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IntroductionTotal bilirubin tests are highly demanded in clinical laboratories. Since icteric index (I-index) has zero cost, we aimed to evaluate its clinical utility and cost-effectiveness to determine if total bilirubin is necessary to be tested. We took into account if haemolysis could interfere to icteric index determination.Material and methodsRetrospectively we reviewed I-index results in two cohorts (43,372 and 8507 non-haemolysed and haemolysed samples, respectively). All determinations were done using Alinity c chemistry analysers (Abbott Diagnostics). Receiver operating characteristic (ROC) curve was used to determine the optimal index cut-off to discriminate between normal and abnormal bilirubin concentration (20.5 µmol/L).ResultsThe ROC curve analysis suggested 21.4 µmol/L as the optimal I-index cut-off but differences in sensitivity and specificity were detected between patient derivation. For rejecting purpose, 15.4 µmol/L and 17.1 µmol/L I-index thresholds were selected based on patient derivation (inpatients and emergency room; and primary care and outpatients, respectively) with 97% sensitivity and 0.25% false negative results. Sensitivity was much lower in haemolysed samples. We selected 34.2 µmol/L I-index as threshold to detect hyperbilirubinemia with 99.7% specificity and 0.26% false positive results, independent of haemolysis. With the icteric index cut-offs proposed, we would save 66% of total bilirubin requested and analyse total bilirubin in around 2% of samples without total bilirubin requested.ConclusionsThis study supports the use of I-index to avoid bilirubin determination and to identify patients with hyperbilirubinemia. This work considers that the economic and test savings could help to increase the efficiency in clinical laboratories.  相似文献   
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After compulsory secondary education; many teenagers face the process of choosing a university degree. This process involves uncertainties referred to their personal abilities, interests, social expectations and professional future. The present work is aimed at determining whether the reasons behind the selection of a particular university degree differ depending on the chosen degree. Another objective is determining whether these reasons differ significantly according to gender. The sample comprises 983 students belonging to the area of social and legal sciences at the University of Seville. The obtained results reveal the existence of four main reasons behind the selection of university degrees for which significant gender-related differences were observed: easy degree, job opportunities, high wages and provision of social services. Besides, these seven reasons are observed to differ widely in six of the considered degrees.  相似文献   
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We used both student interviews and diagnostic testing to reveal students’ misconceptions about number representations in computing systems. This article reveals that students who have passed an undergraduate level computer organization course still possess surprising misconceptions about positional notations, two's complement representation, and overflow. Contrary to common opinion, these misconceptions are widespread and reveal the need for instruction that specifically targets these misconceptions. In addition, these misconceptions will serve as the basis for the creation of a standard assessment tool called the digital logic concept inventory. This concept inventory will provide a rigorous and quantitative metric to assess the effectiveness of new teaching methods.  相似文献   
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In August 2005, Hurricane Katrina displaced the largest number of public school children ever affected by any disaster. Approximately 370,000 children, including 15,000 Latino/Hispanic children from Louisiana, were scattered throughout the 48 U.S. states (Landrieu, 2010; Louisiana Department of Education, 2004). Although much of the media attention, policy, and research have focused on the effects of race—primarily Black/White—in New Orleans disaster relief, Latino immigrant children were the silenced, invisible victims of the evacuation, policy, relief, and recovery services. The largely unreported immigrant evacuation from Louisiana was along a silent underground railroad of sorts, using a network of relatives and countrymen whenever they could (Plocek, 2006). The findings of this article illustrate the theoretical implications and consequences of identifying immigrant children as racially White. This study documents the intersections of local, state, and federal policy regarding schools and recovery relief showing that access to disaster relief and recovery were framed in context of immigration status often placing citizen children in at-risk conditions. Children have become the victims of anti-immigrant sentiment rising from the much symbolic and actual harassment that constitute the daily, shadow lives of the undocumented population.  相似文献   
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Height, mass and skeletal maturity (Fels method) were assessed in 135 elite youth soccer players aged 10.7-16.5 years (only two boys were ?11.0 years). Sample sizes, years of training and current weekly training volume by two-year age groups were: 11-12 years ( n = 63), 2.6 - 1.0 years and 4.1 - 1.7 h; 13-14 years ( n = 29), 3.1 - 1.6 years and 4.5 - 1.7 h; 15-16 years ( n = 43), 4.7 - 2.4 years and 6.1 - 2.0 h. The oldest age group included membersof the national youth team.Heights and masses were compared to US reference values,and skeletal age and chronological age were contrasted. The players were also classified as late, average ('on time') and early maturers on the basis of differences between skeletal and chronological age, with the average category including boys with skeletal ages within - 1 year of chronological age. The mean heights and masses of 11- to 12-year-old soccer players equalled the US reference values, while those of players aged 13-14 and 15-16 years were slightly above the reference values. The mean skeletal age approximated mean chronological age in players aged 11-12 years (12.4 - 1.3 and 12.3 - 0.5 years, respectively), while mean skeletal age was in advance of mean chronological age in the two older groups (14.3 - 1.2 and 13.6 - 0.7 years, respectively, in 13- to 14-year-olds; 16.7 - 1.0 and 15.8 - 0.4 years, respectively, in 15- to 16-year-olds). Seven boys in the oldest age group were already skeletally mature and were not included when calculating differences between skeletal and chronological age. The proportion of late maturing boys in this sample of elite soccer players decreased with increasing chronological age. Among 11- to 12-year-old players, the percentages of late and early maturing boys were equal at 21% ( n = 13). Among 13- to 14-year-old players, the percentages of late and early maturing boys were 7% ( n = 2) and 38% ( n = 11) respectively, while among players aged 15-16 years the percentages of late and early maturing boys were 2% ( n = 1) and 65% ( n = 28) respectively. The results of this comparative analysis suggest that the sport of soccer systematically excludes late maturing boys and favours average and early maturing boys as chronological age and sport specialization increase. It is also possible that late maturing boys selectively drop-out of soccer as age and sport specialization increase.  相似文献   
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