Comparación de ELISAs comerciales para la detección de anticuerpos en la investigación diagnóstica del aborto asociado a Neospora caninum en rodeos lecheros de Uruguay Comparación de ELISAs comerciales para detección de anticuerpos contra N. caninum / A comparative study of commercial ELISAs for antibody detection in the diagnostic investigation of Neospora caninum-associated abortion in dairy cattle herds in Uruguay

Resumen A pesar de su importancia, el diagnóstico etiológico del aborto en bovinos representa un desafío técnico para los veterinarios clínicos y laboratoristas, en parte debido a la dificultad de recuperar los fetos abortados en condiciones extensivas de campo. Dicha dificultad limita la posibilidad de detectar tempranamente los vientres abortados y de efectuar la investigación patológica y microbiológica de los abortos. Neospora caninum es un protozoario cosmopolita identificado como uno de los principales agentes abortigénicos en bovinos. En este estudio proponemos una aproximación seroepidemiológica para diagnosticar abortos por N. caninum en bovinos lecheros usando kits de ELISA comerciales. Se procesaron muestras de entre 12 y 93 vacas y/o vaquillonas con (casos) y sin (controles) historia reciente de aborto en 4 tambos comerciales de Uruguay. La proporción controles:casos analizados varió entre 1:1 y 4,6:1. Las muestras (n=230) fueron analizadas mediante 3 kits comerciales para la detección de anticuerpos IgG anti-N. caninum. En los 4 tambos la proporción de vacas y/o vaquillonas seropositivas por cualquier kit fue significativamente mayor en los casos respecto de los controles (odds ratio=5,13 a 36; p=0,0002 a 0,0485). La concordancia entre los kits varió de débil a fuerte (coeficiente Kappa de Cohen=0,58 a 0,83). Concluimos que, a pesar de la imperfecta concordancia entre estos kits, el empleo de todos ellos permitió arribar a conclusiones similares respecto de la asociación estadísticamente significativa entre seropositividad a N. caninum y aborto, lo que demuestra la utilidad de estos kits para la aproximación diagnóstica del aborto a nivel poblacional en condiciones de campo.

Abstract Bovine abortion causes considerable economic losses to the livestock industry worldwide and is of concern for public health and food safety, given that many abortigenic infectious agents of cattle are zoonotic. Despite its importance, the etiological diagnosis of abortion in cattle is challenging both for veterinary practitioners and laboratory technicians, partly due to the difficulty in recovering aborted fetuses under extensive field conditions for pathological and microbiological diagnostic investigation, and in the early identification of aborted dams. Neospora caninum is a cosmopolitan protozoon identified as one of the main abortigenic agents in cattle worldwide. In this study we propose a comparative seroepidemiological approach for the diagnosis of abortion by N. caninum in dairy cattle. Samples from 12 to 93 cows/heifers with and without recent history of abortion (cases and controls) in four commercial dairy farms were tested. The ratio of controls to cases tested varied from 1:1 to 4.6:1. All samples (n=230) were analyzed by three commercial ELISA kits for the detection of anti-N. caninum antibodies. In all four dairy farms, the proportion of seropositive cows and/or heifers per kit was significantly higher in the cases than in the controls (Odds Ratios=5.13 to 36, p=0.0002 to 0.0485). The agreement among the three kits varied from weak to strong (Cohen´s kappa coefficients=0.58 to 0.83). We conclude that, despite the imperfect agreement between these kits, all of them allowed to arrive at similar conclusions regarding the statistical association between N. caninum seropositivity and abortion, thus representing a useful tool for the diagnostic approach at the population level under field conditions.

[A comparative study of commercial ELISAs for antibody detection in the diagnostic investigation of Neospora caninum-associated abortion in dairy cattle herds in Uruguay]. / Comparación de ELISAs comerciales para la detección de anticuerpos en la investigación diagnóstica del aborto asociado a Neospora caninum en rodeos lecheros de Uruguay.

