Accurate values are a must in medicine. An important parameter in determining the quality of a medical instrument is agreement with a gold standard. Various statistical methods have been used to test for agreement. Some of these methods have been shown to be inappropriate. This can result in misleading conclusions about the validity of an instrument. The Bland-Altman method is the most popular method judging by the many citations of the article proposing this method. However, the number of citations does not necessarily mean that this method has been applied in agreement research. No previous study has been conducted to look into this. This is the first systematic review to identify statistical methods used to test for agreement of medical instruments. The proportion of various statistical methods found in this review will also reflect the proportion of medical instruments that have been validated using those particular methods in current clinical practice.
Matched MeSH terms: Weights and Measures/instrumentation; Weights and Measures/standards
Sexual dimorphism is a common phenomenon in the animal kingdom. To test the consistency of sexual dimorphism patterns among sympatric species of the same genus, ten morphometric characteristics of mud crabs Scylla olivacea, S. tranquebarica and S. paramamosain were measured and compared using Discriminant Function Analysis (DFA). The descriptive analysis revealed that in all three species, body size dimensions and cheliped dimensions were significantly larger in males whereas the abdomen width was female-biased. Also, we described a morphological variation (carapace width, CW ≤ CW at spine 8, 8CW) that is unique to S. olivacea. Discriminant function analysis revealed that all nine morphometric characteristics were sexually dimorphic in S. olivacea, S. tranquebarica (except right cheliped's merus length, ML) and S. paramamosain (except 8CW). The obtained discriminant functions based on the morphometric ratios (with CW as divisor) correctly classified 100% of adults of known sex of all three species. Further, based on the selected body traits, DFA was able to almost completely distinguish males (94%), but not females (74%), among the three Scylla species. This study highlights that congeneric species of portunids (e.g., Scylla spp.) show similar sexually dimorphic characteristics (body size and secondary sexual characteristics).
Anochetus maryatiae, a new species of Formicidae from the subfamily Ponerinae, tribe Ponerini from Ulu Gombak is described and illustrated. This ant genus was last studied in Malaysia by Brown in 1978. Observations were made on morphometric characters which included parameter measurements of total length, head length, head width, mandible length, scape length, antenna length, maximum eye length, oculomandibular distance, funicular length segment 1 to 4, pronotum width, propodeum height, petiole length, petiole height, dorsal petiole width, cephalix index and mandibular index. It was followed by a brief diagnosis, description of morphological structure, microsculpture, pilosity and discussion. Although it has resemblance with Anochetus tua, it could be easily distinguished from other species in having reticulate pronotum. This is the only species from Malaysia with such microsculpture on the pronotum. In addition to that, A. maryatie varies with A. tua in having smaller total length, less than 7.5 mm and lighter colour.
Acetobacter xylinum strains are known as efficient producers of cellulose. A. xylinum is an obligate aerobic bacterium that has an oxygen-based metabolism. The dissolved oxygen (DO) concentration in a rotary discs reactor (RDR) is one of the most important factors that need to be observed during the cellulose synthesis by these bacteria. In this study, the effects of different discs rotation speed (5, 7, 9 and 12 rpm) and fermentation period (3, 4, 5 and 6 days) on the DO concentration and production of bacterial cellulose in a 10-L RDR were examined. The highest yield was obtained at 7 rpm with a total dried weight of 28.3 g for 4 days fermentation. The results showed that the DO concentration in the 10-L RDR increased in the range of 13 to 17% with increasing of discs rotation speed from 7 to 12 rpm. However, fermentation with high discs rotation speed at 12 rpm reduced the bacterial cellulose production. Analysis of data using Statistica 8.0 showed a high coefficient of determination value (R2 = 0.92). In conclusion, discs rotation speed gave more significant effect on the DO concentration and production of bacterial cellulose in 10-L RDR compared to fermentation period. This was further combined with synergistic effect from sufficient consumption of oxygen for the enhanced production of bacterial cellulose and providing the controlled environment for encouraging bacterial growth throughout the fermentation process.
Abdominal pain is one of the key symptoms of irritable bowel syndrome (IBS). Studies have indicated an increase in the incidence of IBS in Asia. However, yet the pathophysiology of this disease remains unknown. Women are more likely to develop the condition than men, especially the constipation-predominant type. Essential fatty acid (EFA) malnutrition is one of several theories discussing the mechanism of IBS.The authors hypothesized that significant EFA deficiency may cause abdominal pain in patients with IBS. However, because patterns in the oral intake of EFAs differ between cultures, the authors narrowed this study to examine the nutritional status of Asian female patients with IBSThe authors investigated Asian female patients with IBS and compared them with a group of healthy controls. Thirty patients with IBS and 39 healthy individuals were included in this study. The participants' age, height, weight, and waist size were recorded. The 24-item Hamilton Depression Rating Scale was documented. Both erythrocyte and plasma fatty acid content were analyzed through gas-liquid chromatography.The authors found that patients with IBS exhibited significantly higher scores for depression, higher proportions of plasma saturated fatty acids and monounsaturated fatty acids, and lower proportions of docosahexaenoic acid and total omega-3 polyunsaturated fatty acids in plasma are associated with IBS in Asian female patients. Further study is indicated to confirm the causality of this association.
