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Sample records for combining multiple diagnostic

  1. Diagnostic significance of combined detention of multiple tumour markers in lung cancer

    International Nuclear Information System (INIS)

    Chen Yanming; Qiu Jianming

    2003-01-01

    Objective: To explore the diagnostic value of combined detection of multiple markers in the determination of lung cancer. Methods: Using enzyme-linked immunosorbent assay (ELISA), the serum CEA, CA19-9, CA125, CA15-3 was determined in eighty-six lung cancer patients, thirty benign lung disease patients and thirty healthy persons. Results; Serum concentrations of CEA, CA19-9, CA125 and CA15-3 were significantly higher in patents with lung cancer than that in the patients with benign lung disease patients and healthy persons. The single test sensitivity of CEA, CA19-9, CA125 and CA15-3 for diagnosis of lung cancer is 41.9%, 37.2%, 48.9%, 36% respectively; the combined test sensitivity is 94.2%. Conclusions: Assessing several tumour markers can help differentiating various histological type of lung cancer and increase the sensitivity

  2. A simple method to combine multiple molecular biomarkers for dichotomous diagnostic classification

    Directory of Open Access Journals (Sweden)

    Amin Manik A

    2006-10-01

    Full Text Available Abstract Background In spite of the recognized diagnostic potential of biomarkers, the quest for squelching noise and wringing in information from a given set of biomarkers continues. Here, we suggest a statistical algorithm that – assuming each molecular biomarker to be a diagnostic test – enriches the diagnostic performance of an optimized set of independent biomarkers employing established statistical techniques. We validated the proposed algorithm using several simulation datasets in addition to four publicly available real datasets that compared i subjects having cancer with those without; ii subjects with two different cancers; iii subjects with two different types of one cancer; and iv subjects with same cancer resulting in differential time to metastasis. Results Our algorithm comprises of three steps: estimating the area under the receiver operating characteristic curve for each biomarker, identifying a subset of biomarkers using linear regression and combining the chosen biomarkers using linear discriminant function analysis. Combining these established statistical methods that are available in most statistical packages, we observed that the diagnostic accuracy of our approach was 100%, 99.94%, 96.67% and 93.92% for the real datasets used in the study. These estimates were comparable to or better than the ones previously reported using alternative methods. In a synthetic dataset, we also observed that all the biomarkers chosen by our algorithm were indeed truly differentially expressed. Conclusion The proposed algorithm can be used for accurate diagnosis in the setting of dichotomous classification of disease states.

  3. Improved localisation of neoclassical tearing modes by combining multiple diagnostic estimates

    Science.gov (United States)

    Rapson, C. J.; Fischer, R.; Giannone, L.; Maraschek, M.; Reich, M.; Treutterer, W.; The ASDEX Upgrade Team

    2017-07-01

    Neoclassical tearing modes (NTMs) strongly degrade confinement in tokamaks, and are a leading cause of disruptions. They can be stabilised by targeted electron cyclotron current drive (ECCD), however the effectiveness of ECCD depends strongly on the accuracy or misalignment between ECCD and the NTM. The first step to ensure minimal misalignment is a good estimate of the NTM location. In previous NTM control experiments, three methods have been used independently to estimate the NTM location: the magnetic equilibrium, correlation between magnetic and spatially-resolved temperature fluctuations, and the amplitude response of the NTM to nearby ECCD. This submission describes an algorithm which has been designed to fuse these three estimates into one, taking into account many of the characteristics of each diagnostic. Although the method diverges from standard data fusion methods, results from simulation and experiment confirm that the algorithm achieves its stated goal of providing an estimate that is more reliable and accurate than any of the individual estimates.

  4. Multiple sclerosis - etiology and diagnostic potential.

    Science.gov (United States)

    Kamińska, Joanna; Koper, Olga M; Piechal, Kinga; Kemona, Halina

    2017-06-30

    Multiple sclerosis (MS) is a chronic inflammatory and demyelinating disease of autoimmune originate. The main agents responsible for the MS development include exogenous, environmental, and genetic factors. MS is characterized by multifocal and temporally scattered central nervous system (CNS) damage which lead to the axonal damage. Among clinical courses of MS it can be distinguish relapsing-remitting multiple sclerosis (RRMS), secondary progressive multiple sclerosis (SPSM), primary progressive multiple sclerosis (PPMS), and progressive-relapsing multiple sclerosis (RPMS). Depending on the severity of signs and symptoms MS can be described as benign MS or malignant MS. MS diagnosis is based on McDonald's diagnostic criteria, which link clinical manifestation with characteristic lesions demonstrated by magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) analysis, and visual evoked potentials. Among CSF laboratory tests used to the MS diagnosis are applied: Tibbling & Link IgG index, reinbegrams, and CSF isoelectrofocusing for oligoclonal bands detection. It should be emphasized, that despite huge progress regarding MS as well as the availability of different diagnostics methods this disease is still a diagnostic challenge. It may result from fact that MS has diverse clinical course and there is a lack of single test, which would be of appropriate diagnostic sensitivity and specificity for quick and accurate diagnosis.

  5. Multiple sclerosis - etiology and diagnostic potential

    Directory of Open Access Journals (Sweden)

    Joanna Kamińska

    2017-06-01

    Full Text Available Multiple sclerosis (MS is a chronic inflammatory and demyelinating disease of autoimmune originate. The main agents responsible for the MS development include exogenous, environmental, and genetic factors. MS is characterized by multifocal and temporally scattered central nervous system (CNS damage which lead to the axonal damage. Among clinical courses of MS it can be distinguish relapsing-remitting multiple sclerosis (RRMS, secondary progressive multiple sclerosis (SPSM, primary progressive multiple sclerosis (PPMS, and progressive-relapsing multiple sclerosis (RPMS. Depending on the severity of signs and symptoms MS can be described as benign MS or malignant MS. MS diagnosis is based on McDonald’s diagnostic criteria, which link clinical manifestation with characteristic lesions demonstrated by magnetic resonance imaging (MRI, cerebrospinal fluid (CSF analysis, and visual evoked potentials. Among CSF laboratory tests used to the MS diagnosis are applied: Tibbling & Link IgG index, reinbegrams, and CSF isoelectrofocusing for oligoclonal bands detection. It should be emphasized, that despite huge progress regarding MS as well as the availability of differentdiagnostics methods this disease is still a diagnostic challenge. It may result from fact that MS has diverse clinical course and there is a lack of single test, which would be of appropriate diagnostic sensitivity and specificity for quick and accurate diagnosis.

  6. Multiple diagnostic approaches to palpable breast mass

    Energy Technology Data Exchange (ETDEWEB)

    Chin, Soo Yil; Kim, Kie Hwan; Moon, Nan Mo; Kim, Yong Kyu; Jang, Ja June [Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    1985-12-15

    The combination of the various diagnostic methods of palpable breast mass has improved the diagnostic accuracy. From September 1983 to August 1985 pathologically proven 85 patients with palpable breast masses examined with x-ray mammography, ultrasonography, penumomammography and aspiration cytology at Korea Cancer Center Hospital were analyzed. The diagnostic accuracies of each methods were 77.6% of mammogram, 74.1% of ultrasonogram, 90.5% of penumomammogram and 92.4% of aspiration cytology. Pneumomammograms was accomplished without difficulty or complication and depicted more clearly delineated mass with various pathognomonic findings; air-ductal pattern in fibroadenoma (90.4%) and cystosarcoma phylloides (100%), air-halo in fibrocystic disease (14.2%), fibroadenoma (100%), cystosarcoma phylloides (100%), air-cystogram in cystic type of fibrocystic disease (100%) and vaculoar pattern or irregular air collection without retained peripheral gas in carcinoma.

  7. Multiple diagnostic approaches to palpable breast mass

    International Nuclear Information System (INIS)

    Chin, Soo Yil; Kim, Kie Hwan; Moon, Nan Mo; Kim, Yong Kyu; Jang, Ja June

    1985-01-01

    The combination of the various diagnostic methods of palpable breast mass has improved the diagnostic accuracy. From September 1983 to August 1985 pathologically proven 85 patients with palpable breast masses examined with x-ray mammography, ultrasonography, penumomammography and aspiration cytology at Korea Cancer Center Hospital were analyzed. The diagnostic accuracies of each methods were 77.6% of mammogram, 74.1% of ultrasonogram, 90.5% of penumomammogram and 92.4% of aspiration cytology. Pneumomammograms was accomplished without difficulty or complication and depicted more clearly delineated mass with various pathognomonic findings; air-ductal pattern in fibroadenoma (90.4%) and cystosarcoma phylloides (100%), air-halo in fibrocystic disease (14.2%), fibroadenoma (100%), cystosarcoma phylloides (100%), air-cystogram in cystic type of fibrocystic disease (100%) and vaculoar pattern or irregular air collection without retained peripheral gas in carcinoma

  8. Diagnostic system for combine cycle power plant

    International Nuclear Information System (INIS)

    Shimizu, Yujiro; Nomura, Masumi; Tanaka, Satoshi; Ito, Ryoji; Kita, Yoshiyuki

    2000-01-01

    We developed the Diagnostic System for Combined Cycle Power Plant which enables inexperienced operators as well as experienced operators to cope with abnormal conditions of Combined Cycle Power Plant. The features of this system are the Estimate of Emergency Level for Operation and the Prediction of Subsequent Abnormality, adding to the Diagnosis of Cause and the Operation Guidance. Moreover in this system, Diagnosis of Cause was improved by using our original method and support screens can be displayed for educational means in normal condition as well. (Authors)

  9. Reproducibility of 24-hour combined multiple intraluminal impedance (MII) and pH measurements in infants and children. Evaluation of a diagnostic procedure for gastroesophageal reflux disease

    DEFF Research Database (Denmark)

    Dalby, Kasper; Nielsen, Rasmus G; Markoew, Simone

    2007-01-01

    Gastroesophageal reflux disease (GERD) is a common disease in infants and children. Prolonged (24-hr) pH monitoring in the esophagus for determination of increased acid exposure has, together with endoscopy, been the only routinely implemented method for GERD diagnosis. The recently introduced...... of nonacid and acidic reflux episodes) and pH in the esophagus in infants and children. Upper endoscopy followed by 2 x 24-hr consecutive combined MII and pH monitoring was performed in 33 infants and children referred to a tertiary center for evaluation of GERD. The study was performed in a hospital setting...... without dietary restrictions. Bland-Altman difference versus mean plots and calculation of the limits of agreement (LOA) were used for assessment of the reproducibility of the total number of acidic and nonacidic reflux episodes. LOA for the number of acidic reflux episodes on day 2 were 0.2-5.3 times...

  10. Structured diagnostic imaging in patients with multiple trauma

    International Nuclear Information System (INIS)

    Linsenmaier, U.; Rieger, J.; Rock, C.; Pfeifer, K.J.; Reiser, M.; Kanz, K.G.

    2002-01-01

    Purpose. Development of a concept for structured diagnostic imaging in patients with multiple trauma.Material and methods. Evaluation of data from a prospective trial with over 2400 documented patients with multiple trauma. All diagnostic and therapeutic steps, primary and secondary death and the 90 days lethality were documented.Structured diagnostic imaging of multiple injured patients requires the integration of an experienced radiologist in an interdisciplinary trauma team consisting of anesthesia, radiology and trauma surgery. Radiology itself deserves standardized concepts for equipment, personnel and logistics to perform diagnostic imaging for a 24-h-coverage with constant quality.Results. This paper describes criteria for initiation of a shock room or emergency room treatment, strategies for documentation and interdisciplinary algorithms for the early clinical care coordinating diagnostic imaging and therapeutic procedures following standardized guidelines. Diagnostic imaging consists of basic diagnosis, radiological ABC-rule, radiological follow-up and structured organ diagnosis using CT. Radiological trauma scoring allows improved quality control of diagnosis and therapy of multiple injured patients.Conclusion. Structured diagnostic imaging of multiple injured patients leads to a standardization of diagnosis and therapy and ensures constant process quality. (orig.) [de

  11. Bayesian modeling and inference for diagnostic accuracy and probability of disease based on multiple diagnostic biomarkers with and without a perfect reference standard.

    Science.gov (United States)

    Jafarzadeh, S Reza; Johnson, Wesley O; Gardner, Ian A

    2016-03-15

    The area under the receiver operating characteristic (ROC) curve (AUC) is used as a performance metric for quantitative tests. Although multiple biomarkers may be available for diagnostic or screening purposes, diagnostic accuracy is often assessed individually rather than in combination. In this paper, we consider the interesting problem of combining multiple biomarkers for use in a single diagnostic criterion with the goal of improving the diagnostic accuracy above that of an individual biomarker. The diagnostic criterion created from multiple biomarkers is based on the predictive probability of disease, conditional on given multiple biomarker outcomes. If the computed predictive probability exceeds a specified cutoff, the corresponding subject is allocated as 'diseased'. This defines a standard diagnostic criterion that has its own ROC curve, namely, the combined ROC (cROC). The AUC metric for cROC, namely, the combined AUC (cAUC), is used to compare the predictive criterion based on multiple biomarkers to one based on fewer biomarkers. A multivariate random-effects model is proposed for modeling multiple normally distributed dependent scores. Bayesian methods for estimating ROC curves and corresponding (marginal) AUCs are developed when a perfect reference standard is not available. In addition, cAUCs are computed to compare the accuracy of different combinations of biomarkers for diagnosis. The methods are evaluated using simulations and are applied to data for Johne's disease (paratuberculosis) in cattle. Copyright © 2015 John Wiley & Sons, Ltd.

  12. Combined interferometric and polarimetric diagnostics for TEXTOR

    International Nuclear Information System (INIS)

    Soltwisch, H.

    1980-01-01

    A method for combining Faraday rotation measurements with a phase modulated HCN interferometer is described. Extended to a multichannel system this technique should allow to investigate the distributions of electron density and poloidal magnetic field in a Tokamak plasma. We discuss the principle of operation and appropriate evaluation of measured data with regard to TEXTOR parameters and give an estimate for the expected experimental accuracy. (orig./GG) 891 GG/orig.- 892 KN

  13. Diagnostic radiology on multiple injured patients: interdisciplinary management

    International Nuclear Information System (INIS)

    Linsenmaier, U.; Pfeifer, K.J.; Kanz, K.G.; Mutschler, W.

    2001-01-01

    The presence of a radiologist within the admitting area of an emergency department and his capability as a member of the trauma team have a major impact on the role of diagnostic radiology in trauma care. The knowledge of clinical decision criteria, algorithms, and standards of patient care are essential for the acceptance within a trauma team. We present an interdisciplinary management concept of diagnostic radiology for trauma patients, which comprises basic diagnosis, organ diagnosis, radiological ABC, and algorithms of early clinical care. It is the result of a prospective study comprising over 2000 documented multiple injured patients. The radiologist on a trauma team should support trauma surgery and anesthesia in diagnostic and clinical work-up. The radiological ABC provides a structured approach for diagnostic imaging in all steps of the early clinical care of the multiple injured patient. Radiological ABC requires a reevaluation in cases of equivocal findings or difficulties in the clinical course. Direct communication of radiological findings with the trauma team enables quick clinical decisions. In addition, the radiologist can priority-oriented influence the therapy by using interventional procedures. The clinical radiologist is an active member of the interdisciplinary trauma team, not only providing diagnostic imaging but also participating in clinical decisions. (orig.) [de

  14. Optimal Combinations of Diagnostic Tests Based on AUC.

    Science.gov (United States)

    Huang, Xin; Qin, Gengsheng; Fang, Yixin

    2011-06-01

    When several diagnostic tests are available, one can combine them to achieve better diagnostic accuracy. This article considers the optimal linear combination that maximizes the area under the receiver operating characteristic curve (AUC); the estimates of the combination's coefficients can be obtained via a nonparametric procedure. However, for estimating the AUC associated with the estimated coefficients, the apparent estimation by re-substitution is too optimistic. To adjust for the upward bias, several methods are proposed. Among them the cross-validation approach is especially advocated, and an approximated cross-validation is developed to reduce the computational cost. Furthermore, these proposed methods can be applied for variable selection to select important diagnostic tests. The proposed methods are examined through simulation studies and applications to three real examples. © 2010, The International Biometric Society.

  15. Ductal carcinoma in a multiple fibroadenoma: Diagnostic inaccuracies

    Directory of Open Access Journals (Sweden)

    Rao Shalinee

    2010-01-01

    Full Text Available We present the diagnostic inaccuracies encountered in a case of multiple fibroadenoma with malignant transformation. A 30-year-old lady presented with lump in the right breast of one month duration which on clinical examination, X-ray mammogram, sonomammogram were suggestive of multiple fibroadenomas. Fine needle aspiration cytology of the largest lump revealed features of malignancy and a core biopsy showed pleomorphic cells that could not be categorized. Due to the clinical, radiological and pathological diagnostic ambiguity, lumpectomy was performed and frozen section showed features of only conventional fibroadenoma. Representative bits on routine processing showed only features of fibroadenoma. Hence, complete submission of all lumps was done, which revealed fibroadenoma with invasive ductal carcinoma in one. Patient underwent modified radical mastectomy which showed multiple fibroadenomas, focal fibrocystic disease with a focus of residual invasive tumor and metastatic deposit in one axillary lymph node. This case report highlights the diagnostic challenges in detecting malignancy in fibroadenoma and a need for extensive tissue sampling in multiple fibroadenomas to detect the rare occurrence of carcinoma.

  16. Ductal carcinoma in a multiple fibroadenoma: diagnostic inaccuracies.

    Science.gov (United States)

    Rao, Shalinee; Latha, P Suvarna; Ravi, A; Thanka, J

    2010-01-01

    We present the diagnostic inaccuracies encountered in a case of multiple fibroadenoma with malignant transformation. A 30-year-old lady presented with lump in the right breast of one month duration which on clinical examination, X-ray mammogram, sonomammogram were suggestive of multiple fibroadenomas. Fine needle aspiration cytology of the largest lump revealed features of malignancy and a core biopsy showed pleomorphic cells that could not be categorized. Due to the clinical, radiological and pathological diagnostic ambiguity, lumpectomy was performed and frozen section showed features of only conventional fibroadenoma. Representative bits on routine processing showed only features of fibroadenoma. Hence, complete submission of all lumps was done, which revealed fibroadenoma with invasive ductal carcinoma in one. Patient underwent modified radical mastectomy which showed multiple fibroadenomas, focal fibrocystic disease with a focus of residual invasive tumor and metastatic deposit in one axillary lymph node. This case report highlights the diagnostic challenges in detecting malignancy in fibroadenoma and a need for extensive tissue sampling in multiple fibroadenomas to detect the rare occurrence of carcinoma.

  17. Combining multiple decisions: applications to bioinformatics

    International Nuclear Information System (INIS)

    Yukinawa, N; Ishii, S; Takenouchi, T; Oba, S

    2008-01-01

    Multi-class classification is one of the fundamental tasks in bioinformatics and typically arises in cancer diagnosis studies by gene expression profiling. This article reviews two recent approaches to multi-class classification by combining multiple binary classifiers, which are formulated based on a unified framework of error-correcting output coding (ECOC). The first approach is to construct a multi-class classifier in which each binary classifier to be aggregated has a weight value to be optimally tuned based on the observed data. In the second approach, misclassification of each binary classifier is formulated as a bit inversion error with a probabilistic model by making an analogy to the context of information transmission theory. Experimental studies using various real-world datasets including cancer classification problems reveal that both of the new methods are superior or comparable to other multi-class classification methods

  18. Nonparametric predictive inference for combining diagnostic tests with parametric copula

    Science.gov (United States)

    Muhammad, Noryanti; Coolen, F. P. A.; Coolen-Maturi, T.

