“Real life use” of troponin in the emergency department: a survey of over 3000 cases     

Matteo Vidali  Enrica Verzotti  Nicole Cabraz  Francesca Santi  Alessia Puma  Giorgio Bellomo  Alessandro Lupi  Giuseppe Lippi  Gian Carlo Avanzi 《Biochemia medica : ?asopis Hrvatskoga dru?tva medicinskih biokemi?ara / HDMB》2015,25(3):421-429

Introduction

The aim of this study was to identify clinical variables which may be independently associated with positivity of a cardiac troponin I (cTnI) assay in a large population of patients admitted to the emergency department (ED).

Materials and methods

3166 subjects, with at least two troponin I tests ordered within 6 hours in the ED, were studied. Patient data were statistically analyzed to identify clinical associations with increased values of Troponin I.

Results

Although patients with diagnosis of acute coronary syndrome displayed troponin I values significantly higher than those of other groups, positivity to troponin I (> 40 ng/L) was also observed in patients with other clinical conditions. In multivariate analysis, age, elevated heart rate and electrocardiographyc changes were independently associated with troponin I positivity at admission. In the whole study population troponin I positivity exhibited high sensitivity and negative predictive value, counterbalanced by low specificity and limited positive predictive value.

Conclusions

Troponin I positivity should be combined with history and clinical evaluation and cautiously interpreted in the ED, especially in patients exhibiting factors associated with higher troponin I levels such as older age, elevated heart rate or ECG changes.Key words: troponin I, acute coronary syndrome, emergency service, hospital, chest pain  相似文献   

A LPV modeling of turbocharged spark-ignition automotive engine oriented to fault detection and isolation purposes     

Gianfranco Gagliardi  Francesco Tedesco  Alessandro Casavola 《Journal of The Franklin Institute》2018,355(14):6710-6745

This paper illustrates the derivation of a linear parameter varying (LPV) model approximation of a turbocharged Spark-Ignition (SI) automotive engine and its usage in designing a model-based fault detection and isolation (FDI) scheme. The LPV approximation is derived from a detailed nonlinear mathematical model of the engine on the basis of the well known Jacobian approach. The resulting LPV representation is then exploited for synthesizing a bank of LPV-FDI $H_{\infty }/H_{?}$ Luenberger observers. Each observer is in charge of detecting a particular class of fault and is designed for having low sensitivity to all other exogenous inputs so as to allow an effective fault isolation. The adopted FDI scheme is gain-scheduled and exploits a set of engine variables, assumed to be measurable on-line, as a scheduling parameters. The goodness of the LPV approximation of the engine model and the effectiveness of the LPV-FDI architecture are demonstrated by several numerical simulations.  相似文献   

Comparison of motor competence levels on two assessments across childhood     

Alessandro H. N. Ré  Samuel W. Logan  Maria T. Cattuzzo  Rafael S. Henrique  Mariana C. Tudela  David F. Stodden 《Journal of sports sciences》2018,36(1):1-6

This study compared performances and motor delay classifications for the Test of Gross Motor Development-2nd edition (TGMD-2) and the Körperkoordinationstest Für Kinder (KTK) in a sample of 424 healthy children (47% girls) between 5 and 10 years of age. Low-to-moderate correlations (r range = 0.34–0.52) were found between assessments across age. In general, both boys and girls demonstrated higher raw scores across age groups. However, percentile scores indicated younger children outperformed older children, denoting a normative percentile-based decrease in motor competence (MC) in the older age groups. In total, the TGMD-2 and KTK classified 39.4% and 18.4% children, respectively, as demonstrating very low MC (percentile ≤5). In conclusion, the TGMD-2 classified significantly more children with motor delays than the KTK and the differences between children’s motor skill classification levels by these assessments became greater as the age groups increased. Therefore, the TGMD-2 may demonstrate more susceptibility to sociocultural influences and be more influenced by cumulative motor experiences throughout childhood. Low-to-moderate correlations between assessments also suggest the TGMD-2 and KTK may measure different aspects of MC. As such, it may be important to use multiple assessments to comprehensively assess motor competence.  相似文献