The Painlev'e Test of Higher Dimensional KdV Equation

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cdmp p级题库

cdmp p级题库The problem at hand is related to the CDMP P-level question bank. To address this issue, it is important to consider various perspectives and provide a comprehensive response.From an educational standpoint, having a well-designed and comprehensive question bank is crucial for the success of any certification program. The CDMP P-level question bank plays a significant role in assessing the knowledge and skills of individuals seeking certification in data management. It is essential that the question bank covers a wide range of topics, including data governance, data quality, data modeling, and data integration, among others. By ensuring a diverse and comprehensive set of questions, the question bank can effectively evaluate the proficiency of candidates in various areas of data management.Moreover, the quality of the question bank is of utmost importance. The questions should be carefully crafted totest not only the candidates' theoretical knowledge but also their practical understanding and application of concepts. Each question should be clear, concise, and unambiguous to avoid any confusion or misinterpretation. Furthermore, the question bank should be regularly updated to keep up with the evolving field of data management. This can include incorporating new technologies, industry best practices, and emerging trends in data management.In addition to the educational perspective, it is crucial to consider the perspective of the candidates. The CDMP P-level certification is a significant milestone for individuals in their data management careers. Therefore, the question bank should provide a fair and accurate representation of the knowledge and skills required at this level. Candidates should feel confident that the questions are relevant, challenging, and aligned with the expectations of the industry. This will ensure that the certification holds value and serves as a credible recognition of their expertise in data management.Furthermore, it is important to address the emotionalaspect of the problem. Candidates invest significant time, effort, and resources in preparing for the CDMP P-level certification. They may experience various emotions, such as anxiety, stress, and excitement, throughout the preparation process. The question bank should be designedin a way that supports candidates' emotional well-being and motivates them to succeed. This can be achieved by providing clear instructions, offering practice questions, and providing feedback on performance. Additionally, the question bank should be accessible and user-friendly, allowing candidates to navigate through the questions easily.From a practical standpoint, the CDMP P-level question bank should be easily accessible to candidates. It should be available in various formats, such as online platforms or downloadable resources, to cater to different learning preferences. The question bank should also be accompanied by detailed explanations and references to relevant study materials. This will enable candidates to understand the rationale behind the correct answers and further enhance their knowledge in specific areas. Moreover, the questionbank should include a sufficient number of questions to adequately assess the candidates' proficiency level.In conclusion, the CDMP P-level question bank plays a crucial role in evaluating the knowledge and skills of individuals seeking certification in data management. It is essential to ensure that the question bank is comprehensive, of high quality, and regularly updated. Additionally, it should be designed to support candidates' emotional well-being and provide a fair representation of the knowledgeand skills required at the P-level. By considering these perspectives and addressing the various aspects of the problem, the CDMP P-level question bank can effectively serve its purpose and contribute to the success of data management professionals.。