    2017-09-01

    Measuring the accuracy of diagnostic tests is crucial in many application areas including medicine and health care. The Receiver Operating Characteristic (ROC) curve is a popular statistical tool for describing the performance of diagnostic tests. The area under the ROC curve (AUC) is often used as a measure of the overall performance of the diagnostic test. In this paper, we interest in developing strategies for combining test results in order to increase the diagnostic accuracy. We introduce nonparametric predictive inference (NPI) for combining two diagnostic test results with considering dependence structure using parametric copula. NPI is a frequentist statistical framework for inference on a future observation based on past data observations. NPI uses lower and upper probabilities to quantify uncertainty and is based on only a few modelling assumptions. While copula is a well-known statistical concept for modelling dependence of random variables. A copula is a joint distribution function whose marginals are all uniformly distributed and it can be used to model the dependence separately from the marginal distributions. In this research, we estimate the copula density using a parametric method which is maximum likelihood estimator (MLE). We investigate the performance of this proposed method via data sets from the literature and discuss results to show how our method performs for different family of copulas. Finally, we briefly outline related challenges and opportunities for future research.

  19. Multiple exostotic hypochondroplasia: Syndrome of combined hypochondroplasia and multiple exostoses

    International Nuclear Information System (INIS)

    Dominguez, R.; Young, L.W.; Girdany, B.R.; Steele, M.W.

    1984-01-01

    This is a report of a family with major focus on the daughter who had short stature. The mother had hypochondroplasia and the father had multiple exostoses. The daughter's skeletal roentgenograms show features of both hypochondroplasia and multiple exostoses. The roentgenographic, clinical and genetic aspects of these skeletal dysplasias are reviewed and hypochrondroplasia is contrasted with achondroplasia. The genetic and counseling implications of the association of hypochondroplasia and multiple exostoses are discussed. (orig.)

  20. Multiple exostotic hypochondroplasia: Syndrome of combined hypochondroplasia and multiple exostoses

    Energy Technology Data Exchange (ETDEWEB)

    Dominguez, R.; Young, L.W.; Girdany, B.R.; Steele, M.W.

    1984-07-01

    This is a report of a family with major focus on the daughter who had short stature. The mother had hypochondroplasia and the father had multiple exostoses. The daughter's skeletal roentgenograms show features of both hypochondroplasia and multiple exostoses. The roentgenographic, clinical and genetic aspects of these skeletal dysplasias are reviewed and hypochrondroplasia is contrasted with achondroplasia. The genetic and counseling implications of the association of hypochondroplasia and multiple exostoses are discussed.

  1. Imaging and diagnostic criteria for multiple sclerosis: are we there yet?

    International Nuclear Information System (INIS)

    Josey, Lawrence; Curley, Michael; Mousavi, Foroogh Jafari; Taylor, Bruce V.; Lucas, Robyn; Coulthard, Alan

    2012-01-01

    Excluding post traumatic injury, Multiple Sclerosis (MS) is the most common disabling neurological disorder of young adults. Although the effect on mortality is limited, the association of a young demographic and significant morbidity combine to make MS a devastating disease. Since MS was given its first detailed description in 1868, diagnostic criteria continue to evolve. Recently, there has been an international commitment to combine both clinical and paraclinical tests to arrive at an earlier diagnosis. Widespread acceptance of the use of MRI in diagnosis, monitoring and research has made the role of the radiologist more critical than ever in this disease. The primary diagnostic criteria for MS are the International Panel criteria, commonly referred to as the McDonald criteria and it is essential that the radiology community is aware of the work preceding these criteria, so that they are understood in the correct context and the importance acknowledged. Literature review utilising key word search to obtain the historical and current context of magnetic resonance imaging in the diagnosis of MS. A succinct description of the evolution of criteria for the diagnosis of MS. Radiologists must recognise that there are specific diagnostic criteria for MS that continue to evolve as a result of new research, improved technology and clinical experience and it is crucial that these criteria be applied in daily practice. It should be evident that diagnostic imaging criteria for MS will be most effective when combined with standardised MRI protocols such as those published by the international Consortium of Multiple Sclerosis Centres.

  2. A diagnostic tree model for polytomous responses with multiple strategies.

    Science.gov (United States)

    Ma, Wenchao

    2018-04-23

    Constructed-response items have been shown to be appropriate for cognitively diagnostic assessments because students' problem-solving procedures can be observed, providing direct evidence for making inferences about their proficiency. However, multiple strategies used by students make item scoring and psychometric analyses challenging. This study introduces the so-called two-digit scoring scheme into diagnostic assessments to record both students' partial credits and their strategies. This study also proposes a diagnostic tree model (DTM) by integrating the cognitive diagnosis models with the tree model to analyse the items scored using the two-digit rubrics. Both convergent and divergent tree structures are considered to accommodate various scoring rules. The MMLE/EM algorithm is used for item parameter estimation of the DTM, and has been shown to provide good parameter recovery under varied conditions in a simulation study. A set of data from TIMSS 2007 mathematics assessment is analysed to illustrate the use of the two-digit scoring scheme and the DTM. © 2018 The British Psychological Society.

  3. Combining multiple classifiers for age classification

    CSIR Research Space (South Africa)

    Van Heerden, C

    2009-11-01

    Full Text Available The authors compare several different classifier combination methods on a single task, namely speaker age classification. This task is well suited to combination strategies, since significantly different feature classes are employed. Support vector...

  4. Diagnostic x-ray procedures and risk of leukemia, lymphoma, and multiple myeloma

    International Nuclear Information System (INIS)

    Boice, J.D. Jr.; Morin, M.M.; Glass, A.G.; Friedman, G.D.; Stovall, M.; Hoover, R.N.; Fraumeni, J.F. Jr.

    1991-01-01

    Exposure to diagnostic x-rays and the risk of leukemia, non-Hodgkin's lymphoma (NHL), and multiple myeloma were studied within two prepaid health plans. Adult patients with leukemia (n = 565), NHL (n = 318), and multiple myeloma (n = 208) were matched to controls (n = 1390), and over 25,000 x-ray procedures were abstracted from medical records. Dose response was evaluated by assigning each x-ray procedure a score based on estimated bone marrow dose. X-ray exposure was not associated with chronic lymphocytic leukemia, one of the few malignant conditions never linked to radiation (relative risk [RR], 0.66). For all other forms of leukemia combined (n = 358), there was a slight elevation in risk (RR, 1.17) but no evidence of a dose-response relationship when x-ray procedures near the time of diagnosis were excluded. Similarly, patients with NHL were exposed to diagnostic x-ray procedures more often than controls (RR, 1.32), but the RR fell to 0.99 when the exposure to diagnostic x-ray procedures within 2 years of diagnosis was ignored. For multiple myeloma, overall risk was not significantly high (RR, 1.14), but there was consistent evidence of increasing risk with increasing numbers of diagnostic x-ray procedures. These data suggest that persons with leukemia and NHL undergo x-ray procedures frequently just prior to diagnosis for conditions related to the development or natural history of their disease. There was little evidence that diagnostic x-ray procedures were causally associated with leukemia or NHL. The risk for multiple myeloma, however, was increased among those patients who were frequently exposed to x-rays

  5. Combined PET/MRI in cerebral and paediatric diagnostics

    International Nuclear Information System (INIS)

    Pfluger, T.; Vollmar, C.; Porn, U.; Schmid, R.; Dresel, S.; Leinsinger, G.; Schmid, I.; Winkler, P.; Fischer, S.; Hahn, K.

    2002-01-01

    The aim of this overview is presentation of MRI and PET as synergistic modalities for combined analysis of morphology and function. For operative planning in epilepsy surgery, definition of the epileptogenic focus based on functional PET diagnostics and morphological MRI is decisive. For staging and follow-up examinations in oncology, MRI should be complemented by PET for the assessment of tumor vitality. In paediatric oncology patients we could demonstrate a therapy relevant increase of sensitivity/specificity with combined PET/MRI in contrast to single modalities. In the brain, full spectrum of digital image registration and three-dimensional reconstruction should be used. In extracranial cases, image fusion is disturbing due to a partial loss of image information of single modalities by the fusion process. (orig.) [de

  6. Primary progressive multiple sclerosis diagnostic criteria: a reappraisal.

    Science.gov (United States)

    Montalban, X; Sastre-Garriga, J; Filippi, M; Khaleeli, Z; Téllez, N; Vellinga, M M; Tur, C; Brochet, B; Barkhof, F; Rovaris, M; Miller, D H; Polman, C H; Rovira, A; Thompson, A J

    2009-12-01

    The diagnostic criteria used in primary progressive (PP) and relapsing-remitting (RR) multiple sclerosis (MS) show substantial differences. This introduces complexity in the diagnosis of MS which could be resolved if these criteria could be unified in terms of the requirements for dissemination in space (DIS). The aim of this study was to assess whether a single algorithm may be used to demonstrate DIS in all forms of MS. Five sets of RRMS criteria for DIS were applied to a cohort of 145 patients with established PPMS (mean disease duration: 11 years - PPMS-1): C1: Barkhof-Tintoré (as in 2005 McDonald's criteria); C2: Swanton et al. (as in JNNP 2006); C3: presence of oligoclonal bands plus two lesions (as in McDonald's criteria); C4 and C5: a two-step approach was also followed (patients not fulfilling C1 or C2 were then assessed for C3). Two sets of PPMS criteria for DIS were applied: C6: Thompson et al. (as in 2001 McDonald's criteria); C7: 2005 McDonald criteria. A second sample of 55 patients with less than 5 years of disease duration (PPMS-2) was also analysed using an identical approach. For PPMS-1/PPMS-2, fulfilment was: C1:73.8%/66.7%; C2:72.1%/59.3%; C3:89%/79.2%; C4:96%/92.3%; C5:96%/85.7%; C6:85.8%/78.7%; C7:91%/80.4%. Levels of fulfilment suggest that the use of a single set of criteria for DIS in RRMS and PPMS might be feasible, and reinforce the added value of cerebrospinal fluid (CSF) findings to increase fulfilment in PPMS. Unification of the DIS criteria for both RRMS and PPMS could be considered in further revisions of the MS diagnostic criteria.

  7. Combined sensing platform for advanced diagnostics in exhaled mouse breath

    Science.gov (United States)

    Fortes, Paula R.; Wilk, Andreas; Seichter, Felicia; Cajlakovic, Merima; Koestler, Stefan; Ribitsch, Volker; Wachter, Ulrich; Vogt, Josef; Radermacher, Peter; Carter, Chance; Raimundo, Ivo M.; Mizaikoff, Boris

    2013-03-01

    Breath analysis is an attractive non-invasive strategy for early disease recognition or diagnosis, and for therapeutic progression monitoring, as quantitative compositional analysis of breath can be related to biomarker panels provided by a specific physiological condition invoked by e.g., pulmonary diseases, lung cancer, breast cancer, and others. As exhaled breath contains comprehensive information on e.g., the metabolic state, and since in particular volatile organic constituents (VOCs) in exhaled breath may be indicative of certain disease states, analytical techniques for advanced breath diagnostics should be capable of sufficient molecular discrimination and quantification of constituents at ppm-ppb - or even lower - concentration levels. While individual analytical techniques such as e.g., mid-infrared spectroscopy may provide access to a range of relevant molecules, some IR-inactive constituents require the combination of IR sensing schemes with orthogonal analytical tools for extended molecular coverage. Combining mid-infrared hollow waveguides (HWGs) with luminescence sensors (LS) appears particularly attractive, as these complementary analytical techniques allow to simultaneously analyze total CO2 (via luminescence), the 12CO2/13CO2 tracer-to-tracee (TTR) ratio (via IR), selected VOCs (via IR) and O2 (via luminescence) in exhaled breath, yet, establishing a single diagnostic platform as both sensors simultaneously interact with the same breath sample volume. In the present study, we take advantage of a particularly compact (shoebox-size) FTIR spectrometer combined with novel substrate-integrated hollow waveguide (iHWG) recently developed by our research team, and miniaturized fiberoptic luminescence sensors for establishing a multi-constituent breath analysis tool that is ideally compatible with mouse intensive care stations (MICU). Given the low tidal volume and flow of exhaled mouse breath, the TTR is usually determined after sample collection via gas

  8. Association analysis of multiple traits by an approach of combining ...

    Indian Academy of Sciences (India)

    Lili Chen

    diseases. Joint analysis of multiple traits can increase statistical power of association analysis and uncover the underlying genetic ... genthaler and Thilly 2007), the combined multivariate and ... Because of using reverse regression model, our.

  9. Measuring and combining multiple diagnostic and prognostic sepsis biomarkers

    DEFF Research Database (Denmark)

    Kofoed, K.

    This PhD-thesis is based on work performed at Clinical Research Centre and Department of Infectious Diseases at Copenhagen University Hospital, Hvidovre, and includes a review, a method development study, and two clinical studies. The background of the thesis is, that timely and accurate diagnosis...... of sepsis is of great importance for choice of treatment, level of monitoring and prognosis. In this biomarkers could be a significant aid, and thus the search for and application of "new" sepsis biomarkers is of great importance. The thesis reviews the definitions and the epidemiology, and gives...

  10. Combining multiple influence strategies to increase consumer compliance

    OpenAIRE

    Kaptein, M.C.; Duplinsky, S.

    2013-01-01

    In this paper, we investigate the effects and implications of utilising multiple social influence strategies simultaneously to endorse a single product or call to action. In three, studies we show that combinations of social influence strategies do not increase compliance - this is contrary to commonly held beliefs and practice. Studies 1 and 2 show that combining implementations of both the consensus and authority strategies to promote a single behaviour does not lead to an increase in the e...

  11. Magnetic resonance imaging in the diagnostics of multiple sclerosis

    International Nuclear Information System (INIS)

    Larsen, J.P.; Tjoerstad, K.; Kaass, B.; Oedegaard, H.

    1987-01-01

    Multiple sclerosis is an important and frequent neurological disease and the diagnosis might be difficult. The clinical criteria of multiple sclerosis and the role of laboratory examinations in the diagnosis of the disease are discussed. In particular the help offered by the magnetic resonance imaging method is the subject of this paper. Three patients are reported and discussed

  12. Combining multiple influence strategies to increase consumer compliance

    NARCIS (Netherlands)

    Kaptein, M.C.; Duplinsky, S.

    2013-01-01

    In this paper, we investigate the effects and implications of utilising multiple social influence strategies simultaneously to endorse a single product or call to action. In three, studies we show that combinations of social influence strategies do not increase compliance - this is contrary to

  13. Malignant degeneration of multiple cartilaginous exostosis. Diagnostic significance of MRT

    International Nuclear Information System (INIS)

    Bair, H.J.; Schmitt, R.; Moos, P.; Fellner, F.; Dvorak, O.; Rupprecht, H.; Lenz, M.

    1997-01-01

    In summary it can be said that diagnostic radiology, and particularly MRT, for evaluation of malignant degeneration of cartilaginous extoses is of high importance, also because of the difficulties posed by a biopsy for verification of malignancy. Cases of malignant cartilaginous extosis have a good prognosis at the early stages of the disease, when the extosis still is restricted to the focal region. (Orig./AJ) [de

  14. Combining the IADPSG criteria with the WHO diagnostic criteria for ...

    African Journals Online (AJOL)

    Macrosomia or at least one adverse outcome were more likely in GDM patients who met the diagnostic criteria by both the IADPSG and WHO criteria (P = 0.001). Conclusion: A diagnosis of GDM that meets both the WHO and IADPSG criteria provides stronger prediction for adverse pregnancy outcome than a diagnosis that ...

  15. Radiological diagnosis in patients with head injury alone or in combination with multiple trauma

    International Nuclear Information System (INIS)

    Rieger, J.; Linsenmaier, U.; Pfeifer, K.J.; Reiser, M.

    2002-01-01

    Purpose. Head injury alone or in combination with multiple trauma is the main cause of death and severe disability in individuals under 45 years old. This review is intended to describe the relevant imaging modalities, to analyze their specific value and limitations and to illustrate the most important radiologic findings. The indications for diagnostic imaging within the context of an interdisciplinary linkage of diagnostic and therapeutic measures are discussed.Material and methods. Recent publications are analyzed and compared to the experiences of our own hospital. In terms of a critical synoptic assessment the currently best standard of care is described in consideration of an interdisciplinary care concept.Results. Radiologic imaging modalities crucially contribute to the complete injury assessment and provide an indispensable basis for any therapeutic decision. Comprehensive neuromonitoring and reliable demonstration of delayed or secondary brain damage is impossible without modern imaging technology. Computed tomography (CT) further continues to be the most important imaging modality, while magnetic resonance imaging despite it's partly superior diagnostic informations remains reserved to particular diagnostic problems.Conclusions. Suitable constructive prerequisites, an interdisciplinary care concept and integration of the radiologist in hospital-adapted diagnostic and therapeutic algorithms significantly improves the outcome of patients with acute head injury. Beside the correct diagnosis itself the time to establish a diagnosis above all has a crucial impact on successful management and good outcome of these patients. (orig.) [de

  16. Combining results of multiple search engines in proteomics.

    Science.gov (United States)

    Shteynberg, David; Nesvizhskii, Alexey I; Moritz, Robert L; Deutsch, Eric W

    2013-09-01

    A crucial component of the analysis of shotgun proteomics datasets is the search engine, an algorithm that attempts to identify the peptide sequence from the parent molecular ion that produced each fragment ion spectrum in the dataset. There are many different search engines, both commercial and open source, each employing a somewhat different technique for spectrum identification. The set of high-scoring peptide-spectrum matches for a defined set of input spectra differs markedly among the various search engine results; individual engines each provide unique correct identifications among a core set of correlative identifications. This has led to the approach of combining the results from multiple search engines to achieve improved analysis of each dataset. Here we review the techniques and available software for combining the results of multiple search engines and briefly compare the relative performance of these techniques.

  17. Combining Results of Multiple Search Engines in Proteomics*

    Science.gov (United States)

    Shteynberg, David; Nesvizhskii, Alexey I.; Moritz, Robert L.; Deutsch, Eric W.

    2013-01-01

    A crucial component of the analysis of shotgun proteomics datasets is the search engine, an algorithm that attempts to identify the peptide sequence from the parent molecular ion that produced each fragment ion spectrum in the dataset. There are many different search engines, both commercial and open source, each employing a somewhat different technique for spectrum identification. The set of high-scoring peptide-spectrum matches for a defined set of input spectra differs markedly among the various search engine results; individual engines each provide unique correct identifications among a core set of correlative identifications. This has led to the approach of combining the results from multiple search engines to achieve improved analysis of each dataset. Here we review the techniques and available software for combining the results of multiple search engines and briefly compare the relative performance of these techniques. PMID:23720762

  18. Clinical diagnostic criteria of multiple sclerosis: the role of magnetic resonance imaging

    International Nuclear Information System (INIS)

    Belair, M.; Girard, M.

    2004-01-01

    The objective of this article is to summarize the diagnostic criteria recommended by the International Panel on the Diagnosis of Multiple Sclerosis in 2001. The recommendations of another working group, the Consortium of Multiple Sclerosis Centers Consensus Meeting, which met in Vancouver in 2001, concerning the diagnosis and follow-up of patients with multiple sclerosis are also presented in an effort to standardize the protocols for magnetic resonance imaging of these patients. (author)

  19. Multiple foci of splenic tissue autotransplantation: Splenosis in diagnostic imaging

    International Nuclear Information System (INIS)

    Laskowska, K.; Burzynska-Makuch, M.; Drewa, S.; Lasek, W.; Pilecki, S.; Junik, R.

