy, comparison between hemispheres in patients with a brain tumour versus a healthy control group.

    NARCIS (Netherlands)

    Wyler, B.; Wyffels, P.; de Hert, S.; Okito, Jean Pierre Kalala; Struys, Michel; Vereecke, Hugo Eric Marc

    2013-01-01

    Background and Goal of Study: Electroencephalogram during anaesthesia may be affected by brain tumour.(1) We studied whether patients with a brain tumour have different BIS responses after laryngoscopy (LAR). We compared tumour patients with healthy control patients. Materials and Methods: After EC

  18. Digital collaborative learning: identifying what students value [v1; ref status: indexed, http://f1000r.es/55h

    Directory of Open Access Journals (Sweden)

    Claire Hemingway

    2015-03-01

    Full Text Available Digital technologies are changing the learning landscape and connecting classrooms to learning environments beyond the school walls.  Online collaborations among students, teachers, and scientists are new opportunities for authentic science experiences.  Here we present findings generated on PlantingScience (www.plantingscience.org, an online community where scientists from more than 14 scientific societies have mentored over 14,000 secondary school students as they design and think through their own team investigations on plant biology.  The core intervention is online discourse between student teams and scientist mentors to enhance classroom-based plant investigations.  We asked: (1 what attitudes about engaging in authentic science do students reveal, and (2 how do student attitudes relate to design principles of the program? Lexical analysis of open-ended survey questions revealed that students most highly value working with plants and scientists.  By examining student responses to this cognitive apprenticeship model, we provide new perspectives on the importance of the personal relationships students form with scientists and plants when working as members of a research community. These perspectives have implications for plant science instruction and e-mentoring programs.

  19. The value of population pharmacokinetics and simulation for postmarketing safety evaluation of dosing guidelines for drugs with a narrow therapeutic index: buflomedil as a case study.

    Science.gov (United States)

    Bourguignon, Laurent; Ducher, Michel; Matanza, David; Bleyzac, Nathalie; Uhart, Mathieu; Odouard, Emmanuel; Maire, Pascal; Goutelle, Sylvain

    2012-04-01

    Population pharmacokinetics and simulation techniques currently play an important role in new drug development. This paper illustrates the potential value of those methods in postmarketing safety assessment, using buflomedil in elderly patients as an example. We retrospectively assessed the risk of buflomedil overdosing associated with the latest dosing recommendations of the French Drug Agency (AFSSAPS). First, buflomedil concentrations measured in 24 elderly patients were analysed with a nonparametric population approach. Then, the pharmacokinetic model was used to perform a 1000-patient Monte Carlo simulation for the two recommended buflomedil dosage regimens. The maximum concentrations calculated after 10 days of therapy were compared with levels observed in reported cases of toxicity to assess the probability of overdosing. A three-compartment model best fit concentration data. Population predictions showed little bias (-0.14 mg/L) and good precision (8.73 mg(2) /L(2)). Overall results of the simulation study showed that the application of the two recommended dosage regimens of buflomedil was associated with overdosing (C(max) > 10 mg/L) and potential toxicity in 2.9% of geriatric patients. In patients with mild renal impairment, who may receive the higher-dosage regimen by therapeutic error, the probability of overdosing was 6.2%. Despite specific dosing recommendations in case of renal impairment, this study shows that the use of buflomedil could be associated with significant risk of overdosing in geriatric patients. Such results might have enhanced decision-making when buflomedil safety was reassessed by AFSSAPS in 2006. The retrospective case of buflomedil illustrates how these methods may be valuable in postmarketing safety evaluation of potentially toxic drugs.

  20. Prognostic value of Ki67 and p53 in patients with estrogen receptor-positive and human epidermal growth factor receptor 2-negative breast cancer: Validation of the cut-off value of the Ki67 labeling index as a predictive factor

    Science.gov (United States)

    OHARA, MASAHIRO; MATSUURA, KAZUO; AKIMOTO, ETSUSHI; NOMA, MIDORI; DOI, MIHOKO; NISHIZAKA, TAKASHI; KAGAWA, NAOKI; ITAMOTO, TOSHIYUKI

    2016-01-01

    The aim of this study was to evaluate the significance of the Ki67 labeling index and p53 status as prognostic and predictive indicators of operable estrogen receptor (ER)-positive and human epidermal growth factor receptor 2 (HER2)-negative breast cancer. Among 697 consecutive patients with primary breast cancer who underwent curative surgery between 2002 and 2013, 308 patients with ER-positive and HER2-negative breast cancer were assessed. The results of the multivariate Cox analysis demonstrated that a high Ki67 labeling index was significantly associated with a short recurrence-free interval (RFI) (p=0.004) and was marginally associated with a worse overall survival (p=0.074). A positive p53 status was not associated with worse outcomes. To validate the cut-off values of the Ki67 labeling index for identifying patients who may benefit from additional chemotherapy, prognostic factors were investigated in breast cancer patients treated postoperatively with endocrine therapy alone. Analysis of receiver operating characteristic curves demonstrated that a Ki67 labeling index cut-off of 20.0% was optimal for predicting recurrence among patients who did not receive adjuvant chemotherapy. The 5-year RFIs for patients with Ki67 <20 and ≥20% were 97.2 and 86.6%, respectively (p=0.0244). A high Ki67 labeling index (≥20%) was significantly associated with large tumors (p<0.01), lymph node metastasis (p=0.0236) and positive p53 status (p<0.001). The univariate analysis demonstrated that Ki67 labeling index ≥20%, lymph node metastasis and progesterone receptor negativity were significant worse prognostic factors for RFI (p=0.0333, 0.0116 and 0.0573, respectively). The Ki67 labeling index was found to be a useful prognostic factor in patients with ER-positive and HER2-negative breast cancer and the cut-off values of the Ki67 labeling index for making a decision regarding adjuvant treatment were validated. PMID:27073684

  1. Speech Indexing

    NARCIS (Netherlands)

    Ordelman, R.J.F.; Jong, de F.M.G.; Leeuwen, van D.A.; Blanken, H.M.; de Vries, A.P.; Blok, H.E.; Feng, L.

    2007-01-01

    This chapter will focus on the automatic extraction of information from the speech in multimedia documents. This approach is often referred to as speech indexing and it can be regarded as a subfield of audio indexing that also incorporates for example the analysis of music and sounds. If the objecti

  2. Analysis on Index System of Farmer's Credit Evaluation Based on the BBC and Value Chain Risk%基于BBC与价值链风险分析的农户信用评价指标体系探析

    Institute of Scientific and Technical Information of China (English)

    杨宏玲; 郭高玲

    2011-01-01

    The purpose of this article is to evaluate the credit status which financial institutions provide loans to farmers who go back home for work. Based on the research of farmer credit evaluation analysis, the paper finds out that the farmer's credit evaluation index system mainly uses the “5C” or “4C” analysis method, which is thought less diversity. Therefore, the paper puts forward a new farmer's credit evaluation index system based on the value chain risk analysis method with balanced score card. With the personal balanced score card, based on value chain risk analysis, it finds the potential factors of farm households to repay the loan, and then constructs the farmer' s credit evaluation index system according to these factors. The new farmer's credit evaluation index system is more comprehensive and reasonable compared to the traditional.%主要针对"农民工返乡创业"这一社会现象,金融机构对其提供资金支持时,对农户信用进行评价为研究目的.通过对现有农户信用评价的研究分析,发现在构建农户信用评价指标体系时,所采用的方法主要以"5C"或"4C"分析法为模型,方法比较单一,所以,提出了基于价值链风险分析与平衡积分卡方法的农户信用评价指标体系.以个人平衡积分卡为框架,通过对农产品价值链风险分析,找出影响农户偿还贷款的潜在因素,根据这些因素来选取评价指标,构建农户信用评价指标体系.新的农户信用评价指标体系与传统的评价体系相比,更为全面、合理.

  3. 基于指标规范值的区域生态环境质量灰色聚类评价%Grey Clustering Evaluation on Regional Eco-environmental Quality Based on Normalized Index Value

    Institute of Scientific and Technical Information of China (English)

    田文鑫; 李柞泳; 刘伟; 余春雪

    2011-01-01

    [ Objective ] The aim was to assess regional eco-environmental quality by means of grey clustering method based on normalized index value. [ Method ] Eco-environmental quality in Chaohu basin was assessed by using grey clustering method based on normalizedindex value, and the evaluation results were compared with those of unascertained measure method to verify the feasibility of grey clustering method used to evaluate regional eco-environmental quality. [ Result ] In the grey clustering assessment based on normalized index value,indexes whose standard normalized values in the same grade were close to each other were classified into one class and had the same whitening function,which reduced the number of whitening functions. Grey clustering method based on normalized index value was used to assess eco-environmental quality in Chaohu basin, and the evaluation results were basically in accordance with those of unascertained measure method, namely eco-environmental quality in Hefei, Chaohu and Lu'an belonged to the third (pass), fourth (worse), fifth grade (bad),except for one grade difference in overall basin,and the results showed that the method had practicality and could be applied to assess regional eco-environmental quality. [ Conclusion ] The study could provide theoretical foundation for the establishment of comprehensive management countermeasures of regional ecological environment.%[目的]采用指标规范值的灰色聚类法对区域生态环境质量进行评价.[方法]以巢湖流域为例,介绍了基于指标规范值的区域生态环境质量灰色聚类评价法,并将评价结果与未确知测度法得出的评价结果相比较,进一步验证该方法在区域生态环境质量评价中的可行性.[结果]基于指标规范值的区域生态环境质量灰色聚类评价,将同级标准规范值相近的指标归为一类,同属一类的指标只需设计为相同的白化函数,从而大大减少了白化函数的设计个数.将指标规

  4. Eccentric connectivity index

    CERN Document Server

    Ilić, Aleksandar

    2011-01-01

    The eccentric connectivity index $\\xi^c$ is a novel distance--based molecular structure descriptor that was recently used for mathematical modeling of biological activities of diverse nature. It is defined as $\\xi^c (G) = \\sum_{v \\in V (G)} deg (v) \\cdot \\epsilon (v)$\\,, where $deg (v)$ and $\\epsilon (v)$ denote the vertex degree and eccentricity of $v$\\,, respectively. We survey some mathematical properties of this index and furthermore support the use of eccentric connectivity index as topological structure descriptor. We present the extremal trees and unicyclic graphs with maximum and minimum eccentric connectivity index subject to the certain graph constraints. Sharp lower and asymptotic upper bound for all graphs are given and various connections with other important graph invariants are established. In addition, we present explicit formulae for the values of eccentric connectivity index for several families of composite graphs and designed a linear algorithm for calculating the eccentric connectivity in...

  5. Tail risk research for Shanghai composite index based on conditional extreme value model%基于条件极值模型的上证综指尾部风险研究

    Institute of Scientific and Technical Information of China (English)

    常昊; 梁冯珍

    2013-01-01

    Based on traditional ARMA-GARCH time series models,conditional extreme value theory(EVT) model were introduced and applied to do out of sample prediction and back testing about VaR and ES for Shanghai composite index.Research showed that ARMA -GARCH model with skewed t innovations,and conditional EVT models perform well for VaR and ES prediction.%在传统ARMA-GARCH时间序列模型的基础上,介绍条件极值模型并运用这些模型对近十几年来上证综指进行VaR和ES样本外预测与事后检验.研究表明假设新息序列为偏t分布的ARMA-GARCH模型与条件极值模型在预测VaR和ES方面均具有出色效果.

  6. An improved molecular connectivity index

    Institute of Scientific and Technical Information of China (English)

    李新华; 俞庆森; 朱龙观

    2000-01-01

    Through modification of the delta values of the molecular connectivity indexes, and connecting the quantum chemistry with topology method effectively, the molecular connectivity indexes are converted into quantum-topology indexes. The modified indexes not only keep all information obtained from the original molecular connectivity method but also have their own virtue in application, and at the same time make up some disadvantages of the quantum and molecular connectivity methods.

  7. AA Index

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The geomagnetic aa index provides a long climatology of global geomagnetic activity using 2 antipodal observatories at Greenwich and Melbourne- IAGA Bulletin 37,...

  8. Walkability Index

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Walkabiliy Index dataset characterizes every Census 2010 block group in the U.S. based on its relative walkability. Walkability depends upon characteristics of...

  9. 房地产价格指数时间序列R/S分析及政策价值%A R/S Analysis on Time Series of Housing Sales Price Index and the Value of Policies

    Institute of Scientific and Technical Information of China (English)

    陈仲常; 纪同辉

    2012-01-01

    针对中国房地产泡沫和房屋销售价格时间序列的特征问题,利用基于R/S分析法的赫斯特指数作为测算的依据。对房屋销售价格指数季度数据和国房景气指数中的销售价格指数月度数据进行了对比实证研究(样本区间为1998年~2010年)。研究结果表明房屋销售价格具有明显的分形结构,并表现出状态持续性,在没有外力作用条件下,房地产泡沫风险会积累性增加。这一发现的政策价值在于明确了房地产具有消费品和投资品双重性质,不能完全依赖市场自发力量进行调节,政府也不应在泡沫风险很大时强制干预,而应采用全程监管方法,实现房地产业稳定发展的目标。%In this paper,we propose hurst index which is based on the R/S analysis to quantify the features about price time series of houses.The sales price index of National Housing boom index monthly data and housing sales price index for the quarterly data are compared with empirical research(Sample interal from 1998 to 2010).The empirical results show that the price time series of houses has obvious fractal structure;without external force,the real estate bubble will increase because of accumulated risk.The value of this discovery lies in formulate policy.Real estate,as the dual nature of the consumer goods and investment goods,can not rely on market forces to regulate the spontaneous.When the risk of real estate bubble high,the authorities should not mandatory intervene real estate market,but in order to achieve stability development goals,the full supervision should be adopted.

  10. Virginia ESI: INDEX (Index Polygons)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains vector polygons representing the boundaries of all hardcopy cartographic products produced as part of the Environmental Sensitivity Index...

  11. Louisiana ESI: INDEX (Index Polygons)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains vector polygons representing the boundaries of all the hardcopy cartographic products produced as part of the Environmental Sensitivity Index...

  12. Maryland ESI: INDEX (Index Polygons)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains vector polygons representing the boundaries of all hardcopy cartographic products produced as part of the Environmental Sensitivity Index...

  13. Prognostic value of the age-adjusted International Prognostic Index in chemosensitive recurrent or refractory non-Hodgkin's lymphomas treated with high-dose BEAM therapy and autologous stem cell transplantation.

