WorldWideScience

Sample records for changing patient classification

  1. Changing patient classification system for hospital reimbursement in Romania.

    Science.gov (United States)

    Radu, Ciprian-Paul; Chiriac, Delia Nona; Vladescu, Cristian

    2010-06-01

    To evaluate the effects of the change in the diagnosis-related group (DRG) system on patient morbidity and hospital financial performance in the Romanian public health care system. Three variables were assessed before and after the classification switch in July 2007: clinical outcomes, the case mix index, and hospital budgets, using the database of the National School of Public Health and Health Services Management, which contains data regularly received from hospitals reimbursed through the Romanian DRG scheme (291 in 2009). The lack of a Romanian system for the calculation of cost-weights imposed the necessity to use an imported system, which was criticized by some clinicians for not accurately reflecting resource consumption in Romanian hospitals. The new DRG classification system allowed a more accurate clinical classification. However, it also exposed a lack of physicians' knowledge on diagnosing and coding procedures, which led to incorrect coding. Consequently, the reported hospital morbidity changed after the DRG switch, reflecting an increase in the national case-mix index of 25% in 2009 (compared with 2007). Since hospitals received the same reimbursement over the first two years after the classification switch, the new DRG system led them sometimes to change patients' diagnoses in order to receive more funding. Lack of oversight of hospital coding and reporting to the national reimbursement scheme allowed the increase in the case-mix index. The complexity of the new classification system requires more resources (human and financial), better monitoring and evaluation, and improved legislation in order to achieve better hospital resource allocation and more efficient patient care.

  2. 75 FR 10529 - Mail Classification Change

    Science.gov (United States)

    2010-03-08

    ... POSTAL REGULATORY COMMISSION [Docket Nos. MC2010-19; Order No. 415] Mail Classification Change...-filed Postal Service request to make a minor modification to the Mail Classification Schedule. The.... concerning a change in classification which reflects a change in terminology from Bulk Mailing Center (BMC...

  3. 76 FR 47614 - Mail Classification Change

    Science.gov (United States)

    2011-08-05

    ... POSTAL REGULATORY COMMISSION [Docket No. MC2011-27; Order No. 785] Mail Classification Change...-filed Postal Service request for a change in classification to the ``Reply Rides Free'' program. The... Service filed a notice of classification change pursuant to 39 CFR 3020.90 and 3020.91 concerning the...

  4. Changing tides: increasing evidence to embrace a patient classification system.

    Science.gov (United States)

    Malloch, Kathy

    2012-01-01

    The effective use of a patient classification system (PCS) in a way that provides value to all health care organizations has yet to be realized given the challenging developmental pathway of these systems. As the science and technology of workforce management emerges along with evidence to support the relationships between nurse work and patient care needs, it is no longer appropriate to rely on systems that provide aggregated and minimal data to address the need for safer patient care and retention of nurses. Specificity about patient care needs in a valid and reliable PCS is essential on our pathway to improved resource utilization, improved decision making, integration of nurse cognitive and knowledge work, and management of variances from planned resource use. Advancements with technology, the ability to create and monitor equitable nurse-patient assignments, conceptual clarity, evidence, regulatory requirements, and professional role development point to a new receptiveness for PCSs.

  5. Advances in Patient Classification for Traditional Chinese Medicine: A Machine Learning Perspective

    Science.gov (United States)

    Zhao, Changbo; Li, Guo-Zheng; Wang, Chengjun; Niu, Jinling

    2015-01-01

    As a complementary and alternative medicine in medical field, traditional Chinese medicine (TCM) has drawn great attention in the domestic field and overseas. In practice, TCM provides a quite distinct methodology to patient diagnosis and treatment compared to western medicine (WM). Syndrome (ZHENG or pattern) is differentiated by a set of symptoms and signs examined from an individual by four main diagnostic methods: inspection, auscultation and olfaction, interrogation, and palpation which reflects the pathological and physiological changes of disease occurrence and development. Patient classification is to divide patients into several classes based on different criteria. In this paper, from the machine learning perspective, a survey on patient classification issue will be summarized on three major aspects of TCM: sign classification, syndrome differentiation, and disease classification. With the consideration of different diagnostic data analyzed by different computational methods, we present the overview for four subfields of TCM diagnosis, respectively. For each subfield, we design a rectangular reference list with applications in the horizontal direction and machine learning algorithms in the longitudinal direction. According to the current development of objective TCM diagnosis for patient classification, a discussion of the research issues around machine learning techniques with applications to TCM diagnosis is given to facilitate the further research for TCM patient classification. PMID:26246834

  6. Advances in Patient Classification for Traditional Chinese Medicine: A Machine Learning Perspective.

    Science.gov (United States)

    Zhao, Changbo; Li, Guo-Zheng; Wang, Chengjun; Niu, Jinling

    2015-01-01

    As a complementary and alternative medicine in medical field, traditional Chinese medicine (TCM) has drawn great attention in the domestic field and overseas. In practice, TCM provides a quite distinct methodology to patient diagnosis and treatment compared to western medicine (WM). Syndrome (ZHENG or pattern) is differentiated by a set of symptoms and signs examined from an individual by four main diagnostic methods: inspection, auscultation and olfaction, interrogation, and palpation which reflects the pathological and physiological changes of disease occurrence and development. Patient classification is to divide patients into several classes based on different criteria. In this paper, from the machine learning perspective, a survey on patient classification issue will be summarized on three major aspects of TCM: sign classification, syndrome differentiation, and disease classification. With the consideration of different diagnostic data analyzed by different computational methods, we present the overview for four subfields of TCM diagnosis, respectively. For each subfield, we design a rectangular reference list with applications in the horizontal direction and machine learning algorithms in the longitudinal direction. According to the current development of objective TCM diagnosis for patient classification, a discussion of the research issues around machine learning techniques with applications to TCM diagnosis is given to facilitate the further research for TCM patient classification.

  7. MULTI-TEMPORAL CLASSIFICATION AND CHANGE DETECTION USING UAV IMAGES

    Directory of Open Access Journals (Sweden)

    S. Makuti

    2018-05-01

    Full Text Available In this paper different methodologies for the classification and change detection of UAV image blocks are explored. UAV is not only the cheapest platform for image acquisition but it is also the easiest platform to operate in repeated data collections over a changing area like a building construction site. Two change detection techniques have been evaluated in this study: the pre-classification and the post-classification algorithms. These methods are based on three main steps: feature extraction, classification and change detection. A set of state of the art features have been used in the tests: colour features (HSV, textural features (GLCM and 3D geometric features. For classification purposes Conditional Random Field (CRF has been used: the unary potential was determined using the Random Forest algorithm while the pairwise potential was defined by the fully connected CRF. In the performed tests, different feature configurations and settings have been considered to assess the performance of these methods in such challenging task. Experimental results showed that the post-classification approach outperforms the pre-classification change detection method. This was analysed using the overall accuracy, where by post classification have an accuracy of up to 62.6 % and the pre classification change detection have an accuracy of 46.5 %. These results represent a first useful indication for future works and developments.

  8. Changing beliefs for changing movement and pain: Classification-based cognitive functional therapy (CB-CFT) for chronic non-specific low back pain.

    Science.gov (United States)

    Meziat Filho, N

    2016-02-01

    This case report presents the effect of classification-based cognitive functional therapy in a patient with chronic disabling low back pain. The patient was assessed using a multidimensional biopsychosocial classification system and was classified as having flexion pattern of movement impairment disorder. Management of this patient was to change her belief that bending over and sitting would cause damage to her disc, combined with active exercises for graded exposure to lumbar flexion to restore normal movement. Three months after the first appointment, the treatment resulted in reduced pain, the mitigation of fear avoidance beliefs and the remediation of functional disability. The patient returned to work and was walking for one hour a day on a treadmill. The cognitive intervention to change the patient's negative beliefs related to the biomedical model was important to make the graded exercises and the lifestyle changes possible. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. 42 CFR 412.10 - Changes in the DRG classification system.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Changes in the DRG classification system. 412.10... § 412.10 Changes in the DRG classification system. (a) General rule. CMS issues changes in the DRG... after the same date the payment rates are effective. (b) Basis for changes in the DRG classification...

  10. Patient casemix classification for medicare psychiatric prospective payment.

    Science.gov (United States)

    Drozd, Edward M; Cromwell, Jerry; Gage, Barbara; Maier, Jan; Greenwald, Leslie M; Goldman, Howard H

    2006-04-01

    For a proposed Medicare prospective payment system for inpatient psychiatric facility treatment, the authors developed a casemix classification to capture differences in patients' real daily resource use. Primary data on patient characteristics and daily time spent in various activities were collected in a survey of 696 patients from 40 inpatient psychiatric facilities. Survey data were combined with Medicare claims data to estimate intensity-adjusted daily cost. Classification and Regression Trees (CART) analysis of average daily routine and ancillary costs yielded several hierarchical classification groupings. Regression analysis was used to control for facility and day-of-stay effects in order to compare hierarchical models with models based on the recently proposed payment system of the Centers for Medicare & Medicaid Services. CART analysis identified a small set of patient characteristics strongly associated with higher daily costs, including age, psychiatric diagnosis, deficits in daily living activities, and detox or ECT use. A parsimonious, 16-group, fully interactive model that used five major DSM-IV categories and stratified by age, illness severity, deficits in daily living activities, dangerousness, and use of ECT explained 40% (out of a possible 76%) of daily cost variation not attributable to idiosyncratic daily changes within patients. A noninteractive model based on diagnosis-related groups, age, and medical comorbidity had explanatory power of only 32%. A regression model with 16 casemix groups restricted to using "appropriate" payment variables (i.e., those with clinical face validity and low administrative burden that are easily validated and provide proper care incentives) produced more efficient and equitable payments than did a noninteractive system based on diagnosis-related groups.

  11. Changes in computed tomography features following preoperative chemotherapy for nephroblastoma: relation to histopathological classification

    International Nuclear Information System (INIS)

    Olsen, Oeystein E.; Jeanes, Annmarie C.; Roebuck, Derek J.; Owens, Catherine M.; Sebire, Neil J.; Risdon, Rupert A.; Michalski, Anthony J.

    2004-01-01

    The objective of this study is to assess computed tomography (CT) changes, both volume estimates and subjective features, following preoperative chemotherapy for nephroblastoma (Wilms' tumour) in patients treated on the United Kingdom Children's Cancer Study Group Wilms' Tumour Study-3 (UKW-3) protocol and to compare CT changes and histopathological classification. Twenty-one nephroblastomas in 15 patients treated on UKW-3 were included. All patients were examined by CT before and after preoperative chemotherapy treatment. CT images were reviewed (estimated volume change and subjectively assessed features). CT changes were compared to histopathological classification. Of the 21 tumours, all five high-risk tumours decreased in volume following chemotherapy (median -79%; range -37 to -91%). The sole low-risk tumour decreased in volume by 98%. Ten intermediate-risk tumours decreased in volume (median -72%; range -6 to -98%) and five intermediate-risk tumours increased (median +110%; range +11 to +164%). None of the five high-risk tumours, compared to 15/16 intermediate or low-risk tumours, became less dense and/or more homogeneous, or virtually disappeared, following chemotherapy. Volume change following chemotherapy did not relate to histopathological risk group. Changes in subjectively assessed qualitative CT features were more strongly related to histopathological risk group. (orig.)

  12. The classification of osteonecrosis in patients with cancer: validation of a new radiological classification system

    International Nuclear Information System (INIS)

    Niinimäki, T.; Niinimäki, J.; Halonen, J.; Hänninen, P.; Harila-Saari, A.; Niinimäki, R.

    2015-01-01

    Aim: To validate a new, non-joint-specific radiological classification system that is suitable regardless of the site of the osteonecrosis (ON) in patients with cancer. Material and methods: Critical deficiencies in the existing ON classification systems were identified and a new, non-joint-specific radiological classification system was developed. Seventy-two magnetic resonance imaging (MRI) images of patients with cancer and ON lesions were graded, and the validation of the new system was performed by assessing inter- and intra-observer reliability. Results: Intra-observer reliability of ON grading was good or very good, with kappa values of 0.79–0.86. Interobserver agreement was lower but still good, with kappa values of 0.62–0.77. Ninety-eight percent of all intra- or interobserver differences were within one grade. Interobserver reliability of assessing the location of ON was very good, with kappa values of 0.93–0.98. Conclusion: All the available radiological ON classification systems are joint specific. This limitation has spurred the development of multiple systems, which has led to the insufficient use of classifications in ON studies among patients with cancer. The introduced radiological classification system overcomes the problem of joint-specificity, was found to be reliable, and can be used to classify all ON lesions regardless of the affected site. - Highlights: • Patients with cancer may have osteonecrosis lesions at multiple sites. • There is no non-joint-specific osteonecrosis classification available. • We introduced a new non-joint-specific osteonecrosis classification. • The validation was performed by assessing inter- and intra-observer reliability. • The classification was reliable and could be used regardless of the affected site.

  13. Change classification in SAR time series: a functional approach

    Science.gov (United States)

    Boldt, Markus; Thiele, Antje; Schulz, Karsten; Hinz, Stefan

    2017-10-01

    Change detection represents a broad field of research in SAR remote sensing, consisting of many different approaches. Besides the simple recognition of change areas, the analysis of type, category or class of the change areas is at least as important for creating a comprehensive result. Conventional strategies for change classification are based on supervised or unsupervised landuse / landcover classifications. The main drawback of such approaches is that the quality of the classification result directly depends on the selection of training and reference data. Additionally, supervised processing methods require an experienced operator who capably selects the training samples. This training step is not necessary when using unsupervised strategies, but nevertheless meaningful reference data must be available for identifying the resulting classes. Consequently, an experienced operator is indispensable. In this study, an innovative concept for the classification of changes in SAR time series data is proposed. Regarding the drawbacks of traditional strategies given above, it copes without using any training data. Moreover, the method can be applied by an operator, who does not have detailed knowledge about the available scenery yet. This knowledge is provided by the algorithm. The final step of the procedure, which main aspect is given by the iterative optimization of an initial class scheme with respect to the categorized change objects, is represented by the classification of these objects to the finally resulting classes. This assignment step is subject of this paper.

  14. Classification of the eye changes of Graves' disease

    NARCIS (Netherlands)

    Wiersinga, W. M.; Prummel, M. F.; Mourits, M. P.; Koornneef, L.; Buller, H. R.

    1991-01-01

    Classification of the eye changes of Graves' disease may have clinical use in the description of the present eye state, in the assessment of treatment results, and in the choice of therapy. Requirements for any classification system should include simplicity, clinical nature (i.e., easily carried

  15. 42 CFR 412.513 - Patient classification system.

    Science.gov (United States)

    2010-10-01

    ... LTC-DRG classification system provides a LTC-DRG, and an appropriate weighting factor, for those cases... intermediary decides that a different LTC-DRG should be assigned, the case will be reviewed by the appropriate... 42 Public Health 2 2010-10-01 2010-10-01 false Patient classification system. 412.513 Section 412...

  16. An ensemble classification approach for improved Land use/cover change detection

    Science.gov (United States)

    Chellasamy, M.; Ferré, T. P. A.; Humlekrog Greve, M.; Larsen, R.; Chinnasamy, U.

    2014-11-01

    Change Detection (CD) methods based on post-classification comparison approaches are claimed to provide potentially reliable results. They are considered to be most obvious quantitative method in the analysis of Land Use Land Cover (LULC) changes which provides from - to change information. But, the performance of post-classification comparison approaches highly depends on the accuracy of classification of individual images used for comparison. Hence, we present a classification approach that produce accurate classified results which aids to obtain improved change detection results. Machine learning is a part of broader framework in change detection, where neural networks have drawn much attention. Neural network algorithms adaptively estimate continuous functions from input data without mathematical representation of output dependence on input. A common practice for classification is to use Multi-Layer-Perceptron (MLP) neural network with backpropogation learning algorithm for prediction. To increase the ability of learning and prediction, multiple inputs (spectral, texture, topography, and multi-temporal information) are generally stacked to incorporate diversity of information. On the other hand literatures claims backpropagation algorithm to exhibit weak and unstable learning in use of multiple inputs, while dealing with complex datasets characterized by mixed uncertainty levels. To address the problem of learning complex information, we propose an ensemble classification technique that incorporates multiple inputs for classification unlike traditional stacking of multiple input data. In this paper, we present an Endorsement Theory based ensemble classification that integrates multiple information, in terms of prediction probabilities, to produce final classification results. Three different input datasets are used in this study: spectral, texture and indices, from SPOT-4 multispectral imagery captured on 1998 and 2003. Each SPOT image is classified

  17. Validating the Danish adaptation of the World Health Organization's International Classification for Patient Safety classification of patient safety incident types

    DEFF Research Database (Denmark)

    Mikkelsen, Kim Lyngby; Thommesen, Jacob; Andersen, Henning Boje

    2013-01-01

    Objectives Validation of a Danish patient safety incident classification adapted from the World Health Organizaton's International Classification for Patient Safety (ICPS-WHO). Design Thirty-three hospital safety management experts classified 58 safety incident cases selected to represent all types.......513 (range: 0.193–0.804). Kappa and ICC showed high correlation (r = 0.99). An inverse correlation was found between the prevalence of type and inter-rater reliability. Results are discussed according to four factors known to determine the inter-rater agreement: skill and motivation of raters; clarity...

  18. The DSM-5: Classification and criteria changes.

    Science.gov (United States)

    Regier, Darrel A; Kuhl, Emily A; Kupfer, David J

    2013-06-01

    The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) marks the first significant revision of the publication since the DSM-IV in 1994. Changes to the DSM were largely informed by advancements in neuroscience, clinical and public health need, and identified problems with the classification system and criteria put forth in the DSM-IV. Much of the decision-making was also driven by a desire to ensure better alignment with the International Classification of Diseases and its upcoming 11th edition (ICD-11). In this paper, we describe select revisions in the DSM-5, with an emphasis on changes projected to have the greatest clinical impact and those that demonstrate efforts to enhance international compatibility, including integration of cultural context with diagnostic criteria and changes that facilitate DSM-ICD harmonization. It is anticipated that this collaborative spirit between the American Psychiatric Association (APA) and the World Health Organization (WHO) will continue as the DSM-5 is updated further, bringing the field of psychiatry even closer to a singular, cohesive nosology. Copyright © 2013 World Psychiatric Association.

  19. Proposition of a Classification of Adult Patients with Hemiparesis in Chronic Phase.

    Science.gov (United States)

    Chantraine, Frédéric; Filipetti, Paul; Schreiber, Céline; Remacle, Angélique; Kolanowski, Elisabeth; Moissenet, Florent

    2016-01-01

    Patients who have developed hemiparesis as a result of a central nervous system lesion, often experience reduced walking capacity and worse gait quality. Although clinically, similar gait patterns have been observed, presently, no clinically driven classification has been validated to group these patients' gait abnormalities at the level of the hip, knee and ankle joints. This study has thus intended to put forward a new gait classification for adult patients with hemiparesis in chronic phase, and to validate its discriminatory capacity. Twenty-six patients with hemiparesis were included in this observational study. Following a clinical examination, a clinical gait analysis, complemented by a video analysis, was performed whereby participants were requested to walk spontaneously on a 10m walkway. A patient's classification was established from clinical examination data and video analysis. This classification was made up of three groups, including two sub-groups, defined with key abnormalities observed whilst walking. Statistical analysis was achieved on the basis of 25 parameters resulting from the clinical gait analysis in order to assess the discriminatory characteristic of the classification as displayed by the walking speed and kinematic parameters. Results revealed that the parameters related to the discriminant criteria of the proposed classification were all significantly different between groups and subgroups. More generally, nearly two thirds of the 25 parameters showed significant differences (p<0.05) between the groups and sub-groups. However, prior to being fully validated, this classification must still be tested on a larger number of patients, and the repeatability of inter-operator measures must be assessed. This classification enables patients to be grouped on the basis of key abnormalities observed whilst walking and has the advantage of being able to be used in clinical routines without necessitating complex apparatus. In the midterm, this

  20. Changes in classification of genetic variants in BRCA1 and BRCA2.

    Science.gov (United States)

    Kast, Karin; Wimberger, Pauline; Arnold, Norbert

    2018-02-01

    Classification of variants of unknown significance (VUS) in the breast cancer genes BRCA1 and BRCA2 changes with accumulating evidence for clinical relevance. In most cases down-staging towards neutral variants without clinical significance is possible. We searched the database of the German Consortium for Hereditary Breast and Ovarian Cancer (GC-HBOC) for changes in classification of genetic variants as an update to our earlier publication on genetic variants in the Centre of Dresden. Changes between 2015 and 2017 were recorded. In the group of variants of unclassified significance (VUS, Class 3, uncertain), only changes of classification towards neutral genetic variants were noted. In BRCA1, 25% of the Class 3 variants (n = 2/8) changed to Class 2 (likely benign) and Class 1 (benign). In BRCA2, in 50% of the Class 3 variants (n = 16/32), a change to Class 2 (n = 10/16) or Class 1 (n = 6/16) was observed. No change in classification was noted in Class 4 (likely pathogenic) and Class 5 (pathogenic) genetic variants in both genes. No up-staging from Class 1, Class 2 or Class 3 to more clinical significance was observed. All variants with a change in classification in our cohort were down-staged towards no clinical significance by a panel of experts of the German Consortium for Hereditary Breast and Ovarian Cancer (GC-HBOC). Prevention in families with Class 3 variants should be based on pedigree based risks and should not be guided by the presence of a VUS.

  1. The Japanese Histologic Classification and T-score in the Oxford Classification system could predict renal outcome in Japanese IgA nephropathy patients.

    Science.gov (United States)

    Kaihan, Ahmad Baseer; Yasuda, Yoshinari; Katsuno, Takayuki; Kato, Sawako; Imaizumi, Takahiro; Ozeki, Takaya; Hishida, Manabu; Nagata, Takanobu; Ando, Masahiko; Tsuboi, Naotake; Maruyama, Shoichi

    2017-12-01

    The Oxford Classification is utilized globally, but has not been fully validated. In this study, we conducted a comparative analysis between the Oxford Classification and Japanese Histologic Classification (JHC) to predict renal outcome in Japanese patients with IgA nephropathy (IgAN). A retrospective cohort study including 86 adult IgAN patients was conducted. The Oxford Classification and the JHC were evaluated by 7 independent specialists. The JHC, MEST score in the Oxford Classification, and crescents were analyzed in association with renal outcome, defined as a 50% increase in serum creatinine. In multivariate analysis without the JHC, only the T score was significantly associated with renal outcome. While, a significant association was revealed only in the JHC on multivariate analysis with JHC. The JHC and T score in the Oxford Classification were associated with renal outcome among Japanese patients with IgAN. Superiority of the JHC as a predictive index should be validated with larger study population and cohort studies in different ethnicities.

  2. 76 FR 16460 - Parcel Select Price and Classification Changes

    Science.gov (United States)

    2011-03-23

    ... a recently-filed Postal Service notice of rate and classification changes affecting Parcel Select. The Postal Service seeks to implement new prices for Parcel Select for forwarding and return to sender... the United States Postal Service of Changes in Rates of General Applicability for a Competitive...

  3. A Challenge to Change: Necessary Changes in the Library Classification System for the Chicago Public Schools.

    Science.gov (United States)

    Williams, Florence M.

    This report addresses the feasibility of changing the classification of library materials in the Chicago Public School libraries from the Dewey Decimal classification system (DDC) to the Library of Congress system (LC), thus patterning the city school libraries after the Chicago Public Library and strengthening the existing close relationship…

  4. Automatic multi-modal MR tissue classification for the assessment of response to bevacizumab in patients with glioblastoma

    International Nuclear Information System (INIS)

    Liberman, Gilad; Louzoun, Yoram; Aizenstein, Orna; Blumenthal, Deborah T.; Bokstein, Felix; Palmon, Mika; Corn, Benjamin W.; Ben Bashat, Dafna

    2013-01-01

    Background: Current methods for evaluation of treatment response in glioblastoma are inaccurate, limited and time-consuming. This study aimed to develop a multi-modal MRI automatic classification method to improve accuracy and efficiency of treatment response assessment in patients with recurrent glioblastoma (GB). Materials and methods: A modification of the k-Nearest-Neighbors (kNN) classification method was developed and applied to 59 longitudinal MR data sets of 13 patients with recurrent GB undergoing bevacizumab (anti-angiogenic) therapy. Changes in the enhancing tumor volume were assessed using the proposed method and compared with Macdonald's criteria and with manual volumetric measurements. The edema-like area was further subclassified into peri- and non-peri-tumoral edema, using both the kNN method and an unsupervised method, to monitor longitudinal changes. Results: Automatic classification using the modified kNN method was applicable in all scans, even when the tumors were infiltrative with unclear borders. The enhancing tumor volume obtained using the automatic method was highly correlated with manual measurements (N = 33, r = 0.96, p < 0.0001), while standard radiographic assessment based on Macdonald's criteria matched manual delineation and automatic results in only 68% of cases. A graded pattern of tumor infiltration within the edema-like area was revealed by both automatic methods, showing high agreement. All classification results were confirmed by a senior neuro-radiologist and validated using MR spectroscopy. Conclusion: This study emphasizes the important role of automatic tools based on a multi-modal view of the tissue in monitoring therapy response in patients with high grade gliomas specifically under anti-angiogenic therapy

  5. Improved Correlation of the Neuropathologic Classification According to Adapted World Health Organization Classification and Outcome After Radiotherapy in Patients With Atypical and Anaplastic Meningiomas

    International Nuclear Information System (INIS)

    Combs, Stephanie E.; Schulz-Ertner, Daniela; Debus, Jürgen; Deimling, Andreas von; Hartmann, Christian

    2011-01-01

    Purpose: To evaluate the correlation between the 1993 and 2000/2007 World Health Organization (WHO) classification with the outcome in patients with high-grade meningiomas. Patients and Methods: Between 1985 and 2004, 73 patients diagnosed with atypical or anaplastic meningiomas were treated with radiotherapy. Sections from the paraffin-embedded tumor material from 66 patients (90%) from 13 different pathology departments were re-evaluated according to the first revised WHO classification from 1993 and the revised classifications from 2000/2007. In 4 cases, the initial diagnosis meningioma was not reproducible (5%). Therefore, 62 patients with meningiomas were analyzed. Results: All 62 tumors were reclassified according to the 1993 and 2000/2007 WHO classification systems. Using the 1993 system, 7 patients were diagnosed with WHO grade I meningioma (11%), 23 with WHO grade II (37%), and 32 with WHO grade III meningioma (52%). After scoring using the 2000/2007 system, we found 17 WHO grade I meningiomas (27%), 32 WHO grade II meningiomas (52%), and 13 WHO grade III meningiomas (21%). According to the 1993 classification, the difference in overall survival was not statistically significant among the histologic subgroups (p = .96). Using the 2000/2007 WHO classifications, the difference in overall survival became significant (p = .02). Of the 62 reclassified patients 29 developed tumor progression (47%). No difference in progression-free survival was observed among the histologic subgroups (p = .44). After grading according to the 2000/2007 WHO classifications, significant differences in progression-free survival were observed among the three histologic groups (p = .005). Conclusion: The new 2000/2007 WHO classification for meningiomas showed an improved correlation between the histologic grade and outcome. This classification therefore provides a useful basis to determine the postoperative indication for radiotherapy. According to our results, a comparison of the

  6. Improved Correlation of the Neuropathologic Classification According to Adapted World Health Organization Classification and Outcome After Radiotherapy in Patients With Atypical and Anaplastic Meningiomas

    Energy Technology Data Exchange (ETDEWEB)

    Combs, Stephanie E., E-mail: Stephanie.Combs@med.uni-heidelberg.de [Department of Radiation Oncology, University Hospital of Heidelberg, Heidelberg (Germany); Schulz-Ertner, Daniela [Radiologisches Institut, Markuskrankenhaus Frankfurt, Frankfurt am Main (Germany); Debus, Juergen [Department of Radiation Oncology, University Hospital of Heidelberg, Heidelberg (Germany); Deimling, Andreas von; Hartmann, Christian [Department of Neuropathology, Institute for Pathology, University Hospital of Heidelberg, Heidelberg (Germany); Clinical Cooperation Unit Neuropathology, German Cancer Research Center, Heidelberg (Germany)

    2011-12-01

    Purpose: To evaluate the correlation between the 1993 and 2000/2007 World Health Organization (WHO) classification with the outcome in patients with high-grade meningiomas. Patients and Methods: Between 1985 and 2004, 73 patients diagnosed with atypical or anaplastic meningiomas were treated with radiotherapy. Sections from the paraffin-embedded tumor material from 66 patients (90%) from 13 different pathology departments were re-evaluated according to the first revised WHO classification from 1993 and the revised classifications from 2000/2007. In 4 cases, the initial diagnosis meningioma was not reproducible (5%). Therefore, 62 patients with meningiomas were analyzed. Results: All 62 tumors were reclassified according to the 1993 and 2000/2007 WHO classification systems. Using the 1993 system, 7 patients were diagnosed with WHO grade I meningioma (11%), 23 with WHO grade II (37%), and 32 with WHO grade III meningioma (52%). After scoring using the 2000/2007 system, we found 17 WHO grade I meningiomas (27%), 32 WHO grade II meningiomas (52%), and 13 WHO grade III meningiomas (21%). According to the 1993 classification, the difference in overall survival was not statistically significant among the histologic subgroups (p = .96). Using the 2000/2007 WHO classifications, the difference in overall survival became significant (p = .02). Of the 62 reclassified patients 29 developed tumor progression (47%). No difference in progression-free survival was observed among the histologic subgroups (p = .44). After grading according to the 2000/2007 WHO classifications, significant differences in progression-free survival were observed among the three histologic groups (p = .005). Conclusion: The new 2000/2007 WHO classification for meningiomas showed an improved correlation between the histologic grade and outcome. This classification therefore provides a useful basis to determine the postoperative indication for radiotherapy. According to our results, a comparison of the

  7. 75 FR 69142 - Postal Rate and Classification Changes

    Science.gov (United States)

    2010-11-10

    .... Overall, Priority Mail International (PMI) prices increase on average by 3.8 percent. Classification... and for insurance with EMI and PMI increase. The unique price tier for Canada when optional insurance is purchased for PMI parcels is eliminated. Details of these changes may be found in the Attachment...

  8. 40 CFR 164.25 - Filing copies of notification of intent to cancel registration or change classification or...

    Science.gov (United States)

    2010-07-01

    ... intent to cancel registration or change classification or refusal to register, and statement of issues... copies of notification of intent to cancel registration or change classification or refusal to register... appropriate notice of intention to cancel, the notice of intention to change the classification or the...

  9. Towards an international classification for patient safety : the conceptual framework

    NARCIS (Netherlands)

    Sherman, H.; Castro, G.; Fletcher, M.; Hatlie, M.; Hibbert, P.; Jakob, R.; Koss, R.; Lewalle, P.; Loeb, J.; Perneger, Th.; Runciman, W.; Thomson, R.; Schaaf, van der T.W.; Virtanen, M.

    2009-01-01

    Global advances in patient safety have been hampered by the lack of a uniform classification of patient safety concepts. This is a significant barrier to developing strategies to reduce risk, performing evidence-based research and evaluating existing healthcare policies relevant to patient safety.

  10. Classification of bone scintigrams in hemodialysis patients

    International Nuclear Information System (INIS)

    Ishibashi, Kazunari; Miyamae, Tatsuya

    1985-01-01

    Bone scintigrams from a total of 75 hemodialysis patients using sup(99m)Tc-methylene-diphosphonate (MDP) were classified into two groups; Group I (56 patients) in which the uptake of the radioactivity appeared to be relatively high in the soft tissue and low in the bone, and Group II (19 patients) in which high uptake in the bone and low uptake in the soft tissue were observed. Patients in Group I were further classified into two subgroups; Group I sub(A) (articular type, 21 patients) which was characterized by relatively high uptake into the joint, and Group I sub(B) (reduction type, 35 patients) where uptake was faint in the whole region of the bone. The classification of patients in Group II was also performed; Group II sub(A) (spinal type, 14 patients) where high spinal uptake was observed, and Group II sub(B) (cranio-facial type, 5 patients) where high uptake into the cranio-facial region was observed. The results were compared with 146 subjects with normal bone scintigram in terms of the ratio of bone to soft tissue uptake (B/S ratio) for the cranial bone, jaw bone, lumbar vertebra and femoral bone, and the ratio of epiphysis to diaphysis uptake (E/D ratio) for the femoral bone. The B/S ratio was low in Group I and high in Group II for the bone studied, and the E/D ratio was markedly high in Group I sub(A). Histobiochemical examination indicated that patients in Group I sub(A) and Group II may have osteomalacia and secondary hyperparathyroidism, respectively. It was considered that the visual classification and semiquantitative study as described here were useful for evaluating the pathological condition of renal osteodystrophy. (author)

  11. Classification of bone scintigrams in hemodialysis patients

    Energy Technology Data Exchange (ETDEWEB)

    Ishibashi, Kazunari; Miyamae, Tatsuya

    1985-03-01

    Bone scintigrams from a total of 75 hemodialysis patients using /sup 99m/Tc-methylene-diphosphonate (MDP) were classified into two groups; Group I (56 patients) in which the uptake of the radioactivity appeared to be relatively high in the soft tissue and low in the bone, and Group II (19 patients) in which high uptake in the bone and low uptake in the soft tissue were observed. Patients in Group I were further classified into two subgroups; Group I sub(A) (articular type, 21 patients) which was characterized by relatively high uptake into the joint, and Group I sub(B) (reduction type, 35 patients) where uptake was faint in the whole region of the bone. The classification of patients in Group II was also performed; Group II sub(A) (spinal type, 14 patients) where high spinal uptake was observed, and Group II sub(B) (cranio-facial type, 5 patients) where high uptake into the cranio-facial region was observed. The results were compared with 146 subjects with normal bone scintigram in terms of the ratio of bone to soft tissue uptake (B/S ratio) for the cranial bone, jaw bone, lumbar vertebra and femoral bone, and the ratio of epiphysis to diaphysis uptake (E/D ratio) for the femoral bone. The B/S ratio was low in Group I and high in Group II for the bone studied, and the E/D ratio was markedly high in Group I sub(A). Histobiochemical examination indicated that patients in Group I sub(A) and Group II may have osteomalacia and secondary hyperparathyroidism, respectively. It was considered that the visual classification and semiquantitative study as described here were useful for evaluating the pathological condition of renal osteodystrophy.

  12. 42 CFR 412.620 - Patient classification system.

    Science.gov (United States)

    2010-10-01

    ...-mix group classifications and weighting factors. We may periodically adjust the case-mix groups and... rehabilitation facilities into mutually exclusive case-mix groups. (2) For purposes of this subpart, case-mix... assessments under § 412.610(c)(1) are used to classify a Medicare patient into an appropriate case-mix group...

  13. Classification of Patient Care Complexity: Cloud Technology.

    Science.gov (United States)

    de Oliveira Riboldi, Caren; Macedo, Andrea Barcellos Teixeira; Mergen, Thiane; Dias, Vera Lúcia Mendes; da Costa, Diovane Ghignatti; Malvezzi, Maria Luiza Falsarella; Magalhães, Ana Maria Muller; Silveira, Denise Tolfo

    2016-01-01

    Presentation of the computerized structure to implement, in a university hospital in the South of Brazil, the Patients Classification System of Perroca, which categorizes patients according to the care complexity. This solution also aims to corroborate a recent study at the hospital, which evidenced that the increasing workload presents a direct relation with the institutional quality indicators. The tools used were the Google applications with high productivity interconnecting the topic knowledge on behalf of the nursing professionals and information technology professionals.

  14. Ototoxicity (cochleotoxicity) classifications: A review.

    Science.gov (United States)

    Crundwell, Gemma; Gomersall, Phil; Baguley, David M

    2016-01-01

    Drug-mediated ototoxicity, specifically cochleotoxicity, is a concern for patients receiving medications for the treatment of serious illness. A number of classification schemes exist, most of which are based on pure-tone audiometry, in order to assist non-audiological/non-otological specialists in the identification and monitoring of iatrogenic hearing loss. This review identifies the primary classification systems used in cochleototoxicity monitoring. By bringing together classifications published in discipline-specific literature, the paper aims to increase awareness of their relative strengths and limitations in the assessment and monitoring of ototoxic hearing loss and to indicate how future classification systems may improve upon the status-quo. Literature review. PubMed identified 4878 articles containing the search term ototox*. A systematic search identified 13 key classification systems. Cochleotoxicity classification systems can be divided into those which focus on hearing change from a baseline audiogram and those that focus on the functional impact of the hearing loss. Common weaknesses of these grading scales included a lack of sensitivity to small adverse changes in hearing thresholds, a lack of high-frequency audiometry (>8 kHz), and lack of indication of which changes are likely to be clinically significant for communication and quality of life.

  15. Stochastic change detection in uncertain nonlinear systems using reduced-order models: classification

    International Nuclear Information System (INIS)

    Yun, Hae-Bum; Masri, Sami F

    2009-01-01

    A reliable structural health monitoring methodology (SHM) is proposed to detect relatively small changes in uncertain nonlinear systems. A total of 4000 physical tests were performed using a complex nonlinear magneto-rheological (MR) damper. With the effective (or 'genuine') changes and uncertainties in the system characteristics of the semi-active MR damper, which were precisely controlled with known means and standard deviation of the input current, the tested MR damper was identified with the restoring force method (RFM), a non-parametric system identification method involving two-dimensional orthogonal polynomials. Using the identified RFM coefficients, both supervised and unsupervised pattern recognition techniques (including support vector classification and k-means clustering) were employed to detect system changes in the MR damper. The classification results showed that the identified coefficients with orthogonal basis function can be used as reliable indicators for detecting (small) changes, interpreting the physical meaning of the detected changes without a priori knowledge of the monitored system and quantifying the uncertainty bounds of the detected changes. The classification errors were analyzed using the standard detection theory to evaluate the performance of the developed SHM methodology. An optimal classifier design procedure was also proposed and evaluated to minimize type II (or 'missed') errors

  16. [Changes introduced into the recent International Classification of Headache Disorders: ICHD-III beta classification].

    Science.gov (United States)

    Belvis, Robert; Mas, Natàlia; Roig, Carles

    2015-01-16

    The International Headache Society (IHS) has published the third edition of the International Classification of Headache Disorders (ICHD-III beta), the most commonly used guide to diagnosing headaches in the world. To review the recent additions to the guide, to explain the new entities that appear in it and to compare the conditions that have had their criteria further clarified against the criteria in the previous edition. We have recorded a large number of clarifications in the criteria in practically all the headaches and neuralgias in the classification, but the conditions that have undergone the most significant clarifications are chronic migraine, primary headache associated with sexual activity, short-lasting unilateral neuralgiform headache attacks, new daily persistent headache, medication-overuse headache, syndrome of transient headache and neurological deficits with cerebrospinal fluid lymphocytosis. The most notable new entities that have been incorporated are external-compression headache, cold-stimulus headache, nummular headache, headache attributed to aeroplane travel and headache attributed to autonomic dysreflexia. Another point to be highlighted is the case of the new headaches (still not considered entities in their own right) included in the appendix, some of the most noteworthy being epicrania fugax, vestibular migraine and infantile colic. The IHS recommends no longer using the previous classification and changing over to the new classification (ICHD-III beta) in healthcare, teaching and research, in addition to making this new guide as widely known as possible.

  17. Comparison of World Health Organization and Asia-Pacific body mass index classifications in COPD patients

    Directory of Open Access Journals (Sweden)

    Lim JU

    2017-08-01

    . We enrolled 1,462 patients. Medical history including age, sex, St George’s Respiratory Questionnaire (SGRQ-C, the modified Medical Research Council (mMRC dyspnea scale, and post-bronchodilator forced expiratory volume in 1 second (FEV1 were evaluated. Patients were categorized into different BMI groups according to the two BMI classification systems. Result: FEV1 and the diffusing capacity of the lung for carbon monoxide (DLCO percentage revealed an inverse “U”-shaped pattern as the BMI groups changed from underweight to obese when WHO cutoffs were applied. When Asia-Pacific cutoffs were applied, FEV1 and DLCO (% exhibited a linearly ascending relationship as the BMI increased, and the percentage of patients in the overweight and obese groups linearly decreased with increasing severity of the Global Initiative for Chronic Obstructive Lung Disease criteria. From the underweight to the overweight groups, SGRQ-C and mMRC had a decreasing relationship in both the WHO and Asia-Pacific classifications. The prevalence of comorbidities in the different BMI groups showed similar trends in both BMI classifications systems. Conclusion: The present study demonstrated that patients with COPD who have a high BMI have better pulmonary function and health-related quality of life and reduced dyspnea symptoms. Furthermore, the Asia-Pacific BMI classification more appropriately reflects the correlation of obesity and disease manifestation in Asian COPD patients than the WHO classification. Keywords: body mass index, COPD, comorbidity

  18. Changes in preoperative characteristics in patients undergoing radical prostatectomy

    DEFF Research Database (Denmark)

    Røder, Martin Andreas; Brasso, Klaus; Christensen, Ib Jarle

    2014-01-01

    of a shift in attitude with increasing opportunistic PSA testing. This had led to an increasing number of RPs being performed in Denmark. The objective of this study was to analyze changes in preoperative characteristics over time for the complete cohort of 6489 men who underwent RP between 1995 and 2011....... Our hypothesis was that an increasing amount of men undergo RP for lower risk PCa. MATERIAL AND METHODS: All patients operated from 1995 to 2011 were identified via patient files and registries. Changes over time in age at surgery, preoperative PSA, clinical T-category, biopsy Gleason score (GS......, especially after 2005. Biopsy GS = 7 was found in 20.2% of the patients in 2005 compared to 57.1% in 2011. The proportion of T1 disease increased from 32% to 56%. Significant changes in percentage of patients according to the D'Amico classification were found. After 2005 the proportion of intermediate...

  19. The Australian National Sub-Acute and Non-Acute Patient casemix classification.

    Science.gov (United States)

    Eagar, K

    1999-01-01

    The Australian National Sub-Acute and Non-Acute Patient (AN-SNAP) Version 1 casemix classification was completed in 1997. AN-SNAP is designed for the classification of sub-acute and non-acute care provided in both inpatient and ambulatory settings and is intended to be useful for both funding and clinical management purposes. The National Sub-Acute and Non-Acute Casemix Classification study has produced the first version of a national classification of sub-acute and non-acute care. Ongoing refinement (leading to Version 2) will be possible through further analysis of the existing data set in combination with analysis of the results of a carefully planned and phased implementation.

  20. Classification of multiple sclerosis patients by latent class analysis of magnetic resonance imaging characteristics.

    Science.gov (United States)

    Zwemmer, J N P; Berkhof, J; Castelijns, J A; Barkhof, F; Polman, C H; Uitdehaag, B M J

    2006-10-01

    Disease heterogeneity is a major issue in multiple sclerosis (MS). Classification of MS patients is usually based on clinical characteristics. More recently, a pathological classification has been presented. While clinical subtypes differ by magnetic resonance imaging (MRI) signature on a group level, a classification of individual MS patients based purely on MRI characteristics has not been presented so far. To investigate whether a restricted classification of MS patients can be made based on a combination of quantitative and qualitative MRI characteristics and to test whether the resulting subgroups are associated with clinical and laboratory characteristics. MRI examinations of the brain and spinal cord of 50 patients were scored for 21 quantitative and qualitative characteristics. Using latent class analysis, subgroups were identified, for whom disease characteristics and laboratory measures were compared. Latent class analysis revealed two subgroups that mainly differed in the extent of lesion confluency and MRI correlates of neuronal loss in the brain. Demographics and disease characteristics were comparable except for cognitive deficits. No correlations with laboratory measures were found. Latent class analysis offers a feasible approach for classifying subgroups of MS patients based on the presence of MRI characteristics. The reproducibility, longitudinal evolution and further clinical or prognostic relevance of the observed classification will have to be explored in a larger and independent sample of patients.

  1. Changing Histopathological Diagnostics by Genome-Based Tumor Classification

    Directory of Open Access Journals (Sweden)

    Michael Kloth

    2014-05-01

    Full Text Available Traditionally, tumors are classified by histopathological criteria, i.e., based on their specific morphological appearances. Consequently, current therapeutic decisions in oncology are strongly influenced by histology rather than underlying molecular or genomic aberrations. The increase of information on molecular changes however, enabled by the Human Genome Project and the International Cancer Genome Consortium as well as the manifold advances in molecular biology and high-throughput sequencing techniques, inaugurated the integration of genomic information into disease classification. Furthermore, in some cases it became evident that former classifications needed major revision and adaption. Such adaptations are often required by understanding the pathogenesis of a disease from a specific molecular alteration, using this molecular driver for targeted and highly effective therapies. Altogether, reclassifications should lead to higher information content of the underlying diagnoses, reflecting their molecular pathogenesis and resulting in optimized and individual therapeutic decisions. The objective of this article is to summarize some particularly important examples of genome-based classification approaches and associated therapeutic concepts. In addition to reviewing disease specific markers, we focus on potentially therapeutic or predictive markers and the relevance of molecular diagnostics in disease monitoring.

  2. Psychological and social problems in primary care patients - general practitioners' assessment and classification.

    Science.gov (United States)

    Rosendal, Marianne; Vedsted, Peter; Christensen, Kaj Sparle; Moth, Grete

    2013-03-01

    To estimate the frequency of psychological and social classification codes employed by general practitioners (GPs) and to explore the extent to which GPs ascribed health problems to biomedical, psychological, or social factors. A cross-sectional survey based on questionnaire data from GPs. Setting. Danish primary care. 387 GPs and their face-to-face contacts with 5543 patients. GPs registered consecutive patients on registration forms including reason for encounter, diagnostic classification of main problem, and a GP assessment of biomedical, psychological, and social factors' influence on the contact. The GP-stated reasons for encounter largely overlapped with their classification of the managed problem. Using the International Classification of Primary Care (ICPC-2-R), GPs classified 600 (11%) patients with psychological problems and 30 (0.5%) with social problems. Both codes for problems/complaints and specific disorders were used as the GP's diagnostic classification of the main problem. Two problems (depression and acute stress reaction/adjustment disorder) accounted for 51% of all psychological classifications made. GPs generally emphasized biomedical aspects of the contacts. Psychological aspects were given greater importance in follow-up consultations than in first-episode consultations, whereas social factors were rarely seen as essential to the consultation. Psychological problems are frequently seen and managed in primary care and most are classified within a few diagnostic categories. Social matters are rarely considered or classified.

  3. Advances in Patient Classification for Traditional Chinese Medicine: A Machine Learning Perspective

    Directory of Open Access Journals (Sweden)

    Changbo Zhao

    2015-01-01

    data analyzed by different computational methods, we present the overview for four subfields of TCM diagnosis, respectively. For each subfield, we design a rectangular reference list with applications in the horizontal direction and machine learning algorithms in the longitudinal direction. According to the current development of objective TCM diagnosis for patient classification, a discussion of the research issues around machine learning techniques with applications to TCM diagnosis is given to facilitate the further research for TCM patient classification.

  4. Organizational change in quality management aspects: a quantitative proposal for classification

    Directory of Open Access Journals (Sweden)

    André Tavares de Aquino

    Full Text Available Abstract Periodically, organizations need to change the quality management aspects of processes and products in order to suit the demands of their internal and external (consumer and competitor market environments. In the context of the present study, quality management changes involve tools, programs, methods, standards and procedures that can be applied. The purpose of this study is to help senior management to identify types of change and, consequently, determine how it should be correctly conducted within an organization. The methodology involves a classification model, with multicriteria support, and three organizational change ratings were adopted (the extremes, type I and type II, as confirmed in the literature, and the intermediary, proposed herein. The multicriteria method used was ELECTRE TRI and the model was applied to two companies of the Textile Local Productive Arrangement in Pernambuco, Brazil. The results are interesting and show the consistency and coherence of the proposed classification model.

  5. A new patient classification for laser resurfacing and peels: predicting responses, risks, and results.

    Science.gov (United States)

    Fanous, Nabil

    2002-01-01

    Traditional classifications for skin treatment modalities are based on skin characteristics, the most important being skin color. Other factors are considered as well, such as oiliness, thickness, pathology, and sensitivity. While useful, these classifications are occasionally inadequate in predicting and explaining the outcome of some peels, dermabrasions, or laser resurfacing procedures. Why, for example, would a Korean patient with a light white skin inadvertently develop more hyperpigmentation than his darker skinned French counterpart? The new classification introduced here is based on the racial and genetic origins of patients. It suggests that racial genetic predisposition is the determining factor in human response to skin injury, including skin treatments. This classification takes into account both skin and features, rather than skin alone. It offers a new approach in evaluating patients scheduled for skin peels or laser resurfacing, in the hope of helping physicians to better predict reactions, select the appropriate type and intensity of the skin treatment and, ultimately, better control the outcome. Six categories (sub-races) are described: Nordics, Europeans, Mediterraneans, Indo-Pakistanis, Africans, and Asians. The reaction of each sub-race to peels, laser resurfacing, or dermabrasion is analyzed. The risks associated with each group are noted. This new classification provides physicians with a practical way to evaluate patients prior to treatment, with a view to determining each patient's suitability, postoperative reaction, the likelihood of complications, and likely result.

  6. Classification of Mistakes in Patient Care in a Nigerian Hospital ...

    African Journals Online (AJOL)

    The study shows that there are wide variations within and between professional health groups in the classification of errors in patient care. The implications of the absence of a classificatory scheme for errors in patient care for service improvement and organisational learning in the hospital environment are discussed.

  7. Automated Classification of Consumer Health Information Needs in Patient Portal Messages.

    Science.gov (United States)

    Cronin, Robert M; Fabbri, Daniel; Denny, Joshua C; Jackson, Gretchen Purcell

    2015-01-01

    Patients have diverse health information needs, and secure messaging through patient portals is an emerging means by which such needs are expressed and met. As patient portal adoption increases, growing volumes of secure messages may burden healthcare providers. Automated classification could expedite portal message triage and answering. We created four automated classifiers based on word content and natural language processing techniques to identify health information needs in 1000 patient-generated portal messages. Logistic regression and random forest classifiers detected single information needs well, with area under the curves of 0.804-0.914. A logistic regression classifier accurately found the set of needs within a message, with a Jaccard index of 0.859 (95% Confidence Interval: (0.847, 0.871)). Automated classification of consumer health information needs expressed in patient portal messages is feasible and may allow direct linking to relevant resources or creation of institutional resources for commonly expressed needs.

  8. Poor Prognostic Factors in Patients with Malignant Pleural Mesothelioma Classified as Pathological Stage IB According to the Eighth Edition TNM Classification.

    Science.gov (United States)

    Takuwa, Teruhisa; Hashimoto, Masaki; Kuroda, Ayumi; Nakamura, Akifumi; Nakamichi, Toru; Fukuda, Akihiro; Matsumoto, Seiji; Kondo, Nobuyuki; Hasegawa, Seiki

    2018-04-03

    The change in TNM classification of malignant pleural mesothelioma (MPM) between the seventh and eighth edition classifications has resulted in the downstaging of many advanced-stage patients into pathological stage IB. Many mesotheliomas without lymph node metastasis have been classified as stage IB in the eighth edition classification. Stage IB mesotheliomas comprised a heterogeneous group with different prognosis. It is necessary to clarify the prognostic factors in this group. Between September 2009 and August 2016, a total of 89 patients with MPM underwent curative intent surgery [pleurectomy decortication n = 57 (64.1%), extrapleural pneumonectomy n = 32 (35.9%)] at our institution. Of these, 40 were reclassified as stage IB according to the eighth edition TNM classification. Independent unfavorable prognostic factors were identified by univariate analyses using the log-rank test and Cox proportional hazards regression models. Three independent significant factors were identified that indicated an unfavorable prognosis: a nonepithelioid subtype, lymphovascular invasion, and preoperative forced expiratory volume in 1 s (FEV1) < 2000 ml. Patients with no, one, and two of these risk factors showed 3-year overall survival probabilities of 94.7, 62.5, and 0%, respectively. The 3-year survival of patients with one factor did not differ significantly from that of patients with stage III MPM, whereas that of patients with two factors was significantly shorter (p = 0.015). Independent poor prognostic factors for patients with stage IB MPM patients, allowing subgroups with poorer and more favorable prognoses to be identified. This should help personalize decisions on adjuvant chemotherapy.

  9. Automated Classification of Consumer Health Information Needs in Patient Portal Messages

    Science.gov (United States)

    Cronin, Robert M.; Fabbri, Daniel; Denny, Joshua C.; Jackson, Gretchen Purcell

    2015-01-01

    Patients have diverse health information needs, and secure messaging through patient portals is an emerging means by which such needs are expressed and met. As patient portal adoption increases, growing volumes of secure messages may burden healthcare providers. Automated classification could expedite portal message triage and answering. We created four automated classifiers based on word content and natural language processing techniques to identify health information needs in 1000 patient-generated portal messages. Logistic regression and random forest classifiers detected single information needs well, with area under the curves of 0.804–0.914. A logistic regression classifier accurately found the set of needs within a message, with a Jaccard index of 0.859 (95% Confidence Interval: (0.847, 0.871)). Automated classification of consumer health information needs expressed in patient portal messages is feasible and may allow direct linking to relevant resources or creation of institutional resources for commonly expressed needs. PMID:26958285

  10. Mixing geometric and radiometric features for change classification

    Science.gov (United States)

    Fournier, Alexandre; Descombes, Xavier; Zerubia, Josiane

    2008-02-01

    Most basic change detection algorithms use a pixel-based approach. Whereas such approach is quite well defined for monitoring important area changes (such as urban growth monitoring) in low resolution images, an object based approach seems more relevant when the change detection is specifically aimed toward targets (such as small buildings and vehicles). In this paper, we present an approach that mixes radiometric and geometric features to qualify the changed zones. The goal is to establish bounds (appearance, disappearance, substitution ...) between the detected changes and the underlying objects. We proceed by first clustering the change map (containing each pixel bitemporal radiosity) in different classes using the entropy-kmeans algorithm. Assuming that most man-made objects have a polygonal shape, a polygonal approximation algorithm is then used in order to characterize the resulting zone shapes. Hence allowing us to refine the primary rough classification, by integrating the polygon orientations in the state space. Tests are currently conducted on Quickbird data.

  11. A quantitative index for classification of plantar thermal changes in the diabetic foot

    Science.gov (United States)

    Hernandez-Contreras, D.; Peregrina-Barreto, H.; Rangel-Magdaleno, J.; Gonzalez-Bernal, J. A.; Altamirano-Robles, L.

    2017-03-01

    One of the main complications caused by diabetes mellitus is the development of diabetic foot, which in turn, can lead to ulcerations. Because ulceration risks are linked to an increase in plantar temperatures, recent approaches analyze thermal changes. These approaches try to identify spatial patterns of temperature that could be characteristic of a diabetic group. However, this is a difficult task since thermal patterns have wide variations resulting on complex classification. Moreover, the measurement of contralateral plantar temperatures is important to determine whether there is an abnormal difference but, this only provides information when thermal changes are asymmetric and in absence of ulceration or amputation. Therefore, in this work is proposed a quantitative index for measuring the thermal change in the plantar region of participants diagnosed diabetes mellitus regards to a reliable reference (control) or regards to the contralateral foot (as usual). Also, a classification of the thermal changes based on a quantitative index is proposed. Such classification demonstrate the wide diversity of spatial distributions in the diabetic foot but also demonstrate that it is possible to identify common characteristics. An automatic process, based on the analysis of plantar angiosomes and image processing, is presented to quantify these thermal changes and to provide valuable information to the medical expert.

  12. Classification of spondylolytic clefts in patients with spondylolysis or isthmic spondylolisthesis using positional MRI.

    Science.gov (United States)

    Niggemann, Pascal; Kuchta, Johannes; Hadizadeh, Dariusch; Pieper, Claus Christian; Schild, Hans Heinz

    2017-02-01

    Background Posterior instability is a pathologic movement occurring in the spondylolytic cleft. Purpose To present a new classification system for the evaluation of spondylolytic cleft by positional magnetic resonance imaging (MRI) and determine the prevalence of the different types. Material and Methods A total of 176 segments of the lumbar spine with spondylolysis or isthmic spondylolisthesis were examined using positional MRI. Scans were obtained in neutral sitting, flexion, and extension positions. No visible movement in the cleft was defined as type A, fluid displaced into the cleft as type BI, displacement of the flava ligaments at the level of the cleft as type BII, and intraspinal cysts arising from the spondylolytic cleft as type BIII. The movements were characterized by a radiologist and a neurosurgeon experienced in positional MRI. Clinical findings were correlated with the different types of instability. Results A high agreement was found between the two observers. In total, 131 segments were characterized as type A, six as type BI, 24 as type BII, and 10 as type BIII. In five segments, the type differed between the right and the left side. Two patients had a mixed type BI/II, another two patients had a mixed type BII/III, and one patient had a mixed type BI/III. Patients with type BII and BIII instabilities suffered more often from radicular symptoms compared to patients without any instability. Conclusion The presented classification might help to better understand and study changes encountered in the spondylolytic cleft in patients with spondylolysis and isthmic spondylolisthesis using positional MRI.

  13. McKenzie Classification of Extremity Lesions - An audit of primary care patients in 3 clinics

    DEFF Research Database (Denmark)

    Melbye, Martin

    2007-01-01

    Syndrome classification based on mechanical testing guides clinical decision making in conservative musculoskeletal care. The aim of this audit was to investigate how many patients presenting with problems in the extremities could be classified into the mechanical syndromes described by Robin Mc...... ranged from 4,5 to 6 years. The mechanical classification  determined by the therapists,  and was recorded on the first three visits. Mechanical classification was based on strict operational definitions. Assessment sheets were collected from each therapist, to determine their adherence...... to the operational definitions. 135 consecutive patients were included over an 18 months period and 28 patients were excluded. Of  the 107 patients with extremity joint problems, 73% were classified into one of McKenzie's mechanical syndromes by therapists trained in the McKenzie method. 34% of patients were...

  14. A simple classification system was recommended for patients with restricted shoulder or neck range of motion

    NARCIS (Netherlands)

    Groenier, KH; Winters, JC; van Schuur, Wijbrand H.; De Winter, AF; Meyboom-De Jong, B

    Objective: To construct an empirical classification of patients with shoulder complaints, and then to investigate the relationship between the empirical classification and the setting in which the patients were recruited, their demographic and clinical characteristics, and the original diagnostic

  15. Classification of Alzheimer's Patients through Ubiquitous Computing.

    Science.gov (United States)

    Nieto-Reyes, Alicia; Duque, Rafael; Montaña, José Luis; Lage, Carmen

    2017-07-21

    Functional data analysis and artificial neural networks are the building blocks of the proposed methodology that distinguishes the movement patterns among c's patients on different stages of the disease and classifies new patients to their appropriate stage of the disease. The movement patterns are obtained by the accelerometer device of android smartphones that the patients carry while moving freely. The proposed methodology is relevant in that it is flexible on the type of data to which it is applied. To exemplify that, it is analyzed a novel real three-dimensional functional dataset where each datum is observed in a different time domain. Not only is it observed on a difference frequency but also the domain of each datum has different length. The obtained classification success rate of 83 % indicates the potential of the proposed methodology.

  16. Etiological classification of ischemic stroke in young patients: a comparative study of TOAST, CCS, and ASCO.

    Science.gov (United States)

    Gökçal, Elif; Niftaliyev, Elvin; Asil, Talip

    2017-09-01

    Analysis of stroke subtypes is important for making treatment decisions and prognostic evaluations. The TOAST classification system is most commonly used, but the CCS and ASCO classification systems might be more useful to identify stroke etiologies in young patients whose strokes have a wide range of different causes. In this manuscript, we aim to compare the differences in subtype classification between TOAST, CCS, and ASCO in young stroke patients. The TOAST, CCS, and ASCO classification schemes were applied to 151 patients with ischemic stroke aged 18-49 years old and the proportion of subtypes classified by each scheme was compared. For comparison, determined etiologies were defined as cases with evident and probable subtypes when using the CCS scheme and cases with grade 1 and 2 subtypes but no other grade 1 subtype when using the ASCO scheme. The McNemar test with Bonferroni correction was used to assess significance. By TOAST, 41.1% of patients' stroke etiology was classified as undetermined etiology, 19.2% as cardioembolic, 13.2% as large artery atherosclerosis, 11.3% as small vessel occlusion, and 15.2% as other causes. Compared with TOAST, both CCS and ASCO assigned fewer patients to the undetermined etiology group (30.5% p CCS and ASCO classification schemes in young stroke patients seems feasible, and using both schemes may result in fewer patients being classified as undetermined etiology. New studies with more patients and a prospective design are needed to explore this topic further.

  17. Applying Topographic Classification, Based on the Hydrological Process, to Design Habitat Linkages for Climate Change

    Directory of Open Access Journals (Sweden)

    Yongwon Mo

    2017-11-01

    Full Text Available The use of biodiversity surrogates has been discussed in the context of designing habitat linkages to support the migration of species affected by climate change. Topography has been proposed as a useful surrogate in the coarse-filter approach, as the hydrological process caused by topography such as erosion and accumulation is the basis of ecological processes. However, some studies that have designed topographic linkages as habitat linkages, so far have focused much on the shape of the topography (morphometric topographic classification with little emphasis on the hydrological processes (generic topographic classification to find such topographic linkages. We aimed to understand whether generic classification was valid for designing these linkages. First, we evaluated whether topographic classification is more appropriate for describing actual (coniferous and deciduous and potential (mammals and amphibians habitat distributions. Second, we analyzed the difference in the linkages between the morphometric and generic topographic classifications. The results showed that the generic classification represented the actual distribution of the trees, but neither the morphometric nor the generic classification could represent the potential animal distributions adequately. Our study demonstrated that the topographic classes, according to the generic classification, were arranged successively according to the flow of water, nutrients, and sediment; therefore, it would be advantageous to secure linkages with a width of 1 km or more. In addition, the edge effect would be smaller than with the morphometric classification. Accordingly, we suggest that topographic characteristics, based on the hydrological process, are required to design topographic linkages for climate change.

  18. Cognitive-Behavioral Classifications of Chronic Pain in Patients with Multiple Sclerosis

    Science.gov (United States)

    Khan, Fary; Pallant, Julie F.; Amatya, Bhasker; Young, Kevin; Gibson, Steven

    2011-01-01

    The aim of this study was to replicate, in patients with multiple sclerosis (MS), the three-cluster cognitive-behavioral classification proposed by Turk and Rudy. Sixty-two patients attending a tertiary MS rehabilitation center completed the Pain Impact Rating questionnaire measuring activity interference, pain intensity, social support, and…

  19. Fast and Robust Segmentation and Classification for Change Detection in Urban Point Clouds

    Science.gov (United States)

    Roynard, X.; Deschaud, J.-E.; Goulette, F.

    2016-06-01

    Change detection is an important issue in city monitoring to analyse street furniture, road works, car parking, etc. For example, parking surveys are needed but are currently a laborious task involving sending operators in the streets to identify the changes in car locations. In this paper, we propose a method that performs a fast and robust segmentation and classification of urban point clouds, that can be used for change detection. We apply this method to detect the cars, as a particular object class, in order to perform parking surveys automatically. A recently proposed method already addresses the need for fast segmentation and classification of urban point clouds, using elevation images. The interest to work on images is that processing is much faster, proven and robust. However there may be a loss of information in complex 3D cases: for example when objects are one above the other, typically a car under a tree or a pedestrian under a balcony. In this paper we propose a method that retain the three-dimensional information while preserving fast computation times and improving segmentation and classification accuracy. It is based on fast region-growing using an octree, for the segmentation, and specific descriptors with Random-Forest for the classification. Experiments have been performed on large urban point clouds acquired by Mobile Laser Scanning. They show that the method is as fast as the state of the art, and that it gives more robust results in the complex 3D cases.

  20. Classification of childhood epilepsies in a tertiary pediatric neurology clinic using a customized classification scheme from the international league against epilepsy 2010 report.

    Science.gov (United States)

    Khoo, Teik-Beng

    2013-01-01

    In its 2010 report, the International League Against Epilepsy Commission on Classification and Terminology had made a number of changes to the organization, terminology, and classification of seizures and epilepsies. This study aims to test the usefulness of this revised classification scheme on children with epilepsies aged between 0 and 18 years old. Of 527 patients, 75.1% only had 1 type of seizure and the commonest was focal seizure (61.9%). A specific electroclinical syndrome diagnosis could be made in 27.5%. Only 2.1% had a distinctive constellation. In this cohort, 46.9% had an underlying structural, metabolic, or genetic etiology. Among the important causes were pre-/perinatal insults, malformation of cortical development, intracranial infections, and neurocutaneous syndromes. However, 23.5% of the patients in our cohort were classified as having "epilepsies of unknown cause." The revised classification scheme is generally useful for pediatric patients. To make it more inclusive and clinically meaningful, some local customizations are required.

  1. Adverse events following cervical manipulative therapy: consensus on classification among Dutch medical specialists, manual therapists, and patients.

    Science.gov (United States)

    Kranenburg, Hendrikus A; Lakke, Sandra E; Schmitt, Maarten A; Van der Schans, Cees P

    2017-12-01

    To obtain consensus-based agreement on a classification system of adverse events (AE) following cervical spinal manipulation. The classification system should be comprised of clear definitions, include patients' and clinicians' perspectives, and have an acceptable number of categories. Design : A three-round Delphi study. Participants : Thirty Dutch participants (medical specialists, manual therapists, and patients) participated in an online survey. Procedure : Participants inventoried AE and were asked about their preferences for either a three- or a four-category classification system. The identified AE were classified by two analysts following the International Classification of Functioning, Disability and Health (ICF), and the International Classification of Diseases and Related Health Problems (ICD-10). Participants were asked to classify the severity for all AE in relation to the time duration. Consensus occurred in a three-category classification system. There was strong consensus for 16 AE in all severities (no, minor, and major AE) and all three time durations [hours, days, weeks]. The 16 AE included anxiety, flushing, skin rash, fainting, dizziness, coma, altered sensation, muscle tenderness, pain, increased pain during movement, radiating pain, dislocation, fracture, transient ischemic attack, stroke, and death. Mild to strong consensus was reached for 13 AE. A consensus-based classification system of AE is established which includes patients' and clinicians' perspectives and has three categories. The classification comprises a precise description of potential AE in accordance with internationally accepted classifications. After international validation, clinicians and researchers may use this AE classification system to report AE in clinical practice and research.

  2. FAST AND ROBUST SEGMENTATION AND CLASSIFICATION FOR CHANGE DETECTION IN URBAN POINT CLOUDS

    Directory of Open Access Journals (Sweden)

    X. Roynard

    2016-06-01

    Full Text Available Change detection is an important issue in city monitoring to analyse street furniture, road works, car parking, etc. For example, parking surveys are needed but are currently a laborious task involving sending operators in the streets to identify the changes in car locations. In this paper, we propose a method that performs a fast and robust segmentation and classification of urban point clouds, that can be used for change detection. We apply this method to detect the cars, as a particular object class, in order to perform parking surveys automatically. A recently proposed method already addresses the need for fast segmentation and classification of urban point clouds, using elevation images. The interest to work on images is that processing is much faster, proven and robust. However there may be a loss of information in complex 3D cases: for example when objects are one above the other, typically a car under a tree or a pedestrian under a balcony. In this paper we propose a method that retain the three-dimensional information while preserving fast computation times and improving segmentation and classification accuracy. It is based on fast region-growing using an octree, for the segmentation, and specific descriptors with Random-Forest for the classification. Experiments have been performed on large urban point clouds acquired by Mobile Laser Scanning. They show that the method is as fast as the state of the art, and that it gives more robust results in the complex 3D cases.

  3. Establishment and application of medication error classification standards in nursing care based on the International Classification of Patient Safety

    Directory of Open Access Journals (Sweden)

    Xiao-Ping Zhu

    2014-09-01

    Conclusion: Application of this classification system will help nursing administrators to accurately detect system- and process-related defects leading to medication errors, and enable the factors to be targeted to improve the level of patient safety management.

  4. Detecting Arctic Climate Change Using Koeppen Climate Classification

    Energy Technology Data Exchange (ETDEWEB)

    Wang, M. [Joint Institute for the Study of Atmosphere and Oceans, University of Washington, Seattle, Washington (United States); Overland, J.E. [NOAA/Pacific Marine Environmental Laboratory, Sand Point Way NE, Seattle, Washington (United States)

    2004-11-01

    Ecological impacts of the recent warming trend in the Arctic are already noted as changes in tree line and a decrease in tundra area with the replacement of ground cover by shrubs in northern Alaska and several locations in northern Eurasia. The potential impact of vegetation changes to feedbacks on the atmospheric climate system is substantial because of the large land area impacted and the multi-year persistence of the vegetation cover. Satellite NDVI estimates beginning in 1981 and the Koeppen climate classification, which relates surface types to monthly mean air temperatures from 1901 onward, track these changes on an Arctic-wide basis. Temperature fields from the NCEP/NCAR reanalysis and CRU analysis serve as proxy for vegetation cover over the century. A downward trend in the coverage of tundra group for the first 40 yr of the twentieth century was followed by two increases during 1940s and early 1960s, and then a rapid decrease in the last 20 yr. The decrease of tundra group in the 1920-40 period was localized, mostly over Scandinavia; whereas the decrease since 1990 is primarily pan-Arctic, but largest in NW Canada, and eastern and coastal Siberia. The decrease in inferred tundra coverage from 1980 to 2000 was 1.4 x 106 km{sup 2}, or about a 20% reduction in tundra area based on the CRU analyses. This rate of decrease is confirmed by the NDVI data. These tundra group changes in the last 20 yr are accompanied by increase in the area of both the boreal and temperate groups. During the tundra group decrease in the first half of the century boreal group area also decreased while temperate group area increased. The calculated minimum coverage of tundra group from both the Koeppen classification and NDVI indicates that the impact of warming on the spatial coverage of the tundra group in the 1990s is the strongest in the century, and will have multi-decadal consequences for the Arctic.

  5. Testing the McSad depression specific classification system in patients with somatic conditions: validity and performance.