    2005-01-01

    Splenosis is usually defined as an autotransplantation of lienal tissue in the abdomen or cest following trauma to the spleen and/or splenectomy. The authors present the case of patient 15 years after a splenectomy performed because of extensive abdominal trauma. A new computed tomographic (CT) scan of the abdomen revealed multiple homogenous nodules, different in size, spread in the abdomen. Their density was characteristic of spleen. Ultrasound examination revealed only the largest tumors, located close to the liver and apparently isoechogenic to it. Static scintigraphy and SPECT were performed to prove the presence of splenosis. After treating the patient with colloid sulfide, multiple foci of increased radioisotope accumulation were identified in the abdomen, extrahepatic at the same locations as the masses visible on the CT scans, which were comparable to splenic tissue. Nodules revealed during CT or abdominal US in patients previously treated by splenectomy require further imaging with static scintigraphy of the liver and spleen in order to confirm or exclude splenosis. (author)

  20. Combined Scanning Confocal Ultrasound Diagnostic and Treatment System for Bone Quality Assessment and Fracture Healing

    Data.gov (United States)

    National Aeronautics and Space Administration — The objectives of this study are to develop a combined diagnostic and treatment ultrasound technology for early prediction of bone disorder and guided acceleration...

  1. Radiological diagnostics of multiple myeloma; Radiologische Diagnostik des multiplen Myeloms

    Energy Technology Data Exchange (ETDEWEB)

    D' Anastasi, M.; Grandl, S.; Reiser, M.F.; Baur-Melnyk, A. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany)

    2014-06-15

    Robust and reliable imaging methods are required to estimate the skeletal tumor load in multiple myeloma, as well as for the diagnosis of extraskeletal manifestations. Imaging also plays an essential role in the assessment of fracture risk and of vertebral fractures. The conventional skeletal survey has been the gold standard in the imaging of multiple myeloma for many years. Other modalities which have been investigated and are in use are whole-body computed tomography (WBCT), 18F-fluorodeoxyglucose positron emission tomography computed tomography (FDG PET-CT) and whole-body magnetic resonance imaging (WBMRI). These techniques are able to depict both mineralized bone and the bone marrow with a high sensitivity for myeloma lesions. Several studies have shown that cross-sectional imaging is superior to the skeletal survey in the detection of myeloma lesions and WBMRI has been shown to be significantly more sensitive than WBCT for the detection of focal myeloma lesions as well as for diffuse infiltration. The FDG PET-CT technique has a sensitivity comparable to WBMRI. Due to the higher sensitivity in the detection of myeloma lesions WBCT and WBMRI should replace the skeletal survey. A WBCT should be performed if there is suspicion of multiple myeloma. If no focal lesions are found WBMRI or at least MRI of the spine and pelvis should be additionally performed if available. If WBMRI has been initially performed and focal lesions are present, an additional WBCT may be performed to assess the extent of bone destruction and fracture risk. In cases of monoclonal gammopathy of undetermined significance (MGUS), solitary and smoldering myeloma, a WBMRI, if available, should be performed in addition to WBCT. (orig.) [German] Die Aufgabe der bildgebenden Diagnostik beim multiplen Myelom (MM) ist die zuverlaessige Erfassung der Tumorlast im Skelett sowie auch der extraskelettalen Manifestationen und der assoziierten Komplikationen (z. B. Wirbelkoerperfrakturen, Frakturgefahr

  2. Automatic plankton image classification combining multiple view features via multiple kernel learning.

    Science.gov (United States)

    Zheng, Haiyong; Wang, Ruchen; Yu, Zhibin; Wang, Nan; Gu, Zhaorui; Zheng, Bing

    2017-12-28

    Plankton, including phytoplankton and zooplankton, are the main source of food for organisms in the ocean and form the base of marine food chain. As the fundamental components of marine ecosystems, plankton is very sensitive to environment changes, and the study of plankton abundance and distribution is crucial, in order to understand environment changes and protect marine ecosystems. This study was carried out to develop an extensive applicable plankton classification system with high accuracy for the increasing number of various imaging devices. Literature shows that most plankton image classification systems were limited to only one specific imaging device and a relatively narrow taxonomic scope. The real practical system for automatic plankton classification is even non-existent and this study is partly to fill this gap. Inspired by the analysis of literature and development of technology, we focused on the requirements of practical application and proposed an automatic system for plankton image classification combining multiple view features via multiple kernel learning (MKL). For one thing, in order to describe the biomorphic characteristics of plankton more completely and comprehensively, we combined general features with robust features, especially by adding features like Inner-Distance Shape Context for morphological representation. For another, we divided all the features into different types from multiple views and feed them to multiple classifiers instead of only one by combining different kernel matrices computed from different types of features optimally via multiple kernel learning. Moreover, we also applied feature selection method to choose the optimal feature subsets from redundant features for satisfying different datasets from different imaging devices. We implemented our proposed classification system on three different datasets across more than 20 categories from phytoplankton to zooplankton. The experimental results validated that our system

  3. PET-CT for nuclear medicine diagnostics of multiple myeloma

    International Nuclear Information System (INIS)

    Dimitrakopoulou-Strauss, A.

    2014-01-01

    Functional or morphofunctional imaging modalities are used in myeloma patients for the diagnosis and therapy management within research protocols. Despite new staging criteria, which take into account the viability of a myeloma lesion, positron emission tomography (PET) is not used routinely. The impact of PET is therefore open. The role of PET and PET computed tomography (PET-CT) for the diagnosis and therapy management is discussed. The use of PET with 18F-fluorodeoxyglucose (FDG) allows the measurement of viable myeloma lesions and correlates with the stage of disease. A negative FDG examination correlates with a better prognosis. Furthermore, the number of focal lesions as well as the whole functional volume of myeloma lesions in FDG have a prognostic impact. Several studies have demonstrated the impact of FDG for the assessment of therapy monitoring and show that FDG is an earlier indicator for therapy response as compared to magnetic resonance imaging (MRI). The CT component of the new hybrid systems allows the assessment of osteolytic lesions in CT and their viability in FDG. The combination of PET with an MRT scanner allows the simultaneous measurement of bone marrow infiltration, focal lesions and their viability. The use of modern hybrid scanners, such as PET-CT and PET-MRT facilitates the simultaneous measurement of viable myeloma lesions, osteolytic lesions and bone marrow infiltration in the whole body; therefore, it is expected that these imaging modalities will play a greater role both in diagnosis and therapy management. (orig.) [de

  4. Tuning Cell and Tissue Development by Combining Multiple Mechanical Signals.

    Science.gov (United States)

    Sinha, Ravi; Verdonschot, Nico; Koopman, Bart; Rouwkema, Jeroen

    2017-10-01

    Mechanical signals offer a promising way to control cell and tissue development. It has been established that cells constantly probe their mechanical microenvironment and employ force feedback mechanisms to modify themselves and when possible, their environment, to reach a homeostatic state. Thus, a correct mechanical microenvironment (external forces and mechanical properties and shapes of cellular surroundings) is necessary for the proper functioning of cells. In vitro or in the case of nonbiological implants in vivo, where cells are in an artificial environment, addition of the adequate mechanical signals can, therefore, enable the cells to function normally as in vivo. Hence, a wide variety of approaches have been developed to apply mechanical stimuli (such as substrate stretch, flow-induced shear stress, substrate stiffness, topography, and modulation of attachment area) to cells in vitro. These approaches have not just revealed the effects of the mechanical signals on cells but also provided ways for probing cellular molecules and structures that can provide a mechanistic understanding of the effects. However, they remain lower in complexity compared with the in vivo conditions, where the cellular mechanical microenvironment is the result of a combination of multiple mechanical signals. Therefore, combinations of mechanical stimuli have also been applied to cells in vitro. These studies have had varying focus-developing novel platforms to apply complex combinations of mechanical stimuli, observing the co-operation/competition between stimuli, combining benefits of multiple stimuli toward an application, or uncovering the underlying mechanisms of their action. In general, they provided new insights that could not have been predicted from previous knowledge. We present here a review of several such studies and the insights gained from them, thereby making a case for such studies to be continued and further developed.

  5. Searching for neurodegeneration in multiple sclerosis at clinical onset: Diagnostic value of biomarkers.

    Science.gov (United States)

    Novakova, Lenka; Axelsson, Markus; Malmeström, Clas; Imberg, Henrik; Elias, Olle; Zetterberg, Henrik; Nerman, Olle; Lycke, Jan

    2018-01-01

    Neurodegeneration occurs during the early stages of multiple sclerosis. It is an essential, devastating part of the pathophysiology. Tools for measuring the degree of neurodegeneration could improve diagnostics and patient characterization. This study aimed to determine the diagnostic value of biomarkers of degeneration in patients with recent clinical onset of suspected multiple sclerosis, and to evaluate these biomarkers for characterizing disease course. This cross-sectional study included 271 patients with clinical features of suspected multiple sclerosis onset and was the baseline of a prospective study. After diagnostic investigations, the patients were classified into the following disease groups: patients with clinically isolated syndrome (n = 4) or early relapsing remitting multiple sclerosis (early RRMS; n = 93); patients with relapsing remitting multiple sclerosis with disease durations ≥2 years (established RRMS; n = 39); patients without multiple sclerosis, but showing symptoms (symptomatic controls; n = 89); and patients diagnosed with other diseases (n = 46). In addition, we included healthy controls (n = 51) and patients with progressive multiple sclerosis (n = 23). We analyzed six biomarkers of neurodegeneration: cerebrospinal fluid neurofilament light chain levels; cerebral spinal fluid glial fibrillary acidic protein; cerebral spinal fluid tau; retinal nerve fiber layer thickness; macula volume; and the brain parenchymal fraction. Except for increased cerebral spinal fluid neurofilament light chain levels, median 670 ng/L (IQR 400-2110), we could not find signs of early degeneration in the early disease group with recent clinical onset. However, the intrathecal immunoglobin G production and cerebral spinal fluid neurofilament light chain levels showed diagnostic value. Moreover, elevated levels of cerebral spinal fluid glial fibrillary acidic protein, thin retinal nerve fiber layers, and low brain parenchymal fractions were associated with

  6. Optimizing the diagnostic power with gastric emptying scintigraphy at multiple time points

    Directory of Open Access Journals (Sweden)

    Gajewski Byron J

    2011-05-01

    Full Text Available Abstract Background Gastric Emptying Scintigraphy (GES at intervals over 4 hours after a standardized radio-labeled meal is commonly regarded as the gold standard for diagnosing gastroparesis. The objectives of this study were: 1 to investigate the best time point and the best combination of multiple time points for diagnosing gastroparesis with repeated GES measures, and 2 to contrast and cross-validate Fisher's Linear Discriminant Analysis (LDA, a rank based Distribution Free (DF approach, and the Classification And Regression Tree (CART model. Methods A total of 320 patients with GES measures at 1, 2, 3, and 4 hour (h after a standard meal using a standardized method were retrospectively collected. Area under the Receiver Operating Characteristic (ROC curve and the rate of false classification through jackknife cross-validation were used for model comparison. Results Due to strong correlation and an abnormality in data distribution, no substantial improvement in diagnostic power was found with the best linear combination by LDA approach even with data transformation. With DF method, the linear combination of 4-h and 3-h increased the Area Under the Curve (AUC and decreased the number of false classifications (0.87; 15.0% over individual time points (0.83, 0.82; 15.6%, 25.3%, for 4-h and 3-h, respectively at a higher sensitivity level (sensitivity = 0.9. The CART model using 4 hourly GES measurements along with patient's age was the most accurate diagnostic tool (AUC = 0.88, false classification = 13.8%. Patients having a 4-h gastric retention value >10% were 5 times more likely to have gastroparesis (179/207 = 86.5% than those with ≤10% (18/113 = 15.9%. Conclusions With a mixed group of patients either referred with suspected gastroparesis or investigated for other reasons, the CART model is more robust than the LDA and DF approaches, capable of accommodating covariate effects and can be generalized for cross institutional applications, but

  7. Operative and diagnostic hysteroscopy: A novel learning model combining new animal models and virtual reality simulation.

    Science.gov (United States)

    Bassil, Alfred; Rubod, Chrystèle; Borghesi, Yves; Kerbage, Yohan; Schreiber, Elie Servan; Azaïs, Henri; Garabedian, Charles

    2017-04-01

    Hysteroscopy is one of the most common gynaecological procedure. Training for diagnostic and operative hysteroscopy can be achieved through numerous previously described models like animal models or virtual reality simulation. We present our novel combined model associating virtual reality and bovine uteruses and bladders. End year residents in obstetrics and gynaecology attended a full day workshop. The workshop was divided in theoretical courses from senior surgeons and hands-on training in operative hysteroscopy and virtual reality Essure ® procedures using the EssureSim™ and Pelvicsim™ simulators with multiple scenarios. Theoretical and operative knowledge was evaluated before and after the workshop and General Points Averages (GPAs) were calculated and compared using a Student's T test. GPAs were significantly higher after the workshop was completed. The biggest difference was observed in operative knowledge (0,28 GPA before workshop versus 0,55 after workshop, pvirtual reality simulation is an efficient model not described before. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Structured diagnostic imaging in patients with multiple trauma; Strukturierte radiologische Diagnostik beim Polytrauma

    Energy Technology Data Exchange (ETDEWEB)

    Linsenmaier, U.; Rieger, J.; Rock, C.; Pfeifer, K.J.; Reiser, M. [Institut fuer Klinische Radiologie, Klinikum der Universitaet Muenchen, Innenstadt (Germany); Kanz, K.G. [Chirurgische Klinik, Klinikum der Universitaet Muenchen, Innenstadt (Germany)

    2002-07-01

    Purpose. Development of a concept for structured diagnostic imaging in patients with multiple trauma.Material and methods. Evaluation of data from a prospective trial with over 2400 documented patients with multiple trauma. All diagnostic and therapeutic steps, primary and secondary death and the 90 days lethality were documented.Structured diagnostic imaging of multiple injured patients requires the integration of an experienced radiologist in an interdisciplinary trauma team consisting of anesthesia, radiology and trauma surgery. Radiology itself deserves standardized concepts for equipment, personnel and logistics to perform diagnostic imaging for a 24-h-coverage with constant quality.Results. This paper describes criteria for initiation of a shock room or emergency room treatment, strategies for documentation and interdisciplinary algorithms for the early clinical care coordinating diagnostic imaging and therapeutic procedures following standardized guidelines. Diagnostic imaging consists of basic diagnosis, radiological ABC-rule, radiological follow-up and structured organ diagnosis using CT. Radiological trauma scoring allows improved quality control of diagnosis and therapy of multiple injured patients.Conclusion. Structured diagnostic imaging of multiple injured patients leads to a standardization of diagnosis and therapy and ensures constant process quality. (orig.) [German] Fragestellung. Entwicklung eines strukturierten Konzeptes zur radiologischen Diagnostik polytraumatisierter Patienten.Methodik. Die Datenevaluation erfolgte auf Basis einer prospektiven interdisziplinaere Polytraumastudie mit ueber 2400 Patienten. Alle diagnostischen und therapeutischen Schritte werden jeweils unter Angabe von Zeitpunkt und auftretenden Komplikationen erfasst, ein primaeres oder sekundaeres Versterben und die 90-Tage-Letalitaet werden dokumentiert.Die strukturierte radiologische Diagnostik von Mehrfachverletzen verlangt die Integration eines erfahrenen Radiologen in

  9. Diagnostic Utility of Total IgE in Foods, Inhalant, and Multiple Allergies in Saudi Arabia.

    Science.gov (United States)

    Al-Mughales, Jamil A

    2016-01-01

    Objective. To assess the diagnostic significance of total IgE in foods, inhalant, and multiple allergies. Methods. Retrospective review of the laboratory records of patients who presented with clinical suspicion of food or inhalant allergy between January 2013 and December 2014. Total IgE level was defined as positive for a value >195 kU/L; and diagnosis was confirmed by the detection of specific IgE (golden standard) for at least one food or inhalant allergen and at least two allergens in multiple allergies. Results. A total of 1893 (male ratio = 0.68, mean age = 39.0 ± 19.2 years) patients were included. Total IgE had comparable sensitivity (55.8% versus 59.6%) and specificity (83.9% versus 84.4%) in food versus inhalant allergy, respectively, but a superior PPV in inhalant allergy (79.1% versus 54.4%). ROC curve analysis showed a better diagnostic value in inhalant allergies (AUC = 0.817 (95% CI = 0.796-0.837) versus 0.770 (95% CI = 0.707-0.833)). In multiple allergies, total IgE had a relatively good sensitivity (78.6%), while negative IgE testing (allergies with 91.5% certitude. Conclusion. Total IgE assay is not efficient as a diagnostic test for foods, inhalant, or multiple allergies. The best strategy should refer to specific IgE testing guided by a comprehensive atopic history.

  10. Isothermal multiple displacement amplification: a methodical approach enhancing molecular routine diagnostics of microcarcinomas and small biopsies

    Directory of Open Access Journals (Sweden)

    Mairinger FD

    2014-08-01

    Full Text Available Fabian D Mairinger,1 Robert FH Walter,2 Claudia Vollbrecht,3 Thomas Hager,1 Karl Worm,1 Saskia Ting,1 Jeremias Wohlschläger,1 Paul Zarogoulidis,4 Konstantinos Zarogoulidis,4 Kurt W Schmid1 1Institute of Pathology, 2Ruhrlandklinik, West German Lung Center, University Hospital Essen, Essen, 3Institute of Pathology, University Hospital Cologne, Cologne, Germany; 4Pulmonary Department, Oncology Unit, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece Background and methods: Isothermal multiple displacement amplification (IMDA can be a powerful tool in molecular routine diagnostics for homogeneous and sequence-independent whole-genome amplification of notably small tumor samples, eg, microcarcinomas and biopsies containing a small amount of tumor. Currently, this method is not well established in pathology laboratories. We designed a study to confirm the feasibility and convenience of this method for routine diagnostics with formalin-fixed, paraffin-embedded samples prepared by laser-capture microdissection. Results: A total of 250 µg DNA (concentration 5 µg/µL was generated by amplification over a period of 8 hours with a material input of approximately 25 cells, approximately equivalent to 175 pg of genomic DNA. In the generated DNA, a representation of all chromosomes could be shown and the presence of elected genes relevant for diagnosis in clinical samples could be proven. Mutational analysis of clinical samples could be performed without any difficulty and showed concordance with earlier diagnostic findings. Conclusion: We established the feasibility and convenience of IMDA for routine diagnostics. We also showed that small amounts of DNA, which were not analyzable with current molecular methods, could be sufficient for a wide field of applications in molecular routine diagnostics when they are preamplified with IMDA. Keywords: isothermal multiple displacement amplification, isothermal, whole

  11. An update on the use of cerebrospinal fluid analysis as a diagnostic tool in multiple sclerosis.

    Science.gov (United States)

    Gastaldi, Matteo; Zardini, Elisabetta; Franciotta, Diego

    2017-01-01

    Intrathecal B-lymphocyte activation is a hallmark of multiple sclerosis (MS), a multi-factorial inflammatory-demyelinating disease of the central nervous system. Such activation has a counterpart in the cerebrospinal fluid (CSF) oligoclonal IgG bands (OCB), whose diagnostic role in MS has been downgraded within the current McDonald's criteria. With a theoretico-practical approach, the authors review the physiopathological basis of the CSF dynamics, and the state-of-the-art of routine CSF analysis and CSF biomarkers in MS. Areas covered: The authors discuss pros and cons of CSF analysis, including critical evaluations of both well-established, and promising diagnostic and prognostic laboratory tools. New acquisitions on the CSF and cerebral interstitial fluid dynamics are also presented. The authors searched the PubMed database for English-language articles reported between January 2010 and June 2016, using the key words 'multiple sclerosis', 'cerebrospinal fluid', 'oligoclonal bands'. Reference lists of relevant articles were scanned for additional studies. Expert commentary: The availability of performing high-quality, routine CSF tests in specialized laboratories, the emerging potential of novel CSF biomarkers, and the trend for early treatments should induce a reappraisal of CSF analysis for diagnostic and prognostic purposes in MS. Further procedural and methodological improvements seem to be necessary in both research and translational diagnostic CSF settings.