    Science.gov (United States)

    Jabbour, E; Peslin, N; Arnaud, P; Ferme, C; Carde, P; Vantelon, J M; Bocaccio, C; Bourhis, J H; Koscielny, S; Ribrag, V

    2005-06-01

    High-dose therapy (HDT) is now recommended for patients under 60 years of age with chemosensitive relapsed aggressive non-Hodgkin's lymphoma. However, approximately half of these patients will be cured by HDT. Prognostic factors are needed to predict which patients with chemosensitive lymphoma to second-line therapy could benefit from HDT. We retrospectively investigated the prognostic value of the widely used age-adjusted International Prognostic Index (AA-IPI) calculated at the time of relapse (35 patients) or just before second-line salvage therapy for primary refractory disease (5 patients). The median age was 51 years (range 18-64 years). Thirty-six patients had diffuse large B-cell lymphoma. Salvage cytoreductive therapy before HDT was DHAP/ESHAP (cytarabine, cysplatin, etoposide, steroids) in 17 patients, VIM3-Ara-c/MAMI (high-dose cytarabine, ifosfamide, methyl-gag, amsacrine) in 17 patients, CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) or reinforced CHOP in 4 patients, high-dose cyclophosphamide and etoposide in 2 patients. The HDT regimen consisted of BEAM (carmusine, cytarabine, etoposide, melphalan) in all cases. Eleven patients were in partial remission and 29 in complete remission at the time of HDT. Ten patients had an IPI >1, 16 had relapsed early (6 months after first-line chemotherapy) (P=1), but the AA-IPI >1 was associated with a poor outcome (P=0.03). In conclusion, the AA-IPI could have a prognostic value in patients with chemosensitive recurrent lymphoma treated with BEAM HDT.

  14. 低血糖指数膳食在妊娠期糖尿病营养治疗的应用价值%The Application Value of Low Glycemic Index Dietary in the Treatment of Gestational Diabetes Mellitus

    Institute of Scientific and Technical Information of China (English)

    王晓娟; 严宗逊

    2016-01-01

    Objective: To analyze the application value of low glycemic index dietary in the treatment of gestational diabetes mellitus.Methods: From January 2015 to January 2016,the data of 128 patients with ges-tational diabetes admitted in gynecology clinic of our hospital were analyzed retrospectively .The control group (58 cases) were given general nutrition intervention, and the intervention of low blood sugar index (cases) was established as the study group (70 cases), and the results were recorded and analyzed .Results:The car-bohydrate intaking and dietary GI in the study group were lower than those in the control group , and the fat in-taking was higher than that in the control group .The difference was statistically significant (P <0.05).Con-clusion: During pregnancy, diabetes with low blood sugar index in dietary nutrition therapy can effectively control blood sugar.%目的:分析低血糖指数膳食在妊娠期糖尿病营养治疗的应用价值。方法:选取我院2015年1月至2016年1月孕妇门诊收治的128例妊娠期糖尿病患者予以回顾性分析,设计治疗方案时将予以普通营养干预的设为对照组(58例),将行低血糖指数膳食为特征营养干预的设为研究组(70例),记录并分析结果。结果:研究组碳水化合物摄入供热与膳食 GI 均低于对照组,且脂肪摄入供热高于对照组,比较差异具有统计学意义(P<0.05)。结论:妊娠期糖尿病营养治疗中予以低血糖指数膳食可有效控制血糖。

  15. 尿中氧化应激指标作为学生体检中测定指标的意义%Value of urine oxidative stress index as a biomarker in student health examination

    Institute of Scientific and Technical Information of China (English)

    郭琪; 吕兆阳; 任艳苹; 王家仲

    2013-01-01

    [Objective] To explore the value of urine oxidative stress index as a biomarker in student health examination. [ Methods ] Through morning urine collection of 34 obesity college students with body mass index ( BMI) over 30, the urinary sodium, creatinine, oxidative stress indices (H2O2 and thiobarbituric acid reactive substances (TBARS) were determined. [Results] The urine TBARS level was significantly correlated with daily salt intake, obesity , blood pressure , blood lipids(P <0. 05). [ Conclusion] It is recommended that the urine oxidative stress index (urine TBARS excretion) as a biomarker in student health examination which can provide specific guidance in lifestyle of the student population with quantitative data basis, at the same time as a risk factor for cardiovascular disease can deepen students'understanding of cardiovascular disease hazards as quantization marker.%目的 探讨尿中氧化应激指标作为学生体检中测定指标的意义.方法 通过对体重指数(BMI)30以上的肥胖大学生34人进行晨尿采集,测定尿钠、肌酐、氧化应激指标[(H202和硫代巴比妥酸反应产物(TBARS)],观察尿中氧化应激水平和摄盐量(通过晨尿钠和肌酐公式测算)及现有体检指标(肥胖、血压、血脂等)的关系.结果 尿中TBARS排泄量和日食盐摄入量、肥胖、血压、血脂之间有统计学意义的相关性(P<0.05).结论 建议学生体检中增加尿中TBARS排泄量测定,可以为学生人群的具体生活方式的指导提供量化的数据依据,同时作为一个心血管疾病的危险因子可以加深学生对心血管等疾病危害性的量化认识.

  16. Browse Title Index

    African Journals Online (AJOL)

    Items 101 - 150 of 490 ... Vol 197 (2003), Determination of land and tree values of hybrid poplar ... Vol 76, No 1 (2014), Dynamic base-age invariant site index models for ... nitens hybrid clonal trials and their response to snow events, Abstract.

  17. Browse Title Index

    African Journals Online (AJOL)

    Items 151 - 200 of 411 ... Browse Title Index ... Issue, Title ... Vol 1, No 1 (2012), From Theory into Practice: Theatre-in-Education and Child ... Vol 1, No 4 (2012), Inflation - Adjusted Accounting and Corporate Value Redefinition: Fixing Nigeria ...

  18. INDEXING MECHANISM

    Science.gov (United States)

    Kock, L.J.

    1959-09-22

    A device is presented for loading and unloading fuel elements containing material fissionable by neutrons of thermal energy. The device comprises a combination of mechanical features Including a base, a lever pivotally attached to the base, an Indexing plate on the base parallel to the plane of lever rotation and having a plurality of apertures, the apertures being disposed In rows, each aperture having a keyway, an Index pin movably disposed to the plane of lever rotation and having a plurality of apertures, the apertures being disposed in rows, each aperture having a keyway, an index pin movably disposed on the lever normal to the plane rotation, a key on the pin, a sleeve on the lever spaced from and parallel to the index pin, a pair of pulleys and a cable disposed between them, an open collar rotatably attached to the sleeve and linked to one of the pulleys, a pin extending from the collar, and a bearing movably mounted in the sleeve and having at least two longitudinal grooves in the outside surface.

  19. Determinación del valor normal del índice de Tei del ventrículo izquierdo en caninos sanos Determination of the normal value of the left ventricular Tei index in healthy dogs

    Directory of Open Access Journals (Sweden)

    C. Lightowler

    2006-12-01

    Full Text Available Estudios recientes han demostrado que en la mayoría de los pacientes con insuficiencia cardiaca congestiva coexisten tanto alteración de la función sistólica como disfunción de la diastólica y, en muchos casos, la función sistólica se encuentra normal y la insuficiencia cardiaca esta sustentada solamente por la disfunción diastólica, hecho que tiene implicancias diagnósticas, terapéuticas y pronósticas. Recientemente, Tei y colaboradores propusieron un nuevo índice Doppler que permite el estudio combinado de algunos de los intervalos sistólicos y diastólicos. En base a estos antecedentes los autores determinaron el valor normal del índice de Tei para el ventrículo izquierdo en caninos sanos con el objeto de utilizar dicho valor como índice de la función sistodiatólica. Se obtuvo un valor medio de 0,372 con un desvío estándar de 0,04. Asimismo pudo verificarse que no existe correlación con la frecuencia cardiaca (P> 0,0975 ni con la tensión arterial sistólica (P> 0,0895 pero si con el acortamiento fraccional del ventrículo izquierdo (PRecent studies have showed that in the majority of the patients with congestive cardiac failure coexist alteration of systolic and diastolic function and in many cases the systolic function is normal and the cardiac failure this supported only by the diastolic dysfunction. This fact has therapeutic, diagnostic and prognostic implications. Recently, Tei and co-workers proposed a new Doppler index that permits the combined evaluation of some of the systolic and diastolic intervals. Supported by these antecedents the authors determined the normal value of the left ventricular Tei index in healthy dogs in order to evaluate the systodiatolic function. A mean value of 0,372 with a standard deviation of 0,04 was obtained. Likewise the authors could verified that not correlation exists with cardiac rate (P> 0,0975 neither with the systolic arterial pressure (P> 0,0895 but a significant correlation

  20. Fasting serum leptin levels in the analysis of body mass index cut-off values: are they useful for overweight screening in children and adolescents? A school population-based survey in three provinces of central Italy.

    Science.gov (United States)

    Falorni, A; Galmacci, G; Bini, V; Papi, F; Molinari, D; De Giorgi, G; Faraoni, F; Celi, F; Di Stefano, G; Berioli, M G; Contessa, G; Bacosi, M L

    1998-12-01

    Body mass index (BMI) was determined in a population of school students from three provinces of central Italy. Fasting serum leptin concentrations were assayed in a large number of subjects from the same area, to determine their distribution as plotted against the standard deviation score (z-score) of BMI. Height and weight were recorded from 31170 subjects (16175 male and 14995 female), aged 3-18 y, to construct BMI charts of children and adolescents from central Italy. Percentiles and z-score were calculated using the LMS method of Cole. Serum leptin concentrations were assayed in 1929 subjects (996 male and 933 female) after overnight fasting. BMI percentiles of central Italy were higher than those from standards of other European and USA populations. When plotted against the z-score of BMI, serum leptin values were distributed according to an exponential curve, showing a steep pattern and a wide distribution, as BMI values increased. The hypothesis of the existence of two subgroups, based on a different relation between leptin and BMI, was verified and a separation point between the two subgroups was identified using cluster analysis, discriminant analysis and a novel method developed by our group, hereafter referred to as 'regression clustering'. This method allows identification of the value of the independent variable (z-score of BMI) which can be taken as a separation point. This analysis provided the best results and indicated the following separation points: central Italy standard, z-score = 0.72 (76.4th percentile) for males and z-score = 0.69 (75.5th percentile) for females; French standard (the one suggested for a European population by the European Childhood Obesity Group, ECOG), z-score = 1.46 (92.8th percentile) for males and z-score = 1.96 (97.5th percentile) for females. Similar but variable results were obtained when the same analysis was performed on serum leptin concentration, subdivided according to pubertal development (stage I, stage II

  1. 末梢灌注指数与全身麻醉患者血流动力学及儿茶酚胺的相关性%Correlation of tip perfusion index with hemodynamics and catechalomines in patients undergoing general anesthesia

    Institute of Scientific and Technical Information of China (English)

    李淑琴; 罗宝蓉; 王保国

    2008-01-01

    Objective To explore the correlation of tip perfusion index (TPI) with the hemodynamics and catechalomines and to assess the value and meaning of TPI for monitoring stress responses in general anesthesia. Methods Twenty patients who were to receive selective neurosurgery underwent induction and maintenance of propofol and remifentanil by target controlled infusion (TCI). A 60mA-5OHz5s electrostimulus was applied before tracheal intubation and head holder setting respectively. TPI, SBP,diastolic blood pressure (DBP), heart rate (HR), and bispectral index (BIS) were recorded at nine time points: before induction (baseline), before and after electrostimulation, before and after tracheal intubation, before and after electrostimulation, and before and after head holder setting. The changes of parameters (△TPI,△SBP,△DBP,△HR, and △BIS) were calculated after each stimulation. Five out of 20 patients were selected randomly to monitor the plasma concentration of catecholamine at the above time points. The responses to tracheal intubation and head holder setting were defined as the SBP increasing >15mm Hg over the baseline value. Results △TPI was significantly correlated with △SBP and △DBP (r=0.623 and 0.317, P0.05).电刺激后ATPI小于刺激前TPI10%的患者,气管插管和上头架反应显著减少.TPI与NE和E负相关(r值分别为-0.679和-0.364,P值分别<0.01和0.05).结论 (1)应激引起TPI变化与血压变化密切相关,而且电刺激后TPI变化对气管插管后和上头架后血压变化有一定预测作用.(2),TPI变化间接反映了血浆NE的水平.

  2. Body mass index values for newborns according to gestational age Valores de Índice de Masa Corporal en recién nacidos de acuerdo con la edad gestacional

    Directory of Open Access Journals (Sweden)

    R. S. Brock

    2008-10-01

    Full Text Available Objective: The combination of twho anthropometric parameters has been more appropriate to assess body composition and proportions in children, with special attention to the Body Mass Index (BMI, as it relates weight and length. However the BMI values for the neonatal period have not been determined yet. This study shows the BMI for newborns at different gestational ages represented in a normal smoothed percentile curve. Methods: Retrospective study including 2,406 appropriate for gestational age newborns following the Alexander et al curve (1996 from 29 to 42 weeks of gestational age. Weight and lenght were measured following standard procedures. For the construction aof a normal smoothed percentile curve, the 3rd, 5th, 10th, 25th, 50th, 75th, 90th and 95th percentiles were determined and a statistical procedure based on the mathematical model "sinosuoidal fit" was applied to establish a curve that estimates biological growth parameters. Results: The Body Mass Index values for gestational age in all percentiles shows a steady increase up to 38 weeks, levels off up to the 40th week, followed by a slight decrease to the 42nd week in both genders. Conclusion: The results show a direct correlation between gestational age and Body Mass Index for both genders in the nine percentiles, and can provide a useful reference to assess intra-uterine proportional growth.Objetivo: La combinación de dos parámetros antropométricos ha sido descrita como una manera más apropiada para determinar la composición y proporciones del cuerpo en niños, con especial atención para el índice de masa corporal (IMC, pues relaciona el peso y la estatura. Sin embargo, los valores del IMC para el periodo neonatal no han sido determinados todavía. Este estudio muestra el IMC para recién nacidos de diversas edades gestacionales presentados en una curva de percentiles suavizados. Métodos: En un estudio retrospectivo incluyendo 2.406 recién nacidos apropiados para la edad

  3. 不同撤机指标对慢性阻塞性肺疾病患者撤机的预测价值研究%The predictive value of different index on COPD patients in weaning process

    Institute of Scientific and Technical Information of China (English)

    段俊峰; 陈小菊; 王涛; 张文波; 向小均

    2014-01-01

    Objective To compare the predictive effect of different index on chronic obstructive pulmonary disease (COPD) patients in weaning process.Methods Seventeen patients with COPD after mechanical ventilation for at least 48 hours who were ready for weaning were enrolled.All patient accepted 2 hours spontaneous breathing trial under the T-piece.The airway occlusion pressure (P0.1),maximal inspiratory pressure (Pimax) and rapid shallow breathing index (RSBI) were detected at 30 minutes after spontaneous breathing trial.The clinical value of P0.1,Pimax and RSBI index for prognosis of successful weaning from COPD patients were assessed.Results Ten patients were successfully weaned from ventilation,and seven patients were difficulty weaned from ventilation.P0.1 and RSBI in weaning success group were lower than those in weaning failure group (P <0.05).Pimax in weaning success group was higher than that in weaning failure group (P <0.05).P0.1 was superior to RSBI and Pimax in predicting weaning outcomes from COPD patients,which sensitivity was 89%,the specificity was 75%,and the accuracy was 82%.They were higher than those of Pimax and RSBI.Conclusions The RSBI,P<1 and Pimax are valuable predictor for the patients with COPD to wean from mechanical ventilation,and the predicting value of P0.1 is the biggest.%目的 比较不同撤机指标对COPD患者撤机的预测价值.方法 选取机械通气48 h以上且已达到撤机标准的17例COPD患者,采用T型管方法进行自主呼吸试验2h,在自主呼吸试验进行30 min时检测气道闭合压(P0.1)、最大吸气压(Pimax)和呼吸浅快指数(RSBI)值,探讨它们在预测COPD患者撤机中的价值.结果 10例COPD患者撤机成功,7例失败.成功组患者的P0.1和RSBI值明显小于失败组,而Pimax值则明显大于失败组,其差异均具有显著统计学意义(P<0.05).P0.1预测COPD患者撤机的价值明显优于Pimax和RSBI,其灵敏度、特异性和准确性均

  4. Afghanistan Index

    DEFF Research Database (Denmark)

    Linnet, Poul Martin

    2007-01-01

    The Afghanistan index is a compilation of quantitative and qualitative data on the reconstruction and security effort in Afghanistan. The index aims at providing data for benchmarking of the international performance and thus provides the reader with a quick possibility to retrieve valid...... basis. The data are divided into different indicators such as security, polls, drug, social, economic, refugees etc. This represents a practical division and does not indicate that a picture as to for instance security can be obtained by solely looking at the data under security. In order to obtain...... a more valid picture on security this must incorporate an integrated look on all data meaning that for instance the economic data provides an element as to the whole picture of security....