Bovine abortion causes considerable economic losses to the livestock industry worldwide and is of concern for public health and food safety, given that many abortigenic infectious agents of cattle are zoonotic. Despite its importance, the etiological diagnosis of abortion in cattle is challenging both for veterinary practitioners and laboratory technicians, partly due to the difficulty in recovering aborted fetuses under extensive field conditions for pathological and microbiological diagnostic investigation, and in the early identification of aborted dams. Neospora caninum is a cosmopolitan protozoon identified as one of the main abortigenic agents in cattle worldwide. In this study we propose a comparative seroepidemiological approach for the diagnosis of abortion by N. caninum in dairy cattle. Samples from 12 to 93 cows/heifers with and without recent history of abortion (cases and controls) in four commercial dairy farms were tested. The ratio of controls to cases tested varied from 1:1 to 4.6:1. All samples (n=230) were analyzed by three commercial ELISA kits for the detection of anti-N. caninum antibodies. In all four dairy farms, the proportion of seropositive cows and/or heifers per kit was significantly higher in the cases than in the controls (Odds Ratios=5.13 to 36, p=0.0002 to 0.0485). The agreement among the three kits varied from weak to strong (Cohens kappa coefficients=0.58 to 0.83). We conclude that, despite the imperfect agreement between these kits, all of them allowed to arrive at similar conclusions regarding the statistical association between N. caninum seropositivity and abortion, thus representing a useful tool for the diagnostic approach at the population level under field conditions.

Confiabilidad, precisión o reproducibilidad de las mediciones. Métodos de valoración, utilidad y aplicaciones en la práctica clínica / Reliability, precision or reproducibility of the measurements. Methods of assessment, utility and applications in clinical practice

Resumen En investigación, la confiabilidad (precisión, consistencia y reproducibilidad), corresponde a una propiedad psicométrica que dice relación con la ausencia de error de la medición; o del grado de consistencia y estabilidad de las puntuaciones obtenidas a lo largo de sucesivos procesos de medición con un mismo instrumento. Por ello, es esperable que, a mayor variabilidad de resultados, menor sea la precisión del instrumento de medición utilizado, concepto que aplica desde el laboratorio a la práctica clínica. La reproducibilidad se determina aplicando el coeficiente de confiabilidad, que es la correlación entre las puntuaciones obtenidas por los sujetos, en dos formas paralelas de una prueba (porque se supone que miden lo mismo). Por ello, asumiendo que midan lo mismo, las puntuaciones de los sujetos en estudio deberían ser iguales en ambas aplicaciones. De este modo, cuando la correlación es 1, la confiabilidad, precisión o reproducibilidad es máxima; y mientras más cercana a 0 es peor. La precisión en las mediciones está influenciada por el que mide (observador), por aquello con lo que se mide (instrumento de medición), y por lo que es medido (lo observado). Por ende, se ha de tomar en cuenta la variabilidad de cada uno de estos componentes al momento de planificar la medición de la variable en estudio; de tal modo de reducir al máximo los sesgos de medición. Así, las formas más comunes de determinar confiabilidad son: modelos de formas paralelas, test-retest y de dos mitades. Este manuscrito se centra en los conceptos de medición y las diversas técnicas estadísticas utilizadas para ello, como paso previo a la aplicación en la clínica. Por ello, el objetivo de este manuscrito es generar un documento de estudio y consulta relacionado con la confiabilidad, reproducibilidad o precisión del proceso de medición.

Reliability (accuracy, consistency and reproducibility) is a psychometric property, which is related to the absence of measurement error, or, to the degree of consistency and stability of the scores obtained through successive measurement processes with the same instrument. Thus a greater variability of results will lower the accuracy or reliability of instrument used, fact that is transverse from the laboratory to the clinical practice. It is determined by applying the reliability coefficient, which is the correlation between the scores obtained by the subjects in two parallel forms of a test. Assuming that the two forms of the test are parallel (measure the same), the scores of the subjects under study should be the same in both applications. In this way, when the correlation is 1, the reliability or precision is maximum. On the other hand, reliability could be influenced by the observer (the one that measures), the measuring instrument (by that with which it is measured), and by the observed (by what is measured). Therefore, the variability of each of these components must be taken into account when planning the measurement of the variable under study, in such a way to reduce measurement biases as much as possible. The most common ways to determine reliability are the models of parallel forms, test-retest and two halves. This manuscript focuses on the concepts of measurement and the various statistical techniques used for this, as a step prior to application in the clinic. Therefore, the aim of this manuscript is to generate a consultation document related to the reliability or reproducibility of the measurement process.