  12. Robust handling of dynamics and multiple failures in a diagnostic event analyzer

    International Nuclear Information System (INIS)

    Finch, F.E.; Kramer, M.A.

    1991-01-01

    MIDAS diagnoses malfunctions in continuous chemical and refinery processes using a plant-independent strategy based on qualitative and quantitative process models. MIDAS specifically addresses problems not treated in past systems, including: process dynamics with control system responses, multiple faults and induced failures, and out-of-order and false alarms. This paper discusses both the structure of the process models and the diagnostic reasoning strategies employed by MIDAS

  13. 78 FR 21128 - Molecular Diagnostic Instruments With Combined Functions; Draft Guidance for Industry and Food...

    Science.gov (United States)

    2013-04-09

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-D-0258] Molecular Diagnostic Instruments With Combined Functions; Draft Guidance for Industry and Food and Drug Administration Staff; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food...

  14. Isothermal multiple displacement amplification: a methodical approach enhancing molecular routine diagnostics of microcarcinomas and small biopsies.

    Science.gov (United States)

    Mairinger, Fabian D; Walter, Robert Fh; Vollbrecht, Claudia; Hager, Thomas; Worm, Karl; Ting, Saskia; Wohlschläger, Jeremias; Zarogoulidis, Paul; Zarogoulidis, Konstantinos; Schmid, Kurt W

    2014-01-01

    Isothermal multiple displacement amplification (IMDA) can be a powerful tool in molecular routine diagnostics for homogeneous and sequence-independent whole-genome amplification of notably small tumor samples, eg, microcarcinomas and biopsies containing a small amount of tumor. Currently, this method is not well established in pathology laboratories. We designed a study to confirm the feasibility and convenience of this method for routine diagnostics with formalin-fixed, paraffin-embedded samples prepared by laser-capture microdissection. A total of 250 μg DNA (concentration 5 μg/μL) was generated by amplification over a period of 8 hours with a material input of approximately 25 cells, approximately equivalent to 175 pg of genomic DNA. In the generated DNA, a representation of all chromosomes could be shown and the presence of elected genes relevant for diagnosis in clinical samples could be proven. Mutational analysis of clinical samples could be performed without any difficulty and showed concordance with earlier diagnostic findings. We established the feasibility and convenience of IMDA for routine diagnostics. We also showed that small amounts of DNA, which were not analyzable with current molecular methods, could be sufficient for a wide field of applications in molecular routine diagnostics when they are preamplified with IMDA.

  15. Combined interpretation of multiple geophysical techniques: an archaeological case study

    Science.gov (United States)

    Riedl, S.; Reichmann, S.; Tronicke, J.; Lück, E.

    2009-04-01

    In order to locate and ascertain the dimensions of an ancient orangery, we explored an area of about 70 m x 60 m in the Rheinsberg Palace Garden (Germany) with multiple geophysical techniques. The Rheinsberg Park, situated about 100 km northwest of Berlin, Germany, was established by the Prussian emperors in the 18th century. Due to redesign of the architecture and the landscaping during the past 300 years, buildings were dismantled and detailed knowledge about some original buildings got lost. We surveyed an area close to a gazebo where, after historical sources, an orangery was planned around the year 1740. However, today it is not clear to what extent this plan has been realized and if remains of this building are still buried in the subsurface. Applied geophysical techniques include magnetic gradiometry, frequency domain electromagnetic (FDEM) and direct current (DC) resistivity mapping as well as ground penetrating radar (GPR). To get an overview of the site, we performed FDEM electrical conductivity mapping using an EM38 instrument and magnetic gradiometry with caesium magnetometers. Both data sets were collected with an in- and crossline data point spacing of ca. 10 cm and 50 cm, respectively. DC resistivity surveying was performed using a pole-pole electrode configuration with an electrode spacing of 1.5 m and a spacing of 1.0 m between individual readings. A 3-D GPR survey was conducted using 200 MHz antennae and in- and crossline spacing of ca. 10 cm and 40 cm, respectively. A standard processing sequence including 3-D migration was applied. A combined interpretation of all collected data sets illustrates that the magnetic gradient and the EM38 conductivity maps is are dominated by anomalies from metallic water pipes from belonging to the irrigation system of the park. The DC resistivity map outlines a rectangular area which might indicate the extension of a former building south of the gazebo. The 3-D GPR data set provides further insights about

  16. The Added Value of the Combined Use of the Autism Diagnostic Interview-Revised and the Autism Diagnostic Observation Schedule: Diagnostic Validity in a Clinical Swedish Sample of Toddlers and Young Preschoolers

    Science.gov (United States)

    Zander, Eric; Sturm, Harald; Bölte, Sven

    2015-01-01

    The diagnostic validity of the new research algorithms of the Autism Diagnostic Interview-Revised and the revised algorithms of the Autism Diagnostic Observation Schedule was examined in a clinical sample of children aged 18-47 months. Validity was determined for each instrument separately and their combination against a clinical consensus…

  17. 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.

  18. Diagnostics

    DEFF Research Database (Denmark)

    Donné, A.J.H.; Costley, A.E.; Barnsley, R.

    2007-01-01

    of the measurements—time and spatial resolutions, etc—will in some cases be more stringent. Many of the measurements will be used in the real time control of the plasma driving a requirement for very high reliability in the systems (diagnostics) that provide the measurements. The implementation of diagnostic systems...... on ITER is a substantial challenge. Because of the harsh environment (high levels of neutron and gamma fluxes, neutron heating, particle bombardment) diagnostic system selection and design has to cope with a range of phenomena not previously encountered in diagnostic design. Extensive design and R......&D is needed to prepare the systems. In some cases the environmental difficulties are so severe that new diagnostic techniques are required. The starting point in the development of diagnostics for ITER is to define the measurement requirements and develop their justification. It is necessary to include all...

  19. Tissue classification and diagnostics using a fiber probe for combined Raman and fluorescence spectroscopy

    Science.gov (United States)

    Cicchi, Riccardo; Anand, Suresh; Crisci, Alfonso; Giordano, Flavio; Rossari, Susanna; De Giorgi, Vincenzo; Maio, Vincenza; Massi, Daniela; Nesi, Gabriella; Buccoliero, Anna Maria; Guerrini, Renzo; Pimpinelli, Nicola; Pavone, Francesco S.

    2015-07-01

    Two different optical fiber probes for combined Raman and fluorescence spectroscopic measurements were designed, developed and used for tissue diagnostics. Two visible laser diodes were used for fluorescence spectroscopy, whereas a laser diode emitting in the NIR was used for Raman spectroscopy. The two probes were based on fiber bundles with a central multimode optical fiber, used for delivering light to the tissue, and 24 surrounding optical fibers for signal collection. Both fluorescence and Raman spectra were acquired using the same detection unit, based on a cooled CCD camera, connected to a spectrograph. The two probes were successfully employed for diagnostic purposes on various tissues in a good agreement with common routine histology. This study included skin, brain and bladder tissues and in particular the classification of: malignant melanoma against melanocytic lesions and healthy skin; urothelial carcinoma against healthy bladder mucosa; brain tumor against dysplastic brain tissue. The diagnostic capabilities were determined using a cross-validation method with a leave-one-out approach, finding very high sensitivity and specificity for all the examined tissues. The obtained results demonstrated that the multimodal approach is crucial for improving diagnostic capabilities. The system presented here can improve diagnostic capabilities on a broad range of tissues and has the potential of being used for endoscopic inspections in the near future.

  20. Combination of interferometry and thermography data for cultural heritage structural diagnostic research

    Science.gov (United States)

    Tornari, Vivi; Andrianakis, Michalis; Hatzigiannakis, Kostas; Kosma, Kiki; Detalle, Vincent; Giovanacci, David

    2017-07-01

    The demand for non destructive and non invasive structural diagnostic techniques able to perform on field remote structural evaluation of historical structures and works of art it faces an increased demand. The techniques must have some basic important characteristics The non destructivity, accuracy, repeatability, non physical contact, portability, resolution, broad range of applicability depending on the type of artwork and the question at hand, are all among the important requirements underlying the requirement for on-field structural diagnostics. In this respect there are two known techniques that have been developed at full to provide a suited structural diagnostic application in artwork conservation. The systems presented here but discussed in detail elsewhere are stimulated infrared thermography (SIRT) and digital holographic speckle pattern interferometry (DHSPI) the prior can be found n market at commercial devise level while the latter is at laboratory prototype level. The two systems are being exploited for their complimentary advantages and in this paper are used in combined testing on art related targets according to the above criteria to confirm the enhanced diagnostic information that their complimentary use provides. Results confirm the effectiveness of each technique alone and the combination of data of both techniques in the conservation field. Each system is first briefly described and examples are given with the aim to present the suitability and appropriateness for use in structural documentation analysis and reports. The experimental work is in laboratory work-in-progress focusing on the hybriding of data synthesis.

  1. Noise characterization of weighting schemes for combination of multiple exposures

    DEFF Research Database (Denmark)

    Kirk, Kristian; Andersen, Hans Jørgen

    2006-01-01

    A method for capturing high intensity dynamic range scenes with a low dynamic range camera consists in taking a series of images with different exposure settings and combining these into a single high dynamic range image. The combined image values are found by weighted averaging of values from...

  2. Synergy Effect of Combining Fluorescence and Mid Infrared Fiber Spectroscopy for Kidney Tumor Diagnostics

    Directory of Open Access Journals (Sweden)

    Andrey Bogomolov

    2017-11-01

    Full Text Available Matching pairs of tumor and non-tumor kidney tissue samples of four patients were investigated ex vivo using a combination of two methods, attenuated total reflection mid infrared spectroscopy and fluorescence spectroscopy, through respectively prepared and adjusted fiber probes. In order to increase the data information content, the measurements on tissue samples in both methods were performed in the same 31 preselected positions. Multivariate data analysis revealed a synergic effect of combining the two methods for the diagnostics of kidney tumor compared to individual techniques.

  3. Survey of diagnostic and treatment practices for multiple sclerosis in Europe

    DEFF Research Database (Denmark)

    Fernández, O; Delvecchio, M; Edan, G

    2017-01-01

    BACKGROUND AND PURPOSE: Up-to-date information is needed on the extent to which neurologists treating multiple sclerosis (MS) in Europe are integrating rapidly evolving diagnostic criteria, disease-modifying therapies and recommendations for monitoring disease activity into their clinical practice...... syndrome (CIS), relapsing-remitting MS (RRMS) and RRMS with breakthrough disease. RESULTS: Multiple sclerosis neurologists from 11 European countries responded to survey 1 (n = 233) and survey 2 (n = 171). Respondents agreed that they would not treat the patients in the RIS or CIS cases but would treat...... a patient with a relatively mild form of RRMS. Choice of treatment was evenly distributed among first-line injectables and oral treatments for mild RRMS, and moved to second-line treatment as the RRMS case increased in severity. Additional results on RRMS with breakthrough disease are presented. CONCLUSIONS...

  4. Multiple-instance learning as a classifier combining problem

    DEFF Research Database (Denmark)

    Li, Yan; Tax, David M. J.; Duin, Robert P. W.

    2013-01-01

    In multiple-instance learning (MIL), an object is represented as a bag consisting of a set of feature vectors called instances. In the training set, the labels of bags are given, while the uncertainty comes from the unknown labels of instances in the bags. In this paper, we study MIL with the ass...

  5. Interobserver agreement on Poser's and the new McDonald's diagnostic criteria for multiple sclerosis.

    Science.gov (United States)

    Zipoli, V; Portaccio, E; Siracusa, G; Pracucci, G; Sorbi, S; Amato, M P

    2003-10-01

    We assessed the interobserver agreement on the diagnosis of multiple sclerosis (MS) in a study sample consisting of 41 MS (15 relapsing remitting, two secondary progressive, five primary progressive and 19 presenting their first clinical attack) and three non-MS cases. Clinical and paraclinical information was recorded in standardized forms. Four neurologists were asked to make a diagnosis using Poser's and McDonald's criteria and to assess MRI scans according to the McDonald's guidelines. In terms of the kappa statistic (kappa), we found a moderate agreement on the overall diagnosis using both Poser's and McDonald's criteria (kappa, respectively 0.57 and 0.52). As for distinct diagnostic categories, we observed a moderate to substantial agreement for the three McDonald categories (range of kappa values 0.49-0.64) and a fair to substantial agreement for the nine Poser categories (range of kappa values 0.37-0.67). Taking into account clinical information, the agreement on dissemination over time was substantially higher (kappa = 0.69) than that found on dissemination over space (kappa = 0.46). In contrast, for MRI assessment, the agreement for spatial dissemination was substantial (kappa = 0.74) compared with the fair agreement (kappa = 0.25) yielded by dissemination over time. The new McDonald's criteria yield a good overall diagnostic reliability, and compare favourably with Poser's classification in terms of agreement on distinct diagnostic categories.

  6. Diagnostic value of combined tumor markers detection for gastric and colorectal cancers

    International Nuclear Information System (INIS)

    Chen Wenzhang; Dong Lin

    2007-01-01

    Objective: To investigate the value of combined tumor markers detection in the clinical diagnosis for gastric cancer and colorectal cancel. Methods: The serum concentration of CEA, CA199, CA125, CA242 were measured by radioimmunoassay and Immunoradioassy in 46 patients with gastric cancer, 62 patients with colorectal cancer and 30 controls. Results: The diagnostic sensitivity, specificity, and accuracy of CEA were 37.0%, 96.7%, 59.2% respectively in gastric cancer,and 51.6%, 96.7%, 66.3% respectively in colorectal cancer, those of CA199 were 47.8%, 100.0%, 65.8% in gastric cancer, and 43.5%, 100.0%, 62, 0% in colorectal cancer, those of CA125 were 41.3%, 96.7%, 63.2% in gastric cancer, and 38.7%, 100.0%, 58.7% in colorectal cancer, those of CA242 were 54.3%, 100.0%, 71.5% in gastric cancer, and 51.6%, 100.0%, 67.4% in colorectal cancer. The diagnostic sensitivity specificity and accuracy of combined four markers were 73.9%, 93.3%, 82.9% in gastric cancer, and 77.4%, 96.7%, 83.7% in colorectal cancer. Compared with the respective value of any single marker, the diagnostic sensitivity and accuracy were significantly improved (P<0.05). Conclusion: Combined tumor markers detection could improve the diagnostic sensitivity and accuracy in gastric and colorectal cancers and was helpful for screening. (authors)

  7. Diagnostic radiology on multiple injured patients: interdisciplinary management; Radiologische Diagnostik beim Polytrauma: interdisziplinaeres Management

    Energy Technology Data Exchange (ETDEWEB)

    Linsenmaier, U.; Pfeifer, K.J. [Inst. fuer Radiologische Diagnostik, Klinikum der Univ. Muenchen (Germany); Kanz, K.G.; Mutschler, W. [Chirurgische Klinik Innenstadt, Klinikum der Univ. Muenchen, (Germany)

    2001-06-01

    The presence of a radiologist within the admitting area of an emergency department and his capability as a member of the trauma team have a major impact on the role of diagnostic radiology in trauma care. The knowledge of clinical decision criteria, algorithms, and standards of patient care are essential for the acceptance within a trauma team. We present an interdisciplinary management concept of diagnostic radiology for trauma patients, which comprises basic diagnosis, organ diagnosis, radiological ABC, and algorithms of early clinical care. It is the result of a prospective study comprising over 2000 documented multiple injured patients. The radiologist on a trauma team should support trauma surgery and anesthesia in diagnostic and clinical work-up. The radiological ABC provides a structured approach for diagnostic imaging in all steps of the early clinical care of the multiple injured patient. Radiological ABC requires a reevaluation in cases of equivocal findings or difficulties in the clinical course. Direct communication of radiological findings with the trauma team enables quick clinical decisions. In addition, the radiologist can priority-oriented influence the therapy by using interventional procedures. The clinical radiologist is an active member of the interdisciplinary trauma team, not only providing diagnostic imaging but also participating in clinical decisions. (orig.) [German] Die Anwesenheit des Radiologen im Schockraum und dessen Teamfaehigkeit bestimmen den Status der diagnostischen Radiologie in der Traumaversorgung. Voraussetzung zur Mitarbeit im interdisziplinaeren Traumateam ist die detaillierte Kenntnis der wesentlichen Entscheidungskriterien, Algorithmen und Behandlungsablaeufe. Das hier vorgestellte interdisziplinaere Managementkonzept der radiologischen Diagnostik beim Polytrauma mit Basisdiagnostik, Organdiagnostik, radiologischer ABC-Regel und Algorithmen zur fruehklinischen Behandlung beruht auf einer prospektiven Polytraumastudie mit

  8. Combination Therapy Strategies Against Multiple-Resistant Streptococcus Suis

    Directory of Open Access Journals (Sweden)

    Yang Yu

    2018-05-01

    Full Text Available Streptococcus suis is a major swine pathogen, an emerging zoonotic agent responsible for meningitis, endocarditis and septicaemia followed by deafness in humans. The development of antimicrobial resistance in S. suis increases the risk for therapeutic failure in both animals and humans. In this study, we report the synergism of combination therapy against multi-resistant S. suis isolates from swine. Twelve antibiotic profiles were determined against 11 S. suis strains. To investigate their synergistic/antagonistic activity, checkerboard assay was performed for all the possible combinations. In-vitro killing curves and in-vivo treatment trials were used to confirm the synergistic activity of special combinations against S. suis dominant clones. In this study, 11 S. suis isolates were highly resistant to erythromycin, clindamycin, trimethoprim/sulfamethoxazole, and tetracycline with ratios of 80–100%, and the resistance percentages to enrofloxacin, florfenicol, and spectinomycin were ~50%. The checkerboard data identified two combination regimens, ampicillin plus apramycin and tiamulin plus spectinomycin which gave the greatest level of synergism against the S. suis strains. In-vitro kill-curves showed a bacterial reduction of over 3-logCFU with the use of combination treatments, whilst the application of mono-therapies achieve less than a 2-logCFU cell killing. In-vivo models confirm that administration of these two combinations significantly reduced the number of bacterial cells after 24 h of treatment. In conclusions, the combinations of ampicillin plus apramycin and tiamulin plus spectinomycin showed the greatest synergism and may be potential strategies for treatment of multi-resistant S. suis in animal.

  9. Case-based reasoning combined with statistics for diagnostics and prognosis

    International Nuclear Information System (INIS)

    Olsson, T; Funk, P

    2012-01-01

    Many approaches used for diagnostics today are based on a precise model. This excludes diagnostics of many complex types of machinery that cannot be modelled and simulated easily or without great effort. Our aim is to show that by including human experience it is possible to diagnose complex machinery when there is no or limited models or simulations available. This also enables diagnostics in a dynamic application where conditions change and new cases are often added. In fact every new solved case increases the diagnostic power of the system. We present a number of successful projects where we have used feature extraction together with case-based reasoning to diagnose faults in industrial robots, welding, cutting machinery and we also present our latest project for diagnosing transmissions by combining Case-Based Reasoning (CBR) with statistics. We view the fault diagnosis process as three consecutive steps. In the first step, sensor fault signals from machines and/or input from human operators are collected. Then, the second step consists of extracting relevant fault features. In the final diagnosis/prognosis step, status and faults are identified and classified. We view prognosis as a special case of diagnosis where the prognosis module predicts a stream of future features.