  5. SUBJECT INDEX

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    2, 4, 6-trinitrobenzenesulphonic acid, zinc sulfate, experimental colitis, 2003328AC133 antigen, hematopoietic stem cells, fetal blood, immunophe-notyping, 2003138ALR2 gene, eNOS gene, PON1 gene, RAGE gene, 2003179 ATN-ISI, prognosis, acute renal failure, acute tubular necrosis-individual severity index, acute physiology and chronic health evaluation, 2003118 Alzheimer disease, interleukin-1 beta, tumor necrosis factor alpha,

  6. 基于味觉活力值的烟气苦味指数模型的建立%Establishment of Bitterness Index Model for Tobacco Smoke Based on Taste Active Values

    Institute of Scientific and Technical Information of China (English)

    冒德寿; 刘强; 李智宇; 蔡柄彪; 侯春; 王凯; 洪鎏; 曲荣芬; 李海涛

    2015-01-01

    为研究烟气苦味的物质基础及作用模式,以食品风味学苦味机理和苦味物质基础为指导,采用味觉活力值法,对51个烟叶样品烟气中13种生物碱及相关碱性物质(统称为生物碱)含量、苦味阈值和味觉活力值(Taste active value,TAV)进行检测或计算,建立了烟气苦味指数模型,并与感官评价进行了拟合研究。结果表明:①13种生物碱标准工作曲线的线性关系良好(R2>0.99),相对标准偏差(RSD)≤10%,加标平均回收率(n=5)处于79.51%~94.80%之间,建立的烟气生物碱检测方法满足实际定量需求。②13种生物碱对烟气苦味均有贡献,麦斯明、假木贼碱和烟碱贡献率较大,TAV值均大于20,以麦斯明的贡献最大;可替宁、降烟碱、烟碱烯、吲哚和吡啶的TAV值处于2~20之间,贡献次之,而3-乙基吡啶、喹啉、异喹啉、新烟草碱和2,3′-联吡啶的TAV值<2,贡献较小。③以13种生物碱味觉活力值为基础建立的烟气苦味指数模型,与感官评价结果的拟合效果理想。%In order to investigate the substance basis and action mode of tobacco smoke bitterness, by referring to the bitter mechanism and bitter substance basis in food flavor science, the contents, bitterness thresholds and taste active values (TAVs) of 13 alkaloids in smoke of 51 tobacco samples were determined or calculated with taste active value method, a bitterness index model for tobacco smoke was established, the model was further verified with sensory evaluation. The results showed that: 1) The calibration curves of the 13 alkaloids displayed good linearity with the correlation coefficients (R2) above 0.99, the average recoveries (n=5) ranged from 79.51 to 94.80% with the relative standard deviations (RSD, n=5) ≤10%. The developed method was suitable for quantitative determination of smoke alkaloids. 2) Myosmine, anabasine and nicotine made major contribution to

  7. Value of coma evaluating approaches in predicting prognosis of patients after cardiopulmonary resuscitation%不同昏迷评估方法判定心肺复苏成功患者预后的价值

    Institute of Scientific and Technical Information of China (English)

    张明; 钱俊英; 李涛; 解建; 徐拥庆; 姜志明

    2012-01-01

    目的 探讨昏迷的客观评估方法和主观评估方法判定心脏骤停后心肺复苏成功患者预后的价值.方法 选择心脏骤停后心肺复苏成功的昏迷患者39例,复苏后24h内行脑电双频指数(BIS)监测,同时进行格拉斯哥昏迷量表(GCS)评分和GCS-Pittsburgh评分,观察其6个月时的预后,并分析不同评估方法判定预后的价值.结果 6个月后,预后良好11例,预后不良28例.三种评估方法的预后不良组分值均明显低于预后良好组(P均<0.05);患者运动反应、对光反射、脑干反射及自主呼吸消失判断预后不良的敏感性均为100%,其中脑干反射的敏感性和特异性均较高;BIS监测判断预后不良的特异性、阳性预测值和准确性显著高于GCS-Pittsburgh评分(P<0.05).结论 三种昏迷评估方法均可判定心肺复苏后昏迷患者预后,但客观评估方法BIS监测对预后不良的判定价值优于主观评估方法.%Objective To determine the value of the objective bispectral index (BIS) and the subjective GCS and GCS-Pittsburgh score in evaluating the prognosis of comatose patients after cardiopulmonary resuscitation (CPR) because of cardiac arrest. Methods A total of 39 comatose patients after successful CPR because of cardiac arrest were included. BIS, CCS and GCS-Pittsburgh value were recorded within 24 hours after CPR, then to observe the prognosis for six months, analyze and evaluate the value of different approachs in predicting prognosis. Results After six months, 11 cases were in bad-prognosis group, 28 cases in good-prognosis group. The evaluation values of bad-prognosis group were lower than those of good-prognosis group ( P < 0.05 ). The sensitivity of vanish of motor reaction, light reflex, brainstem reflex and spontaneously breathing were 100% to predict bad-prognosis. The sensitivity and specificity of brainstem reflex were both high. The specificity, positive predictive and accuracy values of BIS were higher

  8. Beyond the Kubler index

    Science.gov (United States)

    Eberl, D.D.; Velde, B.

    1989-01-01

    The value of peak width at half-height for the illite 001 XRD reflection is known as the Kubler index or the illite "crystallinity' index. This measurement, which has been related to the degree of metamorphism of very low-grade, pelitic rocks, is a function of at least two crystal-chemical factors: 1) illite X-ray scattering domain size; and 2) illite structural distortions (especially swelling). Reynolds' NEWMOD computer program is used to construct a grid with which these two contributions to illite peak width can be determined independently from measurements of the 001 peak width at half-height and the Srodon intensity ratio. This method yields more information about changes undergone by illite during metamorphism than application of the Kubler index method alone. -Authors

  9. The Value of Value

    DEFF Research Database (Denmark)

    Sørensen, Asger

    parts of business ethics given prominence to especially one term, namely `value'. The question that interests me is the following: What does the articulation of ethics and morality in terms of values mean for ethics and morality as such. Or, to put the question in a more fashionably way: What...... is the value of value for morality and ethics?To make things a bit more precise, we can make use of the common distinction between ethics and morality, i.e. that morality is the immediate, collective and unconscious employment of morals, whereas ethics is the systematic, individual and conscious reflections...

  10. 熵指数和脑电双频指数与麻醉镇静深度38例临床观察%The relationship observation of entropy index and bispectral index and anaesthesia calm depth

    Institute of Scientific and Technical Information of China (English)

    贾树山; 刘强; 张勇; 姚光; 王耀岐

    2008-01-01

    目的 比较熵指数和脑电双频指数(BIS)与丙泊酚镇静深度的相关性.方法 38例患者入室后在丙泊酚麻醉诱导直至患者对指令性反应消失后,观察丙泊酚镇静深度的评价不同镇静/ 警觉评分(OAA/S)时RE、SE和BIS 的变化.结果 OAA/ S 评分与反应熵(RE)、状态熵(SE)和BIS 的相关系数分别为rRE =0. 7643 、rSE = 0.7372 和rBIS = 0.8602 , rBIS与rRE和rSE之间差异均有统计学意义,( P<0.01),而rRE与rSE之间差异无显著意义.结论 研究发现熵指数和BIS与OAA/ S评分均具有良好的相关性.

  11. Predictive Value of Beat-to-Beat QT Variability Index across the Continuum of Left Ventricular Dysfunction: Competing Risks of Non-cardiac or Cardiovascular Death, and Sudden or Non-Sudden Cardiac Death

    Science.gov (United States)

    Tereshchenko, Larisa G.; Cygankiewicz, Iwona; McNitt, Scott; Vazquez, Rafael; Bayes-Genis, Antoni; Han, Lichy; Sur, Sanjoli; Couderc, Jean-Philippe; Berger, Ronald D.; de Luna, Antoni Bayes; Zareba, Wojciech

    2012-01-01

    Background The goal of this study was to determine the predictive value of beat-to-beat QT variability in heart failure (HF) patients across the continuum of left ventricular dysfunction. Methods and Results Beat-to-beat QT variability index (QTVI), heart rate variance (LogHRV), normalized QT variance (QTVN), and coherence between heart rate variability and QT variability have been measured at rest during sinus rhythm in 533 participants of the Muerte Subita en Insuficiencia Cardiaca (MUSIC) HF study (mean age 63.1±11.7; males 70.6%; LVEF >35% in 254 [48%]) and in 181 healthy participants from the Intercity Digital Electrocardiogram Alliance (IDEAL) database. During a median of 3.7 years of follow-up, 116 patients died, 52 from sudden cardiac death (SCD). In multivariate competing risk analyses, the highest QTVI quartile was associated with cardiovascular death [hazard ratio (HR) 1.67(95%CI 1.14-2.47), P=0.009] and in particular with non-sudden cardiac death [HR 2.91(1.69-5.01), P<0.001]. Elevated QTVI separated 97.5% of healthy individuals from subjects at risk for cardiovascular [HR 1.57(1.04-2.35), P=0.031], and non-sudden cardiac death in multivariate competing risk model [HR 2.58(1.13-3.78), P=0.001]. No interaction between QTVI and LVEF was found. QTVI predicted neither non-cardiac death (P=0.546) nor SCD (P=0.945). Decreased heart rate variability (HRV) rather than increased QT variability was the reason for increased QTVI in this study. Conclusions Increased QTVI due to depressed HRV predicts cardiovascular mortality and non-sudden cardiac death, but neither SCD nor excracardiac mortality in HF across the continuum of left ventricular dysfunction. Abnormally augmented QTVI separates 97.5% of healthy individuals from HF patients at risk. PMID:22730411

  12. Predictive value of beat-to-beat QT variability index across the continuum of left ventricular dysfunction: competing risks of noncardiac or cardiovascular death and sudden or nonsudden cardiac death.

    Science.gov (United States)

    Tereshchenko, Larisa G; Cygankiewicz, Iwona; McNitt, Scott; Vazquez, Rafael; Bayes-Genis, Antoni; Han, Lichy; Sur, Sanjoli; Couderc, Jean-Philippe; Berger, Ronald D; de Luna, Antoni Bayes; Zareba, Wojciech

    2012-08-01

    The goal of the present study was to determine the predictive value of beat-to-beat QT variability in heart failure patients across the continuum of left ventricular dysfunction. Beat-to-beat QT variability index (QTVI), log-transformed heart rate variance, normalized QT variance, and coherence between heart rate variability and QT variability have been measured at rest during sinus rhythm in 533 participants of the Muerte Subita en Insuficiencia Cardiaca heart failure study (mean age, 63.1±11.7; men, 70.6%; left ventricular ejection fraction >35% in 254 [48%]) and in 181 healthy participants from the Intercity Digital Electrocardiogram Alliance database. During a median of 3.7 years of follow-up, 116 patients died, 52 from sudden cardiac death (SCD). In multivariate competing risk analyses, the highest QTVI quartile was associated with cardiovascular death (subhazard ratio, 1.67 [95% CI, 1.14-2.47]; P=0.009) and, in particular, with non-SCD (subhazard ratio, 2.91 [1.69-5.01]; P<0.001). Elevated QTVI separated 97.5% of healthy individuals from subjects at risk for cardiovascular (subhazard ratio, 1.57 [1.04-2.35]; P=0.031) and non-SCD in multivariate competing risk model (subhazard ratio, 2.58 [1.13-3.78]; P=0.001). No interaction between QTVI and left ventricular ejection fraction was found. QTVI predicted neither noncardiac death (P=0.546) nor SCD (P=0.945). Decreased heart rate variability rather than increased QT variability was the reason for increased QTVI in the present study. Increased QTVI because of depressed heart rate variability predicts cardiovascular mortality and non-SCD but neither SCD nor extracardiac mortality in heart failure across the continuum of left ventricular dysfunction. Abnormally augmented QTVI separates 97.5% of healthy individuals from heart failure patients at risk.

  13. Value of bath ankylosing spondylitis disease activity index and mini-bath ankylosing spondylitis disease activity index for diagnosis of ankylosing spondylitis%比较BASDAI和mini-BASDAI对强直性脊柱炎病情的判断价值

    Institute of Scientific and Technical Information of China (English)

    杜旭娜; 李晏; 张胜利; 朱剑; 黄烽

    2012-01-01

    Objective To assess the value of bath ankylosing spondylitis disease activity index(BASDAI) and mini-BASDAI for diagnosis of ankylosing spondylitis(AS). Methods Patients with AS were divided into "P+" group and "P-" group according to the involvement of their peripheral joints. BASDAI was used to assess the disease activity of patients with ankylosing spondylitis and mini-BASDAI was calculated by omitting questions 3 and 4 in BASDAI. Results A total of 264 AS patients were included in this study. The BASDAI, mini-BASDAI, BASFI, BASMI, ESR, and CRP were significantly higher in "P+" group than in "P-" group. The value of mini-BASDAI was higher than that of BASDAI in both groups. However, no significant difference was found in other markers of disease activity between the two groups. Conclusion Mini-BASDAI is not advantageous to BASDAI in assessing disease activity of patients without involvement of peripheral joints and BASDAI remains a valid indication.%目的 评价Bath 强直性脊柱炎病情活动指标(bath ankylosing spondylitis disease activity index,BASDAI) 和改良的BASDAI 即mini-BASDAI 在评价无外周关节受累的强直性脊柱炎(ankylosing spondylitis,AS) 的病情活动度时的价值.方法 根据是否有外周关节受累,将患者分为P+ 组(有外周关节受累) 和P- 组(无外周关节受累).采用BASDAI 对患者的疾病活动度进行评价,然后再省略BASDAI 中的第3、4 个问题计算出mini-BASDAI.结果 本研究共纳入264 例AS 患者.有P+ 组的患者其各项炎症指标(BASDAI、miniBASDAI、Bath 强直性脊柱炎功能指数(bath ankylosing spondylitis functionalindex,BASFI)、Bath 强直性脊柱炎计量指数(bath ankylosing spondylitis metrology index,BASMI)、血沉、C- 反应蛋白) 均显著高于P- 组患者.两组mini-BASDAI 值均高于BASDAI,但两者与其他疾病活动度评价指标之间的相关性并无差异,如医生总体评价与BSADAI 的相关系数为0.703,与mini-BASDAI

  14. Adding value(s)

    DEFF Research Database (Denmark)

    Carré, David

    2015-01-01

    , 1992). In response, behavioral economics (Camerer, 1999) has shown that agents have values other than optimization underpinning their decisions. Therefore, concerns arose regarding which values are guiding the agent but not about how such values became relevant for the agent. In this presentation, I......Most economic inquires revolve around agents making decisions. Getting the ‘best value’, it is assumed, drives such decisions: gaining most while risking least. This assumption has been debunked by showing that people does not always choose neither maximum benefit nor less risk (Kahneman & Tversky...... will explore the consequences of shifting to the latter perspective, i.e. looking for the generative framework of values. Here I argue that economic behavior should also be seen as a sense-making process, guided by values that are chosen/rejected along with fellow human beings, in specific socio...