A Reconsideration of Testing for Competence Rather Than for Intelligence

A Reconsideration of Testing for CompetenceRather Than for IntelligenceGerald V. Barrett and Robert L. DepinetThe University of AkronCorrespondence concerning this article should be addressed to GeraldV. Barrett, Department of Psychology, The University of Akron, BuchtelCollege of Arts and Sciences, Akron, OH 44325-4301.October 1991 ° American PsychologistDavid C. McClelland's 1973 article has deeply influenced both professional and public opinion. In it, he presented five major themes: (a) Grades in school did not predict occupational success, (b) intelligence tests and aptitude tests did not predict occupational success or other important life outcomes, (c) tests and academic performance only predicted job performance because of an underlying relationship with social status, (d) such tests were unfair to minorities, and (e) "competencies" would be better able to predict important behaviors than would more traditional tests. Despite the pervasive influence of these assertions, this review of the literature showed only limited support for these claims.In 1973, David C. McClelland's lead article in the American Psychologist profoundly affected both the field of psychology and popular opinion. This article was designed to "review skeptically the main lines of evidence for the validity of intelligence and aptitude tests and to draw some inferences from this review as to new lines that testing might take in the future" (p. 1). The main themes he endorsed and continues to promote (e.g., Klemp & McClelland, 1986) have been published widely in newspapers, magazines, and popular books as well as psychology textbooks. Belief in these views, however, has become so widespread that often they are presented as com- mon knowledge (e.g., Feldman, 1990).Table 1 reviews a number of works that cited McClelland (1973) and shows that the impact of McClelland's article has increased over time. Soon after the article was published, McClelland's views were integrated into introductory psychology textbooks. By the late 1980s, these themes had become part of generally accepted public opinion, with newspaper and magazine writers commonly citing McClelland as an authority on intelligence testing.It was McClelland's (1973) belief that intelligence testing should be replaced by competency-based testing. His argument against intelligence testing rested on the assertion that intelligence tests and aptitude tests have not been shown to be related to important life outcomes because psychologists were unable and unwilling to test this relationship. McClelland argued that intelligence tests have been correlated with each other and with grades in school but not with other life outcomes.McClelland (1973) stated that intellectual ability scores and academic performance were theresult of social status, and he labeled them a sort of game. He asserted that a test must resemble job performance or other criteria to be related to the performance on the criteria. He also claimed that intelligence and aptitude testing were unfair to minorities. He advocated that the profession should focus on what he termed competency testing and criterion sampling, maintaining that intelligence testing and aptitude testing should be discarded.The main points of McClelland's (1973) article can be summarized in the following five themes: (a) Grades in school did not predict occupational success, (b) intelligence tests and aptitude tests did not predict occupational success or other important life outcomes, (c) tests and academic performance only predicted job performance as a result of an underlying relationship to social status, (d) traditional tests were unfair to minorities, and (e) "competencies" would more successfully predict important behaviors than would more traditional tests.In the present article, these themes are examined through a comprehensive review of relevant literature. Although McClelland's (1973) article contained many subthemes, only those themes we believe to be the main issues are addressed here. This does not imply, however, that we agree with any aspects of McClelland's article that are not addressed here.Do Grades Predict Occupational Success?McClelland (1973) claimed that "the games people are required to play on aptitude tests are similar to the games teachers require in the classroom" (p. 1). As evidence, McClelland presented four citations that he interpreted as support for his position, while ignoring disconfirming evidence. He also included his personal experiences at Wesleyan University as evidence, maintaining that "A" students could not be distinguished from barely passing students in later occupational success. This finding differs greatly from that found in a similar, more scientific comparison done by Nicholson (1915) at the same school. Nicholson found that academically exceptional students were much more likely to achieve distinction in later life. The results of Nicholson's study are summarized in Table 2.Table 1 Support for McClelland's (1973) Concepts in Newspapers, Magazines, Popular Books, and TextbooksPublication Author(s) Statement NewspapersNew York Times Goleman (1988) IQ tests severely limited as predictors of job successNew York Times Goleman (1984) Intelligence unrelated to career successPlain Dealer Drexler (1981) Tests unrelated to accomplishments in leadership, arts, science, music, writing, speech, and drama; tests discriminate by culture MagazinesAtlantic MonthlyPsychology TodayPsychology TodayPopular booksMore Like UsWhiz KidsPsychology textsPsychology: An IntroductionIntroduction to PsychologyPsychology: Being HumanPsychologyUnderstanding Human BehaviorElements of PsychologyEssentials of PsychologyPsychology: An IntroductionIntroductory PsychologyFallows (1985)Goleman (1981)Koenig (1974)Fallows (1989)Machlowitz (1985)Morris (1990)Coon (1986)Rubin & McNeil (1985)Crider, Goethals,Kavanaugh, &Solomon (1983)McConnell (1983)Krech & Crutchfield(1982)Silverman (1979)Mussen &Rosenzweig (1977)Davids & Engen(1975)Promote replacing aptitude tests with competence testsTests and grades are unrelated to career successTests and grades have less value than competence testsTests and grades are useless as predictors of occupational success Bright people do not do better in lifeIQ and grades are unrelated to occupational successIQ does not predict important behaviors or successSuggests replacing IQ tests with competence testsTests are unfair by race and socioeconomic statusAbility is unrelated to career successTests and grades are unrelated to life outcomesTesting results in categorical labelsTest scores are unrelated to job successSuggests replacing IQ tests with competence testsSome limitations do exist when grades are used as predictors. Grades vary greatly among disciplines (Barrett & Alexander, 1989; EUiott & Strenta, 1988; Schoenfeldt & Brush, 1975) as well as among colleges (Barrett & Alexander, 1989; Humphreys, 1988; Nelson, 1975). Because different students usually take different courses, the reliability of grades is relatively low unless a common set of courses is taken (Butler & McCauley, 1987). Despite these shortcomings, a number of meta-analyses have shown that grades do have a small-to-moderate correlation with occupational success (Cohen, 1984; Dye & Reek, 1988, 1989; O'Leary, 1980; Samson, Graue, Weinstein, & Walberg, 1984). Despite an overlap among the data used by these studies and variability among results (r =. 15 to .29), they all reached similar conclusions. A wide variety of measures of occupational success such as salary, promotion rate, and supervisory ratings have been positively related to grade point average.Table 2 Success of Wesleyan GraduatesClasses/academic standing Percentage who achieved distinction in later life1831-1959Valedictorians and salutatorians 49Phi Beta Kappa 31No scholarly distinction 61860-1889Highest honors 47Phi Beta Kappa 31No scholarly distinction 101890-1899Highest honors 60Phi Beta Kappa 30No scholarly distinction 11Note. Adapted from "Success in college and in later life" by F. W. Nicholson,1915, School and Society, 12, p. 229-232. In the public domain.The results of these recta-analyses reflect the diverse individual studies that showed a relationship between academic performance and occupational success. This relationship may have stemmed from underlying associations between academic performance and intellectual ability, motivation (Howard, 1986), and attitudes toward work (Palmer, 1964). Hunter (1983, 1986) supported this possibility by demonstrating through path analysis that higher ability led to increased job knowledge, which in turn led to better job performance. This relationship was true at all educational levels, including medical school graduates, graduate-level MBAs, college graduates in both engineering and liberal arts, technical school graduates, and high school graduates in the United States and in other countries, such as Sweden (Husen, 1969). The correlations between grades and occupational success have ranged from .14 to .59. However, some research has indicated that these relationships were underestimated because the range onthe predictor grades was restricted (Dye & Reck, 1989; Elliott & Strenta, 1988). Even when limitations are considered, both meta-analyses and diverse individual studies showed grades as predictors of occupational success.Do Intelligence Tests and Aptitude Tests Relate to Job Success or Other Life Outcomes?Thorndike and Hagen's (1959) study was McClelland's (1973) central evidence that aptitude tests did not predict occupational success. The Thorndike and Hagen study involved more than 12,000 correlations between aptitude tests and various measures of occupational success for more than 10,000 individuals. They concluded that the number of significant correlations did not exceed the number that would be expected by chance. From these results, MeClelland concluded that "in other words, the tests were invalid" (p. 3).This characterization of the research by Thorndike and Hagen (1959) has often been quoted as proof that aptitude tests cannot predict job success (Haney, 1982; Nairn, 1980). However, McClelland (1973) did not address some extremely important points.Perhaps the most basic point overlooked was that aptitude tests did, in fact, predict success for those professionals for whom they were designed, namely, pilots and navigators. The test battery consisted of dial and table reading, speed of identification, two-hand coordination, complex coordination, rotary pursuit, finger dexterity, aiming stress, discrimination in reaction time, reading comprehension, mathematics, numerical operations, and mechanical principles (Dubois, 1947). All of these tests were specifically designed to predict success in avionics, and the content of these tests was directly related to that field. The mechanical principles test, for example, asked the direction of the wind as shown by a wind sock.The validity of the test battery was demonstrated during World War II (Dubois, 1947) when an unscreened group was used as part of the validation process. Of those who failed the test battery, only 8.6% subsequently graduated from training (45 of 520), and no one in the lowest stanine (150 subjects) graduated. Conversely, 85% of those in the upper stanines graduated (Dubois, 1947).M eClelland (1973)was concerned that cultural bias was present in aptitude tests. The avionics battery studied by Thorndike and Hagen (1959) was used to predict the success of pilots during World War II (Dubois, 1947) and included West Point cadets, Chinese people, women, and Blacks as subjects. The battery was found valid for all of these groups. This agrees with later findings that, in general, aptitude tests are valid for all groups (Boehm, 1972; Hunter, Sehmidt, & Hunter, 1979; Hunter, Schmidt, & Rauschenberger, 1984).Thorndike and Hagen (1959) surveyed a sample of individuals who had taken the pilot and navigators test battery in 1943. The respondents, who ranged in age from 18 to 26 years at the time of testing, were asked to supply self-report data in seven areas, including monthly income in1955. Validity coefficients were then computed between results on the avionics test battery and self-reported income.This validation procedure contained obvious flaws. The eight-year age range among subjects influenced the job experience of the respondents. Some respondents were well established in their careers. Others were only beginning. Differences in job experience would translate into wide salary differences, even within the same occupation, contaminating the criterion measure.The respondents were in diverse occupations and were dispersed geographically throughout the United States. Even if the avionics test had been appropriate for predicting the success of both an English academic and a physician and even if they were the same ages at the time the salary data were collected, the differences in mean occupational salary would obscure any potential relationship.While McClelland (1973) was claiming that the avionics battery was invalid for predicting occupational success, other researchers using the same data set as Thorndike and Hagen (1959) refined the procedure and obtained additional criterion data in 1969 (Beaton, 1975; Hause, 1972, 1975; Tanbman & Wales, 1973, 1974). These researchers determined that the numerical aptitude factor, derived by factor analysis, was positively related to later income. These studies also showed that this relationship increased over time as the former aviators and navigators matured in their respective occupation. When the data were broken down by occupation, those respondents scoring in the top one tenth in numerical ability earned 30% more than those scoring in the bottom four tenths. When ability was held constant, education was not a significant factor in relation to earnings (Taubman & Wales, 1974).Taubman and Wales (1974) found that those with scores in the top ability level within each educational category (from high school through professional education) had considerably higher salaries than those at the lowest ability level. For individuals with master's degrees, those scoring in the bottom one fifth averaged an annual salary of $14,000, whereas those in the top one fifth averaged $22,200.Comparable results were obtained in a longitudinal study in Sweden over a 26-year period (Husen, 1969). Men included in the group with the highest intellectual ability, when tested at age 10, earned twice the income of those in the lowest category, a practical and significant difference in income. The evidence presented here leads to the inevitable conclusion that intelligence tests and aptitude tests are positively related to job success.Recent EvidenceMany researchers have tested the relationship between cognitive ability and job performance using meta-analytic techniques. Data from approximately 750 studies on the General Aptitude Test Battery (GATB) showed that the test validly predicted job performance for many different occupations (Hartigan & Wigdor, 1989). Hunter and Hunter's ( 1984 ) recta-analysis demonstrated that in entrylevel positions, cognitive ability predicted job performance with an average validityof .53. This study also showed an average correlation of.45 between intellectual ability and job proficiency. Other studies using a number of different measures of job proficiency have found similar relationships to cognitive ability (Distefano & Pryer, 1985; Hunter, 1983, 1986; Pearlman, Schmidt, & Hunter, 1980; Schmidt, Hunter, & Caplan, 1981).McClelland (1973) implied that supervisors' ratings were biased. However, research has shown that the sex and race of either the rater or ratee do not exert important influence on ratings (Pulakos, White, Oppler, & Borman, 1989). More objective criterion measures produced even higher validity coefficients with aptitude test scores. In Nathan and Alexander's (1988) meta-analysis, the criteria of ratings, rankings, work samples, and production quantities all resulted in high test validities. Production quantity and work sample criteria resulted in substantial validity coefficients, negating McClelland's claim that validity coefficients were obtained only by using biased supervisory ratings. In fact, Smither and Reilly (1987) found that the intelligence of the rater was related to the accuracy of job performance ratings.In a study using path analysis, Schmidt, Hunter, and Outerbridge (1986) found that cognitive ability correlated with job knowledge (.46), work samples (.38), and supervisory ratings (. 16). They concluded that cognitive ability led to an increase in job knowledge, a position also supported by Gottfredson (1986).Practical TasksTo support his assertion that intelligence was not appli- cable to employment situations, McClelland (1973) stated that intelligence as measured in aptitude and intelligence testing was not useful in practical, everyday situations. Schaie (1978) explored this theory, describing the issues that must be addressed to attain external validity. He suggested that criteria should include actual real-world tasks. Willis and Schaie (1986) tested this proposition on older adults. Both the individuals tested and the criterion tasks used in the study, such as ability to comprehend the label on a medicine bottle or to understand the yellow pages of the telephone directory, differed substantially from typical academic tasks. According to McClelland's view, a relationship should not exist between mental abilities, such as fluid and crystallized intelligence, and performance on the eight categories of real-life tasks used by Willis and Schaie.This idea was not supported by the study results. An extremely high relationship existed between intelligence and performance on real-life tasks. Intellectual ability accounted for 80% of the variance in task performance (Willis & Schaie, 1986). In a second study, they again found intellectual ability to be related to both selfperceived performance and the ratings assigned by judges for performing a number of practical tasks. These results were replicated on several samples of older adults (Schaie, 1987).Correlations between performance and scores on intelligence and aptitude tests are supported in other, more unstructured and ambiguous situations including business management (Bray & Grant, 1966; Campbell, Dunnette, Lawler, & Weick, 1970; Siegel & Ghiselli, 1971), performance in groups (Mann, 1959), and success in science (Price, 1963). Michell and Lambourne (1979) studied16-year-old students and found that those with higher cognitive ability were better able to answer openended questions. Students with higher cognitive ability were also able to sustain discussion longer, ask more interpretive questions, and achieve a more complex understanding of issues. In addition, intelligence has been shown to be related to musical ability (Lynn & Gault, 1986) and creativity (Cropley & Maslany, 1969; Drevdahl & Cattell, 1958; Hocevar, 1980; MacKinnon, 1962; McDermid, 1965; Richards, Kinney, Benet, & Merzel, 1988). From examining these studies, we find cognitive ability to be positively related to a variety of real-world behaviors.SummaryA review of the relevant literature shows that intelligence tests are valid predictors of job success and other important life outcomes. Cognitive ability is the best predictor of performance in most employment situations (Arvey, 1986; Hunter, 1986), and this relationship remains stable over extended periods of time (Austin & Hanisch, 1990). Using samples of the size usually found in personnel work, Thorndike (1986) concluded that cognitive "g" is the best predictor of job success. Ironically, this was the same author whose earlier study was presented in McClelland's (1973) article as evidence that aptitude tests cannot be used to predict job performance.The evidence from these varied scientific studies leads again and again to the same conclusion: Intelligence and aptitude tests are positively related to job performance.Is There an Artifactual Relationship Between Intellectual Ability and Job Success Based on Social Status?A major part of McClelland's (1973) argument against the use of intelligence or aptitude tests was his claim that "the tests are clearly discriminatory against those who have not been exposed to the culture, entrance to which is guarded by the tests" (13. 7). Available scientific evidence has refuted this contention; IQ is related to occupational success. However, McClelland maintained that "'the correlation between intelligence test scores and job success often may be an artifact, the product of their joint association with class status" (p. 3).Despite the numerous ways of defining socioeconomic status (SES), we will show that occupational success is primarily a result of individual cognitive ability and education, both factors that are relatively independent of social origin. We will also show that the strength of the relationship between IQ and job success is not strongly related to the social prestige of particular careers, regardless of variations between occupations. We agree with Gottfredson (1986) that it is more useful to focus on areas such as individual ability rather than irrelevant SES factors, such as family income, over which individuals have no control.Definition of Socioeconomic StatusMcClelland's (1973) definition of SES differs considerably from those used by other researchers. To McClelland, socioeconomic status belongs to the power elite--those who have credentials, power, pull, opportunities, values, aspirations, money, and material advantages. Some of these factors (e.g., values and aspirations) have been shown to be related to later success (Sewell & Hauser, 1976). They have not been described as socioeconomic status by other researchers, however, because these factors do not belong exclusively to the wealthy (Greenberg & Davidson, 1972).McClelland (1973) also described SES in terms of income. Other researchers in the area (e.g., Scarr & Weinberg, 1978; Sewell & Hauser, 1976) have found in- come to have weak connections with later success, with correlations of only. 17 between the adult's income and the income of his or her parents (Sewell & Hauser, 1976). These findings are consistent with Alwin and Thornton (1984) and Williams (1976), who found correlations between. 12 and .25 between family income and the intelligence of the children. Although variation exists in the correlations found, none of the results supported McClelland's view of strong financial effects.Some variables that have been examined as operational measures of SES include family structure, dwelling conditions, and school attendance record (Greenberg & Davidson, 1972); number of siblings in the family, region of residence, and size of community (Peterson & Karplus, 1981); number of people per room in the home (Greenberg & Davidson, 1972; Herzog, Newcomb, & Cisin, 1972); mother's educational level (Herzog et al., 1972; Peterson & Karplus, 1981; Sewell & Hauser, 1976; Willerman, 1979); father's educational level (Duncan, Featherman, & Duncan, 1972; Peterson & Karplus, 1981; Sewell & Hauser, 1976; Willerman 1979); father's occupation (Duncan et al., 1972; Greenberg & Davidson, 1972; Peterson & Karplus, 1981; Sewell & Hauser, 1976; Willerman, 1979); family income (Peterson & Karplus, 1981; Sewell & Hauser, 1976); and median neighborhood income and educational level (Scarr, 1981). Socioeconomic status has often been operationally defined as a combination of these factors. Because SES has been defined in so many ways, the specific variables explored were theoretically more important and practical than the general term socioeconomic status.Effects of Socioeconomic Status VariablesMeasures described as SES, such as parental education, have been related to children's success (Duncan et al., 1972; Scarr & Weinberg, 1978; Sewell & Hauser, 1976). These factors were most likely proxies for explanatory factors such as orderliness in the home and value placed on education. Studies show that parental background variables make little contribution to the distribution of individuals to occupations, whereas years of education and cognitive ability make a large contribution (Duncan et al., 1972; Gottfredson & Brown, 1981). A well-known longitudinal study (Vaillant, 1977) found that broad measures of SES before an individual's enrollment in college had no relation to outcome variables 30 years later. However, among people of equal ability, the most significant predictor of adult occupational achievement was the parents' attitudetoward school and education (Kraus, 1984).The operational measures of SES that have been found to be important determinants of later outcomes (e.g., values and attitudes) were factors that could be influenced. Even the poorest of families could develop and use these factors to benefit their children (Greenberg & Davidson, 1972). Unfortunately, some families are so destitute that their environment would not even be considered as humane, and this deprivation would have detrimental effects on later accomplishments. For the vast majority of people in all socioeconomic and racial subgroups, however, this is not the case (Scarf, 1981).Education and measured cognitive ability were shown to be more important to later outcomes than were such factors as income. However, the effect of SES on these variables must be examined further.Test performance. Oakland (1983) found that the relationship between IQ scores andachievement test performance was the same across SES levels. A factor analysis of ability measures in different SES groups showed that factor structure was not contingent on SES (Humphreys & Taber, 1973). Spaeth (1976) and Valencia, Henderson, and Rankin (1985) found that the effects of parental SES on a child's IQ score were mediated by family interaction and exposure to stimuli provided by parents. In addition, Spaeth concluded that parental influence was a great deal more important than that of teachers and schools. The effects of the latter were much less personal and direct. He concluded that the direct effect of parental SES on child's IQ was -.03. In related research, SES has not been found to have a significant effect on the IQ scores of adult, adopted twins reared apart (Bouchard, Lykken, McGue, Segal, & Tellegen, 1990).Simple measures of SES did not adequately capture the parts of the environment that produced individual differences, even within families (Mercy & Steelman, 1982; Rowe & Plomin, 1981). Even such simple, specific variables as amount of time spent on homework and amount of time spent watching TV on weekdays were related in the expected direction to performance on academic achievement tests (Keith, Reimers, Fehrmann, Pottehaum, & Aubey, 1986). Ultimately, parents could help children learn to cope with cognitive complexity, an effect independent of SES (Spaeth, 1976).College attendance. Contrary to McClelland's (1973, p. 3) assertion that entrance intoprestigious jobs was based on social background, entrance into higher status jobs has instead been shown to be primarily determined by educational attainment (Alexander & Eckland, 1975; Bajema, 1968; Gottfredson & Brown, 1981; Schiefelbein & Farrell, 1984; Sewell & Hauser, 1976). Therefore, what determines attendance at college is very important.McClelland ( 1973) stated that an individual's socioeconomic class was the primary factor in determining his or her ability to attend college. Research has shown the flaws in this assertion. Although socioeconomic background is associated with college attendance, other factors are。

Evaluation of five different questionnaires for assessing sleep apnea syndrome in a sleep clinic.

Original ArticleEvaluation of ﬁve different questionnaires for assessing sleep apnea syndrome in a sleepclinicAthanasia Pataka a ,⇑,Euphemia Daskalopoulou b ,George Kalamaras a ,Katalin Fekete Passa a ,Parakevi Argyropoulou aa Respiratory Failure Unit,G.Papanikolaou Hospital,Exohi,Thessaloniki,GreecebSleep Laboratory,Department of Internal Medicine,‘St Paul’General Hospital,Thessaloniki,Greecea r t i c l e i n f o Article history:Received 15November 2013Received in revised form 7March 2014Accepted 10March 2014Available online 20April 2014Keywords:ESS STOPSTOPBangBerlin Questionnaire4-Variable Screening Tool Evaluationa b s t r a c tBackground:Obstructive sleep apnea/hypopnea syndrome (OSAHS)is a major cause of morbidity and mortality.Different clinical models and questionnaires have been used to evaluate patients with the highest OSAHS probability.Objectives:To evaluate the clinical utility of ﬁve different questionnaires –STOP,STOPBang (SB),Berlin Questionnaire (BQ),Epworth Sleepiness Scale (ESS),and 4-Variable Screening Tool (4-V)–in a sleep clinic in order to identify patients at risk for OSAHS and to assess the best possible combination of these tools.Methods:1853(74.4%males)patients (mean age 52±14years;mean body mass index 32.8±7kg/m 2)visiting a sleep clinic were studied retrospectively.Results:SB had the highest sensitivity (97.6%),the largest area under the receiver operating characteris-tics curve (AUC)(0.73;95%CI,0.7–0.76)and best OR (5.9;95%CI,3.6–9.5),but the lowest speciﬁcity (12.7%)for AHI P 15.The 4-V P 14had the highest speciﬁcity (74.4%)followed by ESS (67%).BQ had good sensitivity (87%),worse speciﬁcity (33%)than 4-V and ESS but better than STOP (13%)and SB (12.7%).The combination of questionnaires did not improve their predictive value.Conclusions:SB had the highest sensitivity,OR,and AUC,but rather low speciﬁcity,and 4-V the highest speciﬁcity.The combination of different questionnaires did not improve their predictive value.Ó2014Elsevier B.V.All rights reserved.1.IntroductionPolysomnography (PSG)is the ‘gold standard’for obstructive sleep apnoea/hypopnoea syndrome (OSAHS)diagnosis but is expensive and time-consuming.In order to evaluate the patients with the highest probability of OSAHS,different clinical models have been developed utilizing clinical variables as symptoms (snoring,apneas)and physical examination measurements [body mass index (BMI),neck circumference,hypertension]suggestive of OSAHS [1,2].Additionally several questionnaires have been designed to identify patients at risk for OSAHS [3].Some patients may be misdiagnosed as the degree of heterogeneity between questionnaires and clinical prediction models is high [2,4].As ﬁnancial resources are rather limited due to the economic crisis [5],an effective screening tool might be cost-effective.This screening tool could help to prioritize patients with the greatest likelihood of having OSAHS to undergo a sleep study and receive treatment.The aims of this study were:(i)to evaluate the clinical utility of ﬁve different questionnaires:the STOP questionnaire,the STOP-Bang (SB)clinical scale,the Berlin Questionnaire (BQ),the Epworth Sleepiness Scale,and the 4-Variable Screening Tool (4-V)in a sleep clinic in order to assess strategies to expedite severity stratiﬁcation of patients at risk for OSAHS;and (ii)to evaluate the combination of the above tools.2.Methods2.1.Study design and ethicsThis was a retrospective study of the patients visiting the Sleep Clinic of the Respiratory Failure Unit of G.Papanikolaou Hospital (2009–2012).The ethics committee reviewed and approved the protocol,and did not require patient consent.Patients aged >18years referred for evaluation of a possible sleep disorder were included.Body mass index (BMI),age,neck circumference,and/10.1016/j.sleep.2014.03.0121389-9457/Ó2014Elsevier B.V.All rights reserved.⇑Corresponding author.Address:Medical School,Aristotle University of Thessaloniki,Respiratory Failure Unit,G.Papanikolaou Hospital,57010Exohi,Thessaloniki,Greece.Tel./fax:+302313307253.E-mail address:patakath@yahoo.gr (A.Pataka).gender were documented.All the participants answered the ESS, BQ,and the STOP questionnaire during theirﬁrst visit.The SB and4-V were also calculated by a technician(G.K.).The ESS[6]measures sleep propensity in order to differentiate persons with excessive daytime sleepiness(EDS).The ESS is a sim-ple,self-administered questionnaire(eight questions)that asks the subject to rate on a scale of0–3the chances of dozing in eight dif-ferent situations commonly met in daily life(sum of eight ques-tions can vary from0to24).Scores>10are considered as abnormal sleepiness.The ESS has been validated in Greek[7].The BQ[8]was designed to identify individuals at higher risk of having OSAHS in primary care.It includes three categories(10 questions):(1)snoring severity(items1–5),(2)EDS(items6–9), and(3)history of hypertension or obesity(item10).High risk for OSAHS is deﬁned when there are persistent symptoms(more than three or four times per week)in categories1and2,and hyperten-sion(P140/90mmHg or use of medication)or BMI P30kg/m2in category3.Categories1and2are positive when the sum of all items is P2.Patients are classiﬁed as having high risk for OSAHS if scores are positive on two or more categories.Patients scoring positive in only one or none of the categories are classiﬁed as low risk.BQ was recently validated in Greek[9].The STOP questionnaire[10–13]is a self-report,forced-choice (yes/no)scale consisting of four questions related to snoring,tired-ness during daytime,observed apneas and high blood pressure (STOP).High risk for OSAHS is deﬁned when two or more questions are answered positively.The Bang portion is evaluated by assessing BMI>35kg/m2,age(>50years),neck circumference(>40cm),and gender(male).One point is assigned for each positive answer and zero for each negative answer.High risk for OSAHS on the SB is deﬁned when three or more of the eight questions are answered positively and negative when two or fewer.The4-V[14]is a tool for the identiﬁcation of moderate to severe OSAHS and consists of four variables(gender,blood pressure,BMI, and self-reported snoring).For the calculation of the4-V we used the following equation[15]:OSAHS¼ðgenderÃ4ÞþðBMI category valueÞþðBP category valueÞþðsnoringÃ4Þ:Cut-offs P11and P14were evaluated.Males were scored with1 and females with0.Snoring almost every day or often was consid-ered as‘yes’and was scored with1,and snoring sometimes or almost never was considered as‘no’and was scored with0.BMI (kg/m2)was categorized as<21.0,21.0–22.9,23.0–24.9,25.0–26.9, 27.0–29.9,P30,and values from1to6were assigned,respectively [14].Blood pressure(BP)(mmHg)was divided into the following categories:systolic BP(SBP)<140or diastolic BP(DBP)<90,SBP 140–159or DBP90–99,SBP160–179or DBP100–109,SBP P180 or DBP P110,and values between1and4were assigned,respec-tively[14].All the participants underwent in-laboratory PSG consisting of electroencephalography(EEG),submental electromyography (EMG),electro-oculography(EOG),electrocardiography(ECG), snoring(microphone on anterior neck),airﬂow(oronasal thermis-tor and nasal pressure transducer),thoracic and abdominal respiratory effort,body position detection,and oximetry(Alice5 Diagnostic Sleep System,Philips Respironics).PSGs were manually scored according the American Academy of Sleep Medicine guide-lines[16].Apnea was deﬁned as the decrease in airﬂow to P90%of baseline for P10s and hypopnea as a decrease in airﬂow of P30% for P10s with oxygen desaturation of P4%from pre-event baseline.The apnea–hypopnea index(AHI)was calculated as the number of apneas and hypopneas per hour of sleep.Obstructive apnea was deﬁned as the absence of airﬂow,but with the persistence of ventilatory effort.Witnessed apneas were deﬁned as observed breathing pauses during sleep noticed from the partic-ipant or a household member.The patients were asked if they or a member of their family noticed cessation of breathing during their sleep and how often(nearly every day,3–4times/week,1–2times/ week,1–2times/month,never or nearly never).The severity of OSAHS was determined by the AHI:5–14as mild;15–29as moderate;P30as severe[17].Oxygen desaturation index(ODI) was deﬁned as the number of scored desaturations>4%by the time in bed[18].2.2.Statistical analysisSPSS version17.0(SPSS Science,Apache Software Foundation, Chicago,IL,USA)was used.Sensitivity(Se),speciﬁcity(Sp),positive predictive values(PPV),negative predictive values(NPV),and positive and negative likelihood ratios(LR+/LRÀ)were calculated. Combined sensitivity and speciﬁcity was also estimated(zoe. /~bv20/bmed2400/Bank/SeSp.pdf)[19,20].In the parallel strategy the combination is positive if at least one test is positive.It is negative if all tests are negative.Se¼1À½ð1ÀSe1ÞÂð1ÀSe2ÞÂ...Âð1ÀSekÞ :Sp¼Sp1ÂSp2Â...ÂSpk:In the serial strategy,the combination is positive if all tests are posi-tive.It is negative if at least one test is negative.Se¼Se1ÂSe2Â...ÂSek:Sp¼1À½ð1ÀSp1ÞÂð1ÀSp2ÞÂ...Âð1ÀSpkÞ :Separate bivariate logistic regression models were used to deter-mine the odds ratio(OR)in predicting OSAHS.The Pearson correla-tion coefﬁcient was used to determine whether there was a signiﬁcant correlation between different questionnaires in the entire study population and in different risk groups.For non-parametric variables,the Spearman correlation coefﬁcient was used.The v2-test was used for categorical variables.Analysis of variance(ANOVA)with post-hoc contrasts by t-tests for continuous variables(Bonferroni)was used to analyze the differences between group means.Tests were two-tailed and P<0.05was accepted as statistically signiﬁcant.Data were presented as mean±SD unless otherwise stated.The discriminatory ability of each questionnaire for diagnosing OSAHS was evaluated using receiver operating characteristic(ROC)curves.3.ResultsFrom the2050patients that visited the Sleep Clinic,1853(74.4% males)were included in the study(mean age52±14years,BMI 32.8±7kg/m2,AHI33±26.6).Patients with missing data were excluded.Patients’characteristics are presented in Table1.There was signiﬁcant difference between OSAHS severity and age (P<0.001),BMI(P<0.001),neck circumference(P<0.001),ODI (P<0.001),witnessed apneas(>3–4days/week)(P<0.001),ESS (P<0.001),STOP(P<0.001),SB(P<0.001),BQ(P<0.001)and 4-V(P<0.001).However,in the post-hoc analysis there was no signiﬁcant difference of age between moderate and severe OSAHS, of BMI between mild and moderate OSAHS,of ESS between no and mild OSAHS,and of4-V between mild and moderate OSAHS.From the patients with AHI P15,95.7%had P2positive answers in the STOP questionnaire,97.6%had P3positive answers for the SB questionnaire,74%had high risk in the BQ,54%had ESS P11,53%had4-V P11,and55%had4-V P14.From the patients with severe OSAHS(AHI P30),97%had P2positive answers in the STOP questionnaire,98.7%had P3positive answers for the SBA.Pataka et al./Sleep Medicine15(2014)776–781777questionnaire,78.3%had high risk in the BQ,54.6%had ESS>10, 45.3%4-V P11,and61%had4-V P14.When we compared theﬁve questionnaires,SB had the highest sensitivity,NPV,the largest area under the ROC curve(AUC)and best OR,but the lowest speciﬁcity for OSAHS(AHI P5,P15, P30).The4-V P14had the highest speciﬁcity followed by the ESS.BQ had good sensitivity,worse speciﬁcity than4-V P14and ESS,but better than STOP and SB(Tables2–4).When the predictive values were calculated for each severity group of OSAHS(mild, moderate and severe)sensitivities,PPVs,AUC,and ORs rose with the severity of disease in all questionnaires(Table4).No signiﬁcant differences existed when patient were evaluated according to gender or age.The correlations between the questionnaires in the total popu-lation studied and in the different severity groups of OSAHS are seen in Table5.BQ correlated well with all the other question-naires(P<0.001)in the total population,but in mild and severe OSAHS there was poor correlation with4-V P11.As SB had the best sensitivity and4-V P14the best speciﬁcity, we calculated the combined sensitivity and speciﬁcity in series(ie the combination is positive if all tests are positive and it is negative if at least one test is negative)and in parallel(ie the combination is positive if at least one test is positive and it is negative if all tests are negative)(Table6).Similarly,we calculated the combined sen-sitivity and speciﬁcity for the ESS and SB,ESS and BQ,BQ and4-V, SB,ESS,and BQ,and those of all the questionnaires–apart from STOP as it is included in SB.No improvement was found in the predictive values from the combination of questionnaires.The sensitivity of all questionnaires was low(25.2%)and speciﬁcity was high(95%)when combined in series,but the sensitivity was almost100%(99.9%)and the speciﬁcity was rather low(20.6%) when combined in parallel.4.DiscussionWhen evaluating the predictive values of different question-naires in order to identify patients at risk for OSAHS in a sleep clinic,we found that the SB had the highest sensitivity,NPV,AUC and OR,whereas the4-V had the highest speciﬁcity and PPV.We combined different questionnaires with no signiﬁcant improve-ment in the predictive values.OSAHS is associated with a wide range of medical conse-quences,and,as obesity is increasing,its prevalence and conse-quences also increase[21,22].The waiting lists for sleep studies are rather long and the need for effective tools for the assessment of patients at high risk for OSAHS is evident,especially in countries such as Greece where the lack of primary care facilities leads to the referral of majority of patients to tertiary hospitals.The ideal test should be inexpensive,simple,non-time-consuming,with high sensitivity in order to detect patients early in the disease process and with sufﬁcient speciﬁcity to eliminate unnecessary testing.In the study of Silva et al.[15]ESS,STOP,SB and4-V were eval-uated in the general population.The SB had the highest sensitivity [for respiratory disturbance index(RDI)P15:87.0%;and for RDI P30:70.4%]and the4-V had the highest speciﬁcity(for both RDI P15and RDI P30:93.2%).The ESS did not predict OSAHS as wellTable1Characteristics of the subjects involved in the study.Characteristics All AHI<5AHI5–14AHI15–29AHI P30Number1853354(19.1%)251(13.6%)349(18.8%)898(48.5%) Sex(male/female)a1379/474232/122177/74256/93713/185 Age(years)(mean±SD)b52±1447.9±1550.3±14.953±13.353.8±13.4 BMI(kg/m2)(mean±SD)b32.8±728.8±5.231±6.931.6±635.2±7 Neck circumference(cm)(mean±SD)b41.8±4.339.1±3.740.4±3.941.4±4.343.4±3.9 ODI/h a37.5±29.27.2±5.412±7.827.9±11.860.9±23.2 Witnessed apneas(>3–4days/week)a1208(65.2%)63(18%)141(56%)259(74.3%)745(83%) ESS(mean±SD)b11.2±5.49.2±59.4±4.611±4.912.5±5.5 ESS>10a828(44.8%)111(32%)75(30%)151(43.3%)491(54.6%) Berlin high risk a1258(68%)185(52.2%)149(59.3%)221(63.3%)703(78.3%) Berlin low risk a299(16.1%)101(28.5%)61(24.3%)59(16.9%)78(8.6%) STOP(score)(mean±SD)b 2.8±0.9 2.4±1 2.5±0.8 2.8±0.93±0.8 STOPBang(score)(mean±SD)b5±1.5 3.9±1.45 4.4±0.85 4.9±1.4 5.6±1.3 STOP P2positive answers a1661(89.6%)241(68%)228(91%)321(92%)871(97%) STOPBang P3positive answers a1434(77.4%)240(68%)224(89.2%)332(94.5)889(98.7%) 4-Variable(mean±SD)b13.3±2.512±2.812.8±2.513.2±2.514±2 4-Variable P11a1374(74%)215(61%)178(83%)268(76.8%)713(79.4%) 4-Variable P14a836(45.1%)81(23%)77(30.7%)140(40%)538(60%)BMI,body mass index;ODI,oxygen desaturation index;AHI,apnea–hypopnea index;ESS,Epworth Sleepiness Scale;4-Variable,4-Variable Screening Tool.a v2-Test,P<0.001.b P<0.001in one way analysis of variance.Table2Predictive parameters for ESS,Berlin,STOP,STOPBang and the4-Variable Screening Tool questionnaires for OSAHS(AHI P5).Parameters ESS Berlin STOP STOPBang4-VariableP11P14Sensitivity50%84.4%95%96.2%78%50.7% Speciﬁcity67%35.3%15.7%14%40.8%78% PPV86.6%85.3%84%83.3%84.3%90.3% NPV24%33.8%40.5%45%31.1%27.9% LR(+)/LR(À) 1.5/0.7 1.3/0.4 1.13/0.3 1.2/0.3 1.3/0.5 2.3/0.6 AUC(95%CI)0.59(0.55–0.62)0.6(0.56–0.64)0.65(0.6–0.7)0.74(0.7–0.8)0.59(0.55–0.64)0.68(0.64–0.7) OR(95%CI)2(1.6–2.6)3(2.2–3.9) 3.5(2.4–5.3) 4.1(2.6–6.45) 2.4(1.7–3.3) 3.6(0.55–5.2)ESS,Epworth Sleepiness Scale;OSAHS,obstructive sleep apnea–hypopnea syndrome;AHI,apnea–hypopnea index;PPV,positive predictive value;NPV,negative predictive value;LR,likelihood ratio;AUC,area under the receiver operating characteristics curve;CI,conﬁdence interval;OR,odds ratio.778 A.Pataka et al./Sleep Medicine15(2014)776–781A.Pataka et al./Sleep Medicine15(2014)776–781779Table3Predictive parameters for ESS,Berlin,STOP,STOPBang and the4-Variable Screening Tool questionnaires for moderate and severe OSAHS(AHI P15).Parameters ESS Berlin STOP STOPBang4-VariableP11P14Sensitivity54%87%96%97.6%79%55% Speciﬁcity67%32.6%13%12.7%36%74.4% PPV77.5%73.4%71%70.6%71%81% NPV41.2%54.1%58%71%46.5%45% LR(+)/LR(À) 1.65/0.7 1.3/0.4 1.1/0.34 1.1/0.2 1.2/0.6 2.1/0.6 AUC(95%CI)0.6(0.58–0.64)0.6(0.57–0.63)0.67(0.6–0.7)0.73(0.7–0.76)0.58(0.54–0.6)0.67(0.64–0.7) OR(95%CI) 2.4(1.96–3) 3.3(2.5–4.2) 3.3(2.2–4.8) 5.9(3.6–9.5) 2.2(1.6–2.9) 3.5(2.7–4.7)ESS,Epworth Sleepiness Scale;OSAHS,obstructive sleep apnea–hypopnea syndrome;AHI,apnea–hypopnea index;PPV,positive predictive value;NPV,negative predictive value;LR,likelihood ratio;AUC,area under the receiver operating characteristics curve;CI,conﬁdence interval;OR,odds ratio.Table4Predictive parameters for ESS,Berlin,STOP,STOPBang and the4-Variable Screening Tool questionnaires for mild,moderate and severe OSAHS.OSAHS severity ESS Berlin STOP STOPBang4-VariableP11P14Mild(AHI5–14)Sensitivity33.3%71.8%91.7%90%73.6%30% Speciﬁcity50.6%17.2% 6.4% 4.9%13%52% PPV9.1%11.5%12.8%12.2%12.7%8%NPV83.6%80.2%84%76.8%86.6%83% LR(+)/LR(À)0.6/1.30.86/1.60.98/1.30.9/21/10.6/1.3 AUC(95%CI)0.42(0.4–0.46)0.45(0.4–0.5)0.49(0.45–0.5)0.48(0.4–0.5)0.5(0.4–0.55)0.4(0.36–0.45) OR(95%CI)0.5(0.4–0.7)0.53(0.4–0.75)0.76(0.44–1.3)0.46(0.27–0.8)0.94(0.6–1.4)0.45(0.3–0.66)Moderate(AHI15–29)Sensitivity44.5%78%92.7%94.8%77.5%38.5% Speciﬁcity52.1%18% 6.6% 5.5%25.6%53.4% PPV17%16.5%17.3%17%18.6%16% NPV81%80.4%72%84%81.5%79% LR(+)/LR(À)0.9/10.96/1.21/1.11/0.91/10.8/1.1 AUC(95%CI)0.48(0.45–0.5)0.48(0.44–0.5)0.5(0.46–0.5)0.52(0.46–0.54)0.5(0.45–0.55)0.46(0.4–0.5) OR(95%CI)0.875(0.7–1.1)0.8(0.6–1.1)0.9(0.54–1.5) 1.1(0.6–2)1(0.7–1.44)0.72(0.5–1)Severe(AHI P30)Sensitivity57%90%97%98.7%81%61% Speciﬁcity62.4%28.5%11%9.9%32%69.3% PPV59%56%52.3%52.7%52%64.4% NPV60%74%78.4%88.4%64.8%66.2% LR(+)/LR(À) 1.5/0.7 1.3/0.35 1.1/0.3 1.1/0.13 1.2/0.62/0.56 AUC(95%CI)0.6(0.57–0.6)0.6(0.56–0.6)0.63(0.6–0.66)0.72(0.7–0.75)0.56(0.53–0.6)0.66(0.63–0.7) OR(95%CI) 2.2(1.8–2.67) 3.6(2.7–4.75)4(2.5–6.3)8.5(4.4–16.5)2(1.5–2.6) 3.5(2.7–4.6)ESS,Epworth Sleepiness Scale;OSAHS,obstructive sleep apnea–hypopnea syndrome;AHI,apnea–hypopnea index;PPV,positive predictive value;NPV,negative predictive value;LR,likelihood ratio;AUC,area under the receiver operating characteristics curve;CI,conﬁdence interval;OR,odds ratio.Table5Correlations(r)between different questionnaires and severity groups of OSAHS.Questionnaires Severity groups ESS STOP STOPBang4-VariableESS All patients 1.0000.256*0.272*0.148*Mild 1.0000.0200.0210.075Moderate 1.0000.243*0.170**0.026Severe 1.0000.216*0.260*0.105*** STOP All patients0.256* 1.0000.732*0.24*Mild0.020 1.0000.751*0.251**Moderate0.24* 1.0000.717*0.192***Severe0.216* 1.0000.682*0.115*** STOPBang All patients0.272*0.732* 1.0000.555*Mild0.0210.751* 1.0000.536*Moderate0.170**0.717* 1.0000.525*Severe0.260*0.682* 1.0000.440* 4-Variable All patients0.148*0.240*0.555* 1.000Mild0.0750.251**0.536* 1.000Moderate0.0260.192***0.525* 1.000Severe0.105***0.115***0.440* 1.000r,Spearman correlation coefﬁcient;OSAHS,obstructive sleep apnea hypopnea syndrome;ESS,Epworth Sleepiness Scale.*P<0.001.**P=0.005.***P<0.05.as STOP,SB and4-V.The sensitivities were higher in our study, whereas speciﬁcities were lower than in studies validating the questionnaires in the general population,possibly because our population was‘preselected’and at high risk.High sensitivity is important as a negative result rules out the disease.However,very low speciﬁcity is problematic as healthy subjects could be misdiag-nosed,leading to unnecessary testing.The STOP and SB questionnaires have the advantage of being straightforward and need only a few minutes to complete and score[10,11].Their sensitivities were found to be high(for AHI P15,96%for STOP and97.6%for SB;and for AHI P30,97%and 98.7%,respectively)in our study.However,speciﬁcities were rather low(for AHI P15,13%for STOP and12.7%for SB;and for AHI P30,11%and9.9%,respectively).In the validation of the STOP and SB[10]in preoperative patients the sensitivities were lower or similar to those in our study(for AHI P15,74.3%for STOP and 92.9%for SB;for AHI P30,79.5%for STOP,but100%for SB), whereas speciﬁcities were better(for AHI P15,53.3%for STOP and43%for SB;for AHI P30,48.6%,and37%respectively).When BANG was incorporated into the STOP questionnaire there was an increase of sensitivity and NPV as in previous studies[10–12]. In the general population,a higher SB had high speciﬁcity for detecting OSAHS[11,23]and the increase in SB score has been related to higher probability of severe OSAHS.The predictive parameters of BQ vary,depending on the popu-lations studied and the different AHI or RDI cut-off values[24]. Sensitivity and PPV were good in our population,but speciﬁcity was low compared to that in other studies[8,25–29],possibly because of the population studied.EDS is an important criterion for the assessment of OSAHS severity and for the determination of the application and accep-tance of treatment[30].ESS measures the average sleep propensity across a range of speciﬁed situations in daily life,but it is subjec-tive,so it was not surprising that the sensitivity was rather low and speciﬁcity moderate in our study,similarly with other studies [15].The4-V was designed and validated in an Asian population[14] with sensitivities of74%and95.2%for AHI P15and AHI P30, respectively,and speciﬁcities of66.1%and61%for AHI P15and AHI P30,respectively,for a cut-off P11[14].With a cut-off P14the sensitivity was lower(33.3%and57.1%for AHI P15and AHI P30respectively)but speciﬁcity improved(94.1%and91.3% for AHI P15and AHI P30respectively).In our study,for a cut-off P11the sensitivity was similar to that of Takegami for AHI P15(79%)but lower(81%)for AHI P30,and speciﬁcity was lower in both groups.For a cut-off P14,the sensitivity was lower but speciﬁcity improved.In the study by Silva et al.[15]only the cut-off P14was evaluated.Sensitivities were lower(24.7%for moderate OSAHS and41.5%for severe OSAHS)and speciﬁcities higher(93.2%for both moderate and severe OSAHS)than those of our study but similar with those of Takegami[14].It has been found that there are differences between Asian and Caucasian pop-ulations in obesity and craniofacial anatomy as risk factors for OSAHS.Caucasians are more obese,whereas the cranial base dimensions of Asians are signiﬁcantly decreased[31].In the study by Takegami et al.[14]neck circumference was not a signiﬁcant variable for OSAHS identiﬁcation when multivariate logistic regression analysis was applied.On the contrary,in Caucasians neck circumference is an important indicator of OSAHS.In our pop-ulation,neck circumference differed signiﬁcantly as OSAHS sever-ity worsened(Table1).For the calculation of4-V we used the BMI categories as indicated in the study by Takegami that differ from the World Health Organization BMI classiﬁcation[32].We attempted toﬁnd the best combination of questionnaires. The combination of all the questionnaires slightly improved the predictive values as for AHI P15as the combined sensitivity and speciﬁcity in parallel were99.9%and20.6%,respectively–not sig-niﬁcantly better than those of SB or BQ.Neither the combination of SB(best sensitivity)with4-V P14(best speciﬁcity)nor the combi-nation of ESS with SB improved the predictive values.Our study was retrospective and performed in a single centre, deriving variables from pre-existing data.Further studies in the general population and during the follow-up of patients receiving treatment for OSAHS would be interesting.As the response rate among patients decreases with increasing length of the questionnaires,it is important to choose those ques-tionnaires that have the best predictive values.In populations with high risk for OSAHS,such as those referred to sleep centers,tools with high sensitivities–such as STOP,SB,and BQ–should be used in order to avoid missing cases.Funding sourcesNone.Conﬂict of interestThe ICMJE Uniform Disclosure Form for Potential Conﬂicts of Interest associated with this article can be viewed by clicking on the following link:/10.1016/j.sleep.2014.03.012. AcknowledgementsWe would like to thank Dr Bettina Haidich,Dr Christos Nakas and Dr Victor Schoenbach for their suggestions in the statistical analysis.References[1]Kushida CA,Littner MR,Morgenthaler T,Alessi CA,Bailey D,Coleman Jr J,et al.Practice parameters for the indications for polysomnography and related procedures:an update for2005.Sleep2005;28:499–521.[2]Ramachandran SK,Josephs LA.A meta-analysis of clinical screening tests forobstructive sleep apnea.Anesthesiology2009;110:928–39.[3]Flemons WW,Douglas NJ,Kuna ST,Rodenstein DO,Wheatley J.Access todiagnosis and treatment of patients with suspected sleep apnea.Am J Respir Crit Care Med2004;169:668–72.Table6Combined sensitivities and speciﬁcities for the different questionnaires(AHI P15).Questionnaire combinations Series ParallelSensitivity(%)Speciﬁcity(%)Sensitivity(%)Speciﬁcity(%)SB–4-V53.777.698.99.45 SB–ESS52.770.998.98.5 ESS–BQ4768.99421.8 BQ–4-V47.982.79424.2 ESS–4-V29.791.579.350 SB–ESS–BQ45.8580.699.828.7 SB–ESS–BQ–4-V25.29599.920.6AHI,apnea–hypopnea index;ESS,Epworth Sleepiness Scale;SB,STOPBANG;BQ,Berlin Questionnaire;4-V,4-Variable Screening Tool P14.780 A.Pataka et al./Sleep Medicine15(2014)776–781[4]Abrishami A,Khajehdehi A,Chung F.A systematic review of screeningquestionnaires for obstructive sleep apnea.Can J Anaesth2010;57:423–38. [5]Pataka A,Chavouzis N,Fekete Passa K,Pitsiou G,Argyropoulou P.Theﬁnancialcrisis has an impact in sleep medicine:experience of a sleep clinic in Greece.Sleep Breath2013;17:1329–32.[6]Johns MW.A new method for measuring daytime sleepiness.Sleep1991;14:540–5.[7]Tsara V,Serasli E,Amﬁlochiou A,Constantinidis T,Christaki P.Greek version ofthe Epworth Sleepiness Scale.Sleep Breath2004;8:91–5.[8]Netzer NC,Stoohs RA,Netzer CM,Clark K,Strohl ing the Berlinquestionnaire to identify patients at risk for the sleep apnea syndrome.Ann Intern Med1999;131:485–91.[9]Bouloukaki I,Komninos ID,Mermigkis C,Micheli K,Komninou M,Moniaki V,et al.Translation and validation of Berlin questionnaire in primary health care in Greece.BMC Pulm Med2013;13:6.[10]Chung F,Yegneswaran B,Liao P,Chung SA,Vairavanathan S,Islam S,et al.STOPquestionnaire:a tool to screen patients for obstructive sleep apnea.Anesthesiology2008;108:812–21.[11]Farney RJ,Walker BS,Farney RM,Snow GL,Walker JM.The STOPBangequivalent model and prediction of severity of obstructive sleep apnea: relation to polysomnographic measurements of the apnea/hypopnea index.J Clin Sleep Med2011;7:459–65.[12]Ong TH,Raudha S,Fook-Chong S,Lew N,Hsu AAL.Simplifying STOPBang:useof a simple questionnaire to screen for OSA in an Asian population.Sleep Breath2010;14:371–6.[13]Pataka A,Chavouzis N,Fekete Passa K,Bagalas V,Pitsiou G,Stanopoulos G,et al.Validation of the Stop Bang questionnaire in a sleep clinic in Greece for the prediction of obstructive sleep apnea.Barcelona,Spain:ERS Annual Congress;2013[Abstract P4052].[14]Takegami M,Hashino Y,Chin K,Sokejima S,Kodtani H.Simple four-variablescreening tool for identiﬁcation of patients with sleep-disordered breathing.Sleep2009;32:939–48.[15]Silva GE,Vana KD,Goodwin JL,Sherrill DL,Quan SF.Identiﬁcation of patientswith sleep disordered breathing:comparing the four-variable screening tool, STOP,STOPBang,and Epworth Sleepiness Scales.J Clin Sleep Med2011;7: 467–72.[16]Iber K,Ancoli-Israel S,Chesson AL,Quan SF.The AASM manual for the scoringof sleep and associated events.Westchester,IL:American Academy of Sleep Medicine;2007.[17]Anonymous.Sleep-related breathing disorders in adults:recommendations forsyndrome deﬁnition and measurement techniques in clinical research.The Report of an American Academy of Sleep Medicine Task Force.Sleep1999;22: 667–89.[18]Ryan PJ,Hilton MF,Boldy DAR,Evans A,Bradbury S,Sapiano S,et al.Validationof British Thoracic Society guidelines for the diagnosis of the sleep apnoea/ hypopnoea syndrome:can polysomnography be avoided?Thorax1995;50: 972–5.[19]Parikh R,Mathai A,Parikh S,Chandra Sekhar G,Thomas R.Understanding andusing sensitivity,speciﬁcity and predictive values.Indian J Ophthalmol2008;56:45–50.[20]Praud A,Champion JL,Corde Y,Drapeau A,Meyer L,Garin-Bastuji B.Assessment of the diagnostic sensitivity and speciﬁcity of an indirect ELISA kit for the diagnosis of Brucella ovis infection in rams.BMC Vet Res2012;8:68.[21]Marshall NS,Wong KK,Liu PY,Cullen SR,Knuiman MW,Grunstein RR.Sleepapnea as an independent risk factor for all-cause mortality:the Busselton health study.Sleep2008;31:1079.[22]Young T,Finn L,Peppard PE,Szklo-Coxe M,Austin D,Nieto FJ,et al.Sleepdisordered breathing and mortality:eighteen-year follow-up of the Wisconsin sleep cohort.Sleep2008;31:1071–8.[23]Chung F,Subramanyam R,Liao P,Sasaki E,Shapiro C,Sun Y.High STOPBangscore indicates a high probability of obstructive sleep apnoea.Br J Anaesth 2012;108:768–75.[24]Sforza E,Chouchou F,Pichot V,Herrmann F,Barthélémy JC,Roche F.Is theBerlin questionnaire a useful tool to diagnose obstructive sleep apnea in the elderly?Sleep Med2011;12:142–6.[25]Chung F,Yegneswaran B,Liao P,Chung SA,Vairavanathan S,Islam S,et al.Validation of the Berlin questionnaire and American society of anesthesiologists checklist as screening tools for obstructive sleep apnea in surgical patients.Anesthesiology2008;108:822–30.[26]Chilukuri K,Dalal D,Marine JE,Scherr D,Henrikson CA,Cheng A,et al.Predictive value of obstructive sleep apnoea assessed by the Berlin questionnaire for outcomes after the catheter ablation of atrialﬁbrillation.Europace2009;11:896–901.[27]Vaz AP,Drummond M,Mota PC,Severo M,Almeida J,Winck JC.Translation ofBerlin questionnaire to Portuguese language and its application in OSA identiﬁcation in a sleep disordered breathing clinic.Rev Port Pneumol 2011;17:59–65.[28]Sharma SK,Vasudev C,Sinha S,Banga A,Pandey RM,Handa KK.Validation ofthe modiﬁed Berlin questionnaire to identify patients at risk for the obstructive sleep apnoea syndrome.Indian J Med Res2006;124:281–90. [29]Saleh AB,Ahmad MA,Awadalla NJ.Development of Arabic version of Berlinquestionnaire to identify obstructive sleep apnea at risk patients.Ann Thorac Med2011;6:212–6.[30]Engleman HM,Martin SE,Kingshott RN,Mackay TW,Deary IJ,Douglas NJ.Randomised placebo controlled trial of daytime function after continuous positive airway pressure(CPAP)therapy for the sleep apnea/hypopnea syndrome.Thorax1998;53:341–5.[31]Li KK,Kushida C,Powell NB,Riley RW,Guilleminault C.Obstructive sleepapnea syndrome:a comparison between Far-East Asian and white men.Laryngoscope2000;110:1689–93.[32]World Health Organization.BMI classiﬁcation.Global database on body massindex.2006[http://apps.who.int/bmi/index.jsp?introPage=intro_3.html].A.Pataka et al./Sleep Medicine15(2014)776–781781。

2024THUSSAT中学生标准学术能力诊断性测试英语试题及答案

中学生标准学术能力诊断性测试2024年1月测试英语试卷本试卷共 150分，考试时间100 分钟。

第一部分阅读理解(共两节，满分 60分)第一节(共15 小题；每小题3分，满分 45分)阅读下列短文，从每题所给的A、B、C和D四个选项中，选出最佳选项，并在答题卡上将该项涂黑。

AFrom hawk hikes to private sleepovers at the zoo, there is a great selection of animal-related experiences available to groups. Here are some top options to get closer to various wonderful wildlife.Chester ZooThe newest attractions here are the Madagascar Lemur Walkthrough experience, which gives visitors the opportunity to walk alongside ring-tailed and red-ruffed lemurs, and the interactive American Wetland Aviary, which is home to birds like scarlet ibises and flamingos. Group rates are available for parties of 15or more and there are various catering options, including sit-down meals at the restaurant at the heart of the zoo.ZSL Whipsnade ZooUntil September 2022, it is offering groups of up to 60 the opportunity to experience a private Nature Night, on which they’ll get to explore the zoo privately after the public has left, take part in activities like quizzes, camp overnight, and get up early for a private tour along the green trail before it reopens to the public again.West Midland Safari ParkThe latest attraction at the park is the new African Walking Trail. Opened in May, the trail features three viewpoints that allow visitors to see the park's African animals on foot. There's also a four-mile drive-through safari area with red panda, penguin and lorikeet areas. Groups of ten plus, arriving in the same vehicle, can save more than 40%.Knowsley Safari ParkThe five-mile safari drive through the site takes you past free-roaming lions, rhinos and more than 100cheeky baboons. There's a foot safari area, where the highlight is the Amur Tiger Trail with transparent walled viewing areas where you can get nose-to-nose with 450-pound tigers. Groups of 15 people and more, arriving in one vehicle, qualify for special ticket rates.1. Who is the passage intended for?A. Animal-loving students.B. Forest hiking fans.C. Group tour organizers.D. Wildlife preservationists.2. Visitors can experience private tours in .A. Chester ZooB. ZSL Whipsnade ZooC. West Midland Safari ParkD. Knowsley Safari Park3. From the passage, we know that .A. delicious meals are offered to tourists in the four parksB. private tours are available in the four parksC. all the parks can provide driving-through servicesD. visitors can have access to walking trails in the four parksBScientists regularly make vital new discoveries, but few can claim to have invented an entirely new field of science. Chemist Carolyn Bertozzi is one of them. Her discovery of biorthogonal chemistry(生物正交化学) in 2003 created a brand-new discipline of scientific investigation, which has enabled countless advances in medical science and led to a far greater understanding of biology at a molecular(分子的) level. On October 5, Bertozzi was awarded the Nobel Prize in Chemistry, jointly with two other professors. She is also the only woman to be awarded a Nobel Prize in science this year, after an all-male line-up in 2021.Bertozzi was the middle daughter of an MIT physics professor and a secretary. Few predicted that Bertozzi would be the most famous person in the family. While her academic performance was not bad in high school, she was fond of playing soccer. She end ed up being admitted to Harvard University. Despite her talent in soccer, she found it too time-consuming and quit the sport to devote herself to academics.But before becoming a rock star scientist, Bertozzi almost became an actual rock star. When she started at Harvard, she was tempted to major in music. That idea was “unpopular” with her parents, and she was timid about defying them. Instead, she chose the premed (医学预科的) track that included classes in math and sciences, and declared herself a biology major at the end of her first year of college.Her interest in music did not completely fall by the wayside, however. Bertozzi played keyboards and sang backup vocals for a hair metal band. Bertozzi, however, did not play with the band for long. Once the band's practices and performances conflicted with her labs and classes, there was only one outcome.Plus, she’d soon have organic chemistry to think about a course which is infamous for weeding out pre-meds. Without any clear career ambitions up to that point, Bertozzi had been thinking about possibly becoming a doctor when, in her sophomore year(大二学年), she suddenly fell so head over heels in love with her chemistry course that she couldn't tear herself away from her textbooks long enough to go out onSaturday nights. A torture to many was pure pleasure for her. Bertozzi changed her major from bi ology to chemistry a year later.Bertozzi has sometimes joked about her having missed out on her chance to follow Morello to LosAngeles. “I didn't get on that bus, and my playing is now limited to ‘The Wheel s on the Bus Go Round,’ I'm waiting for my sons to get old enough to appreciate 1980s heavy metal!”4. Which of the following statements is TRUE according to the passage?A. Bertozzi is one of those scientists who made significant new discoveries.B. Bertozzi was the only female to win a Nobel Prize in science in 2021.C. Bertozzi played keyboards and sang backup vocals throughout her college years.D. Bertozzi initially planned to become a doctor.5. The underlined word in Para 3 means .A. tellB. disobeyC. approachD. threaten6. The organic chemistry course Bertozzi took was known to be .A. easy and enjoyableB. difficult to pass for pre-med studentsC. popular among hair metal band playersD. a required course for all college students7. What kind of person do you think Carolyn Bertozzi is?A. Brave and sympathetic.B. Athletic and critical.C. Humble and passionate.D. Talented and creative.CWillie Sutton, a once celebrated American criminal, was partly famous for saying he robbed banks because “that’s where the money is.” Actually, museums are where the money is. In a single gallery there can be paintings worth more, taken together, than a whole fleet of jets. And while banks can hide their money in basements, museums have to put their valuables in plain sight.Nothing could be worse than the thought of a painting as important as The Scream, Edvard Munch's impressive image of a man screaming against the backdrop of a blood-red sky, disappearing into a criminal underworld that doesn't care much about careful treatment of art works. Art theft is a vast problem around the world. As many as 10,000 precious items of all kinds disappear each year. And for smaller museums in particular, it may not be a problem they can afford to solve. The money for insurance on very famous pictures would be budget destroyers even for the largest museums.Although large museums have had their share of embarrassing robberies, the greatest problem is small institutions. Neither can afford heavy security. Large museums attach alarms to their most valuable paintings, but a modest alarm system can cost $500,000 or more. Some museums are looking into tracking equipment that would allow them to follow stolen items once they leave the museums. But conservators are concerned that if they have to insert something, it might damage the object. Meanwhile, smaller museums can barely afford enough guards, relying instead on elderly staff.Thieves sometimes try using artworks as money for other underworld deals. The planners of the 2006robbery of Russborough House near Dublin, who stole 18 paintings, tried in vain to trade them for Irish Republican Army members held in British prison. Others demand a ransom(赎金) from the museum that owns the pictures. Once thieves in Frankfurt, Germany, made off with two major works by J. M. W. Turner from the Tate Gallery in London. The paintings, worth more than $80 million, were recovered in 2012 after the Tate paid more than $5 million to people having “information” about the paintings. Though ransom is illegal in Britain, money for looking into a case is not, provided that police agree the source of the information is unconnected to the crime. All the same, where information money end s and ransom begins is often a gray area.8. Why do smaller museums face a greater challenge in preventing art theft?A. They lack experienced staff.B. They cannot afford high-tech security systems.C. They do not have valuable artworks.D. They lack interest in art conservation.9. What is the concern of conservators regarding the use of tracking equipment to prevent art theft?A. It might damage the artwork.B. It is too expensive for smaller museums.C. It is difficult to insert into the paintings.D. It is ineffective for valuable paintings.10. From Paragraph 4, we can learn that .A. the thieves demanded a ransom from the Tate GalleryB. the Tate Gallery regained the lost paintings illegallyC. the money paid was considered an information fee, not a ransomD. the police requested the Tate Gallery to pay the money11. The purpose of this passage is .A. to remind criminals to protect and preserve the paintingB. to give suggestions on how to avoid the crimes of art theftC. to urge museums to set up more advanced security systemsD. to make people aware of art theft and the necessity of good security systemsDWho cares if people think wrongly that the Internet has had more important influences than the washing machine? Why does it matter that people are more impressed by the most recent changes?It would not matter if these misjudgments were just a matter of people's opinions. However, they have real impacts, as they result in misguided use of scarce resources.The fascination with the ICT(Information and Communication Technology) revolution, represented by the Internet, has made some rich countries wrongly conclude that making things is so “yesterday” that they should try to live on ideas. This belief in “post-industrial society” has led those countries to neglect their manufacturing sector(制造业) with negative consequences for their economies.Even more worryingly, the fascination with the Internet by people in rich countries has moved the international community to worry about the “digital divide” between the rich countries and the poor countries. This has led companies and individuals to donate money to developing countries to buy computer equipment and Internet facilities. The question, however, is whether this is what the developing countries need the most. Perhaps giving money for those less fashionable things such as digging wells, extending electricity networks and making more affordable washing machines would have improved people's lives more than giving every child a laptop computer or setting up Internet centres in rural villages, I am not saying that those things are necessarily more important, but many donators have rushed into fancy programmes without carefully assessing the relative long-term costs and benefits of alternative uses of their money.In yet another example, a fascination with the new has led people to believe that the recent changes in the technologies of communications and transportation are so revolutionary that now we live in a “borderless world”. As a result, in the last twenty years or so, many people have come to believe that whatever change is happening today is the result of great technological progress, going against which will be like trying to turn the clock back. Believing in such a world, many governments have put an end to some of the very necessary regulations on cross-border flows of capital, labour and goods, with poor results.Understanding technological trends is very important for correctly designing economic policies, both at thenational and the international levels, and for making the right career choices at the individual level. However, our fascination with the latest, and our under valuation of what has already become common, can, and has, led us in all sorts of wrong directions.12. What are the effects of people' misjudgments on the influences of new technology?A. It stimulates innovation.B. It affects their personal opinions.C. It influences their use of resources.D. It leads to improved technology.13. Why is the “digital divide” a concern related to the fascination with the Internet in rich countries?A. It leads to competition between rich and poor countries.B. It results in a lack of access to technology in developing countries.C. It increases the cost of computer equipment in rich countries.D. It promotes global digital cooperation.14. From Paragraph 4, we know that .A. donating for technology is always the better optionB. the author does not provide opinions on this matterC. donating for technology and basic needs should be balancedD. donating for basic needs should be prioritized over technology15. What is the passage mainly about?A. Significance of information and communication technology.B. Serious consequences of over-emphasizing high technology.C. Technological trends guiding economic policy making.D. How to use donation money in the new age.第二节(共5小题；每小题3 分，满分 15分)根据短文内容，从短文后的选项中选出能填入空白处的最佳选项。