  10. A Three Monoclonal Antibody Combination Potently Neutralizes Multiple Botulinum Neurotoxin Serotype E Subtypes.

    Science.gov (United States)

    Garcia-Rodriguez, Consuelo; Razai, Ali; Geren, Isin N; Lou, Jianlong; Conrad, Fraser; Wen, Wei-Hua; Farr-Jones, Shauna; Smith, Theresa J; Brown, Jennifer L; Skerry, Janet C; Smith, Leonard A; Marks, James D

    2018-03-01

    Human botulism is most commonly caused by botulinum neurotoxin (BoNT) serotypes A, B, and E. For this work, we sought to develop a human monoclonal antibody (mAb)-based antitoxin capable of binding and neutralizing multiple subtypes of BoNT/E. Libraries of yeast-displayed single chain Fv (scFv) antibodies were created from the heavy and light chain variable region genes of humans immunized with pentavalent-toxoid- and BoNT/E-binding scFv isolated by Fluorescence-Activated Cell Sorting (FACS). A total of 10 scFv were isolated that bound one or more BoNT/E subtypes with nanomolar-level equilibrium dissociation constants (K D ). By diversifying the V-regions of the lead mAbs and selecting for cross-reactivity, we generated three scFv that bound all four BoNT/E subtypes tested at three non-overlapping epitopes. The scFvs were converted to IgG that had K D values for the different BoNT/E subtypes ranging from 9.7 nM to 2.28 pM. An equimolar combination of the three mAbs was able to potently neutralize BoNT/E1, BoNT/E3, and BoNT/E4 in a mouse neutralization assay. The mAbs have potential utility as therapeutics and as diagnostics capable of recognizing multiple BoNT/E subtypes. A derivative of the three-antibody combination (NTM-1633) is in pre-clinical development with an investigational new drug (IND) application filing expected in 2018.

  11. A Three Monoclonal Antibody Combination Potently Neutralizes Multiple Botulinum Neurotoxin Serotype E Subtypes

    Directory of Open Access Journals (Sweden)

    Consuelo Garcia-Rodriguez

    2018-03-01

    Full Text Available Human botulism is most commonly caused by botulinum neurotoxin (BoNT serotypes A, B, and E. For this work, we sought to develop a human monoclonal antibody (mAb-based antitoxin capable of binding and neutralizing multiple subtypes of BoNT/E. Libraries of yeast-displayed single chain Fv (scFv antibodies were created from the heavy and light chain variable region genes of humans immunized with pentavalent-toxoid- and BoNT/E-binding scFv isolated by Fluorescence-Activated Cell Sorting (FACS. A total of 10 scFv were isolated that bound one or more BoNT/E subtypes with nanomolar-level equilibrium dissociation constants (KD. By diversifying the V-regions of the lead mAbs and selecting for cross-reactivity, we generated three scFv that bound all four BoNT/E subtypes tested at three non-overlapping epitopes. The scFvs were converted to IgG that had KD values for the different BoNT/E subtypes ranging from 9.7 nM to 2.28 pM. An equimolar combination of the three mAbs was able to potently neutralize BoNT/E1, BoNT/E3, and BoNT/E4 in a mouse neutralization assay. The mAbs have potential utility as therapeutics and as diagnostics capable of recognizing multiple BoNT/E subtypes. A derivative of the three-antibody combination (NTM-1633 is in pre-clinical development with an investigational new drug (IND application filing expected in 2018.

  12. Application of multislice spiral CT (MSCT) in multiple injured patients and its effect on diagnostic and therapeutic algorithms

    International Nuclear Information System (INIS)

    Boehm, T.; Alkadhi, H.; Schertler, T.; Baumert, B.; Roos, J.; Marincek, B.; Wildermuth, S.

    2004-01-01

    The initial diagnostic work-up of trauma victims with multiple injuries is currently a combination of conventional radiography (CR), ultrasound (US), and computed tomography (CT). This article reviews the diagnostic quality of the different imaging modalities regarding detection and classification of injuries. CT performs better than US in detecting traumatic lesions of abdominal parenchymal organs. Furthermore, CT is better than CR in detecting therapeutically relevant chest and bone injuries. MSCT may replace CR and US under the condition that it is faster than or at least as fast as the conventional approach to diagnose lite threatening injuries. This can be achieved only by changing the work-flow for the entire trauma team including radiologist. Furthermore, certain prerequisites must be fulfilled including integration of a MSCT scanner into the emergency room. An optimized whole body CT protocol for the assessment of trauma victims using MSCT as well as a two-step algorithm for reporting the imaging findings depending on their clinical significance is presented. (orig.)

  13. Facile integration of multiple magnetite nanoparticles for theranostics combining efficient MRI and thermal therapy

    Science.gov (United States)

    Huang, Guoming; Zhu, Xianglong; Li, Hui; Wang, Lirong; Chi, Xiaoqin; Chen, Jiahe; Wang, Xiaomin; Chen, Zhong; Gao, Jinhao

    2015-01-01

    Multifunctional nanostructures with both diagnostic and therapeutic capabilities have attracted considerable attention in biomedical research because they can offer great advantages in disease management and prognosis. In this work, a facile way to transfer the hydrophobic iron oxide (IO) nanoparticles into aqueous media by employing carboxylic graphene oxide (GO-COOH) as the transferring agent has been reported. In this one-step process, IO nanoparticles adhere to GO-COOH and form water-dispersible clusters via hydrophobic interactions between the hydrophobic ligands of IO nanoparticles and the basal plane of GO-COOH. The multiple IO nanoparticles on GO-COOH sheets (IO/GO-COOH) present a significant increase in T2 contrast enhancement. Moreover, the IO/GO-COOH nanoclusters also display a high photothermal conversion efficiency and can effectively inhibit tumor growth through the photothermal effects. It is envisioned that such IO/GO-COOH nanocomposites combining efficient MRI and photothermal therapy hold great promise in theranostic applications.Multifunctional nanostructures with both diagnostic and therapeutic capabilities have attracted considerable attention in biomedical research because they can offer great advantages in disease management and prognosis. In this work, a facile way to transfer the hydrophobic iron oxide (IO) nanoparticles into aqueous media by employing carboxylic graphene oxide (GO-COOH) as the transferring agent has been reported. In this one-step process, IO nanoparticles adhere to GO-COOH and form water-dispersible clusters via hydrophobic interactions between the hydrophobic ligands of IO nanoparticles and the basal plane of GO-COOH. The multiple IO nanoparticles on GO-COOH sheets (IO/GO-COOH) present a significant increase in T2 contrast enhancement. Moreover, the IO/GO-COOH nanoclusters also display a high photothermal conversion efficiency and can effectively inhibit tumor growth through the photothermal effects. It is envisioned

  14. NEUROPHYSIOLOGY PARAMETERS IN DIAGNOSTICS OF MULTIPLE SCLEROSIS AND ACUTE DISSEMINATED ENCEPHALOMYELITIS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    V. B. Voitenkov

    2017-01-01

    Full Text Available Our research objective was to evaluate the importance of neurophysiological methods in diagnosing the state of visual, somatosensory and motor pathways condition in the early stages of multiple sclerosis (MS and acute disseminated encephalomyelitis (ADEM in children.Materials and methods. Twenty-four children with a debut of multiple sclerosis, 15 children with debute of acute disseminated encephalomyelitis and 20 neurologically healthy children of the comparison group were examined. All patients were evaluated by neurologist, brain MRI and CSF analysis (isoelectrofocusing to oligoclonal IgG, oligoclonal bands test, visual evoked potentials (VEP, transcranial magnetic stimulation (TMS and somatosensory evoked potentials (SSEP.Results. In children with MS asymmetry of the conduction along the motor pathways on the spinal level was higher than in patients with ADEM and controls, functional state of somatosensory cortex neurons was lower and conduction along somatosensory pathways on the spinal level was slower – all differences significant. According to the visual evoked potentials, in more than half of the cases, there was an increase in the latency of the P100 peak. Also in MS group there was a significant disruption of the visual pathway in 54% of the cases. Neurophysiological changes in 58% of cases were demyelinating, and violations of the axonal type occurred in 37% of cases.Conclusions. Neurophysiological diagnostic methods such as transcranial magnetic stimulation, visual evoked potentials, somatosensory evoked potentials are highly informative for the differential diagnosis of multiple sclerosis and acute disseminated encephalomyelitis. More pronounced spinal lesions in early stages of MS than in ADEM in children may be the cause of the neurophysiologic differences, and prevalence of the sensory system involvement at this stage may be the reason behind more extended SSEP abnormalities comparing with TMS. VEP changes may reflect primary

  15. Learning Combinations of Multiple Feature Representations for Music Emotion Prediction

    DEFF Research Database (Denmark)

    Madsen, Jens; Jensen, Bjørn Sand; Larsen, Jan

    2015-01-01

    Music consists of several structures and patterns evolving through time which greatly influences the human decoding of higher-level cognitive aspects of music like the emotions expressed in music. For tasks, such as genre, tag and emotion recognition, these structures have often been identified...... and used as individual and non-temporal features and representations. In this work, we address the hypothesis whether using multiple temporal and non-temporal representations of different features is beneficial for modeling music structure with the aim to predict the emotions expressed in music. We test...

  16. A plasma amplifier to combine multiple beams at NIF

    Science.gov (United States)

    Kirkwood, R. K.; Turnbull, D. P.; Chapman, T.; Wilks, S. C.; Rosen, M. D.; London, R. A.; Pickworth, L. A.; Colaitis, A.; Dunlop, W. H.; Poole, P.; Moody, J. D.; Strozzi, D. J.; Michel, P. A.; Divol, L.; Landen, O. L.; MacGowan, B. J.; Van Wonterghem, B. M.; Fournier, K. B.; Blue, B. E.

    2018-05-01

    Combining laser beams in a plasma is enabled by seeded stimulated Brillouin scattering which allows cross-beam energy transfer (CBET) to occur and re-distributes the energy between beams that cross with different incident angles and small differences in wavelength [Kirkwood et al. Phys. Plasmas 4, 1800 (1997)]. Indirect-drive implosions at the National Ignition Facility (NIF) [Haynam et al. Appl. Opt. 46, 3276-3303 (2007)] have controlled drive symmetry by using plasma amplifiers to transfer energy between beams [Kirkwood et al., Plasma Phys. Controlled Fusion 55, 103001 (2013); Lindl et al., Phys. Plasmas 21, 020501 (2014); and Hurricane et al. Nature 506, 343-348 (2014)]. In this work, we show that the existing models are well enough validated by experiments to allow a design of a plasma beam combiner that, once optimized, is expected to produce a pulse of light in a single beam with the energy greatly enhanced over existing sources. The scheme combines up to 61 NIF beams with 120 kJ of available energy into a single f/20 beam with a 1 ns pulse duration and a 351 nm wavelength by both resonant and off-resonance CBET. Initial experiments are also described that have already succeeded in producing a 4 kJ, 1 ns pulse in a single beam by combination of up to eight incident pump beams containing <1.1 kJ/beam, which are maintained near resonance for CBET in a plasma that is formed by 60 pre-heating beams [Kirkwood et al., Nat. Phys. 14, 80 (2018)].

  17. Quality of Diagnosis and Treatment Plans After Using the 'Diagnostic Guideline for Anxiety and Challenging Behaviours' in People with Intellectual Disabilities: A Comparative Multiple Case Study Design.

    Science.gov (United States)

    Pruijssers, Addy; van Meijel, Berno; Maaskant, Marian; Keeman, Noortje; van Achterberg, Theo

    2016-07-01

    People with intellectual disabilities often have a multitude of concurrent problems due to the combination of cognitive impairments, psychiatric disorders (particularly anxiety) and related challenging behaviours. Diagnoses in people with intellectual disabilities are complicated. This study evaluates the quality of the diagnoses and treatment plans after using a guideline that was developed to support professionals in their diagnostic tasks. A comparative multiple case study with an experimental and control condition, applying deductive analyses of diagnoses and treatment plans. The analyses revealed that the number of diagnostic statements and planned treatment actions in the experimental group was significantly larger and more differentiated than in the control condition. In the control group, consequential harm and protective factors were hardly mentioned in diagnoses and treatment plans. Working with the 'Diagnostic Guideline for Anxiety and CB' leads to improved diagnoses and treatment plans compared with care as usual. © 2015 John Wiley & Sons Ltd.

  18. Diagnostic value of combined assessment of olfaction and sustantia nigra hyperechogenicity for Parkinson's disease.

    Science.gov (United States)

    López Hernández, N; García Escrivá, A; Shalabi Benavent, M

    2015-10-01

    Hyposmia and substantia nigra hyperechogenicity (SN+) are characteristic markers of Parkinson's disease (PD), although their diagnostic value in isolation may be limited. We evaluated the combined prevalence of both disorders in patients diagnosed with PD and assessed their diagnostic yield compared to a sample with essential tremor (ET) and another group of healthy subjects. Patients diagnosed with PD and ET and treated in our outpatient clinic were enrolled. Olfaction was assessed using the "Sniffin' Sticks" odour identification test (SS-12) and hyperechogenicity of the substantia nigra (SN+) was assessed by transcranial duplex ultrasound. A total of 98 subjects were analysed, comprising 30 with PD, 21 with ET, and 47 controls. The respective prevalence rates of hyposmia (SS-12 .24cm(2)) were 70% and 83.3% in PD, 33.3% and 9.5% in ET, and 17% and 10.6% in controls. Both markers were present in 63% of patients with PD, none of the patients with ET, and only 2 of the controls. Combined use of substantia nigra sonography and olfactory testing with SS-12, two rapid, safe, and accessible tests, was more specific than each isolated marker for distinguishing patients with PD from patients with ET and control subjects. Since both markers have been described in very early phases of PD, combined use may be helpful in providing early diagnosis of PD. Copyright © 2013 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  19. Validation and analysis of the coupled multiple response Colorado upper-division electrostatics diagnostic

    Directory of Open Access Journals (Sweden)

    Bethany R. Wilcox

    2015-11-01

    Full Text Available Standardized conceptual assessment represents a widely used tool for educational researchers interested in student learning within the standard undergraduate physics curriculum. For example, these assessments are often used to measure student learning across educational contexts and instructional strategies. However, to support the large-scale implementation often required for cross-institutional testing, it is necessary for these instruments to have question formats that facilitate easy grading. Previously, we created a multiple-response version of an existing, validated, upper-division electrostatics diagnostic with the goal of increasing the instrument’s potential for large-scale implementation. Here, we report on the validity and reliability of this new version as an independent instrument. These findings establish the validity of the multiple-response version as measured by multiple test statistics including item difficulty, item discrimination, and internal consistency. Moreover, we demonstrate that the majority of student responses to the new version are internally consistent even when they are incorrect and provide an example of how the new format can be used to gain insight into student difficulties with specific content in electrostatics.

  20. Combined adaptive multiple subtraction based on optimized event tracing and extended wiener filtering

    Science.gov (United States)

    Tan, Jun; Song, Peng; Li, Jinshan; Wang, Lei; Zhong, Mengxuan; Zhang, Xiaobo

    2017-06-01

    The surface-related multiple elimination (SRME) method is based on feedback formulation and has become one of the most preferred multiple suppression methods used. However, some differences are apparent between the predicted multiples and those in the source seismic records, which may result in conventional adaptive multiple subtraction methods being barely able to effectively suppress multiples in actual production. This paper introduces a combined adaptive multiple attenuation method based on the optimized event tracing technique and extended Wiener filtering. The method firstly uses multiple records predicted by SRME to generate a multiple velocity spectrum, then separates the original record to an approximate primary record and an approximate multiple record by applying the optimized event tracing method and short-time window FK filtering method. After applying the extended Wiener filtering method, residual multiples in the approximate primary record can then be eliminated and the damaged primary can be restored from the approximate multiple record. This method combines the advantages of multiple elimination based on the optimized event tracing method and the extended Wiener filtering technique. It is an ideal method for suppressing typical hyperbolic and other types of multiples, with the advantage of minimizing damage of the primary. Synthetic and field data tests show that this method produces better multiple elimination results than the traditional multi-channel Wiener filter method and is more suitable for multiple elimination in complicated geological areas.

  1. A combined statistical model for multiple motifs search

    International Nuclear Information System (INIS)

    Gao Lifeng; Liu Xin; Guan Shan

    2008-01-01

    Transcription factor binding sites (TFBS) play key roles in genebior 6.8 wavelet expression and regulation. They are short sequence segments with definite structure and can be recognized by the corresponding transcription factors correctly. From the viewpoint of statistics, the candidates of TFBS should be quite different from the segments that are randomly combined together by nucleotide. This paper proposes a combined statistical model for finding over-represented short sequence segments in different kinds of data set. While the over-represented short sequence segment is described by position weight matrix, the nucleotide distribution at most sites of the segment should be far from the background nucleotide distribution. The central idea of this approach is to search for such kind of signals. This algorithm is tested on 3 data sets, including binding sites data set of cyclic AMP receptor protein in E.coli, PlantProm DB which is a non-redundant collection of proximal promoter sequences from different species, collection of the intergenic sequences of the whole genome of E.Coli. Even though the complexity of these three data sets is quite different, the results show that this model is rather general and sensible. (general)

  2. What is the added value of combined core biopsy and fine needle aspiration in the diagnostic process of renal tumours?

    NARCIS (Netherlands)

    Barwari, K.; Kümmerlin, I.P.E.D.; Ten Kate, F.J.; Algaba, F.; Trias, I.; Wijkstra, H.; Rosette, de la J.J.M.C.H.; Laguna, M.P.

    2013-01-01

    Purpose Non-diagnostic results still hinder the routine use of core biopsy (CB) and fine needle aspiration (FNA) in the diagnostic process of renal tumours. Furthermore, substantial interobserver variability has been reported. We assessed the added value of combining the results of CB and FNA by

  3. What is the added value of combined core biopsy and fine needle aspiration in the diagnostic process of renal tumours?

    NARCIS (Netherlands)

    Barwari, K.; Kummerlin, I. P.; ten Kate, F. J.; Algaba, F.; Trias, I.; Wijkstra, H.; de la Rosette, J. J.; Laguna, P.

    2013-01-01

    Non-diagnostic results still hinder the routine use of core biopsy (CB) and fine needle aspiration (FNA) in the diagnostic process of renal tumours. Furthermore, substantial interobserver variability has been reported. We assessed the added value of combining the results of CB and FNA by five

  4. Blood-brain barrier disruption induced by diagnostic ultrasound combined with microbubbles in mice.

    Science.gov (United States)

    Zhao, Bingxia; Chen, Yihan; Liu, Jinfeng; Zhang, Li; Wang, Jing; Yang, Yali; Lv, Qing; Xie, Mingxing

    2018-01-12

    To investigate the effects of the microbubble (MB) dose, mechanism index (MI) and sonication duration on blood-brain barrier (BBB) disruption induced by diagnostic ultrasound combined with MBs as well as to investigate the potential molecular mechanism. The extent of BBB disruption increased with MB dose, MI and sonication duration. A relatively larger extent of BBB disruption associated with minimal tissue damage was achieved by an appropriate MB dose and ultrasound exposure parameters with diagnostic ultrasound. Decreased expression of ZO-1, occludin and claudin-5 were correlated with disruption of the BBB, as confirmed by paracellular passage of the tracer lanthanum nitrate into the brain parenchyma after BBB disruption. These findings indicated that this technique is a promising tool for promoting brain delivery of diagnostic and therapeutic agents in the diagnosis and treatment of brain diseases. The extent of BBB disruption was qualitatively assessed by Evans blue (EB) staining and quantitatively analyzed by an EB extravasation measurement. A histological examination was performed to evaluate tissue damage. Expression of tight junction (TJ) related proteins ZO-1, occludin and claudin-5 was determined by western blotting analysis and immunohistofluorescence. Transmission electron microscopy was performed to observe ultrastructure changes of TJs after BBB disruption.

  5. [Revision of McDonald's new diagnostic criteria for multiple sclerosis].