Some diseases may underlie finger clubbing. However, there is a dearth of information about early stage of finger clubbing because only few researchers have shown interest in it. We determined the Digital Index of normal, healthy subjects by using thread and manual Vernier calipers, the time used for the procedure, and its interrater reliability. The value of Digital Index was 8.86 ± 0.29 (Mean ± SD) with a range of 8.15 to 9.41. Interrater reliability was excellent with Pearson's correlation coefficient of 0.966. Overall, the time taken to measure the Digital Index ranged from 21.93 to 68.80 minutes with an average of 35.97 ± 9.16 (Mean ± SD). Determining Digital Index need much time, but this can be overcome if we use Digital Index Quantitator (DIQ). Availability of DIQ in the hospital wards will be of much benefit. DIQ can also be used to accurately quantify the progression or regression of the clubbing process. This article proves that we need morphometry of digital clubbing as well as the correlation of the physical sign of clubbing with Digital Index.
Body measurement is the first process that must be encountered before any
custom-made compression garment can be designed. The current practice of
obtaining the measurement is by traditional methods using tools like
measuring tape. However, this method is considered to be time-consuming
and usually not accurate. The most popular solution to the problem is by using
non-contact measurement. The development of the 3D whole body scanner
has made non-contact body measurement become a reality due to its capacity
to capture a vast amount of information. However, the cost to buy the whole
body scanner is quite expensive. Moreover, their sizes are also bulky which
make them less portable. Thus, a handheld body scanner provides a solution
to the problem. Despite that, current handheld scanner only provide image
and visualization aspect, but not the measurement aspect. This paper reports
the development of a method to acquire body data from a 3D handheld
scanner. In this new method, the point cloud of a body part was collected
using the handheld scanner. Then, the data was transformed into point
coordinates. Several processes were developed to filter the number of points
to allow for faster processing time and increasing the measurement accuracy.
In the first process, only points at specific height/layers are selected. In the
second process, the remaining points are rearranged according to their height
and angle. In the last process, the number of points is further reduced. In this
process, the number of points per layer is limited to 72 points. Results show
that the method can be used to determine body measurement.
Skulls of the red-cheeked squirrel (Dremomys rufigenis) from various geographical locations: Malaysia (peninsular area), Vietnam (south district)-Laos, and Thailand (north district) were osteometrically examined. The skull size of the squirrels in the southern (Malaysia) population was fundamentally larger than that in the northern (Vietnam, Laos and Thailand) populations. The proportion indices indicated that the splanchnocranium was relatively longer in the Malaysia population, and that the interorbital space was narrower in Vietnam-Laos, and Thailand populations. We suggest that the long nose and laterally-oriented orbits in the skull may be better adapted for terrestrial-insectivorous life in the Malaysia population and the binocular sense facilitated by rostrally-oriented eyes contributes to the arboreal-fruit eating behavior in the two northern populations. The Malaysia population was clearly distinguished from the other populations by the principal component analysis. We suggest that the geographical barrier of the Isthmus of Kra influences the morphological variation of the skull among the squirrel populations.
Handgrip strength is useful for screening the nutritional status of adult population as it is strongly associated with physical disabilities and mortality. Therefore, we aimed to determine the predictors of handgrip strength among adults of a rural community in Malaysia using a cross-sectional study design with multistage sampling. All adults aged 30 years and older from 1250 households were invited to our study. Structured questionnaire on sociodemographic characteristics, medical history, occupation history, lifestyle practices, and measurements, including anthropometry and handgrip strength were taken. There were 2199 respondents with 55.2% females and majority were of Malay ethnicity. Their mean (standard deviation) age was 53.4 (13.2) years. The response rate for handgrip strength was 94.2%. Females had significantly lower handgrip strength than males (P < .05). In the multiple linear regression models, significant predictors of handgrip strength for males were age, height, job groups, and diabetes, while for females, the significant predictors were age, weight, height, and diabetes.
Enhanced muscle strength is seen when resistance exercise is combined with the consumption of nutritional supplements. Although there is a limited number of studies available about the efficacy of gamma oryzanol supplementation with resistance exercise in humans, but its usage as a nutritional supplement for strength is common in athletes. The aim of this study was to determine the effects of gamma oryzanol supplementation during 9-week resistance training on muscular strength and anthropometric measurements of young healthy males.