The Wiener test for higher order elliptic equations

a rX iv:mat h /34395v1[mat h.AP]24Apr23ICM 2002·Vol.III ·1–3The Wiener Test for Higher Order Elliptic Equations Vladimir Maz’ya ∗1.Introduction.Wiener’s criterion for the regularity of a boundary point with respect to the Dirichlet problem for the Laplace equation [W]has been ex-tended to various classes of elliptic and parabolic partial diﬀerential equations.They include linear divergence and nondivergence equations with discontinuous coeﬃcients,equations with degenerate quadratic form,quasilinear and fully nonlin-ear equations,as well as equations on Riemannian manifolds,graphs,groups,and metric spaces (see [LSW],[FJK],[DMM],[LM],[KM],[MZ],[AH],[Lab],[TW]to mention only a few).A common feature of these equations is that all of them are of second order,and Wiener type characterizations for higher order equations have been unknown so far.Indeed,the increase of the order results in the loss of the maximum principle,Harnack’s inequality,barrier techniques,and level truncation arguments,which are ingredients in diﬀerent proofs related to the Wiener test for the second order equations.In the present work we extend Wiener’s result to elliptic diﬀerential operators L (∂)of order 2m in the Euclidean space R n with constant real coeﬃcients L (∂)=(−1)m |α|=|β|=m a αβ∂α+β.We assume without loss of generality that a αβ=a βαand (−1)m L (ξ)>0for all nonzero ξ∈R n .In fact,the results can be extended to equations with variable (for example,H¨o lder continuous)coeﬃcients in divergence form but we leave aside this generalization to make exposition more lucid.We use the notation ∂for the gradient (∂x 1,...,∂x n ),where ∂x k is the partial derivative with respect to x k .By Ωwe denote an open set in R n and by B ρ(y )theball {x ∈R n :|x −y |<ρ},where y ∈R n .We write B ρinstead of B ρ(O ).Consider the Dirichlet problemL (∂)u =f,f ∈C ∞0(Ω),u ∈˚H m (Ω),(1)where we use the standard notation C∞0(Ω)for the space of inﬁnitely diﬀerentiablefunctions in R n with compact support in Ωas well as ˚H m (Ω)for the completion ofC ∞0(Ω)in the energy norm.190Vladimir Maz’yaWe call the point O∈∂Ωregular with respect to L(∂)if for any f∈C∞0(Ω) the solution of(1)satisﬁeslimΩ∋x→Ou(x)=0.(2) For n=2,3,...,2m−1the regularity is a consequence of the Sobolev imbed-ding theorem.Therefore,we suppose that n≥2m.In the case m=1the above deﬁnition of regularity is equivalent to that given by Wiener.The following result coincides with Wiener’s criterion in the case n=2and m=1.Theorem1Let2m=n.Then O is regular with respect to L(∂)if and only if1C2m(Bρ\Ω)ρ−1dρ=∞.(3)Here and elsewhere C2m is the potential-theoretic Bessel capacity of order2m (see[AHed]).If n=2m and O belongs to a continuum contained in the complement ofΩ,condition(3)holds.The case n>2m is more delicate because no result of Wiener’s type is valid for all operators L(∂)(see[MN]).To be more precise,even the vertex of a cone can be irregular with respect to L(∂)if the fundamental solution of L(∂):F(x)=F(x/|x|)|x|2m−n,x∈R n\O,(4) changes sign.Examples of operators L(∂)with this property were given in[MN]and [D].For instance,according to[MN]the vertex of a suﬃciently thin8-dimensional cone K is irregular with respect to the operatorL(∂)u:=10∂4x8u+∆2u,u∈˚H2(R8\K).In the sequel,Wiener’s type characterization of regularity for n>2m is given for a subclass of the operators L(∂)called positive with the weight F.This means that for all real-valued u∈C∞0(R n\O),R n L(∂)u(x)·u(x)F(x)dx≥cmk=1R n|∇k u(x)|2|x|2k−n dx,(5)where∇k is the gradient of order k,i.e.∇k={∂α}with|α|=k.The positivity of the left-hand side in(5)is equivalent to the inequalityR nR nL(ξ)+L(η)The Wiener Test for Higher Order Elliptic Equations191 Note that in direct analogy with the case of the Laplacian we could say,in Theorems1and2,that O is irregular with respect to L(∂)if and only if the set R n\Ωis2m-thin in the sense of linear potential theory[L],[AHed].Let,for example,the exterior ofΩcontain the region{x:0<x n<1, x21+...+x2n−1 1/2<f(x n)},where f is an increasing function such that f(0)=f′(0)=0.Then the point O satisﬁes(6)if and only if1|log f(τ)|−1τ−1dτ=∞for n=2m+1and 1f(τ)τ2m−n dτ=∞for n≥2m+2.Since,obviously,the operator L(∂)of the second order is positive with the weight F,Wiener’s result for n>2is contained in Theorem2.We note that the pointwise positivity of F follows from(5),but the converse is not true.In particular,the m-harmonic operator with2m<n satisﬁes(5)if and only if n=5,6,7for m=2and n=2m+1,2m+2for m>2(see[M2],where the proof of suﬃciency of(6)is given for(−∆)m with m and n as above,and also[E] dealing with the suﬃciency for noninteger powers of the Laplacian in the intervals (0,1)and[n/2−1,n/2)).We state some auxiliary assertions of independent interest which concern the so called L-capacitary potential U K of the compact set K⊂R n,n>2m,i.e.the solution of the variational probleminf{ R n L(∂)u·u dx:u∈C∞0(R n),u=1in vicinity of K}.These assertions are used in the proof of necessity in Theorem2.By the m-harmonic capacity cap m(K)of a compact set K we meaninf |α|=m m!192Vladimir Maz’yaCorollary1LetΩ=R n and2m<n.For all y∈R n\K there holds the estimate|∇j U K(y)|≤c j dist(y,K)2m−n−j cap m K,(9) where j=0,1,2,...and c j does not depend on K and y.By M we denote the Hardy-Littlewood maximal operator.Corollary2Let2m<n and let0<θ<1.Also let K be a compact subset ofdx|x|n−2k≤c1M R(u)exp −c2 Rρcap m(¯Bτ\Ω)dτThe Wiener Test for Higher Order Elliptic Equations193 The present work gives answers to some questions posed in[M2].I present several simply formulated unsolved problems.1.Is it possible to replace the positivity of L(∂)with the weight F(x)by the positivity of F(x)in Theorem2?A particular case of this problem is the following one.2.Does Theorem2hold for the operator(−∆)m,wheren≥8,m=2and n≥2m+3,m>2?(13) The next problem concerns Green’s function G m of the Dirichlet problem for (−∆)m in an arbitrary domainΩ.3.Prove or disprove the estimatec(m,n)|G m(x,y)|≤194Vladimir Maz’ya then either u∈˚H m(Ω)andlim supρ→0supBρ∩Ω|u(x)|exp c 1ρcap m(¯Bρ\Ω)dρρ >0.It would be interesting to extend this assertion to other values of n and m.References[AH]Adams,D.R.&Herd,A.,The necessity of the Wiener test for some semi-linear elliptic PDE.Ind.Univ.Math.J.,41(1992),109–124.[AHed]Adams,D.R.&Hedberg,L.I.,Function Spaces and Potential Theory.Springer-Verlag,Berlin,1996.[DMM]Dal Maso,G.&Mosco,U.,Wiener criteria and energy decay for relaxed Dirichlet problems.Arch.Rational Mech.Anal.,95(1986),345–387. [D]Davies,E.B.,Limits in L p regularity of self-adjoint elliptic operators.J.Diﬀ.Equations,135:1(1997),83–102.[E]Eilertsen,S.,On weighted positivity and the Wiener regularity of a bound-ary point for the fractional Laplacian.Ark.f¨o r Mat.,38:1(2000),53–75. [FJK]Fabes,E.G.,Jerison,D.&Kenig,C.,The Wiener test for degenerate elliptic equations.Ann.Inst.Fourier(Grenoble),32(1982),151–182. [KM]Kilpel¨a inen,T.&Mal´y,J.,The Wiener test and potential estimates for quasi-linear elliptic equations.Acta Math.,172(1994),137–161. [KoM]Kozlov,V.A.&Maz’ya,V.,Boundary behavior of solutions to linear and nonlinear elliptic equations in plane convex domains.Math.Research Let-ters,8(2001),1–5.[L]Landkof,N.S.,Foundations of Modern Potential Theory.Nauka,Moscow, 1966(Russian).English translation:Springer-Verlag,Berlin,1972. [Lab]Labutin,D.A.Potential estimates for a class of fully nonlinear elliptic equations.Duke Math.J.,111(2002),1–49.[LM]Lindqvist,P.&Martio,O.,Two theorems of N.Wiener for solutions of quasilinear elliptic equations,Acta Math.,155(1985),153–171. [LSW]Littman,W.,Stampacchia,G.&Weinberger,H.F.,Regular points for elliptic equations with discontinuous coeﬃcients.Ann.Scuola Norm.Sup.Pisa,Ser.III,17(1963),43–77.[MZ]Mal´y,J.&Ziemer,W.P.Regularity of Solutions of Elliptic Partial Diﬀer-ential Equations.Mathematical Surveys and Monographs51,AMS,Prov-idence,RI,1997.[M1]Maz’ya,V.,The Dirichlet problem for elliptic equations of arbitrary order in unbounded regions.Dokl.Akad.Nauk SSSR,150(1963),1221–1224(Russian).English translation in Soviet Math.,4(1963),860–863.The Wiener Test for Higher Order Elliptic Equations195 [M2]Maz’ya,V.,Unsolved problems connected with the Wiener criterion.In The Legacy of Norbert Wiener:A Centennial Symposium,Proc.,Cam-bridge,Massachusetts,Amer.Math.Soc.,199–208,1994.[M3]Maz’ya,V.,On Wiener’s type regularity of a boundary point for higher order elliptic equations.Nonlinear Analysis,Function Spaces and Applica-tions VI,119–155.Proceedings of the Spring School held in Prague,May31–June6,1998.Prague,1999.[MN]Maz’ya,V.&Nazarov,S.,The apex of a cone can be irregular in Wiener’s sense for a fourth-order elliptic equation.Mat.Zametki,39:1(1986),24–28(Russian).English translation in Math.Notes,39(1986),14–16. [MP]Maz’ya,V.&Plamenevskii,B.A.,On the maximum principle for the biharmonic equation in a domain with conical points.Izv.Vyssh.Uchebn.Zaved.Mat.(1981)no.2,52–59(Russian).English translation in SovietMath.(Iz.VUZ),25(1981),61–70.[TW]Trudinger,N.S.&Wang,X.-J.,On the weak continuity of elliptic operators and applications to potential theory.Amer.J.Math.,124(2002),369–410. [W]Wiener,N.,The Dirichlet problem.J.Math.and Phys.,3(1924),127–146.Reprinted in Norbert Wiener:Collected Works with Commentaries,vol.1,394–413,MIT Press,Cambridge,Massachusetts,1976.。

CP Asymmetries in Higgs decays to ZZ at the LHC

a r X i v :0708.3612v 1 [h e p -p h ] 27 A u g 2007CP Asymmetries in Higgs decays to ZZ at the LHCRohini M.Godbole 1,David ler 2,M.Margarete M¨u hlleitner 3,41Centre for High Energy Physics,Indian Institute of Science,Bangalore,560012,India.2Dept.of Physics and Astronomy,University of Glasgow,Glasgow G128QQ,U.K.3Theory Division,Physics Department,CERN,CH-1211Geneva 23,Switzerland.4Laboratoire d’Annecy-Le-Vieux de Physique Th´e orique,LAPTH,France.Abstract.We examine the eﬀect of a general HZZ coupling through a study of the Higgs decay to leptons via Z bosons at the LHC.We discuss various methods for placing limits on additional couplings,including measurement of the partial width,threshold scans,and asymmetries constructed from angular observables.We ﬁnd that only the asymmetries provide a deﬁnitive test of additional couplings.We further estimate the signiﬁcances they provide.1.IntroductionThe veriﬁcation of the Higgs mechanism as the cause of electroweak symmetry breaking and the discovery of the Higgs boson is the next big goal of particle physics.However,it is not enough to simply ﬁnd a new resonance in the Higgs search channels at the next generation of colliders.One must ensure that this resonance is indeed the Higgs boson by measuring its properties:its CP and spin,to demonstrate its predicted scalar nature;its couplings to known particles,to verify that these couplings are proportional to the particle’s mass;and the Higgs self couplings,in order to reconstruct the Higgs potential itself.This will be a challenging programme and will not be fully realised at the Large Hadron Collider (LHC)(e.g.the quartic Higgs self coupling will be out of reach).However,such an analysis will be crucial in our investigation of electroweak symmetry breaking in scenarios where the suspected Higgs boson is all we ﬁnd at the LHC,as well as scenarios where new physics is discovered.In the former case,testing for deviations from the Standard Model (SM)may provide clues to resolving some of the SM’s long standing problems;in the latter case,the Higgs boson properties will provide essential information on the nature of the new physics.It is interesting to note that the Higgs boson’s CP (and spin)is intimately related to its couplings to other SM particles,since its scalar or pseudoscalar nature allow or forbid certain tensor structures in the Higgs boson couplings.In this report,we investigate the tensor structure of the HZZ vertex in order to shed some light on the Higgs boson’s CP.We write down the most general tensor vertex for this coupling and investigate how the additional terms inﬂuence the decay H →ZZ (∗)→4leptons at the LHC.For a more detailed description of this analysis,see Ref.[1].The most general vertex for a spinless particle coupling to a pair of Z bosons,with four-momenta q 1and q 2,is given by,V µνHZZ=igm Zm 2Z+c ǫµναβp αk βwhere p=q1+q2and k=q1−q2,θW denotes the weak-mixing angle andǫµναβis the totally antisymmetric tensor withǫ0123=1.The CP conserving tree-level Standard Model coupling is recovered for a=1and b=c=0.Terms containing a and b are associated with the coupling of a CP-even Higgs,while that containing c is associated with that of a CP-odd Higgs boson.The simulanteous appearance of a non-zero a(and/or b)together with a non-zero c would lead to CP violation.In general these parameters can be momentum-dependent form factors that may be generated from loops containing new heavy particles or equivalently from the integration over heavy degrees of freedom giving rise to higher dimensional operators.The form factors b and c may,in general,be complex, but since an overall phase will not aﬀect the observables studied here,we are free to adopt the convention that a is real.2.The total widthOne method of investigating the tensor structure of the HZZ coupling is to examine the threshold behaviour of the decay H→ZZ∗[2].Notice that the additional terms in the vertexwidth on the virtuality of the most virtual Z boson.width from the SM prediction.Alternatively,one could examine the magnitude of the total decay width for H→ZZ∗→4leptons to see if it diﬀers from the SM.For the vertex of Equation1,the dependence on the coeﬃcients a,b and c is given by,∂2ΓHm4H +|b|2m4H4+|c|28q21q22m2Zβ2 m4H ,(2)whereβis the usual Lorentz boost factor for the Z-bosons.(Notice that the only term with a linearβdependence(from the phase space)is proportional to a2,illustrating the principle described above for the threshold scan.)If additional terms are present one expects them toincrease or decrease the width according to this equation.We used the ATLAS study of Ref.[3,4] (including cuts and eﬃciencies)to estimate the number of signal and background events for the SM and CP-violating scenarios(scaling the signal according to Equation2).In Figure2we plot the number of standard deviations from the SM that the CP-violating scenario would imply,for a150GeV Higgs boson and an integrated luminosity of300fb−1(we set b=0for simplicity). The white area represents scenarios where the signiﬁcance of the deviation is less than3σ,the light blue/grey region represents a3−5σdeviation,while the dark blue/grey region represents a greater than5σdeviation.This measurement would allow one to rule out much of the a−|c| parameter space,but does not allow one to deﬁnitively rule out(or place signiﬁcant limits on) the CP-odd coupling|c|.A SM-like rate is perfectly consistent with a large value of|c|and a small value of a.3.Asymmetries as a probe of CP violationTo deﬁnitively ascertain whether or not extra tensor structures are present in the HZZ vertex one is better served by measuring asymmetries which vanish when such terms are absent.Such an asymmetry can be constructed from an observable,O,based on the angles of theﬁnal state leptons,Γ(O>0)−Γ(O<0)A=。

