• Title/Summary/Keyword: severity levels

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Serum procalcitonin as a diagnostic marker of neonatal sepsis

  • Park, In Ho;Lee, Seung Hyun;Yu, Seung Taek;Oh, Yeon Kyun
    • Clinical and Experimental Pediatrics
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    • v.57 no.10
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    • pp.451-456
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    • 2014
  • Purpose: We evaluated serum procalcitonin (PCT) as a diagnostic marker of neonatal sepsis, and compared PCT levels with C-reactive protein (CRP) levels. Methods: We retrospectively reviewed the medical records of 269 neonates with a suspected infection, admitted to Wonkwang University School of Medicine & Hospital between January 2011 and December 2012, for whom PCT and CRP values had been obtained. Neonates were categorized into 4 groups according to infection severity. CRP and PCT values were analyzed and compared, and their effectiveness as diagnostic markers was determined by using receiver operating characteristic (ROC) curve analysis. We also calculated the sensitivity, specificity, and positive, and negative predictive values. Results: The mean PCT and CRP concentrations were respectively $56.27{\pm}81.89$ and $71.14{\pm}37.17mg/L$ in the "confirmed sepsis" group; $15.64{\pm}32.64$ and $39.23{\pm}41.41mg/L$ in the "suspected sepsis" group; $9.49{\pm}4.30$ and $0.97{\pm}1.16mg/L$ in the "mild infection" group; and $0.21{\pm}0.12$ and $0.72{\pm}0.7mg/L$ in the control group. High concentrations indicated greater severity of infection (P<0.001). Five of 18 patients with confirmed sepsis had low PCT levels (<1.0 mg/L) despite high CRP levels. In the ROC analysis, the area under the curve was 0.951 for CRP and 0.803 for PCT. The cutoff concentrations of 0.5 mg/L for PCT and 1.0 mg/L for CRP were optimal for diagnosing neonatal sepsis (sensitivity, 88.29% vs. 100%; specificity, 58.17% vs. 85.66%; positive predictive value, 13.2% vs. 33.3%; negative predictive value, 98.6% vs. 100%, respectively). Conclusion: PCT is a highly effective early diagnostic marker of neonatal infection. However, it may not be as reliable as CRP.

Low Serum Potassium Levels Associated with Disease Severity in Children with Nonalcoholic Fatty Liver Disease

  • Tabbaa, Adam;Shaker, Mina;Lopez, Rocio;Hoshemand, Kazem;Nobili, Valerio;Alkhouri, Naim
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.3
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    • pp.168-174
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    • 2015
  • Purpose: Recent studies have suggested that decreased serum potassium level may contribute to various metabolic disorders in adult patients including nonalcoholic fatty liver disease (NAFLD). We aimed to study the correlation between serum potassium levels and the histologic severity of NAFLD in children. Methods: Pediatric patients with biopsy-proven NAFLD were included in this study. Demographic, clinical, and histopathological data were obtained. Multivariable logistic regression analysis was used to assess whether potassium levels are associated with the presence of nonalcoholic steatohepatitis (NASH) or fibrosis after adjusting for possible confounders. A p-value <0.05 was considered statistically significant. Results: Among 125 biopsies, 49.6% (62) had evidence of NASH while 66.4% (83) had some degree of fibrosis (stage 1-3). Mean serum potassium was significantly lower in NASH group as compared to non-NASH group ($4.4{\pm}0.42mmoL/L$ vs. $4.8{\pm}0.21$, p<0.001). Higher potassium level had negative correlation with presence of steatosis, ballooning, lobular inflammation, fibrosis and NAFLD activity score (p<0.05). On multivariable analysis and after adjusting for the metabolic syndrome and insulin resistance, higher potassium level was significantly associated with lower likelihood of having a histological diagnosis of NASH on biopsy (odds ratio [OR], 0.12; 95% confidence interval [95% CI], 0.05-0.28; p<0.001). Similarly, the likelihood of having fibrosis decreases by 76% for every 0.5 mmoL/L increase in potassium (OR, 0.24; 95% CI, 0.11-0.54; p<0.001). Conclusion: Our study shows an inverse relationship between serum potassium levels and the presence of aggressive disease (NASH and fibrosis) in children with NAFLD.

Phonation Threshold Flow and Phonation Threshold Pressure in Patients with Adductor Spasmodic Dysphonia

  • Choi, Seong-Hee;Jiang, Jack J.;Yun, Bo-Ram;Lee, Ji-Yeoun;Lim, Sung-Eun;Choi, Hong-Shik
    • Phonetics and Speech Sciences
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    • v.2 no.3
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    • pp.157-164
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    • 2010
  • This study investigated the characteristics of two aerodynamic indices, PTP (Phonation threshold pressure) and PTF (Phonation threshold flow) in patients with ADSD (adductor spasmodic dysphonia) and to see if two new aerodynamic indices can differentiate between normal and ADSD group. Additionally, PTP and PTF values were compared in terms of overall severity of ADSD in the patient group. The severity of ADSD was rated on a 7-point rating scale by two experienced speech language pathologists. The Kay Elemetrics Phonatory Aerodynamic System (PAS) (Kay Elemetrics Corp., Lincoln Park, NJ) was used to collect PTP and PTF measurements from 16 female normal subjects, 31 female patients with ADSD. Significantly lower PTF values (P< 0.05) were observed in ADSD when compared to those of normal control. Also, significantly lower PTF values in severe ADSD patients (P<.001). However, PTP could not distinguish patients with ADSD from control groups (P=0.119) and among the ADSD groups according to the severity (P=0.177). Consequently, PTF was more sensitive than PTP which might differentiate between normal speakers and ADSD and among different levels of severity within ADSD, suggesting that PTF could be a useful diagnostic parameter to measure the aerodynamic function of ADSD and provide the neurolaryngeal dysfunction in patients with ADSD.

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Estimation of the Expected Loss per Exposure of Export Insurance using GLM (일반화 선형모형을 이용한 수출보험의 지급비율 추정)

  • Ju, Hyo Chan;Lee, Hangsuck
    • The Korean Journal of Applied Statistics
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    • v.26 no.6
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    • pp.857-871
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    • 2013
  • Export credit insurance is a policy tool for export growth. In the era of free trade under the governance of WTO, export credit insurance is still allowed as one of the few instruments to increase exports. This paper, using data on short-term export insurance contracts issued to foreign subsidiaries of Korean companies, calculates the expected loss per exposure by combining the effect of risk factors (credit rate of foreign importers, size of mother company, and payment period) on loss frequency and loss severity in different levels. We, applying generalized linear models (GLM), first fit loss frequency and loss severity to negative binomial and lognormal distribution, respectively, and then estimate the loss frequency rate per contract and the ratio of loss severity to coverage amount. Finally, we calculate the expected loss per exposure for each level of risk factors by combining these two rates. Based on the result of statistical analysis, we present the implication for the current premium rate of export insurance.

The relationship between the level of salivary alpha amylase activity and pain severity in patients with symptomatic irreversible pulpitis

  • Ahmadi-Motamayel, Fatemeh;Shahriari, Shahriar;Goodarzi, Mohammad Taghi;Moghimbeigi, Abbas;Jazaeri, Mina;Babaei, Parisa
    • Restorative Dentistry and Endodontics
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    • v.38 no.3
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    • pp.141-145
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    • 2013
  • Objectives: Assessment of dental pain severity is very challenging in dentistry. Previous studies have suggested that elevated salivary alpha amylase may contribute to increased physical stresses. There is a close association between salivary alpha amylase and plasma norepinephrine under stressful physical conditions. The aim of this study was to evaluate the relationship between pain severity and salivary alpha amylase levels in patients with symptomatic irreversible pulpitis. Materials and Methods: Thirty-six patients (20 females and 16 males) with severe tooth pain due to symptomatic irreversible pulpitis were selected. The visual analogue scale (VAS) score was used to assess the pain severity in each patient. Unstimulated whole saliva was collected, and the level of alpha amylase activity was assessed by the spectrophotometric method. Statistical analysis was performed using SPSS 13. Results: The level of alpha amylase was significantly increased in the saliva in association with pain severity assessed by VAS. The salivary alpha amylase was also elevated with increased age and in males. Conclusions: There was a significant correlation between the VAS pain scale and salivary alpha amylase level, which indicates this biomarker may be a good index for the objective assessment of pain intensity.

Trait Anxiety as a Mediator of the Association between Attention Deficit Hyperactivity Disorder Symptom Severity and Functional Impairment

  • Oh, Yunhye;Yoon, Hee Joon;Kim, Ji-Hae;Joung, Yoo Sook
    • Clinical Psychopharmacology and Neuroscience
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    • v.16 no.4
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    • pp.407-414
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    • 2018
  • Objective: Anxiety has been shown to influence functional impairment in patients with attention deficit hyperactivity disorder (ADHD). This study aimed to compare functional impairment in subjects with and without adult ADHD and to investigate the associations among trait anxiety, functional impairment, and ADHD symptom severity. Moreover, the effects of ADHD symptom subtypes on trait anxiety and functional impairment were also examined. Methods: The sample included 209 adults between the ages of 20 and 31 years. Fifty-one adults received a diagnosis of ADHD, and an additional age, sex-matched group of 51 adults comprised the adult control. Participants were assessed with Conners' Adult ADHD Rating Scales (CAARS), the Beck Depression Inventory (BDI), the Spielberg Trait Anxiety Inventory (STAI-T), and the Sheehan Disability Scale (SDS). The relationships among ADHD severity, anxiety, and functional impairment were investigated using Pearson's correlation analysis. Subtypes of ADHD symptoms that predicted anxiety and functional impairment were investigated using regression analyses. Results: Adult ADHD patients significantly differed from normal control subjects according to BDI, STAI-T, and SDS assessment. Significant positive correlations were noted between ADHD severity, anxiety, and functional impairment. Multiple linear regression analysis confirmed anxiety as a mediator between functional impairment and ADHD CAARS symptom subscales. Conclusion: Patients with adult ADHD showed higher levels of anxiety, depression, and functional impairment. Additionally, ADHD symptoms and anxiety impacted subject functional impairment. Our results suggest that anxiety may be a strong mediator between ADHD severity and functional impairment.

Evaluation of Barley and Wheat Germplasm for Resistance to Head Blight and Mycotoxin Production by Fusarium asiaticum and F. graminearum

  • Seul Gi, Baek;Jin Ju, Park;Sosoo, Kim;Mi-Jeong, Lee;Ji-Seon, Paek;Jangnam, Choi;Ja Yeong, Jang;Jeomsoon, Kim;Theresa, Lee
    • The Plant Pathology Journal
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    • v.38 no.6
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    • pp.637-645
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    • 2022
  • Fusarium head blight (FHB) is one of the most serious diseases in barley and wheat, as it is usually accompanied by the production of harmful mycotoxins in the grains. To identify FHB-resistant breeding resources, we evaluated 60 elite germplasm accessions of barley (24) and wheat (36) for FHB and mycotoxin accumulation. Assessments were performed in a greenhouse and five heads per accession were inoculated with both Fusarium asiaticum (Fa73, nivalenol producer) and F. graminearum (Fg39, deoxynivalenol producer) strains. While the accessions varied in disease severity and mycotoxin production, four wheat and one barley showed <20% FHB severity repeatedly by both strains. Mycotoxin levels in these accessions ranged up to 3.9 mg/kg. FHB severity was generally higher in barley than in wheat, and Fa73 was more aggressive in both crops than Fg39. Fg39 itself, however, was more aggressive toward wheat and produced more mycotoxin in wheat than in barley. FHB severity by Fa73 and Fg39 were moderately correlated in both crops (r = 0.57/0.60 in barley and 0.42/0.58 in wheat). FHB severity and toxin production were also correlated in both crops, with a stronger correlation for Fa73 (r = 0.42/0.82 in barley, 0.70 in wheat) than for Fg39.