  15. Toe-branchial Index:Values in Diagnosis of Lower Extremity Arterial Diseases of Early DM%趾臂指数诊断早期糖尿病下肢血管病变的价值研究

    Institute of Scientific and Technical Information of China (English)

    王莉; 杨彩哲; 王良宸; 关小宏; 张妲; 陈莹; 王敏

    2014-01-01

    Objective To investigate the values of toe - brachial index(TBI)in diagnosis of lower extremity arterial disease(LEAD)in patients with early diabetes mellitus(DM). Methods A total of 265 T2DM patients hospitalized in de-partment of endocrinology,Air Force General Hospital from June 2012 to August 2013 had ankle branchial index(ABI)and TBI measurement and were divided according to TBI scores,into groups low TBI(L - TBI group,TBI ﹤ 0. 07),normal TBI(N -TBI group,TBI ≥0. 7). The general information and clinical indicators including gender,age,BMI,duration diabetes, smoking history,complications and comorbidities〔 hypertension,coronary heart disease( CHD),cerebrovascular diseases (CVD),diabetic foot(DF)〕,total cholesterol(TC),low density lipoprotein cholesterol(LDL - C),high density lipopro-tein cholesterol(HDL - C),triglycerides(TG),fibrinogen(FIB),glycated hemoglobin(HbA1c )were collected,and dia-betes control rate was analyzed. ABI≤0. 9 was taken as the gold standard for LEAD to evaluate the related indicators of TBI ﹤0. 07 diagnosing LEAD(sensitivity,specificity,positive predictive value,negative predictive value,positive likelihood ratio, negative likelihood ratio). Kappa test was used to assess the consistency between TBI,ABI. Results There were 138 patients in N - TBI group,127 in L - TBI group. There was significant difference in age,duration of diabetes,incidences of hyperten-sion,CHD,DF and CVD,FIB between 2 groups(P ﹤ 0. 05). Serum lipid parameters were measured in 121 of L - TBI group, in 137 of N - TBI group. The control rates of TC,LDL - C were higher in L - TBI group than in N - TBI group(P ﹤ 0. 05). HbA1c was detected in 120 of L - TBI group,26 reached the goal(21. 7% ),and in 131 of N - TBI group,24 reached the goal (18. 3% );the difference was not significant( χ2 = 0. 44,P = 0. 51). The sensitivity of TBI ﹤ 0. 7 diagnosing LEAD was 81. 8% (63 / 77),specificity 71. 5% (313 / 438),the positive predictive value was 33. 5% (63 / 188

  16. Value of tissue Doppler-derived Tei index and two-dimensional speckle tracking imaging derived longitudinal strain on predicting outcome of patients with light-chain cardiac amyloidosis.

    Science.gov (United States)

    Liu, Dan; Hu, Kai; Herrmann, Sebastian; Cikes, Maja; Ertl, Georg; Weidemann, Frank; Störk, Stefan; Nordbeck, Peter

    2017-06-01

    Prognosis of patients with light-chain cardiac amyloidosis (AL-CA) is poor. Speckle tracking imaging (STI) derived longitudinal deformation parameters and Doppler-derived left ventricular (LV) Tei index are valuable predictors of outcome in patients with AL-CA. We estimated the prognostic utility of Tei index and deformation parameters in 58 comprehensively phenotyped patients with AL-CA after a median follow-up of 365 days (quartiles 121, 365 days). The primary end point was all-cause mortality. 19 (33%) patients died during follow-up. Tei index (0.89 ± 0.29 vs. 0.61 ± 0.16, p < 0.001) and E to global early diastolic strain rate ratio (E/GLSRdias) were higher while global longitudinal systolic strain (GLSsys) was lower in non-survivors than in survivors (all p < 0.05). Tei index, NYHA functional class, GLSsys and E/GLSRdias were independent predictors of all-cause mortality risk, and Tei index ≥0.9 (HR 7.01, 95% CI 2.43-20.21, p < 0.001) was the best predictor of poor outcome. Combining Tei index and GLSsys yielded the best results on predicting death within 1 year (100% with Tei index ≥0.9 and GLSsys ≤13%) or survival (95% with Tei index ≤0.9 and GLSsys ≥13%). We conclude that 1-year mortality risk in AL-CA patients can be reliably predicted using Tei index or deformation parameters, with combined analysis offering best performance.

  17. Value of Mentzer index in differentiation between alpha thalassemia carriers and iron deficiency anemia%Mentzer指数在鉴别轻型α地中海贫血与缺铁性贫血中的价值

    Institute of Scientific and Technical Information of China (English)

    梅敏; 帅虎; 朱甫津; 谭尚华

    2011-01-01

    Objective To evaluates the value of Mentzer index ( MI ) in differentiating alpha thalassemia carriers from iron deficiency anemia.Methods The data on alpha thalassemia gene,blood cell count,and serum levels of iron and ferritin were retrospectively analyzed in 151 patients with reduced hemoglobin A2( HbA2 )levels on hemoglobin electrophoresis.Based on α -globin gene analysis and levels of iron and ferritin,the patients were assigned to alpha thalassemia carriers group ( n =90 ),or iron deficiency anemia group ( n =61 ).Results MI differed significantly between iron deficiency anemia group and alpha thalassemia carriers with normal iron group ( P < 0.01 ),iron deficiency anemia group and alpha thalassemia carriers with iron deficiency group ( P< 0.01 ),iron deficiency anemia group and alpha thalassemia carriers group ( P < 0.01 ); but did not differ significantly between alpha thalassemia carriers with normal iron group and alpha thalassemia carriers with iron deficiency group ( P> 0.05 ).The area under the curve ( AUC ) for MI of receiver operating characteristic curve ( ROC ) was 0.849 between iron deficiency anemia group and alpha thalassemia carriers group,and the cut-off point was 13.1.As MI was -- 13.1,the sensitivity for detecting iron deficiency anemia was 96.7%,specificity 61.1%,and Youden index 0.58.If MI combined with RDW,the sensitivity was 100%.Conclusions Mentzer index has certain accuracy in differentiating alpha thalassemia carriers with reduced HbA2 levels from iron deficiency anemia.Both MI and RDW under the cut-off point can exclude the possibility of iron deficiency anemia.%目的 评估Mentzer指数(Mentzer index,MI)在鉴别HbA2减低中轻型α地中海贫血与缺铁性贫血中的价值.方法 回顾本院3年来血红蛋白电泳中HbA2减低的151例人群的α地贫基因、血常规、铁蛋白、血清铁数据,根据地贫基因分析和铁蛋白、血清铁水平将其分成2组:轻型α地中海贫血组(n=90),

  18. 氧合指数在急性左心衰竭中的应用价值%Application Value of Oxygenation Index in the Treatment of Acute Left Ventricular Failure

    Institute of Scientific and Technical Information of China (English)

    王灵; 王万灵; 王振华

    2016-01-01

    Objective To investigate the value of oxygenation index(PaO2 / FiO2 ) in the prediction of mechanical ventilation and prognosis of patients with acute left ventricular failure(ALHF). Methods From January 2011 to May 2015,we enrolled 48 ALHF patients who were admitted into the Department of ICU of People's Hospital of Qiandongnan. At admission, monitored indexes included PaO2 ,PaCO2 ,SaO2 ,SBE,Lac and 6 h Lac,and PaO2 / FiO2 and 6 h lactic acid clearance were calculated at admission. Acute physiology and chronic health(APACHE Ⅱ score)were evaluated. The relation between PaO2 /FiO2 and gender,age,whether mechanical ventilation was conducted,whether death occurred,PaO2 ,PaCO2 ,SaO2 ,SBE, Lac,lactate clearance rate and APACHEⅡ score was analyzed. By making ROC curves,the sensitivity and specificity of PaO2 /FiO2 in the prediction of mechanical ventilation and death were analyzed,and cut - off values were found to make further risk stratification of ALHF. Results The PaO2 / FiO2 of ALHF patients was(196. 7 ± 51. 2);15 patients were administrated with mechanical ventilation and 6 patients died. PaO2 / FiO2 had negative correlation with mechanical ventilation,death,Lac and APACHEⅡ score and had positive correlation with PaO2 and SaO2 ( P ﹤ 0. 05);PaO2 / FiO2 had no obvious correlation with gender,age,hospitalization time,PaCO2 ,SBE and lactate clearance rate(P ﹥ 0. 05). ROC curves showed that when PaO2 /FiO2 was 176. 6,its sensitivity and specificity in the prediction of mechanical ventilation were 81. 8% and 80. 0% with AUC =0. 782 and a OR value of 0. 066;when PaO2 / FiO2 was 150. 8,its sensitivity and specificity in the prediction of mechanical ventilation were 85. 7% and 60. 0% with AUC = 0. 798 and a OR value of 0. 135. Patients ﹤ mechanical ventilation/ death PaO2 /FiO2 cut - off value were higher in APACHEⅡ score than patients ﹥ mechanical ventilation/ death PaO2 / FiO2 cut - off value,and the difference was significant( Z = - 5. 268,P ﹤ 0. 001

  19. 左心房容积指数及左心房内径指数对射血分数正常心力衰竭的诊断价值对比分析%Compraison between index left atrium volume and index left atrium diameter of their diagnostic value for heart failure with preserved ejection fraction

    Institute of Scientific and Technical Information of China (English)

    叶茜; 杨昕宇; 朱楠; 何大军

    2012-01-01

    Objective To explore the value of left atrium volume index (LAVI)and left atrium diameter index ( LADI) in diagnosis of heart failure with preserved ejection fraction ( HFPEF). Methods Thirty-live patients with HFPEF and 35 patients with Non-HFPEF recruited from Oct 2010 to Oct 2011 in the second people's hospital of Dazhou were enrolled in this study. A series of parameters including left ventricular ejection fraction (LVEF) , LAVI, LADI, left ventricular mass index (LVMI) , mitral low velocity peak at early diastole ( E) , mitral low velocity peak at the end of diastole (A) , initial mitral low deceleration time ( DT) , mitral ring velocity at early diastole (E') , E/A ratio and E/E'ratio were measured and compared between two groups of patients ( HFPEF and Non-HFPEF). Parameters exhibited significant variations between two groups were tested by Pearson association analysis and ROC curve analysis for their association with HFPEF. Results At the cutting edge of 36 ml/m2 , a remarkable association between LAVI and HFPEF was observed. The specificity, sensitivity and accuracy of LAVI for diagnosing HFPEF were 84%. LADI showed a lesser association with HFPEF at the cutting edge of 2.5 cm/m2 , for which the specificity, sensitivity and accuracy were 65% ,70% and 66% , respectively. Conclusions LAVI might play a role as a potential indicator in the diagnosis of HFPEF.%目的 探讨超声心动图左心房容积指数(LAVI)及左心房内径指数(LADI)对射血分数保存心力衰竭(HFPEF)的诊断价值.方法 选取2010年9月至2011年9月于达州市第二人民医院住院的心力衰竭患者70例,其中HEPEF患者35例,非HEPEF患者35例,分别比较2组患者左心室射血分数(LVEF)、LAVI、LADI、左心室质量指数(LVMI)、舒张早期血流速度(E)、舒张晚期血流速度(A)、早期二尖瓣减速时间(DT)、舒张早期运动速度(E′)、舒张早期血流速度与舒张晚期血流速度比值(E/A)、舒张早期二尖瓣血流速度与

  20. A Framework for Quantifying the Impacts of Sub-Pixel Reflectance Variance and Covariance on Cloud Optical Thickness and Effective Radius Retrievals Based on the Bi-Spectral Method.

    Science.gov (United States)

    Zhang, Z; Werner, F.; Cho, H. -M.; Wind, Galina; Platnick, S.; Ackerman, A. S.; Di Girolamo, L.; Marshak, A.; Meyer, Kerry

    2017-01-01

    The so-called bi-spectral method retrieves cloud optical thickness (t) and cloud droplet effective radius (re) simultaneously from a pair of cloud reflectance observations, one in a visible or near infrared (VIS/NIR) band and the other in a shortwave-infrared (SWIR) band. A cloudy pixel is usually assumed to be horizontally homogeneous in the retrieval. Ignoring sub-pixel variations of cloud reflectances can lead to a significant bias in the retrieved t and re. In this study, we use the Taylor expansion of a two-variable function to understand and quantify the impacts of sub-pixel variances of VIS/NIR and SWIR cloud reflectances and their covariance on the t and re retrievals. This framework takes into account the fact that the retrievals are determined by both VIS/NIR and SWIR band observations in a mutually dependent way. In comparison with previous studies, it provides a more comprehensive understanding of how sub-pixel cloud reflectance variations impact the t and re retrievals based on the bi-spectral method. In particular, our framework provides a mathematical explanation of how the sub-pixel variation in VIS/NIR band influences the re retrieval and why it can sometimes outweigh the influence of variations in the SWIR band and dominate the error in re retrievals, leading to a potential contribution of positive bias to the re retrieval.

  1. A Framework for Quantifying the Impacts of Sub-Pixel Reflectance Variance and Covariance on Cloud Optical Thickness and Effective Radius Retrievals Based on the Bi-Spectral Method.

