A sequential test for assessing observed agreement between raters

Assessing the agreement between two or more raters is an important topic in medical practice. Existing techniques, which deal with categorical data, are based on contingency tables. This is often an obstacle in practice as we have to wait for a long time to collect the appropriate sample size of subjects to construct the contingency table. In this paper, we introduce a nonparametric sequential test for assessing agreement, which can be applied as data accrues, does not require a contingency table, facilitating a rapid assessment of the agreement. The proposed test is based on the cumulative sum of the number of disagreements between the two raters and a suitable statistic representing the waiting time until the cumulative sum exceeds a predefined threshold. We treat the cases of testing two raters' agreement with respect to one or more characteristics and using two or more classification categories, the case where the two raters extremely disagree, and finally the case of testing more than two raters' agreement. The numerical investigation shows that the proposed test has excellent performance. Compared to the existing methods, the proposed method appears to require significantly smaller sample size with equivalent power. Moreover, the proposed method is easily generalizable and brings the problem of assessing the agreement between two or more raters and one or more characteristics under a unified framework, thus providing an easy to use tool to medical practitioners.     

Ephippia of Daphnia magna straus — A technique for their mass production and quick revival

A new rearing technique ideally suitable for promoting either the parthenogenetic or the gametogenetic (ephippia) type of reproduction ofDaphnia magna in the laboratory is described. Airdrying and rehydration induces rapid hatching. Using this technique it is possible to measure the toxicity of chemicals to ephippia in an 8 day test procedure.     

Porcine growth hormone gene expression from viral promoters in transgenic swine

Abstract

The production of porcine growth hormone (pGH) from novel expression vectors containing the promoter/enhancer elements of the Moloney murine leukemia virus (MLV) LTR or the human cytomegalovirus (CMV) immediate early gene was examined in transgenic swine. Both fusion genes resulted in elevated levels of serum pGH, elevation of insulin‐like growth factor 1 (IGF‐1), and a pronounced decrease in carcass fat deposition. The two viral promoter/enhancer elements were constitutively active in the transgenic swine throughout the life of the animals. In individual swine, the CMV‐pGH transgene was expressed predominantly in the pancreas while the MLV‐pGH transgene was expressed in a wide variety of tissues. These swine were infertile, had insulin resistance, and demonstrated an accelerated form of osteochondritis dissicans. Our results show that excess pGH produces a phenotype identical to that seen in swine expressing heterologous growth hormones, and provides a baseline for assessing the overall efficiency of producing transgenic swine. Furthermore, our data suggests that unregulated pGH production, even at 15 times normal levels and independent of the tissue source, has adverse effects that outweigh the desired reduction in carcass fat deposition in transgenic swine.     

News from the Biological Stain Commission No. 12

Abstract

In this 12^th issue of News from the Biological Stain Commission (BSC) under the heading of Regulatory affairs, the Biological Stain Commission’s International Affairs Committee presents information from the meetings of ISO/TC 212/WG 1 Quality and competence in the medical laboratory and ISO/TC 212/WG 3 In vitro diagnostic products both held on 2 – 3 June 2010, plus information on the second plenary meeting of ISO/TC 212 Clinical laboratory testing and in vitro diagnostic test systems held on 4 June 2010. All meetings took place in Seoul, Republic of Korea. Finally, information is provided concerning the 25^th meeting of CEN/TC 140 In vitro diagnostic medical devices held on 23 June 2010 in Berlin, Germany.     

Evolutionary transitions in symbioses: dramatic reductions in bathymetric and geographic ranges of Zoanthidea coincide with loss of symbioses with invertebrates