    Science.gov (United States)

    Wiendl, H; Kieseier, B C; Gold, R; Hohlfeld, R; Bendszus, M; Hartung, H-P

    2006-10-01

    In 2001, an international panel suggested new diagnostic criteria for multiple sclerosis (MS). These criteria integrate clinical, imaging (MRI), and paraclinical results in order to facilitate diagnosis. Since then, these so-called McDonald criteria have been broadly accepted and widely propagated. In the meantime a number of publications have dealt with the sensitivity and specificity for MS diagnosis and with implementing these new criteria in clinical practice. Based on these empirical values and newer data on MS, an international expert group recently proposed a revision of the criteria. Substantial changes affect (1) MRI criteria for the dissemination of lesions over time, (2) the role of spinal cord lesions in the MRI and (3) diagnosis of primary progressive MS. In this article we present recent experiences with the McDonald and revised criteria.

  6. Significance of combined determination of multiple autoantibodies in patients with systemic lupus erythematosus

    International Nuclear Information System (INIS)

    Tao Hongqun; Li Xiaolong; Gong Jianguang; Wen Huaikai

    2006-01-01

    Objective: To explore the roles played by autoantibodies in systemic lupus erythematosus. Methods: Serum anti-dsDNA antibody (with RIA) and serum anti-nucleosome antibody (AnuA), AHA, anti SmD1-, anti Ro60UD-, anti U1 -RNP- , anti-Ro52KD, anti-SSB antibodies (with anti-nucleo antibodies linear spectrum blotting method) were detected in 50 patients with clinically proven systemic lupus erythematosus. Results: The positive rate with anti-SmD1 antibody was highest (82%), followed by anti-Ro60KD antibody (80%) and AnuA (72%). Positive rate with anti dsDNA-, AHA, anti-U1-RNP-, anti- Ro52KD and anti SSB-antibodies was 44%, 32%, 58%, 48% and 24% respectively. Positive rate with anti-SC1-70, ACA and Jo-1 antibodies was extremely low (below 10%). Conclusion: Multiple auto-antibodies were present in serum of patients with systemic lupus erythematosus and combined detection of them would improve the diagnostic sensitivity. (authors)

  7. Survey of diagnostic and treatment practices for multiple sclerosis in Europe.

    Science.gov (United States)

    Fernández, O; Delvecchio, M; Edan, G; Fredrikson, S; Gionvannoni, G; Hartung, H-P; Havrdova, E; Kappos, L; Pozzilli, C; Soerensen, P S; Tackenberg, B; Vermersch, P; Comi, G

    2017-03-01

    Up-to-date information is needed on the extent to which neurologists treating multiple sclerosis (MS) in Europe are integrating rapidly evolving diagnostic criteria, disease-modifying therapies and recommendations for monitoring disease activity into their clinical practice. A steering committee of MS neurologists used a modified Delphi process to develop case- and practice-based questions for two sequential surveys distributed to MS neurologists throughout Europe. Case-based questions were developed for radiologically isolated syndrome (RIS), clinically isolated syndrome (CIS), relapsing-remitting MS (RRMS) and RRMS with breakthrough disease. Multiple sclerosis neurologists from 11 European countries responded to survey 1 (n = 233) and survey 2 (n = 171). Respondents agreed that they would not treat the patients in the RIS or CIS cases but would treat a patient with a relatively mild form of RRMS. Choice of treatment was evenly distributed among first-line injectables and oral treatments for mild RRMS, and moved to second-line treatment as the RRMS case increased in severity. Additional results on RRMS with breakthrough disease are presented. Although there was general agreement on some aspects of treatment, responses to other management and clinical practice questions varied considerably. These results, which reflect current clinical practice patterns, highlight the need for additional MS treatment education and awareness and may help inform the development of MS practice guidelines in Europe. © 2017 EAN.

  8. Diagnostic test pepsinogen I and combination with tumor marker CEA in gastric cancer

    Science.gov (United States)

    Sembiring, J.; Sarumpaet, K.; Ganie, R. A.

    2018-03-01

    Gastric cancer (GC) is the fifth leading cause of cancer and the third leading cause of cancer-related mortality globally. Human pepsinogens (HP) are considered promising serological biomarkers for the screening of atrophic gastritis (AG) and GC. HP are biochemically and immunochemically classified into two groups: pepsinogen I (PG I) and PG II. Carcinoembryonic antigen (CEA) is a glycoprotein, which is present in normal mucosal cells but increased amounts are associated with adenocarcinoma, especially colorectal cancer. CEA in combination with other tumour markers can be used in pre-operative staging and thereby assist in the planning of the type of surgery required and future management options. The purpose of this study was to diagnose test PG I and combination with tumor marker CEA in 32 patients suspected with GC. There was a significant difference in levels of CEA between GC group with non-GC with a value p <0.001. PGI sensitivity was 70.58% and specificity 93.3%. The sensitivity of PGI and CEA combination of 94.1% and specificity 80%. The area of AUC obtained was 92.7% at 95% confidence interval (82.7-100%). This AUC value indicated that the value of diagnostic accuracy of the PGI and CEA combinations of 92.7%.

  9. A calderón multiplicative preconditioner for the combined field integral equation

    KAUST Repository

    Bagci, Hakan; Andriulli, Francesco P.; Cools, Kristof; Olyslager, Femke; Michielssen, Eric

    2009-01-01

    A Calderón multiplicative preconditioner (CMP) for the combined field integral equation (CFIE) is developed. Just like with previously proposed Caldern-preconditioned CFIEs, a localization procedure is employed to ensure that the equation

  10. Diagnostic value of combined static-excretory MR Urography in children with hydroneph

    Directory of Open Access Journals (Sweden)

    Sally Emad-Eldin

    2015-03-01

    Full Text Available The aim of this study was to determine the feasibility, accuracy and diagnostic potential of combined static-excretory MR Urography in children with sonographically detected hydronephrosis. We prospectively evaluated 28 children (11 girls and 17 boys, mean age 8.3 years (range 2 months–16 years. Static-excretory MR Urography was performed in all cases. The results of MR Urography were compared with the results of other imaging modalities, cystoscopy and surgery. In 28 children, 61 renal units were evaluated by MR Urography (the renal unit is the kidney and its draining ureter. The final diagnoses included: normal renal units (n = 23; uretropelvic junction obstruction (n = 14; megaureter (n = 8; midureteric stricture (n = 1, complicated duplicated systems (n = 5, post ESWL non-obstructive dilation (n = 2, extrarenal pelvis (n = 4, dysplastic kidney (n = 4. Complex pathology and more than one disease entity in were found in 7 children. The MRI diagnosis correlated with the final diagnosis in 57 units, with diagnostic accuracy 93.4%. In conclusions static and excretory MRU give both morphological and functional information in a single examination without exposure to ionizing radiation and iodinated contrast agent. It is a valuable imaging technique for children with upper urinary tract dilatation; especially in cases of complex congenital pathologies and severely hydronephrotic kidney.

  11. A new combination of multiple autoimmune syndrome? Coexistence of vitiligo, autoimmune thyroid disease and ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Firdevs Topal

    2011-09-01

    Full Text Available The occurrence of three or more autoimmune disorders in one patient defines multiple autoimmune syndrome. The pathogenesis of multiple autoimmune syndrome is not known yet and environmental triggers and genetic susceptibility have been suggested to be involved. Herein, we report a 47-year-old woman who had Hashimoto’s thyroiditis, vitiligo and newly diagnosed ulcerative colitis. Diagnosis of ulcerative colitis was confirmed with histopathologic examination. This case presents a new combination of multiple autoimmune syndrome.

  12. [Diagnostic and evolutionary profile of multiple myeloma in Senegal: monocentric study conducted from 2005 to 2016].

    Science.gov (United States)

    Fall, Seynabou; Dieng, Fatma; Diouf, Coumba; Djiba, Boundia; Ndao, Awa Cheikh; Ndiaye, Fatou Samba Diago

    2017-01-01

    Accessibility to innovative multiple myeloma therapies is limited in sub-Saharan Africa. This study aimed to describe the diagnostic and evolutionary features observed during treatment of our patients with myeloma. We conducted a retrospective, descriptive, analytical study (2005 - 2016) of patients with myeloma included in the study based on International Myeloma Working Group (IMWG) Criteria (2003,2014) at the Hopital Aristide Le Dantec (Senegal). We collected data from 136 medical records (69 men, 67 women) of patients with an average age of 59 years ± 10.1 years, who were less than 65 years of age in 69.1% of cases. Tell-tale signs included bone pain (96.3%), renal failure (36.8%), infection (23.5%), pathological fracture (17.6%), spinal cord compression (16.9%) and malignant hypercalcaemia (16.2%). Isotopic antiglobulin test showed that anti-IgG could be detected in 61.3% of cases and Kappa in 65% of cases. Patients were classified stage III (59.4%) and I-II (40.6%)of the index staging system. The median survival of patients under conventional traitement (Méphalan-Prédnisone: 67.6%, innovative: 5.9%) was 20 months (1-78 months). Survival rates are better in the absence of neurological and infectious complications and for patients with score I-II of the index Staging System. In our study, multiple myeloma was frequently diagnosed before age 65, at advanced stage of tumor mass. Early detection and access to adequate therapies could improve overall survival.

  13. Combined Acquisition Technique (CAT) for Neuroimaging of Multiple Sclerosis at Low Specific Absorption Rates (SAR)

    Science.gov (United States)

    Biller, Armin; Choli, Morwan; Blaimer, Martin; Breuer, Felix A.; Jakob, Peter M.; Bartsch, Andreas J.

    2014-01-01

    Purpose To compare a novel combined acquisition technique (CAT) of turbo-spin-echo (TSE) and echo-planar-imaging (EPI) with conventional TSE. CAT reduces the electromagnetic energy load transmitted for spin excitation. This radiofrequency (RF) burden is limited by the specific absorption rate (SAR) for patient safety. SAR limits restrict high-field MRI applications, in particular. Material and Methods The study was approved by the local Medical Ethics Committee. Written informed consent was obtained from all participants. T2- and PD-weighted brain images of n = 40 Multiple Sclerosis (MS) patients were acquired by CAT and TSE at 3 Tesla. Lesions were recorded by two blinded, board-certificated neuroradiologists. Diagnostic equivalence of CAT and TSE to detect MS lesions was evaluated along with their SAR, sound pressure level (SPL) and sensations of acoustic noise, heating, vibration and peripheral nerve stimulation. Results Every MS lesion revealed on TSE was detected by CAT according to both raters (Cohen’s kappa of within-rater/across-CAT/TSE lesion detection κCAT = 1.00, at an inter-rater lesion detection agreement of κLES = 0.82). CAT reduced the SAR burden significantly compared to TSE (pCAT were 29.0 (±5.7) % for the T2-contrast and 32.7 (±21.9) % for the PD-contrast (expressed as percentages of the effective SAR limit of 3.2 W/kg for head examinations). Average SPL of CAT was no louder than during TSE. Sensations of CAT- vs. TSE-induced heating, noise and scanning vibrations did not differ. Conclusion T2−/PD-CAT is diagnostically equivalent to TSE for MS lesion detection yet substantially reduces the RF exposure. Such SAR reduction facilitates high-field MRI applications at 3 Tesla or above and corresponding protocol standardizations but CAT can also be used to scan faster, at higher resolution or with more slices. According to our data, CAT is no more uncomfortable than TSE scanning. PMID:24608106

  14. Combined acquisition technique (CAT for neuroimaging of multiple sclerosis at low specific absorption rates (SAR.

    Directory of Open Access Journals (Sweden)

    Armin Biller

    Full Text Available PURPOSE: To compare a novel combined acquisition technique (CAT of turbo-spin-echo (TSE and echo-planar-imaging (EPI with conventional TSE. CAT reduces the electromagnetic energy load transmitted for spin excitation. This radiofrequency (RF burden is limited by the specific absorption rate (SAR for patient safety. SAR limits restrict high-field MRI applications, in particular. MATERIAL AND METHODS: The study was approved by the local Medical Ethics Committee. Written informed consent was obtained from all participants. T2- and PD-weighted brain images of n = 40 Multiple Sclerosis (MS patients were acquired by CAT and TSE at 3 Tesla. Lesions were recorded by two blinded, board-certificated neuroradiologists. Diagnostic equivalence of CAT and TSE to detect MS lesions was evaluated along with their SAR, sound pressure level (SPL and sensations of acoustic noise, heating, vibration and peripheral nerve stimulation. RESULTS: Every MS lesion revealed on TSE was detected by CAT according to both raters (Cohen's kappa of within-rater/across-CAT/TSE lesion detection κCAT = 1.00, at an inter-rater lesion detection agreement of κLES = 0.82. CAT reduced the SAR burden significantly compared to TSE (p<0.001. Mean SAR differences between TSE and CAT were 29.0 (± 5.7 % for the T2-contrast and 32.7 (± 21.9 % for the PD-contrast (expressed as percentages of the effective SAR limit of 3.2 W/kg for head examinations. Average SPL of CAT was no louder than during TSE. Sensations of CAT- vs. TSE-induced heating, noise and scanning vibrations did not differ. CONCLUSION: T2-/PD-CAT is diagnostically equivalent to TSE for MS lesion detection yet substantially reduces the RF exposure. Such SAR reduction facilitates high-field MRI applications at 3 Tesla or above and corresponding protocol standardizations but CAT can also be used to scan faster, at higher resolution or with more slices. According to our data, CAT is no more uncomfortable than TSE scanning.

  15. Detecting Renibacterium salmoninarum in wild brown trout by use of multiple organ samples and diagnostic methods

    Science.gov (United States)

    Guomundsdottir, S.; Applegate, Lynn M.; Arnason, I.O.; Kristmundsson, A.; Purcell, Maureen K.; Elliott, Diane G.

    2017-01-01

    Renibacterium salmoninarum, the causative agent of salmonid bacterial kidney disease (BKD), is endemic in many wild trout species in northerly regions. The aim of the present study was to determine the optimal R. salmoninarum sampling/testing strategy for wild brown trout (Salmo trutta L.) populations in Iceland. Fish were netted in a lake and multiple organs—kidney, spleen, gills, oesophagus and mid-gut—were sampled and subjected to five detection tests i.e. culture, polyclonal enzyme-linked immunosorbent assay (pELISA) and three different PCR tests. The results showed that each fish had encountered R. salmoninarum but there were marked differences between results obtained depending on organ and test. The bacterium was not cultured from any kidney sample while all kidney samples were positive by pELISA. At least one organ from 92.9% of the fish tested positive by PCR. The results demonstrated that the choice of tissue and diagnostic method can dramatically influence the outcome of R. salmoninarum surveys.

  16. Combining a thermal-imaging diagnostic with an existing imaging VISAR diagnostic at the National Ignition Facility (NIF)

    International Nuclear Information System (INIS)

    Robert M, Malone; John R, Celesteb; Peter M, Celliers; Brent C, Froggeta; Robert L, Guyton; Morris I, Kaufman; Tony L, Lee; Brian J, MacGowan; Edmund W, Ng; Imants P, Reinbachs; Ronald B, Robinson; Lynn G, Seppala; Tom W, Tunnell; Phillip W, Watts

    2005-01-01

    Optical diagnostics are currently being designed to analyze high-energy density physics experiments at the National Ignition Facility (NIF). Two independent line-imaging Velocity Interferometer System for Any Reflector (VISAR) interferometers have been fielded to measure shock velocities, breakout times, and emission of targets having sizes of 1-5 mm. An 8-inch-diameter, fused silica triplet lens collects light at f/3 inside the 30-foot-diameter NIF vacuum chamber. VISAR recordings use a 659.5-nm probe laser. By adding a specially coated beam splitter to the interferometer table, light at wavelengths from 540 to 645 nm is spilt into a thermal-imaging diagnostic. Because fused silica lenses are used in the first triplet relay, the intermediate image planes for different wavelengths separate by considerable distances. A corrector lens on the interferometer table reunites these separated wavelength planes to provide a good image. Thermal imaging collects light at f/5 from a 2-mm object placed at Target Chamber Center (TCC). Streak cameras perform VISAR and thermal-imaging recording. All optical lenses are on kinematic mounts so that pointing accuracy of the optical axis may be checked. Counter-propagating laser beams (orange and red) are used to align both diagnostics. The red alignment laser is selected to be at the 50 percent reflection point of the beam splitter. This alignment laser is introduced at the recording streak cameras for both diagnostics and passes through this special beam splitter on its way into the NIF vacuum chamber

  17. Early diagnostic role of PSA combined miR-155 detection in prostate cancer.

    Science.gov (United States)

    Guo, T; Wang, X-X; Fu, H; Tang, Y-C; Meng, B-Q; Chen, C-H

    2018-03-01

    As a kind of malignant tumor in the male genitourinary system, prostate cancer exhibits significantly increased occurrence. Prostate-specific antigen (PSA) expression can be seen in the prostate cancer, prostatitis, and other diseases, therefore, lack of diagnostic specificity. The miR-155 expression is abnormally increased in the tumors. Therefore, this study aims to explore the clinical significance of PSA combined miR-155 detection in the early diagnosis of prostate cancer. A total of 86 patients diagnosed with prostate cancer were enrolled in this study. PSA and miR-155 gene expression in tumor tissue were detected by using Real-time PCR. The serum levels of PSA were measured by using enzyme-linked immunosorbent assay (ELISA). The correlation of PSA and miR-155 expression with age, body mass index (BMI), tumor volume, tumor-node-metastasis (TNM) stage, lymph node metastasis (LNM), and other clinicopathological features were analyzed, respectively. Serum PSA expression and PSA gene in tumor tissue were significantly higher compared to that in adjacent tissues (pPSA gene and protein increased significantly with the clinical stage of TNM and decreased following the increase of grade (pPSA and miR-155 expressions were positively correlated with TNM stage, tumor volume, and LNM, and negatively correlated with grade (pPSA and miR-155 were closely related to the clinicopathological features of prostate cancer. Combined detection is helpful for the early diagnosis of prostate cancer.