    Science.gov (United States)

    Zhang, Z; Werner, F.; Cho, H. -M.; Wind, Galina; Platnick, S.; Ackerman, A. S.; Di Girolamo, L.; Marshak, A.; Meyer, Kerry

    2017-01-01

    The so-called bi-spectral method retrieves cloud optical thickness (t) and cloud droplet effective radius (re) simultaneously from a pair of cloud reflectance observations, one in a visible or near infrared (VIS/NIR) band and the other in a shortwave-infrared (SWIR) band. A cloudy pixel is usually assumed to be horizontally homogeneous in the retrieval. Ignoring sub-pixel variations of cloud reflectances can lead to a significant bias in the retrieved t and re. In this study, we use the Taylor expansion of a two-variable function to understand and quantify the impacts of sub-pixel variances of VIS/NIR and SWIR cloud reflectances and their covariance on the t and re retrievals. This framework takes into account the fact that the retrievals are determined by both VIS/NIR and SWIR band observations in a mutually dependent way. In comparison with previous studies, it provides a more comprehensive understanding of how sub-pixel cloud reflectance variations impact the t and re retrievals based on the bi-spectral method. In particular, our framework provides a mathematical explanation of how the sub-pixel variation in VIS/NIR band influences the re retrieval and why it can sometimes outweigh the influence of variations in the SWIR band and dominate the error in re retrievals, leading to a potential contribution of positive bias to the re retrieval.

  2. Indexing Moving Points

    DEFF Research Database (Denmark)

    Agarwal, Pankaj K.; Arge, Lars Allan; Erickson, Jeff

    2003-01-01

    also describe an indexing scheme in which the number of I/Os required to answer a query depends monotonically on the difference between the query time stamp t and the current time. Finally, we develop an efficient indexing scheme to answer approximate nearest-neighbor queries among moving points.......We propose three indexing schemes for storing a set S of N points in the plane, each moving along a linear trajectory, so that any query of the following form can be answered quickly: Given a rectangle R and a real value t, report all K points of S that lie inside R at time t. We first present...... an indexing structure that, for any given constant >0, uses O(N/B) disk blocks and answers a query in O((N/B)1/2+ +K/B) I/Os, where B is the block size. It can also report all the points of S that lie inside R during a given time interval. A point can be inserted or deleted, or the trajectory of a point can...

  3. 早期BIS监测对脓毒症相关性脑病的评估价值%The value of early stage BIS m onitoring in the assessment of sepsis

    Institute of Scientific and Technical Information of China (English)

    张莉

    2015-01-01

    Objective To investigate the continuous bispectral index ( BIS) monitoring for the early diagnosis , disease severity evaluation in patients with sepsis encephalopathy .Methods This retrospective analysis contained 80 patients with sepsis admitted in our department , and these patients were divided into encephalopathy group (experimental group ) and non-encephalopathy group ( control group).After ICU admission, all the patients received standard sepsis recovery treatment ( sepsis treatment guide2012).Immediately after ICU admission, they were continuously monitored the BIS for 24 h in order to get a 24-h-average; at the same time , the Glasgow coma scale ( GCS ) and acute physiology and chronic health evaluation Ⅱ( APACHEⅡ) were recorded , and blood samples were taken for the detection of serum PCT and S -100 B protein content .The average BIS values , PCT, S-100 B protein, GCS score and APACHEⅡ score were compared between the groups , and correlation analysis was also done between the groups .Results ①When compared the encephalopathy group and non -encephalopathy group , the BIS, PCT, S -100B protein, GCS score and APACHEⅡ score had significant difference(P<0.01).②The BIS value was positively correlated with GCS , APACHEⅡscore significantly (P<0.01).Conclusion Continuous BIS monitoring can evaluate sepsis severity in patients with brain injury , and to make an early diagnosis.%目的 探讨早期脑电双频指数( bispectral index , BIS)监测对脓毒症相关性脑病( sepsis-associated encephalopathy , SAE)患者诊断、病情严重程度的评估价值. 方法 回顾性分析ICU收治的脓毒症患者80例,根据是否出现中枢神经系统障碍分为脑病组(试验组)和非脑病组(对照组). 所有患者均在入住 ICU 后进行标准脓毒症复苏治疗流程(按脓毒症治疗指南2012 ). 入ICU后立即行BIS持续监测24 h取其均值,同时记录格拉斯哥昏迷评分( GCS)、急性生理与慢性健康状况评分

  4. A Microfilm Index to "Chemical Abstracts"

    Science.gov (United States)

    Robinson, F.

    1973-01-01

    To improve access to the recent Chemical Abstracts,'' a cumulative quarterly index, based on the keyword phrases, has been produced in microfilm form. The index is available soon after the end of each quarter. Abstract titles are included in the index, thus increasing its value as a working tool. (4 references) (Author/SJ)

  5. 血脂指标比值对颈动脉粥样斑块预测价值的比较%Comparison of the Value of Serum Lipids Index Ratio in the Prediction of Carotid Atherosclerotic Plaques

    Institute of Scientific and Technical Information of China (English)

    宋川; 郑延松; 王丽凤; 陈志来; 郭民法

    2012-01-01

    目的 探讨总胆固醇与高密度脂蛋白胆固醇(TC/HDL-C)比值和低密度脂蛋白胆固醇/高密度脂蛋白胆固醇(LDL-C/HDL-C)比值对颈动脉粥样斑块的预测价值.方法 选取2010年5月-2011年10月在我院健康医学中心进行健康体检并接受颈部血管超声检查和血脂检测的4 282例体检者作为研究对象,对颈动脉粥样斑块与相关因素[年龄、性别、教育程度、吸烟、饮酒、腰围、体质指数、血压和血糖、血红蛋白、血尿酸、TC、三酰甘油(TG)、LDL-C、HDL-C、超敏C反应蛋白水平及糖尿病、高血压、冠心病、脑卒中家族史]进行分析.结果 4 282例体检者中1 438例(33.6%)存在颈动脉粥样斑块,2 844例(66.4%)未发现明显的颈动脉粥样斑块.年龄、性别、吸烟、血糖、收缩压、LDL-C、HDL-C、超敏C反应蛋白均为颈动脉粥样斑块的危险因素.若用LDL-C/HDL-C和TC/HDL-C分别替代LDL-C、HDL-C或者TC和HDL-C,LDL-C/HDL-C和TC/HDL-C比值仍为颈动脉粥样斑块的危险因素.与TC/HDL-C比值(β=0.1760)相比,LDL-C/HDL-C比值的偏回归系数(β=0.3292)更高.结论 当用于预测颈动脉粥样斑块时,LDL-C/HDL-C比值比TC/HDL-C比值更具临床使用价值.%Objective To explore the value of the ratio of TC to HDL - C and the ratio of LDL - C to HDL - C ( LDL - C/HDL - C ) in the prediction of carotid atherosclerotic plaques. Methods 4 282 subjects registered for health examination and underwent carotid Doppler ultrasound scan and serum lipids test in the department of health science center in our hospital from May 2010 to October 2011 were involved into the study. Carotid atherosclerotic plaques and related factors ( age, gender, education, smoking status, alcohol intake, waist circumference, body mass index, blood pressure, blood glucose, hemoglobin, blood uric acid, TC, TG, LDL - C, HDL - C, hs - CRP, diabetes, hypertension, coronary heart disease and family history of stroke ) were analyzed. Results

  6. 体重指数预测乳腺癌新辅助化疗疗效和预后的价值%Value of body mass index predicting efficacy of neoadjuvant chemotherapy and prognostic in breast cancer

    Institute of Scientific and Technical Information of China (English)

    王永南; 万舰; 张安秦; 李文萍; 陈中杨; 罗懿忠

    2015-01-01

    目的 探讨体重指数预测乳腺癌新辅助化疗的疗效和预后的价值.方法 收集广东省妇幼保健院2007年1月-2013年12月收治的99例接受新辅助化疗ⅡB~ⅢC期的乳腺癌患者的临床资料,分析体重指数和乳腺癌新辅助化疗的疗效和预后的关系.结果 所有患者临床完全缓解率为12.1%(12/99),部分缓解率为68.7% (68/99),稳定或进展率为19.2%(19/99),总体有效率为80.8%(80/99),病理完全缓解率为9.1%(9/99).体重指数与新辅助化疗有效率相关(P=0.039),与病理完全缓解率无关(P=0.454).单因素分析和多因素分析发现,体重指数与无病生存率和总生存率不相关(P>0.05).结论 体重指数与乳腺癌新辅助化疗临床有效率相关,超重或肥胖可能预测乳腺癌新辅助化疗疗效不佳.体重指数是否影响乳腺癌新辅助化疗患者的预后尚不明确,需进一步研究.%Objective Resarech on the value of body mass index (BMI) predicting efficacy of neoadjuvant chemotherapy and prognostic in breast cancer.Methods Clinical data of 99 patients who received neoadjuvant chemotherapy Ⅱ B-Ⅲ C stage breast cancer patients was collected between January 2007 and December 2013 in Women and Children Hospital of Guangdong Province.Anaslysing the relation of BMI and efficacy of neoadjuvant chemotherapy and prognosis.Results In the study, Clinaical complete ressiom was 12.1% (12/99), partal ressiom was 68.7% (68/99), stable disease or disease progression was 19.2% (19/99), respone rate was 80.8% (80/99), pathlogic complete ression was 9.1% (9/99).BMI was significantly associated with response rate(P =0.039), but not with pathlogic complete ression (P =0.454).Univariate and multivariate analysis showed that BMI was not significantly associated with disease free survival and overall survival(P > 0.05).Conclusions BMI was significantly associated with response rate, overweight or obese patients would prodict poorly efficacy

  7. MCV、MCH联合Hb电泳在地中海贫血筛查中的临床应用价值%The clinical value of MCV, MCH United Hb electrophoresis indexes on screening thalassemia

    Institute of Scientific and Technical Information of China (English)

    毛锦芳

    2012-01-01

    OBJECTIVE To study the value of the tests of mcv, inch and hemoglobin (Hb) electrophoresis analyses in diagnosis of thalassemia, and practice prenatal diagnosis on the couples at high risk of having fetus with thalassemia, especially for those who preliminary selection positive or/and the couples carry identity gene. Finally, we aimed to prevent having fetus with thalassemia major. METHODS MCV, MCH and United Hb electrophoresis were used to conduct the prenatal screening. RESULTS The number of thalassemia screened was 3720, and the positive rate was 20.56%. There were α-thalassemia 445 cases of all the cases, and the positive rate was 11.96%. There were β-thalassemia 320 cases, and the positive rate was 8.60%. The Genetic diagnosis of thalassemia were 545 cases. The coverage rate of repeated screening rate was 14.65%. Of them, there were α-thalassemia 308 cases, and account for 8.28%. There were β-thalassemia 185 cases, and account for 4.79%. There were complex thalassemia 52 cases, and accounted for 1.40%. CONCLUSION MCV, MCH and hemoglobin electrophoresis could use as positive indexes on screening thalassemia, combined with genetic diagnosis, and shows great significance in screening and diagnosis Thalassemia.%目的 探讨平均红细胞体积(MCV)、平均红细胞血红蛋白(MCH)联合血红蛋白(Hb)电泳在地中海贫血筛查中的临床应用价值,对地中海贫血初筛阳性者、夫妇为同型地中海贫携带者进行基因诊断,避免重型地中海贫血患儿出生.方法 采用血常规五分类中的MCV、MCH联合血红蛋白电泳进行孕妇产前筛查.结果 在3720例被筛查人群中,筛查阳性765例,阳性率20.56%,其中:筛出α地中海贫血445例,阳性率11.96%,β地中海贫血320例,阳性率8.60%.经基因诊断确诊地中海贫血545例,占筛查总数的14.65%,其中:α地贫308例,占8.28%,β地贫杂合子185例,占4.97%,α复合β地贫52例,占1.40%.结论 MCV、MCH联合血红蛋白电泳可

  8. 血糖不稳定指数在评估重症监护患者预后中的价值%Values of glycemic lability index in the prognostic evaluation of critically ill patients in intensive care unit

    Institute of Scientific and Technical Information of China (English)

    蔡燕; 马圭; 金兆辰; 张文波; 蒋鹏程

    2011-01-01

    目的 评估血糖不稳定指数(GLI)作为血糖波动的指标对重症监护病房(ICU)危重症患者转归的预测价值.方法 观察72例危重症患者入ICU 24 h内每2h的血糖情况,计算血糖GLI,日内平均血糖波动幅度(MAGE),最大血糖波动幅度(LAGE),平均值(MEAN),标准差(SD),变异系数(CV);观察患者30 d转归;应用受试者工作特征曲线(ROC曲线)评估各指标与预后的相关性.根据MEAN和GLI的中位数分为4个亚组,比较各亚组间30 d病死率.结果 72例患者中31例死亡,总体病死率为43.1%.GLI的ROC曲线下面积(AUC)(0.798±0.051)优于MAGE(0.785±0.053),LAGE(0.772 ±0.056),SD(0.761±0.056),CV(0.729±0.059)及MEAN(0.670±0.065)的AUC.GLI与入ICU 24 h内APACHEⅡ评分显著相关(R2=0.787,P<0.001).亚组分析显示,低MEAN+低GLI组呼吸机撤机时间、CRRT使用率、ICU入住时间和30 d病死率分别为(3.3±4.4)d,41.6%,12.5%,(4.6±4.5)d,16.7%较其他3组明显降低,其预后最佳,高MEAN+高GLI组预后最差.结论 入ICU 24 h内GLI作为血糖波动的指标与危重症患者预后显著相关.%Objective To access the predictive values of glycemic lability index(GLI)as an indicator of glucose variability in the prognosis of critically ill patients.Methods A prospective study of 72 critically ill patients admitted into intensive care unit(ICU)were performed.Capillary glucose was measured on admission and every 2 hrs afterward during the first 24 hrs.GLI,mean amplitude of glycemic excursion(MAGE),largest amplitude of glycemic excursions(LAGE),mean,standard deviation(SD)and coefficient of variability(CV)were calculated respectively.The 30 day mortality was selected as the end-point.Receiver operating curve(ROC)was drawn to explore the association between each indicator of glucose variability and prognosis.The subjects were subsequently divided into 4 subgroups according to the median of mean and GLI.The 30-day mortality was then compared between the subgroups

  9. Assessment Value of Extravascular Lung Water Index and Pulmonary Vascular Permeability Index on Illness Severity and Prognosis of Patients With Septic Shock%血管外肺水指数和肺血管通透性指数对脓毒性休克患者病情及预后的评估价值研究

    Institute of Scientific and Technical Information of China (English)

    陶飞; 胡桂芳; 邓烈华; 姚华国

    2016-01-01

    预后的指标。%Objective To analyze the assessment value of extravascular lung water index(EVLWI) and pulmonary vascular permeability index(PVPI)on illness severity and prognosis of patients with septic shock. Methods From March 2011 to December 2015,a total of 57 patients with septic shock were selected in the Intensive Care Unit(ICU),Central Hospital of Chancheng District,Foshan;in the ICU,the Affiliated Hospital of Guangdong Medical College. According to the prognosis after 28 days of admission,all of the 57 patients were divided into survivor group(n = 41)and death group(n = 16),EVLWI and PVPI were compared between the two groups after 1 day,2 days and 3 days of admission of ICU,and their correlations with APACHEⅡ score,with SOFA score were analyzed,ROC curve was drawn to evaluate the assessment value of EVLWI and PVPI on prognosis of patients with septic shock. Results No statistically significant differences of EVLWI was found between the two groups after 1 day of admission of ICU( P ﹥ 0. 05);EVLWI of death group was statistically significantly higher than that of survivor group after 2 days and 3 days of admission of ICU,respectively( P < 0. 05);PVPI of death group was statistically significantly higher than that of survivor group after 1 day,2 days and 3 days of admission of ICU,respectively(P < 0. 05). Of survivor group,EVLWI and PVPI after 2 days and 3 days of admission of ICU were statistically significantly lower than those after 1 day of admission of ICU,EVLWI and PVPI after 3 day of admission of ICU were statistically significantly lower than those after 2 days of admission of ICU(P < 0. 05);of death group,there was no statistically significant differences of EVLWI or PVPI after 1 day,2 days or 3 days of admission of ICU( P ﹥ 0. 05). Spearman rank correlation analysis showed that,EVLWI was positively correlated with APACHEⅡ score,SOFA score of patients with septic shock,respectively(rs = 0. 531,0. 625,P <0. 05);PVPI was positively

  10. A Framework Based on 2-D Taylor Expansion for Quantifying the Impacts of Subpixel Reflectance Variance and Covariance on Cloud Optical Thickness and Effective Radius Retrievals Based on the Bispectral Method

    Science.gov (United States)

    Zhang, Z.; Werner, F.; Cho, H.-M.; Wind, G.; Platnick, S.; Ackerman, A. S.; Di Girolamo, L.; Marshak, A.; Meyer, K.