Two fundamental symbiosis‐based trophic types are recognized among Zoanthidea (Cnidaria, Anthozoa): fixed carbon is either obtained directly from zooxanthellae photosymbionts or from environmental sources through feeding with the assistance of host‐invertebrate behaviour and structure. Each trophic type is characteristic of the suborders of Zoanthidea and is associated with substantial distributional asymmetries: suborder Macrocnemina are symbionts of invertebrates and have global geographic and bathymetric distributions and suborder Brachycnemina are hosts of endosymbiotic zooxanthellae and are restricted to tropical photic zones. While exposure to solar radiation could explain the bathymetric asymmetry it does not explain the geographic asymmetry, nor is it clear why evolutionary transitions to the zooxanthellae‐free state have apparently occurred within Macrocnemina but not within Brachycnemina. To better understand the transitions between symbiosis‐based trophic types of Zoanthidea, a concatenated data set of nuclear and mitochondrial nucleotide sequences were used to test hypotheses of monophyly for groups defined by morphology and symbiosis, and to reconstruct the evolutionary transitions of morphological and symbiotic characters. The results indicate that the morphological characters that define Macrocnemina are plesiomorphic and the characters that define its subordinate taxa are homoplasious. Symbioses with invertebrates have ancient and recent transitions with a general pattern of stability in host associations through evolutionary time. The reduction in distribution of Zoanthidea is independent of the evolution of zooxanthellae symbiosis and consistent with hypotheses of the benefits of invertebrate symbioses, indicating that the ability to persist in most habitats may have been lost with the termination of symbioses with invertebrates.     

Dormancy and germination: making every seed count in restoration

From 50 to 90% of wild plant species worldwide produce seeds that are dormant upon maturity, with specific dormancy traits driven by species' occurrence geography, growth form, and genetic factors. While dormancy is a beneficial adaptation for intact natural systems, it can limit plant recruitment in restoration scenarios because seeds may take several seasons to lose dormancy and consequently show low or erratic germination. During this time, seed predation, weed competition, soil erosion, and seed viability loss can lead to plant re‐establishment failure. Understanding and considering seed dormancy and germination traits in restoration planning are thus critical to ensuring effective seed management and seed use efficiency. There are five known dormancy classes (physiological, physical, combinational, morphological, and morphophysiological), each requiring specific cues to alleviate dormancy and enable germination. The dormancy status of a seed can be determined through a series of simple steps that account for initial seed quality and assess germination across a range of environmental conditions. In this article, we outline the steps of the dormancy classification process and the various corresponding methodologies for ex situ dormancy alleviation. We also highlight the importance of record‐keeping and reporting of seed accession information (e.g. geographic coordinates of the seed collection location, cleaning and quality information, storage conditions, and dormancy testing data) to ensure that these factors are adequately considered in restoration planning.     

Molecular Targets for the Testing of COVID‐19

The pandemic outbreaks of coronavirus disease 2019 (COVID‐19), caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), spread all over the world in a short period of time. Efficient identification of the infection by SARS‐CoV‐2 has been one of the most important tasks to facilitate all the following counter measurements in dealing with the infectious disease. In Taiwan, a COVID‐19 Open Science Platform adheres to the spirit of open science: sharing sources, data, and methods to promote progress in academic research while corroborating findings from various disciplines has established in mid‐February 2020, for collaborative research in support of the development of detection methods, therapeutics, and a vaccine for COVID‐19. Research priorities include infection control, epidemiology, clinical characterization and management, detection methods (including viral RNA detection, viral antigen detection, and serum antibody detection), therapeutics (neutralizing antibody and small molecule drugs), vaccines, and SARS‐CoV‐2 pathogenesis. In addition, research on social ethics and the law are included to take full account of the impact of the COVID‐19 virus.     