Cribaje visual en la Atención Primaria de Salud en menores de tres años / Visual screening in under three-year old children at the primary health care

Objetivos: determinar el grado de concordancia entre los resultados de la aplicación, por pediatras de Atención Primaria, del cribaje visual que establece una guía de práctica clínica, propuesta para cuidados visuales preventivos en edad pediátrica y el criterio de verdad dado por el examen de especialistas en Oftalmología.Métodos: se realizó un estudio descriptivo, prospectivo y transversal en una muestra de 481 pacientes de 6 a 35 meses de edad, en la consulta de Oftalmología del hospital pediátrico Marfán, de febrero del año 2014 a enero de 2015. Participaron dos especialistas en Pediatría, de Atención Primaria, dos especialistas en Oftalmología y un licenciado en Óptica y Optometría. El análisis de la concordancia entre los resultados del cribado visual realizado por pediatras y el criterio de verdad se realizó mediante el cálculo del índice Kappa a partir de cuatro variables, empleando el programa epitat 4. Resultados: la estimación de la fuerza de concordancia fue buena en el examen del comportamiento visual y del reflejo de fondo de ojo con K= 0,649 y 0,754; muy buena en el examen externo de anexos, globo ocular y alineación ocular, con K= 0,817 y 0,899. Conclusiones: el nivel de concordancia diagnóstica encontrado entre pediatras y oftalmólogos hace factible la aplicación de los procedimientos de examen que establece la Guía de Práctica Clínica propuesta(AU)

Objectives: to determine the level of agreement between the results of the application by primary health carepediatricians of the visual screening that sets a clinical practice guideline for preventive visual care at pediatric ages and the true criteria from the test performed by ophthalmologists. Methods: descriptive, prospective and cross-sectional study of a sample of 481 children aged 6 to 35 months old, who were seen at the ophthalmology service of Marfan pediatric hospital from February 2014 to January 2015. Two primary health care pediatricians, two ophthalmologists and a certified optometrist participated. The analysis of the level of agreement between the results of the visual screening by pediatricians and the truth criterion was made through the calculation of Kappa´s agreement index based on four variables by using Epidat 4 program. Results: the estimation of the force of agreement was good in the visual behavior and in the fundus reflection, with k= 0.649 and 0.754, respectively; it was very good in the external exam of the adnexa, the eyeball and the ocular alignment with k= 0.817 and 0.899, respectively. Conclusions: the level of diagnostic agreement found between ophthalmologists and pediatricians makes the application of the examination procedures established by the suggested clinical practice guideline possible(AU)

The agreement between two screening tests for language evaluation in premature and low weight children / Concordância entre dois testes de triagem na avaliação da linguagem em crianças nascidas prematuras e de baixo peso

Abstract Objectives: to evaluate the agreement of the results in two screening tests on children's development - Denver II and Early Language Milestone Scale (ELM) aged two to three years old, born prematurely and with low weight. Methods: two screening instruments: Denver II and ELM were applied for the development in an observational cross-sectional descriptive study. The agreement between Denver II Test and its language sector and ELM were assessed by Kappa coefficient. Results: 77 children evaluated, 36.3% had an overall loss of the development performed by Denver II and 32.5% loss of the language by ELM. The agreement between the results of Denver II test considering all sectors versus ELM showed Kappa coefficient of 0.856 (p<0.001) and considering only the language sector of Denver II versus ELM, the Kappa coefficient was 0.886 (p<0.001). Conclusions: the developmental impairment observed in the children studied by assessing Denver II and through its language sector showed agreement with changes in the language abilities observed in ELM.

Resumo Objetivos: avaliar a concordância dos resultados da linguagem de dois testes de triagem do desenvolvimento infantil - Denver II e Early Language Milestone Scale (ELM) em crianças de dois a três anos de idade cronológica, nascidas prematuras e com baixo peso. Métodos: estudo observacional descritivo transversal através da aplicação dois instrumentos de triagem de desenvolvimento: Denver II e a ELM (Early Language Milestone Scale). A concordância entre o teste de Denver II e seu setor de linguagem e a ELM foi avaliada pelo coeficiente Kappa. Resultados: das 77 crianças avaliadas, 36,3% tiveram prejuízo global do desenvolvimento pelo Denver II e 32,5% prejuízo da linguagem pela ELM. A concordância entre os resultados do teste de Denver II considerando todos os setores versus ELM mostrou coeficiente Kappa de 0,856 (p<0,001) e considerando somente o setor da linguagem do Denver II versus ELM o coeficiente Kappa foi de 0,886 (p<0,001). Conclusões: o comprometimento do desenvolvimento observado nas crianças estudadas através da avaliação do Denver II e através do seu setor de linguagem mostrou concordância com as alterações de habilidades de linguagem observadas na ELM.

Cribaje visual en la Atención Primaria de Salud en menores de tres años / Visual screening in under three-year old children at the primary health care

Objetivos: determinar el grado de concordancia entre los resultados de la aplicación, por pediatras de Atención Primaria, del cribaje visual que establece una guía de práctica clínica, propuesta para cuidados visuales preventivos en edad pediátrica y el criterio de verdad dado por el examen de especialistas en Oftalmología. Métodos: se realizó un estudio descriptivo, prospectivo y transversal en una muestra de 481 pacientes de 6 a 35 meses de edad, en la consulta de Oftalmología del hospital pediátrico Marfán, de febrero del año 2014 a enero de 2015. Participaron dos especialistas en Pediatría, de Atención Primaria, dos especialistas en Oftalmología y un licenciado en Óptica y Optometría. El análisis de la concordancia entre los resultados del cribado visual realizado por pediatras y el criterio de verdad se realizó mediante el cálculo del índice Kappa a partir de cuatro variables, empleando el programa epitat 4. Resultados: la estimación de la fuerza de concordancia fue buena en el examen del comportamiento visual y del reflejo de fondo de ojo con K= 0,649 y 0,754; muy buena en el examen externo de anexos, globo ocular y alineación ocular, con K= 0,817 y 0,899. Conclusiones: el nivel de concordancia diagnóstica encontrado entre pediatras y oftalmólogos hace factible la aplicación de los procedimientos de examen que establece la Guía de Práctica Clínica propuesta(AU)

Objectives: to determine the level of agreement between the results of the application by primary health carepediatricians of the visual screening that sets a clinical practice guideline for preventive visual care at pediatric ages and the true criteria from the test performed by ophthalmologists. Methods: descriptive, prospective and cross-sectional study of a sample of 481 children aged 6 to 35 months old, who were seen at the ophthalmology service of Marfan pediatric hospital from February 2014 to January 2015. Two primary health care pediatricians, two ophthalmologists and a certified optometrist participated. The analysis of the level of agreement between the results of the visual screening by pediatricians and the truth criterion was made through the calculation of Kappa´s agreement index based on four variables by using Epidat 4 program. Results: the estimation of the force of agreement was good in the visual behavior and in the fundus reflection, with k= 0.649 and 0.754, respectively; it was very good in the external exam of the adnexa, the eyeball and the ocular alignment with k= 0.817 and 0.899, respectively. Conclusions: the level of diagnostic agreement found between ophthalmologists and pediatricians makes the application of the examination procedures established by the suggested clinical practice guideline possible(AU)

Escala de avaliação de altas habilidades / superdotação ­ versão professor: validade de conteúdo / Scale for assessment of giftedness - teacher's version: evidence of validity content / Escala de Evaluación de Altas Habilidades/ Superdotación ­ versión del profesor: validez de contenido

A avaliação das altas habilidades embora escassa na literatura científica é de grande relevância dentro da Psicologia. Diante disso, o objetivo deste estudo foi verificar, através da validade de conteúdo, a adequação dos itens que compõem a Escala de Avaliação de Altas Habilidades ­ Versão Professor. Para isso, seis estudantes de pós graduação na área da avaliação psicológica atuaram como juízes, classificando os 41 itens do instrumento em cinco fatores (capacidade intelectual acadêmica, habilidades acadêmicas específicas, liderança, criatividade e talento artístico). Os resultados demonstraram a adequação dos itens, tendo a maioria deles apresentado índices de concordância perfeita acima de 80% (n=29) e entre 60 e 80% (n=8), indicando concordância moderada. Apenas quatro itens apresentaram concordância igual ou inferior a 50%, sugerindo a necessidade de reformulações. As análises dos coeficientes Kappa evidenciaram índices entre 0,69 e 0,81. Os resultados apontaram a adequação da escala ao conteúdo do modelo que pretende avaliar.

The assessment of high abilities is of great importance in psychology, despite scarce studies in literature. Therefore, the aim of this study was to verify, through content validity, the appropriateness of the items of the High Assessment Scale Skills - Teacher Version. The judges were six post-graduate students in the psychological assessment area who rated the 41 items of the instrument in six factors (academic intellectual ability, specific academic skills, leadership, creativity, artistic talent). The results demonstrated the suitability of the items, most of them with concordance rates above 80% (n = 29) and between 60 and 80% (n = 8). Only four items showed agreement at or below 50%, suggesting the need for reformulation. The analysis of the Kappa coefficients showed indices between 0.69 and 0.81. In general, the results indicated the suitability of the scale to the contents of the pretended model.

La evaluación de altas habilidades aunque escasos en la literatura es de gran importancia en la psicología. Por esto, el objetivo del estudio fue verificar, a través de la validez de contenido, la adecuación de los ítems que componen la Escala de Evaluación de Altas Habilidades - versión del Profesor. Así, seis estudiantes de posgrado en área de evaluación psicológica actuaron como jueces, y hicieron la clasificación de los 41 ítems del instrumento en seis factores (capacidad académica intelectual, habilidades académicas específicas, liderazgo, creatividad y talento artístico). Los resultados demostraron la idoneidad de los ítems, una ves que la mayoría de tuvieron las tasas de concordancia perfecta por encima del 80% (n = 29) y entre 60 y 80% (n = 8), indicando acuerdo moderado. Sólo cuatro ítems presentaron acuerdos iguales o inferiores al 50%, lo que sugiere la necesidad de reformulación. El análisis de los coeficientes Kappa mostró tasas entre 0,69 y 0,81. En general, los resultados indicaron la idoneidad de la escala para el contenido del modelo.

Escala de projetos de vida para adolescentes: evidências de validade de conteúdo / Life's projects scale for adolescents: evidence of content validity / Escala de proyectos de vida para los adolescentes: validez de contenido

A temática dos projetos de vida de adolescentes tem se mostrado um tema relevante na Psicologia, especificamente, na Psicologia do Desenvolvimento. Diante da lacuna de instrumentais que tenham esse objetivo, o presente estudo consistiu na investigação das evidências de validade de conteúdo da Escala de Projetos de Vida para Adolescentes (EPVA), em desenvolvimento. Para isso, cinco peritos no assunto atuaram como juízes, classificando os 116 itens do instrumento em sete dimensões: relacionamentos afetivos, estudo, trabalho, aspirações positivas, bens materiais, religião/espiritualidade e sentido da vida. A análise dos coeficientes de concordância demonstraram a adequação dos itens, sendo possível manter 88% da escala inicial. As análises dos coeficientes de Kappa evidenciaram índice de concordância acima de 0,75 para todos os juízes. Os resultados apontaram para a adequação da escala ao construto e dimensões que pretende avaliar.

The thematic of the life projects of adolescents has been shown relevant in Psychology, specifically in Developmental Psychology. Faced with the lack of instruments that have this objective, the present study consisted in the investigation of the evidence of content validity of the Scale of Life Projects for Adolescents (EPVA), in development. Five experts on the subject acted as judges, classifying the 116 items of the instrument in seven dimensions: affective relationships, study, work, positive aspirations, material goods, religion / spirituality and meaning of life. The analysis of the coefficients of agreement showed the adequacy of the items, being possible to maintain 88% of the initial scale. Analysis of Kappa coefficient showed a concordance index above 0.75 for all judges. The results pointed to the adequacy of the scale to the construct and dimensions that it intends to evaluate.

La temática de los proyectos de vida de adolescentes se ha mostrado un tema relevante en la Psicología, específicamente, en la Psicología del Desarrollo. Ante la falta de instrumentos que tienen ese objetivo, el presente estudio consistió en la investigación de las evidencias de validez de contenido de la Escala de Proyectos de Vida para Adolescentes (EPVA), en desarrollo. Para ello, cinco expertos en el asunto actuaron como jueces, clasificando los 116 ítems del instrumento en siete dimensiones: relaciones afectivas, estudio, trabajo, aspiraciones positivas, bienes materiales, religión / espiritualidad y sentido de la vida. El análisis de los coeficientes de concordancia demostró la adecuación de los ítems, siendo posible mantener el 88% de la escala inicial. Los análisis de los coeficientes de Kappa evidenciaron un índice de concordancia superior a 0,75 para todos los jueces. Los resultados apuntaron a la adecuación de la escala al constructo y dimensiones que ésta pretende evaluar.

Evaluation of RT-PCR and hemi-nested RT-PCR in brain samples from dogs with neurologic signs compatible with distemper / Avaliação das técnicas de RT-PCR e heminested RT-PCR em cérebros de cães com sinais neurológicos compatíveis com cinomose

The diagnostic value of RT-PCR and hemi-nested RT-PCR (hnRT-PCR) was compared in brain samples of dogs presenting neurological signs compatible with canine distemper. Samples of central nervous system (CNS) were collected from 68 dogs and tested by direct immunofluorescence test (RFID) and, independent of the results, they were stored at -20°C for at least three years. They were submitted to the RT-PCR and hnRT-PCR techniques aiming to determine the gene responsible for the viral nucleoprotein decoding. Fifty-nine samples were positive for RIFD, 40 for RT-PCR (Kappa = 0.358) and 54 for hnRT-PCR (Kappa = 0.740). All nine RIFD negative samples were also negative for RT-PCR and hnRT-PCR. In spite of the storage duration and proper sample conditions, the estimated accordance between hnRT-PCR and RIFD demonstrated that hnRT-PCR technique can be applied in retrospective studies...

Foi comparado o valor diagnóstico das técnicas de RT-PCR e heminested RT-PCR (hnRT-PCR) em amostras de cérebro de cães com sintomatologia nervosa compatível com cinomose. Fragmentos do sistema nervoso central (SNC) colhidos de 68 animais foram testados pela Imunofluorescência direta (IFD) e, independentemente do resultado, foram armazenados a -20°C por pelo menos três anos. Após esse período, foram submetidos a RT-PCR e a hnRT-PCR com oligonucleotídeos iniciadores direcionados ao gene codificador da nucleoproteína N. As proporções de resultados positivos/examinados foram: 59/68 para a IFD, 40/68 para a RT-PCR (Kappa = 0,358) e 54/68 quando associada à heminested PCR (Kappa = 0,740). Houve nove resultados negativos nas três técnicas empregadas. Os resultados do coeficiente Kappa entre a IFD e hnRT-PCR demonstram que apesar das condições de armazenamento, a hnRT-PCR pode ser utilizada em estudos retrospectivos...