    2016-01-01

    The bispectral method retrieves cloud optical thickness (t) and cloud droplet effective radius (re) simultaneously from a pair of cloud reflectance observations, one in a visible or near-infrared (VIS/NIR) band and the other in a shortwave infrared (SWIR) band. A cloudy pixel is usually assumed to be horizontally homogeneous in the retrieval. Ignoring subpixel variations of cloud reflectances can lead to a significant bias in the retrieved t and re. In the literature, the retrievals of t and re are often assumed to be independent and considered separately when investigating the impact of subpixel cloud reflectance variations on the bispectral method. As a result, the impact on t is contributed only by the subpixel variation of VIS/NIR band reflectance and the impact on re only by the subpixel variation of SWIR band reflectance. In our new framework, we use the Taylor expansion of a two-variable function to understand and quantify the impacts of subpixel variances of VIS/NIR and SWIR cloud reflectances and their covariance on the t and re retrievals. This framework takes into account the fact that the retrievals are determined by both VIS/NIR and SWIR band observations in a mutually dependent way. In comparison with previous studies, it provides a more comprehensive understanding of how subpixel cloud reflectance variations impact the t and re retrievals based on the bispectral method. In particular, our framework provides a mathematical explanation of how the subpixel variation in VIS/NIR band influences the re retrieval and why it can sometimes outweigh the influence of variations in the SWIR band and dominate the error in re retrievals, leading to a potential contribution of positive bias to the re retrieval. We test our framework using synthetic cloud fields from a large-eddy simulation and real observations from Moderate Resolution Imaging Spectroradiometer. The predicted results based on our framework agree very well with the numerical simulations. Our

  11. A Framework Based on 2-D Taylor Expansion for Quantifying the Impacts of Subpixel Reflectance Variance and Covariance on Cloud Optical Thickness and Effective Radius Retrievals Based on the Bispectral Method

    Science.gov (United States)

    Zhang, Z.; Werner, F.; Cho, H.-M.; Wind, G.; Platnick, S.; Ackerman, A. S.; Di Girolamo, L.; Marshak, A.; Meyer, K.

    2016-01-01

    The bispectral method retrieves cloud optical thickness (t) and cloud droplet effective radius (re) simultaneously from a pair of cloud reflectance observations, one in a visible or near-infrared (VIS/NIR) band and the other in a shortwave infrared (SWIR) band. A cloudy pixel is usually assumed to be horizontally homogeneous in the retrieval. Ignoring subpixel variations of cloud reflectances can lead to a significant bias in the retrieved t and re. In the literature, the retrievals of t and re are often assumed to be independent and considered separately when investigating the impact of subpixel cloud reflectance variations on the bispectral method. As a result, the impact on t is contributed only by the subpixel variation of VIS/NIR band reflectance and the impact on re only by the subpixel variation of SWIR band reflectance. In our new framework, we use the Taylor expansion of a two-variable function to understand and quantify the impacts of subpixel variances of VIS/NIR and SWIR cloud reflectances and their covariance on the t and re retrievals. This framework takes into account the fact that the retrievals are determined by both VIS/NIR and SWIR band observations in a mutually dependent way. In comparison with previous studies, it provides a more comprehensive understanding of how subpixel cloud reflectance variations impact the t and re retrievals based on the bispectral method. In particular, our framework provides a mathematical explanation of how the subpixel variation in VIS/NIR band influences the re retrieval and why it can sometimes outweigh the influence of variations in the SWIR band and dominate the error in re retrievals, leading to a potential contribution of positive bias to the re retrieval. We test our framework using synthetic cloud fields from a large-eddy simulation and real observations from Moderate Resolution Imaging Spectroradiometer. The predicted results based on our framework agree very well with the numerical simulations. Our

  12. A Framework Based on 2-D Taylor Expansion for Quantifying the Impacts of Sub-Pixel Reflectance Variance and Covariance on Cloud Optical Thickness and Effective Radius Retrievals Based on the Bi-Spectral Method

    Science.gov (United States)

    Zhang, Z.; Werner, F.; Cho, H. -M.; Wind, G.; Platnick, S.; Ackerman, A. S.; Di Girolamo, L.; Marshak, A.; Meyer, Kerry

    2016-01-01

    The bi-spectral method retrieves cloud optical thickness and cloud droplet effective radius simultaneously from a pair of cloud reflectance observations, one in a visible or near-infrared (VISNIR) band and the other in a shortwave infrared (SWIR) band. A cloudy pixel is usually assumed to be horizontally homogeneous in the retrieval. Ignoring sub-pixel variations of cloud reflectances can lead to a significant bias in the retrieved and re. In the literature, the retrievals of and re are often assumed to be independent and considered separately when investigating the impact of sub-pixel cloud reflectance variations on the bi-spectral method. As a result, the impact on is contributed only by the sub-pixel variation of VISNIR band reflectance and the impact on re only by the sub-pixel variation of SWIR band reflectance. In our new framework, we use the Taylor expansion of a two-variable function to understand and quantify the impacts of sub-pixel variances of VISNIR and SWIR cloud reflectances and their covariance on the and re retrievals. This framework takes into account the fact that the retrievals are determined by both VISNIR and SWIR band observations in a mutually dependent way. In comparison with previous studies, it provides a more comprehensive understanding of how sub-pixel cloud reflectance variations impact the and re retrievals based on the bi-spectral method. In particular, our framework provides a mathematical explanation of how the sub-pixel variation in VISNIR band influences the re retrieval and why it can sometimes outweigh the influence of variations in the SWIR band and dominate the error in re retrievals, leading to a potential contribution of positive bias to the re retrieval. We test our framework using synthetic cloud fields from a large-eddy simulation and real observations from Moderate Resolution Imaging Spectroradiometer. The predicted results based on our framework agree very well with the numerical simulations. Our framework can be used

  13. Index and Indexing Assessment: Criteria and Standards

    Directory of Open Access Journals (Sweden)

    Hassan Ashrafi

    2007-10-01

    Full Text Available Indexing is one of the most important methods of content representation where by assigning descriptors to the documents, their subject content are made known. Since index and indexing are remarkably significant in information retrieval, its quality and evaluation and provision of criteria and standards had always been the mainstay of researchers in this field. Given the fact that Indexing is a complex process, offering definitions, principles and methods could be step towards optimal use of the information. The present study, while offering a capsule definition of index, will investigate the indexing evaluation criteria and would follow it up with a definition of indexing. Finally a number of standards in the field of indexing are presented and would make its conclusions.

  14. EJSCREEN Indexes 2015 Internal

    Data.gov (United States)

    U.S. Environmental Protection Agency — There is an EJ Index for each environmental indicator. There are 12 EJ Indexes in EJSCREEN reflecting the 12 environmental indicators. The EJ Index names are:...

  15. EJSCREEN Indexes 2016 Public

    Data.gov (United States)

    U.S. Environmental Protection Agency — There is an EJ Index for each environmental indicator. There are eleven EJ Indexes in EJSCREEN reflecting the 11 environmental indicators. The EJ Index names are:...

  16. EJSCREEN Indexes 2015 Public

    Data.gov (United States)

    U.S. Environmental Protection Agency — There is an EJ Index for each environmental indicator. There are eight EJ Indexes in EJSCREEN reflecting the 8 environmental indicators. The EJ Index names are:...

  17. Risk management of stock index futures

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    The Hong Kong Hang Seng index futures is taken as a study object and a method of empirical analysis is adopted in order to verify the validity of the application of the value-at-risk (VaR) method in the risk measurement of the stock index futures market. The results suggest that under normal market conditions it is feasible to apply the VaR method in the measurement of the market risks of stock index futures. The daily VaR value of the stock index futures provides a foreseeable profit and loss of the stock ...

  18. 探讨同型半胱氨酸联合超敏 C-反应蛋白和血脂类项目检测在冠心病中的临床价值%Investigation of clinical value of homocysteine combined with high-sensitive C-reactive protein and blood lipid index detection in coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    邓世忠

    2015-01-01

    Objective To investigate the clinical value of homocysteine (HCY) combined with high-sensitive C-reactive protein (hs-CRP) and blood lipid index detection in coronary heart disease. Methods There were 90 coronary heart disease patients as observation group, and another 90 healthy people as control group. Detected data of HCY, hs-CRP, and normal blood lipid indexes were summarized in the two groups, and their data were comparatively analyzed. Results The control group had all higher detected values of HCY, hs-CRP, and normal blood lipid indexes than the observation group, and their difference had statistical significance (P<0.05). Conclusion Detection of HCY, hs-CRP, and normal blood lipid index contains important significance and value in clinical treatment of coronary heart disease.%目的:探讨同型半胱氨酸(HCY)联合超敏 C-反应蛋白(hs-CRP)和血脂类项目检测在冠心病中的临床价值。方法90例冠心病患者设为观察组,90例健康体检者设为对照组。对两组的 HCY、hs-CRP 和常见血脂类检测数据进行统计,并对各项数据进行对比分析。结果对照组的 HCY、hs-CRP 和常见血脂类测量值均优于观察组的测量值,两组比较差异具有统计学意义(P<0.05)。结论HCY、hs-CRP 和血脂类项目的检测在冠心病临床治疗中具有重要的意义和价值。

  19. Correlating data from different sensors to increase the positive predictive value of alarms: an empiric assessment [v1; ref status: indexed, http://f1000r.es/RKkXdB

    Directory of Open Access Journals (Sweden)

    Yuval Bitan

    2012-11-01

    Full Text Available Objectives: Alarm fatigue from high false alarm rate is a well described phenomenon in the intensive care unit (ICU. Progress to further reduce false alarms must employ a new strategy. Highly sensitive alarms invariably have a very high false alarm rate. Clinically useful alarms have a high Positive-Predictive Value. Our goal is to demonstrate one approach to suppressing false alarms using an algorithm that correlates information across sensors and replicates the ways that human evaluators discriminate artifact from real signal. Methods: After obtaining IRB approval and waiver of informed consent, a set of definitions, (hypovolemia, left ventricular shock, tamponade, hemodynamically significant ventricular tachycardia, and hemodynamically significant supraventricular tachycardia, were installed in the monitors in a 10 bed cardiothoracic ICU and evaluated over an 85 day study period. The logic of the algorithms was intended to replicate the logic of practitioners, and correlated information across sensors in a way similar to that used by practitioners. The performance of the alarms was evaluated via a daily interview with the ICU attending and review of the tracings recorded over the previous 24 hours in the monitor. True alarms and false alarms were identified by an expert clinician, and the performance of the algorithms evaluated using the standard definitions of sensitivity, specificity, positive predictive value, and negative predictive value. Results: Between 1 and 221 instances of defined events occurred over the duration of the study, and the positive predictive value of the definitions varied between 4.1% and 84%. Conclusions: Correlation of information across alarms can suppress artifact, increase the positive predictive value of alarms, and can employ more sophisticated definitions of alarm events than present single-sensor based systems.

  20. Growth Index after Planck

    CERN Document Server

    Xu, Lixin

    2013-01-01

    To investigate the possible deviation from the standard $\\Lambda$CDM model and the Einstein's gravity theory in the dynamical perspectives, the growth index $\\gamma_L$ was proposed. Recently, thanks to the measurement of the cosmic growth rate via the redshift-space distortion, one can understand the evolution of density contrast through $f\\sigma_8(z)$, where $f(z)=d\\ln \\delta/d \\ln a$ is the growth rate of matter and $\\sigma_8(z)$ is the rms amplitude of the density contrast $\\delta$ at the comoving $8h^{-1}$ Mpc scale. In this paper, we use the red-shift space distortion data points to investigate the growth index on the bases of the Einstein's gravity theory and a modified gravity theory under the assumption $f=\\Omega_m(a)^{\\gamma_L}$. To fix the background evolution, the cosmic observational data points from the type Ia supernovae SNLS3, cosmic microwave background radiation from {\\it Planck} and baryon acoustic oscillation are used. Via the Markov Chain Monte Carlo method, the $\\gamma_L$ values were obta...

  1. Public Values

    DEFF Research Database (Denmark)

    Beck Jørgensen, Torben; Rutgers, Mark R.

    2015-01-01

    administration is approached in terms of processes guided or restricted by public values and as public value creating: public management and public policy-making are both concerned with establishing, following and realizing public values. To study public values a broad perspective is needed. The article suggest......This article provides the introduction to a symposium on contemporary public values research. It is argued that the contribution to this symposium represent a Public Values Perspective, distinct from other specific lines of research that also use public value as a core concept. Public...... a research agenda for this encompasing kind of public values research. Finally the contributions to the symposium are introduced....

  2. Automated Water Extraction Index

    DEFF Research Database (Denmark)

    Feyisa, Gudina Legese; Meilby, Henrik; Fensholt, Rasmus

    2014-01-01

    Classifying surface cover types and analyzing changes are among the most common applications of remote sensing. One of the most basic classification tasks is to distinguish water bodies from dry land surfaces. Landsat imagery is among the most widely used sources of data in remote sensing of water...... resources; and although several techniques of surface water extraction using Landsat data are described in the literature, their application is constrained by low accuracy in various situations. Besides, with the use of techniques such as single band thresholding and two-band indices, identifying...... an appropriate threshold yielding the highest possible accuracy is a challenging and time consuming task, as threshold values vary with location and time of image acquisition. The purpose of this study was therefore to devise an index that consistently improves water extraction accuracy in the presence...

  3. Nucleic acid indexing

    Science.gov (United States)

    Guilfoyle, Richard A.; Guo, Zhen

    1999-01-01

    A restriction site indexing method for selectively amplifying any fragment generated by a Class II restriction enzyme includes adaptors specific to fragment ends containing adaptor indexing sequences complementary to fragment indexing sequences near the termini of fragments generated by Class II enzyme cleavage. A method for combinatorial indexing facilitates amplification of restriction fragments whose sequence is not known.