    Science.gov (United States)

    Papageorgiou, Katerina; Vermeulen, Karin M; Schroevers, Maya J; Buskens, Erik; Ranchor, Adelita V

    2013-07-26

    Valuations of depression are useful to evaluate depression interventions offered to patients with chronic somatic conditions. The only classification system to describe depression developed specifically for valuation purposes is the McSad, but it has not been used among somatic patients. The aim of this study was to test the construct validity of the McSad among diabetes and cancer patients and then to compare the McSad to the commonly used EuroQol - 5 Dimensions (EQ-5DTM) classification system. The comparison was expected to shed light on their capacity to reflect the range of depression states experienced by somatic patients. Cross-sectional data were collected online from 114 diabetes and 195 cancer patients; additionally, 241 cancer patients completed part of the survey on paper. Correlational analyses were performed to test the construct validity. Specifically, we hypothesized high correlations of the McSad domains with depression (Center for Epidemiological Studies Depression Scale (CES-D) and the Patient Health Questionnaire (PHQ-9)). We also expected low/moderate correlations with self-esteem (Rosenberg Self-Esteem scale - RSE) and extraversion (Eysenck Personality Questionnaire Extraversion scale - EPQ-e). Multiple linear regression analyses were run so that the proportion of variance in depression scores (CES-D, PHQ-9) explained by the McSad could be compared to the proportion explained by the EQ-5D classification system. As expected, among all patients groups, we found moderate to high correlations for the McSad domains with the CES-D (.41 to .70) and the PHQ-9 (.52 to .76); we also found low to moderate correlations with the RSE (-.21 to .-48) and the EPQ-e (.18 to .31). Linear regression analyses showed that the McSad explained a greater proportion of variance in depression (CES-D, PHQ-9) (Diabetes: 73%, 82%; Cancer: 72%, 72%) than the EQ-5D classification system (Diabetes: 47%, 59%; Cancer: 51%, 47%). Findings support the construct validity of the Mc

  6. The influence of different classification standards of age groups on prognosis in high-grade hemispheric glioma patients.

    Science.gov (United States)

    Chen, Jian-Wu; Zhou, Chang-Fu; Lin, Zhi-Xiong

    2015-09-15

    Although age is thought to correlate with the prognosis of glioma patients, the most appropriate age-group classification standard to evaluate prognosis had not been fully studied. This study aimed to investigate the influence of age-group classification standards on the prognosis of patients with high-grade hemispheric glioma (HGG). This retrospective study of 125 HGG patients used three different classification standards of age-groups (≤ 50 and >50 years old, ≤ 60 and >60 years old, ≤ 45 and 45-65 and ≥ 65 years old) to evaluate the impact of age on prognosis. The primary end-point was overall survival (OS). The Kaplan-Meier method was applied for univariate analysis and Cox proportional hazards model for multivariate analysis. Univariate analysis showed a significant correlation between OS and all three classification standards of age-groups as well as between OS and pathological grade, gender, location of glioma, and regular chemotherapy and radiotherapy treatment. Multivariate analysis showed that the only independent predictors of OS were classification standard of age-groups ≤ 50 and > 50 years old, pathological grade and regular chemotherapy. In summary, the most appropriate classification standard of age-groups as an independent prognostic factor was ≤ 50 and > 50 years old. Pathological grade and chemotherapy were also independent predictors of OS in post-operative HGG patients. Copyright © 2015. Published by Elsevier B.V.

  7. A Novel Classification Method for Syndrome Differentiation of Patients with AIDS

    Directory of Open Access Journals (Sweden)

    Yufeng Zhao

    2015-01-01

    Full Text Available We consider the analysis of an AIDS dataset where each patient is characterized by a list of symptoms and is labeled with one or more TCM syndromes. The task is to build a classifier that maps symptoms to TCM syndromes. We use the minimum reference set-based multiple instance learning (MRS-MIL method. The method identifies a list of representative symptoms for each syndrome and builds a Gaussian mixture model based on them. The models for all syndromes are then used for classification via Bayes rule. By relying on a subset of key symptoms for classification, MRS-MIL can produce reliable and high quality classification rules even on datasets with small sample size. On the AIDS dataset, it achieves average precision and recall 0.7736 and 0.7111, respectively. Those are superior to results achieved by alternative methods.

  8. New Classification of Focal Cortical Dysplasia: Application to Practical Diagnosis

    Science.gov (United States)

    Bae, Yoon-Sung; Kang, Hoon-Chul; Kim, Heung Dong; Kim, Se Hoon

    2012-01-01

    Background and Purpose: Malformation of cortical development (MCD) is a well-known cause of drug-resistant epilepsy and focal cortical dysplasia (FCD) is the most common neuropathological finding in surgical specimens from drug-resistant epilepsy patients. Palmini’s classification proposed in 2004 is now widely used to categorize FCD. Recently, however, Blumcke et al. recommended a new system for classifying FCD in 2011. Methods: We applied the new classification system in practical diagnosis of a sample of 117 patients who underwent neurosurgical operations due to drug-resistant epilepsy at Severance Hospital in Seoul, Korea. Results: Among 117 cases, a total of 16 cases were shifted to other FCD subtypes under the new classification system. Five cases were reclassified to type IIIa and five cases were categorized as dual pathology. The other six cases were changed within the type I category. Conclusions: The most remarkable changes in the new classification system are the advent of dual pathology and FCD type III. Thus, it will be very important for pathologists and clinicians to discriminate between these new categories. More large-scale research needs to be conducted to elucidate the clinical influence of the alterations within the classification of type I disease. Although the new FCD classification system has several advantages compared to the former, the correlation with clinical characteristics is not yet clear. PMID:24649461

  9. Classification of Alzheimer’s Patients through Ubiquitous Computing

    Directory of Open Access Journals (Sweden)

    Alicia Nieto-Reyes

    2017-07-01

    Full Text Available Functional data analysis and artificial neural networks are the building blocks of the proposed methodology that distinguishes the movement patterns among c’s patients on different stages of the disease and classifies new patients to their appropriate stage of the disease. The movement patterns are obtained by the accelerometer device of android smartphones that the patients carry while moving freely. The proposed methodology is relevant in that it is flexible on the type of data to which it is applied. To exemplify that, it is analyzed a novel real three-dimensional functional dataset where each datum is observed in a different time domain. Not only is it observed on a difference frequency but also the domain of each datum has different length. The obtained classification success rate of 83 % indicates the potential of the proposed methodology.

  10. Automated classification of eligibility criteria in clinical trials to facilitate patient-trial matching for specific patient populations.

    Science.gov (United States)

    Zhang, Kevin; Demner-Fushman, Dina

    2017-07-01

    To develop automated classification methods for eligibility criteria in ClinicalTrials.gov to facilitate patient-trial matching for specific populations such as persons living with HIV or pregnant women. We annotated 891 interventional cancer trials from ClinicalTrials.gov based on their eligibility for human immunodeficiency virus (HIV)-positive patients using their eligibility criteria. These annotations were used to develop classifiers based on regular expressions and machine learning (ML). After evaluating classification of cancer trials for eligibility of HIV-positive patients, we sought to evaluate the generalizability of our approach to more general diseases and conditions. We annotated the eligibility criteria for 1570 of the most recent interventional trials from ClinicalTrials.gov for HIV-positive and pregnancy eligibility, and the classifiers were retrained and reevaluated using these data. On the cancer-HIV dataset, the baseline regex model, the bag-of-words ML classifier, and the ML classifier with named entity recognition (NER) achieved macro-averaged F2 scores of 0.77, 0.87, and 0.87, respectively; the addition of NER did not result in a significant performance improvement. On the general dataset, ML + NER achieved macro-averaged F2 scores of 0.91 and 0.85 for HIV and pregnancy, respectively. The eligibility status of specific patient populations, such as persons living with HIV and pregnant women, for clinical trials is of interest to both patients and clinicians. We show that it is feasible to develop a high-performing, automated trial classification system for eligibility status that can be integrated into consumer-facing search engines as well as patient-trial matching systems. Published by Oxford University Press on behalf of the American Medical Informatics Association 2017. This work is written by US Government employees and is in the public domain in the US.

  11. Etiologic classification of TIA and minor stroke by A-S-C-O and causative classification system as compared to TOAST reduces the proportion of patients categorized as cause undetermined.

    Science.gov (United States)

    Desai, Jamsheed A; Abuzinadah, Ahmad R; Imoukhuede, Oje; Bernbaum, Manya L; Modi, Jayesh; Demchuk, Andrew M; Coutts, Shelagh B

    2014-01-01

    The assortment of patients based on the underlying pathophysiology is central to preventing recurrent stroke after a transient ischemic attack and minor stroke (TIA-MS). The causative classification of stroke (CCS) and the A-S-C-O (A for atherosclerosis, S for small vessel disease, C for Cardiac source, O for other cause) classification schemes have recently been developed. These systems have not been specifically applied to the TIA-MS population. We hypothesized that both CCS and A-S-C-O would increase the proportion of patients with a definitive etiologic mechanism for TIA-MS as compared with TOAST. Patients were analyzed from the CATCH study. A single-stroke physician assigned all patients to an etiologic subtype using published algorithms for TOAST, CCS and ASCO. We compared the proportions in the various categories for each classification scheme and then the association with stroke progression or recurrence was assessed. TOAST, CCS and A-S-C-O classification schemes were applied in 469 TIA-MS patients. When compared to TOAST both CCS (58.0 vs. 65.3%; p TIA and minor stroke patients classified as 'cause undetermined.' ASCO resulted in the fewest patients classified as cause undetermined. Stroke recurrence after TIA-MS is highest in patients with multiple high-risk etiologies or cryptogenic stroke classified by ASCO. © 2014 S. Karger AG, Basel.

  12. A proposal for a pharmacokinetic interaction significance classification system (PISCS) based on predicted drug exposure changes and its potential application to alert classifications in product labelling.

    Science.gov (United States)

    Hisaka, Akihiro; Kusama, Makiko; Ohno, Yoshiyuki; Sugiyama, Yuichi; Suzuki, Hiroshi

    2009-01-01

    Pharmacokinetic drug-drug interactions (DDIs) are one of the major causes of adverse events in pharmacotherapy, and systematic prediction of the clinical relevance of DDIs is an issue of significant clinical importance. In a previous study, total exposure changes of many substrate drugs of cytochrome P450 (CYP) 3A4 caused by coadministration of inhibitor drugs were successfully predicted by using in vivo information. In order to exploit these predictions in daily pharmacotherapy, the clinical significance of the pharmacokinetic changes needs to be carefully evaluated. The aim of the present study was to construct a pharmacokinetic interaction significance classification system (PISCS) in which the clinical significance of DDIs was considered with pharmacokinetic changes in a systematic manner. Furthermore, the classifications proposed by PISCS were compared in a detailed manner with current alert classifications in the product labelling or the summary of product characteristics used in Japan, the US and the UK. A matrix table was composed by stratifying two basic parameters of the prediction: the contribution ratio of CYP3A4 to the oral clearance of substrates (CR), and the inhibition ratio of inhibitors (IR). The total exposure increase was estimated for each cell in the table by associating CR and IR values, and the cells were categorized into nine zones according to the magnitude of the exposure increase. Then, correspondences between the DDI significance and the zones were determined for each drug group considering the observed exposure changes and the current classification in the product labelling. Substrate drugs of CYP3A4 selected from three therapeutic groups, i.e. HMG-CoA reductase inhibitors (statins), calcium-channel antagonists/blockers (CCBs) and benzodiazepines (BZPs), were analysed as representative examples. The product labelling descriptions of drugs in Japan, US and UK were obtained from the websites of each regulatory body. Among 220

  13. Efficacy of the Kyoto Classification of Gastritis in Identifying Patients at High Risk for Gastric Cancer.

    Science.gov (United States)

    Sugimoto, Mitsushige; Ban, Hiromitsu; Ichikawa, Hitomi; Sahara, Shu; Otsuka, Taketo; Inatomi, Osamu; Bamba, Shigeki; Furuta, Takahisa; Andoh, Akira

    2017-01-01

    Objective The Kyoto gastritis classification categorizes the endoscopic characteristics of Helicobacter pylori (H. pylori) infection-associated gastritis and identifies patterns associated with a high risk of gastric cancer. We investigated its efficacy, comparing scores in patients with H. pylori-associated gastritis and with gastric cancer. Methods A total of 1,200 patients with H. pylori-positive gastritis alone (n=932), early-stage H. pylori-positive gastric cancer (n=189), and successfully treated H. pylori-negative cancer (n=79) were endoscopically graded according to the Kyoto gastritis classification for atrophy, intestinal metaplasia, fold hypertrophy, nodularity, and diffuse redness. Results The prevalence of O-II/O-III-type atrophy according to the Kimura-Takemoto classification in early-stage H. pylori-positive gastric cancer and successfully treated H. pylori-negative cancer groups was 45.1%, which was significantly higher than in subjects with gastritis alone (12.7%, pgastritis scores of atrophy and intestinal metaplasia in the H. pylori-positive cancer group were significantly higher than in subjects with gastritis alone (all pgastritis classification may thus be useful for detecting these patients.

  14. A classification tree for the prediction of benign versus malignant disease in patients with small renal masses.

    Science.gov (United States)

    Rendon, Ricardo A; Mason, Ross J; Kirkland, Susan; Lawen, Joseph G; Abdolell, Mohamed

    2014-08-01

    To develop a classification tree for the preoperative prediction of benign versus malignant disease in patients with small renal masses. This is a retrospective study including 395 consecutive patients who underwent surgical treatment for a renal mass classification tree to predict the risk of having a benign renal mass preoperatively was developed using recursive partitioning analysis for repeated measures outcomes. Age, sex, volume on preoperative imaging, tumor location (central/peripheral), degree of endophytic component (1%-100%), and tumor axis position were used as potential predictors to develop the model. Forty-five patients (11.4%) were found to have a benign mass postoperatively. A classification tree has been developed which can predict the risk of benign disease with an accuracy of 88.9% (95% CI: 85.3 to 91.8). The significant prognostic factors in the classification tree are tumor volume, degree of endophytic component and symptoms at diagnosis. As an example of its utilization, a renal mass with a volume of classification tree to predict the risk of benign disease in small renal masses has been developed to aid the clinician when deciding on treatment strategies for small renal masses.

  15. Classification of patients seen at a hemodynamics unit according to the degree of dependence on nursing care

    OpenAIRE

    Hammermüller, Aline; Rabelo, Eneida Rejane; Goldmeier, Sílvia; Azzolin, Karina de Oliveira

    2008-01-01

    OBJECTIVE: To classify patients in a hemodynamics healthcare unit, according to the degree of dependence on nursing care. METHODS: Cross-sectional study performed in June/2005 at the Hemodynamics unit of a university hospital. Data were collected during the first hour post-procedure, using Perroca's instrument of patient classification. RESULTS: Among 164 patients, 52% were female, aged 60 ± 14.8 years. The average score of classification was 31.9 ± 4.8, rated as intermediate. As for instrume...

  16. Disability and Functional Profiles of Patients with Myasthenia Gravis Measured with ICF Classification

    Science.gov (United States)

    Leonardi, Matilde; Raggi, Alberto; Antozzi, Carlo; Confalonieri, Paolo; Maggi, Lorenzo; Cornelio, Ferdinando; Mantegazza, Renato

    2009-01-01

    The objective of this study is to describe functional profiles of patients with myasthenia gravis (MG), and the relationships among symptoms, activities and environmental factors (EF), by using WHO's International Classification of Functioning Disability and Health (ICF). Patients were consecutively enrolled at the Besta Institute of Milan, Italy.…

  17. Diagnosis-related groups for stroke in Europe: patient classification and hospital reimbursement in 11 countries.

    Science.gov (United States)

    Peltola, Mikko; Quentin, Wilm

    2013-01-01

    Diagnosis-related groups (DRGs) are increasingly being used for various purposes in many countries. However, there are no studies comparing different DRG systems in the care of stroke. As part of the EuroDRG project, researchers from 11 countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, the Netherlands, Poland, Sweden and Spain) compared how their DRG systems deal with stroke patients. The study aims to assist clinicians and national authorities to optimize their DRG systems. National or regional databases were used to identify hospital cases with a diagnosis of stroke. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that individually represent at least 1% of stroke cases. In addition, standardized case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained. European DRG systems vary widely: they classify stroke patients according to different sets of variables (between 1 and 7 classification variables) into diverging numbers of DRGs (between 1 and 10 DRGs). In 6 of the countries more than half of the patients are concentrated within a single DRG. The countries' systems also vary with respect to the evaluation of different kinds of stroke patients. The most complex DRG is considered 3.8 times more resource intensive than an index case in Finland. By contrast, in England, the DRG system does not account for complex cases. Comparisons of quasi prices for the case vignettes show that hypothetical payments for the index case amount to only EUR 907 in Poland but to EUR 7,881 in Ireland. Large variations in the classification of stroke patients raise concerns whether all systems rely on the most appropriate classification variables and whether the DRGs adequately reflect differences in the complexity of treating different groups of patients. Learning from other DRG systems may help in improving the national systems. Clinicians and

  18. Metastatic Medulloblastoma in Childhood: Chang's Classification Revisited

    Directory of Open Access Journals (Sweden)

    Christelle Dufour

    2012-01-01

    Patients and Methods. This population-based study concerned 117 newly diagnosed children with disseminated medulloblastoma treated at the Institute Gustave Roussy between 1988 and 2008. Metastatic disease was assessed using the Chang staging system, their form (positive cerebrospinal fluid (CSF, nodular or laminar, and their extension (positive cerebrospinal fluid, local, extensive. All patients received preirradiation chemotherapy. Results. The overall survival did not differ according to Chang M-stage. The 5-year overall survival was 59% in patients with nodular metastases compared to 35% in those with laminar metastases. The 5-year overall survival was 76% in patients without disease at the end of pre-irradiation chemotherapy compared to 34% in those without a complete response (P=0.0008. Conclusions. Radiological characteristics of metastases correlated with survival in patients with medulloblastoma. Complete response to sandwich chemotherapy was a strong predictor of survival.

  19. Automatic classification of patients with idiopathic Parkinson's disease and progressive supranuclear palsy using diffusion MRI datasets

    Science.gov (United States)

    Talai, Sahand; Boelmans, Kai; Sedlacik, Jan; Forkert, Nils D.

    2017-03-01

    Parkinsonian syndromes encompass a spectrum of neurodegenerative diseases, which can be classified into various subtypes. The differentiation of these subtypes is typically conducted based on clinical criteria. Due to the overlap of intra-syndrome symptoms, the accurate differential diagnosis based on clinical guidelines remains a challenge with failure rates up to 25%. The aim of this study is to present an image-based classification method of patients with Parkinson's disease (PD) and patients with progressive supranuclear palsy (PSP), an atypical variant of PD. Therefore, apparent diffusion coefficient (ADC) parameter maps were calculated based on diffusion-tensor magnetic resonance imaging (MRI) datasets. Mean ADC values were determined in 82 brain regions using an atlas-based approach. The extracted mean ADC values for each patient were then used as features for classification using a linear kernel support vector machine classifier. To increase the classification accuracy, a feature selection was performed, which resulted in the top 17 attributes to be used as the final input features. A leave-one-out cross validation based on 56 PD and 21 PSP subjects revealed that the proposed method is capable of differentiating PD and PSP patients with an accuracy of 94.8%. In conclusion, the classification of PD and PSP patients based on ADC features obtained from diffusion MRI datasets is a promising new approach for the differentiation of Parkinsonian syndromes in the broader context of decision support systems.

  20. Changes in perfusion scintigraphy in the first days of heparin therapy in patients with acute pulmonary embolism

    NARCIS (Netherlands)

    de Groot, M. R.; Oostdijk, A. H.; Engelage, A. H.; van Marwijk Kooy, M.; Büller, H. R.

    2000-01-01

    Patients with suspected pulmonary embolism often receive heparin therapy for hours to days before ventilation/perfusion scintigraphy is completed. We assessed to what extent the lung scan classification and pulmonary vascular perfusion changed over a period of 2-4 days of full anticoagulant therapy.

  1. Comparison of pixel -based and artificial neural networks classification methods for detecting forest cover changes in Malaysia

    International Nuclear Information System (INIS)

    Deilmai, B R; Rasib, A W; Ariffin, A; Kanniah, K D

    2014-01-01

    According to the FAO (Food and Agriculture Organization), Malaysia lost 8.6% of its forest cover between 1990 and 2005. In forest cover change detection, remote sensing plays an important role. A lot of change detection methods have been developed, and most of them are semi-automated. These methods are time consuming and difficult to apply. One of the new and robust methods for change detection is artificial neural network (ANN). In this study, (ANN) classification scheme is used to detect the forest cover changes in the Johor state in Malaysia. Landsat Thematic Mapper images covering a period of 9 years (2000 and 2009) are used. Results obtained with ANN technique was compared with Maximum likelihood classification (MLC) to investigate whether ANN can perform better in the tropical environment. Overall accuracy of the ANN and MLC techniques are 75%, 68% (2000) and 80%, 75% (2009) respectively. Using the ANN method, it was found that forest area in Johor decreased as much as 1298 km2 between 2000 and 2009. The results also showed the potential and advantages of neural network in classification and change detection analysis

  2. The 2015 World Health Organization Classification of Lung Tumors: Impact of Genetic, Clinical and Radiologic Advances Since the 2004 Classification.

    Science.gov (United States)

    Travis, William D; Brambilla, Elisabeth; Nicholson, Andrew G; Yatabe, Yasushi; Austin, John H M; Beasley, Mary Beth; Chirieac, Lucian R; Dacic, Sanja; Duhig, Edwina; Flieder, Douglas B; Geisinger, Kim; Hirsch, Fred R; Ishikawa, Yuichi; Kerr, Keith M; Noguchi, Masayuki; Pelosi, Giuseppe; Powell, Charles A; Tsao, Ming Sound; Wistuba, Ignacio

    2015-09-01

    The 2015 World Health Organization (WHO) Classification of Tumors of the Lung, Pleura, Thymus and Heart has just been published with numerous important changes from the 2004 WHO classification. The most significant changes in this edition involve (1) use of immunohistochemistry throughout the classification, (2) a new emphasis on genetic studies, in particular, integration of molecular testing to help personalize treatment strategies for advanced lung cancer patients, (3) a new classification for small biopsies and cytology similar to that proposed in the 2011 Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification, (4) a completely different approach to lung adenocarcinoma as proposed by the 2011 Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification, (5) restricting the diagnosis of large cell carcinoma only to resected tumors that lack any clear morphologic or immunohistochemical differentiation with reclassification of the remaining former large cell carcinoma subtypes into different categories, (6) reclassifying squamous cell carcinomas into keratinizing, nonkeratinizing, and basaloid subtypes with the nonkeratinizing tumors requiring immunohistochemistry proof of squamous differentiation, (7) grouping of neuroendocrine tumors together in one category, (8) adding NUT carcinoma, (9) changing the term sclerosing hemangioma to sclerosing pneumocytoma, (10) changing the name hamartoma to "pulmonary hamartoma," (11) creating a group of PEComatous tumors that include (a) lymphangioleiomyomatosis, (b) PEComa, benign (with clear cell tumor as a variant) and (c) PEComa, malignant, (12) introducing the entity pulmonary myxoid sarcoma with an EWSR1-CREB1 translocation, (13) adding the entities myoepithelioma and myoepithelial carcinomas, which can show EWSR1 gene rearrangements, (14) recognition of usefulness of WWTR1-CAMTA1 fusions in diagnosis of epithelioid

  3. The Groningen Laryngomalacia Classification System-Based on Systematic Review and Dynamic Airway Changes

    NARCIS (Netherlands)

    van der Heijden, Martijn; Dikkers, Frederik G.; Halmos, Gyorgy B.

    2015-01-01

    Objective: Laryngomalacia is the most common cause of dyspnea and stridor in newborn infants. Laryngomalacia is a dynamic change of the upper airway based on abnormally pliable supraglottic structures, which causes upper airway obstruction. In the past, different classification systems have been

  4. ILAE Classification of the Epilepsies Position Paper of the ILAE Commission for Classification and Terminology

    Science.gov (United States)

    Scheffer, Ingrid E; Berkovic, Samuel; Capovilla, Giuseppe; Connolly, Mary B; French, Jacqueline; Guilhoto, Laura; Hirsch, Edouard; Jain, Satish; Mathern, Gary W.; Moshé, Solomon L; Nordli, Douglas R; Perucca, Emilio; Tomson, Torbjörn; Wiebe, Samuel; Zhang, Yue-Hua; Zuberi, Sameer M

    2017-01-01

    Summary The ILAE Classification of the Epilepsies has been updated to reflect our gain in understanding of the epilepsies and their underlying mechanisms following the major scientific advances which have taken place since the last ratified classification in 1989. As a critical tool for the practising clinician, epilepsy classification must be relevant and dynamic to changes in thinking, yet robust and translatable to all areas of the globe. Its primary purpose is for diagnosis of patients, but it is also critical for epilepsy research, development of antiepileptic therapies and communication around the world. The new classification originates from a draft document submitted for public comments in 2013 which was revised to incorporate extensive feedback from the international epilepsy community over several rounds of consultation. It presents three levels, starting with seizure type where it assumes that the patient is having epileptic seizures as defined by the new 2017 ILAE Seizure Classification. After diagnosis of the seizure type, the next step is diagnosis of epilepsy type, including focal epilepsy, generalized epilepsy, combined generalized and focal epilepsy, and also an unknown epilepsy group. The third level is that of epilepsy syndrome where a specific syndromic diagnosis can be made. The new classification incorporates etiology along each stage, emphasizing the need to consider etiology at each step of diagnosis as it often carries significant treatment implications. Etiology is broken into six subgroups, selected because of their potential therapeutic consequences. New terminology is introduced such as developmental and epileptic encephalopathy. The term benign is replaced by the terms self-limited and pharmacoresponsive, to be used where appropriate. It is hoped that this new framework will assist in improving epilepsy care and research in the 21st century. PMID:28276062

  5. Recursive Partitioning Analysis for New Classification of Patients With Esophageal Cancer Treated by Chemoradiotherapy

    International Nuclear Information System (INIS)

    Nomura, Motoo; Shitara, Kohei; Kodaira, Takeshi; Kondoh, Chihiro; Takahari, Daisuke; Ura, Takashi; Kojima, Hiroyuki; Kamata, Minoru; Muro, Kei; Sawada, Satoshi

    2012-01-01

    Background: The 7th edition of the American Joint Committee on Cancer staging system does not include lymph node size in the guidelines for staging patients with esophageal cancer. The objectives of this study were to determine the prognostic impact of the maximum metastatic lymph node diameter (ND) on survival and to develop and validate a new staging system for patients with esophageal squamous cell cancer who were treated with definitive chemoradiotherapy (CRT). Methods: Information on 402 patients with esophageal cancer undergoing CRT at two institutions was reviewed. Univariate and multivariate analyses of data from one institution were used to assess the impact of clinical factors on survival, and recursive partitioning analysis was performed to develop the new staging classification. To assess its clinical utility, the new classification was validated using data from the second institution. Results: By multivariate analysis, gender, T, N, and ND stages were independently and significantly associated with survival (p < 0.05). The resulting new staging classification was based on the T and ND. The four new stages led to good separation of survival curves in both the developmental and validation datasets (p < 0.05). Conclusions: Our results showed that lymph node size is a strong independent prognostic factor and that the new staging system, which incorporated lymph node size, provided good prognostic power, and discriminated effectively for patients with esophageal cancer undergoing CRT.

  6. MO-DE-207B-03: Improved Cancer Classification Using Patient-Specific Biological Pathway Information Via Gene Expression Data

    Energy Technology Data Exchange (ETDEWEB)

    Young, M; Craft, D [Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States)

    2016-06-15

    Purpose: To develop an efficient, pathway-based classification system using network biology statistics to assist in patient-specific response predictions to radiation and drug therapies across multiple cancer types. Methods: We developed PICS (Pathway Informed Classification System), a novel two-step cancer classification algorithm. In PICS, a matrix m of mRNA expression values for a patient cohort is collapsed into a matrix p of biological pathways. The entries of p, which we term pathway scores, are obtained from either principal component analysis (PCA), normal tissue centroid (NTC), or gene expression deviation (GED). The pathway score matrix is clustered using both k-means and hierarchical clustering, and a clustering is judged by how well it groups patients into distinct survival classes. The most effective pathway scoring/clustering combination, per clustering p-value, thus generates various ‘signatures’ for conventional and functional cancer classification. Results: PICS successfully regularized large dimension gene data, separated normal and cancerous tissues, and clustered a large patient cohort spanning six cancer types. Furthermore, PICS clustered patient cohorts into distinct, statistically-significant survival groups. For a suboptimally-debulked ovarian cancer set, the pathway-classified Kaplan-Meier survival curve (p = .00127) showed significant improvement over that of a prior gene expression-classified study (p = .0179). For a pancreatic cancer set, the pathway-classified Kaplan-Meier survival curve (p = .00141) showed significant improvement over that of a prior gene expression-classified study (p = .04). Pathway-based classification confirmed biomarkers for the pyrimidine, WNT-signaling, glycerophosphoglycerol, beta-alanine, and panthothenic acid pathways for ovarian cancer. Despite its robust nature, PICS requires significantly less run time than current pathway scoring methods. Conclusion: This work validates the PICS method to improve

  7. A comparison of perceived and calculated weight status classification congruence between pre- and post-bariatric surgery patients.

    Science.gov (United States)

    Ferriby, Megan; Pratt, Keeley; Noria, Sabrena; Needleman, Bradley

    2017-08-01

    One prominent reason patients undergo bariatric surgery is to reduce their excess weight and body mass index. Weight status classifications (WSCs), based on calculated body mass index, organize patients into distinct groups (underweight, healthy weight, overweight, class I obesity, class II obesity, and class III obesity) for treatment recommendations, including surgery for patients with obesity. Bariatric patients' perceptions of their WSC is important to consider, because patients who accurately perceive their WSC presurgery have greater motivation for health behavior changes; alternatively, incongruence between perceived and calculated WSC could deter motivation and ultimately their health changes postsurgery. This study seeks to understand the congruence between patients' perceived and calculated WSC, and to determine if there are differences in congruence between groups of pre- or postsurgery, male and female, and emerging/early adulthood and middle/late adulthood patients. University Hospital. Self-report measures. Results indicate the presurgery patients were more congruent in their perceptions of WSC compared with their postsurgery peers and emerging/early adulthood patients were more congruent in their perceptions of WSC compared with middle/late adulthood patients. No gender differences emerged in the full sample, but when divided by surgical status, presurgery females reported more congruent perceptions of WSC compared with their postsurgery peers. Males did not differ in their rates of congruence. These rates of incongruence may suggest a need for assessment of patients' perceived WSC, particularly postsurgery. Published by Elsevier Inc.

  8. Appendectomy and diagnosis-related groups (DRGs): patient classification and hospital reimbursement in 11 European countries.

    Science.gov (United States)

    Quentin, Wilm; Scheller-Kreinsen, David; Geissler, Alexander; Busse, Reinhard

    2012-02-01

    As part of the EuroDRG project, researchers from 11 countries (i.e., Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain) compared how their diagnosis-related groups (DRG) systems deal with appendectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. National or regional databases were used to identify hospital cases with a diagnosis of appendicitis treated with a procedure of appendectomy. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that together comprised at least 97% of cases. Six standardized case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained. European DRG systems vary widely: they classify appendectomy patients according to different sets of variables (between two and six classification variables) into diverging numbers of DRGs (between two and 11 DRGs). The most complex DRG is valued 5.1 times more resource intensive than an index case in France but only 1.1 times more resource intensive than an index case in Finland. Comparisons of quasi prices for the case vignettes show that hypothetical payments for the most complex case vignette amount to only 1,005 in Poland but to 12,304 in France. Large variations in the classification of appendectomy patients raise concerns whether all systems rely on the most appropriate classification variables. Surgeons and national DRG authorities should consider how other countries' DRG systems classify appendectomy patients in order to optimize their DRG system and to ensure fair and appropriate reimbursement.

  9. Classification of breast cancer patients using somatic mutation profiles and machine learning approaches.

    Science.gov (United States)

    Vural, Suleyman; Wang, Xiaosheng; Guda, Chittibabu

    2016-08-26

    The high degree of heterogeneity observed in breast cancers makes it very difficult to classify the cancer patients into distinct clinical subgroups and consequently limits the ability to devise effective therapeutic strategies. Several classification strategies based on ER/PR/HER2 expression or the expression profiles of a panel of genes have helped, but such methods often produce misleading results due to their dynamic nature. In contrast, somatic DNA mutations are relatively stable and lead to initiation and progression of many sporadic cancers. Hence in this study, we explore the use of gene mutation profiles to classify, characterize and predict the subgroups of breast cancers. We analyzed the whole exome sequencing data from 358 ethnically similar breast cancer patients in The Cancer Genome Atlas (TCGA) project. Somatic and non-synonymous single nucleotide variants identified from each patient were assigned a quantitative score (C-score) that represents the extent of negative impact on the gene function. Using these scores with non-negative matrix factorization method, we clustered the patients into three subgroups. By comparing the clinical stage of patients, we identified an early-stage-enriched and a late-stage-enriched subgroup. Comparison of the mutation scores of early and late-stage-enriched subgroups identified 358 genes that carry significantly higher mutations rates in the late stage subgroup. Functional characterization of these genes revealed important functional gene families that carry a heavy mutational load in the late state rich subgroup of patients. Finally, using the identified subgroups, we also developed a supervised classification model to predict the stage of the patients. This study demonstrates that gene mutation profiles can be effectively used with unsupervised machine-learning methods to identify clinically distinguishable breast cancer subgroups. The classification model developed in this method could provide a reasonable

  10. Classification of transient processes with a jumplike change in the reactivity

    International Nuclear Information System (INIS)

    Sabaeva, T.A.

    1989-01-01

    The problem of the change in the neutron flux density accompanying a jumplike (instantaneous) change in the reactivity is classical and is studied in most textbooks and monographs devoted to the regulation of nuclear reactors, where in constructing the response only the feedback on delayed neutrons is taken into account. The use of a linear feedback of a general form permits describing reactors of different types. A classification of feedbacks on reactivity was presented by Sabaeva, where a parabolic region in phase space is separated. A peak in the neutron flux corresponds to the image point falling into this region. In this paper the conditions making it possible to find the change in the neutrons flux immediately after an instantaneous change in the reactivity are derived, and the feedbacks are classified based on this

  11. Applying the WHO conceptual framework for the International Classification for Patient Safety to a surgical population.

    Science.gov (United States)

    McElroy, L M; Woods, D M; Yanes, A F; Skaro, A I; Daud, A; Curtis, T; Wymore, E; Holl, J L; Abecassis, M M; Ladner, D P

    2016-04-01

    Efforts to improve patient safety are challenged by the lack of universally agreed upon terms. The International Classification for Patient Safety (ICPS) was developed by the World Health Organization for this purpose. This study aimed to test the applicability of the ICPS to a surgical population. A web-based safety debriefing was sent to clinicians involved in surgical care of abdominal organ transplant patients. A multidisciplinary team of patient safety experts, surgeons and researchers used the data to develop a system of classification based on the ICPS. Disagreements were reconciled via consensus, and a codebook was developed for future use by researchers. A total of 320 debriefing responses were used for the initial review and codebook development. In total, the 320 debriefing responses contained 227 patient safety incidents (range: 0-7 per debriefing) and 156 contributing factors/hazards (0-5 per response). The most common severity classification was 'reportable circumstance,' followed by 'near miss.' The most common incident types were 'resources/organizational management,' followed by 'medical device/equipment.' Several aspects of surgical care were encompassed by more than one classification, including operating room scheduling, delays in care, trainee-related incidents, interruptions and handoffs. This study demonstrates that a framework for patient safety can be applied to facilitate the organization and analysis of surgical safety data. Several unique aspects of surgical care require consideration, and by using a standardized framework for describing concepts, research findings can be compared and disseminated across surgical specialties. The codebook is intended for use as a framework for other specialties and institutions. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  12. Classification of Alzheimer’s Patients through Ubiquitous Computing †

    Science.gov (United States)

    Nieto-Reyes, Alicia; Duque, Rafael; Montaña, José Luis; Lage, Carmen

    2017-01-01

    Functional data analysis and artificial neural networks are the building blocks of the proposed methodology that distinguishes the movement patterns among c’s patients on different stages of the disease and classifies new patients to their appropriate stage of the disease. The movement patterns are obtained by the accelerometer device of android smartphones that the patients carry while moving freely. The proposed methodology is relevant in that it is flexible on the type of data to which it is applied. To exemplify that, it is analyzed a novel real three-dimensional functional dataset where each datum is observed in a different time domain. Not only is it observed on a difference frequency but also the domain of each datum has different length. The obtained classification success rate of 83% indicates the potential of the proposed methodology. PMID:28753975

  13. A classification of the mechanisms producing pathological tissue changes.

    Science.gov (United States)

    Grippo, John O; Oh, Daniel S

    2013-05-01

    The objectives are to present a classification of mechanisms which can produce pathological changes in body tissues and fluids, as well as to clarify and define the term biocorrosion, which has had a singular use in engineering. Considering the emerging field of biomedical engineering, it is essential to use precise definitions in the lexicons of engineering, bioengineering and related sciences such as medicine, dentistry and veterinary medicine. The mechanisms of stress, friction and biocorrosion and their pathological effects on tissues are described. Biocorrosion refers to the chemical, biochemical and electrochemical changes by degradation or induced growth of living body tissues and fluids. Various agents which can affect living tissues causing biocorrosion are enumerated which support the necessity and justify the use of this encompassing and more precise definition of biocorrosion. A distinction is made between the mechanisms of corrosion and biocorrosion.

  14. Object-based land cover classification and change analysis in the Baltimore metropolitan area using multitemporal high resolution remote sensing data

    Science.gov (United States)

    Weiqi Zhou; Austin Troy; Morgan Grove

    2008-01-01

    Accurate and timely information about land cover pattern and change in urban areas is crucial for urban land management decision-making, ecosystem monitoring and urban planning. This paper presents the methods and results of an object-based classification and post-classification change detection of multitemporal high-spatial resolution Emerge aerial imagery in the...

  15. Patient characteristics in low back pain subgroups based on an existing classification system. A descriptive cohort study in chiropractic practice

    DEFF Research Database (Denmark)

    Eirikstoft, Heidi; Kongsted, Alice

    2014-01-01

    reducible disc syndromes followed by facet joint pain, dysfunction and sacroiliac (SI)-joint pain. Classification was inconclusive in 5% of the patients. Differences in pain, activity limitation, and psychological factors were small across subgroups. Within 10 days, 82% were reported to belong to the same......Sub-grouping of low back pain (LBP) is believed to improve prediction of prognosis and treatment effects. The objectives of this study were: (1) to examine whether chiropractic patients could be sub-grouped according to an existing pathoanatomically-based classification system, (2) to describe...... patient characteristics within each subgroup, and (3) to determine the proportion of patients in whom clinicians considered the classification to be unchanged after approximately 10 days. A cohort of 923 LBP patients was included during their first consultation. Patients completed an extensive...

  16. Study on Classification Accuracy Inspection of Land Cover Data Aided by Automatic Image Change Detection Technology

    Science.gov (United States)

    Xie, W.-J.; Zhang, L.; Chen, H.-P.; Zhou, J.; Mao, W.-J.

    2018-04-01

    The purpose of carrying out national geographic conditions monitoring is to obtain information of surface changes caused by human social and economic activities, so that the geographic information can be used to offer better services for the government, enterprise and public. Land cover data contains detailed geographic conditions information, thus has been listed as one of the important achievements in the national geographic conditions monitoring project. At present, the main issue of the production of the land cover data is about how to improve the classification accuracy. For the land cover data quality inspection and acceptance, classification accuracy is also an important check point. So far, the classification accuracy inspection is mainly based on human-computer interaction or manual inspection in the project, which are time consuming and laborious. By harnessing the automatic high-resolution remote sensing image change detection technology based on the ERDAS IMAGINE platform, this paper carried out the classification accuracy inspection test of land cover data in the project, and presented a corresponding technical route, which includes data pre-processing, change detection, result output and information extraction. The result of the quality inspection test shows the effectiveness of the technical route, which can meet the inspection needs for the two typical errors, that is, missing and incorrect update error, and effectively reduces the work intensity of human-computer interaction inspection for quality inspectors, and also provides a technical reference for the data production and quality control of the land cover data.

  17. A new classification of post-sternotomy dehiscence

    Science.gov (United States)

    Anger, Jaime; Dantas, Daniel Chagas; Arnoni, Renato Tambellini; Farsky, Pedro Sílvio

    2015-01-01

    The dehiscence after median transesternal sternotomy used as surgical access for cardiac surgery is one of its complications and it increases the patient's morbidity and mortality. A variety of surgical techniques were recently described resulting to the need of a classification bringing a measure of objectivity to the management of these complex and dangerous wounds. The different related classifications are based in the primary causal infection, but recently the anatomical description of the wound including the deepness and the vertical extension showed to be more useful. We propose a new classification based only on the anatomical changes following sternotomy dehiscence and chronic wound formation separating it in four types according to the deepness and in two sub-groups according to the vertical extension based on the inferior insertion of the pectoralis major muscle. PMID:25859875

  18. Is overall similarity classification less effortful than single-dimension classification?

    Science.gov (United States)

    Wills, Andy J; Milton, Fraser; Longmore, Christopher A; Hester, Sarah; Robinson, Jo

    2013-01-01

    It is sometimes argued that the implementation of an overall similarity classification is less effortful than the implementation of a single-dimension classification. In the current article, we argue that the evidence securely in support of this view is limited, and report additional evidence in support of the opposite proposition--overall similarity classification is more effortful than single-dimension classification. Using a match-to-standards procedure, Experiments 1A, 1B and 2 demonstrate that concurrent load reduces the prevalence of overall similarity classification, and that this effect is robust to changes in the concurrent load task employed, the level of time pressure experienced, and the short-term memory requirements of the classification task. Experiment 3 demonstrates that participants who produced overall similarity classifications from the outset have larger working memory capacities than those who produced single-dimension classifications initially, and Experiment 4 demonstrates that instructions to respond meticulously increase the prevalence of overall similarity classification.

  19. Breathing (and Coding?) a Bit Easier: Changes to International Classification of Disease Coding for Pulmonary Hypertension.

    Science.gov (United States)

    Mathai, Stephen C; Mathew, Sherin

    2018-04-20

    International Classification of Disease (ICD) coding system is broadly utilized by healthcare providers, hospitals, healthcare payers, and governments to track health trends and statistics at the global, national, and local levels and to provide a reimbursement framework for medical care based upon diagnosis and severity of illness. The current iteration of the ICD system, ICD-10, was implemented in 2015. While many changes to the prior ICD-9 system were included in the ICD-10 system, the newer revision failed to adequately reflect advances in the clinical classification of certain diseases such as pulmonary hypertension (PH). Recently, a proposal to modify the ICD-10 codes for PH was considered and ultimately adopted for inclusion as updates to ICD-10 coding system. While these revisions better reflect the current clinical classification of PH, in the future, further changes should be considered to improve the accuracy and ease of coding for all forms of PH. Copyright © 2018. Published by Elsevier Inc.

  20. Differential Classification of Dementia

    Directory of Open Access Journals (Sweden)

    E. Mohr

    1995-01-01

    Full Text Available In the absence of biological markers, dementia classification remains complex both in terms of characterization as well as early detection of the presence or absence of dementing symptoms, particularly in diseases with possible secondary dementia. An empirical, statistical approach using neuropsychological measures was therefore developed to distinguish demented from non-demented patients and to identify differential patterns of cognitive dysfunction in neurodegenerative disease. Age-scaled neurobehavioral test results (Wechsler Adult Intelligence Scale—Revised and Wechsler Memory Scale from Alzheimer's (AD and Huntington's (HD patients, matched for intellectual disability, as well as normal controls were used to derive a classification formula. Stepwise discriminant analysis accurately (99% correct distinguished controls from demented patients, and separated the two patient groups (79% correct. Variables discriminating between HD and AD patient groups consisted of complex psychomotor tasks, visuospatial function, attention and memory. The reliability of the classification formula was demonstrated with a new, independent sample of AD and HD patients which yielded virtually identical results (classification accuracy for dementia: 96%; AD versus HD: 78%. To validate the formula, the discriminant function was applied to Parkinson's (PD patients, 38% of whom were classified as demented. The validity of the classification was demonstrated by significant PD subgroup differences on measures of dementia not included in the discriminant function. Moreover, a majority of demented PD patients (65% were classified as having an HD-like pattern of cognitive deficits, in line with previous reports of the subcortical nature of PD dementia. This approach may thus be useful in classifying presence or absence of dementia and in discriminating between dementia subtypes in cases of secondary or coincidental dementia.

  1. Acute Kidney Injury Classification in Neuro-ICU Patient Group

    Directory of Open Access Journals (Sweden)

    Canan Akıncı

    2012-12-01

    Full Text Available Objective: To investigate the role of acute kidney injury (AKI classification system for kidney injury outcome in neuro-Intensive care unit (ICU patients. Material and Method: Total 432 patients who admitted to ICU between 2005 and 2009 evaluated in this study. All patients’ AKI stage, Acute Physiology and Chronic Health Evaluation (APACHE-II, Sequential Organ Failure Assessment Score (SOFA, Glasgow Coma Score (GCS, Glasgow Outcome Score (GOS, mortality rate, length of ICU stay, need for intubation, and mechanical ventilation were recorded. Results: AKI was found in 24 of all 432 patents’ (5.5%. We found that, patients with AKI had higher APHACE-II score, SOFA score and mortality rates; longer ICU stay, duration of mechanical ventilation and intubation and lower GCS and GOS than without AKI group. Conclusion: Length of ICU stay and mortality rate were higher in AKI positive group.

  2. Classification of Airflow Limitation Based on z-Score Underestimates Mortality in Patients with Chronic Obstructive Pulmonary Disease.

    Science.gov (United States)

    Tejero, Elena; Prats, Eva; Casitas, Raquel; Galera, Raúl; Pardo, Paloma; Gavilán, Adelaida; Martínez-Cerón, Elisabet; Cubillos-Zapata, Carolina; Del Peso, Luis; García-Río, Francisco

    2017-08-01

    Global Lung Function Initiative recommends reporting lung function measures as z-score, and a classification of airflow limitation (AL) based on this parameter has recently been proposed. To evaluate the prognostic capacity of the AL classifications based on z-score or percentage predicted of FEV 1 in patients with chronic obstructive pulmonary disease (COPD). A cohort of 2,614 patients with COPD recruited outside the hospital setting was examined after a mean (± SD) of 57 ± 13 months of follow-up, totaling 10,322 person-years. All-cause mortality was analyzed, evaluating the predictive capacity of several AL staging systems. Based on Global Initiative for Chronic Obstructive Lung Disease guidelines, 461 patients (17.6%) had mild, 1,452 (55.5%) moderate, 590 (22.6%) severe, and 111 (4.2%) very severe AL. According to z-score classification, 66.3% of patients remained with the same severity, whereas 23.7% worsened and 10.0% improved. Unlike other staging systems, patients with severe AL according to z-score had higher mortality than those with very severe AL (increase of risk by 5.2 and 3.9 times compared with mild AL, respectively). The predictive capacity for 5-year survival was slightly higher for FEV 1 expressed as percentage of predicted than as z-score (area under the curve: 0.714-0.760 vs. 0.649-0.708, respectively). A severity-dependent relationship between AL grades by z-score and mortality was only detected in patients younger than age 60 years. In patients with COPD, the AL classification based on z-score predicts worse mortality than those based on percentage of predicted. It is possible that the z-score underestimates AL severity in patients older than 60 years of age with severe functional impairment.

  3. Cholecystectomy and Diagnosis-Related Groups (DRGs): patient classification and hospital reimbursement in 11 European countries.

    Science.gov (United States)

    Paat-Ahi, Gerli; Aaviksoo, Ain; Swiderek, Maria

    2014-12-01

    As part of the EuroDRG project, researchers from eleven countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain) compared how their Diagnosis-Related Groups (DRG) systems deal with cholecystectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. National or regional databases were used to identify hospital cases with a procedure of cholecystectomy. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that individually contained at least 1% of cases. Six standardised case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained and compared to an index case. European DRG systems vary widely: they classify cholecystectomy patients according to different sets of variables into diverging numbers of DRGs (between two DRGs in Austria and Poland to nine DRGs in England). The most complex DRG is valued at four times more resource intensive than the index case in Ireland but only 1.3 times more resource intensive than the index case in Austria. Large variations in the classification of cholecystectomy patients raise concerns whether all systems rely on the most appropriate classification variables. Surgeons, hospital managers and national DRG authorities should consider how other countries' DRG systems classify cholecystectomy patients in order to optimize their DRG systems and to ensure fair and appropriate reimbursement.

  4. Classification of schizophrenia patients based on resting-state functional network connectivity

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Arbabshirani

    2013-07-01

    Full Text Available There is a growing interest in automatic classification of mental disorders based on neuroimaging data. Small training data sets (subjects and very large amount of high dimensional data make it a challenging task to design robust and accurate classifiers for heterogeneous disorders such as schizophrenia. Most previous studies considered structural MRI, diffusion tensor imaging and task-based fMRI for this purpose. However, resting-state data has been rarely used in discrimination of schizophrenia patients from healthy controls. Resting data are of great interest, since they are relatively easy to collect, and not confounded by behavioral performance on a task. Several linear and non-linear classification methods were trained using a training dataset and evaluate with a separate testing dataset. Results show that classification with high accuracy is achievable using simple non-linear discriminative methods such as k-nearest neighbors which is very promising. We compare and report detailed results of each classifier as well as statistical analysis and evaluation of each single feature. To our knowledge our effects represent the first use of resting-state functional network connectivity features to classify schizophrenia.

  5. Tissue classifications in Monte Carlo simulations of patient dose for photon beam tumor treatments

    Science.gov (United States)

    Lin, Mu-Han; Chao, Tsi-Chian; Lee, Chung-Chi; Tung-Chieh Chang, Joseph; Tung, Chuan-Jong

    2010-07-01

    The purpose of this work was to study the calculated dose uncertainties induced by the material classification that determined the interaction cross-sections and the water-to-material stopping-power ratios. Calculations were made for a head- and neck-cancer patient treated with five intensity-modulated radiotherapy fields using 6 MV photon beams. The patient's CT images were reconstructed into two voxelized patient phantoms based on different CT-to-material classification schemes. Comparisons of the depth-dose curve of the anterior-to-posterior field and the dose-volume-histogram of the treatment plan were used to evaluate the dose uncertainties from such schemes. The results indicated that any misassignment of tissue materials could lead to a substantial dose difference, which would affect the treatment outcome. To assure an appropriate material assignment, it is desirable to have different conversion tables for various parts of the body. The assignment of stopping-power ratio should be based on the chemical composition and the density of the material.

  6. Tissue classifications in Monte Carlo simulations of patient dose for photon beam tumor treatments

    International Nuclear Information System (INIS)

    Lin, Mu-Han; Chao, Tsi-Chian; Lee, Chung-Chi; Tung-Chieh Chang, Joseph; Tung, Chuan-Jong

    2010-01-01

    The purpose of this work was to study the calculated dose uncertainties induced by the material classification that determined the interaction cross-sections and the water-to-material stopping-power ratios. Calculations were made for a head- and neck-cancer patient treated with five intensity-modulated radiotherapy fields using 6 MV photon beams. The patient's CT images were reconstructed into two voxelized patient phantoms based on different CT-to-material classification schemes. Comparisons of the depth-dose curve of the anterior-to-posterior field and the dose-volume-histogram of the treatment plan were used to evaluate the dose uncertainties from such schemes. The results indicated that any misassignment of tissue materials could lead to a substantial dose difference, which would affect the treatment outcome. To assure an appropriate material assignment, it is desirable to have different conversion tables for various parts of the body. The assignment of stopping-power ratio should be based on the chemical composition and the density of the material.

  7. Street-side vehicle detection, classification and change detection using mobile laser scanning data

    Science.gov (United States)

    Xiao, Wen; Vallet, Bruno; Schindler, Konrad; Paparoditis, Nicolas

    2016-04-01

    Statistics on street-side car parks, e.g. occupancy rates, parked vehicle types, parking durations, are of great importance for urban planning and policy making. Related studies, e.g. vehicle detection and classification, mostly focus on static images or video. Whereas mobile laser scanning (MLS) systems are increasingly utilized for urban street environment perception due to their direct 3D information acquisition, high accuracy and movability. In this paper, we design a complete system for car park monitoring, including vehicle recognition, localization, classification and change detection, from laser scanning point clouds. The experimental data are acquired by an MLS system using high frequency laser scanner which scans the streets vertically along the system's moving trajectory. The point clouds are firstly classified as ground, building façade, and street objects which are then segmented using state-of-the-art methods. Each segment is treated as an object hypothesis, and its geometric features are extracted. Moreover, a deformable vehicle model is fitted to each object. By fitting an explicit model to the vehicle points, detailed information, such as precise position and orientation, can be obtained. The model parameters are also treated as vehicle features. Together with the geometric features, they are applied to a supervised learning procedure for vehicle or non-vehicle recognition. The classes of detected vehicles are also investigated. Whether vehicles have changed across two datasets acquired at different times is detected to estimate the durations. Here, vehicles are trained pair-wisely. Two same or different vehicles are paired up as training samples. As a result, the vehicle recognition, classification and change detection accuracies are 95.9%, 86.0% and 98.7%, respectively. Vehicle modelling improves not only the recognition rate, but also the localization precision compared to bounding boxes.

  8. Etiological classifications of transient ischemic attacks: subtype classification by TOAST, CCS and ASCO--a pilot study.

    Science.gov (United States)

    Amort, Margareth; Fluri, Felix; Weisskopf, Florian; Gensicke, Henrik; Bonati, Leo H; Lyrer, Philippe A; Engelter, Stefan T

    2012-01-01

    In patients with transient ischemic attacks (TIA), etiological classification systems are not well studied. The Trial of ORG 10172 in Acute Stroke Treatment (TOAST), the Causative Classification System (CCS), and the Atherosclerosis Small Vessel Disease Cardiac Source Other Cause (ASCO) classification may be useful to determine the underlying etiology. We aimed at testing the feasibility of each of the 3 systems. Furthermore, we studied and compared their prognostic usefulness. In a single-center TIA registry prospectively ascertained over 2 years, we applied 3 etiological classification systems. We compared the distribution of underlying etiologies, the rates of patients with determined versus undetermined etiology, and studied whether etiological subtyping distinguished TIA patients with versus without subsequent stroke or TIA within 3 months. The 3 systems were applicable in all 248 patients. A determined etiology with the highest level of causality was assigned similarly often with TOAST (35.9%), CCS (34.3%), and ASCO (38.7%). However, the frequency of undetermined causes differed significantly between the classification systems and was lowest for ASCO (TOAST: 46.4%; CCS: 37.5%; ASCO: 18.5%; p CCS, and ASCO, cardioembolism (19.4/14.5/18.5%) was the most common etiology, followed by atherosclerosis (11.7/12.9/14.5%). At 3 months, 33 patients (13.3%, 95% confidence interval 9.3-18.2%) had recurrent cerebral ischemic events. These were strokes in 13 patients (5.2%; 95% confidence interval 2.8-8.8%) and TIAs in 20 patients (8.1%, 95% confidence interval 5.0-12.2%). Patients with a determined etiology (high level of causality) had higher rates of subsequent strokes than those without a determined etiology [TOAST: 6.7% (95% confidence interval 2.5-14.1%) vs. 4.4% (95% confidence interval 1.8-8.9%); CSS: 9.3% (95% confidence interval 4.1-17.5%) vs. 3.1% (95% confidence interval 1.0-7.1%); ASCO: 9.4% (95% confidence interval 4.4-17.1%) vs. 2.6% (95% confidence interval

  9. Restaging and Survival Analysis of 4036 Ovarian Cancer Patients According to the 2013 FIGO Classification for Ovarian, Fallopian Tube, and Primary Peritoneal Cancer

    DEFF Research Database (Denmark)

    Rosendahl, Mikkel; Høgdall, Claus Kim; Mosgaard, Berit Jul

    2016-01-01

    OBJECTIVE: With the 2013 International Federation of Gynecology and Obstetrics (FIGO) staging for ovarian, fallopian tube, and primary peritoneal cancer, the number of substages changed from 10 to 14. Any classification of a malignancy should easily assign patients to prognostic groups, refer....... MATERIALS AND METHODS: Demographic, surgical, histological, and survival data from 4036 ovarian cancer patients were used in the analysis. Five-year survival rates (5YSR) and hazard ratios for the old and revised FIGO staging were calculated using Kaplan-Meier curves and Cox regression. RESULTS: A total...

  10. [Clinical Study of 2014 ISUP New Grade Group Classification for Prostate Cancer Patients Treated by Androgen Deprivation Therapy].

    Science.gov (United States)

    Uno, Masahiro; Kawase, Makoto; Kato, Daiki; Ishida, Takashi; Kato, Seiichi; Fujimoto, Yoshinori

    2018-01-01

    The 2014 International Society of Urological Pathology (ISUP) has proposed a new grade group (GG) classification for Gleason scores (GS). The usefulness of the new GG classification was investigated with 518 prostate cancer patients who underwent androgen deprivation therapy. According to the new GG classification, Stages B‒D and the new GG classification relapse-free rate for each stage were calculated using the Kaplan‒Meier method. The new GG classification revealed a significant difference for the relapse-free rate only between some groups. Analysis using the Cox proportional hazards model indicated that the risk of relapse was higher in GGs 4 and 5 than in GG 1. The usefulness about the relapse-free rate in androgen deprivation therapy of the 2014 ISUP new grade group classification a waits future examination.

  11. Recursive partitioning analysis (RPA) classification predicts survival in patients with brain metastases from sarcoma.

    Science.gov (United States)

    Grossman, Rachel; Ram, Zvi

    2014-12-01

    Sarcoma rarely metastasizes to the brain, and there are no specific treatment guidelines for these tumors. The recursive partitioning analysis (RPA) classification is a well-established prognostic scale used in many malignancies. In this study we assessed the clinical characteristics of metastatic sarcoma to the brain and the validity of the RPA classification system in a subset of 21 patients who underwent surgical resection of metastatic sarcoma to the brain We retrospectively analyzed the medical, radiological, surgical, pathological, and follow-up clinical records of 21 patients who were operated for metastatic sarcoma to the brain between 1996 and 2012. Gliosarcomas, sarcomas of the head and neck with local extension into the brain, and metastatic sarcomas to the spine were excluded from this reported series. The patients' mean age was 49.6 ± 14.2 years (range, 25-75 years) at the time of diagnosis. Sixteen patients had a known history of systemic sarcoma, mostly in the extremities, and had previously received systemic chemotherapy and radiation therapy for their primary tumor. The mean maximal tumor diameter in the brain was 4.9 ± 1.7 cm (range 1.7-7.2 cm). The group's median preoperative Karnofsky Performance Scale was 80, with 14 patients presenting with Karnofsky Performance Scale of 70 or greater. The median overall survival was 7 months (range 0.2-204 months). The median survival time stratified by the Radiation Therapy Oncology Group RPA classes were 31, 7, and 2 months for RPA class I, II, and III, respectively (P = 0.0001). This analysis is the first to support the prognostic utility of the Radiation Therapy Oncology Group RPA classification for sarcoma brain metastases and may be used as a treatment guideline tool in this rare disease. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Cholecystectomy and Diagnosis-Related Groups (DRGs: Patient Classification and Hospital Reimbursement in 11 European Countries

    Directory of Open Access Journals (Sweden)

    Gerli Paat-Ahi

    2014-12-01

    Full Text Available Background As part of the EuroDRG project, researchers from eleven countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain compared how their Diagnosis-Related Groups (DRG systems deal with cholecystectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. Methods National or regional databases were used to identify hospital cases with a procedure of cholecystectomy. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that individually contained at least 1% of cases. Six standardised case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained and compared to an index case. Results European DRG systems vary widely: they classify cholecystectomy patients according to different sets of variables into diverging numbers of DRGs (between two DRGs in Austria and Poland to nine DRGs in England. The most complex DRG is valued at four times more resource intensive than the index case in Ireland but only 1.3 times more resource intensive than the index case in Austria. Conclusion Large variations in the classification of cholecystectomy patients raise concerns whether all systems rely on the most appropriate classification variables. Surgeons, hospital managers and national DRG authorities should consider how other countries’ DRG systems classify cholecystectomy patients in order to optimize their DRG systems and to ensure fair and appropriate reimbursement.

  13. The Communication Function Classification System: cultural adaptation, validity, and reliability of the Farsi version for patients with cerebral palsy.

    Science.gov (United States)

    Soleymani, Zahra; Joveini, Ghodsiye; Baghestani, Ahmad Reza

    2015-03-01

    This study developed a Farsi language Communication Function Classification System and then tested its reliability and validity. Communication Function Classification System is designed to classify the communication functions of individuals with cerebral palsy. Up until now, there has been no instrument for assessment of this communication function in Iran. The English Communication Function Classification System was translated into Farsi and cross-culturally modified by a panel of experts. Professionals and parents then assessed the content validity of the modified version. A backtranslation of the Farsi version was confirmed by the developer of the English Communication Function Classification System. Face validity was assessed by therapists and parents of 10 patients. The Farsi Communication Function Classification System was administered to 152 individuals with cerebral palsy (age, 2 to 18 years; median age, 10 years; mean age, 9.9 years; standard deviation, 4.3 years). Inter-rater reliability was analyzed between parents, occupational therapists, and speech and language pathologists. The test-retest reliability was assessed for 75 patients with a 14 day interval between tests. The inter-rater reliability of the Communication Function Classification System was 0.81 between speech and language pathologists and occupational therapists, 0.74 between parents and occupational therapists, and 0.88 between parents and speech and language pathologists. The test-retest reliability was 0.96 for occupational therapists, 0.98 for speech and language pathologists, and 0.94 for parents. The findings suggest that the Farsi version of Communication Function Classification System is a reliable and valid measure that can be used in clinical settings to assess communication function in patients with cerebral palsy. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Testing the McSad depression specific classification system in patients with somatic conditions : validity and performance

    NARCIS (Netherlands)

    Papageorgiou, Katerina; Vermeulen, Karin M.; Schroevers, Maya J.; Buskens, Erik; Ranchor, Adelita V.

    2013-01-01

    Background: Valuations of depression are useful to evaluate depression interventions offered to patients with chronic somatic conditions. The only classification system to describe depression developed specifically for valuation purposes is the McSad, but it has not been used among somatic patients.

  15. Quality of nursing intensity data: inter-rater reliability of the patient classification after two decades in clinical use.

    Science.gov (United States)

    Liljamo, Pia; Kinnunen, Ulla-Mari; Ohtonen, Pasi; Saranto, Kaija

    2017-09-01

    The aim of this study was to measure the inter-rater reliability of the Oulu Patient Classification and to discuss existing methods of reliability testing. The Oulu Patient Classification, part of the RAFAELA ® System, has been developed to assist nursing managers with the proper allocation of nursing resources. Due to the increased intensity of inpatient care during recent years, there is a need for the reliability testing of the classification, which has been in clinical use for 20 years. Retrospective statistical study. To test inter-rater reliability, a pair of nurses classified the same patients, without knowledge of each other's ratings, as a part of annually conducted standardization. Data on the parallel classifications (n = 19,997) was obtained from inpatient units (n = 32) with different specialties at a university hospital in Finland during 2010-2015. Parallel classification practices were also analysed. The reliability of the overall classification and its subareas were calculated using suitable statistical coefficients. Inter-rater reliability coefficients were a reliable or almost perfect means of considering the nursing intensity category and various practices, but there were detectable differences between subareas. The lowest agreement levels occurred in the subareas 'Planning and Coordination of Nursing Care' and 'Guiding of Care/Continued Care and Emotional Support'. There is a need to develop the descriptions of subareas and to clarify the related concepts. Precise nursing documentation can promote a high level of agreement and reliable results. The traditional overall proportion of agreement does not provide an adequate picture of reliability - weighted kappa coefficients should be used instead. © 2017 John Wiley & Sons Ltd.

  16. Application of bivariate mapping for hydrological classification and analysis of temporal change and scale effects in Switzerland

    NARCIS (Netherlands)

    Speich, Matthias J.R.; Bernhard, Luzi; Teuling, Ryan; Zappa, Massimiliano

    2015-01-01

    Hydrological classification schemes are important tools for assessing the impacts of a changing climate on the hydrology of a region. In this paper, we present bivariate mapping as a simple means of classifying hydrological data for a quantitative and qualitative assessment of temporal change.

  17. Occlusal Classification in Relation to Original Cleft Width in Patients With Unilateral Cleft Lip and Palate.

    Science.gov (United States)

    Huang, Andrew H; Patel, Kamlesh B; Maschhoff, Clayton W; Huebener, Donald V; Skolnick, Gary B; Naidoo, Sybill D; Woo, Albert S

    2015-09-01

    To determine a correlation between the width of the cleft palate measured at the time of lip adhesion, definitive lip repair, and palatoplasty and the subsequent occlusal classification of patients born with unilateral cleft lip and palate. Retrospective, observational study. Referral, urban, children's hospital Participants : Dental models and records of 270 patients were analyzed. None. Angle occlusion classification. The mean age at which occlusal classification was determined was 11 ± 0.3 years. Of the children studies, 84 were diagnosed with Class I or II occlusion, 67 were diagnosed with Class III occlusion, and 119 were lost to follow up or transferred care. Mean cleft widths were significantly larger in subjects with Class III occlusion for all measures at time of lip adhesion and definitive lip repair (P cleft widths were significantly greater at the alveolus (P = .025) but not at the midportion of the hard palate (P = .35) or posterior hard palate (P = .10). Cleft widths from the lip through to the posterior hard palate are generally greater in children who are diagnosed with Class III occlusion later in life. Notably, the alveolar cleft width is significantly greater at each time point for patients who went on to develop Class III occlusion. There were no significant differences in cleft widths between patients diagnosed later with Class I and Class II occlusions.

  18. Classification of morphologic changes in photoplethysmographic waveforms

    Directory of Open Access Journals (Sweden)

    Tigges Timo

    2016-09-01

    Full Text Available An ever increasing number of research is examining the question to what extent physiological information beyond the blood oxygen saturation could be drawn from the photoplethysmogram. One important approach to elicit that information from the photoplethysmogram is the analysis of its waveform. One prominent example for the value of photoplethysmographic waveform analysis in cardiovascular monitoring that has emerged is hemodynamic compensation assessment in the peri-operative setting or trauma situations, as digital pulse waveform dynamically changes with alterations in vascular tone or pulse wave velocity. In this work, we present an algorithm based on modern machine learning techniques that automatically finds individual digital volume pulses in photoplethysmographic signals and sorts them into one of the pulse classes defined by Dawber et al. We evaluate our approach based on two major datasets – a measurement study that we conducted ourselves as well as data from the PhysioNet MIMIC II database. As the results are satisfying we could demonstrate the capabilities of classification algorithms in the automated assessment of the digital volume pulse waveform measured by photoplethysmographic devices.

  19. Stroke, thromboembolism and bleeding in patients with atrial fibrillation according to the EHRA valvular heart disease classification.

    Science.gov (United States)

    Bisson, Arnaud; Bodin, Alexandre; Clementy, Nicolas; Bernard, Anne; Babuty, Dominique; Lip, Gregory Y H; Fauchier, Laurent

    2018-06-01

    We compared thromboembolic (TE) and bleeding risks in patients with atrial fibrillation (AF) according to the new 'Evaluated Heartvalves, Rheumatic or Artificial' (EHRA) valve classification. Patients were divided into 3 categories: (i) EHRA type 1 corresponds to the previous 'valvular' AF patients, with either rheumatic mitral valve stenosis or mechanical prosthetic heart valves; (ii) EHRA type 2 includes AF patients with other valvular heart disease (VHD) and valve bioprosthesis or repair; and (iii) 'non-VHD controls' i.e. all AF patients with neither VHD nor post-surgical valve disease. Among 8962 AF patients seen between 2000 and 2010, 357 (4%) were EHRA type 1, 1754 (20%) were EHRA type 2 and 6851 (76%) non-VHD controls. EHRA type 2 patients were older and had a higher CHA 2 DS 2 -VASc and HAS-BLED scores than either type 1 and non-VHD patients. After a mean follow-up of 1264 ± 1160 days, the occurrence of TE events was higher in EHRA type 2 than non-VHD patients (HR (95%CI): 1.30 1.09-1.54), p = 0.003; also, p = 0.31 for type 1 vs 2, p = 0.68 for type 1 vs non-VHD controls). The rate of major BARC bleeding events for AF patients was higher in either EHRA type 1 (HR (95%CI): 3.16(2.11-4.72), p < 0.0001) or type 2 (HR (95%CI): 2.19(1.69-2.84), p < 0.0001) compared to non-VHD controls. The EHRA valve classification of AF patients with VHD appears useful in categorizing these patients, in terms of TE and bleeding risks. This classification can be used in clinical practice for appropriate choices of oral anticoagulation therapy and follow-up. Copyright © 2018 Elsevier B.V. All rights reserved.

  20. Wagner classification and culture analysis of diabetic foot infection

    Directory of Open Access Journals (Sweden)

    Fatma Bozkurt

    2011-03-01

    Full Text Available The aim of this study was to determine the concordance ratio between microorganisms isolated from deep tissue culture and those from superficial culture in patients with diabetic foot according to Wagner’s wound classification method.Materials and methods: A total of 63 patients with Diabetic foot infection, who were admitted to Dicle University Hospital between October 2006 and November 2007, were included into the study. Wagner’s classification method was used for wound classification. For microbiologic studies superficial and deep tissue specimens were obtained from each patient, and were rapidly sent to laboratory for aerob and anaerob cultures. Microbiologic data were analyzed and interpreted in line with sensitivity and specifity formula.Results: Thirty-eight (60% of the patients were in Wagner’s classification ≤2, while 25 (40% patients were Wagner’s classification ≥3. According to our culture results, 66 (69% Gr (+ and 30 (31% Gr (- microorganisms grew in Wagner classification ≤2 patients. While in Wagner classification ≥3; 25 (35% Gr (+ and 46 (65% Gr (- microorganisms grew. Microorganisms grew in 89% of superficial cultures and 64% of the deep tissue cultures in patients with Wagner classification ≤2, while microorganism grew in 64% of Wagner classification ≥3.Conclusion: In ulcers of diabetic food infections, initial treatment should be started according to result of sterile superficial culture, but deep tissue culture should be taken, if unresponsive to initial treatment.