  18. Diagnostic value of radionuclide imaging combined with routine CT in detecting hepatic focal nodular hyperplasia

    International Nuclear Information System (INIS)

    Lu Xuemin; Yu Shuhong; Han Jiankui

    2011-01-01

    Objective: To investigate radionuclide imaging and routine CT in diagnosing hepatic focal nodular hyperplasia (FNH) and the combined diagnostic value of the two modalities. Methods: Thirty-two patients with hepatic FNH were retrospectively studied. All patients underwent routine CT scan. Twenty-four patients were examined by 99 Tc m -sulfur colloid (SC) hepatic planar scintigraphy and SPECT/CT imaging, and then patients who had abnormal foci underwent 99 Tc m -diethyl iminodiacetic acid (EHIDA) triple-phase hepatobiliary imaging. χ 2 -test of four-table or Fisher exact probabilities in 2 × 2 table was applied for statistical analysis. Results: Of all 32 patients pathologically diagnosed as FNH with single solitary nodule, 25 were classified as classic type and the rest 7 as non-classic type. Although routine CT found all hepatic lesions, only 15 cases were diagnosed pathologically as FNH classic type but the rest were either misdiagnosed or left as indeterminate. On radionuclide imaging (hepatic colloid scintigraphy plus triple-phase hepatobiliary images), 11 patients with big foci (with maximal diameter >3 cm) out of 24 patients were correctly diagnosed as FNH, with 7 diagnosed as classic type FNH and 4 as non-classic. Other 13 patients were either misdiagnosed or simply missed. The diagnosing rates of routine CT and radionuclide imaging were 60.0% (15/25) and 38.9% (7/18) for FNH classic type, 0/7 and 4/6 for non-classic type, 50.0% (10/20) and 73.3% (11/15) for big foci, 41.7% (5/12) and 0/9 for small foci (with maximal diameter ≤3 cm), respectively. The total diagnosing rate of radionuclide imaging combined with routine CT was significantly higher than that of routine CT or radionuclide imaging alone (χ 2 =4.48, P<0.05; χ 2 =4.27, P<0.05). Conclusion: Radionuclide imaging in combination with routine CT may improve the diagnostic accuracy for hepatic FNH patients. (authors)

  19. Diagnostic value of combined detection of serum tumor markers for lung cancer

    International Nuclear Information System (INIS)

    Li Yanping; Wang Qun; Zhao Zihong; Zhou Shan

    2013-01-01

    Objective: To investigate the diagnostic value of combined detection of serum tumor markers, including CEA, CA125, neuron-specific enolase (NSE) and cytokeratin fragment antigen 21-1 (CYFRA21-1) for lung cancer patients. Methods: The subjects involved 138 diagnosed lung cancer patients (82 males, 56 females, average age 58.6 years, from October 2010 to March 2012), 96 patients with benign lung diseases (56 males, 40 females, average age 51.3 years) and 45 healthy adults (30 males, 15 females, average age 43.9 years). The pathological types of lung cancer consisted of 66 squamous cell carcinoma (SCC), 52 adenocarcinoma and 20 small cell lung cancer (SCLC). The serum levels of CEA, CA125, NSE and CYFRA21-1 were measured with electrochemiluminescence immunoassay. The diagnostic efficacy for different pathological types was compared among each single tumor marker and combination of tumor markers. One-way analysis of variance q test were used for statistical analysis. Results: The serum levels of CEA, CA125, NSE and CYFRA21-1 in patients with lung cancer were higher than those in patients with benign lung diseases and in healthy subjects (CEA: (19.99±30.99), (10.78±19.77), (3.25±3.42) μg/L; CA125: (79.70±95.98), (44.96±44.97), (20.66±7.13) μg/L; NSE: (35.23±40.22), (15.31±8.42), (13.30±5.65) μg/L; CYFRA21-1: (18.07±43.71), (8.30±8.83), (3.13±1.60) μg/L; F=4.481, 5.436, 4.776, 6.002, all P<0.05). The highest level of CEA, NSE or CYFRA21-1 were found in adenocarcinoma (F=4.932, P<0.05), SCLC (F=5.119, P<0.05) or SCC (F=5.378, P<0.05), respectively. The highest sensitivity tumor markers for SCC, SCLC and adenocarcinoma were CYFRA21-1 (78.8%, 52/66), NSE (75.0%, 15/20) and CEA (57.7%, 30/52), respectively. In combined detection, the highest sensitivity combinations for SCC, SCLC and adenocarcinoma were CEA + CYFRA21-1 + NSE (89.4%, 59/66), CEA + CYFRA21-1 + NSE (80.0%, 16/20) and CEA + CA125 + NSE (78.8%, 41/52), respectively. Conclusions: Combined detection

  20. Combination of preoperative NLR, PLR and CEA could increase the diagnostic efficacy for I-III stage CRC.

    Science.gov (United States)

    Peng, Hong-Xin; Yang, Lin; He, Bang-Shun; Pan, Yu-Qin; Ying, Hou-Qun; Sun, Hui-Ling; Lin, Kang; Hu, Xiu-Xiu; Xu, Tao; Wang, Shu-Kui

    2017-09-01

    Inflammation plays an important role in the development and progression of CRC. The members of inflammatory biomarkers, preoperative NLR and PLR, have been proved by numerous studies to be promising prognostic biomarkers for CRC. However, the diagnostic value of the two biomarkers in CRC remains unknown, and no study reported the combined diagnostic efficacy of NLR, PLR and CEA. Five hundred and fifty-nine patients with I-III stage CRC undergoing surgical resection and 559 gender- and age-matched healthy controls were enrolled in this retrospective study. NLR and PLR were calculated from preoperative peripheral blood cell count detected using white blood cell five classification by Sysmex XT-1800i Automated Hematology System and serum CEA were measured by electrochemiluminescence by ELECSYS 2010. The diagnostic performance of NLR, PLR and CEA for CRC was evaluated by ROC curve. Levels of NLR and PLR in the cases were significantly higher than them in the healthy controls. ROC curves comparison analyses showed that the diagnostic efficacy of NLR (AUC=.755, 95%CI=.728-.780) alone for CRC was significantly higher than PLR (AUC=.723, 95%CI=.696-.749, P=.037) and CEA (AUC=.690, 95%CI=.662-.717, P=.002) alone. In addition, the diagnostic efficacy of the combination of NLR, PLR and CEA(AUC=.831, 95%CI=.807-.852)for CRC was not only significantly higher than NLR alone but also higher than any combinations of the two of these three biomarkers (PCRC diagnostic biomarker, even for early stage CRC, and the combination of NLR, PLR and CEA could significantly improve the diagnostic efficacy. © 2016 Wiley Periodicals, Inc.

  1. The value of diagnostic information to patients with suspected multiple sclerosis. Rochester-Toronto MRI Study Group.

    Science.gov (United States)

    Mushlin, A I; Mooney, C; Grow, V; Phelps, C E

    1994-01-01

    To determine the value of diagnostic information to patients with suspected multiple sclerosis (MS). Because treatment choices would be only minimally affected by earlier diagnosis for most patients with this clinical problem, this study assessed the "nondecisional" value of diagnosis. Prospective survey of patients before and after diagnostic workup, including imaging with magnetic resonance scanning. We assessed the effect of diagnostic information on patients' sense of well-being, as well as direct measures of the utility of information (using time trade-off and willingness-to-pay techniques). Patients referred from primary care practices for diagnostic workup for suspected MS to neurology clinics and practices. Sixty-eight individuals, mean age 37.5 years, 53 female and 15 male. Thirty-one patients were classified as having "probable MS," and 37 were classified as having "possible MS" by the examining neurologist before workup. Present and future health perception, uncertainty about diagnosis-prognosis, and level of anxiety. Willingness to pay for diagnostic information, quality of life as measured by the time trade-off technique, and psychological state of the patient before and after diagnosis. Diagnostic uncertainty fell significantly as a result of the diagnostic workup. Most patients (59/62) said that they were better off having received diagnostic information. Although anxiety seemed to be reduced by testing, overall anxiety levels did not decrease as much as anticipated. Patients also became less optimistic about their future health after testing. On average, patients were willing to forgo 4.5 quality-adjusted life days to receive an earlier diagnosis and their quality of life after diagnosis improved slightly. Subgroups of patients differed in their response to diagnostic information. Those in whom no definitive diagnosis emerged tend to be more anxious rather than being reassured by the "negative" workup. Individuals with "positive" workups became less

  2. [Effects of pamidronate disodium (Bonin) combined with chemotherapy on bone pain in multiple myeloma].

    Science.gov (United States)

    Leng, Yun; Chen, Shi-lun; Shi, Hong-zhi

    2002-10-01

    Objective. To evaluate the therapeutic effects of Disodium Pamidronate (Bonin) on bone pain in multiple myeloma. Method. 18 patients received only chemotherapy and 16 patients with addition of Bonin were compared. Result. The bone pain was significantly relieved both in chemotherapy alone group and in the combination group of Bonin with chemotherapy after treatment (P<0.01, as compared with before therapy). However, the effects of combination group were more dramatical than that of the other group (P<0.05). No obvious side-effects were observed except mild fever in one patient in the combination group. Conclusion. Bonin, as a safe and effective Bisphosphonates preparation, could relieve bone pain in multiple myeloma more effectively when combined with chemotherapy.

  3. Antibacterial activity of combined medicinal plants extract against multiple drug resistant strains

    Directory of Open Access Journals (Sweden)

    Rafiqul Islam

    2015-06-01

    Full Text Available Objective: To find out the combined antibacterial efficacy of Aegle marmelos, Aphanamixis polystachya, Cuscuta reflexa and Aesclynomene indica against bacterial pathogens. Methods: Antibacterial potency of combined plant extracts has been tested against Bacillus subtilis IFO 3026, Sarcina lutea IFO 3232, Xanthomonas campestris IAM 1671, Escherichia coli IFO 3007, Klebsiella pneumoniae ATTC 10031, Proteus vulgaris MTCC 321 and Pseudomonas denitrificans KACC 32026 by disc diffusion assay. Commercially available standard antibiotic discs were also used to find out antibiotic resistance pattern of test organisms. Results: Among the test organisms, Escherichia coli, Proteus vulgaris, Klebsiella pneumoniae and Proteus denitrificans showed resistance against multiple commercially available antibiotics. On the other hand, these multiple drug resistant organisms showed susceptibility against combined plant extracts. Conclusions: These combined plants extracts showed synergistic antibacterial activity and could lead to new antibacterial drug designing.

  4. Diagnostic yield of combined magnetic resonance spectroscopy and diffusion weighted imaging in intracranial neoplasms

    Directory of Open Access Journals (Sweden)

    Ayat E. El Sherbeny

    2014-09-01

    Conclusion: MRS has a robust diagnostic accuracy in cases of well defined high or low grade brain neoplasms. ADC value had the ability to confirm and differentiate low from high grade tumors in many situations where there were diagnostic confusions with MRS due to borderline values.

  5. The diagnostic value of transrectal ultrasonography combined with prostate specific antigen density in prostate cancer

    International Nuclear Information System (INIS)

    Shen Weidong; Zha Yueqin; Wang Ajun; Hou Jianquan; Ouyang Jun

    2008-01-01

    Objective: To discuss the value of transrectal ultrasound (TRUS) and prostate specific antigen density (PSAD) and prostate specific antigen density of transition zone (PSATZ) for diagnosing prostate cancer. Methods: Chose cases of prostate cancer(PCa) and benign prostate hyperplasia(BPH), each was 19, all the eases were authenticated by pathology. Then compared the characteristic of prostate cancer with prostate specific antigen (PSA) and homologous PSAD, PSATZ. Results: Fourteen cases were discovered by ultrasound among the 19 PCa, the others were only diagnosed as BPH.Among the 14 cases, diffuse pathological changing was found in 1 patient, nodular changing in 13 patients (16 nodules were found). Among the 16 nodules, there were 13 hypoechoic nodules (75%) and 3 hyper echoic or compound echoic nodules (25%), and there were 13 nodules in outer zone and 3 nodules in transition zone.The PSA of PCa and BPH was 8.61-98.65 ng/ml [(48.79±25.34)ng/ml] and 0.58-28.36 ng/ml [(9.73±8.19)ng/ml]. There were no significant differences between the volume of prostate and prostate transition zone (P>0.05), but there were significant differences between the PSAD and PSATZ (P<0.01). That the PCa group was higher than that in the BPH group. Conclusion: It is higher sensitive but bess specific in diagonosis PCa by means of transrectal ultrasound. If it is combined with PSAD and PSATZ, the diagnostic rate of PCa is highly raised. (authors)

  6. Diagnostic value of combined determination of serum CEA, CA72-4 and TSGF levels in patients with gastric cancer

    International Nuclear Information System (INIS)

    Wang Yuyi; Gu Yan

    2007-01-01

    Objective: To explore the diagnostic value of combined determination of serum CEA, CA72-4 and TSGF levels for gastric cancer. Methods: Serum CEA, CA72-4(with RIA) and TSGF (with biochemistry)levels were measured in 31 patients with gastric cancer and 35 controls. Results: As a single tumor marker for diagnosis, the sensitivity of CEA, CA72-4 and TSGF was 23. 0%, 38.0%, 48.0% respectively and the specificity was 23.0%, 38.0%, 48.0% respectively with combined detection of the three markers and assuming two or more markers positive as diagnostic, the sensitivity would be 67.0% and specificity would be 88.0%. Conclusion: Combined determination of serum CEA, CA72-4 and TSGF levels could promote the clinical usefulness for diagnosis of gastric cancer. (authors)

  7. Diagnostic performance of combined noninvasive coronary angiography and myocardial perfusion imaging using 320 row detector computed tomography

    DEFF Research Database (Denmark)

    Vavere, Andrea L; Simon, Gregory G; George, Richard T

    2013-01-01

    Multidetector coronary computed tomography angiography (CTA) is a promising modality for widespread clinical application because of its noninvasive nature and high diagnostic accuracy as found in previous studies using 64 to 320 simultaneous detector rows. It is, however, limited in its ability...... to detect myocardial ischemia. In this article, we describe the design of the CORE320 study ("Combined coronary atherosclerosis and myocardial perfusion evaluation using 320 detector row computed tomography"). This prospective, multicenter, multinational study is unique in that it is designed to assess...... the diagnostic performance of combined 320-row CTA and myocardial CT perfusion imaging (CTP) in comparison with the combination of invasive coronary angiography and single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI). The trial is being performed at 16 medical centers located in 8...

  8. Diagnostic value of multiple tumor markers for patients with esophageal carcinoma.

    Science.gov (United States)

    Zhang, Jun; Zhu, Zhenli; Liu, Yan; Jin, Xueyuan; Xu, Zhiwei; Yu, Qiuyan; Li, Ke

    2015-01-01

    Various studies assessing the diagnostic value of serum tumor markers in patients with esophageal cancer remain controversial. This study aims to comprehensively and quantitatively summarize the potential diagnostic value of 5 serum tumour markers in esophageal cancer. We systematically searched PubMed, Embase, Chinese National Knowledge Infrastructure (CNKI) and Chinese Biomedical Database (CBM), through February 28, 2013, without language restriction. Studies were assessed for quality using QUADAS (quality assessment of studies of diagnostic accuracy). The positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were pooled separately and compared with overall accuracy measures using diagnostic odds ratios (DORs) and symmetric summary receiver operating characteristic (SROC) curves. Of 4391 studies initially identified, 44 eligible studies including five tumor markers met the inclusion criteria for the meta-analysis, while meta-analysis could not be conducted for 12 other tumor markers. Approximately 79.55% (35/44) of the included studies were of relatively high quality (QUADAS score≥7). The summary estimates of the positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DOR) for diagnosing EC were as follows: CEA, 5.94/0.76/9.26; Cyfra21-1, 12.110.59/22.27; p53 antibody, 6.71/0.75/9.60; SCC-Ag, 7.66/0.68/12.41; and VEGF-C, 0.74/0.37/8.12. The estimated summary receiver operating characteristic curves showed that the performance of all five tumor markers was reasonable. The current evidence suggests that CEA, Cyfra21-1, p53, SCC-Ag and VEGF-C have a potential diagnostic value for esophageal carcinoma.

  9. The Combine Use of Semi-destructive and Non-destructive Methods for Tiled Floor Diagnostics

    Science.gov (United States)

    Štainbruch, Jakub; Bayer, Karol; Jiroušek, Tomáš; Červinka, Josef

    2017-04-01

    The combination of semi-destructive and non-destructive methods was used to asset the conditions of a tiled floor in the historical monument Minaret, situated in the park complex of the Chateau Lednice (South Moravia Region, Czech Republic), before its renovation. Another set of measurements is going to be performed after the conservation works are finished. (The comparison of the results collected during pre- and post-remediation measurements will be known and presented during the General Assembly meeting in Wien.) The diagnostic complex of methods consisted of photogrammetry, resistivity drilling and georadar. The survey was aimed to contour extends of air gaps beneath the tiles and the efficiency of filling gaps by means of injection, consolidation and gluing individual layers. The state chateau Lednice creates a part of the Lednice-Valtice precinct, a UNESCO landmark, and belongs among the greatest historic monuments in Southern Moravia. In the chateau park there is a romantic observation tower in the shape of a minaret built according to the plans of Josef Hardtmuth between 1798-1804. The Minaret has been extensively renovated for many decades including the restoration of mosaic floors from Venetian terazzo. During the static works of the Minaret building between 1999-2000, the mosaic floors in the rooms on the second floor were transferred and put back onto concrete slabs. Specifically, the floor was cut up to tiles and these were glued to square slabs which were then attached to the base plate. The transfer was not successful and the floor restoration was finalized between 2016-2017. The damage consisted in separating the original floor from the concrete plate which led to creating gaps. Furthermore, the layers of the floor were not compact. It was necessary to fill the gaps and consolidate and glue the layers. The existence of air gap between individual layers of the tiles and their degradation was detected using two different diagnostic methods: semi

  10. Diagnostic accuracy of full-body linear X-ray scanning in multiple trauma patients in comparison to computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Joeres, A.P.W.; Heverhagen, J.T.; Bonel, H. [Inselspital - University Hospital Bern (Switzerland). Univ. Inst. of Diagnostic, Interventional and Pediatric Radiology; Exadaktylos, A. [Inselspital - University Hospital Bern (Switzerland). Dept. of Emergency Medicine; Klink, T. [Inselspital - University Hospital Bern (Switzerland). Univ. Inst. of Diagnostic, Interventional and Pediatric Radiology; Wuerzburg Univ. (Germany). Inst. of Diagnostic and Interventional Radiology

    2016-02-15

    The purpose of this study was to evaluate the diagnostic accuracy of full-body linear X-ray scanning (LS) in multiple trauma patients in comparison to 128-multislice computed tomography (MSCT). 106 multiple trauma patients (female: 33; male: 73) were retrospectively included in this study. All patients underwent LS of the whole body, including extremities, and MSCT covering the neck, thorax, abdomen, and pelvis. The diagnostic accuracy of LS for the detection of fractures of the truncal skeleton and pneumothoraces was evaluated in comparison to MSCT by two observers in consensus. Extremity fractures detected by LS were documented. The overall sensitivity of LS was 49.2%, the specificity was 93.3%, the positive predictive value was 91%, and the negative predictive value was 57.5%. The overall sensitivity for vertebral fractures was 16.7%, and the specificity was 100%. The sensitivity was 48.7% and the specificity 98.2% for all other fractures. Pneumothoraces were detected in 12 patients by CT, but not by LS.40 extremity fractures were detected by LS, of which 4 fractures were dislocated, and 2 were fully covered by MSCT. The diagnostic accuracy of LS is limited in the evaluation of acute trauma of the truncal skeleton. LS allows fast whole-body X-ray imaging, and may be valuable for detecting extremity fractures in trauma patients in addition to MSCT.

  11. The Diagnostic importance of clinical and radiologic features of the Multiple Cemento-osseous dysplasia

    International Nuclear Information System (INIS)

    Han, M. R.; Kim, Y. H.; Kang, B. C.

    1998-01-01

    This case was diagnosed as multiple cementoosseous dysplasia on the basis of clinical and radiological features but was diagnosed as ossifying fibroma on the basis of histopathological feature. The histopathologic features of the multiple cementoosseous dysplasia and cementoossifying fibroma have common features of cementum, fibrous network and bone. Multiple cementoosseous dysplasia is reactive lesion and shows restricted lesion size, occurred on anterior and posterior tooth of the mandible and needs no treatment except periodic follow up. But Cementoossifying fibroma is the true neoplasm and grows continuously and needs surgical removal. The final diagnosis of the multiple cementoosseous dysplasia requires good correlation of the clinical histopathological, and radiological features.

  12. The diagnostic value of ventilation-perfusion scintigraphy combined with plasma D-dimer assay in diagnosis of pulmonary embolism

    International Nuclear Information System (INIS)

    Wang Qian; Huang Lili; Qin Shuling; Yue Minggang; Wang Yu; Nie Yuxin; Liang Tiejun

    2005-01-01

    Objective: To investigate the clinical diagnostic value of ventilation-perfusion scintigraphy combined with plasma D-dimer assay in diagnosis of pulmonary embolism (PE). Methods: One hundred and four patients with clinically suspected PE underwent both pulmonary ventilation-perfusion scintigraphy and plasma D-dimer assay. According to the criteria of prospective investigation of the pulmonary embolism diagnosis (PIOPED), ventilation-perfusion scintigraphy was interpreted as normal, very low or low probability of PE, intermediate probability of PE and high probability of PE. High probability was considered as positive; normal and very low or low probability as negative and intermediate probability as non-diagnostic. Plasma D-dimer levels were measured using a quantitative immunoturbidimetric method, and a cut-off value of 500 mg/L was used in the diagnosis of PE. Clinical diagnostic value of ventilation-perfusion scintigraphy, D-dimer assay and combined use of ventilation-perfusion scintigraphy and D-dimer assay for diagnosing PE was evaluated, respectively, comparing with the final clinical diagnosis that was based on the clinical findings. Results: Among the 104 patients, 44 were diagnosed with PE and 60 were excluded. Ventilation-perfusion scintigraphy provided diagnostic interpretations for 86 (82.7%) patients, and non-diagnostic interpretations for 18 (17.3%) patients. For diagnosing PE, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of ventilation-perfusion scintigraphy was 84.1%, 75.0%, 78.8%, 71.2% and 86.5%, respectively, and with D-dimer assay was 93.2%, 60.0%, 74.0%, 63.1% and 92.3%, respectively. If a plasma D-dimer level of < 500 mg/L was taken as a criterion to exclude PE for those intermediate probability of ventilation-perfusion scintigraphy, the diagnostic specificity and accuracy would be raised to 85.0% and 84.6%, respectively. Conclusions: When a non-diagnostic interpretation was occurred on

  13. A Diagnostic Study of Pre-Service Teachers' Competency in Multiple-Choice Item Development

    Science.gov (United States)

    Asim, Alice E.; Ekuri, Emmanuel E.; Eni, Eni I.