  4. 中文社会科学引文索引(CSSCI)的设计与应用价值%The Design and Application Value of the Chinese Social Sciences Citation Index

    Institute of Scientific and Technical Information of China (English)

    苏新宁

    2012-01-01

    中文社会科学引文索引(CSSCI)启动于1998年底,首次发布于2000年5月,目前共收录期刊529种,收录来源文献110万余条,引用文献近1千万条,已成为教育部评价人文社会科学研究成果的重要平台。CSSCI包括数据处理、信息检索和统计分析三个子系统,具有控制数据质量、提高检索效率、保存引文分析数据、分析学科研究特征等功能。CSSCI的应用价值包括:借助引文索引数据分析学科研究特征:观察学科的成长性和国际化程度;探究学科研究热点和趋势、发现重要学术论著、构建学术网络等研究。图2。参考文献10。%The Chinese Social Sciences Citation Index (CSSCI) project started up in late 1998, and the first version of CSSCI was released in May 2000. The current version of CSSCI includes more than 1.1 million records from academic source and nearly 10 million records from cited literature. The CSSCI system is now considered as an important platform for assessing the scientific research achievements for Humanities and Social Sciences by China Ministry of Education. CSSCI includes three subsystems: data processing, information retrieval and statistical analysis. It can control data quality, improve retrieval efficiency, save citation analysis data, and analyze discipline research features etc. The article also explains in detail how citation index data is used in subject feature analysis, the subject academic growth and the degree of internationalization analysis, research hotspot and tendency exploration, important academic discovery and academic network establishment, etc. 2 figs. 10 refs.

  5. Value-Added Exchange Rates

    OpenAIRE

    Rudolfs Bems; Robert C. Johnson

    2012-01-01

    This paper updates the conceptual foundations for measuring real effective exchange rates (REERs) to allow for vertical specialization in trade. We derive a value-added REER describing how demand for the value added that a country produces changes as the price of its value added changes relative to competitors. We then compute this index for 42 countries from 1970-2009 using trade measured in value added terms and GDP deflators. There are substantial differences between value-added and conven...

  6. Comparison of Polar Cap (PC) index calculations.

    Science.gov (United States)

    Stauning, P.

    2012-04-01

    The Polar Cap (PC) index introduced by Troshichev and Andrezen (1985) is derived from polar magnetic variations and is mainly a measure of the intensity of the transpolar ionospheric currents. These currents relate to the polar cap antisunward ionospheric plasma convection driven by the dawn-dusk electric field, which in turn is generated by the interaction of the solar wind with the Earth's magnetosphere. Coefficients to calculate PCN and PCS index values from polar magnetic variations recorded at Thule and Vostok, respectively, have been derived by several different procedures in the past. The first published set of coefficients for Thule was derived by Vennerstrøm, 1991 and is still in use for calculations of PCN index values by DTU Space. Errors in the program used to calculate index values were corrected in 1999 and again in 2001. In 2005 DMI adopted a unified procedure proposed by Troshichev for calculations of the PCN index. Thus there exists 4 different series of PCN index values. Similarly, at AARI three different sets of coefficients have been used to calculate PCS indices in the past. The presentation discusses the principal differences between the various PC index procedures and provides comparisons between index values derived from the same magnetic data sets using the different procedures. Examples from published papers are examined to illustrate the differences.

  7. Comparative pharmacodynamic modeling of desflurane, sevoflurane and isoflurane.

    NARCIS (Netherlands)

    Kreuer, S.; Bruhn, J.; Wilhelm, W.; Grundmann, U.; Rensing, H.; Ziegeler, S.

    2009-01-01

    BACKGROUND: We compared dose-response curves of the hypnotic effects of desflurane, sevoflurane and isoflurane. In addition, we analyzed the k(e0) values of the different anesthetics. The EEG parameters Bispectral index (BIS, Aspect Medical Systems, Natick, MA, version XP) and Narcotrend index (Moni

  8. Value of fatty liver index in diagnosis of nonalcoholic fatty liver disease%脂肪肝指数在非酒精性脂肪性肝病诊断中的应用价值

    Institute of Scientific and Technical Information of China (English)

    张迪; 孙侃; 刘宇; 张婕; 田晓光; 李勉; 徐瑜; 毕宇芳; 戴蒙

    2012-01-01

    Objective: To investigate the reliability of fatty liver index (FLI) in the screening and diagnosis of nonalcoholic fatty liver disease (NAFLD). Methods: A cross-sectional survey of 2 519 subjects aged 40 years or older in Jiading community of Shanghai was performed. Collection of sociodemographic characteristics and measurement of anthropometries were performed by trained and certified clinical staff with the use of standard protocols. FLI was calculated from waist circumference, body mass index (BMI), triglycerides and gamma-glutamyl-transferase. NAFLD was diagnosed by hepatic ullrasonography. The receiver operating characteristics (ROC) curve was used to examine the diagnostic performance of FLI for detecting NAFLD. Results: Among the 2 139 participants in final analysis, the area under ROC curve of FLI was 0.84 [95% confidence interval ( Cl) 0.82-0.86 ] for detecting NAFLD. A threshold of FLI ≥ 30 was selected as the optimal operating point to detect NAFLD in this study, of which the sensitivity and specificity were 80.6% and 73.8%, respectively. Conclusions: FLI is a simple method for the screening and diagnosis of NAFLD. FLI is suitable for large sample epidemiological study and for the guidance of early intervention and treatment of NAFLD.%目的:通过评估脂肪肝指数(FLI),探讨其对非酒精性脂肪性肝病(NAFLD)的筛查和诊断价值.方法:选取年龄大于40岁的上海嘉定地区常住居民共2519人,通过问卷调查、体格检查及相关人体测量学和生化学指标检测,综合评估人群代谢状态并计算个体FLI.通过高分辨率超声诊断NAFLD.利用受试者工作特征(ROC)曲线评估FLI对于经超声诊断的NAFLD的预测价值.结果:最终共有2139名受试者纳入统计分析.FLI作为诊断NAFLD的ROC曲线下面积为0.84,95%可信区间为0.82~0.86.当FLI≥30时,其诊断NAFLD的敏感性和特异性最好,灵敏度和特异度分别达到80.6%和73.8%.结论:FLI对于NAFLD的诊断具有较

  9. Policies to increase the social value of science and the scientist satisfaction. An exploratory survey among Harvard bioscientists. [v1; ref status: indexed, http://f1000r.es/2iq

    Directory of Open Access Journals (Sweden)

    Andrea Ballabeni

    2014-01-01

    Full Text Available Basic research in the biomedical field generates both knowledge that has a value per se regardless of its possible practical outcome and that has the potential to produce more practical benefits. Policies can increase the benefit potential to society of basic biomedical research by offering various kinds of incentives to basic researchers. In this paper we argue that soft incentives or “nudges” are particularly promising. However, to be well designed, these incentives must take into account the motivations, goals and views of the basic scientists. In the paper we present the results of an investigation that involved more than 300 scientists at Harvard Medical School and affiliated institutes. The study shows that basic researchers’ support for soft incentives is such that the transformative value of fundamental investigations can be increased without affecting the spirit of the basic research and scientists’ work satisfaction. After discussing the findings, we suggest a few examples of nudges and discuss one in more detail.

  10. Policies to increase the social value of science and the scientist satisfaction. An exploratory survey among Harvard bioscientists. [v2; ref status: indexed, http://f1000r.es/3jw

    Directory of Open Access Journals (Sweden)

    Andrea Ballabeni

    2014-06-01

    Full Text Available Basic research in the biomedical field generates both knowledge that has a value per se regardless of its possible practical outcome and knowledge that has the potential to produce more practical benefits. Policies can increase the benefit potential to society of basic biomedical research by offering various kinds of incentives to basic researchers. In this paper we argue that soft incentives or “nudges” are particularly promising. However, to be well designed, these incentives must take into account the motivations, goals and views of the basic scientists. In the paper we present the results of an investigation that involved more than 300 scientists at Harvard Medical School and affiliated institutes. The results of this study suggest that some soft incentives could be valuable tools to increase the transformative value of fundamental investigations without affecting the spirit of the basic research and scientists’ work satisfaction. After discussing the findings, we discuss a few examples of nudges for basic researchers in the biomedical fields.

  11. Prediction of massive bleeding. Shock index and modified shock index.

    Science.gov (United States)

    Terceros-Almanza, L J; García-Fuentes, C; Bermejo-Aznárez, S; Prieto-Del Portillo, I J; Mudarra-Reche, C; Sáez-de la Fuente, I; Chico-Fernández, M

    2017-04-08

    To determine the predictive value of the Shock Index and Modified Shock Index in patients with massive bleeding due to severe trauma. Retrospective cohort. Severe trauma patient's initial attention at the intensive care unit of a tertiary hospital. Patients older than 14 years that were admitted to the hospital with severe trauma (Injury Severity Score >15) form January 2014 to December 2015. We studied the sensitivity (Se), specificity (Sp), positive and negative predictive value (PV+ and PV-), positive and negative likelihood ratio (LR+ and LR-), ROC curves (Receiver Operating Characteristics) and the area under the same (AUROC) for prediction of massive hemorrhage. 287 patients were included, 76.31% (219) were male, mean age was 43,36 (±17.71) years and ISS was 26 (interquartile range [IQR]: 21-34). The overall frequency of massive bleeding was 8.71% (25). For Shock Index: AUROC was 0.89 (95% confidence intervals [CI] 0.84 to 0.94), with an optimal cutoff at 1.11, Se was 91.3% (95% CI: 73.2 to 97.58) and Sp was 79.69% (95% CI: 74.34 to 84.16). For the Modified Shock Index: AUROC was 0.90 (95% CI: 0.86 to 0.95), with an optimal cutoff at 1.46, Se was 95.65% (95% CI: 79.01 to 99.23) and Sp was 75.78% (95% CI: 70.18 to 80.62). Shock Index and Modified Shock Index are good predictors of massive bleeding and could be easily incorporated to the initial workup of patients with severe trauma. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  12. Ankle Brachial Index

    Energy Technology Data Exchange (ETDEWEB)

    Wikstroem, J.; Hansen, T.; Johansson, L.; Lind, L.; Ahlstroem, H. (Dept. of Radiology and Dept. of Medical Sciences, Uppsala Univ. Hospital, Uppsala (SE))

    2008-03-15

    Background: Whole-body magnetic resonance angiography (WBMRA) permits noninvasive vascular assessment, which can be utilized in epidemiological studies. Purpose: To assess the relation between a low ankle brachial index (ABI) and high-grade stenoses in the pelvic and leg arteries in the elderly. Material and Methods: WBMRA was performed in a population sample of 306 subjects aged 70 years. The arteries below the aortic bifurcation were graded after the most severe stenosis according to one of three grades: 0-49% stenosis, 50-99% stenosis, or occlusion. ABI was calculated for each side. Results: There were assessable WBMRA and ABI examinations in 268 (right side), 265 (left side), and 258 cases (both sides). At least one >=50% stenosis was found in 19% (right side), 23% (left side), and 28% (on at least one side) of the cases. The corresponding prevalences for ABI <0.9 were 4.5%, 4.2%, and 6.6%. An ABI cut-off value of 0.9 resulted in a sensitivity, specificity, and positive and negative predictive value of 20%, 99%, 83%, and 84% on the right side, and 15%, 99%, 82%, and 80% on the left side, respectively, for the presence of a >= 50% stenosis in the pelvic or leg arteries. Conclusion: An ABI <0.9 underestimates the prevalence of peripheral arterial occlusive disease in the general elderly population

  13. 广州市儿童及青少年代谢综合征肥胖指标诊断界值的研究%Diagnosis boundary values of metabolic syndrome obesity index for Children and adolescents

    Institute of Scientific and Technical Information of China (English)

    黄瑞娟; 黄志平; 苏喆; 赵喆; 孔卫乾; 麦艳君; 佘文; 黎巨成; 曾智勇; 黄淑贤

    2014-01-01

    目的:研究广州市6~18岁人群腰围(WC)、腰围身高比(WHtR)的分布特征,在心血管疾病(CVD)危险因素评估的基础上提出6~18岁人群WC和WHtR的适宜界值。方法:利用受试者工作特征曲线(ROC)法分析广州市15000名6~18岁儿童及青少年身高、体质量、WC及其相关代谢指征数据(血压、空腹血糖、血脂),探索预测心血管疾病的WC和WHtR的最佳界值点。结果:当WC百分比达到P85时,WHtR达到0.48时,空腹血糖、血压、血脂等心血管危险因素检出率明显增高。结论:建议将中国儿童青少年WC的第85百分位值,WHtR 0.48作为预测儿童青少年心血管病危险因素增加的适宜界值。WC和WHtR作为相对简单的检查方法,能很好地预测心血管疾病,建议列入学生体检的常规测量项目。%Objective: To determine the distribution characteristics of waist circumference (WC), waist height ratio (WHtR) of 6–18 years olds in Guangzhou, and to put forward the WC and WHtR appropriate boundary values for 6–18 years olds on the basis of cardiovascular disease (CVD) risk factor assessment. Methods: We analyzed the height, weight, WC and its metabolic indication data (blood pressure, fasting blood glucose, and blood lipids) of 15 000 children in Guangzhou, aged 6–18, with the receiver-operating characteristic curve (ROC), and explored the best value point of WC and WHtRfor the prediction of cardiovascular diseases. Results: When the WC percent reached P85, and WHtR reached 0.48, the cardiovascular risk factors of fasting blood-glucose, blood pressure, and blood fat were signiifcantly higher. Conclusion: The 85th percentile value of WC and 0.48 of WHtR are the appropriate boundary values in increasing the cardiovascular disease risk factors in Chinese children and teenagers. WC and WHtR as a relatively simple inspection method, can well predict cardiovascular diseases, and be used in the conventional measuring items among

  14. CENDI Indexing Workshop

    Science.gov (United States)

    1994-01-01

    The CENDI Indexing Workshop held at NASA Headquarters, Two Independence Square, 300 E Street, Washington, DC, on September 21-22, 1994 focused on the following topics: machine aided indexing, indexing quality, an indexing pilot project, the MedIndEx Prototype, Department of Energy/Office of Scientific and Technical Information indexing activities, high-tech coding structures, category indexing schemes, and the Government Information Locator Service. This publication consists mostly of viewgraphs related to the above noted topics. In an appendix is a description of the Government Information Locator Service.

  15. Grid of streamflow variability index for Ohio

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — A generalized streamflow-variability index coverage was created by interpolating a grid (with 6,066-ft^2 cells) from at-site values of the streamflow-variability...

  16. ASSESSMENT OF WATER QUALITY INDEX FOR GROUNDWATER ...

    African Journals Online (AJOL)

    2013-12-31

    Dec 31, 2013 ... measurement units in a single metric and its effectiveness as a communication tool. ... Fair. Water quality is usually protected but occasionally threatened or ... Electrical Conductivity (EC) value is an index to represent the total.

