Estimation of sensitivity and specificity of diagnostic tests and disease prevalence when the true disease state is unknown

The performance of a new diagnostic test is frequently evaluated by comparison to a perfect reference test (i.e. a gold standard). In many instances, however, a reference test is less than perfect. In this paper, we review methods for estimation of the accuracy of a diagnostic test when an imperfect reference test with known classification errors is available. Furthermore, we focus our presentation on available methods of estimation of test characteristics when the sensitivity and specificity of both tests are unknown. We present some of the available statistical methods for estimation of the accuracy of diagnostic tests when a reference test does not exist (including maximum likelihood estimation and Bayesian inference). We illustrate the application of the described methods using data from an evaluation of a nested polymerase chain reaction and microscopic examination of kidney imprints for detection of Nucleospora salmonis in rainbow trout.     

Mortality and recovery of runt white sturgeon (Acipenser transmontanus) in a commercial farm in California, USA

We investigated the effect of raising runt white sturgeon (Acipenser transmontanus) separately from dominant fish during the initial stages of grow-out in a commercial farm. Runt fish are poor-growers, have underdeveloped muscle mass, swim slowly and are more-frequently found at the top of the water column. The objective of the study was to describe the mortality and recovery rates (and their determinants) of white-sturgeon runts after separating them from dominant fish. Runt white sturgeon were stocked into twelve 2 m × 2 m rectangular tanks and graded periodically during a follow-up of 46–102 days. Overall mortality rates ranged from 0.3 to 7 dead fish per 1000 sturgeon-days at risk and overall recovery rates from 3.9 to 13.5 recovered fish per 1000 sturgeon-days at risk. Period-specific mortality and recovery rates increased over time. The period-specific mortality rates for all three periods were significantly higher for tanks of runts originating from grow-out tanks with high mortality (p-values: first period = 0.06; second period = 0.09; third period = 0.03), but were similar for tanks of runts of high- and low-mean initial weight. The period-specific recovery rates were significantly higher in runts originating from high-mortality grow-out tanks only for the third period (p = 0.05) but not the first and second periods (p-values = 0.33 and 0.25, respectively). Recovery rates were significantly higher in the higher-mean-weight runts tanks for the first and third period but not for the second (p-values: first period = 0.02; second period = 0.65; third period = 0.06). We concluded that the proportion of runts that recover during a 46–89 day period is substantial (16–58%); therefore, it might be worthwhile growing such fish separately in a fish farm for about three months. Financial analysis showed that this practice was profitable, if the value of white sturgeon fish for the farm exceeded $2.05 per kg.     

Development of a forest certification standard compatible with PEFC and FSC's management requirements. A case study from Greece

Greece currently has no national forest certification standard.This paper explains how a draft forest management standard forGreece was developed to be compatible with both the Forest StewardshipCouncil and the Programme for the Endorsement of Forest Certificationschemes requirements. The draft standard was tested in two contrastingforest areas to investigate its ease of operation, to indicatenecessary refinements to the standard and to reveal major areasof weakness in current forest management practices. Field testingshowed that the standard was operationally efficient and thatrelatively few changes to the standard were necessary. Majorweaknesses in current management practices were identified asbreaches of health and safety, poor training of forest workersand inadequate consultation with stakeholders.     

Removal of sulphur dioxide and sulphates from the atmospheric surface layer during frost formation

In order to establish the amount of removal of SO₂ and sulphates from the lowest layer of the atmosphere during frost formation, a field measurement experiment was conducted in January 1990 in the Ravenna area. Frost can bring about removal of particles, gases and hydrosoluble substances. In common with areas of the Po Valley, Ravenna is frequently subjected to atmospheric conditions that can cause frost. During the winter of 1990, clear skies at night, that were associated with high pressure fields, strongly influenced the formation of frost. Close to industrial plants, characterized by wet emission of plumes, this frost has an adverse impact on soil, commonly known as ‘chemical snow’. A large number of frost samples, collected in three locations representing typical but different features of the area (rural, urban and sea front sites), were analyzed. Analysis of the data reveals that SO₂ is the major contributor SO₄ ^?? trapped in frost.     

Presumed localized tetanus in two cats

In this report two cases of localised tetanus in two young (<1 year) intact male and outdoor DSH cats, which had been missing, are described. Clinical examination revealed severe muscular spasms on the right (case 1) or both thoracic limbs (case 2). In the latter cat, wrinkling of the forehead and mild trismus were also seen. The routine diagnostic workup (CBC, survey radiographs of the spine, CSF analysis) did not reveal any abnormalities in both cats. EMG testing on the affected muscles in the second animal showed persistent spontaneous motor unit potentials, strongly indicating tetanus. The treatment, that was symptomatic (diazepam, metronidazole) and supportive (physical therapy, assist feeding and intravenous fluid therapy) resulted in the progressive improvement of limb rigidity and the restoration of motor dysfunction in a period of 5- (case 1) and 2- (case 2) month duration.     