刘萍萍翻译

定义色的色域边界的测试目标Phil Green彩色影像集团LCP的，英国伦敦2000年12月1．简介在生产中的一个色域是颜色可以在其上复制的范围。

这个范围将取决于许多因素，其中最重要的是介质本身的物理性能和它们一起使用的着色剂。

其他因素包括介质存在的条件，半色调或采纳抖动的方法，和在渲染过程中的任何特性或限制，如固体密度或墨水限制。

在一些行业如报纸的生产，这些因素很多是有一定程度的标准化，并有可能定义一个色域将适用（有一些变化）跨越大部分产品印刷的过程。

虽然色域通常代表两个方面（如xy色度或CIELAB的a* / b *值），这可能会引起误解的原因有两个。

首先，它忽略了亮度范围的可复制（也称为动态范围），这是色域的一个重要方面;第二，通过忽略亮度尺寸可能会出现一个给定的色域里面的颜色，而事实上并非如此。

对于硬拷贝的媒体，如着色剂的组合并不按照简单的加法原则，色域在色彩空间如CIELAB空间中是一种不规则的固体。

在CIELAB中比较不同介质的色域，我们注意到一些非常大的差异，也就是说，摄影逆转材料，而中冷置新闻纸用于重现。

可能对色域最明显有用的信息是援助在原始和繁殖媒体之间的映射颜色的过程。

色域映射算法使用双方媒体的色域边界，来确定需要多少压缩，使比较大的色域适合较小的色域。

这通常需要找到与色域边界一行的交集，通过要映射的点从收敛域边界点（通常在位于轴色差）找。

在最近的一项色域映射模型研究中，来源于高品质的复制品经验发现与经验数据拟合的模型可以通过由包括线性插值从模型中的色域边界形状的'尖'（在给定色相角度最大色度）来改善。

1.1色域边界计算色域边界的许多方法被描述在[1,2,3,4,5,6]。

这些方法的主要特点由Morovic[6进行了总结]。

不同的媒体和图像的色域也已在最近文件[7,8]中进行了比较。

在着色剂空间，色域边界可以被视为一个立方体因为在顶点它有固体着色剂和他们的第二组合的面孔。

化学工业流程选择题

化学工业流程选择题英文回答：1. Which of the following is a major factor to consider when selecting a chemical process?(a) Raw material availability.(b) Product yield.(c) Energy efficiency.(d) Capital investment.(e) All of the above.2. In a continuous process, the reactants are fed into the reactor and the products are removed continuously.3. Which of the following is an advantage of batchprocesses over continuous processes?(a) Higher product yields.(b) Better control over reaction conditions.(c) Lower capital investment.(d) Greater flexibility.(e) None of the above.4. Which of the following is a disadvantage of batch processes compared to continuous processes?(a) Lower production rates.(b) Higher operating costs.(c) Greater potential for human error.(d) All of the above.(e) None of the above.5. Which of the following is a key consideration in the design of a chemical plant?(a) Process safety.(b) Environmental impact.(c) Economic viability.(d) All of the above.(e) None of the above.中文回答：1. 选择化学工艺时要考虑的主要因素有哪些？(a) 原材料的供应。

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a r X i v :s o l v -i n t /9605003v 1 16 M a y 1996The Painlev´e Test of Higher Dimensional KdVEquationYU Song-Ju and Takeshi FUKUYAMADepartment of Physics,Ritsumeikan UniversityKusatsu,Shiga 525JAPANe-mails:fpc30017@bkc.ritsumei.ac.jp,fukuyama @bkc.ritsumei.ac.jpAbstractWe argue the integrability of the generalized KdV(GKdV)equation using the Painlev´e test.For d (≤2)dimensional space,GKdV equation passes the Painlev´e test but does not for d ≥3dimensional space.We also apply the Ablowitz-Ramani-Segur’s conjecture to the GKdV equation in order to complement the Painlev´e test.It is one of the most important challenges in the non-linear integrable physics to extend its spatial dimension to two,three,···.One step to this generalization is the cylindrical and spherical extension of one dimensional integrable systems.Toda lattice and KdV equations are generalized to cylindrical Toda and cylindrical KdV equations. We know that both these generalized systems are also integrable systems.Then it is quite natural to ask whether spherical generalization to higher dimensions becomes also integrable or not.The purpose of the present letter is to answer to this question through the Painlev´e test using KdV equation.d-dimensional generalization of KdV(GKdV)equation is given by[1]u t+6uu x+u xxx+(d−1)2t −u1φx+u0t−6u1u2φx−6u0u3φx+6u2u0x+6u1u1x+6u0u2x−3u1xφxx−3u1xxφx−u1φxxx+u0xxx=0,(9)φ−1;(d−1)u12t +u3φt+u2t+6u2u3φx−6u5φ3x+13u3φxxx+6u2u2x+15u3xφxx+3u3xxφx+u2xxx=0,(11)φ1;(d−1)u312t2φx=0.(14) Thus only GKdV equations with d=1and d=2pass the Painlev´e test.We know that solutions of KdV equation(d=1)and cylindrical KdV equation (d=2)are obtained by uses of Hirota’s method[4,5]and of the inverse scattering method.[6,7,8]Therefore we have reassured the well known result.Important is the fact that d≥3 dimensional extension does not pass the Painlev´e test.Does it mean that these higher dimensional extensions are not integrable?We can say that the nonlinear system is integrable if it passes the Painlev´e test.But is the converse of this statement true at least in this case?In order to answer to this question,we show for d≥3that u has a logarithmic divergence.We have mentioned that we can not have an arbitrary function u6for(d−1)(d−2)= 0.So instead of Eq.(2)we consider the expansion[9]u(x,t)≡φ−2(x,t)∞l=0,(l=6)u l(x,t)φl(x,t)+(u6+v6logφ)φ4.(15)Substituting Eq.(15)into GKdV equation(1),we obtain Eqs.(6)∼(11)and the new equation in place of Eq.(12)φ1;(d−1)u3Repeating the same procedure as in the previous case we obtain(d−1)(d−2)2t∂x)φ·φ=0.(19) Here D is the Hirota’s D operator.[12]We expandφas followsφ≡1+ǫφ(1)+ǫ2φ(2)+ (20)and substitute it into GKdV bilinear equation(19).Comparing both hand sides of equation order by order ofǫ,we obtainǫ;(∂t∂x+∂4x+d−12t∂x)φ(2)=−(D t D x+D4x+d−1(αt′)3/βφ(1)3z−zt′δφ(1)+d−1(αt′)3/βφ(1)2z2−3zt′δφ(1)φ(1)z+2(d−1)Here we have performed independent variables transformation,xz=φ(1).(26)t′δAssuming furthermore that the variables can be separated,the solutions to Eqs.(23) and(24)are classiﬁed into the followingﬁve cases.1.Case of3/β=δ,3/β=1andδ=1φ(1)=0.(27)2.Case of3/β=δ,3/β=1andδ=1φ(1)=0.(28)3.Case of3/β=δ=1φ(1)=0.(29)4.Case of3/β=1andδ=1φ(1)=0.(30)5.Case of3/β=δ=1Only this case allows non trivial solution.Eqs.(23),(24)become(3γ+2d−3)φ(1)z2−(3γ+d−1)φ(1)φ(1)2z=0.(31) Then this case is further divided into subgroup(a)and(b).(a)is furthermore classiﬁed into sub-subgroup i.and ii..(a)Case of d=2Eq.(31)becomes(3γ+1)(φ(1)z2−φ(1)φ(1)2z)=0.(32)i.Case of3γ+1=0We assumeφ(1)≡T(t)Z(z),then T(t)∝t1/3and Eqs.(23),(24) become13Z z+1αZ22z−zZ2z+ZZ z=0.(34) Here we introduce new dependent variable by Z z≡−ψ2,then we obtain from Eqs.(33)and(34)ψzz=zψ.(35) Therefore we get a special solution of2-dimensional case using Airy function(Ai(z))φ(1)(z,t)=Ct−13γ+d−1λ2z=0.(38) Therefore we get another special solution for d(=2)-dimensional caseφ(1)(z,t)=Ctγ(z+z0)3γ+d−12−d is fractional.However,weﬁxγas3γ+1=0,Eq.(39)has only a movablesingularity.We did not and could not exhaust the reductions in the sense of ARS conjecture. Eq.(39)of course does not imply that GKdV equations with d≥3are integrable.As we have mentioned these equations are probably nonintegrable.Deﬁnite conclusion,how-ever,may be obtained when the relationships between the miscellaneous integrability tests are made clear.References[1]A.Nakamura:Prog.Theor.Phys.Suppl.94(1988)195.[2]J.Weiss,U.Tabor and G.Carneval:J.Math.Phys.24(1983)522.[3]For Reviews of the Painlev´e test,A.Ramani,B.Grammaticos and T.Bountis:Phys.Rep.180(1989)159.[4]A.Nakamura:J.Phys.Soc.Jp.49(1980)2380.[5]A.Nakamura,H.Chen:J.Phys.Soc.Jp.50,(1981),711.[6]F.Calogero,A.Degasperis:Lett.AL.Nuovo Ciment.23(1978)143.[7]F.Calogero,A.Degasperis:Lett.AL.Nuovo Ciment.23(1978)150.[8]F.Calogero,A.Degasperis:Lett.AL.Nuovo Ciment.23(1978)155.[9]The authors are grateful to J.Hietarinta for his comment on this point.[10]S.Maxon,J.Viecelli:Phys.Rev.Lett.32(1974)4.[11]M.J.Ablowwitz,A.Ramani and H.Segur:J.Math.Phys.21(1980)715.[12]R.Hirota:Topics in Current Physics17Solitons(Springer-Verlag,1980),p157.。