  17. EJSCREEN Version 1, Primary EJ Index

    Data.gov (United States)

    U.S. Environmental Protection Agency — The primary EJ index measures how much a particular place contributes to overall nationwide differences in environmental indicator values between demographic groups....

  18. Values Research

    Science.gov (United States)

    2009-10-01

    horizontal vs. vertical. • According to the theory of Planned Behavior ( Ajzen , 1988, 2002) attitude, subjective norms and perceived control...determines intention which may end in behavior . 7 Defining Human Values Cross-cultural theories on values emerged in the 80s developed by three main...attitudes with social structure. 4 Defining Human Values • According to Parsons (Parsons & Shils, 1951), values instigate behavior . • In line

  19. Columbia River ESI: INDEX (Index Polygons)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains vector polygons representing the boundaries of all hardcopy cartographic products produced as part of the Environmental Sensitivity Index...

  20. American Samoa ESI: INDEX (Index Polygons)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains vector polygons representing the boundaries of all the hardcopy cartographic products produced as part of the Environmental Sensitivity Index...

  1. Human Use Index (Future)

    Data.gov (United States)

    U.S. Environmental Protection Agency — Human land uses may have major impacts on ecosystems, affecting biodiversity, habitat, air and water quality. The human use index (also known as U-index) is the...

  2. Human Use Index

    Data.gov (United States)

    U.S. Environmental Protection Agency — Human land uses may have major impacts on ecosystems, affecting biodiversity, habitat, air and water quality. The human use index (also known as U-index) is the...

  3. Master Veteran Index (MVI)

    Data.gov (United States)

    Department of Veterans Affairs — As of June 28, 2010, the Master Veteran Index (MVI) database based on the enhanced Master Patient Index (MPI) is the authoritative identity service within the VA,...

  4. Audio Indexing for Efficiency

    Science.gov (United States)

    Rahnlom, Harold F.; Pedrick, Lillian

    1978-01-01

    This article describes Zimdex, an audio indexing system developed to solve the problem of indexing audio materials for individual instruction in the content area of the mathematics of life insurance. (Author)

  5. Glycemic index and diabetes

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000941.htm Glycemic index and diabetes To use the sharing features on ... GI diet also may help with weight loss. Glycemic Index of Certain Foods Low GI foods (0 to ...

  6. IndexCat

    Data.gov (United States)

    U.S. Department of Health & Human Services — IndexCat provides access to the digitized version of the printed Index-Catalogue of the Library of the Surgeon General's Office; eTK for medieval Latin texts; and...

  7. Unified Index Unveiled

    Institute of Scientific and Technical Information of China (English)

    RENWEI

    2005-01-01

    China unveiled a unified stock index to track both markets in Shanghai and Shenzhen in April, a move likely to open a floodgate for more trading derivatives such as index futures. The new index, with 300 component companies traded on Shanghai and Shenzhen stock exchanges, will be the first of its kind on the mainland. The index members will be the largest 300 stocks - 180 from Shanghai and 120 from Shenzhen - in terms of market capitalization,

  8. Index to Volume 110

    Science.gov (United States)

    Marriott, R. A.

    2001-02-01

    The Subject Index references items under general headings; where a contribution covers two or more clearly defined subjects, each is separately referenced, but otherwise sub-headings within the same topic are not included. Book and other reviews are indexed as such, but their subjects are not further cross-indexed. The Author Index details all named contributions, including talks at Ordinary Meetings, but not questions from the floor.

  9. Indexing Executive Compensation Contracts

    NARCIS (Netherlands)

    I. Dittmann (Ingolf); E.G. Maug (Ernst); O.G. Spalt (Oliver)

    2013-01-01

    textabstractWe analyze the efficiency of indexing executive pay by calibrating the standard model of executive compensation to a large sample of US CEOs. The benefits from linking the strike price of stock options to an index are small and fully indexing all options would increase compensation costs

  10. Textile Index Monitor

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Part I–Price Index National Index for China Textile City (located in Keqiao, Shaoxing county in Zhejiang Province, east of China) concludes its price index (periodic code:20101101) at 100.31 points rise of 0.68% as against its previous week.

  11. Textile Index Monitor

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    Part I—Price IndexNational Index for China Textile City (located in Keqiao,Shaoxing county in Zhejiang Province,east of China) concludes its price index (periodic code:20110606) at 110.56 points.

  12. Planetary Kp index forecast using autoregressive models

    CERN Document Server

    Gonzalez, Arian Ojeda; Odriozola, Siomel Savio; Rosa, Reinaldo Roberto; Mendes, Odim

    2014-01-01

    The geomagnetic Kp index is derived from the K index measurements obtained from thirteen stations located around the Earth geomagnetic latitudes between $48^\\circ$ and $63^\\circ$. This index is processed every three hours, is quasi-logarithmic and estimates the geomagnetic activity. The Kp values fall within a range of 0 to 9 and are organized as a set of 28 discrete values. The data set is important because it is used as one of the many input parameters of magnetospheric and ionospheric models. The objective of this work is to use historical data from the Kp index to develop a methodology to make a prediction in a time interval of at least three hours. Five different models to forecast geomagnetic indices Kp and ap are tested. Time series of values of Kp index from 1932 to 15/12/2012 at 21:00 UT are used as input to the models. The purpose of the model is to predict the three measured values after the last measured value of the Kp index (it means the next 9 hours values). The AR model provides the lowest com...

  13. The diagnostic value of combined detection of four indexes in early diagnosis of nephropathy%4项指标联合检测在肾脏疾病早期诊断中的意义

    Institute of Scientific and Technical Information of China (English)

    胡娟娟; 周铁成; 童开; 李小燕; 程晓东

    2015-01-01

    Objective To explore the value of joint detection of serum cystatin C (Cys C) ,retinol‐binding protein(RBP) ,urea ni‐trogen(BUN) and creatinine(Cr) in early diagnosis of nephropathy .Methods A total of 230 cases of inpatients with nephropathy form April 2013 to June 2014 were collected and divided into diabetic nephropathy group (130 cases)and hypertensive nephropathy group(100 cases) .Other 200 healthy individuals were collected as healthy control group .The serum levels of Cys C ,RBP ,BUN and Cr were detected by using the Hitachi 7180 automatic biochemistry analyzer .Results Compared with the healthy control group ,the sertum levels of Cys C ,RBP ,BUN and Cr were significantly increased in the diabetic nephropathy group ,and the serum levels of Cys C and RBP were significantly increased in hypertensive nephropathy group ,there were statistically significant differences (P0 .05) .Positive rates(81 .9% ) of the four indicators in the two nephropathy groups were high‐er than those in the healthy control group ,and the positive rate of joint detection of the four indicators was higher than single detec‐tion in patients with nephropathy .Conclusion Serum RBP and Cys C are sensitive indicators for early renal damage ,and combined with BUN and Cr could increase sensitivity of early diagnosis of nephropathy ,which has significant clinical value .%目的:探讨血清胱抑素C(Cys C)、视黄醇结合蛋白(RBP)、尿素氮(BUN)和肌酐(Cr)联合检测对肾脏疾病的早期诊断价值。方法选取2013年4月至2014年6月各类肾脏疾病住院患者230例,其中糖尿病肾病组130例,高血压肾病组100例;另选取200例体检健康者作为健康对照组;应用日立7180全自动生化分析仪检测血清Cys C、RBP、BUN及Cr水平。结果与健康对照组比较,糖尿病肾病组患者血清Cys C、RBP、BUN、Cr水平均升高,高血压肾病组患者血清Cys C、RBP水平升高,差异有统计学意义(P<0

  14. Impact of Sitting or Semi-Setting Position of Patients During Breast Surgery on Hemodynamic Indexes

    Directory of Open Access Journals (Sweden)

    Kasra Karvandian

    2016-09-01

    Full Text Available Background: Keeping the patient in a sitting or semi-sitting position for time-consuming oncoplastic breast surgery is a major challenge for anesthesiologists due to several considerations. This cohort study was conducted on two groups of patients undergoing breast surgery.Methods: Study participants were categorized into two groups: one group was composed of normotensive women (group A and the other group comprised women with controlled hypertension (group B. After the induction of anesthesia in the supine position, the position was changed to sitting and the surgery was done in the sitting position. Hemodynamic monitoring included ECG, heart rate, non-invasive blood pressure (NIBP, invasive blood pressure (IBP, cardiac output (CO, arterial O2 saturation (SPO2, end-tidal CO2 (EtCO2, and bispectral index (BIS. The amount of administrated fluid and vasopressor was recorded for each patient. Any episode of hemodynamic instability was recorded, too.Results: Hemodynamic variation occurred in both groups, but the changes were more significant in group B and the amount of fluid and vasopressor administration was more prominent in group B. Changing the position caused no significant variation in BIS, SPO2, and EtCO2 in the two groups.Conclusions: The sitting position can be safe for time-consuming oncoplastic breast surgery using adequate hemodynamic monitoring. Hemodynamic changes are more significant in patients with controlled hypertension, and more medical interference is needed for these patients.

  15. Central indexes to the citation distribution: A complement to the h-index

    CERN Document Server

    Dorta-Gonzalez, Pablo; 10.1007/s11192-011-0453-3

    2013-01-01

    The citation distribution of a researcher shows the impact of their production and determines the success of their scientific career. However, its application in scientific evaluation is difficult due to the bi-dimensional character of the distribution. Some bibliometric indexes that try to synthesize in a numerical value the principal characteristics of this distribution have been proposed recently. In contrast with other bibliometric measures, the biases that the distribution tails provoke, are reduced by the h-index. However, some limitations in the discrimination among researchers with different publication habits are presented in this index. This index penalizes selective researchers, distinguished by the large number of citations received, as compared to large producers. In this work, two original sets of indexes, the central area indexes and the central interval indexes, that complement the h-index to include the central shape of the citation distribution, are proposed and compared.

  16. Indexing Motion Detection Data for Surveillance Video

    DEFF Research Database (Denmark)

    Vind, Søren Juhl; Bille, Philip; Gørtz, Inge Li

    2014-01-01

    We show how to compactly index video data to support fast motion detection queries. A query specifies a time interval T, a area A in the video and two thresholds v and p. The answer to a query is a list of timestamps in T where ≥ p% of A has changed by ≥ v values. Our results show that by building...... a small index, we can support queries with a speedup of two to three orders of magnitude compared to motion detection without an index. For high resolution video, the index size is about 20% of the compressed video size....

  17. Analysis in indexing

    DEFF Research Database (Denmark)

    Mai, Jens Erik

    2005-01-01

    is presented as an alternative and the paper discusses how this approach includes a broader range of analyses and how it requires a new set of actions from using this approach; analysis of the domain, users and indexers. The paper concludes that the two-step procedure to indexing is insufficient to explain...... the indexing process and suggests that the domain-centered approach offers a guide for indexers that can help them manage the complexity of indexing. © 2004 Elsevier Ltd. All rights reserved....

  18. Value of combined multiple index in diagnosis of coronary heart disease%多项指标联合检测对诊断冠心病的价值

    Institute of Scientific and Technical Information of China (English)

    张莹莹; 于波; 李丽丽

    2011-01-01

    目的 探讨超敏C反应蛋白(high-sensitivity C-reactive protein,Hs-CRP)、血清半胱氨酸(homocysteine,Hcy)和低密度脂蛋白/高密度脂蛋白比值(low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio,LDL-C/HDL-C)联合检测对冠状动脉粥样硬化性心脏病(coronary heart disease,CHD)的诊断价值.方法 选取2008年7月~2010年12月入院接受冠状动脉造影术检查患者264例,冠心病组165例,对照组(冠脉造影正常)99例,分别测定各组血清中Hs-CRP、Hcy和LDL-C/HDL-C的水平.结果 冠心病组Hs-CRP、Hcy的含量和LDL-C/HDL-C比值均显著高于对照组(P<0.01).联合应用Hs-CRP、Hcy和LDL-C/LDL-C对冠心病的诊断敏感度(94.5%)高于分别单独应用Hs-CRP(85.6%)、Hcy(82.3%)和TC/HDL-C (76.2%)的诊断敏感度(P<0.05).结论 联合应用Hs-CRP、Hcy和LDL-C/HDL-C更有助于冠心病的早期诊断.%Objective To study the value of integrated detection of serum high-sensitivity C-re-active protein (Hs-CRP) ,homocysteine(Hcy)and low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio ( LDL-C/HDL-C) in diagnosis of coronary heart disease (CHD). Methods Hs-CRP,Hcy and LDL-C/HDL-C ratio were analyzed in 165 cases of pa-tient(CHD group) and 99 cases of control( control group) which were enrolled by coronary an-giography. Results The concentration of Hs-CRP, Hcy and LDL-C/HDL-C ratio were significantly higher in CHD patients than those in control group(P <0. 01). The sensitivity of integrated detection of all the three markers(92. 8% ) was higher than the single marker detection of either Hs-CRP (83. 7% ) , Hcy (80. 0% ) or LDL-C/HDL-C (73. 4% ) , P < 0. 05. Conclusion Integrated detection of Hs-CRP,Hcy and LDL-C/HDL-C is more accurate and reliable in the diagnosis of CHD.

  19. 血乳酸、乳酸清除率和氧合指数对重症脓毒症患者预后评估的临床价值%Prognostic value of blood lactic acid, lactic acid clearance and oxygenation index for patients with severe sepsis

    Institute of Scientific and Technical Information of China (English)

    林荣海; 龚仕金; 徐颖鹤; 李莉; 张超; 李军军

    2012-01-01

    目的 探讨血乳酸、乳酸清除率和氧合指数在重症脓毒症患者预后评估中的临床价值.方法 选择46例因重症脓毒症入住ICU的患者,按照28d预后分为生存组和死亡组.比较两组血乳酸浓度、乳酸清除率、氧合指数和急性生理与慢性健康状况(APACHEⅡ)评分,并建立ROC曲线.结果 乳酸、乳酸清除率、氧合指数和APACHEⅡ评分在两组患者中差异均有统计学意义(P<0.05或0.01),乳酸、乳酸清除率、氧合指数与APACHEⅡ评分存在明显正相关(r=0.932,P=0.012).乳酸、乳酸清除率、氧合指数阳性项目越多,28d病死率越高.乳酸、乳酸清除率、氧合指数和APACHEⅡ评分的ROC曲线下面积分别为0.715、0.744、0.701、0.759.结论 血乳酸浓度、乳酸清除率和氧合指数与APACHEⅡ评分显著相关,可以预测重症脓毒症患者的预后.%Objective To investigate the value of blood lactic acid, lactic acid clearance and oxygenation index in prognosis of patients with severe sepsis. Methods Forty-six patients were divided into survival group and death group according to their outcome. Levels of blood lactic acid, lactic acid clearance and oxygenation index were measured, and acute physiology and chronic health evaluation (APACHE II) was scored. ROC was constructed to observe the clinical value of blood lactic acid, lactic acid clearance, oxygenation index and APACHE II on prognosis of severe sepsis. Results There were significant differences in the levels of blood lactic acid, lactic acid clearance, oxygenation index and APACHE II score between two groups. Blood lactic acid, lactic acid clearance and o