心肺运动试验（CPET）评价个体化精准运动整体方案强化管控心脑血管慢病疗效的临床研究*

目的: 探讨研究症状限制性极限运动心肺运动试验（CPET）评价个体化精准运动整体方案强化管控3月后（简称强化管控）的长期慢病患者整体功能的改善。方法: 选取2014年至2016年由我们团队强化管控的长期心脑血管代谢慢病为主的患者20例,签署知情同意书后完成CPET,根据CPET及连续功能学检测结果制定以个体化适度运动强度为核心的整体管理方案,强化管控3月后再行CPET,个体化分析每例患者强化管控前后CPET指标的变化、计算差值和百分差值。结果: 本研究心脑血管代谢性慢病为主的患者20例（18男2女）,年龄（55.75±10.80,26~73）岁,身高（172.20±8.63,153~190）cm,体重（76.35±15.63,53~105）kg,所有患者CPET和强化管控期间均无任何危险事件发生。①强化管控后患者静态肺功能指标及静息收缩压、心率收缩压乘积和空腹血糖等均显著改善（P<0.05）。②强化管控前峰值摄氧量为（55.60±15.69,34.37~77.45）%pred和无氧阈为（60.11±12.26,43.29~80.63）%pred;强化管控后峰值耗氧量为（71.85±21.04,42.40~102.00）%pred和无氧阈为（74.95±17.03,51.90~99.47）%pred;管控后较管控前峰值摄氧量和无氧阈显著提高分别达（29.09±7.38,17.78~41.80）%和（25.16±18.38,1.77~81.86）%（P均<0.01）;其他核心指标峰值氧脉搏、峰值负荷功率、摄氧通气效率平台和递增功率运动持续时间均显著升高（P均<0.01）,二氧化碳排出通气效率最低值及二氧化碳排出通气斜率也显著好转（P<0.01）。③个体化分析而言,强化管控后15例上述8项CPET核心指标全部改善,另5例7项指标改善;全部病例峰值摄氧量（%pred）提高>15%以上,16例>20%,13例>25%,10例>30%。结论: CPET能安全客观定量地评估人体整体功能状态和治疗效果、指导制定个体化精准运动强度。个体化精准运动整体方案强化管控三个月能安全有效逆转长期心脑血管代谢等慢病患者的整体功能状态和异常指标。     

肥厚型心肌病患者运动血压反应异常的两类表现及其相关因素分析*

目的: 运动血压反应不足及运动后恢复期血压降低是肥厚型心肌病（HCM）患者常见的异常表现,本研究的目的是分析HCM患者这两类异常血压反应表现的相关因素及其与心肺运动功能的关系。方法: 回顾性研究2018年4月至2020年1月期间在阜外医院功能检测中心行心肺运动试验（CPET）的HCM患者219例。111例行CPET的性别、年龄匹配的正常体检者作为正常对照组。比较正常对照组与HCM组的CPET运动血压反应。将HCM患者分为运动血压反应正常组及运动血压反应不足组,以及运动后血压正常组及运动后恢复期血压降低组,分别比较上述两类运动血压反应异常者的临床情况及CPET功能指标。结果: 与正常对照组相比,HCM患者运动血压反应不足（8.7%比1.8%,P=0.016）及运动后恢复期血压降低（6.8%比0.0%,P=0.003）的发生率显著升高。在HCM患者中,与运动血压反应正常者相比,运动血压反应不足的HCM患者更多合并冠心病（P=0.029）、肺动脉高压（P=0.002）及房颤/房扑（P=0.036）;与运动后血压正常者相比,运动后恢复期血压下降的HCM患者静息流出道压差（P=0.017）更高,合并流出道梗阻比例（P=0.015）、合并收缩期二尖瓣前移现象（P=0.022）及左室射血分数（P=0.043）更高。经过Logistic多元回归分析,运动血压反应不足的独立相关因素为冠心病（β=1.519,P=0.013）、肺动脉高压（β=2.292, P=0.000）。而运动后恢复期血压下降仅与左室流出道压差有独立的相关性（β=0.018, P=0.005）。运动血压反应不足的HCM患者峰值摄氧量（P=0.003）、峰值心率（P=0.014）及心率储备（P=0.003）更低,NT末端B型脑钠肽前体（P=0.019）及二氧化碳通气当量斜率（P=0.000）更高。运动后恢复期血压下降与各种心肺功能指标均无相关性。结论: HCM运动血压反应不足及运动后恢复期血压降低的发生率均较正常人群显著升高。HCM患者运动血压反应不足与合并冠心病和肺动脉高压有显著的独立相关性,而运动后血压下降仅与左室流出道压差独立相关。运动血压反应不足的HCM患者心肺运动功能降低,而运动后恢复期血压降低与心肺运动功能无显著相关性。