Income Options for the Poorest of the Poor: The Case of Cardamom in Northern Laos

This study examines the potential of cardamom for poverty alleviation and sustainable rural development under conditions of increased resource scarcity in the uplands of northern Laos. Drawing on both qualitative and quantitative fieldwork in Luang Namtha province, the supply chain of cardamom is identified and the socio-economic opportunities for collectors and growers are examined. Rising demand in neighbouring countries, particularly China, provide sound income opportunities for all actors in the cardamom supply chain. Growing improved varieties has become a boon for farmers endowed with relatively large land areas with suitable agro-ecological conditions. However, land-poor and landless collectors of wild cardamom are facing increasing difficulties due to overharvesting, lower prices offered by middlemen, and the rapid conversion of remaining forests into monoculture plantations, especially rubber, which has reduced the natural habitat of cardamom and other non-timber forest products. The major policy implication is that protecting the remaining natural and secondary forests—for instance through making use of evolving international support mechanisms for community-based forest protection, including REDD-plus—will not only be of benefit for biodiversity conservation and climate change mitigation, but would also enhance the livelihoods of the poorest groups in the uplands of northern Laos.     

Accuracy of an indirect fluorescent-antibody test and of a complement-fixation test for the diagnosis of Babesia caballi in field samples from horses

We evaluated the indirect fluorescent-antibody (IFA) test and complement-fixation (CF) test for diagnosis of equine piroplasmosis in the absence of a gold standard. Using Evan's blue, we estimated the specificity of the IFA test on a parasite-free, field horse population to be 98% (95% confidence interval=97, 99). We observed an excellent test agreement (kappa=0.83) between two collaborating laboratories when the IFA test was performed on identical samples from an endemic area. Using Bayesian analysis with informative prior probability distributions, we estimated the sensitivity of the IFA test to be 92% (95% probability interval, PI=81, 98), and specificity to be 95% (95% PI=88, 99). The CF test sensitivity and specificity estimates were 28% (95% PI=15, 47) and 99% (95% PI=96, 100), respectively. We found the IFA to be superior to the CF test, and the inclusion of Evan's blue in test protocol improved the performance of the IFA test. We conclude that the IFA test for Babesia caballi is a sensitive and specific test for the diagnosis of equine piroplasmosis.     

Validation of the indirect fluorescent antibody and the complement fixation tests for the diagnosis of Theileria equi

The indirect fluorescent antibody (IFA) test for Theileria equi was evaluated to assess test's suitability for the serological diagnosis of equine piroplasmosis, to provide performance parameters for the purpose of test validation, and to compare it with the complement fixation (CF) test. Using a protocol that included Evan's blue, the specificity of the IFA test was estimated at 99.0% for T. equi by the classical method of analysis, and 96.6% by the Bayesian method. The use of Evan's blue in the test protocol increased test specificity and contributed to an excellent test agreement between two collaborating laboratories (kappa = 0.96). Using Bayesian analysis, the sensitivity estimate for the IFA test was 89.2%. The CF test sensitivity and specificity estimates for T. equi were 63.1 and 96.4%, respectively, as determined by Bayesian analysis. The IFA test was more sensitive than the CF test but the specificity estimates were similar.     

An experimental simulation of moisture distribution and its uniformity within the soil profile under laboratory conditions

This research is a study on the relationship of irrigation water treatments and soil moisture distribution uniformity (DU). Soil moisture distribution was based on long-term data sets that were collected using a novel electromagnetic sensor-based platform moving inside sub-surface horizontal access-tubes. The research was conducted under controlled laboratory conditions in a soil tank. The irrigation treatments regarding two case studies under dry and wet soil conditions (from permanent wilting point to field capacity) were conducted for a period of 115 and 110 days respectively. In dry soil conditions, the irrigation water treatments strongly affect the DU of soil moisture that can be achieved constantly using non-uniform irrigation treatments. In contrast, the DU of soil moisture in wet soil conditions was maintained at a high percentage and was slightly affected by irrigation treatments. However, obtaining accurate soil moisture information at a large scale over a long period can be used to improve water use efficiency.     

Mortality and recovery of runt white sturgeon (Acipenser transmontanus) in a commercial farm in California, USA

We investigated the effect of raising runt white sturgeon (Acipenser transmontanus) separately from dominant fish during the initial stages of grow-out in a commercial farm. Runt fish are poor-growers, have underdeveloped muscle mass, swim slowly and are more-frequently found at the top of the water column. The objective of the study was to describe the mortality and recovery rates (and their determinants) of white-sturgeon runts after separating them from dominant fish. Runt white sturgeon were stocked into twelve 2 m × 2 m rectangular tanks and graded periodically during a follow-up of 46–102 days. Overall mortality rates ranged from 0.3 to 7 dead fish per 1000 sturgeon-days at risk and overall recovery rates from 3.9 to 13.5 recovered fish per 1000 sturgeon-days at risk. Period-specific mortality and recovery rates increased over time. The period-specific mortality rates for all three periods were significantly higher for tanks of runts originating from grow-out tanks with high mortality (p-values: first period = 0.06; second period = 0.09; third period = 0.03), but were similar for tanks of runts of high- and low-mean initial weight. The period-specific recovery rates were significantly higher in runts originating from high-mortality grow-out tanks only for the third period (p = 0.05) but not the first and second periods (p-values = 0.33 and 0.25, respectively). Recovery rates were significantly higher in the higher-mean-weight runts tanks for the first and third period but not for the second (p-values: first period = 0.02; second period = 0.65; third period = 0.06). We concluded that the proportion of runts that recover during a 46–89 day period is substantial (16–58%); therefore, it might be worthwhile growing such fish separately in a fish farm for about three months. Financial analysis showed that this practice was profitable, if the value of white sturgeon fish for the farm exceeded $2.05 per kg.