BackgroundThe urine dipstick is widely used as an initial screening tool for the evaluation of proteinuria; however, its diagnostic accuracy has not yet been sufficiently evaluated. Therefore, we evaluated its diagnostic accuracy using spot urine albumin/creatinine ratio (ACR) and total protein/creatinine ratio (PCR) in proteinuria.MethodsUsing PCR ≥0.2 g/g or ≥0.5 g/g and ACR ≥300 mg/g or ≥30 mg/g as the reference standard, we calculated the diagnostic accuracy profile: sensitivity, specificity, positive and negative predictive value, and the area under the curve (AUC) of the receiver operating characteristic curve.ResultsPCR and ACR were available for 10,348 and 3,873 instances of dipstick testing. The proportions with PCR ≥0.2 g/g, ≥0.5 g/g and ACR ≥300 mg/g, ≥30 mg/g were 38.2%, 24.6% and 8.9%, 31.7%, respectively. The AUCs for PCR ≥0.2 g/g, ≥0.5 g/g, and ACR ≥300 mg/g were 0.935 (trace: closest to ideal point), 0.968 (1+), and 0.983 (1+), respectively. Both sensitivity and specificity were >80% except for PCR ≥0.5 g/g with trace cutoff. For the reference standard of ACR ≥30 mg/g, the AUC was 0.797 (trace) and the sensitivity was 63.5%.ConclusionUrine dipstick test can be used for screening in older outpatients with ACR ≥300 mg/g or PCR as the reference standard for proteinuria. However, we cannot recommend the test as a screening tool with ACR ≥30 mg/g as the reference owing to its low sensitivity.

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In rallies, it is required to develop the high stiffness and high strength suspension parts in order to maximize the handling performance and reliability to severe race condition. To determine which part we should focus on among the suspension parts in the development stage, it is required to consider the driving condition and the various rally road conditions. First, it is necessary to increase the lateral stiffness and camber stiffness of suspension systems in order to maximize the handling and cornering performance. As the result of finite element (FE) analysis for production car suspension, it is verified that the stiffness of axle assembly affects mainly on the lateral stiffness of suspension system. Second, the shock loads under severe conditions such as landing after jump and bumpy road and the driving and braking torque are concentrated on the axle assembly. As the result of above consideration, developing the high stiffness and high strength axle has been considered as the most important work for the project of rally car suspension development. For the development of new prototype car, hub and upright have been newly developed and new big bore wheel bearing has been selected in order to increase the stiffness of axle assembly. Newly developed suspension components have been installed in the new prototype car and 3 different test cars have been introduced to verify the effect of high stiffness axle. Finally, Kinematic and Compliance (K&C) test result for these 3 test cars shows that the stiffness of axle assembly is the most significant parameter to increase the lateral stiffness of whole suspension system.

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