  1. What lies beneath: detecting sub-canopy changes in savanna woodlands using a three-dimensional classification method

    CSIR Research Space (South Africa)

    Fisher, JT

    2015-07-01

    Full Text Available structural diversity. A 3D classification approach was successful in detecting fine-scale, short-term changes between land uses, and can thus be used as amonitoring tool for savannawoody vegetation structure....

  2. Architecturally Significant Requirements Identification, Classification and Change Management for Multi-tenant Cloud-Based Systems

    DEFF Research Database (Denmark)

    Chauhan, Muhammad Aufeef; Probst, Christian W.

    2017-01-01

    presented a framework for requirements classification and change management focusing on distributed Platform as a Service (PaaS) and Software as a Service (SaaS) systems as well as complex software ecosystems that are built using PaaS and SaaS, such as Tools as a Service (TaaS). We have demonstrated...

  3. Body mass index: different nutritional status according to WHO, OPAS and Lipschitz classifications in gastrointestinal cancer patients.

    Science.gov (United States)

    Barao, Katia; Forones, Nora Manoukian

    2012-01-01

    The body mass index (BMI) is the most common marker used on diagnoses of the nutritional status. The great advantage of this index is the easy way to measure, the low cost, the good correlation with the fat mass and the association to morbidity and mortality. To compare the BMI differences according to the WHO, OPAS and Lipschitz classification. A prospective study on 352 patients with esophageal, gastric or colorectal cancer was done. The BMI was calculated and analyzed by the classification of WHO, Lipschitz and OPAS. The mean age was 62.1 ± 12.4 years and 59% of them had more than 59 years. The BMI had not difference between the genders in patients cancer had more than 65 years. A different cut off must be used for this patients, because undernourished patients may be wrongly considered well nourished.

  4. Lymphoma classification update: B-cell non-Hodgkin lymphomas.

    Science.gov (United States)

    Jiang, Manli; Bennani, N Nora; Feldman, Andrew L

    2017-05-01

    Lymphomas are classified based on the normal counterpart, or cell of origin, from which they arise. Because lymphocytes have physiologic immune functions that vary both by lineage and by stage of differentiation, the classification of lymphomas arising from these normal lymphoid populations is complex. Recent genomic data have contributed additional complexity. Areas covered: Lymphoma classification follows the World Health Organization (WHO) system, which reflects international consensus and is based on pathological, genetic, and clinical factors. A 2016 revision to the WHO classification of lymphoid neoplasms recently was reported. The present review focuses on B-cell non-Hodgkin lymphomas, the most common group of lymphomas, and summarizes recent changes most relevant to hematologists and other clinicians who care for lymphoma patients. Expert commentary: Lymphoma classification is a continually evolving field that needs to be responsive to new clinical, pathological, and molecular understanding of lymphoid neoplasia. Among the entities covered in this review, the 2016 revision of the WHO classification particularly impact the subclassification and genetic stratification of diffuse large B-cell lymphoma and high-grade B-cell lymphomas, and reflect evolving criteria and nomenclature for indolent B-cell lymphomas and lymphoproliferative disorders.

  5. Applying post classification change detection technique to monitor an Egyptian coastal zone (Abu Qir Bay

    Directory of Open Access Journals (Sweden)

    Mamdouh M. El-Hattab

    2016-06-01

    Full Text Available Land cover changes considered as one of the important global phenomena exerting perhaps one of the most significant effects on the environment than any other factor. It is, therefore, vital that accurate data on land cover changes are made available to facilitate the understanding of the link between land cover changes and environmental changes to allow planners to make effective decisions. In this paper, the post classification approach was used to detect and assess land cover changes of one of the important coastal zones in Egypt, Abu Qir Bay zone, based on the comparative analysis of independently produced classification images of the same area at different dates. In addition to satellite images, socioeconomic data were used with the aid of land use model EGSLR to indicate relation between land cover and land use changes. Results indicated that changes in different land covers reflected the changes in occupation status in specific zones. For example, in the south of Idku Lake zone, it was observed that the occupation of settlers changed from being unskilled workers to fishermen based on the expansion of the area of fish farms. Change rates increased dramatically in the period from 2004 to 2013 as remarkable negative changes were found especially in fruits and palm trees (i.e. loss of about 66 km2 of land having fruits and palm trees due to industrialization in the coastal area. Also, a rapid urbanization was monitored along the coastline of Abu Qir Bay zone due to the political conditions in Egypt (25th of January Revolution within this period and which resulted to the temporary absence of monitoring systems to regulate urbanization.

  6. The new Genetico-Racial Skin Classification: How to maximize the safety of any peel or laser treatment on any Asian, Caucasian or Black patient.

    Science.gov (United States)

    Fanous, Nabil; Côté, Valérie; Fanous, Amanda

    2011-01-01

    The popular skin classifications, notably the 'Fitzpatrick' and 'Obaji' classifications, are primarily based on skin colour. Other criteria are occasionally considered, such as the degree of skin oiliness, thickness, sensibility, etc. Although these classifications are easy to understand and apply, their simplicity limits their precision, sophistication and applicability.The new genetico-racial skin classification proposed herein suggests that skin response to any peel or laser treatment is genetically programmed and is, therefore, linked to the genetic and racial origin of the patient. In other words, in addition to skin colour, the patient's facial features and ancestry should be taken into account when classifying any skin.The new genetico-racial skin classification enables the physician to determine with great precision, and before any peel or laser treatment, the level of the patient's suitability and the expected postoperative outcomes; therefore, reducing the likelihood of complications.

  7. Boosted classification trees result in minor to modest improvement in the accuracy in classifying cardiovascular outcomes compared to conventional classification trees

    Science.gov (United States)

    Austin, Peter C; Lee, Douglas S

    2011-01-01

    Purpose: Classification trees are increasingly being used to classifying patients according to the presence or absence of a disease or health outcome. A limitation of classification trees is their limited predictive accuracy. In the data-mining and machine learning literature, boosting has been developed to improve classification. Boosting with classification trees iteratively grows classification trees in a sequence of reweighted datasets. In a given iteration, subjects that were misclassified in the previous iteration are weighted more highly than subjects that were correctly classified. Classifications from each of the classification trees in the sequence are combined through a weighted majority vote to produce a final classification. The authors' objective was to examine whether boosting improved the accuracy of classification trees for predicting outcomes in cardiovascular patients. Methods: We examined the utility of boosting classification trees for classifying 30-day mortality outcomes in patients hospitalized with either acute myocardial infarction or congestive heart failure. Results: Improvements in the misclassification rate using boosted classification trees were at best minor compared to when conventional classification trees were used. Minor to modest improvements to sensitivity were observed, with only a negligible reduction in specificity. For predicting cardiovascular mortality, boosted classification trees had high specificity, but low sensitivity. Conclusions: Gains in predictive accuracy for predicting cardiovascular outcomes were less impressive than gains in performance observed in the data mining literature. PMID:22254181

  8. A content analysis of peripheral arterial disease patient-reported outcome measures using the International Classification of Functioning, Disability and Health.

    Science.gov (United States)

    Osborne, Candice Lee; Kauvar, David Seth

    2017-10-17

    The purpose of this study was to link, classify and describe the content of peripheral arterial disease (PAD)-specific patient-reported outcome measures using the International Classification of Functioning. The results were then analyzed to determine if these assessments provide clinicians and researchers with a comprehensive understanding of the lived experience of patients with PAD. Each meaningful concept in identified PAD assessments was linked to the International Classification of Functioning, Disability and Health to determine included and excluded content areas. An overall perspective was assigned to each assessment item. Inter-rater reliability was established using a kappa statistic. The body functions component is most frequently addressed overall followed by the activities and participation component. International Classification of Functioning chapter and category distribution vary greatly between assessments and no assessment comprehensively examines community participation and relationships. The majority of the assessment items are of the health status-disability and quality of life perspectives. The results of this study suggest the need for the development of a comprehensive PAD assessment that includes a more even distribution of International Classification of Functioning topics and subtopics. A more comprehensive assessment would better capture the lived experience of this patient population. Implications for Rehabilitation A better understanding of the data collected using the current peripheral arterial disease-specific patient-reported outcome measures may contribute to the development of more comprehensive assessment tools that will ultimately lead to improved patient care. This study contributes to the preliminary foundation for the development of a peripheral arterial disease International Classification of Functioning, Disability and Health Core Set. Clinicians and researchers interested in using peripheral arterial disease

  9. An Australian casemix classification for palliative care: technical development and results.

    Science.gov (United States)

    Eagar, Kathy; Green, Janette; Gordon, Robert

    2004-04-01

    To develop a palliative care casemix classification for use in all settings including hospital, hospice and home-based care. 3866 palliative care patients who, in a three-month period, had 4596 episodes of care provided by 58 palliative care services in Australia and New Zealand. A detailed clinical and service utilization profile was collected on each patient with staff time and other resources measured on a daily basis. Each day of care was costed using actual cost data from each study site. Regression tree analysis was used to group episodes of care with similar costs and clinical characteristics. In the resulting classification, the Australian National Sub-acute and Non-acute Patient (AN-SNAP) Classification Version 1, the branch for classifying inpatient palliative care episodes (including hospice care) has 11 classes and explains 20.98% of the variance in inpatient palliative care phase costs using trimmed data. There are 22 classes in the ambulatory palliative care branch that explains 17.14% variation in ambulatory phase cost using trimmed data. The term 'subacute' is used in Australia to describe health care in which the goal--a change in functional status or improvement in quality of life--is a better predictor of the need for, and the cost of, care than the patient's underlying diagnosis. The results suggest that phase of care (stage of illness) is the best predictor of the cost of Australian palliative care. Other predictors of cost are functional status and age. In the ambulatory setting, symptom severity and the model of palliative care are also predictive of cost. These variables are used in the AN-SNAP Version 1 classification to create 33 palliative care classes. The classification has clinical meaning but the overall statistical performance is only moderate. The structure of the classification allows for it to be improved over time as models of palliative care service delivery develop.

  10. [The Classification of Headache: Important Aspects of Patient's History and Clinical Diagnostic].

    Science.gov (United States)

    Kamm, Katharina; Ruscheweyh, Ruth; Eren, Ozan; Straube, Andreas

    2017-03-01

    Headache disorders are the most occuring symptoms in human population. Basis for a successful therapy of headaches is a definite diagnosis, which needs in turn valid criteria for the graduation of headaches. Corresponding to the classification of the International Headache Society (IHS) especially relevant questions about patient's history and clinical examination lead to a diagnosis. © Georg Thieme Verlag KG Stuttgart · New York.

  11. Classification of huminite-ICCP System 1994

    Energy Technology Data Exchange (ETDEWEB)

    Sykorova, I. [Institute of Rock Structure and Mechanics, Academy of Science of the Czech Republic, V Holesovicka 41, 182 09 Prague 8 (Czech Republic); Pickel, W. [Coal and Organic Petrology Services Pty Ltd, 23/80 Box Road, Taren Point, NSW 2229 (Australia); Christanis, K. [Department of Geology, University of Patras, 26500 Rio-Patras (Greece); Wolf, M. [Mergelskull 29, 47802 Krefeld (Germany); Taylor, G.H. [15 Hawkesbury Cres, Farrer Act 2607 (Australia); Flores, D. [Departamento de Geologia, Faculdade de Ciencias do Porto, Praca de Gomes Teixeira, 4099-002 Porto (Portugal)

    2005-04-12

    In the new classification (ICCP System 1994), the maceral group huminite has been revised from the previous classification (ICCP, 1971. Int. Handbook Coal Petr., suppl. to 2nd ed.) to accommodate the nomenclature to changes in the other maceral groups, especially the changes in the vitrinite classification (ICCP, 1998. The new vitrinite classification (ICCP System 1994). Fuel 77, 349-358.). The vitrinite and huminite systems have been correlated so that down to the level of sub-maceral groups, the two systems can be used in parallel. At the level of macerals and for finer classifications, the analyst now has, according to the nature of the coal and the purpose of the analysis, a choice of using either of the two classification systems for huminite and vitrinite. This is in accordance with the new ISO Coal Classification that covers low rank coals as well and allows for the simultaneous use of the huminite and vitrinite nomenclature for low rank coals.

  12. Primary care physicians' use of the proposed classification of common mental disorders for ICD-11

    DEFF Research Database (Denmark)

    Goldberg, David P.; Lam, Tai-Pong; Minhas, Fareed

    2017-01-01

    Background. The World Health Organization is revising the classification of common mental disorders in primary care for ICD-11. Major changes from the ICD-10 primary care version have been proposed for: (i) mood and anxiety disorders; and (ii) presentations of multiple somatic symptoms (bodily...... stress syndrome). This three-part field study explored the implementation of the revised classification by primary care physicians (PCPs) in five countries. Methods. Participating PCPs in Brazil, China, Mexico, Pakistan and Spain were asked to use the revised classification, first in patients...... that they suspected might be psychologically distressed (Part 1), and second in patients with multiple somatic symptoms causing distress or disability not wholly attributable to a known physical pathology, or with high levels of health anxiety (Part 2). Patients referred to Part 1 or Part 2 underwent a structured...

  13. DETECTION OF AUTOANTIBODIES AGAINST MYELOID LYSOSOMAL-ENZYMES - A USEFUL ADJUNCT TO CLASSIFICATION OF PATIENTS WITH BIOPSY-PROVEN NECROTIZING ARTERITIS

    NARCIS (Netherlands)

    Tervaert, J.W.C.; Limburg, Piet; ELEMA, J.D.; HUITEMA, M.G.; The, T.H; Kallenberg, Cees; Horst, G.

    PURPOSE: Assessment of the value of determination of antineutrophil cytoplasmic antibodies (ANCA) and its specificities for classification of patients with biopsy-proven necrotizing arteritis. PATIENTS AND METHODS: The serum samples of 28 consecutive patients with biopsy-proven vasculitis involving

  14. Using a multidisciplinary classification in nursing : The international classification of functioning disability and health

    NARCIS (Netherlands)

    Van Achterberg, T; Holleman, G; Heijnen-Kaales, Y; Van der Brug, Y; Roodbol, G; Stallinga, HA; Hellema, F; Frederiks, CMA

    This paper reports a study to explore systematically the usefulness of the International Classification of Functioning, Disability and Health to nurses giving patient care. The International Classification of Functioning, Disability and Health has a history of more than 20 years. Although this World

  15. Using a multidisciplinary classification in nursing: the International Classification of Functioning Disability and Health

    NARCIS (Netherlands)

    van Achterberg, Theo; Holleman, Gerda; Heijnen-Kaales, Yvonne; van der Brug, Ype; Roodbol, Gabriël; Stallinga, Hillegonda A.; Hellema, Fokje; Frederiks, Carla M. A.

    2005-01-01

    This paper reports a study to explore systematically the usefulness of the International Classification of Functioning, Disability and Health to nurses giving patient care. The International Classification of Functioning, Disability and Health has a history of more than 20 years. Although this World

  16. Classification of hydrocephalus: critical analysis of classification categories and advantages of "Multi-categorical Hydrocephalus Classification" (Mc HC).

    Science.gov (United States)

    Oi, Shizuo

    2011-10-01

    Hydrocephalus is a complex pathophysiology with disturbed cerebrospinal fluid (CSF) circulation. There are numerous numbers of classification trials published focusing on various criteria, such as associated anomalies/underlying lesions, CSF circulation/intracranial pressure patterns, clinical features, and other categories. However, no definitive classification exists comprehensively to cover the variety of these aspects. The new classification of hydrocephalus, "Multi-categorical Hydrocephalus Classification" (Mc HC), was invented and developed to cover the entire aspects of hydrocephalus with all considerable classification items and categories. Ten categories include "Mc HC" category I: onset (age, phase), II: cause, III: underlying lesion, IV: symptomatology, V: pathophysiology 1-CSF circulation, VI: pathophysiology 2-ICP dynamics, VII: chronology, VII: post-shunt, VIII: post-endoscopic third ventriculostomy, and X: others. From a 100-year search of publication related to the classification of hydrocephalus, 14 representative publications were reviewed and divided into the 10 categories. The Baumkuchen classification graph made from the round o'clock classification demonstrated the historical tendency of deviation to the categories in pathophysiology, either CSF or ICP dynamics. In the preliminary clinical application, it was concluded that "Mc HC" is extremely effective in expressing the individual state with various categories in the past and present condition or among the compatible cases of hydrocephalus along with the possible chronological change in the future.

  17. Child-Pugh classification dependent alterations in serum leptin levels among cirrhotic patients: a case controlled study

    Directory of Open Access Journals (Sweden)

    Zeyrek Fadile

    2004-09-01

    Full Text Available Abstract Background As anorexia and hypermetabolism are common in cirrhosis, leptin levels may be increased in this disease. In this study, we investigated the relation between the severity of disease and serum leptin levels in post-hepatitis cirrhosis and the role of body composition, gender and viral aetiology of cirrhosis in this association. Methods Thirty-five cases with post-hepatitis cirrhosis and 15 healthy controls were enrolled in this study. Body composition including body mass index, body fat percentage and body fat mass were determined. Serum leptin levels were assayed. Results Leptin levels were significantly higher among cirrhotic patients independent of sex compared to controls (p = 0.001. Female patients in both groups have had higher leptin levels than males (in cirrhotics p = 0.029, in controls p = 0.02. Cirrhotic patients in each of A, B and C subgroups according to the Child- Pugh classification revealed significantly different levels compared to controls (p = 0.046, p = 0.004, p = 0.0001, respectively. Male cirrhotics in Child-Pugh Class B and C subgroups had significantly higher leptin levels compared to male controls (p = 0.006, p = 0.008. On the other hand, female patients only in Child Pugh class C subgroup have had higher levels of serum leptin compared to controls (p = 0.022. Child-Pugh classification has been found to be the sole discriminator in determination of leptin levels in cirrhotics by linear regression (beta: 0.435 p = 0.015. Conclusion Serum leptin levels increase in advanced liver disease independently of gender, body composition in posthepatitic cirrhosis. The increase is more abundant among patients that belong to C subgroup according to the Child- Pugh classification.

  18. Classification of parotidectomy: a proposed modification to the European Salivary Gland Society classification system.

    Science.gov (United States)

    Wong, Wai Keat; Shetty, Subhaschandra

    2017-08-01

    Parotidectomy remains the mainstay of treatment for both benign and malignant lesions of the parotid gland. There exists a wide range of possible surgical options in parotidectomy in terms of extent of parotid tissue removed. There is increasing need for uniformity of terminology resulting from growing interest in modifications of the conventional parotidectomy. It is, therefore, of paramount importance for a standardized classification system in describing extent of parotidectomy. Recently, the European Salivary Gland Society (ESGS) proposed a novel classification system for parotidectomy. The aim of this study is to evaluate this system. A classification system proposed by the ESGS was critically re-evaluated and modified to increase its accuracy and its acceptability. Modifications mainly focused on subdividing Levels I and II into IA, IB, IIA, and IIB. From June 2006 to June 2016, 126 patients underwent 130 parotidectomies at our hospital. The classification system was tested in that cohort of patient. While the ESGS classification system is comprehensive, it does not cover all possibilities. The addition of Sublevels IA, IB, IIA, and IIB may help to address some of the clinical situations seen and is clinically relevant. We aim to test the modified classification system for partial parotidectomy to address some of the challenges mentioned.

  19. A preliminary examination of patient loyalty: an application of the customer loyalty classification framework in the health care industry.

    Science.gov (United States)

    Heiens, R A; Pleshko, L P

    1997-01-01

    The present article applies the customer loyalty classification framework developed by Dick and Basu (1994) to the health care industry. Based on a two factor classification, consisting of repeat patronage and relative attitude, four categories of patient loyalty are proposed and examined, including true loyalty, latent loyalty, spurious loyalty, and no loyalty. Data is collected and the four patient loyalty categories are profiled and compared on the basis of perceived risk, product class importance, provider decision importance, provider awareness, provider consideration, number of providers visited, and self-reported loyalty.

  20. Phase characteristics of rheograms. Original classification of phase-related changes of rheos

    Directory of Open Access Journals (Sweden)

    Mikhail Y. Rudenko

    2014-05-01

    Full Text Available The phase characteristics of a rheogram are described in literature in general only. The existing theory of impedance rheography is based on an analysis of the form of rheogram envelopes, but not on the phase-related processes and their interpretation according to the applicable laws of physics. The aim of the present paper is to describe the phase-related characteristics of a rheogram of the ascending aorta. The method of the heart cycle phase analysis has been used for this purpose. By synchronizing an ECG of the aorta and a rheogram, an analysis of specific changes in the aorta blood filling in each phase is provided. As a result, the phase changes of a rheogram associated with the ECG phase structure are described and tabulated for first time. The author hereof offers his own original classification of the phase-related changes of rheograms.

  1. Classification schemes for knowledge translation interventions: a practical resource for researchers.

    Science.gov (United States)

    Slaughter, Susan E; Zimmermann, Gabrielle L; Nuspl, Megan; Hanson, Heather M; Albrecht, Lauren; Esmail, Rosmin; Sauro, Khara; Newton, Amanda S; Donald, Maoliosa; Dyson, Michele P; Thomson, Denise; Hartling, Lisa

    2017-12-06

    As implementation science advances, the number of interventions to promote the translation of evidence into healthcare, health systems, or health policy is growing. Accordingly, classification schemes for these knowledge translation (KT) interventions have emerged. A recent scoping review identified 51 classification schemes of KT interventions to integrate evidence into healthcare practice; however, the review did not evaluate the quality of the classification schemes or provide detailed information to assist researchers in selecting a scheme for their context and purpose. This study aimed to further examine and assess the quality of these classification schemes of KT interventions, and provide information to aid researchers when selecting a classification scheme. We abstracted the following information from each of the original 51 classification scheme articles: authors' objectives; purpose of the scheme and field of application; socioecologic level (individual, organizational, community, system); adaptability (broad versus specific); target group (patients, providers, policy-makers), intent (policy, education, practice), and purpose (dissemination versus implementation). Two reviewers independently evaluated the methodological quality of the development of each classification scheme using an adapted version of the AGREE II tool. Based on these assessments, two independent reviewers reached consensus about whether to recommend each scheme for researcher use, or not. Of the 51 original classification schemes, we excluded seven that were not specific classification schemes, not accessible or duplicates. Of the remaining 44 classification schemes, nine were not recommended. Of the 35 recommended classification schemes, ten focused on behaviour change and six focused on population health. Many schemes (n = 29) addressed practice considerations. Fewer schemes addressed educational or policy objectives. Twenty-five classification schemes had broad applicability

  2. Using the Quebec Task Force Classification to subgroup low back pain patients in primary care

    DEFF Research Database (Denmark)

    Hartvigsen, Lisbeth; Kongsted, Alice; Hestbæk, Lise

    ) patients. Compared with patients with LBP alone, patients with leg pain and patients with NRI were more severely affected across baseline characteristics and outcome measures in both CP and GP. QTF categories were associated with activity limitation at all follow-up time-points in both CP and GP (p....05) but not 3 months and 1 year. Nearly twice as many patients with LBP alone compared with patients with LBP + NRI were improved at 2 weeks in both cohorts. None of the outcomes were accurately predicted by the QTF (R2 range: 0.05-0.14); AUC range: 0.53-0.65).ConclusionsThe QTF classification differentiated...

  3. A systematic review and development of a classification framework for factors associated with missing patient-reported outcome data.

    Science.gov (United States)

    Palmer, Michael J; Mercieca-Bebber, Rebecca; King, Madeleine; Calvert, Melanie; Richardson, Harriet; Brundage, Michael

    2018-02-01

    Missing patient-reported outcome data can lead to biased results, to loss of power to detect between-treatment differences, and to research waste. Awareness of factors may help researchers reduce missing patient-reported outcome data through study design and trial processes. The aim was to construct a Classification Framework of factors associated with missing patient-reported outcome data in the context of comparative studies. The first step in this process was informed by a systematic review. Two databases (MEDLINE and CINAHL) were searched from inception to March 2015 for English articles. Inclusion criteria were (a) relevant to patient-reported outcomes, (b) discussed missing data or compliance in prospective medical studies, and (c) examined predictors or causes of missing data, including reasons identified in actual trial datasets and reported on cover sheets. Two reviewers independently screened titles and abstracts. Discrepancies were discussed with the research team prior to finalizing the list of eligible papers. In completing the systematic review, four particular challenges to synthesizing the extracted information were identified. To address these challenges, operational principles were established by consensus to guide the development of the Classification Framework. A total of 6027 records were screened. In all, 100 papers were eligible and included in the review. Of these, 57% focused on cancer, 23% did not specify disease, and 20% reported for patients with a variety of non-cancer conditions. In total, 40% of the papers offered a descriptive analysis of possible factors associated with missing data, but some papers used other methods. In total, 663 excerpts of text (units), each describing a factor associated with missing patient-reported outcome data, were extracted verbatim. Redundant units were identified and sequestered. Similar units were grouped, and an iterative process of consensus among the investigators was used to reduce these units to a

  4. Interictal Epileptiform Discharges (IEDs) classification in EEG data of epilepsy patients

    Science.gov (United States)

    Puspita, J. W.; Soemarno, G.; Jaya, A. I.; Soewono, E.

    2017-12-01

    Interictal Epileptiform Dischargers (IEDs), which consists of spike waves and sharp waves, in human electroencephalogram (EEG) are characteristic signatures of epilepsy. Spike waves are characterized by a pointed peak with a duration of 20-70 ms, while sharp waves has a duration of 70-200 ms. The purpose of the study was to classify spike wave and sharp wave of EEG data of epilepsy patients using Backpropagation Neural Network. The proposed method consists of two main stages: feature extraction stage and classification stage. In the feature extraction stage, we use frequency, amplitude and statistical feature, such as mean, standard deviation, and median, of each wave. The frequency values of the IEDs are very sensitive to the selection of the wave baseline. The selected baseline must contain all data of rising and falling slopes of the IEDs. Thus, we have a feature that is able to represent the type of IEDs, appropriately. The results show that the proposed method achieves the best classification results with the recognition rate of 93.75 % for binary sigmoid activation function and learning rate of 0.1.

  5. Land use classification and change analysis using ERTS-1 imagery in CARETS

    Science.gov (United States)

    Alexander, R. H.

    1973-01-01

    Land use detail in the CARETS area obtainable from ERTS exceeds the expectations of the Interagency Steering Committee and the USGS proposed standardized classification, which presents Level 1 categories for ERTS and Level 2 for high altitude aircraft data. Some Levels 2 and 3, in addition to Level 1, categories were identified on ERTS data. Significant land use changes totaling 39.2 sq km in the Norfolk-Portsmouth SMSA were identified and mapped at Level 2 detail using a combination of procedures employing ERTS and high altitude aircraft data.

  6. Classification of hand eczema

    DEFF Research Database (Denmark)

    Agner, T; Aalto-Korte, K; Andersen, K E

    2015-01-01

    BACKGROUND: Classification of hand eczema (HE) is mandatory in epidemiological and clinical studies, and also important in clinical work. OBJECTIVES: The aim was to test a recently proposed classification system of HE in clinical practice in a prospective multicentre study. METHODS: Patients were...... recruited from nine different tertiary referral centres. All patients underwent examination by specialists in dermatology and were checked using relevant allergy testing. Patients were classified into one of the six diagnostic subgroups of HE: allergic contact dermatitis, irritant contact dermatitis, atopic...... system investigated in the present study was useful, being able to give an appropriate main diagnosis for 89% of HE patients, and for another 7% when using two main diagnoses. The fact that more than half of the patients had one or more additional diagnoses illustrates that HE is a multifactorial disease....

  7. Development of a Patient-Reported Palliative Care-Specific Health Classification System: The POS-E.

    Science.gov (United States)

    Dzingina, Mendwas; Higginson, Irene J; McCrone, Paul; Murtagh, Fliss E M

    2017-06-01

    Generic preference-based measures are commonly used to estimate quality-adjusted life-years (QALYs) to inform resource-allocation decisions. However, concerns have been raised that generic measures may be inappropriate in palliative care. Our objective was to derive a health-state classification system that is amenable to valuation from the ten-item Palliative Care Outcome Scale (POS), a widely used patient-reported outcome measure in palliative care. The dimensional structure of the original POS was assessed using factor analysis. Item performance was assessed, using Rasch analysis and psychometric criteria, to enable the selection of items that represent the dimensions covered by the POS. Data from six studies of patients receiving palliative care were combined (N = 1011) and randomly split into two halves for development and validation. Analysis was undertaken on the development data, and results were validated by repeating the analysis with the validation dataset. Following Rasch and factor analyses, a classification system of seven items was derived. Each item had two to three levels. Rasch threshold map helped identify a set of 14 plausible health states that can be used for the valuation of the instrument to derive a preference-based index. Combining factor analysis and Rasch analysis with psychometric criteria provides a valid method of constructing a classification system for a palliative care-specific preference-based measure. The next stage is to obtain preference weights so the measure can be used in economic evaluations in palliative care.

  8. Radiation-induced morphological changes in the vagina

    International Nuclear Information System (INIS)

    Kirchheiner, K.; Fidarova, E.; Schmid, M.P.; Sturdza, A.; Kranz, A.; Poetter, R.; Nout, R.A.; Wiebe, E.; Polterauer, S.; Doerr, W.; Medical Univ. of Vienna

    2012-01-01

    Background and purpose: Treatment-induced chronic vaginal changes after definitive radio(chemo)therapy for locally advanced cervical cancer patients are reported as one of the most distressing consequences of treatment, with major impact on quality of life. Although these vaginal changes are regularly documented during gynecological follow-up examinations, the classic radiation morbidity grading scales are not concise in their reporting. The aim of the study was therefore to identify and qualitatively describe, on the basis of vaginoscopies, morphological changes in the vagina after definitive radio(chemo)therapy and to establish a classification system for their detailed and reproducible documentation. Patients and methods: Vaginoscopy with photodocumentation was performed prospectively in 22 patients with locally advanced cervical cancer after definitive radio(chemo)therapy at 3-24 months after end of treatment. All patients were in complete remission and without severe grade 3/4 morbidity outside the vagina. Results: Five morphological parameters, which occurred consistently after treatment, were identified: mucosal pallor, telangiectasia, fragility of the vaginal wall, ulceration, and adhesions/occlusion. The symptoms in general were observed at different time points in individual patients; their quality was independent of the time of assessment. Based on the morphological findings, a comprehensive descriptive and semiquantitative scoring system was developed, which allows for classification of vaginal changes. A photographic atlas to illustrate the morphology of the alterations is presented. Conclusion: Vaginoscopy is an easily applicable, informative, and well-tolerated procedure for the objective assessment of morphological vaginal changes after radio(chemo)therapy and provides comprehensive and detailed information. This allows for precise classification of the severity of individual changes. (orig.)

  9. 34 CFR 222.8 - What action must an applicant take upon a change in its boundary, classification, control...

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false What action must an applicant take upon a change in its boundary, classification, control, governing authority, or identity? 222.8 Section 222.8 Education..., DEPARTMENT OF EDUCATION IMPACT AID PROGRAMS General § 222.8 What action must an applicant take upon a change...

  10. Accuracy of the all patient refined diagnosis related groups classification system in congenital heart surgery.

    Science.gov (United States)

    Parnell, Aimee S; Shults, Justine; Gaynor, J William; Leonard, Mary B; Dai, Dingwei; Feudtner, Chris

    2014-02-01

    Administrative data are increasingly used to evaluate clinical outcomes and quality of care in pediatric congenital heart surgery (CHS) programs. Several published analyses of large pediatric administrative data sets have relied on the All Patient Refined Diagnosis Related Groups (APR-DRG, version 24) diagnostic classification system. The accuracy of this classification system for patients undergoing CHS is unclear. We performed a retrospective cohort study of all 14,098 patients 0 to 5 years of age undergoing any of six selected congenital heart operations, ranging in complexity from isolated closure of a ventricular septal defect to single-ventricle palliation, at 40 tertiary-care pediatric centers in the Pediatric Health Information Systems database between 2007 and 2010. Assigned APR-DRGs (cardiac versus noncardiac) were compared using χ2 or Fisher's exact tests between those patients admitted during the first day of life versus later and between those receiving extracorporeal membrane oxygenation support versus those not. Recursive partitioning was used to assess the greatest determinants of APR-DRG type in the model. Every patient admitted on day 1 of life was assigned to a noncardiac APR-DRG (pDRG (pDRG experienced a significantly increased mortality (pDRG coding has systematic misclassifications, which may result in inaccurate reporting of CHS case volumes and mortality. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  11. CT classification and clinical prognosis of cerebral infarction in the area of middle cerebral artery

    International Nuclear Information System (INIS)

    Konno, Jyoji

    1983-01-01

    Computerized tomographies (CT) were repeatedly scanned on 70 patients with cerebral infarction in the middle cerebral artery. Low density area (LDA) was measured with HounFsfield's Unit (HU) and studied on the progressive changes. Classification of LDA was attempted and studied on correlation with mass effect, contrast enhancement, angiographical findings, clinical symptoms and prognosis. It was considered that important points of diagnosis of cerebral infarction were timing of examination of CT and determination of LDA with HUF. It was also thought that CT classification of LDA was usefull to estimate prognosis of the patients with cerebral infarction. (author)

  12. Reproducibility of measurements and variability of the classification algorithm of Stratus OCT in normal, hypertensive, and glaucomatous patients

    Directory of Open Access Journals (Sweden)

    Alfonso Antón

    2009-01-01

    Full Text Available Alfonso Antón1,2,3, Marta Castany1,2, Marta Pazos-Lopez1,2, Ruben Cuadrado3, Ana Flores3, Miguel Castilla11Hospital de la Esperanza-Hospital del Mar (IMAS, Barcelona, Spain; 2Institut Català de la Retina (ICR, Barcelona, Spain. Glaucoma Department; 3Instituto Universitario de Oftalmobiología Aplicada (IOBA, Universidad de Valladolid, Valladolid, EspañaPurpose: To assess the reproducibility of retinal nerve fiber layer (RNFL measurements and the variability of the probabilistic classification algorithm in normal, hypertensive and glaucomatous eyes using Stratus optical coherence tomography (OCT.Methods: Forty-nine eyes (13 normal, 17 ocular hypertensive [OHT] and 19 glaucomatous of 49 subjects were included in this study. RNFL was determined with Stratus OCT using the standard protocol RNFL thickness 3.4. Three different images of each eye were taken consecutively during the same session. To evaluate OCT reproducibility, coefficient of variation (COV and intraclass correlation coefficient (ICC were calculated for average thickness (AvgT, superior average thickness (Savg, and inferior average thickness (Iavg parameters. The variability of the results of the probabilistic classification algorithm, based on the OCT normative database, was also analyzed. The percentage of eyes with changes in the category assigned was calculated for each group.Results: The 50th percentile of COV was 2.96%, 4.00%, and 4.31% for AvgT, Savg, and Iavg, respectively. Glaucoma group presented the largest COV for all three parameters (3.87%, 5.55%, 7.82%. ICC were greater than 0.75 for almost all measures (except from the inferior thickness parameter in the normal group; ICC = 0.64, 95% CI 0.334–0.857. Regarding the probabilistic classification algorithm for the three parameters (AvgT, Savg, Iavg, the percentage of eyes without color-code category changes among the three images was as follows: normal group, 100%, 84.6% and 92%; OHT group, 89.5%, 52.7%, 79%; and

  13. WHO/ISUP classification of the urothelial tumors of the urinary bladder

    Directory of Open Access Journals (Sweden)

    Zdenka Ovčak

    2005-09-01

    Full Text Available Background: The authors present the current classification of urothelial neoplasms of the urinary bladder. The classification of urothelial tumors of the urinary bladder of 1973 was despite some imperfection relatively successfuly used for more than thirty years. The three grade classification of papillary urothelial tumors without invasion has been based on evaluation of variations in architecture of covering epithelium and tumor cell anaplasia. As reccomended by the International Society of Urological Pathologists (ISUP, the World Health Organisation (WHO accepted the new WHO/ ISUP classification in 1998 that was revised in 2002 and finally published in 2004. With intention to avoid unnecessary diagnosis of cancer in patients having papillary urothelial tumors with rare invasive or metastastatic growth, this classification introduced a new entity, the papillary urothelial neoplasia of low malignant potential (PUNLMP. The additional change in classification was the division of invasive urothelial neoplasms only to low and high grade urothelial carcinomas.Conclusions: The authors’ opinion is that although the old classification is not recommended for use anymore the new one is not solving the elementary reproaches to previous classification such as terminological unsuitability and insufficient scientific reasoning. Our proposed solution in classification of papillary urothelial neoplasms would be the application of criteria analogous to that used in diagnostics of papillary noninvasive tumors of the head and neck or alimentary tract.

  14. External Validation of the European Hernia Society Classification for Postoperative Complications after Incisional Hernia Repair: A Cohort Study of 2,191 Patients.

    Science.gov (United States)

    Kroese, Leonard F; Kleinrensink, Gert-Jan; Lange, Johan F; Gillion, Jean-Francois

    2018-03-01

    Incisional hernia is a frequent complication after midline laparotomy. Surgical hernia repair is associated with complications, but no clear predictive risk factors have been identified. The European Hernia Society (EHS) classification offers a structured framework to describe hernias and to analyze postoperative complications. Because of its structured nature, it might prove to be useful for preoperative patient or treatment classification. The objective of this study was to investigate the EHS classification as a predictor for postoperative complications after incisional hernia surgery. An analysis was performed using a registry-based, large-scale, prospective cohort study, including all patients undergoing incisional hernia surgery between September 1, 2011 and February 29, 2016. Univariate analyses and multivariable logistic regression analysis were performed to identify risk factors for postoperative complications. A total of 2,191 patients were included, of whom 323 (15%) had 1 or more complications. Factors associated with complications in univariate analyses (p < 0.20) and clinically relevant factors were included in the multivariable analysis. In the multivariable analysis, EHS width class, incarceration, open surgery, duration of surgery, Altemeier wound class, and therapeutic antibiotic treatment were independent risk factors for postoperative complications. Third recurrence and emergency surgery were associated with fewer complications. Incisional hernia repair is associated with a 15% complication rate. The EHS width classification is associated with postoperative complications. To identify patients at risk for complications, the EHS classification is useful. Copyright © 2017. Published by Elsevier Inc.

  15. The 2017 World Health Organization classification of tumors of the pituitary gland: a summary.

    Science.gov (United States)

    Lopes, M Beatriz S

    2017-10-01

    The 4th edition of the World Health Organization (WHO) classification of endocrine tumors has been recently released. In this new edition, major changes are recommended in several areas of the classification of tumors of the anterior pituitary gland (adenophypophysis). The scope of the present manuscript is to summarize these recommended changes, emphasizing a few significant topics. These changes include the following: (1) a novel approach for classifying pituitary neuroendocrine tumors according to pituitary adenohypophyseal cell lineages; (2) changes to the histological grading of pituitary neuroendocrine tumors with the elimination of the term "atypical adenoma;" and (3) introduction of new entities like the pituitary blastoma and re-definition of old entities like the null-cell adenoma. This new classification is very practical and mostly based on immunohistochemistry for pituitary hormones, pituitary-specific transcription factors, and other immunohistochemical markers commonly used in pathology practice, not requiring routine ultrastructural analysis of the tumors. Evaluation of tumor proliferation potential, by mitotic count and Ki-67 labeling index, and tumor invasion is strongly recommended on individual case basis to identify clinically aggressive adenomas. In addition, the classification offers the treating clinical team information on tumor prognosis by identifying specific variants of adenomas associated with an elevated risk for recurrence. Changes in the classification of non-neuroendocrine tumors are also proposed, in particular those tumors arising in the posterior pituitary including pituicytoma, granular cell tumor of the posterior pituitary, and spindle cell oncocytoma. These changes endorse those previously published in the 2016 WHO classification of CNS tumors. Other tumors arising in the sellar region are also reviewed in detail including craniopharyngiomas, mesenchymal and stromal tumors, germ cell tumors, and hematopoietic tumors. It is

  16. Review of therapeutic agents for burns pruritus and protocols for management in adult and paediatric patients using the GRADE classification

    Directory of Open Access Journals (Sweden)

    Goutos Ioannis

    2010-10-01

    Full Text Available To review the current evidence on therapeutic agents for burns pruritus and use the Grading of Recommendations, Assessment, Development and Evaluation (GRADE classification to propose therapeutic protocols for adult and paediatric patients. All published interventions for burns pruritus were analysed by a multidisciplinary panel of burns specialists following the GRADE classification to rate individual agents. Following the collation of results and panel discussion, consensus protocols are presented. Twenty-three studies appraising therapeutic agents in the burns literature were identified. The majority of these studies (16 out of 23 are of an observational nature, making an evidence-based approach to defining optimal therapy not feasible. Our multidisciplinary approach employing the GRADE classification recommends the use of antihistamines (cetirizine and cimetidine and gabapentin as the first-line pharmacological agents for both adult and paediatric patients. Ondansetron and loratadine are the second-line medications in our protocols. We additionally recommend a variety of non-pharmacological adjuncts for the perusal of clinicians in order to maximise symptomatic relief in patients troubled with postburn itch. Most studies in the subject area lack sufficient statistical power to dictate a ′gold standard′ treatment agent for burns itch. We encourage clinicians to employ the GRADE system in order to delineate the most appropriate therapeutic approach for burns pruritus until further research elucidates the most efficacious interventions. This widely adopted classification empowers burns clinicians to tailor therapeutic regimens according to current evidence, patient values, risks and resource considerations in different medical environments.

  17. BODE index versus GOLD classification for explaining anxious and depressive symptoms in patients with COPD – a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Burghuber Otto

    2009-01-01

    Full Text Available Abstract Background Anxiety and depression are common and treatable risk factors for re-hospitalisation and death in patients with COPD. The degree of lung function impairment does not sufficiently explain anxiety and depression. The BODE index allows a functional classification of COPD beyond FEV1. The aim of this cross-sectional study was (1 to test whether the BODE index is superior to the GOLD classification for explaining anxious and depressive symptoms; and (2 to assess which components of the BODE index are associated with these psychological aspects of COPD. Methods COPD was classified according to the GOLD stages based on FEV1%predicted in 122 stable patients with COPD. An additional four stage classification was constructed based on the quartiles of the BODE index. The hospital anxiety and depression scale was used to assess anxious and depressive symptoms. Results The overall prevalence of anxious and depressive symptoms was 49% and 52%, respectively. The prevalence of anxious symptoms increased with increasing BODE stages but not with increasing GOLD stages. The prevalence of depressive symptoms increased with both increasing GOLD and BODE stages. The BODE index was superior to FEV1%predicted for explaining anxious and depressive symptoms. Anxious symptoms were explained by dyspnoea. Depressive symptoms were explained by both dyspnoea and reduced exercise capacity. Conclusion The BODE index is superior to the GOLD classification for explaining anxious and depressive symptoms in COPD patients. These psychological consequences of the disease may play a role in future classification systems of COPD.

  18. Pain assessment according to the International Spinal Cord Injury Pain classification in patients with spinal cord injury referred to a multidisciplinary pain center.

    Science.gov (United States)

    Mahnig, S; Landmann, G; Stockinger, L; Opsommer, E

    2016-10-01

    This is a retrospective study. The aim of this study was to investigate the epidemiology of pain types in patients with spinal cord injury (SCI) according to the International Spinal Cord Injury Pain (ISCIP) classification. This study was conducted in a multidisciplinary pain center. Socio-demographic and clinical data were examined and ISCIP classification was applied. Sixty-six individuals (51±13 years) with SCI had pain, a lesion older than 5 years in 67% and a pain history older than 5 years in 54% of patients. According to the ISCIP classification, nociceptive pain was present in 58% (musculoskeletal pain) and 3% (visceral pain) of the patients. At-level, below-level neuropathic pain and other neuropathic pain were observed, respectively in 53, 42 and 5% of patients. Unknown pain type was found in 8% of patients. Patients with complete lesions showed significantly more frequent neuropathic pain (P=0.021) and more frequent at-level SCI pain (P=0.00) compared with those with incomplete lesions. Patients with paraplegia had more often at-level pain (P=0.00), whereas patients with tetraplegia reported more often below-level pain (P=0.00). Patients had severe pain (mean intensity: 8.2 (±1.6) on a 0 to 10 numerical scale) and showed high grades of pain chronicity. Mild to severe depression and anxiety were present, respectively in 53 and 56% of patients. The health-related quality of life was low. The use of the ISCIP classification in a clinical setting is mirroring the very complex pain situation in patients with SCI referred to a multidisciplinary pain center, and it might be an important step for adequate pain therapy.

  19. Gynecomastia Classification for Surgical Management: A Systematic Review and Novel Classification System.

    Science.gov (United States)

    Waltho, Daniel; Hatchell, Alexandra; Thoma, Achilleas

    2017-03-01

    Gynecomastia is a common deformity of the male breast, where certain cases warrant surgical management. There are several surgical options, which vary depending on the breast characteristics. To guide surgical management, several classification systems for gynecomastia have been proposed. A systematic review was performed to (1) identify all classification systems for the surgical management of gynecomastia, and (2) determine the adequacy of these classification systems to appropriately categorize the condition for surgical decision-making. The search yielded 1012 articles, and 11 articles were included in the review. Eleven classification systems in total were ascertained, and a total of 10 unique features were identified: (1) breast size, (2) skin redundancy, (3) breast ptosis, (4) tissue predominance, (5) upper abdominal laxity, (6) breast tuberosity, (7) nipple malposition, (8) chest shape, (9) absence of sternal notch, and (10) breast skin elasticity. On average, classification systems included two or three of these features. Breast size and ptosis were the most commonly included features. Based on their review of the current classification systems, the authors believe the ideal classification system should be universal and cater to all causes of gynecomastia; be surgically useful and easy to use; and should include a comprehensive set of clinically appropriate patient-related features, such as breast size, breast ptosis, tissue predominance, and skin redundancy. None of the current classification systems appears to fulfill these criteria.

  20. Impact of FAB classification on predicting outcome in acute myeloid leukemia, not otherwise specified, patients undergoing allogeneic stem cell transplantation in CR1: An analysis of 1690 patients from the acute leukemia working party of EBMT.

    Science.gov (United States)

    Canaani, Jonathan; Beohou, Eric; Labopin, Myriam; Socié, Gerard; Huynh, Anne; Volin, Liisa; Cornelissen, Jan; Milpied, Noel; Gedde-Dahl, Tobias; Deconinck, Eric; Fegueux, Nathalie; Blaise, Didier; Mohty, Mohamad; Nagler, Arnon

    2017-04-01

    The French, American, and British (FAB) classification system for acute myeloid leukemia (AML) is extensively used and is incorporated into the AML, not otherwise specified (NOS) category in the 2016 WHO edition of myeloid neoplasm classification. While recent data proposes that FAB classification does not provide additional prognostic information for patients for whom NPM1 status is available, it is unknown whether FAB still retains a current prognostic role in predicting outcome of AML patients undergoing allogeneic stem cell transplantation. Using the European Society of Blood and Bone Marrow Transplantation registry we analyzed outcome of 1690 patients transplanted in CR1 to determine if FAB classification provides additional prognostic value. Multivariate analysis revealed that M6/M7 patients had decreased leukemia free survival (hazard ratio (HR) of 1.41, 95% confidence interval (CI), 1.01-1.99; P = .046) in addition to increased nonrelapse mortality (NRM) rates (HR, 1.79; 95% CI, 1.06-3.01; P = .028) compared with other FAB types. In the NPM1 wt AML, NOS cohort, FAB M6/M7 was also associated with increased NRM (HR, 2.17; 95% CI, 1.14-4.16; P = .019). Finally, in FLT3-ITD + patients, multivariate analyses revealed that specific FAB types were tightly associated with adverse outcome. In conclusion, FAB classification may predict outcome following transplantation in AML, NOS patients. © 2017 Wiley Periodicals, Inc.

  1. A comparison of change detection measurements using object-based and pixel-based classification methods on western juniper dominated woodlands in eastern Oregon

    Directory of Open Access Journals (Sweden)

    Ryan G. Howell

    2017-03-01

    Full Text Available Encroachment of pinyon (Pinus spp and juniper (Juniperus spp. woodlands in western North America is considered detrimental due to its effects on ecohydrology, plant community structure, and soil stability. Management plans at the federal, state, and private level often include juniper removal for improving habitat of sensitive species and maintaining sustainable ecosystem processes. Remote sensing has become a useful tool in determining changes in juniper woodland structure because of its uses in comparing archived historic imagery with newly available multispectral images to provide information on changes that are no longer detectable by field measurements. Change in western juniper (J. occidentalis cover was detected following juniper removal treatments between 1995 and 2011 using panchromatic 1-meter NAIP and 4-band 1-meter NAIP imagery, respectively. Image classification was conducted using remotely sensed images taken at the Roaring Springs Ranch in southeastern Oregon. Feature Analyst for ArcGIS (object-based extraction and a supervised classification with ENVI 5.2 (pixel-based extraction were used to delineate juniper canopy cover. Image classification accuracy was calculated using an Accuracy Assessment and Kappa Statistic. Both methods showed approximately a 76% decrease in western juniper cover, although differing in total canopy cover area, with object-based classification being more accurate. Classification results for the 2011 imagery were much more accurate (0.99 Kappa statistic because of its low juniper density and the presence of an infrared band. The development of methods for detecting change in juniper cover can lead to more accurate and efficient data acquisition and subsequently improved land management and monitoring practices. These data can subsequently be used to assess and quantify juniper invasion and succession, potential ecological impacts, and plant community resilience.

  2. Casemix classification systems.

    Science.gov (United States)

    Fetter, R B

    1999-01-01

    The idea of using casemix classification to manage hospital services is not new, but has been limited by available technology. It was not until after the introduction of Medicare in the United States in 1965 that serious attempts were made to measure hospital production in order to contain spiralling costs. This resulted in a system of casemix classification known as diagnosis related groups (DRGs). This paper traces the development of DRGs and their evolution from the initial version to the All Patient Refined DRGs developed in 1991.

  3. Accessory cardiac bronchus: Proposed imaging classification on multidetector CT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kang Min; Kim, Young Tong; Han, Jong Kyu; Jou, Sung Shick [Dept. of Radiology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan (Korea, Republic of)

    2016-02-15

    To propose the classification of accessory cardiac bronchus (ACB) based on imaging using multidetector computed tomography (MDCT), and evaluate follow-up changes of ACB. This study included 58 patients diagnosed as ACB since 9 years, using MDCT. We analyzed the types, division locations and division directions of ACB, and also evaluated changes on follow-up. We identified two main types of ACB: blind-end (51.7%) and lobule (48.3%). The blind-end ACB was further classified into three subtypes: blunt (70%), pointy (23.3%) and saccular (6.7%). The lobule ACB was also further classified into three subtypes: complete (46.4%), incomplete (28.6%) and rudimentary (25%). Division location to the upper half bronchus intermedius (79.3%) and medial direction (60.3%) were the most common in all patients. The difference in division direction was statistically significant between the blind-end and lobule types (p = 0.019). Peribronchial soft tissue was found in five cases. One calcification case was identified in the lobule type. During follow-up, ACB had disappeared in two cases of the blind-end type and in one case of the rudimentary subtype. The proposed classification of ACB based on imaging, and the follow-up CT, helped us to understand the various imaging features of ACB.

  4. [Nursing care mapping for patients at risk of falls in the Nursing Interventions Classification].

    Science.gov (United States)

    Luzia, Melissa de Freitas; Almeida, Miriam de Abreu; Lucena, Amália de Fátima

    2014-08-01

    Identifying the prescribed nursing care for hospitalized patients at risk of falls and comparing them with the interventions of the Nursing Interventions Classifications (NIC). A cross-sectional study carried out in a university hospital in southern Brazil. It was a retrospective data collection in the nursing records system. The sample consisted of 174 adult patients admitted to medical and surgical units with the Nursing Diagnosis of Risk for falls. The prescribed care were compared with the NIC interventions by the cross-mapping method. The most prevalent care were the following: keeping the bed rails, guiding patients/family regarding the risks and prevention of falls, keeping the bell within reach of patients, and maintaining patients' belongings nearby, mapped in the interventions Environmental Management: safety and Fall Prevention. The treatment prescribed in clinical practice was corroborated by the NIC reference.

  5. Results of high-energy transurethral microwave thermotherapy in patients categorized according to the American Society of Anesthesiologists operative risk classification

    NARCIS (Netherlands)

    D'Ancona, F. C.; van der Bij, A. K.; Francisca, E. A.; Kho, H.; Debruyne, F. M.; Kiemeney, L. A.; de la Rosette, J. J.

    1999-01-01

    To evaluate the relation between the American Society of Anesthesiologists (ASA) classification and response to transurethral microwave thermotherapy (TUMT) in patients with lower urinary tract symptoms and benign prostatic hyperplasia (BPH). Two hundred forty-seven patients with symptomatic BPH

  6. Adaptive Neuro-Fuzzy Inference System for Classification of Background EEG Signals from ESES Patients and Controls

    Directory of Open Access Journals (Sweden)

    Zhixian Yang

    2014-01-01

    Full Text Available Background electroencephalography (EEG, recorded with scalp electrodes, in children with electrical status epilepticus during slow-wave sleep (ESES syndrome and control subjects has been analyzed. We considered 10 ESES patients, all right-handed and aged 3–9 years. The 10 control individuals had the same characteristics of the ESES ones but presented a normal EEG. Recordings were undertaken in the awake and relaxed states with their eyes open. The complexity of background EEG was evaluated using the permutation entropy (PE and sample entropy (SampEn in combination with the ANOVA test. It can be seen that the entropy measures of EEG are significantly different between the ESES patients and normal control subjects. Then, a classification framework based on entropy measures and adaptive neuro-fuzzy inference system (ANFIS classifier is proposed to distinguish ESES and normal EEG signals. The results are promising and a classification accuracy of about 89% is achieved.

  7. From Molecular Classification to Targeted Therapeutics: The Changing Face of Systemic Therapy in Metastatic Gastroesophageal Cancer

    Directory of Open Access Journals (Sweden)

    Adrian Murphy

    2015-01-01

    Full Text Available Histological classification of adenocarcinoma or squamous cell carcinoma for esophageal cancer or using the Lauren classification for intestinal and diffuse type gastric cancer has limited clinical utility in the management of advanced disease. Germline mutations in E-cadherin (CDH1 or mismatch repair genes (Lynch syndrome were identified many years ago but given their rarity, the identification of these molecular alterations does not substantially impact treatment in the advanced setting. Recent molecular profiling studies of upper GI tumors have added to our knowledge of the underlying biology but have not led to an alternative classification system which can guide clinician’s therapeutic decisions. Recently the Cancer Genome Atlas Research Network has proposed four subtypes of gastric cancer dividing tumors into those positive for Epstein-Barr virus, microsatellite unstable tumors, genomically stable tumors, and tumors with chromosomal instability. Unfortunately to date, many phase III clinical trials involving molecularly targeted agents have failed to meet their survival endpoints due to their use in unselected populations. Future clinical trials should utilize molecular profiling of individual tumors in order to determine the optimal use of targeted therapies in preselected patients.

  8. Mapping of the Universe of Knowledge in Different Classification Schemes

    Directory of Open Access Journals (Sweden)

    M. P. Satija

    2017-06-01

    Full Text Available Given the variety of approaches to mapping the universe of knowledge that have been presented and discussed in the literature, the purpose of this paper is to systematize their main principles and their applications in the major general modern library classification schemes. We conducted an analysis of the literature on classification and the main classification systems, namely Dewey/Universal Decimal Classification, Cutter’s Expansive Classification, Subject Classification of J.D. Brown, Colon Classification, Library of Congress Classification, Bibliographic Classification, Rider’s International Classification, Bibliothecal Bibliographic Klassification (BBK, and Broad System of Ordering (BSO. We conclude that the arrangement of the main classes can be done following four principles that are not mutually exclusive: ideological principle, social purpose principle, scientific order, and division by discipline. The paper provides examples and analysis of each system. We also conclude that as knowledge is ever-changing, classifications also change and present a different structure of knowledge depending upon the society and time of their design.

  9. CLASSIFICATION OF ORTHOGNATHIC SURGERY PATIENTS INTO LOW AND HIGH BLEEDING RISK GROUPS USING THROMBELASTOGRAPHY

    DEFF Research Database (Denmark)

    Elenius Madsen, Daniel

    2012-01-01

    Title: CLASSIFICATION OF ORTHOGNATHIC SURGERY PATIENTS INTO LOW AND HIGH BLEEDING RISK GROUPS USING THROMBELASTOGRAPHY Objectives: Orthognathic surgery involves surgical manipulation of jaw and face skeletal structure. A subgroup of patients undergoing orthognathic surgery suffers from excessive...... into account the complex interplay between coagulation factors, blood platelets and components of the fibrinolytic system. Patients undergoing orthognathic surgery were included in this prospective study, and their preoperative thrombelastographic data were collected and compared to their intraoperative blood...... predictive values. An α angleex above 67o did with 95% certainty predict a blood loss below 400 mL, and a receiver-operating characteristic (ROC) curve showed an area under the curve (AUC) of 0.8. Conclusion: By means of the α angleex it is possible to separate orthognathic surgery patients according...

  10. Customized oligonucleotide microarray gene expression-based classification of neuroblastoma patients outperforms current clinical risk stratification.

    Science.gov (United States)

    Oberthuer, André; Berthold, Frank; Warnat, Patrick; Hero, Barbara; Kahlert, Yvonne; Spitz, Rüdiger; Ernestus, Karen; König, Rainer; Haas, Stefan; Eils, Roland; Schwab, Manfred; Brors, Benedikt; Westermann, Frank; Fischer, Matthias

    2006-11-01

    To develop a gene expression-based classifier for neuroblastoma patients that reliably predicts courses of the disease. Two hundred fifty-one neuroblastoma specimens were analyzed using a customized oligonucleotide microarray comprising 10,163 probes for transcripts with differential expression in clinical subgroups of the disease. Subsequently, the prediction analysis for microarrays (PAM) was applied to a first set of patients with maximally divergent clinical courses (n = 77). The classification accuracy was estimated by a complete 10-times-repeated 10-fold cross validation, and a 144-gene predictor was constructed from this set. This classifier's predictive power was evaluated in an independent second set (n = 174) by comparing results of the gene expression-based classification with those of risk stratification systems of current trials from Germany, Japan, and the United States. The first set of patients was accurately predicted by PAM (cross-validated accuracy, 99%). Within the second set, the PAM classifier significantly separated cohorts with distinct courses (3-year event-free survival [EFS] 0.86 +/- 0.03 [favorable; n = 115] v 0.52 +/- 0.07 [unfavorable; n = 59] and 3-year overall survival 0.99 +/- 0.01 v 0.84 +/- 0.05; both P model, the PAM predictor classified patients of the second set more accurately than risk stratification of current trials from Germany, Japan, and the United States (P < .001; hazard ratio, 4.756 [95% CI, 2.544 to 8.893]). Integration of gene expression-based class prediction of neuroblastoma patients may improve risk estimation of current neuroblastoma trials.

  11. Cutaneous Leiomyoma: Novel Histologic Findings for Classification and Diagnosis

    Directory of Open Access Journals (Sweden)

    Kambiz Kamyab Hesari

    2013-01-01

    Full Text Available Smooth muscle tumors rather benign or malignant can arise wherever the muscular tissue presents but cutaneous leiomyoma is one of the rare benign tumors of the which even the diagnostic criteria from the malignant type of the tumor is still in doubt. This study was aimed to compare the subtypes of cutaneous leiomyoma from different histologic aspects in order to find unique criteria for better classification and diagnosis. The six year data base of our center was reviewed and 25 patients with cutaneous leiomyoma were included in this study. Of 25 patients, 5 were female and 20 were male. 5 patients had angioleiomyoma (ALM and 20 had pilar leiomyoma (PLM. ALM had following characteristics: dilated vascular canals intermingled with compact smooth muscle bundles; well circumscribe counter and myxoid and hyaline changes through the tumor. In contrast, PLMs had following histologic features: poor defined outline, entrapped hair follicles and eccrine glands, acanthosis and elongated rete ridges with hyperpigmentation and smooth muscle bundles which are interdigitated with elongated rete ridges. Here we introduced some distinct histological features for each subtype of the cutaneous leiomyoma which can lead to create novel criteria for classification and diagnosis of the lesion.

  12. Using methods from the data mining and machine learning literature for disease classification and prediction: A case study examining classification of heart failure sub-types

    Science.gov (United States)

    Austin, Peter C.; Tu, Jack V.; Ho, Jennifer E.; Levy, Daniel; Lee, Douglas S.

    2014-01-01

    Objective Physicians classify patients into those with or without a specific disease. Furthermore, there is often interest in classifying patients according to disease etiology or subtype. Classification trees are frequently used to classify patients according to the presence or absence of a disease. However, classification trees can suffer from limited accuracy. In the data-mining and machine learning literature, alternate classification schemes have been developed. These include bootstrap aggregation (bagging), boosting, random forests, and support vector machines. Study design and Setting We compared the performance of these classification methods with those of conventional classification trees to classify patients with heart failure according to the following sub-types: heart failure with preserved ejection fraction (HFPEF) vs. heart failure with reduced ejection fraction (HFREF). We also compared the ability of these methods to predict the probability of the presence of HFPEF with that of conventional logistic regression. Results We found that modern, flexible tree-based methods from the data mining literature offer substantial improvement in prediction and classification of heart failure sub-type compared to conventional classification and regression trees. However, conventional logistic regression had superior performance for predicting the probability of the presence of HFPEF compared to the methods proposed in the data mining literature. Conclusion The use of tree-based methods offers superior performance over conventional classification and regression trees for predicting and classifying heart failure subtypes in a population-based sample of patients from Ontario. However, these methods do not offer substantial improvements over logistic regression for predicting the presence of HFPEF. PMID:23384592

  13. [Diagnosis and classification of headache and temporomandibular disorders, a new opportunity].

    Science.gov (United States)

    Koole, P; Koole, R

    2011-05-01

    Patients with orofacial pains are generally treated by physicians. A small number of patients are treated for pain in the temporomandibular joint, the masticatory and the neck muscles, by dentists and orofacial surgeons. Among half of the patients being treated in neurological headache clinics, the temporomandibular joint and the masticatory muscles are the source of the pain. In order to achieve better research and a classification, the International Headache Society, consisting largely of neurologists, developed a classification system. A comparable development occurred among oral health specialists. Employing these 2 methods with the same patients leads to different diagnoses and treatments. Both the International Classification of Headache Disorders II and the Research Diagnostic Criteria for Temporomandibular Disorders are being revised. This creates the opportunity to establish a single classification for these orofacial pains, preferably within the new International Classification of Headache Disorders.

  14. Bridging interest, classification and technology gaps in the climate change regime

    International Nuclear Information System (INIS)

    Gupta, J.; Van der Werff, P.; Gagnon-Lebrun, F.; Van Dijk, I.; Verspeek, F.; Arkesteijn, E.; Van der Meer, J.

    2002-01-01

    The climate change regime is affected by a major credibility gap; there is a gap between what countries have been stating that they are willing to do and what they actually do. This is visible not just in the inability of the developed countries to stabilise their emissions at 1990 levels by the year 2000 as provided for in the United Nations Framework Convention on Climate Change (FCCC), but by the general reluctance of all countries to ratify the Kyoto Protocol to the Convention (KPFCCC). This research postulates that this credibility gap is affected further by three other types of gaps: 1) the interest gap; 2) the classification gap; and 3) the technology gap. The purpose of this research is thus to identify ways and means to promote industrial transformation in developing countries as a method to address the climate change problem. The title of this project is: Bridging Gaps - Enhancing Domestic and International Technological Collaboration to Enable the Adoption of Climate Relevant Technologies and Practices (CT and Ps) and thereby Foster Participation and Implementation of the Climate Convention (FCCC) by Developing Countries (DCs). In order to enhance technology co-operation, we believe that graduation profiles are needed at the international level and stakeholder involvement at both the national and international levels. refs

  15. Facial aging: A clinical classification

    Directory of Open Access Journals (Sweden)

    Shiffman Melvin

    2007-01-01

    Full Text Available The purpose of this classification of facial aging is to have a simple clinical method to determine the severity of the aging process in the face. This allows a quick estimate as to the types of procedures that the patient would need to have the best results. Procedures that are presently used for facial rejuvenation include laser, chemical peels, suture lifts, fillers, modified facelift and full facelift. The physician is already using his best judgment to determine which procedure would be best for any particular patient. This classification may help to refine these decisions.

  16. Trends and concepts in fern classification

    Science.gov (United States)

    Christenhusz, Maarten J. M.; Chase, Mark W.

    2014-01-01

    Background and Aims Throughout the history of fern classification, familial and generic concepts have been highly labile. Many classifications and evolutionary schemes have been proposed during the last two centuries, reflecting different interpretations of the available evidence. Knowledge of fern structure and life histories has increased through time, providing more evidence on which to base ideas of possible relationships, and classification has changed accordingly. This paper reviews previous classifications of ferns and presents ideas on how to achieve a more stable consensus. Scope An historical overview is provided from the first to the most recent fern classifications, from which conclusions are drawn on past changes and future trends. The problematic concept of family in ferns is discussed, with a particular focus on how this has changed over time. The history of molecular studies and the most recent findings are also presented. Key Results Fern classification generally shows a trend from highly artificial, based on an interpretation of a few extrinsic characters, via natural classifications derived from a multitude of intrinsic characters, towards more evolutionary circumscriptions of groups that do not in general align well with the distribution of these previously used characters. It also shows a progression from a few broad family concepts to systems that recognized many more narrowly and highly controversially circumscribed families; currently, the number of families recognized is stabilizing somewhere between these extremes. Placement of many genera was uncertain until the arrival of molecular phylogenetics, which has rapidly been improving our understanding of fern relationships. As a collective category, the so-called ‘fern allies’ (e.g. Lycopodiales, Psilotaceae, Equisetaceae) were unsurprisingly found to be polyphyletic, and the term should be abandoned. Lycopodiaceae, Selaginellaceae and Isoëtaceae form a clade (the lycopods) that is

  17. Trends and concepts in fern classification.

    Science.gov (United States)

    Christenhusz, Maarten J M; Chase, Mark W

    2014-03-01

    Throughout the history of fern classification, familial and generic concepts have been highly labile. Many classifications and evolutionary schemes have been proposed during the last two centuries, reflecting different interpretations of the available evidence. Knowledge of fern structure and life histories has increased through time, providing more evidence on which to base ideas of possible relationships, and classification has changed accordingly. This paper reviews previous classifications of ferns and presents ideas on how to achieve a more stable consensus. An historical overview is provided from the first to the most recent fern classifications, from which conclusions are drawn on past changes and future trends. The problematic concept of family in ferns is discussed, with a particular focus on how this has changed over time. The history of molecular studies and the most recent findings are also presented. Fern classification generally shows a trend from highly artificial, based on an interpretation of a few extrinsic characters, via natural classifications derived from a multitude of intrinsic characters, towards more evolutionary circumscriptions of groups that do not in general align well with the distribution of these previously used characters. It also shows a progression from a few broad family concepts to systems that recognized many more narrowly and highly controversially circumscribed families; currently, the number of families recognized is stabilizing somewhere between these extremes. Placement of many genera was uncertain until the arrival of molecular phylogenetics, which has rapidly been improving our understanding of fern relationships. As a collective category, the so-called 'fern allies' (e.g. Lycopodiales, Psilotaceae, Equisetaceae) were unsurprisingly found to be polyphyletic, and the term should be abandoned. Lycopodiaceae, Selaginellaceae and Isoëtaceae form a clade (the lycopods) that is sister to all other vascular plants, whereas

  18. A Comprehensive Analysis of the SRS-Schwab Adult Spinal Deformity Classification and Confounding Variables: A Prospective, Non-US Cross-sectional Study in 292 Patients.

    Science.gov (United States)

    Hallager, Dennis Winge; Hansen, Lars Valentin; Dragsted, Casper Rokkjær; Peytz, Nina; Gehrchen, Martin; Dahl, Benny

    2016-05-01

    Cross-sectional analyses on a consecutive, prospective cohort. To evaluate the ability of the Scoliosis Research Society (SRS)-Schwab Adult Spinal Deformity Classification to group patients by widely used health-related quality-of-life (HRQOL) scores and examine possible confounding variables. The SRS-Schwab Adult Spinal Deformity Classification includes sagittal modifiers considered important for HRQOL and the clinical impact of the classification has been validated in patients from the International Spine Study Group database; however, equivocal results were reported for the Pelvic Tilt modifier and potential confounding variables were not evaluated. Between March 2013 and May 2014, all adult spinal deformity patients from our outpatient clinic with sufficient radiographs were prospectively enrolled. Analyses of HRQOL variance and post hoc analyses were performed for each SRS-Schwab modifier. Age, history of spine surgery, and aetiology of spinal deformity were considered potential confounders and their influence on the association between SRS-Schwab modifiers and aggregated Oswestry Disability Index (ODI) scores was evaluated with multivariate proportional odds regressions. P values were adjusted for multiple testing. Two hundred ninety-two of 460 eligible patients were included for analyses. The SRS-Schwab Classification significantly discriminated HRQOL scores between normal and abnormal sagittal modifier classifications. Individual grade comparisons showed equivocal results; however, Pelvic Tilt grade + versus +  + did not discriminate patients according to any HRQOL score. All modifiers showed significant proportional odds for worse aggregated ODI scores with increasing grade levels and the effects were robust to confounding. However, age group and aetiology had individual significant effects. The SRS-Schwab sagittal modifiers reliably grouped patients graded 0 versus + / +  + according to the most widely used HRQOL scores and the

  19. Mechanisms-based classifications of musculoskeletal pain: part 1 of 3: symptoms and signs of central sensitisation in patients with low back (± leg) pain.