The family Poritidae formerly included 6 genera: Alveopora, Goniopora, Machadoporites, Porites, Poritipora, and Stylaraea. Morphologically, the genera can be differentiated based on the number of tentacles, the number of septa and their arrangement, the length of the polyp column, and the diameter of the corallites. However, the phylogenetic relationships within and between the genera are unknown or contentious. On the one hand, Alveopora has been transferred to the Acroporidae recently because it was shown to be more closely related to this family than to the Poritidae by previous molecular studies. On the other hand, Goniopora is morphologically similar to 2 recently described genera, Machadoporites and Poritipora, particularly with regard to the number of septa (approximately 24), but they have not yet been investigated at the molecular level. In this study, we analyzed 93 samples from all 5 poritid genera and Alveopora using 2 genetic markers (the barcoding region of the mitochondrial COI and the ITS region of the nuclear rDNA) to investigate their phylogenetic relationships and to revise their taxonomy. The reconstructed molecular trees confirmed that Alveopora is genetically distant from all poritid genera but closely related to the family Acroporidae, whereas the other genera are genetically closely related. The molecular trees also revealed that Machadoporites and Poritipora were indistinguishable from Goniopora. However, Goniopora stutchburyi was genetically isolated from the other congeneric species and formed a sister group to Goniopora together with Porites and Stylaraea, thus suggesting that 24 septa could be an ancestral feature in the Poritidae. Based on these data, we move G. stutchburyi into a new genus, Bernardpora gen. nov., whereas Machadoporites and Poritipora are merged with Goniopora.
Traditionally it was thought that fitness-related traits such as male mating frequency, with a history of strong directional selection, should have little additive genetic variance and thus respond asymmetrically to bidirectional artificial selection. However, recent findings and theory suggest that a balance between selection for increased male mating frequency and opposing selection pressures on physiologically linked traits will cause male mating frequency to have high additive genetic variation and hence respond symmetrically to selection. We tested these hypotheses in the stalk-eyed fly, Cyrtodiopsis dalmanni, in which males hold harems comprising many females and so have the opportunity to mate at extremely high frequencies. We subjected male stalk-eyed flies to artificial selection for increased ('high') and decreased ('low') mating frequency in the presence of ecologically realistic, high numbers of females. High line males mated significantly more often than control or low line males. The direct response to selection was approximately symmetric in the high and low lines, revealing high additive genetic variation for, and no significant genetic constraints on, increased male mating frequency in C. dalmanni. In order to investigate trade-offs that might constrain male mating frequency under natural conditions we examined correlated responses to artificial selection. We measured accessory gland length, testis length and eyespan after 7 and 14 generations of selection. High line males had significantly larger accessory glands than low line males. No consistent correlated responses to selection were found in testis length or eyespan. Our results suggest that costs associated with the production and maintenance of large accessory glands, although yet to be identified, are likely to be a major constraint on mating frequency in natural populations of C. dalmanni.
The objectives of this study were to investigate whether severity of clubfoot, age, and weight of the patients at initial manipulation and casting influence the total number of castings required.
Individualising a drug dosage regimen is more appropriate if it is based on pharmacokinetics data derived from local populations. In this study, we estimated valproic acid (VPA) and carbamazepine (CBZ) clearances in the Malaysian population from routinely collected therapeutic drug monitoring (TDM) data. We also evaluated the effects of gender, age, weight and concurrent antiepileptic drug (AED) therapy on VPA and CBZ clearance. Data was collected retrospectively from TDM forms of adult patients. Apparent drug clearance was estimated based on the standard steady state clearance equation. Mann-Whitney and KruskalWallis tests were used to evaluate gender and therapy differences, while Spearman’s Rank correlation was used to determine the associations of age and weight with clearance. One hundred thirty-two samples for VPA and 67 for CBZ were included in the analysis. Patients’ ages ranged from 15 to 72 years old. Mean VPA and CBZ clearances were found to be 0.36 l/kg/d and 1.60 l/kg/d, respectively. VPA clearance correlated positively but poorly with weight. Our results showed significant differences in (i) VPA clearance among male and female patients and (ii) VPA clearance between monotherapy and combination therapy. These findings provide a guide to initiate maintenance doses of VPA and CBZ in our local patients. Awareness of factors influencing drug clearance should help to optimise patients’ dosing regimens.
