If "strict" cases of H.P.P.D. turn up only rarely in scientific journals, though, at HPPDonline.com, a Web forum tracking research developments and connecting sufferers, nearly nine thousand monthly visitors give some indication of what lies beyond the academic purview.
However, there are also strict cases of heterotrophy due to the absence of plastids, as in Protoperidinium that feeds on other dinoflagellates [1] and Paulsenella that parasitizes diatoms [2].
Clade models are not restricted to detecting strict cases of positive selection and can be used to consider variation among multiple clades simultaneously [ 21].
In this study, we have used a rather strict case definition of pain, with a frequency of at least once a week, for a relatively short recall period (during the previous 3 months) in order to avoid childhood recall difficulties, which have been previously documented [ 14, 38, 39].
Data regarding demographics, disease manifestations, pharmacological treatment, and sex-related differences were similar regardless of whether the base case or strict case definitions of AS were used, as shown in detail in Additional file 3: Table S2.
We used a strict case definition of UGIB, which has been previously validated; this strategy for identifying cases of UGIB (a rare event) was broad, reducing the likelihood that cases were missed [ 60].
The data analysis was repeated with a less strict case definition of 75% reduction in infectious centers relative to the positive control and including the 43 additional samples that could only be screened at higher dilutions.
Although there has been no strict case definition of AVH, MOH guidelines for clinicians have traditionally defined AVH as an infectious disease characterized by acute onset of jaundice, hepatomegaly, and (where available) a three-fold or greater elevation of serum aminotransferase levels.
Secondly, the rightful use of a strict case definition allowed pooling of the results from different studies, however the wide heterogeneity in the definitions of HCAI used in published studies led to the exclusion of many studies from other parts of the world that might have shown different results.
However, lack of reagents to perform diagnostic testing and lack of strict case definitions have had the result that most reported cases of AVH in the SES database reflect clinical diagnoses that have not been laboratory confirmed.