Role of vitamin C and rectal indomethacin in preventing and alleviating post-endoscopic retrograde cholangiopancreatography pancreatitis: a clinical study

  • Amir Sadeghi;Rana Jafari-Moghaddam;Sara Ataei;Mahboobe Asadiafrooz;Mohammad Abbasinazari
    • Clinical Endoscopy
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    • v.56 no.2
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    • pp.214-220
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    • 2023
  • Background/Aims: This study aimed to determine whether vitamin C in addition to indomethacin decreases the occurrence and severity of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) occurrence and severity. Methods: This randomized clinical trial included patients undergoing ERCP. The participants were administered either rectal indomethacin (100 mg) plus an injection of vitamin C (500 mg) or rectal indomethacin (100 mg) alone just before ERCP. The primary outcomes were PEP occurrence and severity. The secondary amylase and lipase levels were determined after 24 hours. Results: A total of 344 patients completed the study. Based on intention-to-treat analysis, the PEP rates were 9.9% for indomethacin plus vitamin C plus indomethacin and 15.7% for indomethacin alone. Regarding the per-protocol analysis, the PEP rates were 9.7% and 15.7% in the combination and indomethacin arms, respectively. There was a remarkable difference between the two arms in PEP occurrence and severity on intention-to-treat and per-protocol analyses (p=0.034 and p=0.031, respectively). The post-ERCP lipase and amylase concentrations were lower in the combination arm than in the indomethacin alone arm (p=0.034 and p=0.029, respectively). Conclusions: Vitamin C injection in addition to rectal indomethacin reduced PEP occurrence and severity.

Fractal evaluation of the level of alligator cracking in pavements

  • Vallejo, Luis E.
    • Geomechanics and Engineering
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    • v.4 no.3
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    • pp.219-227
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    • 2012
  • Pavement management systems require systematic monitoring of pavement surfaces to determine preventive and corrective maintenance. The process involves the accumulation of large amounts of visual data, typically obtained from site visitation. The pavement surface condition is then correlated to a pavement distress index that is based on a scoring system previously established by state or federal agencies. The scoring system determines if the pavement section requires maintenance, overlay or reconstruction. One of the surface distresses forming part of the overall pavement distress index is the Alligator Crack Index (AC Index). The AC Index involves the visual evaluation of the crack severity of a section of a pavement as being low, medium, or high. This evaluation is then integrated into a formula in order to obtain the AC Index. In this study a quantification of the visual evaluation of the severity of alligator cracking is carried out using photographs and the fractal dimension concept from fractal theory. Pavements with low levels of cracking were found to have a fractal dimension equal to 1.051. Pavements with moderate levels of cracking had a fractal dimension equal to 1.1754. Pavements with high degrees of cracking had a fractal dimension that varied between 1.5037 (high) and 1.7111 (very high). Pavements with a level of cracking equal to 1.8976 represented pavements that disintegrated and developed potholes. Thus, the visual evaluation of the state of cracking of a pavement (the AC Index) could be enhanced with the use of the fractal dimension concept from fractal theory.

CONSTRUCTION SCHEDULE DELAY RISK ASSESSMENT BY USING COMBINED AHP-RII METHODOLOGY FOR AN INTERNATIONAL NPP PROJECT

  • HOSSEN, MUHAMMED MUFAZZAL;KANG, SUNKOO;KIM, JONGHYUN
    • Nuclear Engineering and Technology
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    • v.47 no.3
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    • pp.362-379
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    • 2015
  • In this study, Nuclear Power Plant (NPP) construction schedule delay risk assessment methodology is developed and the construction delay risk is assessed for turnkey international NPP projects. Three levels of delay factors were selected through literature review and discussions with nuclear industry experts. A questionnaire survey was conducted on the basis of an analytic hierarchy process (AHP) and Relative Importance Index (RII) methods and the schedule delay risk is assessed qualitatively and quantitatively by severity and frequency of occurrence of delay factors. This study assigns four main delay factors to the first level: main contractor, utility, regulatory authority, and financial and country factor. The second and the third levels are designed with 12 sub-factors and 32 sub-sub-factors, respectively. This study finds the top five most important sub-sub-factors, which are as follows: policy changes, political instability and public intervention; uncompromising regulatory criteria and licensing documents conflicting with existing regulations; robust design document review procedures; redesign due to errors in design and design changes; and worldwide shortage of qualified and experienced nuclear specific equipment manufacturers. The proposed combined AHP-RII methodology is capable of assessing delay risk effectively and efficiently. Decision makers can apply risk informed decision making to avoid unexpected construction delays of NPPs.