To assist in the broadcasting of time-critical traffic information in an Internet of Vehicles (IoV) and vehicular sensor networks (VSN), fast network connectivity is needed. Accurate traffic information prediction can improve traffic congestion and operation efficiency, which helps to reduce commute times, noise and carbon emissions. In this study, we present a novel approach for predicting the traffic flow volume by using traffic data in self-organizing vehicular networks. The proposed method is based on using a probabilistic generative neural network techniques called deep belief network (DBN) that includes multiple layers of restricted Boltzmann machine (RBM) auto-encoders. Time series data generated from the roadside units (RSUs) for five highway links are used by a three layer DBN to extract and learn key input features for constructing a model to predict traffic flow. Back-propagation is utilized as a general learning algorithm for fine-tuning the weight parameters among the visible and hidden layers of RBMs. During the training process the firefly algorithm (FFA) is applied for optimizing the DBN topology and learning rate parameter. Monte Carlo simulations are used to assess the accuracy of the prediction model. The results show that the proposed model achieves superior performance accuracy for predicting traffic flow in comparison with other approaches applied in the literature. The proposed approach can help to solve the problem of traffic congestion, and provide guidance and advice for road users and traffic regulators.
The functions of dams are for water supply, flood control and hydroelectric power generation. A concrete faced rockfill dam (CFRD) is preferred by dam consultants due to its many advantages. It is designed to withstand all applied loads, namely gravity load due to its massive weight and hydrostatic load due to water thrust from the reservoir. The structural response of the Bakun CFRD which is the second highest dam in the world after the Shuibuya Dam, was analyzed using finite element method. A two-dimensional plane strain finite element analysis of the non-linear Duncan-Chang hyperbolic model was used in the study of the dam in respect to the deformation and stresses of the main dam of Bakun CFRD project. The Dead-Birth-Ghost element technique was used to simulate sequences of the construction of the dam. The comparison of rigid and flexible foundation on the behaviour of the dam is discussed in this study. In the finite element modeling, the concrete slab on the upstream was represented through a six-noded element, while the interface characteristic between the dam body and the concrete slab was modeled using an interface element. The maximum settlement and stresses of the cross-section were found and their distribution was discussed and tabulated in the form of contours. The effect of reservoir filling loading had a gradual effect on the dam response behaviour. Comparisons with no water impoundment in the dam were also discussed.
Analyses of conventional morphometric, meristic and truss morphometric were performed on two
species of Pangasiid catfish, Pangasius pangasius and P. nasutus. The purpose is to find characters that help in differentiating these two species to avoid confusion among fish farmers. Three morphometric approaches (conventional, meristic and truss morphometric) were employed to identify the morphological differences. Conventional morphometric suggested eye diameter, body width, body depth, dorsal fin base length and barbells as characters that have significant differences (P< 0.05) between the species, hence making them as potential diagnostic markers. Truss morphometric analyses approved that P. nasutus have larger dorsal fin base length as suggested by conventional morphometry data. Meristic analysis showed significant difference (P
Monitoring clinical activity at the bedside in the intensive care unit (ICU) can provide useful information to evaluate nursing care and patient recovery. However, it is labour intensive to quantify these activities and there is a need for an automated method to record and quantify these activities. This paper presents an automated system, Clinical Activity Tracking System (CATS), to monitor and evaluate clinical activity at the patient's bedside. The CATS uses four Microsoft Kinect infrared sensors to track bedside nursing interventions. The system was tested in a simulated environment where test candidates performed different motion paths in the detection area. Two metrics, 'Distance' and 'Dwell time', were developed to evaluate interventions or workload in the detection area. Results showed that the system can accurately track the intervention performed by individual or multiple subjects. The results of a 30-day, 24-hour preliminary study in an ICU bed space matched clinical expectations. It was found that the average 24-hour intervention is 22.0minutes/hour. The average intervention during the day time (7am-11pm) is 23.6minutes/hour, 1.4 times higher than 11pm-7am, 16.8minutes/hour. This system provides a unique approach to automatically collect and evaluate nursing interventions that can be used to evaluate patient acuity and workload demand.
Matched MeSH terms: Weights and Measures/instrumentation*; Weights and Measures/standards
A study to determine average knee laxity in the Malaysian population and how it affects daily living was conducted at the University Malaya Medical Centre between January and April 2004. Fifty two male and 76 female subjects were recruited for this study, all of whom were healthy volunteers with no ambulatory problems. Side to side knee laxity testing was performed using a KT-1000 arthrometer. Significant differences in knee laxity were noted among different races and between sexes. For instance, overall, Chinese and female study participants had higher knee laxity: (left knee, 2.17 mm (SD=1.30) and right knee was 2.88 mm (SD= 1.51)). On average, the difference between knees was 0.70 ± 1.26 mm (less than 1 mm) which is a smaller variation than reported in previous studies which suggested 3 mm. Despite finding knee laxity ranging from 0 to 8mm, no correlations were found between Lysholm, IKDC and Tegner knee outcome scores and the degree of knee laxity. No other predictors such as height, weight and age correlated with levels of knee laxity. We therefore conclude that knee laxity is a common occurrence in the normal population and is therefore not suitable as a sole predictor of knee function and should not be used as the only criteria for surgical intervention.
Study site: Orthopedic clinic, Universiti Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia