Context: Urine color (Uc) is used to asses urine concentration when lab techniques are not feasible.
Objective: To compare the accuracy of Uc scoring using four different light conditions and two different scoring techniques with a 7-color Uc chart. Additionally to assess the results' generalizability, a subsample was compared to scores obtained from fresh samples.
Design: Descriptive laboratory study.
Samples: 178 previously frozen urine samples were scored and n=78 samples were compared to its own fresh outcomes.
Main outcome measure: Urine color and accuracy for classifying urine samples were calculated using receiver operating characteristics (ROC) analysis, allowing to compare the diagnostic capacity against a 1.020 urine specific gravity (USG) cut-off and defining optimal Uc cut-off value.
Results: Uc was significantly different between light conditions (P<0.01), with the highest accuracy (80.3%) of correctly classifications of low or high urine concentrations occurring at the brightest light condition. Lower light intensity scored 1.5–2 shades darker on a 7-color Uc scale than bright conditions (P<0.001), with urine color but no further practical differences for accuracy between scoring techniques. Frozen was 0.5–1 shade darker than freshly measured Uc (P<0.004), but they were moderately correlated (r=0.64). A Bland-Altman plot showed that reporting bias mainly affects darker Uc without impacting the diagnostic ability of the method.
Conclusions: Uc scoring, accuracy and Uc cut-off values are affected by lighting condition but not by scoring technique, with higher accuracy and a one-shade lower Uc cut-off value at the brightest light (i.e. LED flashlight).
The purpose of this article is to identify gold standards of care for return to sport following athletic injury, investigate overlooked aspects of return to sport rehabilitation, and provide expert opinion regarding current practices. The article was written by performing a literature review, then providing editorial expert opinion regarding current standards of return to sport. We concluded, through literature review and expert consensus, that a three-pronged approach to return to sport is recommended for therapists. These three prongs are ROM, strength, and hop testing. Cardiovascular readiness and psychological readiness for return to sport must also be assessed."
In this age group, RMHE evoked by warm baths decreases resting sympathetic activity and HR, which can be considered as beneficial effects. The mechanism(s) should be examined in future studies.Supported by National Institutes of Health Grants MPI R01 HL141198 (Li and Cui) and UL1 TR002014 (Sinoway).
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