    LENUS (Irish Health Repository)

    Smart, Keith M

    2012-08-01

    As a mechanisms-based classification of pain \\'central sensitisation pain\\' (CSP) refers to pain arising from a dominance of neurophysiological dysfunction within the central nervous system. Symptoms and signs associated with an assumed dominance of CSP in patients attending for physiotherapy have not been extensively studied. The purpose of this study was to identify symptoms and signs associated with a clinical classification of CSP in patients with low back (± leg) pain. Using a cross-sectional, between-subjects design; four hundred and sixty-four patients with low back (± leg) pain were assessed using a standardised assessment protocol. Patients\\' pain was assigned a mechanisms-based classification based on experienced clinical judgement. Clinicians then completed a clinical criteria checklist specifying the presence or absence of various clinical criteria. A binary logistic regression analysis with Bayesian model averaging identified a cluster of three symptoms and one sign predictive of CSP, including: \\'Disproportionate, non-mechanical, unpredictable pattern of pain provocation in response to multiple\\/non-specific aggravating\\/easing factors\\

  20. Bosniak Classification system

    DEFF Research Database (Denmark)

    Graumann, Ole; Osther, Susanne Sloth; Karstoft, Jens

    2014-01-01

    Background: The Bosniak classification is a diagnostic tool for the differentiation of cystic changes in the kidney. The process of categorizing renal cysts may be challenging, involving a series of decisions that may affect the final diagnosis and clinical outcome such as surgical management....... Purpose: To investigate the inter- and intra-observer agreement among experienced uroradiologists when categorizing complex renal cysts according to the Bosniak classification. Material and Methods: The original categories of 100 cystic renal masses were chosen as “Gold Standard” (GS), established...... to the calculated weighted κ all readers performed “very good” for both inter-observer and intra-observer variation. Most variation was seen in cysts catagorized as Bosniak II, IIF, and III. These results show that radiologists who evaluate complex renal cysts routinely may apply the Bosniak classification...

  1. New classification of proximal humeral fractures

    Energy Technology Data Exchange (ETDEWEB)

    Seemann, W R; Rupp, H G; Siebler, G

    1986-08-01

    Neer's classification of humeral fractures was proved on 657 patients. This classification enables the radiologist to estimate the risk of avascular necrosis of the head of the humerus. The problematic group is that of four part lesions, which has a 19% incidence of humeral head necrosis. Since in this group minimal osteosynthesis produces better functional results than extensive osteosynthesis, a detailed pre-operative radiological description of the fracture type is necessary in order to spare the patient from extensive surgery which could have unsatisfactory results.

  2. Classification of pyodestructive pulmonary diseases

    International Nuclear Information System (INIS)

    Muromskij, Yu.A.; Semivolkov, V.I.; Shlenova, L.A.

    1993-01-01

    Classification of pyodestructive lungs diseases, thier complications and outcomes is proposed which makes it possible for physioians engaged in studying respiratory organs pathology to orient themselves in problems of diagnosis and treatment tactics. The above classification is developed on the basis of studying the disease anamnesis and its clinical process, as well as on the basis of roentgenological and morphological study results by more than 10000 patients

  3. Prognostic classification index in Iranian colorectal cancer patients: Survival tree analysis

    Directory of Open Access Journals (Sweden)

    Amal Saki Malehi

    2016-01-01

    Full Text Available Aims: The aim of this study was to determine the prognostic index for separating homogenous subgroups in colorectal cancer (CRC patients based on clinicopathological characteristics using survival tree analysis. Methods: The current study was conducted at the Research Center of Gastroenterology and Liver Disease, Shahid Beheshti Medical University in Tehran, between January 2004 and January 2009. A total of 739 patients who already have been diagnosed with CRC based on pathologic report were enrolled. The data included demographic and clinical-pathological characteristic of patients. Tree-structured survival analysis based on a recursive partitioning algorithm was implemented to evaluate prognostic factors. The probability curves were calculated according to the Kaplan-Meier method, and the hazard ratio was estimated as an interest effect size. Result: There were 526 males (71.2% of these patients. The mean survival time (from diagnosis time was 42.46± (3.4. Survival tree identified three variables as main prognostic factors and based on their four prognostic subgroups was constructed. The log-rank test showed good separation of survival curves. Patients with Stage I-IIIA and treated with surgery as the first treatment showed low risk (median = 34 months whereas patients with stage IIIB, IV, and more than 68 years have the worse survival outcome (median = 9.5 months. Conclusion: Constructing the prognostic classification index via survival tree can aid the researchers to assess interaction between clinical variables and determining the cumulative effect of these variables on survival outcome.

  4. Azacitidine front-line in 339 patients with myelodysplastic syndromes and acute myeloid leukaemia: comparison of French-American-British and World Health Organization classifications

    Directory of Open Access Journals (Sweden)

    Lisa Pleyer

    2016-04-01

    Full Text Available Abstract Background The MDS-IWG and NCCN currently endorse both FAB and WHO classifications of MDS and AML, thus allowing patients with 20–30 % bone marrow blasts (AML20–30, formerly MDS-RAEB-t to be categorised and treated as either MDS or AML. In addition, an artificial distinction between AML20–30 and AML30+ was made by regulatory agencies by initially restricting approval of azacitidine to AML20–30. Thus, uncertainty prevails regarding the diagnosis, prognosis and optimal treatment timing and strategy for patients with AML20–30. Here, we aim to provide clarification for patients treated with azacitidine front-line. Methods The Austrian Azacitidine Registry is a multicentre database (ClinicalTrials.gov: NCT01595295. For this analysis, we selected 339 patients treated with azacitidine front-line. According to the WHO classification 53, 96 and 190 patients had MDS-RAEB-I, MDS-RAEB-II and AML (AML20–30: n = 79; AML30+: n = 111, respectively. According to the FAB classification, 131, 101 and 111 patients had MDS-RAEB, MDS-RAEB-t and AML, respectively. Results The median ages of patients with MDS and AML were 72 (range 37–87 and 77 (range 23–93 years, respectively. Overall, 80 % of classifiable patients (≤30 % bone marrow blasts had intermediate-2 or high-risk IPSS scores. Most other baseline, treatment and response characteristics were similar between patients diagnosed with MDS or AML. WHO-classified patients with AML20–30 had significantly worse OS than patients with MDS-RAEB-II (13.1 vs 18.9 months; p = 0.010, but similar OS to patients with AML30+ (10.9 vs 13.1 months; p = 0.238. AML patients that showed MDS-related features did not have worse outcomes compared with patients who did not (13.2 vs 8.9 months; p = 0.104. FAB-classified patients with MDS-RAEB-t had similar survival to patients with AML30+ (12.8 vs 10.9 months; p = 0.376, but significantly worse OS than patients with MDS-RAEB (10

  5. Ocular surface changes in type II diabetic patients with proliferative diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Yan Gao

    2015-04-01

    Full Text Available AIM: To detect and analyze the changes on ocular surface and tear function in type II diabetic patients with proliferative diabetic retinopathy (PDR, an advanced stage of diabetic retinopathy (DR, using conventional ophthalmic tests and the high-resolution laser scanning confocal microscopy. METHODS: Fifty-eight patients with type II diabetes were selected. Based on the diagnostic criteria and stage classification of DR, the patients were divided into the non-DR (NDR group and the PDR group. Thirty-six patients with cataract but no other ocular and systemic disease were included as non-diabetic controls. All the patients were subjected to the conventional clinical tests of corneal sensitivity, Schirmer I Test, and corneal fluorescein staining. The non-invasive tear film break-up time (NIBUT and tear interferometry were conducted by a Tearscope Plus. The morphology of corneal epithelia and nerve fibers was examined using the high-resolution confocal microscopy. RESULTS: The NDR group exhibited significantly declined corneal sensitivity and Schirmer I test value, as compared to the non-diabetic controls (P< 0.001. The PDR group showed significantly reduced corneal sensitivity, Schirmer I test value, and NIBUT in comparison to the non-diabetic controls (P < 0.001. Corneal fluorescein staining revealed the progressively injured corneal epithelia in the PDR patients. Moreover, significant decrease in the corneal epithelial density and morphological abnormalities in the corneal epithelia and nerve fibers were also observed in the PDR patients. CONCLUSION: Ocular surface changes, including blunted corneal sensitivity, reduced tear secretion, tear film dysfunction, progressive loss of corneal epithelia and degeneration of nerve fibers, are common in type II diabetic patients, particularly in the diabetic patients with PDR. The corneal sensitivity, fluorescein staining scores, and the density of corneal epithelial cells and nerve fibers in the diabetic

  6. Ocular surface changes in type II diabetic patients with proliferative diabetic retinopathy

    Institute of Scientific and Technical Information of China (English)

    Yan; Gao; Yan; Zhang; Yu-Sha; Ru; Xiao-Wu; Wang; Ji-Zhong; Yang; Chun-Hui; Li; Hong-Xing; Wang; Xiao-Rong; Li; Bing; Li

    2015-01-01

    AIM: To detect and analyze the changes on ocular surface and tear function in type II diabetic patients with proliferative diabetic retinopathy(PDR), an advanced stage of diabetic retinopathy(DR), using conventional ophthalmic tests and the high-resolution laser scanning confocal microscopy.METHODS: Fifty-eight patients with type II diabetes were selected. Based on the diagnostic criteria and stage classification of DR, the patients were divided into the non-DR(NDR) group and the PDR group. Thirty-six patients with cataract but no other ocular and systemic disease were included as non-diabetic controls. All the patients were subjected to the conventional clinical tests of corneal sensitivity, Schirmer I test, and corneal fluorescein staining. The non-invasive tear film break-up time(NIBUT) and tear interferometry were conducted by a Tearscope Plus. The morphology of corneal epithelia and nerve fibers was examined using the high-resolution confocal microscopy.RESULTS: The NDR group exhibited significantly declined corneal sensitivity and Schirmer I test value, as compared to the non-diabetic controls(P <0.001). The PDR group showed significantly reduced corneal sensitivity, Schirmer I test value, and NIBUT in comparison to the non-diabetic controls(P <0.001).Corneal fluorescein staining revealed the progressively injured corneal epithelia in the PDR patients. Moreover,significant decrease in the corneal epithelial density andmorphological abnormalities in the corneal epithelia and nerve fibers were also observed in the PDR patients.CONCLUSION: Ocular surface changes, including blunted corneal sensitivity, reduced tear secretion, tear film dysfunction, progressive loss of corneal epithelia and degeneration of nerve fibers, are common in type II diabetic patients, particularly in the diabetic patients with PDR. The corneal sensitivity, fluorescein staining scores,and the density of corneal epithelial cells and nerve fibers in the diabetic patients correlate with the

  7. Hip arthroplasty. Part 1: prosthesis terminology and classification

    International Nuclear Information System (INIS)

    Pluot, E.; Davis, E.T.; Revell, M.; Davies, A.M.; James, S.L.J.

    2009-01-01

    Hip arthroplasty is an extremely common orthopaedic procedure and there is a wide array of implants that are in current use in the UK. The follow-up of patients who have undergone insertion of a hip prosthesis is shifting from a consultant-lead hospital service towards primary care. As this change in patient care continues it becomes increasingly important that an accurate description of the radiographic features is communicated to the primary-care practitioner so appropriate specialist input can be triggered. This review focuses on the terminology and classification of hip prostheses. This acts as a precursor for Part 2 of this series, which describes the normal and abnormal radiographic findings following hip prosthesis insertion.

  8. Clinical use of dental classification.

    Science.gov (United States)

    Jones, Gordon

    2008-01-01

    The Dental Classification system used by the uniformed services is supposed to predict the incidence of dental emergencies in the operational setting, at least on the unit level. Since most Sailors and Marines are deployed without close dental support, the sea services have adopted a policy of early treatment of class 3 dental conditions during recruit training. The other services are beginning to do the same. Recently, two factors have emerged that are affecting this early dental class 3 treatment. These factors must be considered when planning to provide early dental treatment. First, changing population and dentist provider demographics in the civilian sector are beginning to affect the class 3 treatment needs of incoming military recruits. Second, attrition from recruit training results in treatment provided to recruits who leave military service before finishing their training. Some view this as a waste of resources, others as a cost of doing business. As operational jointness increases, the three services must develop and use a single dental classification terminology, as well as unified standards and guidelines, both for better research in this area and for the readiness and well-being of our patients.

  9. Mechanisms-based classifications of musculoskeletal pain: part 2 of 3: symptoms and signs of peripheral neuropathic pain in patients with low back (± leg) pain.

    LENUS (Irish Health Repository)

    Smart, Keith M

    2012-08-01

    As a mechanisms-based classification of pain \\'peripheral neuropathic pain\\' (PNP) refers to pain arising from a primary lesion or dysfunction in the peripheral nervous system. Symptoms and signs associated with an assumed dominance of PNP in patients attending for physiotherapy have not been extensively studied. The purpose of this study was to identify symptoms and signs associated with a clinical classification of PNP in patients with low back (± leg) pain. Using a cross-sectional, between-subjects design; four hundred and sixty-four patients with low back (± leg) pain were assessed using a standardised assessment protocol. Patients\\' pain was assigned a mechanisms-based classification based on experienced clinical judgement. Clinicians then completed a clinical criteria checklist specifying the presence or absence of various clinical criteria. A binary logistic regression analysis with Bayesian model averaging identified a cluster of two symptoms and one sign predictive of PNP, including: \\'Pain referred in a dermatomal or cutaneous distribution\\

  10. Mechanisms-based classifications of musculoskeletal pain: part 3 of 3: symptoms and signs of nociceptive pain in patients with low back (± leg) pain.

    LENUS (Irish Health Repository)

    Smart, Keith M

    2012-08-01

    As a mechanisms-based classification of pain \\'nociceptive pain\\' (NP) refers to pain attributable to the activation of the peripheral receptive terminals of primary afferent neurones in response to noxious chemical, mechanical or thermal stimuli. The symptoms and signs associated with clinical classifications of NP have not been extensively studied. The purpose of this study was to identify symptoms and signs associated with a clinical classification of NP in patients with low back (± leg) pain. Using a cross-sectional, between-subjects design; four hundred and sixty-four patients with low back (± leg) pain were assessed using a standardised assessment protocol after which their pain was assigned a mechanisms-based classification based on experienced clinical judgement. Clinicians then completed a clinical criteria checklist indicating the presence\\/absence of various symptoms and signs. A regression analysis identified a cluster of seven clinical criteria predictive of NP, including: \\'Pain localised to the area of injury\\/dysfunction\\

  11. Tremor entities and their classification: an update.

    Science.gov (United States)

    Gövert, Felix; Deuschl, Günther

    2015-08-01

    This review focuses on important new findings in the field of tremor and illustrates the consequences for the current definition and classification of tremor. Since 1998 when the consensus criteria for tremor were proposed, new variants of tremors and new diagnostic methods were discovered that have changed particularly the concepts of essential tremor and dystonic tremor. Accumulating evidence exists that essential tremor is not a single entity rather different conditions that share the common symptom action tremor without other major abnormalities. Tremor is a common feature in patients with adult-onset focal dystonia and may involve several different body parts and forms of tremor. Recent advances, in particular, in the field of genetics, suggest that dystonic tremor may even be present without overt dystonia. Monosymptomatic asymmetric rest and postural tremor has been further delineated, and apart from tremor-dominant Parkinson's disease, there are several rare conditions including rest and action tremor with normal dopamine transporter imaging (scans without evidence of dopaminergic deficit) and essential tremor with tremor at rest. Increasing knowledge in the last decades changed the view on tremors and highlights several caveats in the current tremor classification. Given the ambiguous assignment between tremor phenomenology and tremor etiology, a more cautious definition of tremors on the basis of clinical assessment data is needed.

  12. Validation of a new classification for periprosthetic shoulder fractures.

    Science.gov (United States)

    Kirchhoff, Chlodwig; Beirer, Marc; Brunner, Ulrich; Buchholz, Arne; Biberthaler, Peter; Crönlein, Moritz

    2018-06-01

    Successful treatment of periprosthetic shoulder fractures depends on the right strategy, starting with a well-structured classification of the fracture. Unfortunately, clinically relevant factors for treatment planning are missing in the pre-existing classifications. Therefore, the aim of the present study was to describe a new specific classification system for periprosthetic shoulder fractures including a structured treatment algorithm for this important fragility fracture issue. The classification was established, focussing on five relevant items, naming the prosthesis type, the fracture localisation, the rotator cuff status, the anatomical fracture region and the stability of the implant. After considering each single item, the individual treatment concept can be assessed in one last step. To evaluate the introduced classification, a retrospective analysis of pre- and post-operative data of patients, treated with periprosthetic shoulder fractures, was conducted by two board certified trauma surgery consultants. The data of 19 patients (8 male, 11 female) with a mean age of 74 ± five years have been analysed in our study. The suggested treatment algorithm was proven to be reliable, detected by good clinical outcome in 15 of 16 (94%) cases, where the suggested treatment was maintained. Only one case resulted in poor outcome due to post-operative wound infection and had to be revised. The newly developed six-step classification is easy to utilise and extends the pre-existing classification systems in terms of clinically-relevant information. This classification should serve as a simple tool for the surgeon to consider the optimal treatment for his patients.

  13. Diagnostic Criteria, Classification and Treatment Goals in Multiple Sclerosis: The Chronicles of Time and Space.

    Science.gov (United States)

    Ntranos, Achilles; Lublin, Fred

    2016-10-01

    Multiple sclerosis (MS) is one of the most diverse human diseases. Since its first description by Charcot in the nineteenth century, the diagnostic criteria, clinical course classification, and treatment goals for MS have been constantly revised and updated to improve diagnostic accuracy, physician communication, and clinical trial design. These changes have improved the clinical outcomes and quality of life for patients with the disease. Recent technological and research breakthroughs will almost certainly further change how we diagnose, classify, and treat MS in the future. In this review, we summarize the key events in the history of MS, explain the reasoning behind the current criteria for MS diagnosis, classification, and treatment, and provide suggestions for further improvements that will keep enhancing the clinical practice of MS.

  14. Creating high-resolution time series land-cover classifications in rapidly changing forested areas with BULC-U in Google Earth Engine

    Science.gov (United States)

    Cardille, J. A.; Lee, J.

    2017-12-01

    With the opening of the Landsat archive, there is a dramatically increased potential for creating high-quality time series of land use/land-cover (LULC) classifications derived from remote sensing. Although LULC time series are appealing, their creation is typically challenging in two fundamental ways. First, there is a need to create maximally correct LULC maps for consideration at each time step; and second, there is a need to have the elements of the time series be consistent with each other, without pixels that flip improbably between covers due only to unavoidable, stray classification errors. We have developed the Bayesian Updating of Land Cover - Unsupervised (BULC-U) algorithm to address these challenges simultaneously, and introduce and apply it here for two related but distinct purposes. First, with minimal human intervention, we produced an internally consistent, high-accuracy LULC time series in rapidly changing Mato Grosso, Brazil for a time interval (1986-2000) in which cropland area more than doubled. The spatial and temporal resolution of the 59 LULC snapshots allows users to witness the establishment of towns and farms at the expense of forest. The new time series could be used by policy-makers and analysts to unravel important considerations for conservation and management, including the timing and location of past development, the rate and nature of changes in forest connectivity, the connection with road infrastructure, and more. The second application of BULC-U is to sharpen the well-known GlobCover 2009 classification from 300m to 30m, while improving accuracy measures for every class. The greatly improved resolution and accuracy permits a better representation of the true LULC proportions, the use of this map in models, and quantification of the potential impacts of changes. Given that there may easily be thousands and potentially millions of images available to harvest for an LULC time series, it is imperative to build useful algorithms

  15. Can the Ni classification of vessels predict neoplasia? A systematic review and meta-analysis.

    Science.gov (United States)

    Mehlum, Camilla S; Rosenberg, Tine; Dyrvig, Anne-Kirstine; Groentved, Aagot Moeller; Kjaergaard, Thomas; Godballe, Christian

    2018-01-01

    The Ni classification of vascular change from 2011 is well documented for evaluating pharyngeal and laryngeal lesions, primarily focusing on cancer. In the planning of surgery it may be more relevant to differentiate neoplasia from non-neoplasia. We aimed to evaluate the ability of the Ni classification to predict laryngeal or hypopharyngeal neoplasia and to investigate if a changed cutoff value would support the recent European Laryngological Society (ELS) proposal of perpendicular vascular changes as indicative of neoplasia. PubMed, Embase, Cochrane, and Scopus databases. A systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. We systematically searched for publications from 2011 until 2016. All retrieved studies were reviewed and qualitatively assessed. The pooled sensitivity and specificity of the Ni classification with two different cutoffs were calculated, and bubble and summary receiver operating characteristics plots were created. The combined sensitivity of five studies (n = 687) with Ni type IV-V defined as test-positive was 0.89 (95% confidence interval [CI]: 0.76-0.95), and specificity was 0.82 (95% CI: 0.72-0.89). The equivalent combined sensitivity of four studies (n = 624) with Ni type V defined as test-positive was 0.82 (95% CI: 0.75-0.87), and specificity was 0.93 (95% CI: 0.82-0.97). The diagnostic accuracy of the Ni classification in predicting neoplasia was high, without significant difference between the two analyzed cutoff values. Implementation of the proposed ELS classification of vascular changes seems reasonable from a clinical perspective, with comparable accuracy. Attention must be drawn to the accompanying risk of exposing patients to unnecessary surgery. Laryngoscope, 128:168-176, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  16. Classification of Building Object Types

    DEFF Research Database (Denmark)

    Jørgensen, Kaj Asbjørn

    2011-01-01

    made. This is certainly the case in the Danish development. Based on the theories about these abstraction mechanisms, the basic principles for classification systems are presented and the observed misconceptions are analyses and explained. Furthermore, it is argued that the purpose of classification...... systems has changed and that new opportunities should be explored. Some proposals for new applications are presented and carefully aligned with IT opportunities. Especially, the use of building modelling will give new benefits and many of the traditional uses of classification systems will instead...... be managed by software applications and on the basis of building models. Classification systems with taxonomies of building object types have many application opportunities but can still be beneficial in data exchange between building construction partners. However, this will be performed by new methods...

  17. [Aetiological classification of ischaemic strokes: comparison of the new A-S-C-O classification and the classification by the Spanish Society of Neurology's Cerebrovascular Disease Study Group].

    Science.gov (United States)

    Sobrino García, P; García Pastor, A; García Arratibel, A; Vicente Peracho, G; Rodriguez Cruz, P M; Pérez Sánchez, J R; Díaz Otero, F; Vázquez Alén, P; Villanueva Osorio, J A; Gil Núñez, A

    2013-09-01

    The A-S-C-O classification may be better than other methods for classifying ischaemic stroke by aetiology. Our aims are to describe A-S-C-O phenotype distribution (A: atherosclerosis, S: small vessel disease, C: cardiac source, O: other causes; 1: potential cause, 2: causality uncertain, 3: unlikely to be a direct cause although disease is present) and compare them to the Spanish Society of Neurology's Cerebrovascular Disease Study Group (GEECV/SEN) classification. We will also find the degree of concordance between these classification methods and determine whether using the A-S-C-O classification delivers a smaller percentage of strokes of undetermined cause. We analysed those patients with ischaemic stroke admitted to our stroke unit in 2010 with strokes that were classified according to GEECV/SEN and A-S-C-O criteria. The study included 496 patients. The percentages of strokes caused by atherosclerosis and small vessel disease according to GEECV/SEN criteria were higher than the percentages for potential atherosclerotic stroke (A1) (14.1 vs. 11.9%; P=.16) and potential small vessel stroke (S1) (14.3 vs. 3%; Pcause of stroke and other potential causes (O1) were observed. Some degree of atherosclerosis was present in 53.5% of patients (A1, A2, or A3); 65.5% showed markers of small vessel disease (S1, S2, or S3), and 74.9% showed signs of cardioembolism (C1, C2, or C3). Fewer patients in the group without scores of 1 or 2 for any of the A-S-C-O phenotypes were identified as having a stroke of undetermined cause (46.6 vs. 29.2%; P0.8 (unusual causes and O1). Our results show that GEECV/SEN and A-S-C-O classifications are neither fully comparable nor consistent. Using the A-S-C-O classification provided additional information on co-morbidities and delivered a smaller percentage of strokes classified as having an undetermined cause. Copyright © 2012 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  18. Deteksi Penyakit Dengue Hemorrhagic Fever dengan Pendekatan One Class Classification

    Directory of Open Access Journals (Sweden)

    Zida Ziyan Azkiya

    2017-10-01

    Full Text Available Two class classification problem maps input into two target classes. In certain cases, training data is available only in the form of a single class, as in the case of Dengue Hemorrhagic Fever (DHF patients, where only data of positive patients is available. In this paper, we report our experiment in building a classification model for detecting DHF infection using One Class Classification (OCC approach. Data from this study is sourced from laboratory tests of patients with dengue fever. The OCC methods compared are One-Class Support Vector Machine and One-Class K-Means. The result shows SVM method obtained precision value = 1.0, recall = 0.993, f-1 score = 0.997, and accuracy of 99.7% while the K-Means method obtained precision value = 0.901, recall = 0.973, f- 1 score = 0.936, and accuracy of 93.3%. This indicates that the SVM method is slightly superior to K-Means for One-Class Classification of DHF patients.

  19. Understanding the use of standardized nursing terminology and classification systems in published research: A case study using the International Classification for Nursing Practice(®).

    Science.gov (United States)

    Strudwick, Gillian; Hardiker, Nicholas R

    2016-10-01

    In the era of evidenced based healthcare, nursing is required to demonstrate that care provided by nurses is associated with optimal patient outcomes, and a high degree of quality and safety. The use of standardized nursing terminologies and classification systems are a way that nursing documentation can be leveraged to generate evidence related to nursing practice. Several widely-reported nursing specific terminologies and classifications systems currently exist including the Clinical Care Classification System, International Classification for Nursing Practice(®), Nursing Intervention Classification, Nursing Outcome Classification, Omaha System, Perioperative Nursing Data Set and NANDA International. However, the influence of these systems on demonstrating the value of nursing and the professions' impact on quality, safety and patient outcomes in published research is relatively unknown. This paper seeks to understand the use of standardized nursing terminology and classification systems in published research, using the International Classification for Nursing Practice(®) as a case study. A systematic review of international published empirical studies on, or using, the International Classification for Nursing Practice(®) were completed using Medline and the Cumulative Index for Nursing and Allied Health Literature. Since 2006, 38 studies have been published on the International Classification for Nursing Practice(®). The main objectives of the published studies have been to validate the appropriateness of the classification system for particular care areas or populations, further develop the classification system, or utilize it to support the generation of new nursing knowledge. To date, most studies have focused on the classification system itself, and a lesser number of studies have used the system to generate information about the outcomes of nursing practice. Based on the published literature that features the International Classification for Nursing

  20. The Australian National Sub-acute and Non-acute Patient Casemix Classification (AN-SNAP): its application and value in a stroke rehabilitation programme.

    Science.gov (United States)

    Lowthian, P; Disler, P; Ma, S; Eagar, K; Green, J; de Graaff, S

    2000-10-01

    To investigate whether the Australian National Sub-acute and Non-acute Patient Casemix Classification (SNAP) and Functional Independence Measure and Functional Related Group (Version 2) (FIM-FRG2) casemix systems can be used to predict functional outcome, and reduce the variance of length of stay (LOS) of patients undergoing rehabilitation after strokes. The study comprised a retrospective analysis of the records of patients admitted to the Cedar Court Healthsouth Rehabilitation Hospital for rehabilitation after stroke. The sample included 547 patients (83.3% of those admitted with stroke during this period). Patient data were stratified for analysis into the five SNAP or nine FIM-FRG2 groups, on the basis of the admission FIM scores and age. The AN-SNAP classification accounted for a 30.7% reduction of the variance of LOS, and 44.2% of motor FIM, and the FIM-FRG2 accounts for 33.5% and 56.4% reduction respectively. Comparison of the Cedar Court with the national AN-SNAP data showed differences in the LOS and functional outcomes of older, severely disabled patients. Intensive rehabilitation in selected patients of this type appears to have positive effects, albeit with a slightly longer period of inpatient rehabilitation. Casemix classifications can be powerful management tools. Although FIM-FRG2 accounts for more reduction in variance than SNAP, division into nine groups meant that some contained few subjects. This paper supports the introduction of AN-SNAP as the standard casemix tool for rehabilitation in Australia, which will hopefully lead to rational, adequate funding of the rehabilitation phase of care.

  1. Differences in Classification Between Mono- and Polytrauma and Low- and High-Energy Trauma Patients With an Ankle Fracture: A Retrospective Cohort Study.

    Science.gov (United States)

    Briet, Jan Paul; Houwert, Roderick Marijn; Smeeing, Diederik P J; Dijkgraaf, Marcel G W; Verleisdonk, Egbert Jan; Leenen, Luke P H; Hietbrink, Falco

    Although fracture type and treatment options for ankle fractures are well defined, the differences between mono- and polytrauma patients and low- and high-energy trauma have not been addressed. The aim of the present study was to compare the fracture type and trauma mechanism between mono- and polytrauma and low- and high-energy trauma patients with an ankle fracture. We performed a single-center retrospective cohort study. Fractures were classified according to the Lauge-Hansen classification and a descriptive classification. High-energy trauma (HET) was defined using triage criteria. All other patients were classified as having experienced low-energy trauma (LET). The patients were divided into 2 groups according to the injury severity score (ISS). Monotrauma patients were defined as patients with an ISS of 4 to 11 with an isolated ankle fracture or an ankle fracture with a minor contusion or laceration. Polytrauma patients were defined as patients with an ISS of ≥16 with ≥2 body regions involved. Patients with an ISS from 12 to 15 were excluded. A total of 96 patients were eligible for analysis. Of the 96 patients, 62 had experienced monotrauma and 34 had experienced polytrauma. A significant difference was found between the mono- and polytrauma patients in the Lauge-Hansen classification (p polytrauma patients. The same pattern was observed for ankle fractures after HET compared with LET (p polytrauma patients sustain different types of ankle fractures than patients with an isolated ankle fracture. This difference likely results from the high-energy transfer associated with polytrauma, because pronation abduction and supination adduction injuries were only observed after HET. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  2. The dynamic changes of vaginal microecosystem in patients with recurrent vulvovaginal candidiasis: a retrospective study of 800 patients.

    Science.gov (United States)

    Yue, Xin-Ai; Chen, Ping; Tang, Yuanting; Wu, Xiuli; Hu, Zhengqiang

    2015-12-01

    Vaginal microecological environment is an important factor of recurrent vulvovaginal candidiasis (RVVC). This study was undertaken to investigate dynamic changes of vaginal microecosystem in patients with RVVC. Four hundred patients with VVC and 400 healthy women of reproductive age who admitted to the hospital from January 2012 to December 2013 were evaluated retrospectively. Vaginal microecological factors were evaluated before and after treatment until no recurrence, including vaginal cleanliness, white blood cells, Lactobacillus, Lactobacillus classification, bacteria density, flora diversity, Nugent scores, etc. The grouping was done according to the recurrence of the disease. Every time after treatment, the relapsing patients were defined as case group and the cured patients without recurrence were defined as control group. The differences in the results between the case and the control groups were analyzed by t test. With the development of RVVC, the ages of all case groups were lower than the corresponding control groups. In different stages of the disease, the bacteria density of the case groups and their corresponding control groups had no significant difference (P > 0.05). Most of the microecological indicators of the first occurring group were significantly different (P vaginal microecological indicators (except Lactobacillus) of all case groups were higher than that of the control groups. The values of Lactobacillus of all RVVC case groups were lower than that of the RVVC control groups. There were vaginal microecological imbalances in all developing stages of RVVC. As for vaginal flora, diverse sorts changed to normal Lactobacillus dominantly with the development of RVVC. In the first occurrence of RVVC, after antifungal treatment, Lactobacillus is suggested to be timely supplemented to restore vaginal microecological balance.

  3. Cellular image classification

    CERN Document Server

    Xu, Xiang; Lin, Feng

    2017-01-01

    This book introduces new techniques for cellular image feature extraction, pattern recognition and classification. The authors use the antinuclear antibodies (ANAs) in patient serum as the subjects and the Indirect Immunofluorescence (IIF) technique as the imaging protocol to illustrate the applications of the described methods. Throughout the book, the authors provide evaluations for the proposed methods on two publicly available human epithelial (HEp-2) cell datasets: ICPR2012 dataset from the ICPR'12 HEp-2 cell classification contest and ICIP2013 training dataset from the ICIP'13 Competition on cells classification by fluorescent image analysis. First, the reading of imaging results is significantly influenced by one’s qualification and reading systems, causing high intra- and inter-laboratory variance. The authors present a low-order LP21 fiber mode for optical single cell manipulation and imaging staining patterns of HEp-2 cells. A focused four-lobed mode distribution is stable and effective in optical...

  4. Validation of the prognostic gene portfolio, ClinicoMolecular Triad Classification, using an independent prospective breast cancer cohort and external patient populations.

    Science.gov (United States)

    Wang, Dong-Yu; Done, Susan J; Mc Cready, David R; Leong, Wey L

    2014-07-04

    Using genome-wide expression profiles of a prospective training cohort of breast cancer patients, ClinicoMolecular Triad Classification (CMTC) was recently developed to classify breast cancers into three clinically relevant groups to aid treatment decisions. CMTC was found to be both prognostic and predictive in a large external breast cancer cohort in that study. This study serves to validate the reproducibility of CMTC and its prognostic value using independent patient cohorts. An independent internal cohort (n = 284) and a new external cohort (n = 2,181) were used to validate the association of CMTC between clinicopathological factors, 12 known gene signatures, two molecular subtype classifiers, and 19 oncogenic signalling pathway activities, and to reproduce the abilities of CMTC to predict clinical outcomes of breast cancer. In addition, we also updated the outcome data of the original training cohort (n = 147). The original training cohort reached a statistically significant difference (p value of the triad classification was reproduced in the second independent internal cohort and the new external validation cohort. CMTC achieved even higher prognostic significance when all available patients were analyzed (n = 4,851). Oncogenic pathways Myc, E2F1, Ras and β-catenin were again implicated in the high-risk groups. Both prospective internal cohorts and the independent external cohorts reproduced the triad classification of CMTC and its prognostic significance. CMTC is an independent prognostic predictor, and it outperformed 12 other known prognostic gene signatures, molecular subtype classifications, and all other standard prognostic clinicopathological factors. Our results support further development of CMTC portfolio into a guide for personalized breast cancer treatments.

  5. Measuring the relative extent of pulmonary infiltrates by hierarchical classification of patient-specific image features

    Science.gov (United States)

    Tsevas, S.; Iakovidis, D. K.

    2011-11-01

    Pulmonary infiltrates are common radiological findings indicating the filling of airspaces with fluid, inflammatory exudates, or cells. They are most common in cases of pneumonia, acute respiratory syndrome, atelectasis, pulmonary oedema and haemorrhage, whereas their extent is usually correlated with the extent or the severity of the underlying disease. In this paper we propose a novel pattern recognition framework for the measurement of the extent of pulmonary infiltrates in routine chest radiographs. The proposed framework follows a hierarchical approach to the assessment of image content. It includes the following: (a) sampling of the lung fields; (b) extraction of patient-specific grey-level histogram signatures from each sample; (c) classification of the extracted signatures into classes representing normal lung parenchyma and pulmonary infiltrates; (d) the samples for which the probability of belonging to one of the two classes does not reach an acceptable level are rejected and classified according to their textural content; (e) merging of the classification results of the two classification stages. The proposed framework has been evaluated on real radiographic images with pulmonary infiltrates caused by bacterial infections. The results show that accurate measurements of the infiltration areas can be obtained with respect to each lung field area. The average measurement error rate on the considered dataset reached 9.7% ± 1.0%.

  6. European validation of The Comprehensive International Classification of Functioning, Disability and Health Core Set for Osteoarthritis from the perspective of patients with osteoarthritis of the knee or hip.

    Science.gov (United States)

    Weigl, Martin; Wild, Heike

    2017-09-15

    To validate the International Classification of Functioning, Disability and Health Comprehensive Core Set for Osteoarthritis from the patient perspective in Europe. This multicenter cross-sectional study involved 375 patients with knee or hip osteoarthritis. Trained health professionals completed the Comprehensive Core Set, and patients completed the Short-Form 36 questionnaire. Content validity was evaluated by calculating prevalences of impairments in body function and structures, limitations in activities and participation and environmental factors, which were either barriers or facilitators. Convergent construct validity was evaluated by correlating the International Classification of Functioning, Disability and Health categories with the Short-Form 36 Physical Component Score and the SF-36 Mental Component Score in a subgroup of 259 patients. The prevalences of all body function, body structure and activities and participation categories were >40%, >32% and >20%, respectively, and all environmental factors were relevant for >16% of patients. Few categories showed relevant differences between knee and hip osteoarthritis. All body function categories and all but two activities and participation categories showed significant correlations with the Physical Component Score. Body functions from the ICF chapter Mental Functions showed higher correlations with the Mental Component Score than with the Physical Component Score. This study supports the validity of the International Classification of Functioning, Disability and Health Comprehensive Core Set for Osteoarthritis. Implications for Rehabilitation Comprehensive International Classification of Functioning, Disability and Health Core Sets were developed as practical tools for application in multidisciplinary assessments. The validity of the Comprehensive International Classification of Functioning, Disability and Health Core Set for Osteoarthritis in this study supports its application in European patients with

  7. Nurses' perception about risk classification in an emergency service

    Directory of Open Access Journals (Sweden)

    Cristiane Chaves de Souza

    2014-04-01

    Full Text Available Objective. Get to know how nurses perceive the accomplishment of risk classification in an emergency service. Methodology. In this qualitative study, 11 nurses were included with at least two months of experience in the risk classification of patients who visited the emergency service. Semistructured interviews were used to collect the information. The data were collected between August and December 2011. For data analysis, Bardin's theoretical framework was used. Results. The nurses in the study consider the risk classification as a work organization instruments that permits closer contact between nurses and patients. The nursing skills needed for risk classification were identified: knowledge about the scale used, clinical perspective, patience and agility. The availability of risk classification scales was the main facilitator of this work. The main difficulties were the disorganization of the care network and the health team's lack of knowledge of the protocol. Conclusion. Risk classification offers an opportunity for professional autonomy to the extent that it is the main responsible for regulating care at the entry door of the emergency services.

  8. Interobserver and intraobserver reliability of radiographic classification of acromioclavicular joint dislocations.

    Science.gov (United States)

    Ringenberg, Jonathan D; Foughty, Zachary; Hall, Adam D; Aldridge, J Mack; Wilson, Joseph B; Kuremsky, Marshall A

    2018-03-01

    The classification and treatment of acromioclavicular (AC) joint dislocations remain controversial. The purpose of this study was to determine the interobserver and intraobserver reliability of the Rockwood classification system. We hypothesized poor interobserver and intraobserver reliability, limiting the role of the Rockwood classification system in determining severity of AC joint dislocations and accurately guiding treatment decisions. We identified 200 patients with AC joint injuries using the International Classification of Diseases, Ninth Revision code 831.04. Fifty patients met inclusion criteria. Deidentified radiographs were compiled and presented to 6 fellowship-trained upper extremity orthopedic surgeons. The surgeons classified each patient into 1 of the 6 classification types described by Rockwood. A second review was performed several months later by 2 surgeons. A κ value was calculated to determine the interobserver and intraobserver reliability. The interobserver and intraobserver κ values were fair (κ = 0.278) and moderate (κ = 0.468), respectively. Interobserver results showed that 4 of the 50 radiographic images had a unanimous classification. Intraobserver results for the 2 surgeons showed that 18 of the 50 images were rated the same on second review by the first surgeon and 38 of the 50 images were rated the same on second review by the second surgeon. We found that the Rockwood classification system has limited interobserver and intraobserver reliability. We believe that unreliable classification may account for some of the inconsistent treatment outcomes among patients with similarly classified injuries. We suggest that a better classification system is needed to use radiographic imaging for diagnosis and treatment of AC joint dislocations. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  9. [Molecular classification of breast cancer patients obtained through the technique of chromogenic in situ hybridization (CISH)].

    Science.gov (United States)

    Fernández, Angel; Reigosa, Aldo

    2013-12-01

    Breast cancer is a heterogeneous disease composed of a growing number of biological subtypes, with substantial variability of the disease progression within each category. The aim of this research was to classify the samples object of study according to the molecular classes of breast cancer: luminal A, luminal B, HER2 and triple negative, as a result of the state of HER2 amplification obtained by the technique of chromogenic in situ hybridization (CISH). The sample consisted of 200 biopsies fixed in 10% formalin, processed by standard techniques up to paraffin embedding, corresponding to patients diagnosed with invasive ductal carcinoma of the breast. These biopsies were obtained from patients from private practice and the Institute of Oncology "Dr. Miguel Pérez Carreño", for immunohistochemistry (IHC) of hormone receptors and HER2 made in the Hospital Metropolitano del Norte, Valencia, Venezuela. The molecular classification of the patient's tumors considering the expression of estrogen and progesterone receptors by IHC and HER2 amplification by CISH, allowed those cases originally classified as unknown, since they had an indeterminate (2+) outcome for HER2 expression by IHC, to be grouped into the different molecular classes. Also, this classification permitted that some cases, initially considered as belonging to a molecular class, were assigned to another class, after the revaluation of the HER2 status by CISH.

  10. Prediction of Depression in Cancer Patients With Different Classification Criteria, Linear Discriminant Analysis versus Logistic Regression.

    Science.gov (United States)

    Shayan, Zahra; Mohammad Gholi Mezerji, Naser; Shayan, Leila; Naseri, Parisa

    2015-11-03

    Logistic regression (LR) and linear discriminant analysis (LDA) are two popular statistical models for prediction of group membership. Although they are very similar, the LDA makes more assumptions about the data. When categorical and continuous variables used simultaneously, the optimal choice between the two models is questionable. In most studies, classification error (CE) is used to discriminate between subjects in several groups, but this index is not suitable to predict the accuracy of the outcome. The present study compared LR and LDA models using classification indices. This cross-sectional study selected 243 cancer patients. Sample sets of different sizes (n = 50, 100, 150, 200, 220) were randomly selected and the CE, B, and Q classification indices were calculated by the LR and LDA models. CE revealed the a lack of superiority for one model over the other, but the results showed that LR performed better than LDA for the B and Q indices in all situations. No significant effect for sample size on CE was noted for selection of an optimal model. Assessment of the accuracy of prediction of real data indicated that the B and Q indices are appropriate for selection of an optimal model. The results of this study showed that LR performs better in some cases and LDA in others when based on CE. The CE index is not appropriate for classification, although the B and Q indices performed better and offered more efficient criteria for comparison and discrimination between groups.

  11. A practicable approach for periodontal classification

    Science.gov (United States)

    Mittal, Vishnu; Bhullar, Raman Preet K.; Bansal, Rachita; Singh, Karanprakash; Bhalodi, Anand; Khinda, Paramjit K.

    2013-01-01

    The Diagnosis and classification of periodontal diseases has remained a dilemma since long. Two distinct concepts have been used to define diseases: Essentialism and Nominalism. Essentialistic concept implies the real existence of disease whereas; nominalistic concept states that the names of diseases are the convenient way of stating concisely the endpoint of a diagnostic process. It generally advances from assessment of symptoms and signs toward knowledge of causation and gives a feasible option to name the disease for which etiology is either unknown or it is too complex to access in routine clinical practice. Various classifications have been proposed by the American Academy of Periodontology (AAP) in 1986, 1989 and 1999. The AAP 1999 classification is among the most widely used classification. But this classification also has demerits which provide impediment for its use in day to day practice. Hence a classification and diagnostic system is required which can help the clinician to access the patient's need and provide a suitable treatment which is in harmony with the diagnosis for that particular case. Here is an attempt to propose a practicable classification and diagnostic system of periodontal diseases for better treatment outcome. PMID:24379855

  12. Erectile dysfunction as a manifestation of urogenital autonomic neuropathy in patients with type 1 diabetes: epidemiology, classification, pathophysiology, diagnosis and treatment options

    OpenAIRE

    Gagik Radikovich Galstyan; yana Grigor'evna Shwarts; Sergey Anatol'evich Dubsky; Aleksandr Evgen'evich Lepetukhin; Roman Viktorovich Rozhivanov; Dmitry Gennadievich Kurbatov

    2014-01-01

    Sexual dysfunction characterized by a significant decline in the quality of life of patients and leading to infertility and problems in social life is diagnosed in more than 40% of patients with diabetes mellitus (DM).Erectile dysfunction is the most common sexual disorder in DM patients. The article describes epidemiology, classification, pathophysiology, diagnostic and treatment of erectile dysfunction in T1DM patients.

  13. Combining anatomical, diffusion, and resting state functional magnetic resonance imaging for individual classification of mild and moderate Alzheimer's disease

    Directory of Open Access Journals (Sweden)

    Tijn M. Schouten

    2016-01-01

    Full Text Available Magnetic resonance imaging (MRI is sensitive to structural and functional changes in the brain caused by Alzheimer's disease (AD, and can therefore be used to help in diagnosing the disease. Improving classification of AD patients based on MRI scans might help to identify AD earlier in the disease's progress, which may be key in developing treatments for AD. In this study we used an elastic net classifier based on several measures derived from the MRI scans of mild to moderate AD patients (N=77 from the prospective registry on dementia study and controls (N=173 from the Austrian Stroke Prevention Family Study. We based our classification on measures from anatomical MRI, diffusion weighted MRI and resting state functional MRI. Our unimodal classification performance ranged from an area under the curve (AUC of 0.760 (full correlations between functional networks to 0.909 (grey matter density. When combining measures from multiple modalities in a stepwise manner, the classification performance improved to an AUC of 0.952. This optimal combination consisted of grey matter density, white matter density, fractional anisotropy, mean diffusivity, and sparse partial correlations between functional networks. Classification performance for mild AD as well as moderate AD also improved when using this multimodal combination. We conclude that different MRI modalities provide complementary information for classifying AD. Moreover, combining multiple modalities can substantially improve classification performance over unimodal classification.

  14. Real-Time Classification of Patients with Balance Disorders vs. Normal Subjects Using a Low-Cost Small Wireless Wearable Gait Sensor

    Directory of Open Access Journals (Sweden)

    Bhargava Teja Nukala

    2016-11-01

    Full Text Available Gait analysis using wearable wireless sensors can be an economical, convenient and effective way to provide diagnostic and clinical information for various health-related issues. In this work, our custom designed low-cost wireless gait analysis sensor that contains a basic inertial measurement unit (IMU was used to collect the gait data for four patients diagnosed with balance disorders and additionally three normal subjects, each performing the Dynamic Gait Index (DGI tests while wearing the custom wireless gait analysis sensor (WGAS. The small WGAS includes a tri-axial accelerometer integrated circuit (IC, two gyroscopes ICs and a Texas Instruments (TI MSP430 microcontroller and is worn by each subject at the T4 position during the DGI tests. The raw gait data are wirelessly transmitted from the WGAS to a near-by PC for real-time gait data collection and analysis. In order to perform successful classification of patients vs. normal subjects, we used several different classification algorithms, such as the back propagation artificial neural network (BP-ANN, support vector machine (SVM, k-nearest neighbors (KNN and binary decision trees (BDT, based on features extracted from the raw gait data of the gyroscopes and accelerometers. When the range was used as the input feature, the overall classification accuracy obtained is 100% with BP-ANN, 98% with SVM, 96% with KNN and 94% using BDT. Similar high classification accuracy results were also achieved when the standard deviation or other values were used as input features to these classifiers. These results show that gait data collected from our very low-cost wearable wireless gait sensor can effectively differentiate patients with balance disorders from normal subjects in real time using various classifiers, the success of which may eventually lead to accurate and objective diagnosis of abnormal human gaits and their underlying etiologies in the future, as more patient data are being collected.

  15. A simple phenotypic classification for celiac disease

    Directory of Open Access Journals (Sweden)

    Ajit Sood

    2018-04-01

    Full Text Available Background/Aims : Celiac disease is a global health problem. The presentation of celiac disease has unfolded over years and it is now known that it can manifest at different ages, has varied presentations, and is prone to develop complications, if not managed properly. Although the Oslo definitions provide consensus on the various terminologies used in literature, there is no phenotypic classification providing a composite diagnosis for the disease. Methods : Various variables identified for phenotypic classification included age at diagnosis, age at onset of symptoms, clinical presentation, family history and complications. These were applied to the existing registry of 1,664 patients at Dayanand Medical College and Hospital, Ludhiana, India. In addition, age was evaluated as below 15 and below 18 years. Cross tabulations were used for the verification of the classification using the existing data. Expert opinion was sought from both international and national experts of varying fields. Results : After empirical verification, age at diagnosis was considered appropriate in between A1 (<18 and A2 (≧18. The disease presentation has been classified into 3 types–P1 (classical, P2 (non-classical and P3 (asymptomatic. Complications were considered as absent (C0 or present (C1. A single phenotypic classification based on these 3 characteristics, namely age at the diagnosis, clinical presentation, and intestinal complications (APC classification was derived. Conclusions : APC classification (age at diagnosis, presentation, complications is a simple disease explanatory classification for patients with celiac disease aimed at providing a composite diagnosis.

  16. Can the Ni classification of vessels predict neoplasia?

    DEFF Research Database (Denmark)

    Mehlum, Camilla Slot; Rosenberg, Tine; Dyrvig, Anne-Kirstine

    2018-01-01

    OBJECTIVES: The Ni classification of vascular change from 2011 is well documented for evaluating pharyngeal and laryngeal lesions, primarily focusing on cancer. In the planning of surgery it may be more relevant to differentiate neoplasia from non-neoplasia. We aimed to evaluate the ability...... of the Ni classification to predict laryngeal or hypopharyngeal neoplasia and to investigate if a changed cutoff value would support the recent European Laryngological Society (ELS) proposal of perpendicular vascular changes as indicative of neoplasia. DATA SOURCES: PubMed, Embase, Cochrane, and Scopus....... The pooled sensitivity and specificity of the Ni classification with two different cutoffs were calculated, and bubble and summary receiver operating characteristics plots were created. RESULTS: The combined sensitivity of five studies (n = 687) with Ni type IV-V defined as test-positive was 0.89 (95...

  17. New guidelines for dam safety classification

    International Nuclear Information System (INIS)

    Dascal, O.

    1999-01-01

    Elements are outlined of recommended new guidelines for safety classification of dams. Arguments are provided for the view that dam classification systems should require more than one system as follows: (a) classification for selection of design criteria, operation procedures and emergency measures plans, based on potential consequences of a dam failure - the hazard classification of water retaining structures; (b) classification for establishment of surveillance activities and for safety evaluation of dams, based on the probability and consequences of failure - the risk classification of water retaining structures; and (c) classification for establishment of water management plans, for safety evaluation of the entire project, for preparation of emergency measures plans, for definition of the frequency and extent of maintenance operations, and for evaluation of changes and modifications required - the hazard classification of the project. The hazard classification of the dam considers, as consequence, mainly the loss of lives or persons in jeopardy and the property damages to third parties. Difficulties in determining the risk classification of the dam lie in the fact that no tool exists to evaluate the probability of the dam's failure. To overcome this, the probability of failure can be substituted for by a set of dam characteristics that express the failure potential of the dam and its foundation. The hazard classification of the entire project is based on the probable consequences of dam failure influencing: loss of life, persons in jeopardy, property and environmental damage. The classification scheme is illustrated for dam threatening events such as earthquakes and floods. 17 refs., 5 tabs

  18. Acute myocardial infarction and diagnosis-related groups: patient classification and hospital reimbursement in 11 European countries

    Science.gov (United States)

    Quentin, Wilm; Rätto, Hanna; Peltola, Mikko; Busse, Reinhard; Häkkinen, Unto

    2013-01-01

    Aims As part of the diagnosis related groups in Europe (EuroDRG) project, researchers from 11 countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Spain, and Sweden) compared how their DRG systems deal with patients admitted to hospital for acute myocardial infarction (AMI). The study aims to assist cardiologists and national authorities to optimize their DRG systems. Methods and results National or regional databases were used to identify hospital cases with a primary diagnosis of AMI. Diagnosis-related group classification algorithms and indicators of resource consumption were compared for those DRGs that individually contained at least 1% of cases. Six standardized case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained. European DRG systems vary widely: they classify AMI patients according to different sets of variables into diverging numbers of DRGs (between 4 DRGs in Estonia and 16 DRGs in France). The most complex DRG is valued 11 times more resource intensive than an index case in Estonia but only 1.38 times more resource intensive than an index case in England. Comparisons of quasi prices for the case vignettes show that hypothetical payments for the index case amount to only €420 in Poland but to €7930 in Ireland. Conclusions Large variation exists in the classification of AMI patients across Europe. Cardiologists and national DRG authorities should consider how other countries' DRG systems classify AMI patients in order to identify potential scope for improvement and to ensure fair and appropriate reimbursement. PMID:23364755

  19. Acute myocardial infarction and diagnosis-related groups: patient classification and hospital reimbursement in 11 European countries.

    Science.gov (United States)

    Quentin, Wilm; Rätto, Hanna; Peltola, Mikko; Busse, Reinhard; Häkkinen, Unto

    2013-07-01

    As part of the diagnosis related groups in Europe (EuroDRG) project, researchers from 11 countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Spain, and Sweden) compared how their DRG systems deal with patients admitted to hospital for acute myocardial infarction (AMI). The study aims to assist cardiologists and national authorities to optimize their DRG systems. National or regional databases were used to identify hospital cases with a primary diagnosis of AMI. Diagnosis-related group classification algorithms and indicators of resource consumption were compared for those DRGs that individually contained at least 1% of cases. Six standardized case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained. European DRG systems vary widely: they classify AMI patients according to different sets of variables into diverging numbers of DRGs (between 4 DRGs in Estonia and 16 DRGs in France). The most complex DRG is valued 11 times more resource intensive than an index case in Estonia but only 1.38 times more resource intensive than an index case in England. Comparisons of quasi prices for the case vignettes show that hypothetical payments for the index case amount to only €420 in Poland but to €7930 in Ireland. Large variation exists in the classification of AMI patients across Europe. Cardiologists and national DRG authorities should consider how other countries' DRG systems classify AMI patients in order to identify potential scope for improvement and to ensure fair and appropriate reimbursement.

  20. Classification of Radioactive Waste. General Safety Guide

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-11-15

    This publication is a revision of an earlier Safety Guide of the same title issued in 1994. It recommends revised waste management strategies that reflect changes in practices and approaches since then. It sets out a classification system for the management of waste prior to disposal and for disposal, driven by long term safety considerations. It includes a number of schemes for classifying radioactive waste that can be used to assist with planning overall national approaches to radioactive waste management and to assist with operational management at facilities. Contents: 1. Introduction; 2. The radioactive waste classification scheme; Appendix: The classification of radioactive waste; Annex I: Evolution of IAEA standards on radioactive waste classification; Annex II: Methods of classification; Annex III: Origin and types of radioactive waste.

  1. Classification of Radioactive Waste. General Safety Guide

    International Nuclear Information System (INIS)

    2009-01-01

    This publication is a revision of an earlier Safety Guide of the same title issued in 1994. It recommends revised waste management strategies that reflect changes in practices and approaches since then. It sets out a classification system for the management of waste prior to disposal and for disposal, driven by long term safety considerations. It includes a number of schemes for classifying radioactive waste that can be used to assist with planning overall national approaches to radioactive waste management and to assist with operational management at facilities. Contents: 1. Introduction; 2. The radioactive waste classification scheme; Appendix: The classification of radioactive waste; Annex I: Evolution of IAEA standards on radioactive waste classification; Annex II: Methods of classification; Annex III: Origin and types of radioactive waste

  2. An automated Pearson's correlation change classification (APC3) approach for GC/MS metabonomic data using total ion chromatograms (TICs).

    Science.gov (United States)

    Prakash, Bhaskaran David; Esuvaranathan, Kesavan; Ho, Paul C; Pasikanti, Kishore Kumar; Chan, Eric Chun Yong; Yap, Chun Wei

    2013-05-21

    A fully automated and computationally efficient Pearson's correlation change classification (APC3) approach is proposed and shown to have overall comparable performance with both an average accuracy and an average AUC of 0.89 ± 0.08 but is 3.9 to 7 times faster, easier to use and have low outlier susceptibility in contrast to other dimensional reduction and classification combinations using only the total ion chromatogram (TIC) intensities of GC/MS data. The use of only the TIC permits the possible application of APC3 to other metabonomic data such as LC/MS TICs or NMR spectra. A RapidMiner implementation is available for download at http://padel.nus.edu.sg/software/padelapc3.

  3. Knowledge discovery from patients' behavior via clustering-classification algorithms based on weighted eRFM and CLV model: An empirical study in public health care services.

    Science.gov (United States)

    Zare Hosseini, Zeinab; Mohammadzadeh, Mahdi

    2016-01-01

    The rapid growing of information technology (IT) motivates and makes competitive advantages in health care industry. Nowadays, many hospitals try to build a successful customer relationship management (CRM) to recognize target and potential patients, increase patient loyalty and satisfaction and finally maximize their profitability. Many hospitals have large data warehouses containing customer demographic and transactions information. Data mining techniques can be used to analyze this data and discover hidden knowledge of customers. This research develops an extended RFM model, namely RFML (added parameter: Length) based on health care services for a public sector hospital in Iran with the idea that there is contrast between patient and customer loyalty, to estimate customer life time value (CLV) for each patient. We used Two-step and K-means algorithms as clustering methods and Decision tree (CHAID) as classification technique to segment the patients to find out target, potential and loyal customers in order to implement strengthen CRM. Two approaches are used for classification: first, the result of clustering is considered as Decision attribute in classification process and second, the result of segmentation based on CLV value of patients (estimated by RFML) is considered as Decision attribute. Finally the results of CHAID algorithm show the significant hidden rules and identify existing patterns of hospital consumers.

  4. Impact of job classification on employment of seasonal workers

    Directory of Open Access Journals (Sweden)

    Zoran Pandža

    2011-07-01

    Full Text Available The paper aims to improve the existing work organization, thus improving success of business process and ultimately reducing company costs. A change in organizational structure is proposed with the objective of achieving better and more efficient use of resources available within the company. Since the existing organization and classification of jobs does not meet the requirements of the age we live in, there is a need for new classification which would address many changes that have taken place over the years, including changes that are yet to be made for the purpose of further development of the company. Organization and management of the company as well as reorganization and implementation of a new classification is necessary to make it possible for the company to perform regular adjustment of business activities, because the conditions in which the company operates are changing fast. New classification would not actually change the number of sectors. Rather, existing personnel would be allocated in a better way, which would result in reduced needs for seasonal work force. In the process of defining the new organizational structure, one should consider the type, way of doing business, structural variables (division of labour, unity of command, authority and responsibility, span of control, division in business units, etc.. Expected results include improved organization and classification of jobs, improved quality of work, speed and efficiency. It should result in a company organized according to standards that are adjusted to modern times.

  5. Erectile dysfunction as a manifestation of urogenital autonomic neuropathy in patients with type 1 diabetes: epidemiology, classification, pathophysiology, diagnosis and treatment options

    Directory of Open Access Journals (Sweden)

    Gagik Radikovich Galstyan

    2014-05-01

    Full Text Available Sexual dysfunction characterized by a significant decline in the quality of life of patients and leading to infertility and problems in social life is diagnosed in more than 40% of patients with diabetes mellitus (DM.Erectile dysfunction is the most common sexual disorder in DM patients. The article describes epidemiology, classification, pathophysiology, diagnostic and treatment of erectile dysfunction in T1DM patients.

  6. [Classification of severely injured patients in the G-DRG System 2008].

    Science.gov (United States)

    Juhra, C; Franz, D; Roeder, N; Vordemvenne, T; Raschke, M J

    2009-05-01

    Since the introduction of a per-case reimbursement system in Germany (German Diagnosis-Related Groups, G-DRG), the correct reimbursement for the treatment of severely injured patients has been much debated. While the classification of a patient in a polytrauma DRG follows different rules than the usual clinical definition, leading to a high number of patients not grouped as severely injured by the system, the system was also criticized in 2005 for its shortcomings in financing the treatment of severely injured patients. The development of financial reimbursement will be discussed in this paper. 167 patients treated in 2006 and 2007 due to a severe injury at the University-Hospital Münster and grouped into a polytrauma-DRG were included in this study. For each patient, cost-equivalents were estimated. For those patients treated in 2007 (n=110), exact costs were calculated following the InEK cost-calculation method. The reimbursement was calculated using the G-DRG-Systems of 2007, 2008 and 2009. Cost-equivalents/costs and clinical parameters were correlated. A total of 167 patients treated in 2006 and 2007 for a severe injury at the Münster University Hospital and grouped into a polytrauma DRG were included in this study. Cost equivalents were estimated for each patient. For those patients treated in 2007 (n=110), exact costs were calculated following the InEK (Institute for the Hospital Remuneration System) cost calculation method. Reimbursement was calculated using the G-DRG systems of 2007, 2008 and 2009. Cost equivalents/costs and clinical parameters were correlated. With the ongoing development of the G-DRG system, reimbursement for the treatment of severely injured patient has improved, but the amount of underfinancing remains substantial. As treatment of severely injured patients must be reimbursed using the G-DRG system, this system must be further adapted to better meet the needs of severely injured patients. Parameters such as total surgery time, injury

  7. Progress in the diagnosis and classification of pituitary adenomas

    Directory of Open Access Journals (Sweden)

    Luis V Syro

    2015-06-01

    Full Text Available Pituitary adenomas are common neoplasms. Their classification is based upon size, invasion of adjacent structures, sporadic or familial cases, biochemical activity, clinical manifestations, morphological characteristics, response to treatment and recurrence. Although they are considered benign tumors, some of them are difficult to treat due to their tendency to recur, despite standardized treatment. Functional tumors present other challenges for normalizing their biochemical activity. Novel approaches for early diagnosis as well as different perspectives on classification may help to identify subgroups of patients with similar characteristics, creating opportunities to match each patient with the best personalized treatment option. In this paper we present the progress in the diagnosis and classification of different subgroups of patients with pituitary tumors that may be managed with specific considerations according to their tumor subtype.

  8. Critical Evaluation of Headache Classifications.

    Science.gov (United States)

    Özge, Aynur

    2013-08-01

    Transforming a subjective sense like headache into an objective state and establishing a common language for this complaint which can be both a symptom and a disease all by itself have kept the investigators busy for years. Each recommendation proposed has brought along a set of patients who do not meet the criteria. While almost the most ideal and most comprehensive classification studies continued at this point, this time criticisims about withdrawing from daily practice came to the fore. In this article, the classification adventure of scientists who work in the area of headache will be summarized. More specifically, 2 classifications made by the International Headache Society (IHS) and the point reached in relation with the 3rd classification which is still being worked on will be discussed together with headache subtypes. It has been presented with the wish and belief that it will contribute to the readers and young investigators who are interested in this subject.

  9. Inter-tester reliability of a new diagnostic classification system for patients with non-specific low back pain

    DEFF Research Database (Denmark)

    Petersen, Tom Erik; Olsen, Steen; Laslett, Mark

    2004-01-01

    Most patients referred to physiotherapy with low back pain are without a precise medical diagnosis. Identification of subgroups of non-specific low back pain patients may improve clinical outcomes and research efficiency. A pathoanatomic classification system has been developed, classifying...... modest level of total agreement (39%) for the system as a whole might indicate that the utility of the system for general screening purposes is limited, compared with the utility in identification of particular syndromes. Due to low prevalence of positive findings in some of the syndromes, future work...... should focus on testing reliability on a larger sample of patients, and testing of validity and feasibility of the system....

  10. Two-gene signature improves the discriminatory power of IASLC/ATS/ERS classification to predict the survival of patients with early-stage lung adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Sun Y

    2016-07-01

    Full Text Available Yifeng Sun,1,* Likun Hou,2,* Yu Yang,1 Huikang Xie,2 Yang Yang,1 Zhigang Li,1 Heng Zhao,1 Wen Gao,3 Bo Su4 1Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, 2Department of Pathology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 3Department of Thoracic Surgery, Shanghai Huadong Hospital, Fudan University School of Medicine, Shanghai, 4Central Lab, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China *These authors contributed equally to this work Background: In this study, we investigated the contribution of a gene expression–based signature (composed of BAG1, BRCA1, CDC6, CDK2AP1, ERBB3, FUT3, IL11, LCK, RND3, SH3BGR to survival prediction for early-stage lung adenocarcinoma categorized by the new International Association for the Study of Lung Cancer (IASLC/the American Thoracic Society (ATS/the European Respiratory Society (ERS classification. We also aimed to verify whether gene signature improves the risk discrimination of IASLC/ATS/ERS classification in early-stage lung adenocarcinoma. Patients and methods: Total RNA was extracted from 93 patients with pathologically confirmed TNM stage Ia and Ib lung adenocarcinoma. The mRNA expression levels of ten genes in the signature (BAG1, BRCA1, CDC6, CDK2AP1, ERBB3, FUT3, IL11, LCK, RND3, and SH3BGR were detected using real-time polymerase chain reaction. Each patient was categorized according to the new IASLC/ATS/ERS classification by accessing hematoxylin–eosin-stained slides. The corresponding Kaplan–Meier survival analysis by the log-rank statistic, multivariate Cox proportional hazards modeling, and c-index calculation were conducted using the programming language R (Version 2.15.1 with the “risksetROC” package. Results: The multivariate analysis demonstrated that the risk factor of the ten-gene expression signature can significantly improve the discriminatory

  11. Evaluating sequelae after head and neck cancer from the patient perspective with the help of the International Classification of Functioning, Disability and Health.

    Science.gov (United States)

    Tschiesner, Uta; Linseisen, Elisabeth; Coenen, Michaela; Rogers, Simon; Harreus, Ulrich; Berghaus, Alexander; Cieza, Alarcos

    2009-03-01

    Functioning is recognized increasingly as an important study outcome with head and neck cancer (HNC). The International Classification of Functioning, Disability and Health, as adopted by the World Health Organization in 2001, is based on a comprehensive bio-psycho-social view. The objective of this study was to evaluate functioning from the patient perspective and to classify the results using the comprehensive view of the ICF. Patients with HNC were interviewed on their problems in daily life using qualitative methodology. Sampling of patients followed the maximum variation strategy. Sample size was determined by saturation. All individual interviews were digitally recorded and transcribed verbatim. Interview texts were divided into meaning units and the concepts contained in the meaning units were linked to the ICF according to established linking rules. The transcribed data were analyzed and linked by a second health professional and the degree of consensus was calculated using kappa statistics. Concordance of identified ICF categories among different tumor locations was also measured with kappa statistics. Until saturation was reached, 18 patients were interviewed: seven patients with oral cancer, five with hypopharyngeal cancer and six with laryngeal cancer. Thousand four hundred and sixty-two (1,462) different concepts were translated into the ICF using 104 different, second-level ICF categories. These ICF categories are presented in detail. From the patient perspective, the ICF components (a) Body functions, (b) Activities and participation and (c) contextual Environmental factors are equally represented, while (d) Body structures show by far the least number of categories. The concordance between different tumor locations rages between 0.53 and 0.58 (confidence interval 0.42-0.70). The degree of consensus in the linking process was 0.58 (confidence interval 0.45-0.73). The ICF classification can display problems with functioning following HNC sufficiently

  12. Clinical significance of changes of serum insulin-like growth factors contents in patients with cirrhosis of liver

    International Nuclear Information System (INIS)

    Hu Haiqiang; Lei Qiufang; Ye Peihong; Li Xiaohong; Gao Wenjin; Wang Mingtao

    2006-01-01

    Objective: To investigate the association between the serum contents of IGF-I, IGF-II and liver dysfunction (as classified with Child-Pugh grades). Methods: Liver function test profiles as well as serum IGF-I, IGF-II contents ( with IRMA) were studied in 46 patients with liver cirrhosis and 32 controls. Results: According to the degree of liver dysfunction, these 46 patients with cirrhosis could be classified as: Child Grade A, n=17; Child B, n=20; and Child C, n=9. The serum IGF-I and IGF-II contents in the cirrhotic patients were significantly lower than those in the controls (P<0.001). The levels dropped along with the progression of child classification grades. Changes of IGF-II were more sensitive than those of IGF-I. Conclusion: Serum IGF-I and IGF-II contents were closely associated with degree of liver dysfunction and might be of prognostic significance. (authors)

  13. Characterization and classification of patients with different levels of cardiac death risk by using Poincaré plot analysis.

    Science.gov (United States)

    Rodriguez, Javier; Voss, Andreas; Caminal, Pere; Bayes-Genis, Antoni; Giraldo, Beatriz F

    2017-07-01

    Cardiac death risk is still a big problem by an important part of the population, especially in elderly patients. In this study, we propose to characterize and analyze the cardiovascular and cardiorespiratory systems using the Poincaré plot. A total of 46 cardiomyopathy patients and 36 healthy subjets were analyzed. Left ventricular ejection fraction (LVEF) was used to stratify patients with low risk (LR: LVEF > 35%, 16 patients), and high risk (HR: LVEF ≤ 35%, 30 patients) of heart attack. RR, SBP and T Tot time series were extracted from the ECG, blood pressure and respiratory flow signals, respectively. Parameters that describe the scatterplott of Poincaré method, related to short- and long-term variabilities, acceleration and deceleration of the dynamic system, and the complex correlation index were extracted. The linear discriminant analysis (LDA) and the support vector machines (SVM) classification methods were used to analyze the results of the extracted parameters. The results showed that cardiac parameters were the best to discriminate between HR and LR groups, especially the complex correlation index (p = 0.009). Analising the interaction, the best result was obtained with the relation between the difference of the standard deviation of the cardiac and respiratory system (p = 0.003). When comparing HR vs LR groups, the best classification was obtained applying SVM method, using an ANOVA kernel, with an accuracy of 98.12%. An accuracy of 97.01% was obtained by comparing patients versus healthy, with a SVM classifier and Laplacian kernel. The morphology of Poincaré plot introduces parameters that allow the characterization of the cardiorespiratory system dynamics.

  14. Proposed changes in the classification of carcinogenic chemicals in the work area.

    Science.gov (United States)

    Neumann, H G; Thielmann, H W; Filser, J G; Gelbke, H P; Greim, H; Kappus, H; Norpoth, K H; Reuter, U; Vamvakas, S; Wardenbach, P; Wichmann, H E

    1997-12-01

    Carcinogenic chemicals in the work area are currently classified into three categories in Section III of the German List of MAK and BAT Values. This classification is based on qualitative criteria and reflects essentially the weight of evidence available for judging the carcinogenic potential of the chemicals. It is proposed that these Categories--IIIA1, IIIA2, and IIIB--be retained as Categories 1, 2, and 3, to conform with EU regulations. On the basis of our advancing knowledge of reaction mechanisms and the potency of carcinogens, it is now proposed that these three categories be supplemented with two additional categories. The essential feature of substances classified in the new categories is that exposure to these chemicals does not convey a significant risk of cancer to man, provided that an appropriate exposure limit (MAK value) is observed. It is proposed that chemicals known to act typically by nongenotoxic mechanisms and for which information is available that allows evaluation of the effects of low-dose exposures be classified in Category 4. Genotoxic chemicals for which low carcinogenic potency can be expected on the basis of dose-response relationships and toxicokinetics and for which risk at low doses can be assessed will be classified in Category 5. The basis for a better differentiation of carcinogens is discussed, the new categories are defined, and possible criteria for classification are described. Examples for Category 4 (1,4-dioxane) and Category 5 (styrene) are presented. The proposed changes in classifying carcinogenic chemicals in the work area are presented for further discussion.

  15. Classifying Classifications

    DEFF Research Database (Denmark)

    Debus, Michael S.

    2017-01-01

    This paper critically analyzes seventeen game classifications. The classifications were chosen on the basis of diversity, ranging from pre-digital classification (e.g. Murray 1952), over game studies classifications (e.g. Elverdam & Aarseth 2007) to classifications of drinking games (e.g. LaBrie et...... al. 2013). The analysis aims at three goals: The classifications’ internal consistency, the abstraction of classification criteria and the identification of differences in classification across fields and/or time. Especially the abstraction of classification criteria can be used in future endeavors...... into the topic of game classifications....

  16. Issues surrounding the classification of accounting information

    Directory of Open Access Journals (Sweden)

    Huibrecht Van der Poll

    2011-06-01

    Full Text Available The act of classifying information created by accounting practices is ubiquitous in the accounting process; from recording to reporting, it has almost become second nature. The classification has to correspond to the requirements and demands of the changing environment in which it is practised. Evidence suggests that the current classification of items in financial statements is not keeping pace with the needs of users and the new financial constructs generated by the industry. This study addresses the issue of classification in two ways: by means of a critical analysis of classification theory and practices and by means of a questionnaire that was developed and sent to compilers and users of financial statements. A new classification framework for accounting information in the balance sheet and income statement is proposed.

  17. Heterogeneity of European DRG systems and potentials for a common EuroDRG system: Comment on "Cholecystectomy and Diagnosis-Related Groups (DRGs): patient classification and hospital reimbursement in 11 European countries"

    OpenAIRE

    Geissler, Alexander; Quentin, Wilm; Busse, Reinhard

    2015-01-01

    Diagnosis-Related Group (DRG) systems across Europe are very heterogeneous, in particular because of different classification variables and algorithms as well as costing methodologies. But, given the challenge of increasing patient mobility within Europe, health systems are forced to incorporate a common patient classification language in order to compare and identify similar patients e.g. for reimbursement purposes. Beside the national adoption of DRGs for a wide range of purposes (measuring...

  18. Comparison of severity classification in Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis in a nationwide, prospective, inception cohort study.

    Science.gov (United States)

    Sada, Ken-Ei; Harigai, Masayoshi; Amano, Koichi; Atsumi, Tatsuya; Fujimoto, Shouichi; Yuzawa, Yukio; Takasaki, Yoshinari; Banno, Shogo; Sugihara, Takahiko; Kobayashi, Masaki; Usui, Joichi; Yamagata, Kunihiro; Homma, Sakae; Dobashi, Hiroaki; Tsuboi, Naotake; Ishizu, Akihiro; Sugiyama, Hitoshi; Okada, Yasunori; Arimura, Yoshihiro; Matsuo, Seiichi; Makino, Hirofumi

    2016-09-01

    To compare disease severity classification systems for six-month outcome prediction in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Patients with newly diagnosed AAV from 53 tertiary institutions were enrolled. Six-month remission, overall survival, and end-stage renal disease (ESRD)-free survival were evaluated. According to the European Vasculitis Study Group (EUVAS)-defined disease severity, the 321 enrolled patients were classified as follows: 14, localized; 71, early systemic; 170, generalized; and 66, severe disease. According to the rapidly progressive glomerulonephritis (RPGN) clinical grading system, the patients were divided as follows: 60, grade I; 178, grade II; 66, grade III; and 12, grade IV. According to the Five-Factor Score (FFS) 2009, 103, 109, and 109 patients had ≤1, 2, and ≥3 points, respectively. No significant difference in remission rates was found in any severity classification. The overall and ESRD-free survival rates significantly differed between grades I/II, III, and IV, regardless of renal involvement. Severe disease was a good predictor of six-month overall and ESRD-free survival. The FFS 2009 was useful to predict six-month ESRD-free survival but not overall survival. The RPGN grading system was more useful to predict six-month overall and ESRD-free survival than the EUVAS-defined severity or FFS 2009.

  19. Length of stay, discharge destination, and functional improvement: utility of the Australian National Subacute and Nonacute Patient Casemix Classification.

    Science.gov (United States)

    Tooth, Leigh; McKenna, Kryss; Goh, Kong; Varghese, Paul

    2005-07-01

    Although implemented in 1998, no research has examined how well the Australian National Subacute and Nonacute Patient (AN-SNAP) Casemix Classification predicts length of stay (LOS), discharge destination, and functional improvement in public hospital stroke rehabilitation units in Australia. 406 consecutive admissions to 3 stroke rehabilitation units in Queensland, Australia were studied. Sociodemographic, clinical, and functional data were collected. General linear modeling and logistic regression were used to assess the ability of AN-SNAP to predict outcomes. AN-SNAP significantly predicted each outcome. There were clear relationships between the outcomes of longer LOS, poorer functional improvement and discharge into care, and the AN-SNAP classes that reflected poorer functional ability and older age. Other predictors included living situation, acute LOS, comorbidity, and stroke type. AN-SNAP is a consistent predictor of LOS, functional change and discharge destination, and has utility in assisting clinicians to set rehabilitation goals and plan discharge.

  20. Comprehensive Application of the International Classification of Headache Disorders Third Edition, Beta Version.

    Science.gov (United States)

    Kim, Byung-Kun; Cho, Soo-Jin; Kim, Byung-Su; Sohn, Jong-Hee; Kim, Soo-Kyoung; Cha, Myoung-Jin; Song, Tae-Jin; Kim, Jae-Moon; Park, Jeong Wook; Chu, Min Kyung; Park, Kwang-Yeol; Moon, Heui-Soo

    2016-01-01

    The purpose of this study was to test the feasibility and usefulness of the International Classification of Headache Disorders, third edition, beta version (ICHD-3β), and compare the differences with the International Classification of Headache Disorders, second edition (ICHD-2). Consecutive first-visit patients were recruited from 11 headache clinics in Korea. Headache classification was performed in accordance with ICHD-3β. The characteristics of headaches were analyzed and the feasibility and usefulness of this version was assessed by the proportion of unclassified headache disorders compared with ICHD-2. A total of 1,627 patients were enrolled (mean age, 47.4±14.7 yr; 62.8% female). Classification by ICHD-3β was achieved in 97.8% of headache patients, whereas 90.0% could be classified by ICHD-2. Primary headaches (n=1,429, 87.8%) were classified as follows: 697 migraines, 445 tension-type headaches, 22 cluster headaches, and 265 other primary headache disorders. Secondary headache or painful cranial neuropathies/other facial pains were diagnosed in 163 patients (10.0%). Only 2.2% were not classified by ICHD-3β. The main reasons for missing classifications were insufficient information (1.6%) or absence of suitable classification (0.6%). The diagnoses differed from those using ICHD-2 in 243 patients (14.9%). Among them, 165 patients were newly classified from unclassified with ICHD-2 because of the relaxation of the previous strict criteria or the introduction of a new diagnostic category. ICHD-3β would yield a higher classification rate than its previous version, ICHD-2. ICHD-3β is applicable in clinical practice for first-visit headache patients of a referral hospital.

  1. The classification of phocomelia.

    Science.gov (United States)

    Tytherleigh-Strong, G; Hooper, G

    2003-06-01

    We studied 24 patients with 44 phocomelic upper limbs. Only 11 limbs could be grouped in the classification system of Frantz and O' Rahilly. The non-classifiable limbs were further studied and their characteristics identified. It is confirmed that phocomelia is not an intercalary defect.

  2. A new flood type classification method for use in climate change impact studies

    Directory of Open Access Journals (Sweden)

    Thea Turkington

    2016-12-01

    Full Text Available Flood type classification is an optimal tool to cluster floods with similar meteorological triggering conditions. Under climate change these flood types may change differently as well as new flood types develop. This paper presents a new methodology to classify flood types, particularly for use in climate change impact studies. A weather generator is coupled with a conceptual rainfall-runoff model to create long synthetic records of discharge to efficiently build an inventory with high number of flood events. Significant discharge days are classified into causal types using k-means clustering of temperature and precipitation indicators capturing differences in rainfall amount, antecedent rainfall and snow-cover and day of year. From climate projections of bias-corrected temperature and precipitation, future discharge and associated change in flood types are assessed. The approach is applied to two different Alpine catchments: the Ubaye region, a small catchment in France, dominated by rain-on-snow flood events during spring, and the larger Salzach catchment in Austria, affected more by rainfall summer/autumn flood events. The results show that the approach is able to reproduce the observed flood types in both catchments. Under future climate scenarios, the methodology identifies changes in the distribution of flood types and characteristics of the flood types in both study areas. The developed methodology has potential to be used flood impact assessment and disaster risk management as future changes in flood types will have implications for both the local social and ecological systems in the future.

  3. Image Classification Workflow Using Machine Learning Methods

    Science.gov (United States)

    Christoffersen, M. S.; Roser, M.; Valadez-Vergara, R.; Fernández-Vega, J. A.; Pierce, S. A.; Arora, R.

    2016-12-01

    Recent increases in the availability and quality of remote sensing datasets have fueled an increasing number of scientifically significant discoveries based on land use classification and land use change analysis. However, much of the software made to work with remote sensing data products, specifically multispectral images, is commercial and often prohibitively expensive. The free to use solutions that are currently available come bundled up as small parts of much larger programs that are very susceptible to bugs and difficult to install and configure. What is needed is a compact, easy to use set of tools to perform land use analysis on multispectral images. To address this need, we have developed software using the Python programming language with the sole function of land use classification and land use change analysis. We chose Python to develop our software because it is relatively readable, has a large body of relevant third party libraries such as GDAL and Spectral Python, and is free to install and use on Windows, Linux, and Macintosh operating systems. In order to test our classification software, we performed a K-means unsupervised classification, Gaussian Maximum Likelihood supervised classification, and a Mahalanobis Distance based supervised classification. The images used for testing were three Landsat rasters of Austin, Texas with a spatial resolution of 60 meters for the years of 1984 and 1999, and 30 meters for the year 2015. The testing dataset was easily downloaded using the Earth Explorer application produced by the USGS. The software should be able to perform classification based on any set of multispectral rasters with little to no modification. Our software makes the ease of land use classification using commercial software available without an expensive license.

  4. Numeric pathologic lymph node classification shows prognostic superiority to topographic pN classification in esophageal squamous cell carcinoma.

    Science.gov (United States)

    Sugawara, Kotaro; Yamashita, Hiroharu; Uemura, Yukari; Mitsui, Takashi; Yagi, Koichi; Nishida, Masato; Aikou, Susumu; Mori, Kazuhiko; Nomura, Sachiyo; Seto, Yasuyuki

    2017-10-01

    The current eighth tumor node metastasis lymph node category pathologic lymph node staging system for esophageal squamous cell carcinoma is based solely on the number of metastatic nodes and does not consider anatomic distribution. We aimed to assess the prognostic capability of the eighth tumor node metastasis pathologic lymph node staging system (numeric-based) compared with the 11th Japan Esophageal Society (topography-based) pathologic lymph node staging system in patients with esophageal squamous cell carcinoma. We retrospectively reviewed the clinical records of 289 patients with esophageal squamous cell carcinoma who underwent esophagectomy with extended lymph node dissection during the period from January 2006 through June 2016. We compared discrimination abilities for overall survival, recurrence-free survival, and cancer-specific survival between these 2 staging systems using C-statistics. The median number of dissected and metastatic nodes was 61 (25% to 75% quartile range, 45 to 79) and 1 (25% to 75% quartile range, 0 to 3), respectively. The eighth tumor node metastasis pathologic lymph node staging system had a greater ability to accurately determine overall survival (C-statistics: tumor node metastasis classification, 0.69, 95% confidence interval, 0.62-0.76; Japan Esophageal Society classification; 0.65, 95% confidence interval, 0.58-0.71; P = .014) and cancer-specific survival (C-statistics: tumor node metastasis classification, 0.78, 95% confidence interval, 0.70-0.87; Japan Esophageal Society classification; 0.72, 95% confidence interval, 0.64-0.80; P = .018). Rates of total recurrence rose as the eighth tumor node metastasis pathologic lymph node stage increased, while stratification of patients according to the topography-based node classification system was not feasible. Numeric nodal staging is an essential tool for stratifying the oncologic outcomes of patients with esophageal squamous cell carcinoma even in the cohort in which adequate

  5. McMaster-Toronto Arthritis Patient Preference Disability Questionnaire sensitivity to change in low back pain: influence of shifts in priorities.

    Directory of Open Access Journals (Sweden)

    Katherine Sanchez

    Full Text Available OBJECTIVE: To assess the sensitivity to change of the McMaster Toronto Arthritis Patient Preference Disability Questionnaire (MACTAR in chronic low back pain (CLBP and shifts in patients' priorities of disabling activities over time. METHODS: A prospective longitudinal survey of 100 patients (38 males with CLBP in a tertiary care teaching hospital. Evaluation at baseline and 6 months by the MACTAR, Quebec Back Pain Disability Questionnaire (QUEBEC, Hospital Anxiety and Depression scale (HAD, Fear-Avoidance Beliefs Questionnaire (FABQ, Coping Strategies Questionnaire (CSQ, and pain and handicap visual analogue scales (VASs. Patients' perceived improvement or worsening of condition was assessed at 6 months. Effect size (ES and Standardized response mean (SRM and effect size (ES were used to evaluate sensitivity to change of the MACTAR. RESULTS: The MACTAR SRM and ES values (SRM = 0.25; ES = 0.37 were among the highest for the instruments evaluated. For patients considering their condition as improved, the SRM was 0.66 and the ES 1. The 3 disability domains, classified by the International Classification of Functioning, Disability and Health (ICF, most often cited as priorities at baseline remained the most cited at follow-up: mobility (40.9% of patients; community, social and civic life (22.7%; and domestic life (22.4%. At 6 months, 48 patients shifted their priorities, for a decrease in MACTAR SRM and ES values for patients considering their condition improved and an increase in these values for those considering their condition deteriorated. CONCLUSIONS: Although the MACTAR has similar sensitivity to change as other outcome measures widely used in CLBP, shifts in patient priorities over time are common and influence scores and sensitivity to change.

  6. Hydrological Climate Classification: Can We Improve on Köppen-Geiger?

    Science.gov (United States)

    Knoben, W.; Woods, R. A.; Freer, J. E.

    2017-12-01

    Classification is essential in the study of complex natural systems, yet hydrology so far has no formal way to structure the climate forcing which underlies hydrologic response. Various climate classification systems can be borrowed from other disciplines but these are based on different organizing principles than a hydrological classification might use. From gridded global data we calculate a gridded aridity index, an aridity seasonality index and a rain-vs-snow index, which we use to cluster global locations into climate groups. We then define the membership degree of nearly 1100 catchments to each of our climate groups based on each catchment's climate and investigate the extent to which streamflow responses within each climate group are similar. We compare this climate classification approach with the often-used Köppen-Geiger classification, using statistical tests based on streamflow signature values. We find that three climate indices are sufficient to distinguish 18 different climate types world-wide. Climates tend to change gradually in space and catchments can thus belong to multiple climate groups, albeit with different degrees of membership. Streamflow responses within a climate group tend to be similar, regardless of the catchments' geographical proximity. A Wilcoxon two-sample test based on streamflow signature values for each climate group shows that the new classification can distinguish different flow regimes using this classification scheme. The Köppen-Geiger approach uses 29 climate classes but is less able to differentiate streamflow regimes. Climate forcing exerts a strong control on typical hydrologic response and both change gradually in space. This makes arbitrary hard boundaries in any classification scheme difficult to defend. Any hydrological classification should thus acknowledge these gradual changes in forcing. Catchment characteristics (soil or vegetation type, land use, etc) can vary more quickly in space than climate does, which

  7. Classification and clinical features of headache patients: an outpatient clinic study from China.

    Science.gov (United States)

    Wang, Yunfeng; Zhou, Jiying; Fan, Xiaoping; Li, Xuelian; Ran, Li; Tan, Ge; Chen, Lixue; Wang, Kuiyun; Liu, Bowen

    2011-10-01

    This study aimed to analyze and classify the clinical features of headache in neurological outpatients. A cross-sectional study was conducted consecutively from March to May 2010 for headache among general neurological outpatients attending the First Affiliated Hospital of Chongqing Medical University. Personal interviews were carried out and a questionnaire was used to collect medical records. Diagnosis of headache was according to the International classification of headache disorders, 2nd edition (ICHD-II). Headache patients accounted for 19.5% of the general neurology clinic outpatients. A total of 843 (50.1%) patients were defined as having primary headache, 454 (27%) secondary headache, and 386 (23%) headache not otherwise specified (headache NOS). For primary headache, 401 (23.8%) had migraine, 399 (23.7%) tension-type headache (TTH), 8 (0.5%) cluster headache and 35 (2.1%) other headache types. Overall, migraine patients suffered (1) more severe headache intensity, (2) longer than 6 years of headache history and (3) more common analgesic medications use than TTH ones (p headaches than migraine patients, and typically headache frequency exceeded 15 days/month (p headache patients were defined as chronic daily headache. Almost 20% of outpatient visits to the general neurology department were of headache patients, predominantly primary headache of migraine and TTH. In outpatient headaches, more attention should be given to headache intensity and duration of headache history for migraine patients, while more attention to headache frequency should be given for the TTH ones.

  8. Classification deficits in Alzheimer's disease with special reference to living and nonliving things.

    Science.gov (United States)

    Montanes, P; Goldblum, M C; Boller, F

    1996-08-01

    The present study was conducted to assess the hypothesis that visual similarity between exemplars within a semantic category may affect differentially the recognition process of living and nonliving things, according to task demands, in patients with semantic memory disorders. Thirty-nine Alzheimer's patients and 39 normal elderly subjects were presented with a task in which they had to classify pictures and words, depicting either living or nonliving things, at two levels of classification: subordinate (e.g., mammals versus birds or tools versus vehicles) and attribute (e.g., wild versus domestic animals or fast versus slow vehicles). Contrary to previous results (Montañes, Goldblum, & Boller, 1995) in a naming task, but as expected, living things were better classified than nonliving ones by both controls and patients. As expected, classifications at the subordinate level also gave rise to better performance than classifications at the attribute level. Although (and somewhat unexpectedly) no advantage of picture over word classification emerged, some effects consistent with the hypothesis that visual similarity affects picture classification emerged, in particular within a subgroup of patients with predominant verbal deficits and the most severe semantic memory disorders. This subgroup obtained a better score on classification of pictures than of words depicting living items (that share many visual features) when classification is at the subordinate level (for which visual similarity is a reliable clue to classification), but met with major difficulties when classifying those pictures at the attribute level (for which shared visual features are not reliable clues to classification). These results emphasize the fact that some "normal" effects specific to items in living and nonliving categories have to be considered among the factors causing selective category-specific deficits in patients, as well as their relevance in achieving tasks which require either

  9. Classification of Patients Treated for Infertility Using the IVF Method

    Directory of Open Access Journals (Sweden)

    Malinowski Paweł

    2015-12-01

    Full Text Available One of the most effective methods of infertility treatment is in vitro fertilization (IVF. Effectiveness of the treatment, as well as classification of the data obtained from it, is still an ongoing issue. Classifiers obtained so far are powerful, but even the best ones do not exhibit equal quality concerning possible treatment outcome predictions. Usually, lack of pregnancy is predicted far too often. This creates a constant need for further exploration of this issue. Careful use of different classification methods can, however, help to achieve that goal.

  10. Do Patient-Reported Outcome Measures describe functioning in patients with low back pain, using the Brief International Classification of Functioning, Disability and Health Core Set as a reference?

    DEFF Research Database (Denmark)

    Ibsen, Charlotte; Schiøttz-Christensen, Berit; Melchiorsen, Hanne

    2016-01-01

    OBJECTIVE: To link the items in the Patient-Reported Outcome Measures (PROMs): Roland Morris Disability Questionnaire, Short Form 36 (SF-36) and pain scores, to the Brief International Classification of Functioning, Disability and Health (ICF) Core Set for low back pain, and to examine the extent...... Set (34%). A weak correlation was found between the patients' responses and the clinician's assessment. CONCLUSION: The selected PROMs do not cover the prototypical spectrum of problems encountered in patients with low back pain as defined by the Brief ICF Core Set. The clinical assessment of patients...

  11. Pathohistological classification systems in gastric cancer: diagnostic relevance and prognostic value.

    Science.gov (United States)

    Berlth, Felix; Bollschweiler, Elfriede; Drebber, Uta; Hoelscher, Arnulf H; Moenig, Stefan

    2014-05-21

    Several pathohistological classification systems exist for the diagnosis of gastric cancer. Many studies have investigated the correlation between the pathohistological characteristics in gastric cancer and patient characteristics, disease specific criteria and overall outcome. It is still controversial as to which classification system imparts the most reliable information, and therefore, the choice of system may vary in clinical routine. In addition to the most common classification systems, such as the Laurén and the World Health Organization (WHO) classifications, other authors have tried to characterize and classify gastric cancer based on the microscopic morphology and in reference to the clinical outcome of the patients. In more than 50 years of systematic classification of the pathohistological characteristics of gastric cancer, there is no sole classification system that is consistently used worldwide in diagnostics and research. However, several national guidelines for the treatment of gastric cancer refer to the Laurén or the WHO classifications regarding therapeutic decision-making, which underlines the importance of a reliable classification system for gastric cancer. The latest results from gastric cancer studies indicate that it might be useful to integrate DNA- and RNA-based features of gastric cancer into the classification systems to establish prognostic relevance. This article reviews the diagnostic relevance and the prognostic value of different pathohistological classification systems in gastric cancer.

  12. Understanding about the classification of pulp inflammation

    Directory of Open Access Journals (Sweden)

    Trijoedani Widodo

    2007-03-01

    Full Text Available Since most authors use the reversible pulpitis and irreversible pulpitis classification, however, many dentists still do not implement these new classifications. Research was made using a descriptive method by proposing questionnaire to dentists from various dental clinics. The numbers of the dentists participating in this research are 22 dentists. All respondents use the diagnosis sheet during their examinations on patients. Nonetheless, it can't be known what diagnosis card used and most of the dentists are still using the old classification. Concerning responses given towards the new classification: a the new classification had been heard, however, it was not clear (36.3%; b the new classification has never been heard at all (63.6%. Then, responses concerning whether a new development is important to be followed-up or not: a there are those who think that information concerning new development is very important (27.2%; b those who feel that it is important to have new information (68.3%; c those who think that new information is not important (8%. It concluded that information concerning the development of classification of pulp inflammation did not reach the dentists.

  13. The effects of clinical, epidemiological and economic aspects of changes in classification criteria of selected rheumatic diseases

    Directory of Open Access Journals (Sweden)

    Aleksander J. Owczarek

    2014-06-01

    Full Text Available The paper presents the epidemiology and socio-economic aspects of the three most common rheumatic diseases: rheumatoid arthritis (RA, systemic lupus erythematosus (SLE and scleroderma. The incidence of rheumatic diseases in a population is estimated at 4–5%. Prevalence rate for RA in Poland is 0.45% of the adult population and is similar to the rate reported in the EU (0.49%. It is estimated that the average incidence of SLE is 40–55 per 100 thousand and that the annual incidence of systemic sclerosis is 19–35 cases per million (depending on the country. Nearly 18% of all hospital admissions in Poland are associated with rheumatic diseases. The introduction of new classification criteria for rheumatoid arthritis, allowing classification of the early forms of the disease and their use in clinical practice will probably change the assessment of incidence of this disease in the population.

  14. A systematic review of definitions and classification systems of adjacent segment pathology.

    Science.gov (United States)

    Kraemer, Paul; Fehlings, Michael G; Hashimoto, Robin; Lee, Michael J; Anderson, Paul A; Chapman, Jens R; Raich, Annie; Norvell, Daniel C

    2012-10-15

    Systematic review. To undertake a systematic review to determine how "adjacent segment degeneration," "adjacent segment disease," or clinical pathological processes that serve as surrogates for adjacent segment pathology are classified and defined in the peer-reviewed literature. Adjacent segment degeneration and adjacent segment disease are terms referring to degenerative changes known to occur after reconstructive spine surgery, most commonly at an immediately adjacent functional spinal unit. These can include disc degeneration, instability, spinal stenosis, facet degeneration, and deformity. The true incidence and clinical impact of degenerative changes at the adjacent segment is unclear because there is lack of a universally accepted classification system that rigorously addresses clinical and radiological issues. A systematic review of the English language literature was undertaken and articles were classified using the Grades of Recommendation Assessment, Development, and Evaluation criteria. RESULTS.: Seven classification systems of spinal degeneration, including degeneration at the adjacent segment, were identified. None have been evaluated for reliability or validity specific to patients with degeneration at the adjacent segment. The ways in which terms related to adjacent segment "degeneration" or "disease" are defined in the peer-reviewed literature are highly variable. On the basis of the systematic review presented in this article, no formal classification system for either cervical or thoracolumbar adjacent segment disorders currently exists. No recommendations regarding the use of current classification of degeneration at any segments can be made based on the available literature. A new comprehensive definition for adjacent segment pathology (ASP, the now preferred terminology) has been proposed in this Focus Issue, which reflects the diverse pathology observed at functional spinal units adjacent to previous spinal reconstruction and balances

  15. Level of daily physical activity in chronic obstructive pulmonary disease (COPD) patients according to GOLD classification.

    Science.gov (United States)

    Rodó-Pin, Anna; Balañá, Ana; Molina, Lluís; Gea, Joaquim; Rodríguez, Diego A

    2017-02-09

    The Global Initiative for Chronic Obstructive Lung Disease (GOLD guideline) for patients with chronic obstructive pulmonary disease does not adequately reflect the impact of the disease because does not take into account daily physical activity (DPA). Forty eight patients (12 in each GOLD group) were prospectively recruited. DPA was evaluated by accelerometer. Patients were classified into 3 levels of activity (very inactive, sedentary, active). No significant differences in levels of physical activity among GOLD groups (P=.361) were observed. The percentages of very inactive patients were 33% in group A, 42% in group B, 42% in group C and 59% in group D. In addition, high percentage of sedentary patients were observed through 4 groups, in group A (50%), B and C (42%, each), and group D (41%). COPD patients has very low levels of physical activity at all stages of GOLD classification even those defined as low impact (such as GOLD A). Is necessary to detect patients at risk who might benefit from specific interventions. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  16. Activity classification based on inertial and barometric pressure sensors at different anatomical locations.

    Science.gov (United States)

    Moncada-Torres, A; Leuenberger, K; Gonzenbach, R; Luft, A; Gassert, R

    2014-07-01

    Miniature, wearable sensor modules are a promising technology to monitor activities of daily living (ADL) over extended periods of time. To assure both user compliance and meaningful results, the selection and placement site of sensors requires careful consideration. We investigated these aspects for the classification of 16 ADL in 6 healthy subjects under laboratory conditions using ReSense, our custom-made inertial measurement unit enhanced with a barometric pressure sensor used to capture activity-related altitude changes. Subjects wore a module on each wrist and ankle, and one on the trunk. Activities comprised whole body movements as well as gross and dextrous upper-limb activities. Wrist-module data outperformed the other locations for the three activity groups. Specifically, overall classification accuracy rates of almost 93% and more than 95% were achieved for the repeated holdout and user-specific validation methods, respectively, for all 16 activities. Including the altitude profile resulted in a considerable improvement of up to 20% in the classification accuracy for stair ascent and descent. The gyroscopes provided no useful information for activity classification under this scheme. The proposed sensor setting could allow for robust long-term activity monitoring with high compliance in different patient populations.

  17. Activity classification based on inertial and barometric pressure sensors at different anatomical locations

    International Nuclear Information System (INIS)

    Moncada-Torres, A; Leuenberger, K; Gassert, R; Gonzenbach, R; Luft, A

    2014-01-01

    Miniature, wearable sensor modules are a promising technology to monitor activities of daily living (ADL) over extended periods of time. To assure both user compliance and meaningful results, the selection and placement site of sensors requires careful consideration. We investigated these aspects for the classification of 16 ADL in 6 healthy subjects under laboratory conditions using ReSense, our custom-made inertial measurement unit enhanced with a barometric pressure sensor used to capture activity-related altitude changes. Subjects wore a module on each wrist and ankle, and one on the trunk. Activities comprised whole body movements as well as gross and dextrous upper-limb activities. Wrist-module data outperformed the other locations for the three activity groups. Specifically, overall classification accuracy rates of almost 93% and more than 95% were achieved for the repeated holdout and user-specific validation methods, respectively, for all 16 activities. Including the altitude profile resulted in a considerable improvement of up to 20% in the classification accuracy for stair ascent and descent. The gyroscopes provided no useful information for activity classification under this scheme. The proposed sensor setting could allow for robust long-term activity monitoring with high compliance in different patient populations. (paper)

  18. MERRF Classification: Implications for Diagnosis and Clinical Trials.

    Science.gov (United States)

    Finsterer, Josef; Zarrouk-Mahjoub, Sinda; Shoffner, John M

    2018-03-01

    Given the etiologic heterogeneity of disease classification using clinical phenomenology, we employed contemporary criteria to classify variants associated with myoclonic epilepsy with ragged-red fibers (MERRF) syndrome and to assess the strength of evidence of gene-disease associations. Standardized approaches are used to clarify the definition of MERRF, which is essential for patient diagnosis, patient classification, and clinical trial design. Systematic literature and database search with application of standardized assessment of gene-disease relationships using modified Smith criteria and of variants reported to be associated with MERRF using modified Yarham criteria. Review of available evidence supports a gene-disease association for two MT-tRNAs and for POLG. Using modified Smith criteria, definitive evidence of a MERRF gene-disease association is identified for MT-TK. Strong gene-disease evidence is present for MT-TL1 and POLG. Functional assays that directly associate variants with oxidative phosphorylation impairment were critical to mtDNA variant classification. In silico analysis was of limited utility to the assessment of individual MT-tRNA variants. With the use of contemporary classification criteria, several mtDNA variants previously reported as pathogenic or possibly pathogenic are reclassified as neutral variants. MERRF is primarily an MT-TK disease, with pathogenic variants in this gene accounting for ~90% of MERRF patients. Although MERRF is phenotypically and genotypically heterogeneous, myoclonic epilepsy is the clinical feature that distinguishes MERRF from other categories of mitochondrial disorders. Given its low frequency in mitochondrial disorders, myoclonic epilepsy is not explained simply by an impairment of cellular energetics. Although MERRF phenocopies can occur in other genes, additional data are needed to establish a MERRF disease-gene association. This approach to MERRF emphasizes standardized classification rather than clinical

  19. Updating the 2001 National Land Cover Database land cover classification to 2006 by using Landsat imagery change detection methods

    Science.gov (United States)

    Xian, George; Homer, Collin G.; Fry, Joyce

    2009-01-01

    The recent release of the U.S. Geological Survey (USGS) National Land Cover Database (NLCD) 2001, which represents the nation's land cover status based on a nominal date of 2001, is widely used as a baseline for national land cover conditions. To enable the updating of this land cover information in a consistent and continuous manner, a prototype method was developed to update land cover by an individual Landsat path and row. This method updates NLCD 2001 to a nominal date of 2006 by using both Landsat imagery and data from NLCD 2001 as the baseline. Pairs of Landsat scenes in the same season in 2001 and 2006 were acquired according to satellite paths and rows and normalized to allow calculation of change vectors between the two dates. Conservative thresholds based on Anderson Level I land cover classes were used to segregate the change vectors and determine areas of change and no-change. Once change areas had been identified, land cover classifications at the full NLCD resolution for 2006 areas of change were completed by sampling from NLCD 2001 in unchanged areas. Methods were developed and tested across five Landsat path/row study sites that contain several metropolitan areas including Seattle, Washington; San Diego, California; Sioux Falls, South Dakota; Jackson, Mississippi; and Manchester, New Hampshire. Results from the five study areas show that the vast majority of land cover change was captured and updated with overall land cover classification accuracies of 78.32%, 87.5%, 88.57%, 78.36%, and 83.33% for these areas. The method optimizes mapping efficiency and has the potential to provide users a flexible method to generate updated land cover at national and regional scales by using NLCD 2001 as the baseline.

  20. The last classification of vasculitis

    NARCIS (Netherlands)

    Kallenberg, Cees G. M.

    2008-01-01

    Systemic vasculitides are a group of diverse conditions characterized by inflammation of the blood vessels. To obtain homogeneity in clinical characteristics, prognosis, and response to treatment, patients with vasculitis should be classified into defined disease categories. Many classification

  1. [The impact of weight management and related diuretic medication intervention based on body weight changes on cardiac function and re-hospitalization rate in patients with chronic congestive heart failure].

    Science.gov (United States)

    Wang, F W; Shi, J; Shi, J; Yang, J W; Wang, Z H; Ye, J H; Ye, Y; Zheng, H Q; Huang, J

    2017-10-24

    Objective: To explore the impact of weight management and related medication intervention based on body weight changes on cardiac function among patients with chronic congestive heart failure (CHF). Methods: Using prospective, randomized, controlled study methods, consecutive CHF patients, who hospitalized in our department from June 2014 to June 2016 ( n =350), were randomly divided into intervention group ( n =175) and control group ( n =175). Patients in the intervention group received weight management guidance and the post discharge diuretic drugs regimen was adjusted based on body weight changes. The control group received routine medical care post discharge. Left ventricular ejection fraction (LVEF), B type natriuretic peptide precursor (NT-proBNP), 6 minutes walk distance and NYHA classification at one day before discharge and after 6 months were compared between the two groups respectively. Results: Follow-up visit data were not available from 6 patients in the control and intervention group respectively. NYHA classification, LVEF, NT-proBNP and 6 minutes walk distance were similar between the two groups at one day before discharge (all P >0.05). After 6 months, the LVEF and 6 minutes walk distance were significantly higher while NT-proBNP level was significantly lower in the intervention group compared to the control group (all P weight remained unchanged in the intervention group, while body weight tended to be higher in the control group compared to one day before discharge. Conclusion: The weight management and diuretic drug regimen adjudgment intervention based on body weight changes can improve cardiac function and reduced re-hospitalization rate in CHF patients.

  2. The association of patient characteristics and spinal curve parameters with Lenke classification types.

    Science.gov (United States)

    Sponseller, Paul D; Flynn, John M; Newton, Peter O; Marks, Michelle C; Bastrom, Tracey P; Petcharaporn, Maty; McElroy, Mark J; Lonner, Baron S; Betz, Randal R

    2012-06-01

    Retrospective review. To determine the association of patient characteristics and spinal curve parameters with Lenke curve types. The Lenke curve classification may be used for surgical planning and clinical research. We retrospectively reviewed the records of 1912 patients with adolescent idiopathic scoliosis who underwent initial surgery at 21 years of age or younger; collected data on patient's age, patient's sex, primary curve magnitude (Society (SRS) outcomes questionnaire (SRS-22) score; and compared that data by Lenke curve type. Analysis of variance and χ tests were used as appropriate (significance level, P ≤ 0.005). RESULTS.: Lenke types vary by sex: male patients had more major thoracic (types 1-4) than major thoracolumbar/lumbar (types 5 and 6) curves, fewer lumbar C-modifiers (32% vs. 44%), and less apical lumbar translation (1.1 vs. 1.7 cm). Lenke types vary by frequency: the most common type was 1 (50%); the least common, 4 (4%). Lenke types vary by magnitude: type 4 had the greatest percentage of large curves (52% of curves .75°), most smaller curves were types 1 and 5, and type 4 had the largest mean magnitude (78° ± 17°). Lenke types vary by patient age: type 5 curves occurred in the oldest patients (average age at surgery: 15.4 ± 2.2 vs. 14.3 ± 14.6 years for all others) despite having the lowest mean magnitude (P = 0.001); curve size was negatively correlated with age at surgery (r = -0.16, P = 0.001). Lenke types vary by patient self-image: patients with type 4 curves had lower preoperative SRS outcome scores for self-image than did patients with type 1 curves (P = 0.005). Lenke types vary by sex, frequency magnitude, patient age, and patient self-image, which should be considered in designing studies.

  3. Catchment Classification: Connecting Climate, Structure and Function

    Science.gov (United States)

    Sawicz, K. A.; Wagener, T.; Sivapalan, M.; Troch, P. A.; Carrillo, G. A.

    2010-12-01

    Hydrology does not yet possess a generally accepted catchment classification framework. Such a classification framework needs to: [1] give names to things, i.e. the main classification step, [2] permit transfer of information, i.e. regionalization of information, [3] permit development of generalizations, i.e. to develop new theory, and [4] provide a first order environmental change impact assessment, i.e., the hydrologic implications of climate, land use and land cover change. One strategy is to create a catchment classification framework based on the notion of catchment functions (partitioning, storage, and release). Results of an empirical study presented here connects climate and structure to catchment function (in the form of select hydrologic signatures), based on analyzing over 300 US catchments. Initial results indicate a wide assortment of signature relationships with properties of climate, geology, and vegetation. The uncertainty in the different regionalized signatures varies widely, and therefore there is variability in the robustness of classifying ungauged basins. This research provides insight into the controls of hydrologic behavior of a catchment, and enables a classification framework applicable to gauged and ungauged across the study domain. This study sheds light on what we can expect to achieve in mapping climate, structure and function in a top-down manner. Results of this study complement work done using a bottom-up physically-based modeling framework to generalize this approach (Carrillo et al., this session).

  4. Classification and pharmacological treatment of preschool wheezing : changes since 2008

    NARCIS (Netherlands)

    Brand, Paul L. P.; Caudri, Daan; Eber, Ernst; Gaillard, Erol A.; Garcia-Marcos, Luis; Hedlin, Gunilla; Henderson, John; Kuehni, Claudia E.; Merkus, Peter J. F. M.; Pedersen, Soren; Valiuis, Arunas; Wennergren, Goeran; Bush, Andrew

    Since the publication of the European Respiratory Society Task Force report in 2008, significant new evidence has become available on the classification and management of preschool wheezing disorders. In this report, an international consensus group reviews this new evidence and proposes some

  5. Classification of instability after reverse shoulder arthroplasty guides surgical management and outcomes.

    Science.gov (United States)

    Abdelfattah, Adham; Otto, Randall J; Simon, Peter; Christmas, Kaitlyn N; Tanner, Gregory; LaMartina, Joey; Levy, Jonathan C; Cuff, Derek J; Mighell, Mark A; Frankle, Mark A

    2018-04-01

    Revision of unstable reverse shoulder arthroplasty (RSA) remains a significant challenge. The purpose of this study was to determine the reliability of a new treatment-guiding classification for instability after RSA, to describe the clinical outcomes of patients stabilized operatively, and to identify those with higher risk of recurrence. All patients undergoing revision for instability after RSA were identified at our institution. Demographic, clinical, radiographic, and intraoperative data were collected. A classification was developed using all identified causes of instability after RSA and allocating them to 1 of 3 defined treatment-guiding categories. Eight surgeons reviewed all data and applied the classification scheme to each case. Interobserver and intraobserver reliability was used to evaluate the classification scheme. Preoperative clinical outcomes were compared with final follow-up in stabilized shoulders. Forty-three revision cases in 34 patients met the inclusion for study. Five patients remained unstable after revision. Persistent instability most commonly occurred in persistent deltoid dysfunction and postoperative acromial fractures but also in 1 case of soft tissue impingement. Twenty-one patients remained stable at minimum 2 years of follow-up and had significant improvement of clinical outcome scores and range of motion. Reliability of the classification scheme showed substantial and almost perfect interobserver and intraobserver agreement among all the participants (κ = 0.699 and κ = 0.851, respectively). Instability after RSA can be successfully treated with revision surgery using the reliable treatment-guiding classification scheme presented herein. However, more understanding is needed for patients with greater risk of recurrent instability after revision surgery. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  6. A new ambulatory classification and funding model for radiation oncology: non-admitted patients in Victorian hospitals.

    Science.gov (United States)

    Antioch, K M; Walsh, M K; Anderson, D; Wilson, R; Chambers, C; Willmer, P

    1998-01-01

    The Victorian Department of Human Services has developed a classification and funding model for non-admitted radiation oncology patients. Agencies were previously funded on an historical cost input basis. For 1996-97, payments were made according to the new Non-admitted Radiation Oncology Classification System and include four key components. Fixed grants are based on Weighted Radiation Therapy Services targets for megavoltage courses, planning procedures (dosimetry and simulation) and consultations. The additional throughput pool covers additional Weighted Radiation Therapy Services once targets are reached, with access conditional on the utilisation of a minimum number of megavoltage fields by each hospital. Block grants cover specialised treatments, such as brachytherapy, allied health payments and other support services. Compensation grants were available to bring payments up to the level of the previous year. There is potential to provide incentives to promote best practice in Australia through linking appropriate practice to funding models. Key Australian and international developments should be monitored, including economic evaluation studies, classification and funding models, and the deliberations of the American College of Radiology, the American Society for Therapeutic Radiology and Oncology, the Trans-Tasman Radiation Oncology Group and the Council of Oncology Societies of Australia. National impact on clinical practice guidelines in Australia can be achieved through the Quality of Care and Health Outcomes Committee of the National Health and Medical Research Council.

  7. Bilateral weighted radiographs are required for accurate classification of acromioclavicular separation: an observational study of 59 cases.

    Science.gov (United States)

    Ibrahim, E F; Forrest, N P; Forester, A

    2015-10-01

    Misinterpretation of the Rockwood classification system for acromioclavicular joint (ACJ) separations has resulted in a trend towards using unilateral radiographs for grading. Further, the use of weighted views to 'unmask' a grade III injury has fallen out of favour. Recent evidence suggests that many radiographic grade III injuries represent only a partial injury to the stabilising ligaments. This study aimed to determine (1) whether accurate classification is possible on unilateral radiographs and (2) the efficacy of weighted bilateral radiographs in unmasking higher-grade injuries. Complete bilateral non-weighted and weighted sets of radiographs for patients presenting with an acromioclavicular separation over a 10-year period were analysed retrospectively, and they were graded I-VI according to Rockwood's criteria. Comparison was made between grading based on (1) a single antero-posterior (AP) view of the injured side, (2) bilateral non-weighted views and (3) bilateral weighted views. Radiographic measurements for cases that changed grade after weighted views were statistically compared to see if this could have been predicted beforehand. Fifty-nine sets of radiographs on 59 patients (48 male, mean age of 33 years) were included. Compared with unilateral radiographs, non-weighted bilateral comparison films resulted in a grade change for 44 patients (74.5%). Twenty-eight of 56 patients initially graded as I, II or III were upgraded to grade V and two of three initial grade V patients were downgraded to grade III. The addition of a weighted view further upgraded 10 patients to grade V. No grade II injury was changed to grade III and no injury of any severity was downgraded by a weighted view. Grade III injuries upgraded on weighted views had a significantly greater baseline median percentage coracoclavicular distance increase than those that were not upgraded (80.7% vs. 55.4%, p=0.015). However, no cut-off point for this value could be identified to predict an

  8. Prognostic value of a novel risk classification of microvascular invasion in patients with hepatocellular carcinoma after resection.

    Science.gov (United States)

    Zhao, Hui; Chen, Chuang; Fu, Xu; Yan, Xiaopeng; Jia, Wenjun; Mao, Liang; Jin, Huihan; Qiu, Yudong

    2017-01-17

    The present research aimed to evaluate the prognostic value of a novel risk classification of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) after resection. A total of 295 consecutive HCC patients underwent hepatectomy were included in our study. We evaluated the degree of MVI according to the following three features: the number of invaded microvessels (≤5 vs >5), the number of invading carcinoma cells (≤ 50 vs >50), the distance of invasion from tumor edge (≤1 cm vs >1 cm). All patients were divided into three groups according to the three risk factors of MVI: non-MVI group (n=180), low-MVI group (n=60) and high-MVI group (n=55). The overall survival (OS) and recurrence-free survival (RFS) rates of high-MVI group were significantly poorer than those of low-MVI and non-MVI groups (Prisk factors for OS after hepatectomy. High-MVI, type of resection and tumor size were risk factors for RFS. In subgroup analyses, the OS and RFS rates of low-MVI and non-MVI groups were better than high-MVI group regardless of tumor size. In high-MVI group, anatomical liver resection (n=28) showed better OS and RFS rates compared with non-anatomical liver resection (n=29) (P=0.012 and P=0.002). The novel risk classification of MVI based on histopathological features is valuable for predicting prognosis of HCC patients after hepatectomy.

  9. Classification of sudden and arrhythmic death

    DEFF Research Database (Denmark)

    Torp-Pedersen, C; Køber, L; Elming, H

    1997-01-01

    was nearly abolished by the implantable defibrillator, indicating that arrhythmic death by this classification is meaningful, at least in the population studied. For future investigations, a call is made for committees to present data in a way that allows the reader to examine the quality of the data used......Since all death is (eventually) sudden and associated with cardiac arrhythmias, the concept of sudden death is only meaningful if it is unexpected, while arrhythmic death is only meaningful if life could have continued had the arrhythmia been prevented or treated. Current classifications of death...... or autopsy) are available in only a few percent of cases. A main problem in using classifications is the lack of validation data. This situation has, with the MADIT trial, changed in the case of the Thaler and Hinkle classification of arrhythmic death. The MADIT trial demonstrated that arrhythmic death...

  10. Proposal of a new classification scheme for periocular injuries

    Directory of Open Access Journals (Sweden)

    Devi Prasad Mohapatra

    2017-01-01

    Full Text Available Background: Eyelids are important structures and play a role in protecting the globe from trauma, brightness, in maintaining the integrity of tear films and moving the tears towards the lacrimal drainage system and contribute to aesthetic appearance of the face. Ophthalmic trauma is an important cause of morbidity among individuals and has also been responsible for additional cost of healthcare. Periocular trauma involving eyelids and adjacent structures has been found to have increased recently probably due to increased pace of life and increased dependence on machinery. A comprehensive classification of periocular trauma would help in stratifying these injuries as well as study outcomes. Material and Methods: This study was carried out at our institute from June 2015 to Dec 2015. We searched multiple English language databases for existing classification systems for periocular trauma. We designed a system of classification of periocular soft tissue injuries based on clinico-anatomical presentations. This classification was applied prospectively to patients presenting with periocular soft tissue injuries to our department. Results: A comprehensive classification scheme was designed consisting of five types of periocular injuries. A total of 38 eyelid injuries in 34 patients were evaluated in this study. According to the System for Peri-Ocular Trauma (SPOT classification, Type V injuries were most common. SPOT Type II injuries were more common isolated injuries among all zones. Discussion: Classification systems are necessary in order to provide a framework in which to scientifically study the etiology, pathogenesis, and treatment of diseases in an orderly fashion. The SPOT classification has taken into account the periocular soft tissue injuries i.e., upper eyelid, lower eyelid, medial and lateral canthus injuries., based on observed clinico-anatomical patterns of eyelid injuries. Conclusion: The SPOT classification seems to be a reliable

  11. Classification of iRBD and Parkinson's disease patients based on eye movements during sleep.

    Science.gov (United States)

    Christensen, Julie A E; Koch, Henriette; Frandsen, Rune; Kempfner, Jacob; Arvastson, Lars; Christensen, Soren R; Sorensen, Helge B D; Jennum, Poul

    2013-01-01

    Patients suffering from the sleep disorder idiopathic rapid-eye-movement sleep behavior disorder (iRBD) have been observed to be in high risk of developing Parkinson's disease (PD). This makes it essential to analyze them in the search for PD biomarkers. This study aims at classifying patients suffering from iRBD or PD based on features reflecting eye movements (EMs) during sleep. A Latent Dirichlet Allocation (LDA) topic model was developed based on features extracted from two electrooculographic (EOG) signals measured as parts in full night polysomnographic (PSG) recordings from ten control subjects. The trained model was tested on ten other control subjects, ten iRBD patients and ten PD patients, obtaining a EM topic mixture diagram for each subject in the test dataset. Three features were extracted from the topic mixture diagrams, reflecting "certainty", "fragmentation" and "stability" in the timely distribution of the EM topics. Using a Naive Bayes (NB) classifier and the features "certainty" and "stability" yielded the best classification result and the subjects were classified with a sensitivity of 95 %, a specificity of 80% and an accuracy of 90 %. This study demonstrates in a data-driven approach, that iRBD and PD patients may exhibit abnorm form and/or timely distribution of EMs during sleep.

  12. Proteomic classification of breast cancer.

    LENUS (Irish Health Repository)

    Kamel, Dalia

    2012-11-01

    Being a significant health problem that affects patients in various age groups, breast cancer has been extensively studied to date. Recently, molecular breast cancer classification has advanced significantly with the availability of genomic profiling technologies. Proteomic technologies have also advanced from traditional protein assays including enzyme-linked immunosorbent assay, immunoblotting and immunohistochemistry to more comprehensive approaches including mass spectrometry and reverse phase protein lysate arrays (RPPA). The purpose of this manuscript is to review the current protein markers that influence breast cancer prediction and prognosis and to focus on novel advances in proteomic classification of breast cancer.

  13. Behavioral state classification in epileptic brain using intracranial electrophysiology

    Science.gov (United States)

    Kremen, Vaclav; Duque, Juliano J.; Brinkmann, Benjamin H.; Berry, Brent M.; Kucewicz, Michal T.; Khadjevand, Fatemeh; Van Gompel, Jamie; Stead, Matt; St. Louis, Erik K.; Worrell, Gregory A.

    2017-04-01

    Objective. Automated behavioral state classification can benefit next generation implantable epilepsy devices. In this study we explored the feasibility of automated awake (AW) and slow wave sleep (SWS) classification using wide bandwidth intracranial EEG (iEEG) in patients undergoing evaluation for epilepsy surgery. Approach. Data from seven patients (age 34+/- 12 , 4 women) who underwent intracranial depth electrode implantation for iEEG monitoring were included. Spectral power features (0.1-600 Hz) spanning several frequency bands from a single electrode were used to train and test a support vector machine classifier. Main results. Classification accuracy of 97.8  ±  0.3% (normal tissue) and 89.4  ±  0.8% (epileptic tissue) across seven subjects using multiple spectral power features from a single electrode was achieved. Spectral power features from electrodes placed in normal temporal neocortex were found to be more useful (accuracy 90.8  ±  0.8%) for sleep-wake state classification than electrodes located in normal hippocampus (87.1  ±  1.6%). Spectral power in high frequency band features (Ripple (80-250 Hz), Fast Ripple (250-600 Hz)) showed comparable performance for AW and SWS classification as the best performing Berger bands (Alpha, Beta, low Gamma) with accuracy  ⩾90% using a single electrode contact and single spectral feature. Significance. Automated classification of wake and SWS should prove useful for future implantable epilepsy devices with limited computational power, memory, and number of electrodes. Applications include quantifying patient sleep patterns and behavioral state dependent detection, prediction, and electrical stimulation therapies.

  14. ECG changes in epilepsy patients

    DEFF Research Database (Denmark)

    Tigaran, S; Rasmussen, V; Dam, M

    1997-01-01

    To investigate the frequency of ECG abnormalities suggestive of myocardial ischaemia in patients with severe drug resistant epilepsy and without any indication of previous cardiac disease, assuming that these changes may be of significance for the group of epileptic patients with sudden unexpected...

  15. The natural history of cystic echinococcosis in untreated and albendazole-treated patients.

    Science.gov (United States)

    Solomon, N; Kachani, M; Zeyhle, E; Macpherson, C N L

    2017-07-01

    The World Health Organization (WHO) treatment protocols for cystic echinococcosis (CE) are based on the standardized ultrasound (US) classification. This study examined whether the classification reflected the natural history of CE in untreated and albendazole-treated patients. Data were collected during mass US screenings in CE endemic regions among transhumant populations, the Turkana and Berber peoples of Kenya and Morocco. Cysts were classified using the WHO classification. Patient records occurring prior to treatment, and after albendazole administration, were selected. 852 paired before/after observations of 360 cysts from 257 patients were analyzed. A McNemar-Bowker χ 2 test for symmetry was significant (palbendazole-treated patients was significant (palbendazole-induced changes. Regressions may reflect the stability of CE3B cysts. Copyright © 2017. Published by Elsevier B.V.

  16. Clinical study in elderly patients with temporomandibular disorders. A comparison with patients in their 20s

    International Nuclear Information System (INIS)

    Okazaki, Atsuko; Miyajima, Hisashi; Yagi, Minoru; Takagi, Ritsuo

    2010-01-01

    To evaluate the characteristics of temporomandibular disorders (TMD) in elderly patients, we performed a clinicostatistical study in 122 patients aged ≥60 years. Based on medical records, panoramic X-ray images, and MR images, clinical findings (sex-related differences, chief complaint, disease duration, frequency of complication, disorder type classification, joint sound (crepitation), maximum mouth opening, and occlusal support) and imaging findings (articular disc position in type IV, disc configuration, mandibular condyle bony changes) were compared between the elderly subjects and 125 patients in their 20s. As a result, significant differences were observed in disease duration, disorder type classification, and disc configuration, showing prolongation, increases in types I and IV, and an increase in cases of severe deformation, respectively, in the elderly patients. Therefore, management with consideration of these characteristics may be important in the diagnosis and treatment of TMD. (author)

  17. Self-reported pain severity, quality of life, disability, anxiety and depression in patients classified with 'nociceptive', 'peripheral neuropathic' and 'central sensitisation' pain. The discriminant validity of mechanisms-based classifications of low back (±leg) pain.

    LENUS (Irish Health Repository)

    Smart, Keith M

    2012-04-01

    Evidence of validity is required to support the use of mechanisms-based classifications of pain clinically. The purpose of this study was to evaluate the discriminant validity of \\'nociceptive\\' (NP), \\'peripheral neuropathic\\' (PNP) and \\'central sensitisation\\' (CSP) as mechanisms-based classifications of pain in patients with low back (±leg) pain by evaluating the extent to which patients classified in this way differ from one another according to health measures associated with various dimensions of pain. This study employed a cross-sectional, between-subjects design. Four hundred and sixty-four patients with low back (±leg) pain were assessed using a standardised assessment protocol. Clinicians classified each patient\\'s pain using a mechanisms-based classification approach. Patients completed a number of self-report measures associated with pain severity, health-related quality of life, functional disability, anxiety and depression. Discriminant validity was evaluated using a multivariate analysis of variance. There was a statistically significant difference between pain classifications on the combined self-report measures, (p = .001; Pillai\\'s Trace = .33; partial eta squared = .16). Patients classified with CSP (n = 106) reported significantly more severe pain, poorer general health-related quality of life, and greater levels of back pain-related disability, depression and anxiety compared to those classified with PNP (n = 102) and NP (n = 256). A similar pattern was found in patients with PNP compared to NP. Mechanisms-based pain classifications may reflect meaningful differences in attributes underlying the multidimensionality of pain. Further studies are required to evaluate the construct and criterion validity of mechanisms-based classifications of musculoskeletal pain.

  18. Mental changes in patients with AIDS

    NARCIS (Netherlands)

    Derix, M. M.; de Gans, J.; Stam, J.; Portegies, P.

    1990-01-01

    Mental changes are common in patients with acquired immunodeficiency syndrome (AIDS). Neuropsychological data of 32 patients with AIDS and cognitive symptoms were reviewed. All patients were neurologically examined and ancillary investigations were performed. According to the neuropsychological data

  19. Extension classification method for low-carbon product cases

    Directory of Open Access Journals (Sweden)

    Yanwei Zhao

    2016-05-01

    Full Text Available In product low-carbon design, intelligent decision systems integrated with certain classification algorithms recommend the existing design cases to designers. However, these systems mostly dependent on prior experience, and product designers not only expect to get a satisfactory case from an intelligent system but also hope to achieve assistance in modifying unsatisfactory cases. In this article, we proposed a new categorization method composed of static and dynamic classification based on extension theory. This classification method can be integrated into case-based reasoning system to get accurate classification results and to inform designers of detailed information about unsatisfactory cases. First, we establish the static classification model for cases by dependent function in a hierarchical structure. Then for dynamic classification, we make transformation for cases based on case model, attributes, attribute values, and dependent function, thus cases can take qualitative changes. Finally, the applicability of proposed method is demonstrated through a case study of screw air compressor cases.

  20. A new classification system for congenital laryngeal cysts.

    Science.gov (United States)

    Forte, Vito; Fuoco, Gabriel; James, Adrian

    2004-06-01

    A new classification system for congenital laryngeal cysts based on the extent of the cyst and on the embryologic tissue of origin is proposed. Retrospective chart review. The charts of 20 patients with either congenital or acquired laryngeal cysts that were treated surgically between 1987 and 2002 at the Hospital for Sick Children, Toronto were retrospectively reviewed. Clinical presentation, radiologic findings, surgical management, histopathology, and outcome were recorded. A new classification system is proposed to better appreciate the origin of these cysts and to guide in their successful surgical management. Fourteen of the supraglottic and subglottic simple mucous retention cysts posed no diagnostic or therapeutic challenge and were treated successfully by a single endoscopic excision or marsupialization. The remaining six patients with congenital cysts in the study were deemed more complex, and all required open surgical procedures for cure. On the basis of the analysis of the data of these patients, a new classification of congenital laryngeal cysts is proposed. Type I cysts are confined to the larynx, the cyst wall composed of endodermal elements only, and can be managed endoscopically. Type II cysts extend beyond the confines of the larynx and require an external approach. The Type II cysts are further subclassified histologically on the basis of the embryologic tissue of origin: IIa, composed of endoderm only and IIb, containing endodermal and mesodermal elements (epithelium and cartilage) in the wall of the cyst. A new classification system for congenital laryngeal cysts is proposed on the basis of the extent of the cyst and the embryologic tissue of origin. This classification can help guide the surgeon with initial management and help us better understand the origin of these cysts.

  1. Association between traditional clinical high-risk features and gene expression profile classification in uveal melanoma.

    Science.gov (United States)

    Nguyen, Brandon T; Kim, Ryan S; Bretana, Maria E; Kegley, Eric; Schefler, Amy C

    2018-02-01

    To evaluate the association between traditional clinical high-risk features of uveal melanoma patients and gene expression profile (GEP). This was a retrospective, single-center, case series of patients with uveal melanoma. Eighty-three patients met inclusion criteria for the study. Patients were examined for the following clinical risk factors: drusen/retinal pigment epithelium (RPE) changes, vascularity on B-scan, internal reflectivity on A-scan, subretinal fluid (SRF), orange pigment, apical tumor height/thickness, and largest basal dimensions (LBD). A novel point system was created to grade the high-risk clinical features of each tumor. Further analyses were performed to assess the degree of association between GEP and each individual risk factor, total clinical risk score, vascularity, internal reflectivity, American Joint Committee on Cancer (AJCC) tumor stage classification, apical tumor height/thickness, and LBD. Of the 83 total patients, 41 were classified as GEP class 1A, 17 as class 1B, and 25 as class 2. The presence of orange pigment, SRF, low internal reflectivity and vascularity on ultrasound, and apical tumor height/thickness ≥ 2 mm were not statistically significantly associated with GEP class. Lack of drusen/RPE changes demonstrated a trend toward statistical association with GEP class 2 compared to class 1A/1B. LBD and advancing AJCC stage was statistically associated with higher GEP class. In this cohort, AJCC stage classification and LBD were the only clinical features statistically associated with GEP class. Clinicians should use caution when inferring the growth potential of melanocytic lesions solely from traditional funduscopic and ultrasonographic risk factors without GEP data.

  2. The relationship between changes of cervical sagittal alignment after anterior cervical discectomy and fusion and spino-pelvic sagittal alignment under roussouly classification: a four-year follow-up study.

    Science.gov (United States)

    Huang, Dong-Ning; Yu, Miao; Xu, Nan-Fang; Li, Mai; Wang, Shao-Bo; Sun, Yu; Jiang, Liang; Wei, Feng; Liu, Xiao-Guang; Liu, Zhong-Jun

    2017-02-20

    Anterior cervical discectomy and fusion (ACDF) is widely used in the treatment of cervical degenerative disease; however, the variation of cervical sagittal alignment changes after ACDF has been rarely explored. The purpose of this study is to determine the relationship between changes of cervical sagittal alignment after ACDF and spino-pelvic sagittal alignment under Roussouly classification. A cohort of 133 Chinese cervical spondylotic patients who received ACDF from 2011 to 2012 was recruited. All patients were categorized with Roussouly Classification. Lateral X-ray images of global spine were obtained, and preoperative and postoperative parameters were measured and analyzed, including C2-C7 angles (C2-C7), C0-C7 angles (C0-C7), external auditory meatus (EAM) tilt, sacral slope (SS), thoracic kyphosis (TK), lumbar lordosis (LL), spinal sacral angles (SSA), Superior adjacent inter-vertebral angle (SAIV), inferior adjacent inter-vertebral angle (IAIV) and et al. The Wilcoxon signed-rank test was used for intragroup comparisons preoperatively and at postoperative 48 months. Among the parameters, C2-C7 and C0-C7 showed significant increase, while EAM TK, and IAIV decreased significantly. In type I, EAM and TK decreased significantly, however SS showed a significant increase; in type II, TK showed a significant decrease, but SSA showed a significant increase; in type III, a significant increase of C0-C7 was observed with a significant decrease in EAM, nevertheless, LL, SS and SSA showed significant decreases; and in type IV, C2-C7 showed a significant increase and EAM decreased significantly. The percentage of lordotic alignment in cervical spine increased, which was presenting in type I, III and IV. Nevertheless, the amount of patients with straight cervical alignment increased in type II. The backward movement of head occurs is the compensatory mechanism in cervical sagittal alignment modifications after ACDF. The compensatory alteration of spino-pelvic sagittal

  3. The relationship between changes of cervical sagittal alignment after anterior cervical discectomy and fusion and spino-pelvic sagittal alignment under roussouly classification: a four-year follow-up study

    Directory of Open Access Journals (Sweden)

    Dong-Ning Huang

    2017-02-01

    Full Text Available Abstract Background Anterior cervical discectomy and fusion (ACDF is widely used in the treatment of cervical degenerative disease; however, the variation of cervical sagittal alignment changes after ACDF has been rarely explored. The purpose of this study is to determine the relationship between changes of cervical sagittal alignment after ACDF and spino-pelvic sagittal alignment under Roussouly classification. Methods A cohort of 133 Chinese cervical spondylotic patients who received ACDF from 2011 to 2012 was recruited. All patients were categorized with Roussouly Classification. Lateral X-ray images of global spine were obtained, and preoperative and postoperative parameters were measured and analyzed, including C2–C7 angles (C2–C7, C0–C7 angles (C0–C7, external auditory meatus (EAM tilt, sacral slope (SS, thoracic kyphosis (TK, lumbar lordosis (LL, spinal sacral angles (SSA, Superior adjacent inter-vertebral angle (SAIV, inferior adjacent inter-vertebral angle (IAIV and et al. The Wilcoxon signed-rank test was used for intragroup comparisons preoperatively and at postoperative 48 months. Results Among the parameters, C2–C7 and C0–C7 showed significant increase, while EAM TK, and IAIV decreased significantly. In type I, EAM and TK decreased significantly, however SS showed a significant increase; in type II, TK showed a significant decrease, but SSA showed a significant increase; in type III, a significant increase of C0–C7 was observed with a significant decrease in EAM, nevertheless, LL, SS and SSA showed significant decreases; and in type IV, C2–C7 showed a significant increase and EAM decreased significantly. The percentage of lordotic alignment in cervical spine increased, which was presenting in type I, III and IV. Nevertheless, the amount of patients with straight cervical alignment increased in type II. Conclusion The backward movement of head occurs is the compensatory mechanism in cervical sagittal alignment

  4. Reliability of classification for post-traumatic ankle osteoarthritis.

    Science.gov (United States)

    Claessen, Femke M A P; Meijer, Diederik T; van den Bekerom, Michel P J; Gevers Deynoot, Barend D J; Mallee, Wouter H; Doornberg, Job N; van Dijk, C Niek

    2016-04-01

    The purpose of this study was to identify the most reliable classification system for clinical outcome studies to categorize post-traumatic-fracture-osteoarthritis. A total of 118 orthopaedic surgeons and residents-gathered in the Ankle Platform Study Collaborative Science of Variation Group-evaluated 128 anteroposterior and lateral radiographs of patients after a bi- or trimalleolar ankle fracture on a Web-based platform in order to rate post-traumatic osteoarthritis according to the classification systems coined by (1) van Dijk, (2) Kellgren, and (3) Takakura. Reliability was evaluated with the use of the Siegel and Castellan's multirater kappa measure. Differences between classification systems were compared using the two-sample Z-test. Interobserver agreement of surgeons who participated in the survey was fair for the van Dijk osteoarthritis scale (k = 0.24), and poor for the Takakura (k = 0.19) and the Kellgren systems (k = 0.18) according to the categorical rating of Landis and Koch. This difference in one categorical rating was found to be significant (p osteoarthritis scale, and poor interobserver agreement for the Takakura and Kellgren osteoarthritis classification systems. Because of the low interobserver agreement for the van Dijk, Kellgren, and Takakura classification systems, those systems cannot be used for clinical decision-making. Development of diagnostic criteria on basis of consecutive patients, Level II.

  5. Comparison of two motor subtype classifications in de novo Parkinson's disease.

    Science.gov (United States)

    Choi, Seong-Min; Kim, Byeong C; Cho, Bang-Hoon; Kang, Kyung Wook; Choi, Kang-Ho; Kim, Joon-Tae; Lee, Seung-Han; Park, Man-Seok; Kim, Myeong-Kyu; Cho, Ki-Hyun

    2018-04-18

    Clinical subtypes of Parkinson's disease (PD) have been empirically defined based on the prominent motor symptoms. The aim of this study was to compare the prevalence of non-motor symptoms across PD motor subtypes in patients with PD. A total of 192 patients with de novo PD were included. The patients were classified into the tremor-dominant/mixed/akinetic-rigid (TD/mixed/AR) and tremor-dominant/mixed/postural instability and gait disturbance (TD/mixed/PIGD) subtypes, according to previous reports. In the TD/mixed/AR classification, scores for scales related to motor symptoms and activities of daily living (ADL) were significantly different among the groups, and patients with the AR subtype demonstrated more severe scores than patients with the TD subtype. In the TD/mixed/PIGD classification, age, age at symptom onset, scores on motor-related scales, ADL, and non-motor symptoms were significantly different among the groups. Scores including the modified Hoehn and Yahr stages, the motor and ADL subscores of the Unified Parkinson's Disease Rating Scale, the Beck Depression Inventory, and the Non-Motor Symptom Assessment Scale were significantly different after adjustments for age and age at symptom onset, and patients with the PIGD subtype obtained more severe scores than patients with the TD subtype. The TD/mixed/PIGD classification seems to be more suitable for identifying non-motor abnormalities than the TD/mixed/AR classification. Copyright © 2018 Elsevier Ltd. All rights reserved.

  6. Stroke subtyping for genetic association studies? A comparison of the CCS and TOAST classifications.

    Science.gov (United States)

    Lanfranconi, Silvia; Markus, Hugh S

    2013-12-01

    A reliable and reproducible classification system of stroke subtype is essential for epidemiological and genetic studies. The Causative Classification of Stroke system is an evidence-based computerized algorithm with excellent inter-rater reliability. It has been suggested that, compared to the Trial of ORG 10172 in Acute Stroke Treatment classification, it increases the proportion of cases with defined subtype that may increase power in genetic association studies. We compared Trial of ORG 10172 in Acute Stroke Treatment and Causative Classification of Stroke system classifications in a large cohort of well-phenotyped stroke patients. Six hundred ninety consecutively recruited patients with first-ever ischemic stroke were classified, using review of clinical data and original imaging, according to the Trial of ORG 10172 in Acute Stroke Treatment and Causative Classification of Stroke system classifications. There was excellent agreement subtype assigned by between Trial of ORG 10172 in Acute Stroke Treatment and Causative Classification of Stroke system (kappa = 0·85). The agreement was excellent for the major individual subtypes: large artery atherosclerosis kappa = 0·888, small-artery occlusion kappa = 0·869, cardiac embolism kappa = 0·89, and undetermined category kappa = 0·884. There was only moderate agreement (kappa = 0·41) for the subjects with at least two competing underlying mechanism. Thirty-five (5·8%) patients classified as undetermined by Trial of ORG 10172 in Acute Stroke Treatment were assigned to a definite subtype by Causative Classification of Stroke system. Thirty-two subjects assigned to a definite subtype by Trial of ORG 10172 in Acute Stroke Treatment were classified as undetermined by Causative Classification of Stroke system. There is excellent agreement between classification using Trial of ORG 10172 in Acute Stroke Treatment and Causative Classification of Stroke systems but no evidence that Causative

  7. New risk markers may change the HeartScore risk classification significantly in one-fifth of the population

    DEFF Research Database (Denmark)

    Olsen, M H; Hansen, T W; Christensen, M K

    2008-01-01

    subjects with estimated risk below 5%. During the following 9.5 years the composite end point of cardiovascular death, non-fatal myocardial infarction or stroke (CEP) occurred in 204 subjects. CEP was predicted in all three groups by UACR (HRs: 2.1, 2.1 and 2.3 per 10-fold increase, all P...CRP in subjects with low-moderate risk and UACR and Nt-proBNP in subjects with known diabetes of cardiovascular disease changed HeartScore risk classification significantly in 19% of the population....

  8. Malignancy Risk Assessment in Patients with Thyroid Nodules Using Classification and Regression Trees

    Directory of Open Access Journals (Sweden)

    Shokouh Taghipour Zahir

    2013-01-01

    Full Text Available Purpose. We sought to investigate the utility of classification and regression trees (CART classifier to differentiate benign from malignant nodules in patients referred for thyroid surgery. Methods. Clinical and demographic data of 271 patients referred to the Sadoughi Hospital during 2006–2011 were collected. In a two-step approach, a CART classifier was employed to differentiate patients with a high versus low risk of thyroid malignancy. The first step served as the screening procedure and was tailored to produce as few false negatives as possible. The second step identified those with the lowest risk of malignancy, chosen from a high risk population. Sensitivity, specificity, positive and negative predictive values (PPV and NPV of the optimal tree were calculated. Results. In the first step, age, sex, and nodule size contributed to the optimal tree. Ultrasonographic features were employed in the second step with hypoechogenicity and/or microcalcifications yielding the highest discriminatory ability. The combined tree produced a sensitivity and specificity of 80.0% (95% CI: 29.9–98.9 and 94.1% (95% CI: 78.9–99.0, respectively. NPV and PPV were 66.7% (41.1–85.6 and 97.0% (82.5–99.8, respectively. Conclusion. CART classifier reliably identifies patients with a low risk of malignancy who can avoid unnecessary surgery.

  9. 75 FR 78213 - Proposed Information Collection; Comment Request; 2012 Economic Census Classification Report for...

    Science.gov (United States)

    2010-12-15

    ... 8-digit North American Industry Classification System (NAICS) based code for use in the 2012... classification due to changes in NAICS for 2012. Collecting this classification information will ensure the... the reporting burden on sampled sectors. Proper NAICS classification data ensures high quality...

  10. Scaling theory and the classification of phase transitions

    International Nuclear Information System (INIS)

    Hilfer, R.

    1992-01-01

    In this paper, the recent classification theory for phase transitions and its relation with the foundations of statistical physics is reviewed. First it is outlined how Ehrenfests classification scheme can be generalized into a general thermodynamic classification theory for phase transitions. The classification theory implies scaling and multiscaling thereby eliminating the need to postulate the scaling hypothesis as a fourth law of thermodynamics. The new classification has also led to the discovery and distinction of nonequilibrium transitions within equilibrium statistical physics. Nonequilibrium phase transitions are distinguished from equilibrium transitions by orders less than unity and by the fact the equilibrium thermodynamics and statistical mechanics become inapplicable at the critical point. The latter fact requires a change in the Gibbs assumption underlying the canonical and grandcanonical ensembles in order to recover the thermodynamic description in the critical limit

  11. A web-based neurological pain classifier tool utilizing Bayesian decision theory for pain classification in spinal cord injury patients

    Science.gov (United States)

    Verma, Sneha K.; Chun, Sophia; Liu, Brent J.

    2014-03-01

    Pain is a common complication after spinal cord injury with prevalence estimates ranging 77% to 81%, which highly affects a patient's lifestyle and well-being. In the current clinical setting paper-based forms are used to classify pain correctly, however, the accuracy of diagnoses and optimal management of pain largely depend on the expert reviewer, which in many cases is not possible because of very few experts in this field. The need for a clinical decision support system that can be used by expert and non-expert clinicians has been cited in literature, but such a system has not been developed. We have designed and developed a stand-alone tool for correctly classifying pain type in spinal cord injury (SCI) patients, using Bayesian decision theory. Various machine learning simulation methods are used to verify the algorithm using a pilot study data set, which consists of 48 patients data set. The data set consists of the paper-based forms, collected at Long Beach VA clinic with pain classification done by expert in the field. Using the WEKA as the machine learning tool we have tested on the 48 patient dataset that the hypothesis that attributes collected on the forms and the pain location marked by patients have very significant impact on the pain type classification. This tool will be integrated with an imaging informatics system to support a clinical study that will test the effectiveness of using Proton Beam radiotherapy for treating spinal cord injury (SCI) related neuropathic pain as an alternative to invasive surgical lesioning.

  12. Built-up Area Change Analysis in Hanoi Using Support Vector Machine Classification of Landsat Multi-Temporal Image Stacks and Population Data

    Directory of Open Access Journals (Sweden)

    Duong H. Nong

    2015-12-01

    Full Text Available In 1986, the Government of Vietnam implemented free market reforms known as Doi Moi (renovation that provided private ownership of farms and companies, and encouraged deregulation and foreign investment. Since then, the economy of Vietnam has achieved rapid growth in agricultural and industrial production, construction and housing, and exports and foreign investments, each of which have resulted in momentous landscape transformations. One of the most evident changes is urbanization and an accompanying loss of agricultural lands and open spaces. These rapid changes pose enormous challenges for local populations as well as planning authorities. Accurate and timely data on changes in built-up urban environments are essential for supporting sound urban development. In this study, we applied the Support Vector Machine classification (SVM to multi-temporal stacks of Landsat Thematic Mapper (TM and Enhanced Thematic Mapper Plus (ETM+ images from 1993 to 2010 to quantify changes in built-up areas. The SVM classification algorithm produced a highly accurate map of land cover change with an overall accuracy of 95%. The study showed that most urban expansion occurred in the periods 2001–2006 and 2006–2010. The analysis was strengthened by the incorporation of population and other socio-economic data. This study provides state authorities a means to examine correlations between urban growth, spatial expansion, and other socio-economic factors in order to not only assess patterns of urban growth but also become aware of potential environmental, social, and economic problems.

  13. Breast cancer surgery and diagnosis-related groups (DRGs): patient classification and hospital reimbursement in 11 European countries.

    Science.gov (United States)

    Scheller-Kreinsen, David; Quentin, Wilm; Geissler, Alexander; Busse, Reinhard

    2013-10-01

    Researchers from eleven countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Spain, and Sweden) compared how their DRG systems deal with breast cancer surgery patients. DRG algorithms and indicators of resource consumption were assessed for those DRGs that individually contain at least 1% of all breast cancer surgery patients. Six standardised case vignettes were defined and quasi prices according to national DRG-based hospital payment systems were ascertained. European DRG systems classify breast cancer surgery patients according to different sets of classification variables into three to seven DRGs. Quasi prices for an index case treated with partial mastectomy range from €577 in Poland to €5780 in the Netherlands. Countries award their highest payments for very different kinds of patients. Breast cancer specialists and national DRG authorities should consider how other countries' DRG systems classify breast cancer patients in order to identify potential scope for improvement and to ensure fair and appropriate reimbursement. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. An Incremental Classification Algorithm for Mining Data with Feature Space Heterogeneity

    Directory of Open Access Journals (Sweden)

    Yu Wang

    2014-01-01

    Full Text Available Feature space heterogeneity often exists in many real world data sets so that some features are of different importance for classification over different subsets. Moreover, the pattern of feature space heterogeneity might dynamically change over time as more and more data are accumulated. In this paper, we develop an incremental classification algorithm, Supervised Clustering for Classification with Feature Space Heterogeneity (SCCFSH, to address this problem. In our approach, supervised clustering is implemented to obtain a number of clusters such that samples in each cluster are from the same class. After the removal of outliers, relevance of features in each cluster is calculated based on their variations in this cluster. The feature relevance is incorporated into distance calculation for classification. The main advantage of SCCFSH lies in the fact that it is capable of solving a classification problem with feature space heterogeneity in an incremental way, which is favorable for online classification tasks with continuously changing data. Experimental results on a series of data sets and application to a database marketing problem show the efficiency and effectiveness of the proposed approach.

  15. Distribution of female genital tract anomalies in two classifications.

    Science.gov (United States)

    Heinonen, Pentti K

    2016-11-01

    This study assessed the distribution of Müllerian duct anomalies in two verified classifications of female genital tract malformations, and the presence of associated renal defects. 621 women with confirmed female genital tract anomalies were retrospectively grouped under the European (ESHRE/ESGE) and the American (AFS) classification. The diagnosis of uterine malformation was based on findings in hysterosalpingography, two-dimensional ultrasonography, endoscopies, laparotomy, cesarean section and magnetic resonance imaging in 97.3% of cases. Renal status was determined in 378 patients, including 5 with normal uterus and vagina. The European classification covered all 621 women studied. Uterine anomalies without cervical or vaginal anomaly were found in 302 (48.6%) patients. Uterine anomaly was associated with vaginal anomaly in 45.2%, and vaginal anomaly alone was found in 26 (4.2%) cases. Septate uterus was the most common (49.1%) of all genital tract anomalies, followed by bicorporeal uteri (18.2%). The American classification covered 590 (95%) out of the 621 women with genital tract anomalies. The American system did not take into account vaginal anomalies in 170 (34.7%) and cervical anomalies in 174 (35.5%) out of 490 cases with uterine malformations. Renal abnormalities were found in 71 (18.8%) out of 378 women, unilateral renal agenesis being the most common defect (12.2%), also found in 4 women without Müllerian duct anomaly. The European classification sufficiently covered uterine and vaginal abnormalities. The distribution of the main uterine anomalies was equal in both classifications. The American system missed cervical and vaginal anomalies associated with uterine anomalies. Evaluation of renal system is recommended for all patients with genital tract anomalies. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Value of multi-slice CT in the classification diagnosis of hilar cholangiocarcinoma

    International Nuclear Information System (INIS)

    Qian Yi; Zeng Mengsu; Ling Zhiqing; Rao Shengxiang; Liu Yalan

    2008-01-01

    Objective: To evaluate the value of multi-slice CT (MSCT) classification in the assessment of the hilar cholangiocarcinoma resectability. Methods: Thirty patients with surgically and histopathologically proved hilar cholangiocarcinomas who underwent preoperative MSCT and were diagnosed correctly were included in present study. Transverse images and reconstructed MPR images were reviewed for Bismuth-Corlette classification and morphological classification of hilar cholangiocarcinoma. Then MSCT classification was compared with findings of surgery and histopathology. Curative resectabilty of different types according to Bismuth-Corlette classification and morphological classification were analyzed with chi-square test. Results: In 30 cases, the numbers of Type I, II, IIIa, IIIb and IV according to Bismuth-Corlette classification were 1, 3, 4, 5 and 17. Seventeen patients underwent curative resections, among which 1, 2, 1, 4 and 9 belonged to Type I, II, IIIa, IIIb and IV respectively. However, there was no significant difference in curative resectability among different types of Bismuth-Corlette classification (χ 2 = 0.9875, P>0.05). In present study, the accuracy of MSCT in Bismuth-Corlette classification reached 86.7% (26/30). The numbers of periductal infiltrating, mass forming and intraductal growing type were 13, 13 and 4, while 6, 8 and 3 cases of each type underwent curative resections. There was no significant difference in curative resectability among different types of morphological classification (χ 2 =1.2583, P>0.05). The accuracy of MSCT in morphological classification was 100% (30/30) in this study group. Conclusion: MSCT can make accurate diagnosis of Bismuth-Corlette classification and morphological classification, which is helpful in preoperative respectability assessment of hilar cholangiocarcinoma. (authors)

  17. Taste and smell changes in cancer patients

    NARCIS (Netherlands)

    IJpma, Irene

    2017-01-01

    Patients with cancer often experience changes in taste and smell perception during chemotherapy. The aim of this dissertation was to investigate taste and smell changes and short- and long-term effects of chemotherapy in a homogeneous population of testicular cancer patients treated with

  18. A New Classification Approach Based on Multiple Classification Rules

    OpenAIRE

    Zhongmei Zhou

    2014-01-01

    A good classifier can correctly predict new data for which the class label is unknown, so it is important to construct a high accuracy classifier. Hence, classification techniques are much useful in ubiquitous computing. Associative classification achieves higher classification accuracy than some traditional rule-based classification approaches. However, the approach also has two major deficiencies. First, it generates a very large number of association classification rules, especially when t...

  19. [Classification and MR imaging of triangular fibrocartilage complex lesions].

    Science.gov (United States)

    Zhan, H L; Liu, Y; Bai, R J; Qian, Z H; Ye, W; Li, Y X; Wu, B D

    2016-06-07

    To explore the MRI characteristics of injuries of triangular fibrocartilage complex (TFCC), and provide imaging basis for the early diagnosis and treatment of the injuries. A total of 10 healthy volunteers without wrist injuries and 200 patients from Beijing Jishuitan Hospital who complained ulnar-sided wrist pain and were highly suspected as the injury of TFCC underwent the wrist magnetic resonance examination. All subjects were in a prone position and underwent examination on coronal T1WI scan and PD-FS on 3 planes respectively. Then the MRI characteristics of 3 healthy volunteers and 67 patients with TFCC injuries that confirmed by operation were analyzed. According to the comparative analysis of normal anatomy and Palmer classification, the injuries were classified and MRI features of different types of injuries were analyzed. At last, imaging findings were compared with surgical results. Three healthy volunteers without injuries showed mainly in low signal intensity on T1WI and PD-FS images. According to Palmer classification, there were 52 traumatic injuries (ⅠA 9, ⅠB 25, ⅠC 3, ⅠD 13, In addition, 1 has central perforation and ulnar avulsion and 1 has ulnar and radial injuries simultaneously) and 15 degenerative injuries (ⅡA 5, ⅡB 1, ⅡC 2 , ⅡD 1 , ⅡE 6) among 67 patients. The central perforation mainly demonstrated as linear high signal perpendicular to the disk, and run in a sagittal line. The ulnar, distal, and radial avulsion mainly showed the injuries were irregular, the structures were ambiguous, and there was high signal intensity in the injured structures on PD-FS. Degenerative injuries demonstrated the irregularity of TFC and heterogeneous signals on PD-FS. There were mixed intermediate-high signals and changes in the articular cartilage of lunate and ulna, high signal in the lunotriquetral ligament and ulnocarpal or radioulnar arthritis. MRI can demonstrate the anatomy of TFCC accurately, evaluate and make the general classification

  20. Non-stenotic intracranial arteries have atherosclerotic changes in acute ischemic stroke patients: a 3T MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Woo Jin; Choi, Hyun Seok; Jang, Jinhee; Sung, Jinkyeong; Jung, So-Lyung; Ahn, Kook-Jin; Kim, Bum-soo [The Catholic University of Korea, Department of Radiology, Seoul St. Mary' s Hospital, College of Medicine, Seoul (Korea, Republic of); Kim, Tae-Won; Koo, Jaseong [The Catholic University of Korea, Department of Neurology, College of Medicine, Seoul (Korea, Republic of); Shin, Yong Sam [The Catholic University of Korea, Department of Neurosurgery, College of Medicine, Seoul (Korea, Republic of)

    2015-10-15

    The aim of this study is to evaluate the degree of atherosclerotic changes in intracranial arteries by assessing arterial wall thickness using T1-weighted 3D-turbo spin echo (3D-TSE) and time-of-flight MR angiography (TOF-MRA) in patients with acute ischemic stroke as compared with unaffected controls. Thirty-three patients with acute ischemic stroke and 36 control patients were analyzed. Acute ischemic stroke patients were divided according to TOAST classification. At both distal internal carotid arteries and basilar artery without stenosis, TOF-MRA was used to select non-stenotic portion of assessed arteries. 3D-TSE was used to measure the area including the lumen and wall (Area{sub Outer}) and luminal area (Area{sub Inner}). The area of the vessel wall (Area{sub VW}) of assessed intracranial arteries and the ratio index (RI) of each patient were determined. Area{sub Inner}, Area{sub Outer}, Area{sub VW}, and RI showed good inter-observer reliability and excellent intra-observer reliability. Area{sub Inner} did not significantly differ between stroke patients and controls (P = 0.619). However, Area{sub Outer}, Area{sub VW}, and RI were significantly larger in stroke patients (P < 0.001). The correlation coefficient between Area{sub Inner} and Area{sub Outer} was higher in the controls (r = 0.918) than in large vessel disease patients (r = 0.778). RI of large vessel disease patients was significantly higher than that of normal control, small vessel disease, and cardioembolic groups. In patients with acute ischemic stroke, wall thickening and positive remodeling are evident in non-stenotic intracranial arteries. This change is more definite in stroke subtype that is related to atherosclerosis than that in other subtypes which are not. (orig.)

  1. 78 FR 68983 - Cotton Futures Classification: Optional Classification Procedure

    Science.gov (United States)

    2013-11-18

    ...-AD33 Cotton Futures Classification: Optional Classification Procedure AGENCY: Agricultural Marketing... regulations to allow for the addition of an optional cotton futures classification procedure--identified and... response to requests from the U.S. cotton industry and ICE, AMS will offer a futures classification option...

  2. [Definition and classification of pulmonary arterial hypertension].

    Science.gov (United States)

    Nakanishi, Norifumi

    2008-11-01

    Pulmonary hypertension(PH) is a disorder that may occur either in the setting of a variety of underlying medical conditions or as a disease that uniquely affects the pulmonary vasculature. Because an accurate diagnosis of PH in a patient is essential to establish an effective treatment, a classification of PH has been helpful. The first classification, established at WHO Symposium in 1973, classified PH into groups based on the known cause and defined primary pulmonary hypertension (PPH) as a separate entity of unknown cause. In 1998, the second World Symposium on PPH was held in Evian. Evian classification introduced the concept of conditions that directly affected the pulmonary vasculature (i.e., PAH), which included PPH. In 2003, the third World Symposium on PAH convened in Venice. In Venice classification, the term 'PPH' was abandoned in favor of 'idiopathic' within the group of disease known as 'PAH'.

  3. The clinical characteristics and new classification of sticky eyelid syndrome in East Asian patients.

    Science.gov (United States)

    Chang, Minwook; Lee, Hwa; Park, Min Soo; Baek, Sehyun

    2014-12-01

    The aim of this study was to demonstrate the characteristics of sticky eyelid syndrome (SES) and to suggest a modified definition and new classification of the disease in relation to the severity of the syndrome in East Asian patients. Forty-four eyes of 31 patients with sticky eyelid syndrome were included in this study. The medical records of patients who were diagnosed with sticky eyelid syndrome were retrospectively reviewed. Sticky eyelid syndrome was defined as an abnormal adhesion between the upper and lower eyelids during blinking. We divided the subjects into four grades according to the severity of the disease. Among 31 patients, there were 10 men and 21 women. The mean age of patients was 62.5 years. A total of 13 patients had SES bilaterally. All patients had meibomian gland dysfunction (MGD). Thirty-three eyes had dermatochalasis, and 30 eyes had involutional ptosis. Horizontal lower lid laxity was observed in 23 eyes, and reverse ptosis found in 15 eyes. Patients were classified into four groups as follows: G1: 11 (25%), G2: 24 (54.5%), G3: 6 (13.6%) and G4: 3 eyes (6.8%). Patients in Grade 1 tended to improve only with medical treatment for MGD. However, surgical management was necessary for patients in Grades 3 and 4. Meibomian gland dysfunction is a fundamental risk factor for developing sticky eyelid syndrome. Further, combined upper lid ptosis or lower lid laxity may be aggravating factors. According to the grading, medical or surgical management can be chosen. © 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  4. Phylogenetic classification of the world’s tropical forests

    OpenAIRE

    Slik, J. W. Ferry; Franklin, Janet; Arroyo-Rodríguez, Víctor; Field, Richard; Aguilar, Salomon; Aguirre, Nikolay; Ahumada, Jorge; Aiba, Shin-Ichiro; Alves, Luciana F.; K, Anitha; Avella, Andres; Mora, Francisco; Aymard C., Gerardo A.; Báez, Selene; Balvanera, Patricia

    2018-01-01

    Identifying and explaining regional differences in tropical forest dynamics, structure, diversity, and composition are critical for anticipating region-specific responses to global environmental change. Floristic classifications are of fundamental importance for these efforts. Here we provide a global tropical forest classification that is explicitly based on community evolutionary similarity, resulting in identification of five major tropical forest regions and their relationships: (i) Indo-...

  5. DCCA cross-correlation coefficients reveals the change of both synchronization and oscillation in EEG of Alzheimer disease patients

    Science.gov (United States)

    Chen, Yingyuan; Cai, Lihui; Wang, Ruofan; Song, Zhenxi; Deng, Bin; Wang, Jiang; Yu, Haitao

    2018-01-01

    Alzheimer's disease (AD) is a degenerative disorder of neural system that affects mainly the older population. Recently, many researches show that the EEG of AD patients can be characterized by EEG slowing, enhanced complexity of the EEG signals, and EEG synchrony. In order to examine the neural synchrony at multi scales, and to find a biomarker that help detecting AD in diagnosis, detrended cross-correlation analysis (DCCA) of EEG signals is applied in this paper. Several parameters, namely DCCA coefficients in the whole brain, DCCA coefficients at a specific scale, maximum DCCA coefficient over the span of all time scales and the corresponding scale of such coefficients, were extracted to examine the synchronization, respectively. The results show that DCCA coefficients have a trend of increase as scale increases, and decreases as electrode distance increases. Comparing DCCA coefficients in AD patients with healthy controls, a decrease of synchronization in the whole brain, and a bigger scale corresponding to maximum correlation is discovered in AD patients. The change of max-correlation scale may relate to the slowing of oscillatory activities. Linear combination of max DCCA coefficient and max-correlation scale reaches a classification accuracy of 90%. From the above results, it is reasonable to conclude that DCCA coefficient reveals the change of both oscillation and synchrony in AD, and thus is a powerful tool to differentiate AD patients from healthy elderly individuals.

  6. On music genre classification via compressive sampling

    DEFF Research Database (Denmark)

    Sturm, Bob L.

    2013-01-01

    Recent work \\cite{Chang2010} combines low-level acoustic features and random projection (referred to as ``compressed sensing'' in \\cite{Chang2010}) to create a music genre classification system showing an accuracy among the highest reported for a benchmark dataset. This not only contradicts previ...

  7. Longitudinal changes in seizure outcomes after resection of cerebral cavernous malformations in patients presenting with seizures: a long-term follow-up of 46 patients.

    Science.gov (United States)

    Kim, Jiha; Kim, Chi Heon; Chung, Chun Kee

    2014-08-01

    Seizure is the most common presentation in patients with cerebral cavernous malformations (CCMs). Although many articles have documented seizure outcomes after resection of CCM, few have conducted long-term follow-ups; thus, the fluctuating seizure outcomes have been neglected. The purpose of this study is to describe long-term postoperative seizure outcomes in patients with CCM and to compare seizure outcomes between patients with sporadic seizures and those with chronic seizures. Forty-six patients with CCM presenting with seizures underwent surgery. The male-to-female ratio was 1:1, and the average age at initial seizure onset was 27.6 years. The mean preoperative seizure duration was 42.7 months. Patients were divided into two groups: a chronic group (N = 20) and a sporadic group (N = 26) according to seizure frequency and duration. The mean postoperative follow-up duration was 96.3 months, and the postoperative seizure outcomes were checked annually based upon Engel's classification. After the first year of follow-up, 80.8 % of the sporadic group and 75.0 % of the chronic group were evaluated as Engel class I. These rates increased to 100.0 % and 90.0 %, respectively, at the eighth year of follow-up. Overall, 29 (63.0 %) of the 46 patients experienced changes in seizure outcomes over the follow-up period. Despite their delayed improvements, the chronic group showed less favorable outcomes throughout follow-up (p = 0.025). Long-term follow-up is indispensable for accurately assessing postoperative seizure outcomes because these outcomes change continuously. We recommend earlier surgery to achieve seizure-free status in patients with CCM. However, even in the chronic group, surgery is recommended, considering the overall delayed improvement.

  8. A comparative study of PCA, SIMCA and Cole model for classification of bioimpedance spectroscopy measurements.

    Science.gov (United States)

    Nejadgholi, Isar; Bolic, Miodrag

    2015-08-01

    Due to safety and low cost of bioimpedance spectroscopy (BIS), classification of BIS can be potentially a preferred way of detecting changes in living tissues. However, for longitudinal datasets linear classifiers fail to classify conventional Cole parameters extracted from BIS measurements because of their high variability. In some applications, linear classification based on Principal Component Analysis (PCA) has shown more accurate results. Yet, these methods have not been established for BIS classification, since PCA features have neither been investigated in combination with other classifiers nor have been compared to conventional Cole features in benchmark classification tasks. In this work, PCA and Cole features are compared in three synthesized benchmark classification tasks which are expected to be detected by BIS. These three tasks are classification of before and after geometry change, relative composition change and blood perfusion in a cylindrical organ. Our results show that in all tasks the features extracted by PCA are more discriminant than Cole parameters. Moreover, a pilot study was done on a longitudinal arm BIS dataset including eight subjects and three arm positions. The goal of the study was to compare different methods in arm position classification which includes all three synthesized changes mentioned above. Our comparative study on various classification methods shows that the best classification accuracy is obtained when PCA features are classified by a K-Nearest Neighbors (KNN) classifier. The results of this work suggest that PCA+KNN is a promising method to be considered for classification of BIS datasets that deal with subject and time variability. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Sea ice classification using dual polarization SAR data

    International Nuclear Information System (INIS)

    Huiying, Liu; Huadong, Guo; Lu, Zhang

    2014-01-01

    Sea ice is an indicator of climate change and also a threat to the navigation security of ships. Polarimetric SAR images are useful in the sea ice detection and classification. In this paper, backscattering coefficients and texture features derived from dual polarization SAR images are used for sea ice classification. Firstly, the HH image is recalculated based on the angular dependences of sea ice types. Then the effective gray level co-occurrence matrix (GLCM) texture features are selected for the support vector machine (SVM) classification. In the end, because sea ice concentration can provide a better separation of pancake ice from old ice, it is used to improve the SVM result. This method provides a good classification result, compared with the sea ice chart from CIS

  10. Proposed International League Against Epilepsy Classification 2010: new insights.

    Science.gov (United States)

    Udani, Vrajesh; Desai, Neelu

    2014-09-01

    The International League Against Epilepsy (ILAE) Classification of Seizures in 1981 and the Classification of the Epilepsies, in 1989 have been widely accepted the world over for the last 3 decades. Since then, there has been an explosive growth in imaging, genetics and other fields in the epilepsies which have changed many of our concepts. It was felt that a revision was in order and hence the ILAE commissioned a group of experts who submitted the initial draft of this revised classification in 2010. This review focuses on what are the strengths and weaknesses of this new proposed classification, especially in the context of a developing country.

  11. Motivational interviewing: helping patients move toward change.

    Science.gov (United States)

    Richardson, Luann

    2012-01-01

    Motivational Interviewing (MI) is a valuable tool for nurses to help patients address behavior change. MI has been found effective for helping patients with multiple chronic conditions, adherence issues, and lifestyle issues change their health behaviors. For Christian nurses, MI is consistent with biblical principles and can be seen as a form of ministry. This article overviews the process of MI, stages of change, and offers direction for further learning.

  12. Validation of the prognostic gene portfolio, ClinicoMolecular Triad Classification, using an independent prospective breast cancer cohort and external patient populations

    Science.gov (United States)

    2014-01-01

    Introduction Using genome-wide expression profiles of a prospective training cohort of breast cancer patients, ClinicoMolecular Triad Classification (CMTC) was recently developed to classify breast cancers into three clinically relevant groups to aid treatment decisions. CMTC was found to be both prognostic and predictive in a large external breast cancer cohort in that study. This study serves to validate the reproducibility of CMTC and its prognostic value using independent patient cohorts. Methods An independent internal cohort (n = 284) and a new external cohort (n = 2,181) were used to validate the association of CMTC between clinicopathological factors, 12 known gene signatures, two molecular subtype classifiers, and 19 oncogenic signalling pathway activities, and to reproduce the abilities of CMTC to predict clinical outcomes of breast cancer. In addition, we also updated the outcome data of the original training cohort (n = 147). Results The original training cohort reached a statistically significant difference (p risk groups. Conclusions Both prospective internal cohorts and the independent external cohorts reproduced the triad classification of CMTC and its prognostic significance. CMTC is an independent prognostic predictor, and it outperformed 12 other known prognostic gene signatures, molecular subtype classifications, and all other standard prognostic clinicopathological factors. Our results support further development of CMTC portfolio into a guide for personalized breast cancer treatments. PMID:24996446

  13. Classification and regression tree (CART) model to predict pulmonary tuberculosis in hospitalized patients.

    Science.gov (United States)

    Aguiar, Fabio S; Almeida, Luciana L; Ruffino-Netto, Antonio; Kritski, Afranio Lineu; Mello, Fernanda Cq; Werneck, Guilherme L

    2012-08-07

    Tuberculosis (TB) remains a public health issue worldwide. The lack of specific clinical symptoms to diagnose TB makes the correct decision to admit patients to respiratory isolation a difficult task for the clinician. Isolation of patients without the disease is common and increases health costs. Decision models for the diagnosis of TB in patients attending hospitals can increase the quality of care and decrease costs, without the risk of hospital transmission. We present a predictive model for predicting pulmonary TB in hospitalized patients in a high prevalence area in order to contribute to a more rational use of isolation rooms without increasing the risk of transmission. Cross sectional study of patients admitted to CFFH from March 2003 to December 2004. A classification and regression tree (CART) model was generated and validated. The area under the ROC curve (AUC), sensitivity, specificity, positive and negative predictive values were used to evaluate the performance of model. Validation of the model was performed with a different sample of patients admitted to the same hospital from January to December 2005. We studied 290 patients admitted with clinical suspicion of TB. Diagnosis was confirmed in 26.5% of them. Pulmonary TB was present in 83.7% of the patients with TB (62.3% with positive sputum smear) and HIV/AIDS was present in 56.9% of patients. The validated CART model showed sensitivity, specificity, positive predictive value and negative predictive value of 60.00%, 76.16%, 33.33%, and 90.55%, respectively. The AUC was 79.70%. The CART model developed for these hospitalized patients with clinical suspicion of TB had fair to good predictive performance for pulmonary TB. The most important variable for prediction of TB diagnosis was chest radiograph results. Prospective validation is still necessary, but our model offer an alternative for decision making in whether to isolate patients with clinical suspicion of TB in tertiary health facilities in

  14. Classification and regression tree (CART model to predict pulmonary tuberculosis in hospitalized patients

    Directory of Open Access Journals (Sweden)

    Aguiar Fabio S

    2012-08-01

    Full Text Available Abstract Background Tuberculosis (TB remains a public health issue worldwide. The lack of specific clinical symptoms to diagnose TB makes the correct decision to admit patients to respiratory isolation a difficult task for the clinician. Isolation of patients without the disease is common and increases health costs. Decision models for the diagnosis of TB in patients attending hospitals can increase the quality of care and decrease costs, without the risk of hospital transmission. We present a predictive model for predicting pulmonary TB in hospitalized patients in a high prevalence area in order to contribute to a more rational use of isolation rooms without increasing the risk of transmission. Methods Cross sectional study of patients admitted to CFFH from March 2003 to December 2004. A classification and regression tree (CART model was generated and validated. The area under the ROC curve (AUC, sensitivity, specificity, positive and negative predictive values were used to evaluate the performance of model. Validation of the model was performed with a different sample of patients admitted to the same hospital from January to December 2005. Results We studied 290 patients admitted with clinical suspicion of TB. Diagnosis was confirmed in 26.5% of them. Pulmonary TB was present in 83.7% of the patients with TB (62.3% with positive sputum smear and HIV/AIDS was present in 56.9% of patients. The validated CART model showed sensitivity, specificity, positive predictive value and negative predictive value of 60.00%, 76.16%, 33.33%, and 90.55%, respectively. The AUC was 79.70%. Conclusions The CART model developed for these hospitalized patients with clinical suspicion of TB had fair to good predictive performance for pulmonary TB. The most important variable for prediction of TB diagnosis was chest radiograph results. Prospective validation is still necessary, but our model offer an alternative for decision making in whether to isolate patients with

  15. Label-indicator morpheme growth on LSTM for Chinese healthcare question department classification.

    Science.gov (United States)

    Hu, Yang; Wen, Guihua; Ma, Jiajiong; Li, Danyang; Wang, Changjun; Li, Huihui; Huan, Eryang

    2018-04-26

    Current Chinese medicine has an urgent demand for convenient medical services. When facing a large number of patients, understanding patients' questions automatically and precisely is useful. Different from the high professional medical text, patients' questions contain only a small amount of descriptions regarding the symptoms, and the questions are slightly professional and colloquial. The aim of this paper is to implement a department classification system for patient questions. Patients' questions will be classified into 11 departments, such as surgery and others. This paper presents a morpheme growth model that enhances the memories of key elements in questions, and later extracts the "label-indicators" and germinates the expansion vectors around them. Finally, the model inputs the expansion vectors into a neural network to assign department labels for patients' questions. All compared methods are validated by experiments on three datasets that are composed of real patient questions. The proposed method has some ability to improve the performance of the classification. The proposed method is effective for the departments classification of patients questions and serves as a useful system for the automatic understanding of patient questions. Copyright © 2018. Published by Elsevier Inc.

  16. Prediction and classification of respiratory motion

    CERN Document Server

    Lee, Suk Jin

    2014-01-01

    This book describes recent radiotherapy technologies including tools for measuring target position during radiotherapy and tracking-based delivery systems. This book presents a customized prediction of respiratory motion with clustering from multiple patient interactions. The proposed method contributes to the improvement of patient treatments by considering breathing pattern for the accurate dose calculation in radiotherapy systems. Real-time tumor-tracking, where the prediction of irregularities becomes relevant, has yet to be clinically established. The statistical quantitative modeling for irregular breathing classification, in which commercial respiration traces are retrospectively categorized into several classes based on breathing pattern are discussed as well. The proposed statistical classification may provide clinical advantages to adjust the dose rate before and during the external beam radiotherapy for minimizing the safety margin. In the first chapter following the Introduction  to this book, we...

  17. Mapping changes in the largest continuous Amazonian mangrove belt using object-based classification of multisensor satellite imagery

    Science.gov (United States)

    Nascimento, Wilson R.; Souza-Filho, Pedro Walfir M.; Proisy, Christophe; Lucas, Richard M.; Rosenqvist, Ake

    2013-01-01

    Mapping and monitoring mangrove ecosystems is a crucial objective for tropical countries, particularly where human disturbance occurs and because of uncertainties associated with sea level and climatic fluctuation. In many tropical regions, such efforts have focused largely on the use of optical data despite low capture rates because of persistent cloud cover. Recognizing the ability of Synthetic Aperture Radar (SAR) for providing cloud-free observations, this study investigated the use of JERS-1 SAR and ALOS PALSAR data, acquired in 1996 and 2008 respectively, for mapping the extent of mangroves along the Brazilian coastline, from east of the Amazon River mouth, Pará State, to the Bay of São José in Maranhão. For each year, an object-orientated classification of major land covers (mangrove, secondary vegetation, gallery and swamp forest, open water, intermittent lakes and bare areas) was performed with the resulting maps then compared to quantify change. Comparison with available ground truth data indicated a general accuracy in the 2008 image classification of all land covers of 96% (kappa = 90.6%, tau = 92.6%). Over the 12 year period, the area of mangrove increased by 718.6 km2 from 6705 m2 to 7423.60 km2, with 1931.0 km² of expansion and 1213 km² of erosion noted; 5493 km² remained unchanged in extent. The general accuracy relating to changes in mangroves was 83.3% (Kappa 66.1%; tau 66.7%). The study confirmed that these mangroves constituted the largest continuous belt globally and were experiencing significant change because of the dynamic coastal environment and the influence of sedimentation from the Amazon River along the shoreline. The study recommends continued observations using combinations of SAR and optical data to establish trends in mangrove distributions and implications for provision of ecosystem services (e.g., fish/invertebrate nurseries, carbon storage and coastal protection).

  18. Classification and localization of acetabular labral tears

    International Nuclear Information System (INIS)

    Blankenbaker, D.G.; De Smet, A.A.; Keene, J.S.; Fine, J.P.

    2007-01-01

    The purpose of this study was to compare the findings on hip MR arthrography (MRA) with the published MRA and arthroscopic classifications of hip labral tears and to evaluate a clock-face method for localizing hip labral tears. We retrospectively reviewed 65 hip MRA studies with correlative hip arthroscopies. Each labrum was evaluated on MRA using the classification system of Czerny and an MRA modification of the Lage arthroscopic classification. In addition, each tear was localized on MRA by using a clock-face description where 6 o'clock was the transverse ligament and 3 o'clock was anterior. These MRA findings were then correlated with the arthroscopic findings using the clock-face method of localization and the Lage arthroscopic classification of labral tears. At MRA, there were 42 Czerny grade 2 and 23 grade 3 labral tears and 22 MRA Lage type 1, 11 type 2, 22 type 3 and 10 type 4 tears. At arthroscopy, there were 10 Lage type 1 flap tears, 20 Lage type 2 fibrillated tears, 18 Lage type 3 longitudinal peripheral tears and 17 Lage type 4 unstable tears. The Czerny MRA classification and the modified MRA Lage classification had borderline correlation with the arthroscopic Lage classification. Localization of the tears using a clock-face description was within 1 o'clock of the arthroscopic localization of the tears in 85% of the patients. The Lage classification, which is the only published arthroscopic classification system for hip labral tears, does not correlate well with the Czerny MRA or an MRA modification of the Lage classification. Using a clock-face description to localize tears provides a way to accurately localize a labral tear and define its extent. (orig.)

  19. Perianal disease, small bowel disease, smoking, prior steroid or early azathioprine/biological therapy are predictors of disease behavior change in patients with Crohn's disease.

    Science.gov (United States)

    Lakatos, Peter Laszlo; Czegledi, Zsofia; Szamosi, Tamas; Banai, Janos; David, Gyula; Zsigmond, Ferenc; Pandur, Tunde; Erdelyi, Zsuzsanna; Gemela, Orsolya; Papp, Janos; Lakatos, Laszlo

    2009-07-28

    To assess the combined effect of disease phenotype, smoking and medical therapy [steroid, azathioprine (AZA), AZA/biological therapy] on the probability of disease behavior change in a Caucasian cohort of patients with Crohn's disease (CD). Three hundred and forty well-characterized, unrelated, consecutive CD patients were analyzed (M/F: 155/185, duration: 9.4 +/- 7.5 years) with a complete clinical follow-up. Medical records including disease phenotype according to the Montreal classification, extraintestinal manifestations, use of medications and surgical events were analyzed retrospectively. Patients were interviewed on their smoking habits at the time of diagnosis and during the regular follow-up visits. A change in disease behavior was observed in 30.8% of patients with an initially non-stricturing, non-penetrating disease behavior after a mean disease duration of 9.0 +/- 7.2 years. In a logistic regression analysis corrected for disease duration, perianal disease, smoking, steroid use, early AZA or AZA/biological therapy use were independent predictors of disease behavior change. In a subsequent Kaplan-Meier survival analysis and a proportional Cox regression analysis, disease location (P = 0.001), presence of perianal disease (P < 0.001), prior steroid use (P = 0.006), early AZA (P = 0.005) or AZA/biological therapy (P = 0.002), or smoking (P = 0.032) were independent predictors of disease behavior change. Our data suggest that perianal disease, small bowel disease, smoking, prior steroid use, early AZA or AZA/biological therapy are all predictors of disease behavior change in CD patients.

  20. Rule-Based Classification of MMPI Data of Patients with Mental Disorders: Experiments with Basic and Extended Profiles

    Directory of Open Access Journals (Sweden)

    Jerzy Gomula

    2011-10-01

    Full Text Available In the research presented in the paper, we test the classification potential for different configurations of the MMPI data used for nosological diagnosis of patients with mental disorders. Originally, each patient is described by an MMPI profile consisting of a set of values of thirteen attributes (the so-called scales. A profile can be extended by different specialized indexes defined in the professional domain literature. Each created index has been proposed by practitioners and has a proper meaning from the clinical point of view. Adding such indexes leads to the extension of the attribute space for cases to be classified. In the paper, we present results of experiments with basic (original and extended profiles.

  1. Classification of MR brain images by combination of multi-CNNs for AD diagnosis

    Science.gov (United States)

    Cheng, Danni; Liu, Manhua; Fu, Jianliang; Wang, Yaping

    2017-07-01

    Alzheimer's disease (AD) is an irreversible neurodegenerative disorder with progressive impairment of memory and cognitive functions. Its early diagnosis is crucial for development of future treatment. Magnetic resonance images (MRI) play important role to help understand the brain anatomical changes related to AD. Conventional methods extract the hand-crafted features such as gray matter volumes and cortical thickness and train a classifier to distinguish AD from other groups. Different from these methods, this paper proposes to construct multiple deep 3D convolutional neural networks (3D-CNNs) to learn the various features from local brain images which are combined to make the final classification for AD diagnosis. First, a number of local image patches are extracted from the whole brain image and a 3D-CNN is built upon each local patch to transform the local image into more compact high-level features. Then, the upper convolution and fully connected layers are fine-tuned to combine the multiple 3D-CNNs for image classification. The proposed method can automatically learn the generic features from imaging data for classification. Our method is evaluated using T1-weighted structural MR brain images on 428 subjects including 199 AD patients and 229 normal controls (NC) from Alzheimer's Disease Neuroimaging Initiative (ADNI) database. Experimental results show that the proposed method achieves an accuracy of 87.15% and an AUC (area under the ROC curve) of 92.26% for AD classification, demonstrating the promising classification performances.

  2. Reliability of a four-column classification for tibial plateau fractures.

    Science.gov (United States)

    Martínez-Rondanelli, Alfredo; Escobar-González, Sara Sofía; Henao-Alzate, Alejandro; Martínez-Cano, Juan Pablo

    2017-09-01

    A four-column classification system offers a different way of evaluating tibial plateau fractures. The aim of this study is to compare the intra-observer and inter-observer reliability between four-column and classic classifications. This is a reliability study, which included patients presenting with tibial plateau fractures between January 2013 and September 2015 in a level-1 trauma centre. Four orthopaedic surgeons blindly classified each fracture according to four different classifications: AO, Schatzker, Duparc and four-column. Kappa, intra-observer and inter-observer concordance were calculated for the reliability analysis. Forty-nine patients were included. The mean age was 39 ± 14.2 years, with no gender predominance (men: 51%; women: 49%), and 67% of the fractures included at least one of the posterior columns. The intra-observer and inter-observer concordance were calculated for each classification: four-column (84%/79%), Schatzker (60%/71%), AO (50%/59%) and Duparc (48%/58%), with a statistically significant difference among them (p = 0.001/p = 0.003). Kappa coefficient for intr-aobserver and inter-observer evaluations: Schatzker 0.48/0.39, four-column 0.61/0.34, Duparc 0.37/0.23, and AO 0.34/0.11. The proposed four-column classification showed the highest intra and inter-observer agreement. When taking into account the agreement that occurs by chance, Schatzker classification showed the highest inter-observer kappa, but again the four-column had the highest intra-observer kappa value. The proposed classification is a more inclusive classification for the posteromedial and posterolateral fractures. We suggest, therefore, that it be used in addition to one of the classic classifications in order to better understand the fracture pattern, as it allows more attention to be paid to the posterior columns, it improves the surgical planning and allows the surgical approach to be chosen more accurately.

  3. Gastric cancer: epidemiology, prevention, classification, and treatment

    Directory of Open Access Journals (Sweden)

    Sitarz R

    2018-02-01

    Full Text Available Robert Sitarz,1–3 Małgorzata Skierucha,1,2 Jerzy Mielko,1 G Johan A Offerhaus,3 Ryszard Maciejewski,2 Wojciech P Polkowski1 1Department of Surgical Oncology, Medical University of Lublin, Lublin, Poland; 2Department of Human Anatomy, Medical University of Lublin, Lublin, Poland; 3Department of Pathology, University Medical Centre, Utrecht, The Netherlands Abstract: Gastric cancer is the second most common cause of cancer-related deaths in the world, the epidemiology of which has changed within last decades. A trend of steady decline in gastric cancer incidence rates is the effect of the increased standards of hygiene, conscious nutrition, and Helicobacter pylori eradication, which together constitute primary prevention. Avoidance of gastric cancer remains a priority. However, patients with higher risk should be screened for early detection and chemoprevention. Surgical resection enhanced by standardized lymphadenectomy remains the gold standard in gastric cancer therapy. This review briefly summarizes the most important aspects of gastric cancers, which include epidemiology, risk factors, classification, diagnosis, prevention, and treatment. The paper is mostly addressed to physicians who are interested in updating the state of art concerning gastric carcinoma from easily accessible and credible source. Keywords: gastric cancer, epidemiology, classification, risk factors, treatment

  4. A Classification System to Guide Physical Therapy Management in Huntington Disease: A Case Series.

    Science.gov (United States)

    Fritz, Nora E; Busse, Monica; Jones, Karen; Khalil, Hanan; Quinn, Lori

    2017-07-01

    Individuals with Huntington disease (HD), a rare neurological disease, experience impairments in mobility and cognition throughout their disease course. The Medical Research Council framework provides a schema that can be applied to the development and evaluation of complex interventions, such as those provided by physical therapists. Treatment-based classifications, based on expert consensus and available literature, are helpful in guiding physical therapy management across the stages of HD. Such classifications also contribute to the development and further evaluation of well-defined complex interventions in this highly variable and complex neurodegenerative disease. The purpose of this case series was to illustrate the use of these classifications in the management of 2 individuals with late-stage HD. Two females, 40 and 55 years of age, with late-stage HD participated in this case series. Both experienced progressive declines in ambulatory function and balance as well as falls or fear of falling. Both individuals received daily care in the home for activities of daily living. Physical therapy Treatment-Based Classifications for HD guided the interventions and outcomes. Eight weeks of in-home balance training, strength training, task-specific practice of functional activities including transfers and walking tasks, and family/carer education were provided. Both individuals demonstrated improvements that met or exceeded the established minimal detectible change values for gait speed and Timed Up and Go performance. Both also demonstrated improvements on Berg Balance Scale and Physical Performance Test performance, with 1 of the 2 individuals exceeding the established minimal detectible changes for both tests. Reductions in fall risk were evident in both cases. These cases provide proof-of-principle to support use of treatment-based classifications for physical therapy management in individuals with HD. Traditional classification of early-, mid-, and late

  5. Evaluation of cognitive and social functioning in patients requiring long-term inpatient psychiatric care using the International Classification of Functioning, Disability, and Health: a large-scale, multi-institutional observational study.

    Science.gov (United States)

    Kawaguchi, Hideaki; Taguchi, Masamoto; Sukigara, Masune; Sakuragi, Shoji; Sugiyama, Naoya; Chiba, Hisomu; Kawasaki, Tatsuhito

    2017-06-15

    We comprehensively evaluated cognitive and social functioning in patients requiring long-term inpatient psychiatric care using the International Classification of Functioning, Disability, and Health. We surveyed 1967 patients receiving long-term inpatient psychiatric care. Patients were further categorized into an old long-stay group (n = 892, >5 years in hospitals) and a new long-stay group (n = 1075, 1-5 years in hospitals). We obtained responses for all the International Classification of Functioning, Disability, and Health items in domain b (Body Functions) and domain d (Activities and Participation). We estimated weighted means for each item using the propensity score to adjust for confounding factors. Responses were received from 307 hospitals (response rate of hospitals: 25.5%). Cognitive and social functioning in the old long-stay group was more severely impaired than in the new long-stay group. No statistically significant differences were observed regarding the International Classification of Functioning, Disability, and Health items associated with basic activities of daily living between the two groups. Combined therapy consisting of cognitive remediation and rehabilitation on social functioning for this patient population should be started from the early stage of hospitalization. Non-restrictive, independent environments may also be optimal for this patient population. Implications for rehabilitation Rehabilitation of cognitive and social functioning for patients requiring long-term inpatient psychiatric care should be started in the early stages of hospitalization. In psychiatric fields, the International Classification of Functioning, Disability, and Health checklist could facilitate individualized rehabilitation planning by allowing healthcare professionals to visually assess the comprehensive functioning of each patient using graphics such as radar charts.

  6. Why do pathological stage IA lung adenocarcinomas vary from prognosis?: a clinicopathologic study of 176 patients with pathological stage IA lung adenocarcinoma based on the IASLC/ATS/ERS classification.

    Science.gov (United States)

    Zhang, Jie; Wu, Jie; Tan, Qiang; Zhu, Lei; Gao, Wen

    2013-09-01

    Patients with pathological stage IA adenocarcinoma (AC) have a variable prognosis, even if treated in the same way. The postoperative treatment of pathological stage IA patients is also controversial. We identified 176 patients with pathological stage IA AC who had undergone a lobectomy and mediastinal lymph node dissection at the Shanghai Chest Hospital, Shanghai, China, between 2000 and 2006. No patient had preoperative treatment. The histologic subtypes of all patients were classified according to the 2011 International Association for the Study of Lung Cancer (IASLC)/American Thoracic Society (ATS)/European Respiratory Society (ERS) international multidisciplinary lung AC classification. Patients' 5-year overall survival (OS) and 5-year disease-free survival (DFS) were calculated using Kaplan-Meier and Cox regression analyses. One hundred seventy-six patients with pathological stage IA AC had an 86.6% 5-year OS and 74.6% 5-year DFS. The 10 patients with micropapillary predominant subtype had the lowest 5-year DFS (40.0%).The 12 patients with solid predominant with mucin production subtype had the lowest 5-year OS (66.7%). Univariate and multivariate analysis showed that sex and prognositic groups of the IASLC/ATS/ERS histologic classification were significantly associated with 5-year DFS of pathological stage IA AC. Our study revealed that sex was an independent prognostic factor of pathological stage IA AC. The IASLC/ATS/ERS classification of lung AC identifies histologic categories with prognostic differences that could be helpful in clinical therapy.

  7. [The importance of classifications in psychiatry].

    Science.gov (United States)

    Lempérière, T

    1995-12-01

    variously dubbed "a reductive academic exercise of no relevance to patients", "a dehumanizing labelling system, and a potential source of social and political violence", "a destructive prognostic guide", and so on. Other critics point to various aspects of certain classifications: the abandonment of theoretical concepts, the arbitrary nature of certain categories, the selection of definitions and criteria, the privileged position systematically accorded to the notion of category over that of general dimension. Multiaxial systems such as those proposed in successive versions of DSM or the classifications used in child psychiatry go some way towards meeting these criticisms. They go beyond simple labelling and place the patient in an overall medicopsycho-social setting. Nosographical indicators do not constitute an obstacle to psychopathological understanding. No classifications are capable of satisfactorily fulfilling all needs, namely those of daily practice, research and health statistics. The has led to the development of specialized diagnostic criteria and instruments, as in research for example. It should also be noted in this context that different versions of ICD-10 exist for psychiatrists, general practitioners, researchers and healthcare managers. The greatest danger posed by classifications is the potential reification of hypothetical approaches, arbitrary categorization and the dulling of reflection, all of which have created a need for regular revisions underpinned by field trials.

  8. Acute pancreatitis: international classification and nomenclature

    International Nuclear Information System (INIS)

    Bollen, T.L.

    2016-01-01

    The incidence of acute pancreatitis (AP) is increasing and it is associated with a major healthcare concern. New insights in the pathophysiology, better imaging techniques, and novel treatment options for complicated AP prompted the update of the 1992 Atlanta Classification. Updated nomenclature for pancreatic collections based on imaging criteria is proposed. Adoption of the newly Revised Classification of Acute Pancreatitis 2012 by radiologists should help standardise reports and facilitate accurate conveyance of relevant findings to referring physicians involved in the care of patients with AP. This review will clarify the nomenclature of pancreatic collections in the setting of AP.

  9. Subsurface event detection and classification using Wireless Signal Networks.

    Science.gov (United States)

    Yoon, Suk-Un; Ghazanfari, Ehsan; Cheng, Liang; Pamukcu, Sibel; Suleiman, Muhannad T

    2012-11-05

    Subsurface environment sensing and monitoring applications such as detection of water intrusion or a landslide, which could significantly change the physical properties of the host soil, can be accomplished using a novel concept, Wireless Signal Networks (WSiNs). The wireless signal networks take advantage of the variations of radio signal strength on the distributed underground sensor nodes of WSiNs to monitor and characterize the sensed area. To characterize subsurface environments for event detection and classification, this paper provides a detailed list and experimental data of soil properties on how radio propagation is affected by soil properties in subsurface communication environments. Experiments demonstrated that calibrated wireless signal strength variations can be used as indicators to sense changes in the subsurface environment. The concept of WSiNs for the subsurface event detection is evaluated with applications such as detection of water intrusion, relative density change, and relative motion using actual underground sensor nodes. To classify geo-events using the measured signal strength as a main indicator of geo-events, we propose a window-based minimum distance classifier based on Bayesian decision theory. The window-based classifier for wireless signal networks has two steps: event detection and event classification. With the event detection, the window-based classifier classifies geo-events on the event occurring regions that are called a classification window. The proposed window-based classification method is evaluated with a water leakage experiment in which the data has been measured in laboratory experiments. In these experiments, the proposed detection and classification method based on wireless signal network can detect and classify subsurface events.

  10. MRI analysis of the rotator cuff pathology a new classification

    International Nuclear Information System (INIS)

    Tavernier, T.; Lapra, C.; Bochu, M.; Walch, G.; Noel, E.

    1995-01-01

    The different classifications use for the rotator cuff pathology seem to be incomplete. We propose a new classification with many advantages: (1) Differentiate the tendinopathy between less serious (grade 2A) and serious (grade 2B). (2) Recognize the intra-tendinous cleavage of the infra-spinatus associated with complete tear of the supra-spinatus. (3) Differentiate partial and complete tears of the supra-spinatus. We established this classification after a retrospective study of 42 patients operated on for a rotator cuff pathology. Every case had had a preoperative MRI. This classification is simple, especially for the associated intra tendinous cleavage. (authors). 24 refs., 9 figs., 2 tabs

  11. NEW CLASSIFICATION OF ECOPOLICES

    Directory of Open Access Journals (Sweden)

    VOROBYOV V. V.

    2016-09-01

    Full Text Available Problem statement. Ecopolices are the newest stage of the urban planning. They have to be consideredsuchas material and energy informational structures, included to the dynamic-evolutionary matrix netsofex change processes in the ecosystems. However, there are not made the ecopolice classifications, developing on suchapproaches basis. And this determined the topicality of the article. Analysis of publications on theoretical and applied aspects of the ecopolices formation showed, that the work on them is managed mainly in the context of the latest scientific and technological achievements in the various knowledge fields. These settlements are technocratic. They are connected with the morphology of space, network structures of regional and local natural ecosystems, without independent stability, can not exist without continuous man support. Another words, they do not work in with an ecopolices idea. It is come to a head for objective, symbiotic searching of ecopolices concept with the development of their classifications. Purpose statement is to develop the objective evidence for ecopolices and to propose their new classification. Conclusion. On the base of the ecopolices classification have to lie an elements correlation idea of their general plans and men activity type according with natural mechanism of accepting, reworking and transmission of material, energy and information between geo-ecosystems, planet, man, ecopolices material part and Cosmos. New ecopolices classification should be based on the principles of multi-dimensional, time-spaced symbiotic clarity with exchange ecosystem networks. The ecopolice function with this approach comes not from the subjective anthropocentric economy but from the holistic objective of Genesis paradigm. Or, otherwise - not from the Consequence, but from the Cause.

  12. Nuss bar migrations: occurrence and classification

    International Nuclear Information System (INIS)

    Binkovitz, Lauren E.; Binkovitz, Larry A.; Zendejas, Benjamin; Moir, Christopher R.

    2016-01-01

    Pectus excavatum results from dorsal deviation of the sternum causing narrowing of the anterior-posterior diameter of the chest. It can result in significant cosmetic deformities and cardiopulmonary compromise if severe. The Nuss procedure is a minimally invasive technique that involves placing a thin horizontally oriented metal bar below the dorsal sternal apex for correction of the pectus deformity. To identify the frequency and types of Nuss bar migrations, to present a new categorization of bar migrations, and to present examples of true migrations and pseudomigrations. We retrospectively reviewed the electronic medical records and all pertinent radiologic studies of 311 pediatric patients who underwent a Nuss procedure. We evaluated the frequency and type of bar migrations. Bar migration was demonstrated in 23 of 311 patients (7%) and occurred within a mean period of 26 days after surgery. Bar migrations were subjectively defined as deviation of the bar from the position demonstrated on the immediate postoperative radiographs and categorized as superior, inferior, rotation, lateral or flipped using a new classification system. Sixteen of the 23 migrations required re-operation. Nuss bar migration can be diagnosed with careful evaluation of serial radiographs. Nuss bar migration has a wide variety of appearances and requires exclusion of pseudomigration resulting from changes in patient positioning between radiologic examinations. (orig.)

  13. Nuss bar migrations: occurrence and classification

    Energy Technology Data Exchange (ETDEWEB)

    Binkovitz, Lauren E.; Binkovitz, Larry A. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Zendejas, Benjamin; Moir, Christopher R. [Mayo Clinic, Department of Surgery, Rochester, MN (United States)

    2016-12-15

    Pectus excavatum results from dorsal deviation of the sternum causing narrowing of the anterior-posterior diameter of the chest. It can result in significant cosmetic deformities and cardiopulmonary compromise if severe. The Nuss procedure is a minimally invasive technique that involves placing a thin horizontally oriented metal bar below the dorsal sternal apex for correction of the pectus deformity. To identify the frequency and types of Nuss bar migrations, to present a new categorization of bar migrations, and to present examples of true migrations and pseudomigrations. We retrospectively reviewed the electronic medical records and all pertinent radiologic studies of 311 pediatric patients who underwent a Nuss procedure. We evaluated the frequency and type of bar migrations. Bar migration was demonstrated in 23 of 311 patients (7%) and occurred within a mean period of 26 days after surgery. Bar migrations were subjectively defined as deviation of the bar from the position demonstrated on the immediate postoperative radiographs and categorized as superior, inferior, rotation, lateral or flipped using a new classification system. Sixteen of the 23 migrations required re-operation. Nuss bar migration can be diagnosed with careful evaluation of serial radiographs. Nuss bar migration has a wide variety of appearances and requires exclusion of pseudomigration resulting from changes in patient positioning between radiologic examinations. (orig.)

  14. Sequential computerized tomography changes and related final outcome in severe head injury patients

    International Nuclear Information System (INIS)

    Lobato, R.D.; Gomez, P.A.; Alday, R.

    1997-01-01

    The authors analyzed the serial computerized tomography (CT) findings in a large series of severely head injured patients in order to assess the variability in gross intracranial pathology through the acute posttraumatic period and determine the most common patterns of CT change. A second aim was to compare the prognostic significance of the different CT diagnostic categories used in the study (Traumatic Coma Data Bank CT pathological classification) when gleaned either from the initial (postadmission) or the control CT scans, and determine the extent to which having a second CT scan provides more prognostic information than only one scan. 92 patients (13.3 % of the total population) died soon after injury. Of the 587 who survived long enough to have at least one control CT scan 23.6 % developed new diffuse brain swelling, and 20.9 % new focal mass lesions most of which had to be evacuated. The relative risk for requiring a delayed operation as related to the diagnostic category established by using the initial CT scans was by decreasing order: diffuse injury IV (30.7 %), diffuse injury III (30.5 %), non evacuated mass (20 %), evacuated mass (20.2 %), diffuse injury II (12.1 %), and diffuse injury I (8.6 %). Overall, 51.2 % of the patients developed significant CT changes (for worse or better) occurring either spontaneously or following surgery, and their final outcomes were more closely related to the control than to the initial CT diagnoses. In fact, the final outcome was more accurately predicted by using the control CT scans (81.2 % of the cases) than by using the initial CT scans (71.5 % of the cases only). Since the majority of relevant CT changes developed within 48 hours after injury a pathological categorization made by using an early control CT scan seems to be most useful for prognostic purposes. Prognosis associated with the CT pathological categories used in the study was similar independently of the moment of the acute posttraumatic period at which

  15. Multicenter validation of recursive partitioning analysis classification for patients with squamous cell head and neck carcinoma treated with surgery and postoperative radiotherapy.

    NARCIS (Netherlands)

    Jonkman, A.; Kaanders, J.H.A.M.; Terhaard, C.H.J.; Hoebers, F.J.; Ende, P.L. van den; Wijers, O.B.; Verhoef, C.G.; Jong, M. de; Leemans, C.R.; Langendijk, J.A.

    2007-01-01

    PURPOSE: To validate the recursive partitioning analysis (RPA) classification system for squamous cell head and neck cancer as recently reported by the VU University Medical Center. METHODS AND MATERIALS: In eight Dutch head and neck cancer centers, data necessary to classify patients according to

  16. Association of IQ Changes and Progressive Brain Changes in Patients With Schizophrenia.

    Science.gov (United States)

    Kubota, Manabu; van Haren, Neeltje E M; Haijma, Sander V; Schnack, Hugo G; Cahn, Wiepke; Hulshoff Pol, Hilleke E; Kahn, René S

    2015-08-01

    Although schizophrenia is characterized by impairments in intelligence and the loss of brain volume, the relationship between changes in IQ and brain measures is not clear. To investigate the association between IQ and brain measures in patients with schizophrenia across time. Case-control longitudinal study at the Department of Psychiatry at the University Medical Center Utrecht, Utrecht, the Netherlands, comparing patients with schizophrenia and healthy control participants between September 22, 2004, and April 17, 2008. Magnetic resonance imaging of the brain and IQ scores were obtained at baseline and the 3-year follow-up. Participants included 84 patients with schizophrenia (mean illness duration, 4.35 years) and 116 age-matched healthy control participants. Associations between changes in IQ and the total brain, cerebral gray matter, cerebral white matter, lateral ventricular, third ventricles, cortical, and subcortical volumes; cortical thickness; and cortical surface area. Cerebral gray matter volume (P = .006) and cortical volume (P = .03) and thickness (P = .02) decreased more in patients with schizophrenia across time compared with control participants. Patients showed additional loss in cortical volume and thickness of the right supramarginal, posterior superior temporal, left supramarginal, left postcentral, and occipital regions (P values were between IQ increased similarly in patients with schizophrenia and control participants, changes in IQ were negatively correlated with changes in lateral ventricular volume (P = .05) and positively correlated with changes in cortical volume (P = .007) and thickness (P = .004) only in patients with schizophrenia. Positive correlations between changes in IQ and cortical volume and thickness were found globally and in widespread regions across frontal, temporal, and parietal cortices (P values were between <.001 and .03 after clusterwise correction). These findings were independent of symptom

  17. Dynamic species classification of microorganisms across time, abiotic and biotic environments-A sliding window approach.

    Directory of Open Access Journals (Sweden)

    Frank Pennekamp

    Full Text Available The development of video-based monitoring methods allows for rapid, dynamic and accurate monitoring of individuals or communities, compared to slower traditional methods, with far reaching ecological and evolutionary applications. Large amounts of data are generated using video-based methods, which can be effectively processed using machine learning (ML algorithms into meaningful ecological information. ML uses user defined classes (e.g. species, derived from a subset (i.e. training data of video-observed quantitative features (e.g. phenotypic variation, to infer classes in subsequent observations. However, phenotypic variation often changes due to environmental conditions, which may lead to poor classification, if environmentally induced variation in phenotypes is not accounted for. Here we describe a framework for classifying species under changing environmental conditions based on the random forest classification. A sliding window approach was developed that restricts temporal and environmentally conditions to improve the classification. We tested our approach by applying the classification framework to experimental data. The experiment used a set of six ciliate species to monitor changes in community structure and behavior over hundreds of generations, in dozens of species combinations and across a temperature gradient. Differences in biotic and abiotic conditions caused simplistic classification approaches to be unsuccessful. In contrast, the sliding window approach allowed classification to be highly successful, as phenotypic differences driven by environmental change, could be captured by the classifier. Importantly, classification using the random forest algorithm showed comparable success when validated against traditional, slower, manual identification. Our framework allows for reliable classification in dynamic environments, and may help to improve strategies for long-term monitoring of species in changing environments. Our

  18. OCT-Based Quantification and Classification of Optic Disc Structure in Glaucoma Patients.

    Directory of Open Access Journals (Sweden)

    Naoko Takada

    Full Text Available To objectively classify the optic discs of open-angle glaucoma (OAG patients into Nicolela's four disc types, i.e., focal ischemic (FI, myopic (MY, senile sclerotic (SS, and generalized enlargement (GE, with swept-source optical coherence tomography (SS-OCT.This study enrolled 113 eyes of 113 OAG patients (mean age: 62.5 ± 12.6; Humphrey field analyzer-measured mean deviation: -9.4 ± 7.3 dB. Newly developed software was used to quantify a total of 20 optic disc parameters in SS-OCT (DRI OCT-1, TOPCON images of the optic disc. The most suitable reference plane (RP above the plane of Bruch's membrane opening was determined by comparing, at various RP heights, the SS-OCT-measured rim parameters and spectral-domain OCT-measured circumpapillary retinal nerve fiber layer thickness (cpRNFLT, with Pearson's correlation analysis. To obtain a discriminant formula for disc type classification, a training group of 72 eyes of 72 OAG patients and a validation group of 60 eyes of 60 OAG patients were set up.Correlation with cpRNFLT differed with disc type and RP height, but overall, a height of 120 μm minimized the influence of disc type. Six parameters were most significant for disc type discrimination: disc angle (horizontal, average cup depth, cup/disc ratio, rim-decentering ratio, average rim/disc ratio (upper and lower nasal. Classifying the validation group with these parameters returned an identification rate of 80.0% and a Cohen's Kappa of 0.73.Our new, objective SS-OCT-based method enabled us to classify glaucomatous optic discs with high reproducibility and accuracy.

  19. Clinical significance of combined detection of CYFRA21-1, NSE and CEA in classification and staging of patients with lung cancer

    International Nuclear Information System (INIS)

    Hu He; Li Yanhua; Liang Weida; Zhang Qin

    2011-01-01

    To explore clinical value of combined detection of CYFRA21-1, NSE and CEA in classification and staging of patients with lung cancer, the CYFRA21-1, NSE and CEA levels in pleural effusion in 330 patients with lung cancer and in 43 patients with benign were detected by the electrochemiluminescence. The results showed that CYFRA21-1, NSE and CEA levels in pleural effusion in patients with lung cancer group were significantly higher than that of in benign group (P<0.01). The positive rate of tumor markers in different pathological type lung cancer were different,which CYFRA21-1 positive rate in squamous cell cancer group was highest with 65.5%; CEA positive rate in glands cancer group was supreme with 65.0%; the NSE positive rate in differentiation cancer group was highest with 79.5%. The positive rate in three markers combined detection was higher than that in one item detection. The tumor marker levels in lung cancer were positively related with clinical staging. The higher of tumor marker levels and the more late of clinical staging, and the clinical III∼IV period was obviously higher than that I∼II period (P<0.05). The combined detection of CYFRA21-1, NSE and CEA may enhance the positive rate in lung cancer detection, and may have significant clinical value in the classification and staging of patients with lung cancer. (authors)

  20. A proposal of criteria for the classification of systemic sclerosis.

    Science.gov (United States)

    Nadashkevich, Oleg; Davis, Paul; Fritzler, Marvin J

    2004-11-01

    Sensitive and specific criteria for the classification of systemic sclerosis are required by clinicians and investigators to achieve higher quality clinical studies and approaches to therapy. A clinical study of systemic sclerosis patients in Europe and Canada led to a set of criteria that achieve high sensitivity and specificity. Both clinical and laboratory investigations of patients with systemic sclerosis, related conditions and diseases with clinical features that can be mistaken as part of the systemic sclerosis spectrum were undertaken. Laboratory investigations included the detection of autoantibodies to centromere proteins, Scl-70 (topoisomerase I), and fibrillarin (U3-RNP). Based on the investigation of 269 systemic sclerosis patients and 720 patients presenting with related and confounding conditions, the following set of criteria for the classification of systemic sclerosis was proposed: 1) autoantibodies to: centromere proteins, Scl-70 (topo I), fibrillarin; 2) bibasilar pulmonary fibrosis; 3) contractures of the digital joints or prayer sign; 4) dermal thickening proximal to the wrists; 5) calcinosis cutis; 6) Raynaud's phenomenon; 7) esophageal distal hypomotility or reflux-esophagitis; 8) sclerodactyly or non-pitting digital edema; 9) teleangiectasias. The classification of definite SSc requires at least three of the above criteria. Criteria for the classification of systemic sclerosis have been proposed. Preliminary testing has defined the sensitivity and specificity of these criteria as high as 99% and 100%, respectively. Testing and validation of the proposed criteria by other clinical centers is required.

  1. Application of partial least squares near-infrared spectral classification in diabetic identification

    Science.gov (United States)

    Yan, Wen-juan; Yang, Ming; He, Guo-quan; Qin, Lin; Li, Gang

    2014-11-01

    In order to identify the diabetic patients by using tongue near-infrared (NIR) spectrum - a spectral classification model of the NIR reflectivity of the tongue tip is proposed, based on the partial least square (PLS) method. 39sample data of tongue tip's NIR spectra are harvested from healthy people and diabetic patients , respectively. After pretreatment of the reflectivity, the spectral data are set as the independent variable matrix, and information of classification as the dependent variables matrix, Samples were divided into two groups - i.e. 53 samples as calibration set and 25 as prediction set - then the PLS is used to build the classification model The constructed modelfrom the 53 samples has the correlation of 0.9614 and the root mean square error of cross-validation (RMSECV) of 0.1387.The predictions for the 25 samples have the correlation of 0.9146 and the RMSECV of 0.2122.The experimental result shows that the PLS method can achieve good classification on features of healthy people and diabetic patients.

  2. Evaluation of the ACR and SLICC classification criteria in juvenile-onset systemic lupus erythematosus: a longitudinal analysis.

    Science.gov (United States)

    Lythgoe, H; Morgan, T; Heaf, E; Lloyd, O; Al-Abadi, E; Armon, K; Bailey, K; Davidson, J; Friswell, M; Gardner-Medwin, J; Haslam, K; Ioannou, Y; Leahy, A; Leone, V; Pilkington, C; Rangaraj, S; Riley, P; Tizard, E J; Wilkinson, N; Beresford, M W

    2017-10-01

    Objectives The Systemic Lupus International Collaborating Clinics (SLICC) group proposed revised classification criteria for systemic lupus erythematosus (SLICC-2012 criteria). This study aimed to compare these criteria with the well-established American College of Rheumatology classification criteria (ACR-1997 criteria) in a national cohort of juvenile-onset systemic lupus erythematosus (JSLE) patients and evaluate how patients' classification criteria evolved over time. Methods Data from patients in the UK JSLE Cohort Study with a senior clinician diagnosis of probable evolving, or definite JSLE, were analyzed. Patients were assessed using both classification criteria within 1 year of diagnosis and at latest follow up (following a minimum 12-month follow-up period). Results A total of 226 patients were included. The SLICC-2012 was more sensitive than ACR-1997 at diagnosis (92.9% versus 84.1% p < 0.001) and after follow up (100% versus 92.0% p < 0.001). Most patients meeting the SLICC-2012 criteria and not the ACR-1997 met more than one additional criterion on the SLICC-2012. Conclusions The SLICC-2012 was better able to classify patients with JSLE than the ACR-1997 and did so at an earlier stage in their disease course. SLICC-2012 should be considered for classification of JSLE patients in observational studies and clinical trial eligibility.

  3. Joint involvement in patients with early polymyalgia rheumatica using high-resolution ultrasound and its contribution to the EULAR/ACR 2012 classification criteria for polymyalgia rheumatica.

    Science.gov (United States)

    Weigand, Sandra; Ehrenstein, Boris; Fleck, Martin; Hartung, Wolfgang

    2014-04-01

    To assess joint involvement and the contribution of musculoskeletal ultrasound (MSUS) to the novel European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) 2012 classification criteria in patients with polymyalgia rheumatic (PMR). MSUS was performed in 54 consecutive patients with recent-onset PMR. Biceps tenosynovitis of at least 1 shoulder has been observed in 70.4% of patients, and 64.8% had a bilateral biceps tenosynovitis. Subdeltoid bursitis (27.8% unilateral, 5.6% bilateral), glenohumeral synovitis (22.2% unilateral, 9.3% bilateral), and hip involvement (22.2% unilateral, 16.7% bilateral) were observed less frequently. The sensitivities of the classification criteria were 85.2% for EULAR/ACR without MSUS and 81.5% for EULAR/ACR with MSUS. The most common MSUS pathology was a biceps tenosynovitis. However, US findings had no effect on the sensitivity of the novel EULAR/ACR criteria for PMR.

  4. Classification across gene expression microarray studies

    Directory of Open Access Journals (Sweden)

    Kuner Ruprecht

    2009-12-01

    Full Text Available Abstract Background The increasing number of gene expression microarray studies represents an important resource in biomedical research. As a result, gene expression based diagnosis has entered clinical practice for patient stratification in breast cancer. However, the integration and combined analysis of microarray studies remains still a challenge. We assessed the potential benefit of data integration on the classification accuracy and systematically evaluated the generalization performance of selected methods on four breast cancer studies comprising almost 1000 independent samples. To this end, we introduced an evaluation framework which aims to establish good statistical practice and a graphical way to monitor differences. The classification goal was to correctly predict estrogen receptor status (negative/positive and histological grade (low/high of each tumor sample in an independent study which was not used for the training. For the classification we chose support vector machines (SVM, predictive analysis of microarrays (PAM, random forest (RF and k-top scoring pairs (kTSP. Guided by considerations relevant for classification across studies we developed a generalization of kTSP which we evaluated in addition. Our derived version (DV aims to improve the robustness of the intrinsic invariance of kTSP with respect to technologies and preprocessing. Results For each individual study the generalization error was benchmarked via complete cross-validation and was found to be similar for all classification methods. The misclassification rates were substantially higher in classification across studies, when each single study was used as an independent test set while all remaining studies were combined for the training of the classifier. However, with increasing number of independent microarray studies used in the training, the overall classification performance improved. DV performed better than the average and showed slightly less variance. In

  5. Teachable moments for health behavior change and intermediate patient outcomes.

    Science.gov (United States)

    Flocke, Susan A; Clark, Elizabeth; Antognoli, Elizabeth; Mason, Mary Jane; Lawson, Peter J; Smith, Samantha; Cohen, Deborah J

    2014-07-01

    Teachable moments (TM) are opportunities created through physician-patient interaction and used to encourage patients to change unhealthy behaviors. We examine the effectiveness of TMs to increase patients' recall of advice, motivation to modify behavior, and behavior change. A mixed-method observational study of 811 patient visits to 28 primary care clinicians used audio-recordings of visits to identify TMs and other types of advice in health behavior change talk. Patient surveys assessed smoking, exercise, fruit/vegetable consumption, height, weight, and readiness for change prior to the observed visit and 6-weeks post-visit. Compared to other identified categories of advice (i.e. missed opportunities or teachable moment attempts), recall was greatest after TMs occurred (83% vs. 49-74%). TMs had the greatest proportion of patients change in importance and confidence and increase readiness to change; however differences were small. TMs had greater positive behavior change scores than other categories of advice; however, this pattern was statistically non-significant and was not observed for BMI change. TMs have a greater positive influence on several intermediate markers of patient behavior change compared to other categories of advice. TMs show promise as an approach for clinicians to discuss behavior change with patients efficiently and effectively. Copyright © 2014. Published by Elsevier Ireland Ltd.

  6. SAW Classification Algorithm for Chinese Text Classification

    OpenAIRE

    Xiaoli Guo; Huiyu Sun; Tiehua Zhou; Ling Wang; Zhaoyang Qu; Jiannan Zang

    2015-01-01

    Considering the explosive growth of data, the increased amount of text data’s effect on the performance of text categorization forward the need for higher requirements, such that the existing classification method cannot be satisfied. Based on the study of existing text classification technology and semantics, this paper puts forward a kind of Chinese text classification oriented SAW (Structural Auxiliary Word) algorithm. The algorithm uses the special space effect of Chinese text where words...

  7. Classification in context

    DEFF Research Database (Denmark)

    Mai, Jens Erik

    2004-01-01

    This paper surveys classification research literature, discusses various classification theories, and shows that the focus has traditionally been on establishing a scientific foundation for classification research. This paper argues that a shift has taken place, and suggests that contemporary...... classification research focus on contextual information as the guide for the design and construction of classification schemes....

  8. Interobserver Agreement of the Eaton-Glickel Classification for Trapeziometacarpal and Scaphotrapezial Arthrosis.

    Science.gov (United States)

    Becker, Stéphanie J E; Bruinsma, Wendy E; Guitton, Thierry G; van der Horst, Chantal M A M; Strackee, Simon D; Ring, David

    2016-04-01

    To determine whether simplification of the Eaton-Glickel (E-G) classification of trapeziometacarpal (TMC) joint arthrosis (eliminating evaluation of the scaphotrapezial [ST] joint) and information about the patient's symptoms and examination influence interobserver reliability. We also tested the null hypotheses that no patient and/or surgeon factors affect radiographic rating of TMC joint arthrosis and that no surgeon factors affect the radiographic rating of ST joint arthrosis. In an on-line survey, 92 hand surgeons rated TMC joint arthrosis and ST joint arthrosis separately on 30 radiographs (Robert, true lateral, and oblique views) according to the (modified) E-G classification. We randomly assigned 42 observers to review radiographs alone and also informed 50 of the patient's symptoms and examination. Information about symptoms and examination was randomized. Interobserver reliability was determined with the s* statistic. Because of the hierarchical data structure, cross-classified ordinal multilevel regression analyses were performed to identify factors associated with the severity of arthrosis. Shortening the E-G classification to the first 3 stages significantly improved the interobserver reliability, which approached substantial agreement. Providing clinical information to observers marginally improved interobserver reliability. Factors associated with a lower E-G stage for TMC joint arthrosis, among observers who rated the severity of TMC joint arthrosis based on radiographs and clinical information, included female surgeon, practice setting, supervising surgical trainees in the operating room, self-reported number of patients with TMC joint arthrosis typically treated annually, male patient, higher patient age, pain limiting daily activities, and shoulder sign. A self-reported larger number of patients with TMC joint arthrosis treated annually was the only variable associated with a higher modified E-G classification to rate ST joint arthrosis. Our

  9. Study on imaging analysis using three-dimensional CT system for mandibular condylar fracture. Establishing quantitative classification

    International Nuclear Information System (INIS)

    Kurokawa, Hideto

    1997-01-01

    We examined 13 patients with fractures of the condylar process (7 men, 6 women) by using 3-dimensional images. A break-down of 15 examined joints revealed 11 patients with unilateral and 2 patients with bilateral fractures of the condylar process. Eight joints of healthy control individual (2 men and 2 women) were used as controls. Fractures of the condylar process and healthy controls were compared, which comparison led to the following conclusions: Bone fragments of deviated fractures may move slightly within the joint, preferentially internally and medially; following displaced fractures, internal and downward movement of bone fragments within the joint is observed; after the occurrence of deviated dislocation fractures, bone fragments protrude from the joint and clearly move internally and inferiorly, showing a rotation of the bone fragments; after the occurrence of displaced dislocation fractures, bone fragments also protrude from the joint and clearly move anteriorly and inferiorly; sometimes an internal rotation of the bone fragments is observed; and with linear fractures there is only minimal overall increase in, and characteristic changes are not observed. Regarding diagnosis, the classical classification of fractures of the condylar process does not provide a classification for linear fractures. Thus, this type has to be newly added to the common classification: Fissure fractures (type I), Deviated fractures (type II), Displaced fractures (type III), Deviated dislocation fractures (type IV), Displaced dislocation fractures (type V), Longitudinal (type VI). (author)

  10. Classification

    DEFF Research Database (Denmark)

    Hjørland, Birger

    2017-01-01

    This article presents and discusses definitions of the term “classification” and the related concepts “Concept/conceptualization,”“categorization,” “ordering,” “taxonomy” and “typology.” It further presents and discusses theories of classification including the influences of Aristotle...... and Wittgenstein. It presents different views on forming classes, including logical division, numerical taxonomy, historical classification, hermeneutical and pragmatic/critical views. Finally, issues related to artificial versus natural classification and taxonomic monism versus taxonomic pluralism are briefly...

  11. Clinical classification of cancer cachexia: phenotypic correlates in human skeletal muscle.

    Directory of Open Access Journals (Sweden)

    Neil Johns

    Full Text Available BACKGROUND: Cachexia affects the majority of patients with advanced cancer and is associated with a reduction in treatment tolerance, response to therapy, and duration of survival. One impediment towards the effective treatment of cachexia is a validated classification system. METHODS: 41 patients with resectable upper gastrointestinal (GI or pancreatic cancer underwent characterisation for cachexia based on weight-loss (WL and/or low muscularity (LM. Four diagnostic criteria were used >5%WL, >10%WL, LM, and LM+>2%WL. All patients underwent biopsy of the rectus muscle. Analysis included immunohistochemistry for fibre size and type, protein and nucleic acid concentration, Western blots for markers of autophagy, SMAD signalling, and inflammation. FINDINGS: Compared with non-cachectic cancer patients, patients with LM or LM+>2%WL, mean muscle fibre diameter was reduced by about 25% (p = 0.02 and p = 0.001 respectively. No significant difference in fibre diameter was observed if patients had WL alone. Regardless of classification, there was no difference in fibre number or proportion of fibre type across all myosin heavy chain isoforms. Mean muscle protein content was reduced and the ratio of RNA/DNA decreased in patients with either >5%WL or LM+>2%WL. Compared with non-cachectic patients, SMAD3 protein levels were increased in patients with >5%WL (p = 0.022 and with >10%WL, beclin (p = 0.05 and ATG5 (p = 0.01 protein levels were increased. There were no differences in phospho-NFkB or phospho-STAT3 levels across any of the groups. CONCLUSION: Muscle fibre size, biochemical composition and pathway phenotype can vary according to whether the diagnostic criteria for cachexia are based on weight loss alone, a measure of low muscularity alone or a combination of the two. For intervention trials where the primary end-point is a change in muscle mass or function, use of combined diagnostic criteria may allow identification of a more

  12. Memristive Perceptron for Combinational Logic Classification

    Directory of Open Access Journals (Sweden)

    Lidan Wang

    2013-01-01

    Full Text Available The resistance of the memristor depends upon the past history of the input current or voltage; so it can function as synapse in neural networks. In this paper, a novel perceptron combined with the memristor is proposed to implement the combinational logic classification. The relationship between the memristive conductance change and the synapse weight update is deduced, and the memristive perceptron model and its synaptic weight update rule are explored. The feasibility of the novel memristive perceptron for implementing the combinational logic classification (NAND, NOR, XOR, and NXOR is confirmed by MATLAB simulation.

  13. Describing Peripancreatic Collections According to the Revised Atlanta Classification of Acute Pancreatitis: An International Interobserver Agreement Study.

    Science.gov (United States)

    Bouwense, Stefan A; van Brunschot, Sandra; van Santvoort, Hjalmar C; Besselink, Marc G; Bollen, Thomas L; Bakker, Olaf J; Banks, Peter A; Boermeester, Marja A; Cappendijk, Vincent C; Carter, Ross; Charnley, Richard; van Eijck, Casper H; Freeny, Patrick C; Hermans, John J; Hough, David M; Johnson, Colin D; Laméris, Johan S; Lerch, Markus M; Mayerle, Julia; Mortele, Koenraad J; Sarr, Michael G; Stedman, Brian; Vege, Santhi Swaroop; Werner, Jens; Dijkgraaf, Marcel G; Gooszen, Hein G; Horvath, Karen D

    2017-08-01

    Severe acute pancreatitis is associated with peripancreatic morphologic changes as seen on imaging. Uniform communication regarding these morphologic findings is crucial for accurate diagnosis and treatment. For the original 1992 Atlanta classification, interobserver agreement is poor. We hypothesized that for the revised Atlanta classification, interobserver agreement will be better. An international, interobserver agreement study was performed among expert and nonexpert radiologists (n = 14), surgeons (n = 15), and gastroenterologists (n = 8). Representative computed tomographies of all stages of acute pancreatitis were selected from 55 patients and were assessed according to the revised Atlanta classification. The interobserver agreement was calculated among all reviewers and subgroups, that is, expert and nonexpert reviewers; interobserver agreement was defined as poor (≤0.20), fair (0.21-0.40), moderate (0.41-0.60), good (0.61-0.80), or very good (0.81-1.00). Interobserver agreement among all reviewers was good (0.75 [standard deviation, 0.21]) for describing the type of acute pancreatitis and good (0.62 [standard deviation, 0.19]) for the type of peripancreatic collection. Expert radiologists showed the best and nonexpert clinicians the lowest interobserver agreement. Interobserver agreement was good for the revised Atlanta classification, supporting the importance for widespread adaption of this revised classification for clinical and research communications.

  14. Prognosis and therapeutic response according to the world health organization histological classification in advanced thymoma

    International Nuclear Information System (INIS)

    Tagawa, Tetsuzo; Kometani, Takuro; Yamazaki, Koji

    2011-01-01

    The clinical efficacy of the World Health Organization (WHO) classification of thymoma has been reported to be a prognostic factor for patients with thymomas. This study focuses on the relationship between the therapeutic response and the WHO histological classification in patients with advanced thymoma. A retrospective review was performed on 22 patients with Masaoka stage III and IV thymoma treated from 1975 to 2007. There were 1, 1, 7, 3, and 10 patients with WHO histological subtypes A, AB, B1, B2, and B3, respectively. Surgery was performed on 10 patients. There were 2 complete resections, 2 incomplete resections, and 6 exploratory thoracotomies. Of 18 patients with unresectable tumors, 8, 5, and 5 were treated with radiotherapy, chemotherapy, and chemoradiotherapy as the initial therapy, respectively. The response rate in 9 patients with type A-B2 was significantly better than that in 9 patients with type B3 regardless of treatment modality (100% vs 11.1%, P=0.0001). Only the WHO classification was significantly associated with survival, with type B3 having a worse prognosis than A-B2 (P=0.01). Type B3 thymoma showed a lower response rate to treatments and thus shorter survival. The WHO classification is a good predictive factor for therapeutic response in advanced thymoma. (author)

  15. Heterogeneity of European DRG Systems and Potentials for a Common Eurodrg System; Comment on “Cholecystectomy and Diagnosis-Related Groups (DRGs: Patient Classification and Hospital Reimbursement in 11 European Countries”

    Directory of Open Access Journals (Sweden)

    Alexander Geissler

    2015-05-01

    Full Text Available Diagnosis-Related Group (DRG systems across Europe are very heterogeneous, in particular because of different classification variables and algorithms as well as costing methodologies. But, given the challenge of increasing patient mobility within Europe, health systems are forced to incorporate a common patient classification language in order to compare and identify similar patients e.g. for reimbursement purposes. Beside the national adoption of DRGs for a wide range of purposes (measuring hospital activity vs. paying hospitals, a common DRG system can serve as an international communication basis among health administrators and can reduce the national development efforts as it is demonstrated by the NordDRG consortium.

  16. A Look at the Practice of Risk Classification: Integrative Review

    Directory of Open Access Journals (Sweden)

    Luiz Alves Morais Filho

    2017-03-01

    Full Text Available Introduction: the increase in the number of patients in emergency services / emergency brought the need for screening / risk classification as a way to organize the urgency and emergency care in the health institutions. Objectives: know how to develop the risk classification practice in the Brazilian reality using the scientific production, the insertion of nurses in risk classification using the Brazilian scientific production. Methods: an integrative review was carried out, the data occurred during September 2015 in the following databases: Scientific Electronic Library Online (SciELO, Medical Literature Analysis and Retrieval System Online (Medline, and the Latin American and Caribbean System of Information on Health Sciences (LILACS "GOOGLE SCHOLAR." Results: it found 9,874 articles and selected 33 for analysis. The results were organized in 04 categories: Risk classification as assistance qualifier; risk classification’s organization; operation weaknesses of the risk classification and nurse's role in risk classification. Conclusion: We conclude that the risk classification qualifies the assistance in emergency services; there are many difficulties for the risk classification’s operation and the nurse has been established as a professional with technical and legal competence to perform the risk classification.

  17. Evaluation of Urinary Tract Dilation Classification System for Grading Postnatal Hydronephrosis.

    Science.gov (United States)

    Hodhod, Amr; Capolicchio, John-Paul; Jednak, Roman; El-Sherif, Eid; El-Doray, Abd El-Alim; El-Sherbiny, Mohamed

    2016-03-01

    We assessed the reliability and validity of the Urinary Tract Dilation classification system as a new grading system for postnatal hydronephrosis. We retrospectively reviewed charts of patients who presented with hydronephrosis from 2008 to 2013. We included patients diagnosed prenatally and those with hydronephrosis discovered incidentally during the first year of life. We excluded cases involving urinary tract infection, neurogenic bladder and chromosomal anomalies, those associated with extraurinary congenital malformations and those with followup of less than 24 months without resolution. Hydronephrosis was graded postnatally using the Society for Fetal Urology system, and then the management protocol was chosen. All units were regraded using the Urinary Tract Dilation classification system and compared to the Society for Fetal Urology system to assess reliability. Univariate and multivariate analyses were performed to assess the validity of the Urinary Tract Dilation classification system in predicting hydronephrosis resolution and surgical intervention. A total of 490 patients (730 renal units) were eligible to participate. The Urinary Tract Dilation classification system was reliable in the assessment of hydronephrosis (parallel forms 0.92). Hydronephrosis resolved in 357 units (49%), and 86 units (12%) were managed by surgical intervention. The remainder of renal units demonstrated stable or improved hydronephrosis. Multivariate analysis revealed that the likelihood of surgical intervention was predicted independently by Urinary Tract Dilation classification system risk group, while Society for Fetal Urology grades were predictive of likelihood of resolution. The Urinary Tract Dilation classification system is reliable for evaluation of postnatal hydronephrosis and is valid in predicting surgical intervention. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  18. Subsurface Event Detection and Classification Using Wireless Signal Networks

    Directory of Open Access Journals (Sweden)

    Muhannad T. Suleiman

    2012-11-01

    Full Text Available Subsurface environment sensing and monitoring applications such as detection of water intrusion or a landslide, which could significantly change the physical properties of the host soil, can be accomplished using a novel concept, Wireless Signal Networks (WSiNs. The wireless signal networks take advantage of the variations of radio signal strength on the distributed underground sensor nodes of WSiNs to monitor and characterize the sensed area. To characterize subsurface environments for event detection and classification, this paper provides a detailed list and experimental data of soil properties on how radio propagation is affected by soil properties in subsurface communication environments. Experiments demonstrated that calibrated wireless signal strength variations can be used as indicators to sense changes in the subsurface environment. The concept of WSiNs for the subsurface event detection is evaluated with applications such as detection of water intrusion, relative density change, and relative motion using actual underground sensor nodes. To classify geo-events using the measured signal strength as a main indicator of geo-events, we propose a window-based minimum distance classifier based on Bayesian decision theory. The window-based classifier for wireless signal networks has two steps: event detection and event classification. With the event detection, the window-based classifier classifies geo-events on the event occurring regions that are called a classification window. The proposed window-based classification method is evaluated with a water leakage experiment in which the data has been measured in laboratory experiments. In these experiments, the proposed detection and classification method based on wireless signal network can detect and classify subsurface events.

  19. Developing a New Zealand casemix classification for mental health services.

    Science.gov (United States)

    Eagar, Kathy; Gaines, Phillipa; Burgess, Philip; Green, Janette; Bower, Alison; Buckingham, Bill; Mellsop, Graham

    2004-10-01

    This study aimed to develop a casemix classification of characteristics of New Zealand mental health services users. Over a six month period, patient information, staff time and service costs were collected from 8 district health boards. This information was analysed seeking the classification of service user characteristics which best predicted the cost drivers of the services provided. A classification emerged which explained more than two thirds of the variance in service user costs. It can be used to inform service management and funding, but it is premature to have it determine funding.

  20. Mineral resources of Slovakia, questions of classification and valuation

    Directory of Open Access Journals (Sweden)

    Baláž Peter

    1999-06-01

    Full Text Available According to the Constitution of Slovak Republic, mineral resources of Slovakia are in the ownership of Slovak Republic. In 1997, 721 exclusive mineral deposits of mineral fuels, metals and industrial minerals were registered in Slovakia. The classification for economic and uneconomic reserves/resources requires an annual updating, concerning changes of market mineral prices and mine production costs. In terms of economic valuation of mineral resources, a new United Nations international classification for reserves/resources appears as a perspective alternative. Changes of geological and mining legislation are necessary for real valuation of Slovak mineral resources.

  1. 78 FR 54970 - Cotton Futures Classification: Optional Classification Procedure

    Science.gov (United States)

    2013-09-09

    ... Service 7 CFR Part 27 [AMS-CN-13-0043] RIN 0581-AD33 Cotton Futures Classification: Optional Classification Procedure AGENCY: Agricultural Marketing Service, USDA. ACTION: Proposed rule. SUMMARY: The... optional cotton futures classification procedure--identified and known as ``registration'' by the U.S...

  2. Association of Body Mass Index and Body Mass Index Change with Mortality in Incident Peritoneal Dialysis Patients

    Directory of Open Access Journals (Sweden)

    Liping Xiong

    2015-10-01

    Full Text Available Although high body mass index (BMI appears to confer a survival advantage in hemodialysis patients, the association of BMI with mortality in continuous ambulatory peritoneal dialysis (CAPD patients is uncertain. We enrolled incident CAPD patients and BMI was categorized according to World Health Organization classification for Asian population. BMI at baseline and one year after the initiation of peritoneal dialysis (PD treatment was assessed to calculate the BMI change (∆BMI. Patients were split into four categories according quartiles of ∆BMI. Kaplan-Meier method and Cox regression proportional hazard analysis were performed to assess the association of BMI on outcomes. A total of 1263 CAPD patients were included, with a mean age of 47.8 ± 15.0 years, a mean BMI of 21.58 ± 3.13 kg/m2. During a median follow-up of 25.3 months, obesity was associated with increased risk for cardiovascular diseases (CVD death (adjusted hazard ratio (AHR 2.01; 95% CI 1.14, 3.54, but not all-cause mortality. Additionally, patients with more BMI decline (>0.80% during the first year after CAPD initiation had an elevated risk for both all-cause (AHR: 2.21, 95% CI 1.23–3.95 and CVD mortality (AHR 2.31, 95% CI 1.11, 4.84, which was independent of baseline BMI values.

  3. Basic visual dysfunction allows classification of patients with schizophrenia with exceptional accuracy.

    Science.gov (United States)

    González-Hernández, J A; Pita-Alcorta, C; Padrón, A; Finalé, A; Galán, L; Martínez, E; Díaz-Comas, L; Samper-González, J A; Lencer, R; Marot, M

    2014-10-01

    Basic visual dysfunctions are commonly reported in schizophrenia; however their value as diagnostic tools remains uncertain. This study reports a novel electrophysiological approach using checkerboard visual evoked potentials (VEP). Sources of spectral resolution VEP-components C1, P1 and N1 were estimated by LORETA, and the band-effects (BSE) on these estimated sources were explored in each subject. BSEs were Z-transformed for each component and relationships with clinical variables were assessed. Clinical effects were evaluated by ROC-curves and predictive values. Forty-eight patients with schizophrenia (SZ) and 55 healthy controls participated in the study. For each of the 48 patients, the three VEP components were localized to both dorsal and ventral brain areas and also deviated from a normal distribution. P1 and N1 deviations were independent of treatment, illness chronicity or gender. Results from LORETA also suggest that deficits in thalamus, posterior cingulum, precuneus, superior parietal and medial occipitotemporal areas were associated with symptom severity. While positive symptoms were more strongly related to sensory processing deficits (P1), negative symptoms were more strongly related to perceptual processing dysfunction (N1). Clinical validation revealed positive and negative predictive values for correctly classifying SZ of 100% and 77%, respectively. Classification in an additional independent sample of 30 SZ corroborated these results. In summary, this novel approach revealed basic visual dysfunctions in all patients with schizophrenia, suggesting these visual dysfunctions represent a promising candidate as a biomarker for schizophrenia. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. PET imaging in patients with Modic changes

    International Nuclear Information System (INIS)

    Albert, H.B.; Manniche, C.; Petersen, H.; Hoeilund-Carlsen, P.F.

    2009-01-01

    The aim of this study was via PET imaging to reveal if any highly metabolic processes were occurring in Modic changes type 1 and/or in the adjacent discs. Modic changes (MC) are signal changes in the vertebral endplate and body visualised by magnetic resonance imaging (MRI). MC are strongly associated with low back pain (LBP). MC type 1 appear to be inflammation on MRI, and histological and biochemical findings make it highly likely that an inflammation is present. Though MC is painful no known treatment is available, and it is unknown which entities affect the progress or regress of MC. The changes observed on MRI are slow and take months to develop, but faster changes in the metabolism might provide a platform for monitoring patients. Patients from The Back Centre Funen, with low back pain in the area of L1 to S1, MC type 1 in L1 to L5, and a previous herniated lumbar disc. All patients had a PET scan using FDG ( 18 F-fluorodeoxyglucose) as tracer. Included in the study were 11 patients, 4 women and 7 men, mean age 48.1 year (range 20-65). All MC were situated in the vertebrae both above and below the previously herniated disc/discs. Ten patients had MC at 1 level, and 1 had MC at 2 levels. The affected levels were 1 at L2/L3, 6 at L4 /L5, and 5 at L5/S1. All had a previous disc herniation and MC larger than 4 mm in diameter. Technically satisfactory PET scans were obtained. However, PET imaging showed no increases in metabolism in any vertebra or disc of any patient. Modic type 1 changes do not reveal themselves by showing increased metabolism with ordinary FDG PET imaging. PET tracers illuminating inflammation are being developed and hopefully may become more successful. (orig.)

  5. Automatic liver volume segmentation and fibrosis classification

    Science.gov (United States)

    Bal, Evgeny; Klang, Eyal; Amitai, Michal; Greenspan, Hayit

    2018-02-01

    In this work, we present an automatic method for liver segmentation and fibrosis classification in liver computed-tomography (CT) portal phase scans. The input is a full abdomen CT scan with an unknown number of slices, and the output is a liver volume segmentation mask and a fibrosis grade. A multi-stage analysis scheme is applied to each scan, including: volume segmentation, texture features extraction and SVM based classification. Data contains portal phase CT examinations from 80 patients, taken with different scanners. Each examination has a matching Fibroscan grade. The dataset was subdivided into two groups: first group contains healthy cases and mild fibrosis, second group contains moderate fibrosis, severe fibrosis and cirrhosis. Using our automated algorithm, we achieved an average dice index of 0.93 ± 0.05 for segmentation and a sensitivity of 0.92 and specificity of 0.81for classification. To the best of our knowledge, this is a first end to end automatic framework for liver fibrosis classification; an approach that, once validated, can have a great potential value in the clinic.

  6. DTI measurements for Alzheimer’s classification

    Science.gov (United States)

    Maggipinto, Tommaso; Bellotti, Roberto; Amoroso, Nicola; Diacono, Domenico; Donvito, Giacinto; Lella, Eufemia; Monaco, Alfonso; Antonella Scelsi, Marzia; Tangaro, Sabina; Disease Neuroimaging Initiative, Alzheimer's.

    2017-03-01

    Diffusion tensor imaging (DTI) is a promising imaging technique that provides insight into white matter microstructure integrity and it has greatly helped identifying white matter regions affected by Alzheimer’s disease (AD) in its early stages. DTI can therefore be a valuable source of information when designing machine-learning strategies to discriminate between healthy control (HC) subjects, AD patients and subjects with mild cognitive impairment (MCI). Nonetheless, several studies have reported so far conflicting results, especially because of the adoption of biased feature selection strategies. In this paper we firstly analyzed DTI scans of 150 subjects from the Alzheimer’s disease neuroimaging initiative (ADNI) database. We measured a significant effect of the feature selection bias on the classification performance (p-value  informative content provided by DTI measurements for AD classification. Classification performances and biological insight, concerning brain regions related to the disease, provided by cross-validation analysis were both confirmed on the independent test.

  7. Classification of refrigerants; Classification des fluides frigorigenes

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-07-01

    This document was made from the US standard ANSI/ASHRAE 34 published in 2001 and entitled 'designation and safety classification of refrigerants'. This classification allows to clearly organize in an international way the overall refrigerants used in the world thanks to a codification of the refrigerants in correspondence with their chemical composition. This note explains this codification: prefix, suffixes (hydrocarbons and derived fluids, azeotropic and non-azeotropic mixtures, various organic compounds, non-organic compounds), safety classification (toxicity, flammability, case of mixtures). (J.S.)

  8. [Doctor-patient relationship in the context of a changing society].

    Science.gov (United States)

    Siebzehner, Miriam Ines; Balik, Chaya; Matalon, Andre

    2008-12-01

    During the 20th century doctors gained a special status in the medical system, which is about to change as a consequence of a change in the doctor-patient relationship and in the characteristics of the labor market in health care. Some changes correspond with the adoption of business terms within the medical system. The doctor is represented as a supplier of services, while the patient is a consumer. From patient-centered care, the doctor-patient relationship changed to a costumer-supplier of services, as is the case in other fields of the consumer society. This article analyzes the changes in the patterns of the doctor-patient interactions in the light of the changes in society over the last decades such as: the creation of regulations and laws on patients' rights; the establishment of organizations that represent the sick, the distribution of knowledge and information by means of mass communication, changes in the status of the doctors, the academization of other health professionals and changes in the management of health care to a more financially viable approach to the costs of health.

  9. Neuromuscular disease classification system

    Science.gov (United States)

    Sáez, Aurora; Acha, Begoña; Montero-Sánchez, Adoración; Rivas, Eloy; Escudero, Luis M.; Serrano, Carmen

    2013-06-01

    Diagnosis of neuromuscular diseases is based on subjective visual assessment of biopsies from patients by the pathologist specialist. A system for objective analysis and classification of muscular dystrophies and neurogenic atrophies through muscle biopsy images of fluorescence microscopy is presented. The procedure starts with an accurate segmentation of the muscle fibers using mathematical morphology and a watershed transform. A feature extraction step is carried out in two parts: 24 features that pathologists take into account to diagnose the diseases and 58 structural features that the human eye cannot see, based on the assumption that the biopsy is considered as a graph, where the nodes are represented by each fiber, and two nodes are connected if two fibers are adjacent. A feature selection using sequential forward selection and sequential backward selection methods, a classification using a Fuzzy ARTMAP neural network, and a study of grading the severity are performed on these two sets of features. A database consisting of 91 images was used: 71 images for the training step and 20 as the test. A classification error of 0% was obtained. It is concluded that the addition of features undetectable by the human visual inspection improves the categorization of atrophic patterns.

  10. Classification as a generic tool for characterising status and changes of regional scale groundwater systems

    Science.gov (United States)

    Barthel, Roland; Haaf, Ezra

    2016-04-01

    the behavior of groundwater systems. It is based on the hypothesis that similar groundwater systems respond similarly to similar impacts. At its core is the classification of (i) static hydrogeological characteristics (such as aquifer geometry and hydraulic properties), (ii) dynamic changes of the boundary conditions (such as recharge, water levels in surface waters), and (iii) dynamic groundwater system responses (groundwater head and chemical parameters). The dependencies of system responses on explanatory variables are used to map knowledge from observed locations to areas without measurements. Classification of static and dynamic system features combined with information about known system properties and their dependencies provide insight into system behavior that cannot be directly derived through the analysis of raw data. Classification and dependency analysis could finally lead to a new framework for groundwater system assessment on the regional scale as a replacement or supplement to numerical groundwater models and catchment scale hydrological models. This contribution focusses on the main hydrogeological concepts underlying the approach while another EGU contribution (Haaf and Barthel, 2016) explains the methodologies used to classify groundwater systems. References: Barthel, R., 2014. A call for more fundamental science in regional hydrogeology. Hydrogeol J, 22(3): 507-510. Barthel, R., Banzhaf, S., 2016. Groundwater and Surface Water Interaction at the Regional-scale - A Review with Focus on Regional Integrated Models. Water Resour Manag, 30(1): 1-32. Haaf, E., Barthel, R., 2016. An approach for classification of hydrogeological systems at the regional scale based on groundwater hydrographs. Abstract submitted to EGU General Assembly 2016, Vienna, Austria.

  11. Significance and Application of Digital Breast Tomosynthesis for the BI-RADS Classification of Breast Cancer.

    Science.gov (United States)

    Cai, Si-Qing; Yan, Jian-Xiang; Chen, Qing-Shi; Huang, Mei-Ling; Cai, Dong-Lu

    2015-01-01

    Full-field digital mammography (FFDM) with dense breasts has a high rate of missed diagnosis, and digital breast tomosynthesis (DBT) could reduce organization overlapping and provide more reliable images for BI-RADS classification. This study aims to explore application of COMBO (FFDM+DBT) for effect and significance of BI-RADS classification of breast cancer. In this study, we selected 832 patients who had been treated from May 2013 to November 2013. Classify FFDM and COMBO examination according to BI-RADS separately and compare the differences for glands in the image of the same patient in judgment, mass characteristics display and indirect signs. Employ Paired Wilcoxon rank sum test was used in 79 breast cancer patients to find differences between two examine methods. The results indicated that COMBO pattern is able to observe more details in distribution of glands when estimating content. Paired Wilcoxon rank sum test showed that overall classification level of COMBO is higher significantly compared to FFDM to BI-RADS diagnosis and classification of breast (PBI-RADS classification in breast cancer in clinical.

  12. Risk classification priorities in an emergency unit and outcomes of the service provided

    Directory of Open Access Journals (Sweden)

    Rafael Silva Marconato

    2017-12-01

    Full Text Available ABSTRACT Objective: to check the association of the proposed priorities of the institutional protocol of risk classification with the outcomes and evaluate the profile of the care provided in an emergency unit. Method: observational epidemiological study based on data from the computerized files of a Reference Emergency Unit. Care provided to adults was evaluated regarding risk classification and outcomes (death, hospitalization and hospital discharge based on the information recorded in the emergency bulletin. Results: the mean age of the 97,099 registered patients was 43.4 years; 81.5% cases were spontaneous demand; 41.2% had been classified as green, 15.3% yellow, 3.7% blue, 3% red and 36.and 9% had not received a classification; 90.2% of the patients had been discharged, 9.4% hospitalized and 0.4% had died. Among patients who were discharged, 14.7% had been classified as yellow or red, 13.6% green or blue, and 1.8% as blue or green. Conclusion: the protocol of risk classification showed good sensitivity to predict serious situations that can progress to death or hospitalization.

  13. Learning classification models with soft-label information.

    Science.gov (United States)

    Nguyen, Quang; Valizadegan, Hamed; Hauskrecht, Milos

    2014-01-01

    Learning of classification models in medicine often relies on data labeled by a human expert. Since labeling of clinical data may be time-consuming, finding ways of alleviating the labeling costs is critical for our ability to automatically learn such models. In this paper we propose a new machine learning approach that is able to learn improved binary classification models more efficiently by refining the binary class information in the training phase with soft labels that reflect how strongly the human expert feels about the original class labels. Two types of methods that can learn improved binary classification models from soft labels are proposed. The first relies on probabilistic/numeric labels, the other on ordinal categorical labels. We study and demonstrate the benefits of these methods for learning an alerting model for heparin induced thrombocytopenia. The experiments are conducted on the data of 377 patient instances labeled by three different human experts. The methods are compared using the area under the receiver operating characteristic curve (AUC) score. Our AUC results show that the new approach is capable of learning classification models more efficiently compared to traditional learning methods. The improvement in AUC is most remarkable when the number of examples we learn from is small. A new classification learning framework that lets us learn from auxiliary soft-label information provided by a human expert is a promising new direction for learning classification models from expert labels, reducing the time and cost needed to label data.

  14. Abnormal uterine bleeding: advantages of formal classification to patients, clinicians and researchers.

    Science.gov (United States)

    Madhra, Mayank; Fraser, Ian S; Munro, Malcolm G; Critchley, Hilary O D

    2014-07-01

    To highlight the advantages of formal classification of causes of abnormal uterine bleeding from a clinical and scientific perspective. Review and recommendations for local implementation. In the past, research in the field of menstrual disorders has not been funded adequately with respect to the impact of symptoms on individuals, healthcare systems and society. This was confounded by a diverse terminology, which lead to confusion between clinical and scientific groups, ultimately harming the underlying evidence base. To address this, a formal classification system (PALM-COEIN) for the causes of abnormal uterine bleeding has been published for worldwide use by FIGO (International Federation of Gynecology and Obstetrics). This commentary explains problems created by the prior absence of such a system, the potential advantages stemming from its use, and practical suggestions for local implementation. The PALM-COEIN classification is applicable globally and, as momentum gathers, will ameliorate recurrence of historic problems, and harmonise reporting of clinical and scientific research to facilitate future progress in women's health. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

  15. Securing classification and regulatory approval for deepwater projects: management challenges in a global environment

    Energy Technology Data Exchange (ETDEWEB)

    Feijo, Luiz P.; Burton, Gareth C. [American Bureau of Shipping (ABS), Rio de Janeiro, RJ (Brazil)

    2008-07-01

    As the offshore industry continues to develop and move into increasingly deeper waters, technological boundaries are being pushed to new limits. Along with these advances, the design, fabrication and installation of deepwater oil and gas projects has become an increasingly global endeavor. After providing an overview of the history and role of Classification Societies, this paper reviews the challenges of securing classification and regulatory approval in a global environment. Operational, procedural and technological changes which one Classification Society; the American Bureau of Shipping, known as ABS, has implemented to address these challenges are presented. The result of the changes has been a more customized service aiming at faster and more streamlined classification approval process. (author)

  16. [A revolution postponed indefinitely.WHO classification of tumors of the breast 2012: the main changes compared to the 3rd edition (2003)].

    Science.gov (United States)

    Nenutil, Rudolf

    2015-01-01

    In 2012, the new classification of the fourth series WHO blue books of breast tumors was released. The current version represents a fluent evolution, compared to the third edition. Some limited changes regarding terminology, definitions and the inclusion of some diagnostic units were adopted. The information about the molecular biology and genetic background of breast carcinoma has been enriched substantially.

  17. Evaluation of Current Approaches to Stream Classification and a Heuristic Guide to Developing Classifications of Integrated Aquatic Networks

    Science.gov (United States)

    Melles, S. J.; Jones, N. E.; Schmidt, B. J.

    2014-03-01

    Conservation and management of fresh flowing waters involves evaluating and managing effects of cumulative impacts on the aquatic environment from disturbances such as: land use change, point and nonpoint source pollution, the creation of dams and reservoirs, mining, and fishing. To assess effects of these changes on associated biotic communities it is necessary to monitor and report on the status of lotic ecosystems. A variety of stream classification methods are available to assist with these tasks, and such methods attempt to provide a systematic approach to modeling and understanding complex aquatic systems at various spatial and temporal scales. Of the vast number of approaches that exist, it is useful to group them into three main types. The first involves modeling longitudinal species turnover patterns within large drainage basins and relating these patterns to environmental predictors collected at reach and upstream catchment scales; the second uses regionalized hierarchical classification to create multi-scale, spatially homogenous aquatic ecoregions by grouping adjacent catchments together based on environmental similarities; and the third approach groups sites together on the basis of similarities in their environmental conditions both within and between catchments, independent of their geographic location. We review the literature with a focus on more recent classifications to examine the strengths and weaknesses of the different approaches. We identify gaps or problems with the current approaches, and we propose an eight-step heuristic process that may assist with development of more flexible and integrated aquatic classifications based on the current understanding, network thinking, and theoretical underpinnings.

  18. Heterogeneity of European DRG systems and potentials for a common EuroDRG system Comment on "Cholecystectomy and Diagnosis-Related Groups (DRGs): patient classification and hospital reimbursement in 11 European countries".

    Science.gov (United States)

    Geissler, Alexander; Quentin, Wilm; Busse, Reinhard

    2015-03-05

    Diagnosis-Related Group (DRG) systems across Europe are very heterogeneous, in particular because of different classification variables and algorithms as well as costing methodologies. But, given the challenge of increasing patient mobility within Europe, health systems are forced to incorporate a common patient classification language in order to compare and identify similar patients e.g. for reimbursement purposes. Beside the national adoption of DRGs for a wide range of purposes (measuring hospital activity vs. paying hospitals), a common DRG system can serve as an international communication basis among health administrators and can reduce the national development efforts as it is demonstrated by the NordDRG consortium. © 2015 by Kerman University of Medical Sciences.

  19. The value of laparoscopic classifications in decision on definitive ...

    African Journals Online (AJOL)

    The value of laparoscopic classifications in decision on definitive surgery in patients with nonpalpable testes: our ... present our clinical experience with the laparoscopic approach in patients with nonpalpable testes (NPTs) and .... decision making during the procedure. Gatti and. Ostlie [3] have pointed out that laparoscopic ...

  20. The value of laparoscopic classifications in decision on definitive ...

    African Journals Online (AJOL)

    The value of laparoscopic classifications in decision on definitive surgery in patients ... was to present our clinical experience with the laparoscopic approach in patients ... in 10 cases in whom cord structures were seen entering the internal inguinal ring. ... Four canalicular testes (peeping) were treated with open orchiopexy.

  1. Classification of diffuse lung diseases: why and how.

    Science.gov (United States)

    Hansell, David M

    2013-09-01

    The understanding of complex lung diseases, notably the idiopathic interstitial pneumonias and small airways diseases, owes as much to repeated attempts over the years to classify them as to any single conceptual breakthrough. One of the many benefits of a successful classification scheme is that it allows workers, within and between disciplines, to be clear that they are discussing the same disease. This may be of particular importance in the recruitment of individuals for a clinical trial that requires a standardized and homogeneous study population. Different specialties require fundamentally different things from a classification: for epidemiologic studies, a classification that requires categorization of individuals according to histopathologic pattern is not usually practicable. Conversely, a scheme that simply divides diffuse parenchymal disease into inflammatory and noninflammatory categories is unlikely to further the understanding about the pathogenesis of disease. Thus, for some disease groupings, for example, pulmonary vasculopathies, there may be several appropriate classifications, each with its merits and demerits. There has been an interesting shift in the past few years, from the accepted primacy of histopathology as the sole basis on which the classification of parenchymal lung disease has rested, to new ways of considering how these entities relate to each other. Some inventive thinking has resulted in new classifications that undoubtedly benefit patients and clinicians in their endeavor to improve management and outcome. The challenge of understanding the logic behind current classifications and their shortcomings are explored in various examples of lung diseases.

  2. Perianal disease, small bowel disease, smoking, prior steroid or early azathioprine/biological therapy are predictors of disease behavior change in patients with Crohn’s disease

    Science.gov (United States)

    Lakatos, Peter Laszlo; Czegledi, Zsofia; Szamosi, Tamas; Banai, Janos; David, Gyula; Zsigmond, Ferenc; Pandur, Tunde; Erdelyi, Zsuzsanna; Gemela, Orsolya; Papp, Janos; Lakatos, Laszlo

    2009-01-01

    AIM: To assess the combined effect of disease phenotype, smoking and medical therapy [steroid, azathioprine (AZA), AZA/biological therapy] on the probability of disease behavior change in a Caucasian cohort of patients with Crohn’s disease (CD). METHODS: Three hundred and forty well-characterized, unrelated, consecutive CD patients were analyzed (M/F: 155/185, duration: 9.4 ± 7.5 years) with a complete clinical follow-up. Medical records including disease phenotype according to the Montreal classification, extraintestinal manifestations, use of medications and surgical events were analyzed retrospectively. Patients were interviewed on their smoking habits at the time of diagnosis and during the regular follow-up visits. RESULTS: A change in disease behavior was observed in 30.8% of patients with an initially non-stricturing, non-penetrating disease behavior after a mean disease duration of 9.0 ± 7.2 years. In a logistic regression analysis corrected for disease duration, perianal disease, smoking, steroid use, early AZA or AZA/biological therapy use were independent predictors of disease behavior change. In a subsequent Kaplan-Meier survival analysis and a proportional Cox regression analysis, disease location (P = 0.001), presence of perianal disease (P < 0.001), prior steroid use (P = 0.006), early AZA (P = 0.005) or AZA/biological therapy (P = 0.002), or smoking (P = 0.032) were independent predictors of disease behavior change. CONCLUSION: Our data suggest that perianal disease, small bowel disease, smoking, prior steroid use, early AZA or AZA/biological therapy are all predictors of disease behavior change in CD patients. PMID:19630105

  3. An interobserver reliability comparison between the Orthopaedic Trauma Association's open fracture classification and the Gustilo and Anderson classification.

    Science.gov (United States)

    Ghoshal, A; Enninghorst, N; Sisak, K; Balogh, Z J

    2018-02-01

    To evaluate interobserver reliability of the Orthopaedic Trauma Association's open fracture classification system (OTA-OFC). Patients of any age with a first presentation of an open long bone fracture were included. Standard radiographs, wound photographs, and a short clinical description were given to eight orthopaedic surgeons, who independently evaluated the injury using both the Gustilo and Anderson (GA) and OTA-OFC classifications. The responses were compared for variability using Cohen's kappa. The overall interobserver agreement was ĸ = 0.44 for the GA classification and ĸ = 0.49 for OTA-OFC, which reflects moderate agreement (0.41 to 0.60) for both classifications. The agreement in the five categories of OTA-OFC was: for skin, ĸ = 0.55 (moderate); for muscle, ĸ = 0.44 (moderate); for arterial injury, ĸ = 0.74 (substantial); for contamination, ĸ = 0.35 (fair); and for bone loss, ĸ = 0.41 (moderate). Although the OTA-OFC, with similar interobserver agreement to GA, offers a more detailed description of open fractures, further development may be needed to make it a reliable and robust tool. Cite this article: Bone Joint J 2018;100-B:242-6. ©2018 The British Editorial Society of Bone & Joint Surgery.

  4. Building the United States National Vegetation Classification

    Science.gov (United States)

    Franklin, S.B.; Faber-Langendoen, D.; Jennings, M.; Keeler-Wolf, T.; Loucks, O.; Peet, R.; Roberts, D.; McKerrow, A.

    2012-01-01

    The Federal Geographic Data Committee (FGDC) Vegetation Subcommittee, the Ecological Society of America Panel on Vegetation Classification, and NatureServe have worked together to develop the United States National Vegetation Classification (USNVC). The current standard was accepted in 2008 and fosters consistency across Federal agencies and non-federal partners for the description of each vegetation concept and its hierarchical classification. The USNVC is structured as a dynamic standard, where changes to types at any level may be proposed at any time as new information comes in. But, because much information already exists from previous work, the NVC partners first established methods for screening existing types to determine their acceptability with respect to the 2008 standard. Current efforts include a screening process to assign confidence to Association and Group level descriptions, and a review of the upper three levels of the classification. For the upper levels especially, the expectation is that the review process includes international scientists. Immediate future efforts include the review of remaining levels and the development of a proposal review process.

  5. Correspondence between EQ-5D health state classifications and EQ VAS scores

    Directory of Open Access Journals (Sweden)

    Whynes David K

    2008-11-01

    Full Text Available Abstract Background The EQ-5D health-related quality of life instrument comprises a health state classification followed by a health evaluation using a visual analogue scale (VAS. The EQ-5D has been employed frequently in economic evaluations, yet the relationship between the two parts of the instrument remains ill-understood. In this paper, we examine the correspondence between VAS scores and health state classifications for a large sample, and identify variables which contribute to determining the VAS scores independently of the health states as classified. Methods A UK trial of management of low-grade abnormalities detected on screening for cervical pre-cancer (TOMBOLA provided EQ-5D data for over 3,000 women. Information on distress and multi-dimensional health locus of control had been collected using other instruments. A linear regression model was fitted, with VAS score as the dependent variable. Independent variables comprised EQ-5D health state classifications, distress, locus of control, and socio-demographic characteristics. Equivalent EQ-5D and distress data, collected at twelve months, were available for over 2,000 of the women, enabling us to predict changes in VAS score over time from changes in EQ-5D classification and distress. Results In addition to EQ-5D health state classification, VAS score was influenced by the subject's perceived locus of control, and by her age, educational attainment, ethnic origin and smoking behaviour. Although the EQ-5D classification includes a distress dimension, the independent measure of distress was an additional determinant of VAS score. Changes in VAS score over time were explained by changes in both EQ-5D severities and distress. Women allocated to the experimental management arm of the trial reported an increase in VAS score, independently of any changes in health state and distress. Conclusion In this sample, EQ VAS scores were predictable from the EQ-5D health state classification, although

  6. Surgical management of diabetic foot and role of UT (University of Texas) classification

    International Nuclear Information System (INIS)

    Mishwani, A.H.; Kiyani, K.A.

    2011-01-01

    To evaluate the role of University of Texas Classification in the management of Diabetic foot. Design: Descriptive study Place and Duration of Study: Surgical unit II Combined Military Hospital Rawalpindi (2003 to 2008) and Department of Surgery Combined Military Hospital Peshawar (July 2008 to Jan 2010). Patients and Method: A total of 300 patients who reported to Surgical Department with a foot ulcer or infection and diagnosed to have Diabetes Mellitus were studied. Patients of both gender and age >12 years were included. Patients of end stage renal disease, compromised immunity or on steroid therapy were excluded. Detailed history and clinical examination were recorded. Routine investigations including complete blood examination, urine routine examination, renal function tests, x-ray foot, chest x-ray, ECG and pus for culture and sensitivity were recorded. Lesions were classified according to University of Texas classification and treated accordingly. Results: Majority of the patients were of 50 to 70 years age group. Male to female ratio was 4:1. Big toe was the commonest site followed by fore foot and heel. Patients were classified according to UT classification. Patients were managed with antibiotics, dressings, incision and drainage, debridement, vacuum assisted closure (VAC) with or without skin grafting and amputations of different types. Staphylococcus aureus was the commonest isolate. Conclusion: Our study has shown that UT classification is an effective system of assessing the severity of Diabetic foot at the time of presentation and planning its management. Amputation rates, time of healing and morbidity increases with increasing stage and grade. (author)

  7. Unspecific chronic low back pain - a simple functional classification tested in a case series of patients with spinal deformities.

    Science.gov (United States)

    Weiss, Hans-Rudolf; Werkmann, Mario

    2009-02-17

    Up to now, chronic low back pain without radicular symptoms is not classified and attributed in international literature as being "unspecific". For specific bracing of this patient group we use simple physical tests to predict the brace type the patient is most likely to benefit from. Based on these physical tests we have developed a simple functional classification of "unspecific" low back pain in patients with spinal deformities. Between January 2006 and July 2007 we have tested 130 patients (116 females and 14 males) with spinal deformities (average age 45 years, ranging from 14 years to 69) and chronic unspecific low back pain (pain for > 24 months) along with the indication for brace treatment for chronic unspecific low back pain. Some of the patients had symptoms of spinal claudication (n = 16). The "sagittal realignment test" (SRT) was applied, a lumbar hyperextension test, and the "sagittal delordosation test" (SDT). Additionally 3 female patients with spondylolisthesis were tested, including one female with symptoms of spinal claudication and 2 of these patients were 14 years of age and the other 43yrs old at the time of testing. 117 Patients reported significant pain release in the SRT and 13 in the SDT (> or = 2 steps in the Roland & Morris VRS). 3 Patients had no significant pain release in both of the tests (manual investigation we found hypermobility at L5/S1 or a spondylolisthesis at level L5/S1. In the other patients who responded well to the SRT loss of lumbar lordosis was the main issue, a finding which, according to scientific literature, correlates well with low back pain. The 3 patients who did not respond to either test had a fair pain reduction in a generally delordosing brace with an isolated small foam pad inserted at the level of L 2/3, leading to a lordosation at this region. With the exception of 3 patients (2.3%) a clear distribution to one of the two classes has been possible. 117 patients were supplied successfully with a sagittal

  8. SQL based cardiovascular ultrasound image classification.

    Science.gov (United States)

    Nandagopalan, S; Suryanarayana, Adiga B; Sudarshan, T S B; Chandrashekar, Dhanalakshmi; Manjunath, C N

    2013-01-01

    This paper proposes a novel method to analyze and classify the cardiovascular ultrasound echocardiographic images using Naïve-Bayesian model via database OLAP-SQL. Efficient data mining algorithms based on tightly-coupled model is used to extract features. Three algorithms are proposed for classification namely Naïve-Bayesian Classifier for Discrete variables (NBCD) with SQL, NBCD with OLAP-SQL, and Naïve-Bayesian Classifier for Continuous variables (NBCC) using OLAP-SQL. The proposed model is trained with 207 patient images containing normal and abnormal categories. Out of the three proposed algorithms, a high classification accuracy of 96.59% was achieved from NBCC which is better than the earlier methods.

  9. CT-based injury classification

    International Nuclear Information System (INIS)

    Mirvis, S.E.; Whitley, N.O.; Vainright, J.; Gens, D.

    1988-01-01

    Review of preoperative abdominal CT scans obtained in adults after blunt trauma during a 2.5-year period demonstrated isolated or predominant liver injury in 35 patients and splenic injury in 33 patients. CT-based injury scores, consisting of five levels of hepatic injury and four levels of splenic injury, were correlated with clinical outcome and surgical findings. Hepatic injury grades I-III, present in 33 of 35 patients, were associated with successful nonsurgical management in 27 (82%) or with findings at celiotomy not requiring surgical intervention in four (12%). Higher grades of splenic injury generally required early operative intervention, but eight (36%) of 22 patients with initial grade III or IV injury were managed without surgery, while four (36%) of 11 patients with grade I or II injury required delayed celiotomy and splenectomy (three patients) or emergent rehospitalization (one patient). CT-based injury classification is useful in guiding the nonoperative management of blunt hepatic injury in hemodynamically stable adults but appears to be less reliable in predicting the outcome of blunt splenic injury

  10. Non-Hodgkin lymphoma response evaluation with MRI texture classification

    Directory of Open Access Journals (Sweden)

    Heinonen Tomi T

    2009-06-01

    Full Text Available Abstract Background To show magnetic resonance imaging (MRI texture appearance change in non-Hodgkin lymphoma (NHL during treatment with response controlled by quantitative volume analysis. Methods A total of 19 patients having NHL with an evaluable lymphoma lesion were scanned at three imaging timepoints with 1.5T device during clinical treatment evaluation. Texture characteristics of images were analyzed and classified with MaZda application and statistical tests. Results NHL tissue MRI texture imaged before treatment and under chemotherapy was classified within several subgroups, showing best discrimination with 96% correct classification in non-linear discriminant analysis of T2-weighted images. Texture parameters of MRI data were successfully tested with statistical tests to assess the impact of the separability of the parameters in evaluating chemotherapy response in lymphoma tissue. Conclusion Texture characteristics of MRI data were classified successfully; this proved texture analysis to be potential quantitative means of representing lymphoma tissue changes during chemotherapy response monitoring.

  11. Imaging of juvenile spondyloarthritis. Part I: Classifications and radiographs

    Directory of Open Access Journals (Sweden)

    Iwona Sudoł-Szopińska

    2017-09-01

    Full Text Available Juvenile spondyloarthropathies are manifested mainly by symptoms of peripheral arthritis and enthesitis. By contrast with adults, children rarely present with sacroiliitis and spondylitis. Imaging and laboratory tests allow early diagnosis and treatment. Conventional radiographs visualize late inflammatory lesions and post-inflammatory complications. Early diagnosis is possible with the use of ultrasonography and magnetic resonance imaging. The first part of the article presents classifications of juvenile spondyloarthropathies and discusses their radiographic presentation. Typical radiographic features of individual types of juvenile spondyloarthritis are listed (including ankylosing spondylitis, juvenile psoriatic arthritis, reactive arthritis and arthritis in the course of inflammatory bowel diseases. The second part will describe changes visible on ultrasonography and magnetic resonance imaging. In patients with juvenile spondyloarthropathies, these examinations are conducted to diagnose inflammatory lesions in peripheral joints, tendon sheaths, tendons and bursae. Moreover, magnetic resonance imaging also visualizes early inflammatory changes in the axial skeleton and subchondral bone marrow edema, which is considered an early sign of inflammation.

  12. Evidence-based provisional clinical classification criteria for autoinflammatory periodic fevers

    NARCIS (Netherlands)

    Federici, Silvia; Sormani, Maria Pia; Ozen, Seza; Lachmann, Helen J; Amaryan, Gayane; Woo, Patricia; Koné-Paut, Isabelle; Dewarrat, Natacha; Cantarini, Luca; Insalaco, Antonella; Uziel, Yosef; Rigante, Donato; Quartier, Pierre; Demirkaya, Erkan; Herlin, Troels; Meini, Antonella; Fabio, Giovanna; Kallinich, Tilmann; Martino, Silvana; Butbul, Aviel Yonatan; Olivieri, Alma; Kuemmerle-Deschner, Jasmin; Neven, Benedicte; Simon, Anna; Ozdogan, Huri; Touitou, Isabelle; Frenkel, Joost; Hofer, Michael; Martini, Alberto; Ruperto, Nicolino; Gattorno, Marco

    2015-01-01

    The objective of this work was to develop and validate a set of clinical criteria for the classification of patients affected by periodic fevers. Patients with inherited periodic fevers (familial Mediterranean fever (FMF); mevalonate kinase deficiency (MKD); tumour necrosis factor

  13. Classification

    Science.gov (United States)

    Clary, Renee; Wandersee, James

    2013-01-01

    In this article, Renee Clary and James Wandersee describe the beginnings of "Classification," which lies at the very heart of science and depends upon pattern recognition. Clary and Wandersee approach patterns by first telling the story of the "Linnaean classification system," introduced by Carl Linnacus (1707-1778), who is…

  14. Categorization of intraoperative ureteroscopy complications using modified Satava classification system.

    Science.gov (United States)

    Tepeler, Abdulkadir; Resorlu, Berkan; Sahin, Tolga; Sarikaya, Selcuk; Bayindir, Mirze; Oguz, Ural; Armagan, Abdullah; Unsal, Ali

    2014-02-01

    To review our experience with ureteroscopy (URS) in the treatment of ureteral calculi and stratify intraoperative complications of URS according to the modified Satava classification system. We performed a retrospective analysis of 1,208 patients (672 males and 536 females), with a mean age of 43.1 years (range 1-78), who underwent ureteroscopic procedures for removal of ureteral stones. Intraoperative complications were recorded according to modified Satava classification system. Grade 1 complications included incidents without consequences for the patient; grade 2 complications, which are treated intraoperatively with endoscopic surgery (grade 2a) or required endoscopic re-treatment (grade 2b); and grade 3 complications included incidents requiring open or laparoscopic surgery. The stones were completely removed in 1,067 (88.3%) patients after primary procedure by either simple extraction or after fragmentation. The overall incidence of intraoperative complications was 12.6%. The most common complications were proximal stone migration (3.9%), mucosal injury (2.8%), bleeding (1.9%), inability to reach stone (1.8%), malfunctioning or breakage of instruments (0.8%), ureteral perforation (0.8%) and ureteral avulsion (0.16%). According to modified Satava classification system, there were 4.5% grade 1; 4.4% grade 2a; 3.2% grade 2b; and 0.57% grade 3 complications. We think that modified Satava classification is a quick and simple system for describing the severity of intraoperative URS complications and this grading system will facilitate a better comparison for the surgical outcomes obtained from different centers.

  15. [Surgical treatment of chronic pancreatitis based on classification of M. Buchler and coworkers].

    Science.gov (United States)

    Krivoruchko, I A; Boĭko, V V; Goncharova, N N; Andreeshchev, S A

    2011-08-01

    The results of surgical treatment of 452 patients, suffering chronic pancreatitis (CHP), were analyzed. The CHP classification, elaborated by M. Buchler and coworkers (2009), based on clinical signs, morphological peculiarities and pancreatic function analysis, contains scientifically substantiated recommendations for choice of diagnostic methods and complex treatment of the disease. The classification proposed is simple in application and constitutes an instrument for studying and comparison of the CHP course severity, the patients prognosis and treatment.

  16. Acute Changes in Mentation in a Patient with Hepatic Cirrhosis Treated with High Doses of Dexamethasone.

    Science.gov (United States)

    Dabul, Luis; Droney, Andrew; Oms, Juan; Sanchez-Gonzalez, Marcos A

    2017-09-10

    Despite the anti-inflammatory benefits of steroids in the management of multiple medical conditions, they are associated with undesired metabolic and psychiatric side effects. We present a case of a 57-year-old Hispanic man with hepatic cirrhosis due to hepatitis C and no past medical history of psychiatric illnesses who became delirious after treatment with high doses of intravenous Dexamethasone. The patient presented to Larkin Community Hospital, USA with complaints of lower back pain requiring treatment with steroids for severe lumbar central canal stenosis. After three days of treatment, the patient became disoriented to time and place, grossly psychotic with auditory hallucinations and disorganized behavior, manic, aggressive, combative, restless, hard to redirect, and unable to follow commands. He met the criteria for a diagnosis of substance-induced psychotic disorder according to Diagnostic and Statistical Manual of Mental Disorders (DSM) V. Furthermore, the patient had worsening hepatic profile, a high ammonia level of 125 umol/L, and clinical findings consistent with West Haven classification grade 2 encephalopathy. Head computed tomography (CT) scan was normal. He was treated with discontinuation of steroids, lactulose, and Haloperidol returning to baseline mental status after 48 hours. The patient's hospitalization was complicated with a prolonged hospital stay after lumbar surgery. This case illustrates that treatment with high doses of Dexamethasone in a patient with hepatic cirrhosis can cause acute changes in mental status by (i) inducing delirium, and (ii) precipitating hepatic encephalopathy.

  17. Radiologic changes of ulcerated foot in leprosy

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Jung Hyun; Ahn, Eun Joo; Chung, Eun Chul; Rhee, Chung Sik [Ewha Woman' s University College of Medicine, Seoul (Korea, Republic of); Choi, Sung Jun [Institute for Leprosy Research, KLCA, Uiwang (Korea, Republic of)

    1990-12-15

    There are radiologically characteristic bone changes on the foot and tarsus in leprosy. The bone changes are primarily due to Mycobacterium leprae infection and secondarily to the injurious effect, such as trauma, and infection on the denervated tissue. 117 bone changes of 100 leprosy patients with plantar ulcerations from Jan. 1984 to Oct. 1989 in the Korean Leprosy Control Center were analyzed. Male to female ratio was about 2 : 1 and the most prevalent age was 41 to 60 years, and according to Ridley-Jopling's classification. L-type was most common (46%). One hundred and eleven cases (94.9%) showed bone changes, suggesting high incidence of bone changes in patients with plantar ulcers. Specific findings were observed in two cases(1.7%). One hundred and nine cases showed nonspecific bone changes, which were osteomyelitis(23.1%), neurotrophic changes(39.3%), periostitis(5.1%) and arthritis(12.8%). Extensive bone involvement was seen in neurotrophic changes involving forefoot and metatarsal in 22 of 46 cases, and in secondary changes involving metatarsal bone in 23, tarsus in 20 of 49 cases.

  18. Radiologic changes of ulcerated foot in leprosy

    International Nuclear Information System (INIS)

    Yoo, Jung Hyun; Ahn, Eun Joo; Chung, Eun Chul; Rhee, Chung Sik; Choi, Sung Jun

    1990-01-01

    There are radiologically characteristic bone changes on the foot and tarsus in leprosy. The bone changes are primarily due to Mycobacterium leprae infection and secondarily to the injurious effect, such as trauma, and infection on the denervated tissue. 117 bone changes of 100 leprosy patients with plantar ulcerations from Jan. 1984 to Oct. 1989 in the Korean Leprosy Control Center were analyzed. Male to female ratio was about 2 : 1 and the most prevalent age was 41 to 60 years, and according to Ridley-Jopling's classification. L-type was most common (46%). One hundred and eleven cases (94.9%) showed bone changes, suggesting high incidence of bone changes in patients with plantar ulcers. Specific findings were observed in two cases(1.7%). One hundred and nine cases showed nonspecific bone changes, which were osteomyelitis(23.1%), neurotrophic changes(39.3%), periostitis(5.1%) and arthritis(12.8%). Extensive bone involvement was seen in neurotrophic changes involving forefoot and metatarsal in 22 of 46 cases, and in secondary changes involving metatarsal bone in 23, tarsus in 20 of 49 cases

  19. Does the World Health Organization histological classification predict outcomes after thymomectomy? Results of a multicentre study on 750 patients.

    Science.gov (United States)

    Guerrera, Francesco; Rendina, Erino Angelo; Venuta, Federico; Margaritora, Stefano; Ciccone, Anna Maria; Novellis, Pierluigi; Novero, Domenico; Anile, Marco; Bora, Giulia; Rena, Ottavio; Casadio, Caterina; Mussi, Alfredo; Evangelista, Andrea; Ruffini, Enrico; Lucchi, Marco; Filosso, Pier Luigi

    2015-07-01

    The World Health Organization (WHO) thymoma histological classification clinical value remains a controversy. In this study, we evaluated its prognostic significance in patients with thymoma treated with radical intent. Six high-volume Italian Thoracic Surgery Institutions collaborated with their own retrospective anonymized datasets. Demographic, clinical, pathological and treatment data were examined. A WHO histological classification (WHO-HC) collapsed scheme (A/AB and B1/B2 types merged) was proposed and compared with the traditional one. Predictors of survival were assessed using a Cox model with shared frailty. Competing-risk regression models were performed to identify the association between individual factors and freedom from recurrence. Between 1990 and 2011, 750 thymomas were operated on in participating centres. Myasthenia gravis was observed in 363 (48%) patients. A complete resection was achieved in 676 (91%) cases. One hundred and nine patients (15%) had a WHO-HC A type, 166 (22%) AB, 179 (24%) B1, 158 (21%) B2 and 135 (18%) B3. The rate of 5-year OS and cumulative incidence of recurrence for all cases was 91% and 0.11, respectively. Five-year survival rates by WHO-HC in the collapsed scheme were A/AB 93%, early-B 90% and advanced-B 85%. Masaoka stage only was demonstrated to be an independent predictor for survival and recurrence. The WHO-collapsed scheme showed a trend in influencing recurrence overall survival development (hazard ratio: 1.32; P = 0.16). Our results show evidence of lack of significance by WHO-HC in influencing prognosis, even though the proposed collapsed scheme revealed a fair stratification of risk to relapses and better correlation with patients' clinical characteristics. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  20. Comprehensive Application of the International Classification of Headache Disorders Third Edition, Beta Version

    OpenAIRE

    Kim, Byung-Kun; Cho, Soo-Jin; Kim, Byung-Su; Sohn, Jong-Hee; Kim, Soo-Kyoung; Cha, Myoung-Jin; Song, Tae-Jin; Kim, Jae-Moon; Park, Jeong Wook; Chu, Min Kyung; Park, Kwang-Yeol; Moon, Heui-Soo

    2015-01-01

    The purpose of this study was to test the feasibility and usefulness of the International Classification of Headache Disorders, third edition, beta version (ICHD-3?), and compare the differences with the International Classification of Headache Disorders, second edition (ICHD-2). Consecutive first-visit patients were recruited from 11 headache clinics in Korea. Headache classification was performed in accordance with ICHD-3?. The characteristics of headaches were analyzed and the feasibility ...

  1. Classification of diabetic foot ulcers.

    Science.gov (United States)

    Game, Frances

    2016-01-01

    It is known that the relative importance of factors involved in the development of diabetic foot problems can vary in both their presence and severity between patients and lesions. This may be one of the reasons why outcomes seem to vary centre to centre and why some treatments may seem more effective in some people than others. There is a need therefore to classify and describe lesions of the foot in patients with diabetes in a manner that is agreed across all communities but is simple to use in clinical practice. No single system is currently in widespread use, although a number have been published. Not all are well validated outside the system from which they were derived, and it has not always been made clear the clinical purposes to which such classifications should be put to use, whether that be for research, clinical description in routine clinical care or audit. Here the currently published classification systems, their validation in clinical practice, whether they were designed for research, audit or clinical care, and the strengths and weaknesses of each are explored. Copyright © 2016 John Wiley & Sons, Ltd.

  2. Dietary changes among breast cancer patients in Malaysia.

    Science.gov (United States)

    Shaharudin, Soraya Hanie; Sulaiman, Suhaina; Shahril, Mohd Razif; Emran, Nor Aina; Akmal, Sharifah Noor

    2013-01-01

    Breast cancer patients often show an interest in making dietary changes after diagnosis of breast cancer to improve their health condition and prevent cancer recurrence. The objective of the study was to determine changes in dietary intake 2 years after diagnosis among breast cancer patients. One hundred sixteen subjects were asked to complete a semiquantitative food frequency questionnaire, diet recalls, and dietary changes questionnaire to assess dietary intake before and after diagnosis. The information on sociodemographic background, cancer treatment history, and anthropometric indices was also collected. Seventy-two subjects considered diet as a contributing factor to breast cancer, and 67 subjects changed their dietary habits after breast cancer diagnosis. The reasons for changes in diet were physician and dietitian advice and desire to cure cancer. The sources of information were derived from their physician, mass media, and family members. Total energy, protein, total fat, fatty acids, and vitamin E intake were significantly decreased after diagnosis. Meanwhile, the intake of β-carotene and vitamin C increased significantly after diagnosis. The changes included reduction in red meat, seafood, noodles, and poultry intake. An increased consumption of fruits, vegetables, fish, low-fat milk, and soy products was observed. The subjects tended to lower high-fat foods intake and started to eat more fruits and vegetables. Breast cancer patients had changed to a healthier diet after breast cancer diagnosis, although the changes made were small. This will be helpful to dietitians in providing a better understanding of good eating habits that will maintain patients' health after breast cancer diagnosis.

  3. Association between nutritional status and Modic classification in degenerative disc disease.

    Science.gov (United States)

    Seyithanoglu, Hakan; Aydin, Teoman; Taşpınar, Ozgur; Camli, Adil; Kiziltan, Huriye; Eris, Ali Hikmet; Hocaoglu, Ilknur Turk; Ozder, Aclan; Denizli, Ebru; Kepekci, Muge; Keskin, Yasar; Mutluer, Ahmet Serdar

    2016-04-01

    [Purpose] This study was conducted to examine the association between Modic classification and the eating habits in patients with degenerative disc disease (DDD) and to determine the influence of nutrition on disease severity. [Subjects and Methods] Sixty patients with DDD visiting a low back pain outpatient clinic were enrolled. Through face-to-face interviews, they completed questionnaires regarding their demographics, disease activity, smoking and alcohol use, concomitant diseases, disease duration, and nutritional status.Exclusion criteria were age 65 years, other comorbidities, missing MRI data, and inability to speak Turkish. [Results] Forty patients were finally included in the study. The frequency with which they consumed water, salt, fast food, eggs, milk, yogurt, cheese, whole wheat bread, white bread, butter, and margarine was recorded. A weak negative correlation was observed between the Modic types and fish and egg consumption. [Conclusion] Modic changes, which indicate the severity of DDD, seem to be correlated to patients' dietary habits. However, studies with comparison groups and larger samples are needed to confirm our promising results before any cause-and-effect relationship can be proposed.

  4. Computed tomography vs. digital radiography assessment for detection of osteolysis in asymptomatic patients with uncemented cups: a proposal for a new classification system based on computer tomography.

    Science.gov (United States)

    Sandgren, Buster; Crafoord, Joakim; Garellick, Göran; Carlsson, Lars; Weidenhielm, Lars; Olivecrona, Henrik

    2013-10-01

    Digital radiographic images in the anterior-posterior and lateral view have been gold standard for evaluation of peri-acetabular osteolysis for patients with an uncemented hip replacement. We compared digital radiographic images and computer tomography in detection of peri-acetabular osteolysis and devised a classification system based on computer tomography. Digital radiographs were compared with computer tomography on 206 hips, with a mean follow up 10 years after surgery. The patients had no clinical signs of osteolysis and none were planned for revision surgery. On digital radiographs, 192 cases had no osteolysis and only 14 cases had osteolysis. When using computer tomography there were 184 cases showing small or large osteolysis and only 22 patients had no osteolysis. A classification system for peri-acetabular osteolysis is proposed based on computer tomography that is easy to use on standard follow up evaluation. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. The Discriminative validity of "nociceptive," "peripheral neuropathic," and "central sensitization" as mechanisms-based classifications of musculoskeletal pain.

    LENUS (Irish Health Repository)

    Smart, Keith M

    2012-02-01

    OBJECTIVES: Empirical evidence of discriminative validity is required to justify the use of mechanisms-based classifications of musculoskeletal pain in clinical practice. The purpose of this study was to evaluate the discriminative validity of mechanisms-based classifications of pain by identifying discriminatory clusters of clinical criteria predictive of "nociceptive," "peripheral neuropathic," and "central sensitization" pain in patients with low back (+\\/- leg) pain disorders. METHODS: This study was a cross-sectional, between-patients design using the extreme-groups method. Four hundred sixty-four patients with low back (+\\/- leg) pain were assessed using a standardized assessment protocol. After each assessment, patients\\' pain was assigned a mechanisms-based classification. Clinicians then completed a clinical criteria checklist indicating the presence\\/absence of various clinical criteria. RESULTS: Multivariate analyses using binary logistic regression with Bayesian model averaging identified a discriminative cluster of 7, 3, and 4 symptoms and signs predictive of a dominance of "nociceptive," "peripheral neuropathic," and "central sensitization" pain, respectively. Each cluster was found to have high levels of classification accuracy (sensitivity, specificity, positive\\/negative predictive values, positive\\/negative likelihood ratios). DISCUSSION: By identifying a discriminatory cluster of symptoms and signs predictive of "nociceptive," "peripheral neuropathic," and "central" pain, this study provides some preliminary discriminative validity evidence for mechanisms-based classifications of musculoskeletal pain. Classification system validation requires the accumulation of validity evidence before their use in clinical practice can be recommended. Further studies are required to evaluate the construct and criterion validity of mechanisms-based classifications of musculoskeletal pain.

  6. The Assignment of American Society of Anesthesiologists Physical Status Classification for Adult Polytrauma Patients: Results From a Survey and Future Considerations.

    Science.gov (United States)

    Kuza, Catherine M; Hatzakis, George; Nahmias, Jeffry T

    2017-12-01

    The American Society of Anesthesiologists (ASA) physical status (PS) classification system assesses the preoperative health of patients. Previous studies demonstrated poor interrater reliability and variable ASA PS scores, especially in trauma scenarios. There are few studies that evaluated the assignment of ASA PS scores in trauma patients and no studies that evaluated ASA PS assignment in severely injured adult polytrauma patients. Our objective was to assess interrater reliability and identify sources of discrepancy among anesthesiologists and trauma surgeons in designating ASA PS scores to adult polytrauma patients. A link to an online survey containing questions assessing attitudes regarding ASA PS classification, demographic information, and 8 fictional trauma cases was e-mailed to anesthesiologists and trauma surgeons. The participants were asked to assign an ASA PS score to each scenario and explain their choice. Rater-versus-reference and interrater reliability, beyond that expected by chance, among respondents was analyzed using the Fleiss kappa analysis. A total of 349 participants completed the survey. All 8 cases had inconsistent ASA PS scores; several cases had scores ranging from I to VI and variable emergency (E) designations. Using weighted kappa (Kw) analysis for a subset of 201 respondents (101 trauma surgeons [S] and 100 anesthesiologists [A]), we found moderate (Kw = 0.63; SE = 0.024; 95% confidence interval, 0.594-0.666; P polytrauma patients. Although the ASA PS is used in some trauma risk stratification models, discrepancies of ASA PS scores assigned to trauma cases exist. Future modifications of the ASA PS guidelines should aim to improve the interrater reliability of ASA PS scores in trauma patients. Further studies are warranted to determine the value of the ASA PS score as a trauma prognostic metric.

  7. Atmospheric circulation classification comparison based on wildfires in Portugal

    Science.gov (United States)

    Pereira, M. G.; Trigo, R. M.

    2009-04-01

    Atmospheric circulation classifications are not a simple description of atmospheric states but a tool to understand and interpret the atmospheric processes and to model the relation between atmospheric circulation and surface climate and other related variables (Radan Huth et al., 2008). Classifications were initially developed with weather forecasting purposes, however with the progress in computer processing capability, new and more robust objective methods were developed and applied to large datasets prompting atmospheric circulation classification methods to one of the most important fields in synoptic and statistical climatology. Classification studies have been extensively used in climate change studies (e.g. reconstructed past climates, recent observed changes and future climates), in bioclimatological research (e.g. relating human mortality to climatic factors) and in a wide variety of synoptic climatological applications (e.g. comparison between datasets, air pollution, snow avalanches, wine quality, fish captures and forest fires). Likewise, atmospheric circulation classifications are important for the study of the role of weather in wildfire occurrence in Portugal because the daily synoptic variability is the most important driver of local weather conditions (Pereira et al., 2005). In particular, the objective classification scheme developed by Trigo and DaCamara (2000) to classify the atmospheric circulation affecting Portugal have proved to be quite useful in discriminating the occurrence and development of wildfires as well as the distribution over Portugal of surface climatic variables with impact in wildfire activity such as maximum and minimum temperature and precipitation. This work aims to present: (i) an overview the existing circulation classification for the Iberian Peninsula, and (ii) the results of a comparison study between these atmospheric circulation classifications based on its relation with wildfires and relevant meteorological

  8. A Classification System for Recurrent Ameloblastoma of the Jaws ...

    African Journals Online (AJOL)

    This paper reviewed the clinicopathologic presentation of recurrent ameloblastoma in 30 Nigerian patients at three tertiary referral centers with the sole objective of developing a classification system. Most recurrences occurred in patients in their 3rd decade of life (20-29years) and males were more frequently affected than ...

  9. 2012 Provisional classification criteria for polymyalgia rheumatica

    DEFF Research Database (Denmark)

    Dasgupta, Bhaskar; Cimmino, Marco A; Kremers, Hilal Maradit

    2012-01-01

    The objective of this study was to develop European League Against Rheumatism/American College of Rheumatology classification criteria for polymyalgia rheumatica (PMR). Candidate criteria were evaluated in a 6-month prospective cohort study of 125 patients with new-onset PMR and 169 non-PMR compa...

  10. PET imaging in patients with Modic changes

    DEFF Research Database (Denmark)

    Albert, Hanne; Pedersen, Henrik; Manniche, Claus

    2009-01-01

    associated with low back pain (LBP). MC type 1 appear to be inflammation on MRI, and histological and biochemical findings make it highly likely that an inflammation is present. Though MC is painful no known treatment is available, and it is unknown which entities affect the progress or regress of MC....... The changes observed on MRI are slow and take months to develop, but faster changes in the metabolism might provide a platform for monitoring patients. PATIENTS, METHODS: Patients from The Back Centre Funen, with low back pain in the area of L1 to S1, MC type 1 in L1 to L5, and a previous herniated lumbar...... disc. All patients had a PET scan using FDG (18F-fluorodeoxyglucose) as tracer. RESULTS: Included in the study were 11 patients, 4 women and 7 men, mean age 48.1 year (range 20-65). All MC were situated in the vertebrae both above and below the previously herniated disc/discs. Ten patients had MC at 1...

  11. A Comprehensive Analysis of the SRS-Schwab Adult Spinal Deformity Classification and Confounding Variables

    DEFF Research Database (Denmark)

    Hallager, Dennis Winge; Hansen, Lars Valentin; Dragsted, Casper Rokkjær

    2016-01-01

    STUDY DESIGN: Cross-sectional analyses on a consecutive, prospective cohort. OBJECTIVE: To evaluate the ability of the Scoliosis Research Society (SRS)-Schwab Adult Spinal Deformity Classification to group patients by widely used health-related quality-of-life (HRQOL) scores and examine possible...... to confounding. However, age group and aetiology had individual significant effects. CONCLUSION: The SRS-Schwab sagittal modifiers reliably grouped patients graded 0 versus + / +  + according to the most widely used HRQOL scores and the effects of increasing grade level on odds for worse ODI scores remained...... confounding variables. SUMMARY OF BACKGROUND DATA: The SRS-Schwab Adult Spinal Deformity Classification includes sagittal modifiers considered important for HRQOL and the clinical impact of the classification has been validated in patients from the International Spine Study Group database; however, equivocal...

  12. SU-F-R-22: Malignancy Classification for Small Pulmonary Nodules with Radiomics and Logistic Regression

    Energy Technology Data Exchange (ETDEWEB)

    Huang, W; Tu, S [Chang Gung University, Kwei-shan, Tao-Yuan, Taiwan (China)

    2016-06-15

    Purpose: We conducted a retrospective study of Radiomics research for classifying malignancy of small pulmonary nodules. A machine learning algorithm of logistic regression and open research platform of Radiomics, IBEX (Imaging Biomarker Explorer), were used to evaluate the classification accuracy. Methods: The training set included 100 CT image series from cancer patients with small pulmonary nodules where the average diameter is 1.10 cm. These patients registered at Chang Gung Memorial Hospital and received a CT-guided operation of lung cancer lobectomy. The specimens were classified by experienced pathologists with a B (benign) or M (malignant). CT images with slice thickness of 0.625 mm were acquired from a GE BrightSpeed 16 scanner. The study was formally approved by our institutional internal review board. Nodules were delineated and 374 feature parameters were extracted from IBEX. We first used the t-test and p-value criteria to study which feature can differentiate between group B and M. Then we implemented a logistic regression algorithm to perform nodule malignancy classification. 10-fold cross-validation and the receiver operating characteristic curve (ROC) were used to evaluate the classification accuracy. Finally hierarchical clustering analysis, Spearman rank correlation coefficient, and clustering heat map were used to further study correlation characteristics among different features. Results: 238 features were found differentiable between group B and M based on whether their statistical p-values were less than 0.05. A forward search algorithm was used to select an optimal combination of features for the best classification and 9 features were identified. Our study found the best accuracy of classifying malignancy was 0.79±0.01 with the 10-fold cross-validation. The area under the ROC curve was 0.81±0.02. Conclusion: Benign nodules may be treated as a malignant tumor in low-dose CT and patients may undergo unnecessary surgeries or treatments. Our

  13. Sample size and classification error for Bayesian change-point models with unlabelled sub-groups and incomplete follow-up.

    Science.gov (United States)

    White, Simon R; Muniz-Terrera, Graciela; Matthews, Fiona E

    2018-05-01

    Many medical (and ecological) processes involve the change of shape, whereby one trajectory changes into another trajectory at a specific time point. There has been little investigation into the study design needed to investigate these models. We consider the class of fixed effect change-point models with an underlying shape comprised two joined linear segments, also known as broken-stick models. We extend this model to include two sub-groups with different trajectories at the change-point, a change and no change class, and also include a missingness model to account for individuals with incomplete follow-up. Through a simulation study, we consider the relationship of sample size to the estimates of the underlying shape, the existence of a change-point, and the classification-error of sub-group labels. We use a Bayesian framework to account for the missing labels, and the analysis of each simulation is performed using standard Markov chain Monte Carlo techniques. Our simulation study is inspired by cognitive decline as measured by the Mini-Mental State Examination, where our extended model is appropriate due to the commonly observed mixture of individuals within studies who do or do not exhibit accelerated decline. We find that even for studies of modest size ( n = 500, with 50 individuals observed past the change-point) in the fixed effect setting, a change-point can be detected and reliably estimated across a range of observation-errors.

  14. DNA methylation for subtype classification and prediction of treatment outcome in patients with childhood acute lymphoblastic leukemia

    DEFF Research Database (Denmark)

    Milani, Lili; Lundmark, Anders; Kiialainen, Anna

    2010-01-01

    Despite improvements in the prognosis of childhood acute lymphoblastic leukemia (ALL), subgroups of patients would benefit from alternative treatment approaches. Our aim was to identify genes with DNA methylation profiles that could identify such groups. We determined the methylation levels of 1320...... CpG sites in regulatory regions of 416 genes in cells from 401 children diagnosed with ALL. Hierarchical clustering of 300 CpG sites distinguished between T-lineage ALL and B-cell precursor (BCP) ALL and between the main cytogenetic subtypes of BCP ALL. It also stratified patients with high...... ALL and gene sets that discriminated between subtypes of ALL and between ALL and controls in pairwise classification analyses. We also identified 20 individual genes with DNA methylation levels that predicted relapse of leukemia. Thus, methylation analysis should be explored as a method to improve...

  15. Intra- and interobserver reliability of glenoid fracture classifications by Ideberg, Euler and AO.

    Science.gov (United States)

    Gilbert, F; Eden, L; Meffert, R; Konietschke, F; Lotz, J; Bauer, L; Staab, W

    2018-03-27

    Representing 3%-5% of shoulder girdle injuries scapula fractures are rare. Furthermore, approximately 1% of scapula fractures are intraarticularfractures of the glenoid fossa. Because of uncertain fracture morphology and limited experience, the treatment of glenoid fossa fractures is difficult. The glenoid fracture classification by Ideberg (1984) and Euler (1996) is still commonly used in literature. In 2013 a new glenoid fracture classification was introduced by the AO. The purpose of this study was to examine the new AO classification in clinical practice in comparison with the classifications by Ideberg and Euler. In total CT images of 84 patients with glenoid fossa fractures from 2005 to 2018 were included. Parasagittal, paracoronary and axial reconstructions were examined according to the classifications of Ideberg, Euler and the AO by 3 investigators (orthopedic surgeon, radiologist, student of medicine) at three individual time settings. Inter- and intraobserver reliability of the three classification systems were ascertained by computing Inter- and Intraclass (ICCs) correlation coefficients using Spearman's rank correlation coefficient, 95%-confidence intervals as well as F-tests for correlation coefficients. Inter- and intraobserver reliability for the AO classification showed a perspicuous coherence (R = 0.74 and R = 0.79). Low to moderate intraobserver reliability for Ideberg (R = 0.46) and Euler classification (R = 0.41) was found. Furthermore, data show a low Interobserver reliability for both Ideberg and Euler classification (R reliability using AO is significantly higher than those using Ideberg and Euler (p reliable grading of glenoid fossa fractures with high inter- and intraobserver reliability in 84 patients using CT images. It should possibly be applied in order to enable a valid, reliable and consistent academic description of glenoid fossa fractures. The established classifications by Euler and Ideberg are not capable of

  16. Classification differences and maternal mortality

    DEFF Research Database (Denmark)

    Salanave, B; Bouvier-Colle, M H; Varnoux, N

    1999-01-01

    OBJECTIVES: To compare the ways maternal deaths are classified in national statistical offices in Europe and to evaluate the ways classification affects published rates. METHODS: Data on pregnancy-associated deaths were collected in 13 European countries. Cases were classified by a European panel....... This change was substantial in three countries (P statistical offices appeared to attribute fewer deaths to obstetric causes. In the other countries, no differences were detected. According to official published data, the aggregated maternal mortality rate for participating countries was 7.7 per...... of experts into obstetric or non-obstetric causes. An ICD-9 code (International Classification of Diseases) was attributed to each case. These were compared to the codes given in each country. Correction indices were calculated, giving new estimates of maternal mortality rates. SUBJECTS: There were...

  17. Hand eczema classification

    DEFF Research Database (Denmark)

    Diepgen, T L; Andersen, Klaus Ejner; Brandao, F M

    2008-01-01

    of the disease is rarely evidence based, and a classification system for different subdiagnoses of hand eczema is not agreed upon. Randomized controlled trials investigating the treatment of hand eczema are called for. For this, as well as for clinical purposes, a generally accepted classification system...... A classification system for hand eczema is proposed. Conclusions It is suggested that this classification be used in clinical work and in clinical trials....

  18. DNA methylation changes separate allergic patients from healthy controls and may reflect altered CD4+ T-cell population structure.

    Directory of Open Access Journals (Sweden)

    Colm E Nestor

    2014-01-01

    Full Text Available Altered DNA methylation patterns in CD4(+ T-cells indicate the importance of epigenetic mechanisms in inflammatory diseases. However, the identification of these alterations is complicated by the heterogeneity of most inflammatory diseases. Seasonal allergic rhinitis (SAR is an optimal disease model for the study of DNA methylation because of its well-defined phenotype and etiology. We generated genome-wide DNA methylation (N(patients = 8, N(controls = 8 and gene expression (N(patients = 9, Ncontrols = 10 profiles of CD4(+ T-cells from SAR patients and healthy controls using Illumina's HumanMethylation450 and HT-12 microarrays, respectively. DNA methylation profiles clearly and robustly distinguished SAR patients from controls, during and outside the pollen season. In agreement with previously published studies, gene expression profiles of the same samples failed to separate patients and controls. Separation by methylation (N(patients = 12, N(controls = 12, but not by gene expression (N(patients = 21, N(controls = 21 was also observed in an in vitro model system in which purified PBMCs from patients and healthy controls were challenged with allergen. We observed changes in the proportions of memory T-cell populations between patients (N(patients = 35 and controls (N(controls = 12, which could explain the observed difference in DNA methylation. Our data highlight the potential of epigenomics in the stratification of immune disease and represents the first successful molecular classification of SAR using CD4(+ T cells.

  19. Classification and pharmacological treatment of preschool wheezing: changes since 2008

    DEFF Research Database (Denmark)

    Brand, P. L. P.; Caudri, D.; Eber, E.

    2014-01-01

    Since the publication of the European Respiratory Society Task Force report in 2008, significant new evidence has become available on the classification and management of preschool wheezing disorders. In this report, an international consensus group reviews this new evidence and proposes some......, with scheduled close follow-up to monitor treatment effect. The group recommends discontinuing treatment if there is no benefit and taking favourable natural history into account when making decisions about long-term therapy. Oral corticosteroids are not indicated in mild-to-moderate acute wheeze episodes...

  20. Classification of the web

    DEFF Research Database (Denmark)

    Mai, Jens Erik

    2004-01-01

    This paper discusses the challenges faced by investigations into the classification of the Web and outlines inquiries that are needed to use principles for bibliographic classification to construct classifications of the Web. This paper suggests that the classification of the Web meets challenges...... that call for inquiries into the theoretical foundation of bibliographic classification theory....

  1. Security classification of information

    Energy Technology Data Exchange (ETDEWEB)

    Quist, A.S.

    1993-04-01

    This document is the second of a planned four-volume work that comprehensively discusses the security classification of information. The main focus of Volume 2 is on the principles for classification of information. Included herein are descriptions of the two major types of information that governments classify for national security reasons (subjective and objective information), guidance to use when determining whether information under consideration for classification is controlled by the government (a necessary requirement for classification to be effective), information disclosure risks and benefits (the benefits and costs of classification), standards to use when balancing information disclosure risks and benefits, guidance for assigning classification levels (Top Secret, Secret, or Confidential) to classified information, guidance for determining how long information should be classified (classification duration), classification of associations of information, classification of compilations of information, and principles for declassifying and downgrading information. Rules or principles of certain areas of our legal system (e.g., trade secret law) are sometimes mentioned to .provide added support to some of those classification principles.

  2. Ultrasonographic characteristics and BI-RADS-US classification of BRCA1 mutation-associated breast cancer in Guangxi, China.

    Science.gov (United States)

    Li, Cheng; Liu, Junjie; Wang, Sida; Chen, Yuanyuan; Yuan, Zhigang; Zeng, Jian; Li, Zhixian

    2015-01-01

    To retrospectively analyze and compare the ultrasonographic characteristics and BI-RADS-US classification between patients with BRCA1 mutation-associated breast cancer and those without BRCA1 gene mutation in Guangxi, China. The study was performed in 36 lesions from 34 BRCA1 mutation-associated breast cancer patients. A total of 422 lesions from 422 breast cancer patients without BRCA1 mutations served as control group. The comparison of the ultrasonographic features and BI-RADS-US classification between two the groups were reviewed. More complex inner echo was disclosed in BRCA1 mutation-associated breast cancer patients (x(2) = 4.741, P = 0.029). The BI-RADS classification of BRCA1 mutation-associated breast cancer was lower (U = 6094.0, P = 0.022). BRCA1 mutation-associated breast cancer frequently displays as microlobulated margin and complex echo. It also shows more benign characteristics in morphology, and the BI-RADS classification is prone to be underestimated.

  3. Deep learning application: rubbish classification with aid of an android device

    Science.gov (United States)

    Liu, Sijiang; Jiang, Bo; Zhan, Jie

    2017-06-01

    Deep learning is a very hot topic currently in pattern recognition and artificial intelligence researches. Aiming at the practical problem that people usually don't know correct classifications some rubbish should belong to, based on the powerful image classification ability of the deep learning method, we have designed a prototype system to help users to classify kinds of rubbish. Firstly the CaffeNet Model was adopted for our classification network training on the ImageNet dataset, and the trained network was deployed on a web server. Secondly an android app was developed for users to capture images of unclassified rubbish, upload images to the web server for analyzing backstage and retrieve the feedback, so that users can obtain the classification guide by an android device conveniently. Tests on our prototype system of rubbish classification show that: an image of one single type of rubbish with origin shape can be better used to judge its classification, while an image containing kinds of rubbish or rubbish with changed shape may fail to help users to decide rubbish's classification. However, the system still shows promising auxiliary function for rubbish classification if the network training strategy can be optimized further.

  4. 2012 provisional classification criteria for polymyalgia rheumatica

    DEFF Research Database (Denmark)

    Dasgupta, Bhaskar; Cimmino, Marco A; Maradit-Kremers, Hilal

    2012-01-01

    The objective of this study was to develop EULAR/ACR classification criteria for polymyalgia rheumatica (PMR). Candidate criteria were evaluated in a 6-month prospective cohort study of 125 patients with new onset PMR and 169 non-PMR comparison subjects with conditions mimicking PMR. A scoring al...

  5. CLASSIFICATION, DISTRIBUTION AND PRODUCTION OF KNOWLEDGE: THEORETICAL SUMMARY

    Directory of Open Access Journals (Sweden)

    R. A. Tchupin

    2013-01-01

    Full Text Available The paper is devoted to systemizing the main theoretical approaches to classification, distribution and production of knowledge in the global economy. The author focuses on F. Machlup’s knowledge classification and the concept of useful knowledge by J. Mokyr.The interpersonal and public channels of communication and acquisition of knowledge are observed taking into consideration the total changes caused by transition from industrial to postindustrial economy. The paper provides a comparative analysis of the given model and alternative concepts of knowledge generation: finalization of science, strategic research, post-normal science, academic capitalism, post-academic science, and the triple helix concept. The author maintains that the current concepts of knowledge generation reflect the fact of transformation of modern institutional technical environment due to the global technological changes, and increasing contribution of knowledge to the economic development. Accordingly, the roles of the main participants of the given process are changing along with the growing integration of education and science, state and businesses. 

  6. Problems of classification in the family Paramyxoviridae.

    Science.gov (United States)

    Rima, Bert; Collins, Peter; Easton, Andrew; Fouchier, Ron; Kurath, Gael; Lamb, Robert A; Lee, Benhur; Maisner, Andrea; Rota, Paul; Wang, Lin-Fa

    2018-05-01

    A number of unassigned viruses in the family Paramyxoviridae need to be classified either as a new genus or placed into one of the seven genera currently recognized in this family. Furthermore, numerous new paramyxoviruses continue to be discovered. However, attempts at classification have highlighted the difficulties that arise by applying historic criteria or criteria based on sequence alone to the classification of the viruses in this family. While the recent taxonomic change that elevated the previous subfamily Pneumovirinae into a separate family Pneumoviridae is readily justified on the basis of RNA dependent -RNA polymerase (RdRp or L protein) sequence motifs, using RdRp sequence comparisons for assignment to lower level taxa raises problems that would require an overhaul of the current criteria for assignment into genera in the family Paramyxoviridae. Arbitrary cut off points to delineate genera and species would have to be set if classification was based on the amino acid sequence of the RdRp alone or on pairwise analysis of sequence complementarity (PASC) of all open reading frames (ORFs). While these cut-offs cannot be made consistent with the current classification in this family, resorting to genus-level demarcation criteria with additional input from the biological context may afford a way forward. Such criteria would reflect the increasingly dynamic nature of virus taxonomy even if it would require a complete revision of the current classification.

  7. A risk informed safety classification for a Nordic NPP

    International Nuclear Information System (INIS)

    Jaenkaelae, K.

    2002-01-01

    The report describes a study to develop a safety classification proposal or classi- fication recommendations based on risks for selected equipment of a nuclear power plant. The application plant in this work is Loviisa NPP unit 1. The safety classification proposals are to be considered as an exercise in this pilot study and do not necessarily represent final proposals in a real situation. Comparisons to original safety classifications and technical specifications were made. The study concludes that it is possible to change safety classes or safety signifi- cances as considered in technical specifications and in in-service-inspections into both directions without endangering the safety or even by improving the safety. (au)

  8. Hazard classification methodology

    International Nuclear Information System (INIS)

    Brereton, S.J.

    1996-01-01

    This document outlines the hazard classification methodology used to determine the hazard classification of the NIF LTAB, OAB, and the support facilities on the basis of radionuclides and chemicals. The hazard classification determines the safety analysis requirements for a facility

  9. Classification of breast tissue using a laboratory system for small-angle x-ray scattering (SAXS)

    International Nuclear Information System (INIS)

    Sidhu, S; Siu, K K W; Falzon, G; Hart, S A; Fox, J G; Lewis, R A

    2011-01-01

    Structural changes in breast tissue at the nanometre scale have been shown to differentiate between tissue types using synchrotron SAXS techniques. Classification of breast tissues using information acquired from a laboratory SAXS camera source could possibly provide a means of adopting SAXS as a viable diagnostic procedure. Tissue samples were obtained from surgical waste from 66 patients and structural components of the tissues were examined between q = 0.25 and 2.3 nm -1 . Principal component analysis showed that the amplitude of the fifth-order axial Bragg peak, the magnitude of the integrated intensity and the full-width at half-maximum of the fat peak were significantly different between tissue types. A discriminant analysis showed that excellent classification can be achieved; however, only 30% of the tissue samples provided the 16 variables required for classification. This suggests that the presence of disease is represented by a combination of factors, rather than one specific trait. A closer examination of the amorphous scattering intensity showed not only a trend of increased scattering intensity with disease severity, but also a corresponding decrease in the size of the scatterers contributing to this intensity.

  10. SU-D-207B-02: Early Grade Classification in Meningioma Patients Combining Radiomics and Semantics Data

    International Nuclear Information System (INIS)

    Coroller, T; Bi, W; Abedalthagafi, M; Aizer, A; Wu, W; Greenwald, N; Beroukhim, R; Al-Mefty, O; Santagata, S; Dunn, I; Alexander, B; Huang, R; Aerts, H

    2016-01-01

    Purpose: The clinical management of meningioma is guided by its grade and biologic behavior. Currently, diagnosis of tumor grade follows surgical resection and histopathologic review. Reliable techniques for pre-operative determination of tumor behavior are needed. We investigated the association between imaging features extracted from preoperative gadolinium-enhanced T1-weighted MRI and meningioma grade. Methods: We retrospectively examined the pre-operative MRI for 139 patients with de novo WHO grade I (63%) and grade II (37%) meningiomas. We investigated the predictive power of ten semantic radiologic features as determined by a neuroradiologist, fifteen radiomic features, and tumor location. Conventional (volume and diameter) imaging features were added for comparison. AUC was computed for continuous and χ 2 for discrete variables. Classification was done using random forest. Performance was evaluated using cross validation (1000 iterations, 75% training and 25% validation). All p-values were adjusted for multiple testing. Results: Significant association was observed between meningioma grade and tumor location (p<0.001) and two semantic features including intra-tumoral heterogeneity (p<0.001) and overt hemorrhage (p=0.01). Conventional (AUC 0.61–0.67) and eleven radiomic (AUC 0.60–0.70) features were significant from random (p<0.05, Noether test). Median AUC values for classification of tumor grade were 0.57, 0.71, 0.72 and 0.77 respectively for conventional, radiomic, location, and semantic features after using random forest. By combining all imaging data (semantic, radiomic, and location), the median AUC was 0.81, which offers superior predicting power to that of conventional imaging descriptors for meningioma as well as radiomic features alone (p<0.05, permutation test). Conclusion: We demonstrate a strong association between radiologic features and meningioma grade. Pre-operative prediction of tumor behavior based on imaging features offers promise

  11. SU-D-207B-02: Early Grade Classification in Meningioma Patients Combining Radiomics and Semantics Data

    Energy Technology Data Exchange (ETDEWEB)

    Coroller, T; Bi, W; Abedalthagafi, M; Aizer, A; Wu, W; Greenwald, N; Beroukhim, R; Al-Mefty, O; Santagata, S; Dunn, I; Alexander, B; Huang, R; Aerts, H [Dana Farber Cancer Institute, Brigham and Womens Hospital, Harvard Medical School (United States)

    2016-06-15

    Purpose: The clinical management of meningioma is guided by its grade and biologic behavior. Currently, diagnosis of tumor grade follows surgical resection and histopathologic review. Reliable techniques for pre-operative determination of tumor behavior are needed. We investigated the association between imaging features extracted from preoperative gadolinium-enhanced T1-weighted MRI and meningioma grade. Methods: We retrospectively examined the pre-operative MRI for 139 patients with de novo WHO grade I (63%) and grade II (37%) meningiomas. We investigated the predictive power of ten semantic radiologic features as determined by a neuroradiologist, fifteen radiomic features, and tumor location. Conventional (volume and diameter) imaging features were added for comparison. AUC was computed for continuous and χ{sup 2} for discrete variables. Classification was done using random forest. Performance was evaluated using cross validation (1000 iterations, 75% training and 25% validation). All p-values were adjusted for multiple testing. Results: Significant association was observed between meningioma grade and tumor location (p<0.001) and two semantic features including intra-tumoral heterogeneity (p<0.001) and overt hemorrhage (p=0.01). Conventional (AUC 0.61–0.67) and eleven radiomic (AUC 0.60–0.70) features were significant from random (p<0.05, Noether test). Median AUC values for classification of tumor grade were 0.57, 0.71, 0.72 and 0.77 respectively for conventional, radiomic, location, and semantic features after using random forest. By combining all imaging data (semantic, radiomic, and location), the median AUC was 0.81, which offers superior predicting power to that of conventional imaging descriptors for meningioma as well as radiomic features alone (p<0.05, permutation test). Conclusion: We demonstrate a strong association between radiologic features and meningioma grade. Pre-operative prediction of tumor behavior based on imaging features offers

  12. Classification of Hypertrophy of Labia Minora: Consideration of a Multiple Component Approach.

    Science.gov (United States)

    González, Pablo I

    2015-11-01

    Labia minora hypertrophy of unknown and under-reported incidence in the general population is considered a variant of normal anatomy. Its origin is multi-factorial including genetic, hormonal, and infectious factors, and voluntary elongation of the labiae minorae in some cultures. Consults with patients bothered by this condition have been increasing with patients complaining of poor aesthetics and symptoms such as difficulty with vaginal secretions, vulvovaginitis, chronic irritation, and superficial dyspareunia, all of which can have a negative effect on these patients' sexuality and self esteem. Surgical management of labial hypertrophy is an option for women with these physical complaints or aesthetic issues. Labia minora hypertrophy can consist of multiple components, including the clitoral hood, lateral prepuce, frenulum, and the body of the labia minora. To date, there is not a consensus in the literature with respect to the classification and definition of varying grades of hypertrophy, aside from measurement of the length in centimeters. In order to offer patients the most appropriate surgical technique, an objective and understandable classification that can be used as part of the preoperative evaluation is necessary. Such a classification should have the aim of offering patients the best cosmetic and functional results with the fewest complications.

  13. Histologic responses in sixty multibacillary leprosy patients inoculated with autoclaved Mycobacterium leprae and live BCG.

    Science.gov (United States)

    Meyers, W M; McDougall, A C; Fleury, R N; Neves, R; Reyes, O; Binford, C H

    1988-06-01

    Sixty lepromatous or borderline lepromatous patients were submitted to immunotherapy with a mixture of autoclaved Mycobacterium leprae and BCG. The histopathologic findings in skin biopsy specimens taken before and after immunotherapy were evaluated independently by six histopathologists in a workshop setting. Their pooled observations on diagnosis and classification were analyzed to assess the histopathologic changes following various periods of immunotherapy. Expressing the results as the average value of five to six independent observations, there were changes in classification of reversal or upgrading toward the tuberculoid end of the leprosy spectrum in 90.5% of the patients initially classified as lepromatous (LL), and in 83.3% of those initially classified as borderline lepromatous (BL). The histopathologic findings amply support the clinical, bacteriologic and immunological changes following immunotherapy from LL or BL, to BL, mid-borderline (BB) or even borderline tuberculoid (BT) leprosy.

  14. Congenital muscular dystrophies--problems of classification.

    Science.gov (United States)

    Lenard, H G

    1991-04-01

    The classification of congenital muscular dystrophies (CMD), based on perceived clinical and morphological similarities or differences, is controversial. CMD without cerebral involvement has sometimes been divided into a mild and a severe form. This distinction is, however, arbitrary and not uncontested. Whether Ullrich's disease, formerly called atonic-sclerotic dystrophy, is a disease entity and if so, whether it is a primary muscle disorder, is uncertain. CMD without cerebral involvement is inherited in an autosomal recessive fashion in the great majority of cases. CMDs with cerebral involvement are usually classified into at least three forms: the Fukuyama type of CMD, occurring almost exclusively in Japanese patients; CMD with hypomyelination, sometimes also called the occidental type of cerebromuscular dystrophy; and Walker-Warburg syndrome. Muscle-eye-brain disease, described in a number of Finnish patients, may or may not belong in this last category. In CMD with cerebral involvement inheritance is also autosomal recessive. It is possible that single sporadic cases are phenocopies due to infectious or other exogenous causes. Reports of clinical and morphological findings from an increasing number of patients show a high degree of variability within and, on the other hand, certain similarities between the forms of CMD with cerebral involvement. In addition, neuroradiological changes are also found with increasing frequency in CMD patients without clinical neuropsychological abnormalities. It is not unreasonable to speculate that molecular genetic techniques will reveal in the near future a variable defect in one gene locus or defects in a few gene loci as the cause of the various clinical forms of CMDs.

  15. Two Influential Primate Classifications Logically Aligned.

    Science.gov (United States)

    Franz, Nico M; Pier, Naomi M; Reeder, Deeann M; Chen, Mingmin; Yu, Shizhuo; Kianmajd, Parisa; Bowers, Shawn; Ludäscher, Bertram

    2016-07-01

    Classifications and phylogenies of perceived natural entities change in the light of new evidence. Taxonomic changes, translated into Code-compliant names, frequently lead to name:meaning dissociations across succeeding treatments. Classification standards such as the Mammal Species of the World (MSW) may experience significant levels of taxonomic change from one edition to the next, with potential costs to long-term, large-scale information integration. This circumstance challenges the biodiversity and phylogenetic data communities to express taxonomic congruence and incongruence in ways that both humans and machines can process, that is, to logically represent taxonomic alignments across multiple classifications. We demonstrate that such alignments are feasible for two classifications of primates corresponding to the second and third MSW editions. Our approach has three main components: (i) use of taxonomic concept labels, that is name sec. author (where sec. means according to), to assemble each concept hierarchy separately via parent/child relationships; (ii) articulation of select concepts across the two hierarchies with user-provided Region Connection Calculus (RCC-5) relationships; and (iii) the use of an Answer Set Programming toolkit to infer and visualize logically consistent alignments of these input constraints. Our use case entails the Primates sec. Groves (1993; MSW2-317 taxonomic concepts; 233 at the species level) and Primates sec. Groves (2005; MSW3-483 taxonomic concepts; 376 at the species level). Using 402 RCC-5 input articulations, the reasoning process yields a single, consistent alignment and 153,111 Maximally Informative Relations that constitute a comprehensive meaning resolution map for every concept pair in the Primates sec. MSW2/MSW3. The complete alignment, and various partitions thereof, facilitate quantitative analyses of name:meaning dissociation, revealing that nearly one in three taxonomic names are not reliable across treatments

  16. MSCT follow-up in malignant lymphoma. Comparison of manual linear measurements with semi-automated lymph node analysis for therapy response classification

    International Nuclear Information System (INIS)

    Wessling, J.; Puesken, M.; Kohlhase, N.; Persigehl, T.; Mesters, R.; Heindel, W.; Buerke, B.; Koch, R.

    2012-01-01

    Purpose: Assignment of semi-automated lymph node analysis compared to manual measurements for therapy response classification of malignant lymphoma in MSCT. Materials and Methods: MSCT scans of 63 malignant lymphoma patients before and after 2 cycles of chemotherapy (307 target lymph nodes) were evaluated. The long axis diameter (LAD), short axis diameter (SAD) and bi-dimensional WHO were determined manually and semi-automatically. The time for manual and semi-automatic segmentation was evaluated. The ref. standard response was defined as the mean relative change across all manual and semi-automatic measurements (mean manual/semi-automatic LAD, SAD, semi-automatic volume). Statistical analysis encompassed t-test and McNemar's test for clustered data. Results: Response classification per lymph node revealed semi-automated volumetry and bi-dimensional WHO to be significantly more accurate than manual linear metric measurements. Response classification per patient based on RECIST revealed more patients to be correctly classified by semi-automatic measurements, e.g. 96.0 %/92.9 % (WHO bi-dimensional/volume) compared to 85.7/84.1 % for manual LAD and SAD, respectively (mean reduction in misclassified patients of 9.95 %). Considering the use of correction tools, the time expenditure for lymph node segmentation (29.7 ± 17.4 sec) was the same as with the manual approach (29.1 ± 14.5 sec). Conclusion: Semi-automatically derived 'lymph node volume' and 'bi-dimensional WHO' significantly reduce the number of misclassified patients in the CT follow-up of malignant lymphoma by at least 10 %. However, lymph node volumetry does not outperform bi-dimensional WHO. (orig.)

  17. MSCT follow-up in malignant lymphoma. Comparison of manual linear measurements with semi-automated lymph node analysis for therapy response classification

    Energy Technology Data Exchange (ETDEWEB)

    Wessling, J.; Puesken, M.; Kohlhase, N.; Persigehl, T.; Mesters, R.; Heindel, W.; Buerke, B. [Muenster Univ. (Germany). Dept. of Clinical Radiology; Koch, R. [Muenster Univ. (Germany). Inst. of Biostatistics and Clinical Research

    2012-09-15

    Purpose: Assignment of semi-automated lymph node analysis compared to manual measurements for therapy response classification of malignant lymphoma in MSCT. Materials and Methods: MSCT scans of 63 malignant lymphoma patients before and after 2 cycles of chemotherapy (307 target lymph nodes) were evaluated. The long axis diameter (LAD), short axis diameter (SAD) and bi-dimensional WHO were determined manually and semi-automatically. The time for manual and semi-automatic segmentation was evaluated. The ref. standard response was defined as the mean relative change across all manual and semi-automatic measurements (mean manual/semi-automatic LAD, SAD, semi-automatic volume). Statistical analysis encompassed t-test and McNemar's test for clustered data. Results: Response classification per lymph node revealed semi-automated volumetry and bi-dimensional WHO to be significantly more accurate than manual linear metric measurements. Response classification per patient based on RECIST revealed more patients to be correctly classified by semi-automatic measurements, e.g. 96.0 %/92.9 % (WHO bi-dimensional/volume) compared to 85.7/84.1 % for manual LAD and SAD, respectively (mean reduction in misclassified patients of 9.95 %). Considering the use of correction tools, the time expenditure for lymph node segmentation (29.7 {+-} 17.4 sec) was the same as with the manual approach (29.1 {+-} 14.5 sec). Conclusion: Semi-automatically derived 'lymph node volume' and 'bi-dimensional WHO' significantly reduce the number of misclassified patients in the CT follow-up of malignant lymphoma by at least 10 %. However, lymph node volumetry does not outperform bi-dimensional WHO. (orig.)

  18. Biased binomial assessment of cross-validated estimation of classification accuracies illustrated in diagnosis predictions.

    Science.gov (United States)

    Noirhomme, Quentin; Lesenfants, Damien; Gomez, Francisco; Soddu, Andrea; Schrouff, Jessica; Garraux, Gaëtan; Luxen, André; Phillips, Christophe; Laureys, Steven

    2014-01-01

    Multivariate classification is used in neuroimaging studies to infer brain activation or in medical applications to infer diagnosis. Their results are often assessed through either a binomial or a permutation test. Here, we simulated classification results of generated random data to assess the influence of the cross-validation scheme on the significance of results. Distributions built from classification of random data with cross-validation did not follow the binomial distribution. The binomial test is therefore not adapted. On the contrary, the permutation test was unaffected by the cross-validation scheme. The influence of the cross-validation was further illustrated on real-data from a brain-computer interface experiment in patients with disorders of consciousness and from an fMRI study on patients with Parkinson disease. Three out of 16 patients with disorders of consciousness had significant accuracy on binomial testing, but only one showed significant accuracy using permutation testing. In the fMRI experiment, the mental imagery of gait could discriminate significantly between idiopathic Parkinson's disease patients and healthy subjects according to the permutation test but not according to the binomial test. Hence, binomial testing could lead to biased estimation of significance and false positive or negative results. In our view, permutation testing is thus recommended for clinical application of classification with cross-validation.

  19. Validation of a new classification system for interprosthetic femoral fractures.

    Science.gov (United States)

    Pires, Robinson Esteves Santos; Silveira, Marcelo Peixoto Sena; Resende, Alessandra Regina da Silva; Junior, Egidio Oliveira Santana; Campos, Tulio Vinicius Oliveira; Santos, Leandro Emilio Nascimento; Balbachevsky, Daniel; Andrade, Marco Antônio Percope de

    2017-07-01

    Interprosthetic femoral fracture (IFF) incidence is gradually increasing as the population is progressively ageing. However, treatment remains challenging due to several contributing factors, such as poor bone quality, patient comorbidities, small interprosthetic fragment, and prostheses instability. An effective and specific classification system is essential to optimize treatment management, therefore diminishing complication rates. This study aims to validate a previously described classification system for interprosthetic femoral fractures. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Functional mental capacity, treatment as usual and time: magnitude of change in secure hospital patients with major mental illness.

    Science.gov (United States)

    Dornan, Julieanne; Kennedy, Miriam; Garland, Jackie; Rutledge, Emer; Kennedy, Harry G

    2015-10-14

    Decision making ability can change with time, depending on mental or physical health. Little is known about the factors that determine this change and the relationship of capacity to time. As a pilot for studies using functional mental capacities as an outcome measure, we sought to quantify this relationship measuring change over time using competence assessment tools, and rating scales for symptoms and global function. We assessed 37 inpatients in a secure psychiatric hospital. All patients met the diagnostic and statistical manual of mental disorders-fourth edition and International classification of diseases, 10th edition criteria for an Axis 1 mental illness, all with psychosis. Patients were interviewed twice a mean of 323 days apart (median 176 days range 17-1221 days). The MacArthur competence assessment tools for consent to treatment (MacCAT-T) and fitness to plead (MacCAT-FP) were used to quantify functional capacity along with the Positive and Negative Syndrome Scale (PANSS) and global assessment of function (GAF) scale. A comparison was also made between those patients prescribed clozapine in comparison to other antipsychotics. The number judged by treating psychiatrists to lack capacity either to make a treatment choice or to plead in court fell from 35 to 8%. Change was greatest for those admitted within the previous 9 months. The measures of capacity improved between time 1 and time 2 for both consent to treatment and fitness to plead. The measures of capacity improved with positive symptoms within the PANSS and with GAF scores. Those with shorter lengths of stay at baseline had the greatest improvements in the MacCAT-FP scores. Effect sizes were medium or large (0.3-0.7+). As expected, patients prescribed clozapine had larger changes in functional mental capacities and larger effect sizes than those prescribed other psychotropics. The results show a strong relationship between the clinicians' assessment of capacity and structured rating scales. We

  1. Association between gastric cancer and the Kyoto classification of gastritis.

    Science.gov (United States)

    Shichijo, Satoki; Hirata, Yoshihiro; Niikura, Ryota; Hayakawa, Yoku; Yamada, Atsuo; Koike, Kazuhiko

    2017-09-01

    Histological gastritis is associated with gastric cancer, but its diagnosis requires biopsy. Many classifications of endoscopic gastritis are available, but not all are useful for risk stratification of gastric cancer. The Kyoto Classification of Gastritis was proposed at the 85th Congress of the Japan Gastroenterological Endoscopy Society. This cross-sectional study evaluated the usefulness of the Kyoto Classification of Gastritis for risk stratification of gastric cancer. From August 2013 to September 2014, esophagogastroduodenoscopy was performed and the gastric findings evaluated according to the Kyoto Classification of Gastritis in a total of 4062 patients. The following five endoscopic findings were selected based on previous reports: atrophy, intestinal metaplasia, enlarged folds, nodularity, and diffuse redness. A total of 3392 patients (1746 [51%] men and 1646 [49%] women) were analyzed. Among them, 107 gastric cancers were diagnosed. Atrophy was found in 2585 (78%) and intestinal metaplasia in 924 (27%). Enlarged folds, nodularity, and diffuse redness were found in 197 (5.8%), 22 (0.6%), and 573 (17%), respectively. In univariate analyses, the severity of atrophy, intestinal metaplasia, diffuse redness, age, and male sex were associated with gastric cancer. In a multivariate analysis, atrophy and male sex were found to be independent risk factors. Younger age and severe atrophy were determined to be associated with diffuse-type gastric cancer. Endoscopic detection of atrophy was associated with the risk of gastric cancer. Thus, patients with severe atrophy should be examined carefully and may require intensive follow-up. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  2. Magnetic resonance imaging in classification of congenital muscular dystrophies with brain abnormalities

    NARCIS (Netherlands)

    vanderKnaap, MS; Smit, LME; Barth, PG; CatsmanBerrevoets, CE; Brouwer, OF; Begeer, JH; deCoo, IFM; Valk, J.

    A survey was performed of magnetic resonance imaging (MRI) findings in 21 patients with congenital muscular dystrophy (QID) with cerebral abnormalities to evaluate the contribution of MRI to the classification of CMD patients. In 5 patients with Walker-Warburg syndrome (WWS), MRI showed

  3. Systematic analysis of ocular trauma by a new proposed ocular trauma classification

    Directory of Open Access Journals (Sweden)

    Bhartendu Shukla

    2017-01-01

    Full Text Available Purpose: The current classification of ocular trauma does not incorporate adnexal trauma, injuries that are attributable to a nonmechanical cause and destructive globe injuries. This study proposes a new classification system of ocular trauma which is broader-based to allow for the classification of a wider range of ocular injuries not covered by the current classification. Methods: A clinic-based cross-sectional study to validate the proposed classification. We analyzed 535 cases of ocular injury from January 1, 2012 to February 28, 2012 over a 4-year period in an eye hospital in central India using our proposed classification system and compared it with conventional classification. Results: The new classification system allowed for classification of all 535 cases of ocular injury. The conventional classification was only able to classify 364 of the 535 trauma cases. Injuries involving the adnexa, nonmechanical injuries and destructive globe injuries could not be classified by the conventional classification, thus missing about 33% of cases. Conclusions: Our classification system shows an improvement over existing ocular trauma classification as it allows for the classification of all type of ocular injuries and will allow for better and specific prognostication. This system has the potential to aid communication between physicians and result in better patient care. It can also provide a more authentic, wide spectrum of ocular injuries in correlation with etiology. By including adnexal injuries and nonmechanical injuries, we have been able to classify all 535 cases of trauma. Otherwise, about 30% of cases would have been excluded from the study.

  4. Classification of multiple sclerosis lesions using adaptive dictionary learning.

    Science.gov (United States)

    Deshpande, Hrishikesh; Maurel, Pierre; Barillot, Christian

    2015-12-01

    This paper presents a sparse representation and an adaptive dictionary learning based method for automated classification of multiple sclerosis (MS) lesions in magnetic resonance (MR) images. Manual delineation of MS lesions is a time-consuming task, requiring neuroradiology experts to analyze huge volume of MR data. This, in addition to the high intra- and inter-observer variability necessitates the requirement of automated MS lesion classification methods. Among many image representation models and classification methods that can be used for such purpose, we investigate the use of sparse modeling. In the recent years, sparse representation has evolved as a tool in modeling data using a few basis elements of an over-complete dictionary and has found applications in many image processing tasks including classification. We propose a supervised classification approach by learning dictionaries specific to the lesions and individual healthy brain tissues, which include white matter (WM), gray matter (GM) and cerebrospinal fluid (CSF). The size of the dictionaries learned for each class plays a major role in data representation but it is an even more crucial element in the case of competitive classification. Our approach adapts the size of the dictionary for each class, depending on the complexity of the underlying data. The algorithm is validated using 52 multi-sequence MR images acquired from 13 MS patients. The results demonstrate the effectiveness of our approach in MS lesion classification. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Post-operative rotator cuff integrity, based on Sugaya's classification, can reflect abduction muscle strength of the shoulder.

    Science.gov (United States)

    Yoshida, Masahito; Collin, Phillipe; Josseaume, Thierry; Lädermann, Alexandre; Goto, Hideyuki; Sugimoto, Katumasa; Otsuka, Takanobu

    2018-01-01

    Magnetic resonance (MR) imaging is common in structural and qualitative assessment of the rotator cuff post-operatively. Rotator cuff integrity has been thought to be associated with clinical outcome. The purpose of this study was to evaluate the inter-observer reliability of cuff integrity (Sugaya's classification) and assess the correlation between Sugaya's classification and the clinical outcome. It was hypothesized that Sugaya's classification would show good reliability and good correlation with the clinical outcome. Post-operative MR images were taken two years post-operatively, following arthroscopic rotator cuff repair. For assessment of inter-rater reliability, all radiographic evaluations for the supraspinatus muscle were done by two orthopaedic surgeons and one radiologist. Rotator cuff integrity was classified into five categories, according to Sugaya's classification. Fatty infiltration was graded into four categories, based on the Fuchs' classification grading system. Muscle hypotrophy was graded as four grades, according to the scale proposed by Warner. The clinical outcome was assessed according to the constant scoring system pre-operatively and 2 years post-operatively. Of the sixty-two consecutive patients with full-thickness rotator cuff tears, fifty-two patients were reviewed in this study. These subjects included twenty-three men and twenty-nine women, with an average age of fifty-seven years. In terms of the inter-rater reliability between orthopaedic surgeons, Sugaya's classification showed the highest agreement [ICC (2.1) = 0.82] for rotator cuff integrity. The grade of fatty infiltration and muscle atrophy demonstrated good agreement, respectively (0.722 and 0.758). With regard to the inter-rater reliability between orthopaedic surgeon and radiologist, Sugaya's classification showed good reliability [ICC (2.1) = 0.70]. On the other hand, fatty infiltration and muscle hypotrophy classifications demonstrated fair and moderate agreement

  6. Speech-Language and Nutritional Sciences in hospital environment: analysis of terminology of food consistencies classification.

    Science.gov (United States)

    Amaral, Ana Cláudia Fernandes; Rodrigues, Lívia Azevedo; Furlan, Renata Maria Moreira Moraes; Vicente, Laélia Cristina Caseiro; Motta, Andréa Rodrigues

    2015-01-01

    To verify if there is an agreement between speech-language pathologists and nutritionists about the classification of food textures used in hospitals and their opinions about the possible consequences of differences in this classification. This is a descriptive, cross-sectional study with 30 speech-language pathologists and 30 nutritionists who worked in 14 hospitals of public and/or private network in Belo Horizonte, Brazil. The professionals answered a questionnaire, prepared by the researchers, and classified five different foods, with and without theoretical direction. The data were analyzed using Fisher's exact and Z -tests to compare ratios with a 5% significance level. Both speech-language therapists (100%) and nutritionists (90%) perceive divergence in the classification and, 86.2% and 100% of them, respectively, believe that this difference may affect the patients' recovery. Aspiration risk was the most mentioned problem. For the general classification of food textures, most of the professionals (88.5%) suggested four to six terms. As to the terminology used in the classification of food presented without theoretical direction, the professionals cited 49 terms and agreed only in the solid and liquid classifications. With theoretical direction, the professionals also agreed in the classification of thick and thin paste. Both the professionals recognized divergences in the classification of food textures and the consequent risk of damage to patient's recovery. The use of theoretical direction increased the agreement between these professionals.

  7. Risk factors and classifications of hilar cholangiocarcinoma.

    Science.gov (United States)

    Suarez-Munoz, Miguel Angel; Fernandez-Aguilar, Jose Luis; Sanchez-Perez, Belinda; Perez-Daga, Jose Antonio; Garcia-Albiach, Beatriz; Pulido-Roa, Ysabel; Marin-Camero, Naiara; Santoyo-Santoyo, Julio

    2013-07-15

    Cholangiocarcinoma is the second most common primary malignant tumor of the liver. Perihilar cholangiocarcinoma or Klatskin tumor represents more than 50% of all biliary tract cholangiocarcinomas. A wide range of risk factors have been identified among patients with Perihilar cholangiocarcinoma including advanced age, male gender, primary sclerosing cholangitis, choledochal cysts, cholelithiasis, cholecystitis, parasitic infection (Opisthorchis viverrini and Clonorchis sinensis), inflammatory bowel disease, alcoholic cirrhosis, nonalcoholic cirrhosis, chronic pancreatitis and metabolic syndrome. Various classifications have been used to describe the pathologic and radiologic appearance of cholangiocarcinoma. The three systems most commonly used to evaluate Perihilar cholangiocarcinoma are the Bismuth-Corlette (BC) system, the Memorial Sloan-Kettering Cancer Center and the TNM classification. The BC classification provides preoperative assessment of local spread. The Memorial Sloan-Kettering cancer center proposes a staging system according to three factors related to local tumor extent: the location and extent of bile duct involvement, the presence or absence of portal venous invasion, and the presence or absence of hepatic lobar atrophy. The TNM classification, besides the usual descriptors, tumor, node and metastases, provides additional information concerning the possibility for the residual tumor (R) and the histological grade (G). Recently, in 2011, a new consensus classification for the Perihilar cholangiocarcinoma had been published. The consensus was organised by the European Hepato-Pancreato-Biliary Association which identified the need for a new staging system for this type of tumors. The classification includes information concerning biliary or vascular (portal or arterial) involvement, lymph node status or metastases, but also other essential aspects related to the surgical risk, such as remnant hepatic volume or the possibility of underlying disease.

  8. Classification Accuracy Increase Using Multisensor Data Fusion

    Science.gov (United States)

    Makarau, A.; Palubinskas, G.; Reinartz, P.

    2011-09-01

    The practical use of very high resolution visible and near-infrared (VNIR) data is still growing (IKONOS, Quickbird, GeoEye-1, etc.) but for classification purposes the number of bands is limited in comparison to full spectral imaging. These limitations may lead to the confusion of materials such as different roofs, pavements, roads, etc. and therefore may provide wrong interpretation and use of classification products. Employment of hyperspectral data is another solution, but their low spatial resolution (comparing to multispectral data) restrict their usage for many applications. Another improvement can be achieved by fusion approaches of multisensory data since this may increase the quality of scene classification. Integration of Synthetic Aperture Radar (SAR) and optical data is widely performed for automatic classification, interpretation, and change detection. In this paper we present an approach for very high resolution SAR and multispectral data fusion for automatic classification in urban areas. Single polarization TerraSAR-X (SpotLight mode) and multispectral data are integrated using the INFOFUSE framework, consisting of feature extraction (information fission), unsupervised clustering (data representation on a finite domain and dimensionality reduction), and data aggregation (Bayesian or neural network). This framework allows a relevant way of multisource data combination following consensus theory. The classification is not influenced by the limitations of dimensionality, and the calculation complexity primarily depends on the step of dimensionality reduction. Fusion of single polarization TerraSAR-X, WorldView-2 (VNIR or full set), and Digital Surface Model (DSM) data allow for different types of urban objects to be classified into predefined classes of interest with increased accuracy. The comparison to classification results of WorldView-2 multispectral data (8 spectral bands) is provided and the numerical evaluation of the method in comparison to

  9. Advances in Risk Classification and Treatment Strategies for Neuroblastoma

    Science.gov (United States)

    Pinto, Navin R.; Applebaum, Mark A.; Volchenboum, Samuel L.; Matthay, Katherine K.; London, Wendy B.; Ambros, Peter F.; Nakagawara, Akira; Berthold, Frank; Schleiermacher, Gudrun; Park, Julie R.; Valteau-Couanet, Dominique; Pearson, Andrew D.J.

    2015-01-01

    Risk-based treatment approaches for neuroblastoma have been ongoing for decades. However, the criteria used to define risk in various institutional and cooperative groups were disparate, limiting the ability to compare clinical trial results. To mitigate this problem and enhance collaborative research, homogenous pretreatment patient cohorts have been defined by the International Neuroblastoma Risk Group classification system. During the past 30 years, increasingly intensive, multimodality approaches have been developed to treat patients who are classified as high risk, whereas patients with low- or intermediate-risk neuroblastoma have received reduced therapy. This treatment approach has resulted in improved outcome, although survival for high-risk patients remains poor, emphasizing the need for more effective treatments. Increased knowledge regarding the biology and genetic basis of neuroblastoma has led to the discovery of druggable targets and promising, new therapeutic approaches. Collaborative efforts of institutions and international cooperative groups have led to advances in our understanding of neuroblastoma biology, refinements in risk classification, and stratified treatment strategies, resulting in improved outcome. International collaboration will be even more critical when evaluating therapies designed to treat small cohorts of patients with rare actionable mutations. PMID:26304901

  10. ICF-based classification and measurement of functioning.

    Science.gov (United States)

    Stucki, G; Kostanjsek, N; Ustün, B; Cieza, A

    2008-09-01

    If we aim towards a comprehensive understanding of human functioning and the development of comprehensive programs to optimize functioning of individuals and populations we need to develop suitable measures. The approval of the International Classification, Disability and Health (ICF) in 2001 by the 54th World Health Assembly as the first universally shared model and classification of functioning, disability and health marks, therefore an important step in the development of measurement instruments and ultimately for our understanding of functioning, disability and health. The acceptance and use of the ICF as a reference framework and classification has been facilitated by its development in a worldwide, comprehensive consensus process and the increasing evidence regarding its validity. However, the broad acceptance and use of the ICF as a reference framework and classification will also depend on the resolution of conceptual and methodological challenges relevant for the classification and measurement of functioning. This paper therefore describes first how the ICF categories can serve as building blocks for the measurement of functioning and then the current state of the development of ICF based practical tools and international standards such as the ICF Core Sets. Finally it illustrates how to map the world of measures to the ICF and vice versa and the methodological principles relevant for the transformation of information obtained with a clinical test or a patient-oriented instrument to the ICF as well as the development of ICF-based clinical and self-reported measurement instruments.

  11. Classification, disease, and diagnosis.

    Science.gov (United States)

    Jutel, Annemarie

    2011-01-01

    Classification shapes medicine and guides its practice. Understanding classification must be part of the quest to better understand the social context and implications of diagnosis. Classifications are part of the human work that provides a foundation for the recognition and study of illness: deciding how the vast expanse of nature can be partitioned into meaningful chunks, stabilizing and structuring what is otherwise disordered. This article explores the aims of classification, their embodiment in medical diagnosis, and the historical traditions of medical classification. It provides a brief overview of the aims and principles of classification and their relevance to contemporary medicine. It also demonstrates how classifications operate as social framing devices that enable and disable communication, assert and refute authority, and are important items for sociological study.

  12. Stream classification of the Apalachicola-Chattahoochee-Flint River System to support modeling of aquatic habitat response to climate change

    Science.gov (United States)

    Elliott, Caroline M.; Jacobson, Robert B.; Freeman, Mary C.

    2014-01-01

    A stream classification and associated datasets were developed for the Apalachicola-Chattahoochee-Flint River Basin to support biological modeling of species response to climate change in the southeastern United States. The U.S. Geological Survey and the Department of the Interior’s National Climate Change and Wildlife Science Center established the Southeast Regional Assessment Project (SERAP) which used downscaled general circulation models to develop landscape-scale assessments of climate change and subsequent effects on land cover, ecosystems, and priority species in the southeastern United States. The SERAP aquatic and hydrologic dynamics modeling efforts involve multiscale watershed hydrology, stream-temperature, and fish-occupancy models, which all are based on the same stream network. Models were developed for the Apalachicola-Chattahoochee-Flint River Basin and subbasins in Alabama, Florida, and Georgia, and for the Upper Roanoke River Basin in Virginia. The stream network was used as the spatial scheme through which information was shared across the various models within SERAP. Because these models operate at different scales, coordinated pair versions of the network were delineated, characterized, and parameterized for coarse- and fine-scale hydrologic and biologic modeling. The stream network used for the SERAP aquatic models was extracted from a 30-meter (m) scale digital elevation model (DEM) using standard topographic analysis of flow accumulation. At the finer scale, reaches were delineated to represent lengths of stream channel with fairly homogenous physical characteristics (mean reach length = 350 m). Every reach in the network is designated with geomorphic attributes including upstream drainage basin area, channel gradient, channel width, valley width, Strahler and Shreve stream order, stream power, and measures of stream confinement. The reach network was aggregated from tributary junction to tributary junction to define segments for the

  13. Polyp morphology: an interobserver evaluation for the Paris classification among international experts.

    Science.gov (United States)

    van Doorn, Sascha C; Hazewinkel, Y; East, James E; van Leerdam, Monique E; Rastogi, Amit; Pellisé, Maria; Sanduleanu-Dascalescu, Silvia; Bastiaansen, Barbara A J; Fockens, Paul; Dekker, Evelien

    2015-01-01

    The Paris classification is an international classification system for describing polyp morphology. Thus far, the validity and reproducibility of this classification have not been assessed. We aimed to determine the interobserver agreement for the Paris classification among seven Western expert endoscopists. A total of 85 short endoscopic video clips depicting polyps were created and assessed by seven expert endoscopists according to the Paris classification. After a digital training module, the same 85 polyps were assessed again. We calculated the interobserver agreement with a Fleiss kappa and as the proportion of pairwise agreement. The interobserver agreement of the Paris classification among seven experts was moderate with a Fleiss kappa of 0.42 and a mean pairwise agreement of 67%. The proportion of lesions assessed as "flat" by the experts ranged between 13 and 40% (Pagreement did not change (kappa 0.38, pairwise agreement 60%). Our study is the first to validate the Paris classification for polyp morphology. We demonstrated only a moderate interobserver agreement among international Western experts for this classification system. Our data suggest that, in its current version, the use of this classification system in daily practice is questionable and it is unsuitable for comparative endoscopic research. We therefore suggest introduction of a simplification of the classification system.

  14. Clinical value of 64-slice spiral CT for classification of femoral neck fracture

    International Nuclear Information System (INIS)

    Zhu Jiangtao; Gong Jianping; Cai Wu; Zhu Jianbing; Chen Guangqiang; Qian Minghui

    2011-01-01

    Objective: To evaluate the clinical application of 64-slice spiral CT for classification of femoral neck fracture. Methods: The survey was comprised of 46 patients with femoral neck fractures detected with plain radiographs and CT images. Cases were randomly presented in 2 formats: plain radiographs and CT. Garden classification was queried. Modification of garden classification (nondisplaced vs displaced) was taken to compare with plain radiographs and CT in the study. Results: The results of classification for plain radiographs were 2 cases of Garden Ⅰ, 10 cases of Ⅱ, 22 cases of Ⅲ, and 12 cases of Ⅳ. Those for CT were 1 cases of Garden Ⅰ, 4 cases of Ⅱ, 26 cases of Ⅲ, and 15 cases of Ⅳ. CT improved the accuracy of Garden Classification (P<0.05). Conclusion: Garden classification using CT images shows good conformation with results of surgery. 64-Slic CT is better plain radiographs for Garden classification of femoral neck fracture. (authors)

  15. Incremental Learning of Medical Data for Multi-Step Patient Health Classification

    DEFF Research Database (Denmark)

    Kranen, Philipp; Müller, Emmanuel; Assent, Ira

    2010-01-01

    of textile sensors, body sensors and preprocessing techniques as well as the integration and merging of sensor data in electronic health record systems. Emergency detection on multiple levels will show the benefits of multi-step classification and further enhance the scalability of emergency detection...

  16. The World Health Organization Classification of dontogenic Lesions: A Summary of the Changes of the 2017 (4th Edition

    Directory of Open Access Journals (Sweden)

    Merva SOLUK-TEKKEŞİN

    2018-01-01

    Full Text Available The 4th edition of the World Health Organization (WHO Classification of Head and Neck Tumors was published in January 2017. The edition serves to provide an updated classification scheme, and extended genetic and molecular data that are useful as diagnostic tools for the lesions of the head and neck region. This review focuses on the most current update of odontogenic cysts and tumors based on the 2017 WHO edition. The updated classification has some important differences from the 3rd edition (2005, including a new classification of odontogenic cysts, ‘reclassified’ odontogenic tumors, and some new entities.

  17. A NEW CLASSIFICATION OF SMES IN THE DIGITAL ECONOMY CONTEXT

    Directory of Open Access Journals (Sweden)

    Maximilian ROBU

    2013-06-01

    Full Text Available In a highly dynamic and competitive environment as the online one, SMEs need to adapt and change their behavior, requiring a rethinking of classification criteria. Social media is changing the way people interact, but also changing organizations and how they operate. Social networks are no longer just a simple tool to create a network of friends; they have become a destination for business. We can also talk of a new world of business, a new way of working; the freelancers have a share of the increasingly significant. Cloud computing is the support for all changes in the current environment, providing the tools necessary to conduct activities anywhere. Given the mentioned arguments, we consider that the classification of SMEs according to a new set of criteria: operating environment, geographical area, type of employees in the company or how they organize marketing activities.

  18. The dawn of a new era in onco-cardiology: The Kumamoto Classification.