    2013-01-01

    Large class size is an issue in testing at all levels of Education. As a panacea to this, multiple choice test formats has become very popular. This case study was designed to diagnose pre-service teachers' competency in constructing questions (IQT); direct questions (DQT); and best answer (BAT) varieties of multiple choice items. Subjects were 88…

  14. Diagnostic Validity of Combining History Elements and Physical Examination Tests for Traumatic and Degenerative Symptomatic Meniscal Tears.

    Science.gov (United States)

    Décary, Simon; Fallaha, Michel; Frémont, Pierre; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Feldman, Debbie E; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François

    2017-10-27

    The current approach to the clinical diagnosis of traumatic and degenerative symptomatic meniscal tears (SMTs) proposes combining history elements and physical examination tests without systematic prescription of imaging investigations, yet the evidence to support this diagnostic approach is scarce. To assess the validity of diagnostic clusters combining history elements and physical examination tests to diagnose or exclude traumatic and degenerative SMT compared with other knee disorders. Prospective diagnostic accuracy study. Patients were recruited from 2 orthopedic clinics, 2 family medicine clinics, and from a university community. A total of 279 consecutive patients who underwent consultation for a new knee complaint. Each patient was assessed independently by 2 evaluators. History elements and standardized physical examination tests performed by a physiotherapist were compared with the reference standard: an expert physicians' composite diagnosis including a clinical examination and confirmatory magnetic resonance imaging. Participating expert physicians were orthopedic surgeons (n = 3) or sport medicine physicians (n = 2). Penalized logistic regression (least absolute shrinkage and selection operator) was used to identify history elements and physical examination tests associated with the diagnosis of SMT and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures were calculated including sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios (LR+/-) with associated 95% confidence intervals (CIs). Eighty patients had a diagnosis of SMT (28.7%), including 35 traumatic tears and 45 degenerative tears. The combination a history of trauma during a pivot, medial knee pain location, and a positive medial joint line tenderness test was able to diagnose (LR+ = 8.9; 95% CI 6.1-13.1) or exclude (LR- = 0.10; 95% CI 0.03-0.28) a traumatic SMT. Combining a history of

  15. The combined use of conventional MRI and MR spectroscopic imaging increases the diagnostic accuracy in amyotrophic lateral sclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Cervo, Amedeo [Department of Advanced Biomedical Sciences, University “Federico II”, Naples (Italy); Cocozza, Sirio, E-mail: siriococozza@hotmail.it [Department of Advanced Biomedical Sciences, University “Federico II”, Naples (Italy); Saccà, Francesco [Department of Neurosciences, Reproductive Sciences and Odontostomatology, University “Federico II”, Naples (Italy); Giorgio, Sara M.d.A. [Department of Advanced Biomedical Sciences, University “Federico II”, Naples (Italy); Morra, Vincenzo Brescia [Department of Neurosciences, Reproductive Sciences and Odontostomatology, University “Federico II”, Naples (Italy); Tedeschi, Enrico [Department of Advanced Biomedical Sciences, University “Federico II”, Naples (Italy); Marsili, Angela; Vacca, Giovanni [Department of Neurosciences, Reproductive Sciences and Odontostomatology, University “Federico II”, Naples (Italy); Palma, Vincenzo [U.O.C. Neurofisiopatologia, PO S. Gennaro ASL Napoli 1, Naples (Italy); Brunetti, Arturo [Department of Advanced Biomedical Sciences, University “Federico II”, Naples (Italy); Quarantelli, Mario [Biostructure and Bioimaging Institute, National Research Council, Naples (Italy)

    2015-01-15

    Highlights: • We assessed in ALS the diagnostic accuracy of MRI signal and MRS data used alone and in combination. • We found that T2-hypointensity and NAA decrease in motor cortex are two independent phenomena. • These two variables taken alone do not provide acceptable diagnostic accuracy in ALS. • The same variables, when used in combination, improve the diagnostic accuracy of MRI in ALS. - Abstract: Purpose: We aimed to assess, in amyotrophic lateral sclerosis (ALS), the diagnostic accuracy of the combined use of conventional MRI signal changes (namely, hypointensity of the precentral cortex and hyperintensity of the corticospinal tracts on T2-weighted images), and N-Acetyl-Aspartate (NAA) reduction in the motor cortex at Magnetic Resonance Spectroscopy (MRS), which are affected by limited diagnostic accuracy when used separately. Methods: T2-hypointensity and NAA/(Choline + Creatine) ratio of the precentral gyrus and T2-hyperintensity of the corticospinal tracts were measured in 84 ALS patients and 28 healthy controls, using a Region-of-Interest approach. Sensitivity and specificity values were calculated using Fisher stepwise discriminant analysis, and cross-validated using the leave-one-out method. Results: Precentral gyrus T2 signal intensity (p < 10{sup −4}) and NAA peak (p < 10{sup −6}) were significantly reduced in patients, and their values did not correlate significantly to each other both in patients and controls, while no significant differences were obtained in terms of T2-hyperintensity of the corticospinal tract. Sensitivity and specificity of the two discriminant variables, taken alone, were 71.4% and 75.0%, for NAA peak, and 63.1% and 71.4% for T2-hypointensity, respectively. When using these two variables in combination, a significant increase in sensitivity (78.6%) and specificity (82.1%) was achieved. Conclusions: Precentral gyrus T2-hypointensity and NAA peak are not significantly correlated in ALS patients, suggesting that they

  16. The combined use of conventional MRI and MR spectroscopic imaging increases the diagnostic accuracy in amyotrophic lateral sclerosis

    International Nuclear Information System (INIS)

    Cervo, Amedeo; Cocozza, Sirio; Saccà, Francesco; Giorgio, Sara M.d.A.; Morra, Vincenzo Brescia; Tedeschi, Enrico; Marsili, Angela; Vacca, Giovanni; Palma, Vincenzo; Brunetti, Arturo; Quarantelli, Mario

    2015-01-01

    Highlights: • We assessed in ALS the diagnostic accuracy of MRI signal and MRS data used alone and in combination. • We found that T2-hypointensity and NAA decrease in motor cortex are two independent phenomena. • These two variables taken alone do not provide acceptable diagnostic accuracy in ALS. • The same variables, when used in combination, improve the diagnostic accuracy of MRI in ALS. - Abstract: Purpose: We aimed to assess, in amyotrophic lateral sclerosis (ALS), the diagnostic accuracy of the combined use of conventional MRI signal changes (namely, hypointensity of the precentral cortex and hyperintensity of the corticospinal tracts on T2-weighted images), and N-Acetyl-Aspartate (NAA) reduction in the motor cortex at Magnetic Resonance Spectroscopy (MRS), which are affected by limited diagnostic accuracy when used separately. Methods: T2-hypointensity and NAA/(Choline + Creatine) ratio of the precentral gyrus and T2-hyperintensity of the corticospinal tracts were measured in 84 ALS patients and 28 healthy controls, using a Region-of-Interest approach. Sensitivity and specificity values were calculated using Fisher stepwise discriminant analysis, and cross-validated using the leave-one-out method. Results: Precentral gyrus T2 signal intensity (p < 10 −4 ) and NAA peak (p < 10 −6 ) were significantly reduced in patients, and their values did not correlate significantly to each other both in patients and controls, while no significant differences were obtained in terms of T2-hyperintensity of the corticospinal tract. Sensitivity and specificity of the two discriminant variables, taken alone, were 71.4% and 75.0%, for NAA peak, and 63.1% and 71.4% for T2-hypointensity, respectively. When using these two variables in combination, a significant increase in sensitivity (78.6%) and specificity (82.1%) was achieved. Conclusions: Precentral gyrus T2-hypointensity and NAA peak are not significantly correlated in ALS patients, suggesting that they reflect

  17. Self-stimulating rats combine subjective reward magnitude and subjective reward rate multiplicatively.

    Science.gov (United States)

    Leon, M I; Gallistel, C R

    1998-07-01

    For rats that bar pressed for intracranial electrical stimulation in a 2-lever matching paradigm with concurrent variable interval schedules of reward, the authors found that the time allocation ratio is based on a multiplicative combination of the ratio of subjective reward magnitudes and the ratio of the rates of reward. Multiplicative combining was observed in a range covering approximately 2 orders of magnitude in the ratio of the rates of reward from about 1:10 to 10:1) and an order of magnitude change in the size of rewards. After determining the relation between the pulse frequency of stimulation and subjective reward magnitude, the authors were able to predict from knowledge of the subjective magnitudes of the rewards and the obtained relative rates of reward the subject's time allocation ratio over a range in which it varied by more than 3 orders of magnitude.

  18. Diagnostic value of stool DNA testing for multiple markers of colorectal cancer and advanced adenoma: a meta-analysis.

    Science.gov (United States)

    Yang, Hua; Xia, Bing-Qing; Jiang, Bo; Wang, Guozhen; Yang, Yi-Peng; Chen, Hao; Li, Bing-Sheng; Xu, An-Gao; Huang, Yun-Bo; Wang, Xin-Ying

    2013-08-01

    The diagnostic value of stool DNA (sDNA) testing for colorectal neoplasms remains controversial. To compensate for the lack of large-scale unbiased population studies, a meta-analysis was performed to evaluate the diagnostic value of sDNA testing for multiple markers of colorectal cancer (CRC) and advanced adenoma. The PubMed, Science Direct, Biosis Review, Cochrane Library and Embase databases were systematically searched in January 2012 without time restriction. Meta-analysis was performed using a random-effects model using sensitivity, specificity, diagnostic OR (DOR), summary ROC curves, area under the curve (AUC), and 95% CIs as effect measures. Heterogeneity was measured using the χ(2) test and Q statistic; subgroup analysis was also conducted. A total of 20 studies comprising 5876 individuals were eligible. There was no heterogeneity for CRC, but adenoma and advanced adenoma harboured considerable heterogeneity influenced by risk classification and various detection markers. Stratification analysis according to risk classification showed that multiple markers had a high DOR for the high-risk subgroups of both CRC (sensitivity 0.759 [95% CI 0.711 to 0.804]; specificity 0.883 [95% CI 0.846 to 0.913]; AUC 0.906) and advanced adenoma (sensitivity 0.683 [95% CI 0.584 to 0.771]; specificity 0.918 [95% CI 0.866 to 0.954]; AUC 0.946) but not for the average-risk subgroups of either. In the methylation subgroup, sDNA testing had significantly higher DOR for CRC (sensitivity 0.753 [95% CI 0.685 to 0.812]; specificity 0.913 [95% CI 0.860 to 0.950]; AUC 0.918) and advanced adenoma (sensitivity 0.623 [95% CI 0.527 to 0.712]; specificity 0.926 [95% CI 0.882 to 0.958]; AUC 0.910) compared with the mutation subgroup. There was no significant heterogeneity among studies for subgroup analysis. sDNA testing for multiple markers had strong diagnostic significance for CRC and advanced adenoma in high-risk subjects. Methylation makers had more diagnostic value than mutation

  19. A calderón multiplicative preconditioner for the combined field integral equation

    KAUST Repository

    Bagci, Hakan

    2009-10-01

    A Calderón multiplicative preconditioner (CMP) for the combined field integral equation (CFIE) is developed. Just like with previously proposed Caldern-preconditioned CFIEs, a localization procedure is employed to ensure that the equation is resonance-free. The iterative solution of the linear system of equations obtained via the CMP-based discretization of the CFIE converges rapidly regardless of the discretization density and the frequency of excitation. © 2009 IEEE.

  20. Diagnostic accuracy of apparent diffusion coefficient and 123I-metaiodobenzylguanidine for differentiation of multiple system atrophy and Parkinson's disease.

    Directory of Open Access Journals (Sweden)

    Atsushi Umemura

    Full Text Available BACKGROUND: It is often hard to differentiate Parkinson's disease (PD and parkinsonian variant of multiple system atrophy (MSA-P, especially in the early stages. Cardiac sympathetic denervation and putaminal rarefaction are specific findings for PD and MSA-P, respectively. PURPOSE: We investigated diagnostic accuracy of putaminal apparent diffusion coefficient (ADC test for MSA-P and (123I-metaiodobenzylguanidine (MIBG scintigram for PD, especially in early-stage patients. METHODS: The referral standard diagnosis of PD and MSA-P were the diagnostic criteria of the United Kingdom Parkinson's Disease Society Brain Bank Criteria and the second consensus criteria, respectively. Based on the referral standard criteria, diagnostic accuracy [area under the receiver-operator characteristic curve (AUC, sensitivity and specificity] of the ADC and MIBG tests was estimated retrospectively. Diagnostic accuracy of these tests performed within 3 years of symptom onset was also investigated. RESULTS: ADC and MIBG tests were performed on 138 patients (20 MSA and 118 PD. AUC was 0.95 and 0.83 for the ADC and MIBG tests, respectively. Sensitivity and specificity were 85.0% and 89.0% for MSA-P diagnosis by ADC test and 67.0% and 80.0% for PD diagnosis by MIBG test. When these tests were restricted to patients with disease duration ≤ 3 years, the sensitivity and specificity were 75.0% and 91.4% for the ADC test (MSA-P diagnosis and 47.7% and 92.3% for the MIBG test (PD diagnosis. CONCLUSIONS: Both tests were useful in differentiating between PD and MSA-P, even in the early stages. In early-stage patients, elevated putaminal ADC was a diagnostic marker for MSA-P. Despite high specificity of the MIBG test, careful neurological history and examinations were required for PD diagnosis because of possible false-negative results.

  1. Diagnostic accuracy of apparent diffusion coefficient and 123I-metaiodobenzylguanidine for differentiation of multiple system atrophy and Parkinson's disease.

    Science.gov (United States)

    Umemura, Atsushi; Oeda, Tomoko; Hayashi, Ryutaro; Tomita, Satoshi; Kohsaka, Masayuki; Yamamoto, Kenji; Sawada, Hideyuki

    2013-01-01

    It is often hard to differentiate Parkinson's disease (PD) and parkinsonian variant of multiple system atrophy (MSA-P), especially in the early stages. Cardiac sympathetic denervation and putaminal rarefaction are specific findings for PD and MSA-P, respectively. We investigated diagnostic accuracy of putaminal apparent diffusion coefficient (ADC) test for MSA-P and (123)I-metaiodobenzylguanidine (MIBG) scintigram for PD, especially in early-stage patients. The referral standard diagnosis of PD and MSA-P were the diagnostic criteria of the United Kingdom Parkinson's Disease Society Brain Bank Criteria and the second consensus criteria, respectively. Based on the referral standard criteria, diagnostic accuracy [area under the receiver-operator characteristic curve (AUC), sensitivity and specificity] of the ADC and MIBG tests was estimated retrospectively. Diagnostic accuracy of these tests performed within 3 years of symptom onset was also investigated. ADC and MIBG tests were performed on 138 patients (20 MSA and 118 PD). AUC was 0.95 and 0.83 for the ADC and MIBG tests, respectively. Sensitivity and specificity were 85.0% and 89.0% for MSA-P diagnosis by ADC test and 67.0% and 80.0% for PD diagnosis by MIBG test. When these tests were restricted to patients with disease duration ≤ 3 years, the sensitivity and specificity were 75.0% and 91.4% for the ADC test (MSA-P diagnosis) and 47.7% and 92.3% for the MIBG test (PD diagnosis). Both tests were useful in differentiating between PD and MSA-P, even in the early stages. In early-stage patients, elevated putaminal ADC was a diagnostic marker for MSA-P. Despite high specificity of the MIBG test, careful neurological history and examinations were required for PD diagnosis because of possible false-negative results.

  2. Combined intra-articular glucocorticoid, bupivacaine and morphine reduces pain and convalescence after diagnostic knee arthroscopy

    DEFF Research Database (Denmark)

    Rasmussen, Sten; Lorentzen, Jan S; Larsen, Allan S

    2002-01-01

    We studied the effect of intra-articullar saline vs. bupivacaine + morphine or bupivacaine morphine + methylprednisolone after diagnostic knee arthroscopy. In a double-blind randomized study, 60 patients undergoing diagnostic knee arthroscopy without a therapeutic procedure were allocated to groups...... receiving intra-articular saline, intra-articular bupivacaine 150 mg + morphine 4 mg or the same dose of bupivacaine + morphine + intra-articular methylprednisolone 40 mg at the end of arthroscopy during general anesthesia. All patients were instructed to resume normal activities immediately after...

  3. A simple method for combining genetic mapping data from multiple crosses and experimental designs.

    Directory of Open Access Journals (Sweden)

    Jeremy L Peirce

    Full Text Available BACKGROUND: Over the past decade many linkage studies have defined chromosomal intervals containing polymorphisms that modulate a variety of traits. Many phenotypes are now associated with enough mapping data that meta-analysis could help refine locations of known QTLs and detect many novel QTLs. METHODOLOGY/PRINCIPAL FINDINGS: We describe a simple approach to combining QTL mapping results for multiple studies and demonstrate its utility using two hippocampus weight loci. Using data taken from two populations, a recombinant inbred strain set and an advanced intercross population we demonstrate considerable improvements in significance and resolution for both loci. 1-LOD support intervals were improved 51% for Hipp1a and 37% for Hipp9a. We first generate locus-wise permuted P-values for association with the phenotype from multiple maps, which can be done using a permutation method appropriate to each population. These results are then assigned to defined physical positions by interpolation between markers with known physical and genetic positions. We then use Fisher's combination test to combine position-by-position probabilities among experiments. Finally, we calculate genome-wide combined P-values by generating locus-specific P-values for each permuted map for each experiment. These permuted maps are then sampled with replacement and combined. The distribution of best locus-specific P-values for each combined map is the null distribution of genome-wide adjusted P-values. CONCLUSIONS/SIGNIFICANCE: Our approach is applicable to a wide variety of segregating and non-segregating mapping populations, facilitates rapid refinement of physical QTL position, is complementary to other QTL fine mapping methods, and provides an appropriate genome-wide criterion of significance for combined mapping results.

  4. Combination of fast-ion diagnostics in velocity-space tomographies

    DEFF Research Database (Denmark)

    Salewski, Mirko; Geiger, B.; Nielsen, Stefan Kragh

    2013-01-01

    Fast-ion Dα (FIDA) and collective Thomson scattering (CTS) diagnostics provide indirect measurements of fast-ion velocity distribution functions in magnetically confined plasmas. Here we present the first prescription for velocity-space tomographic inversion of CTS and FIDA measurements that can ...

  5. Single and Combined Diagnostic Value of Clinical Features and Laboratory Tests in Acute Appendicitis

    NARCIS (Netherlands)

    Laméris, Wytze; van Randen, Adrienne; Go, Peter M. N. Y. H.; Bouma, Wim H.; Donkervoort, Sandra C.; Bossuyt, Patrick M. M.; Stoker, Jaap; Boermeester, Marja A.

    2009-01-01

    Objectives: The objective was to evaluate the diagnostic accuracy of clinical features and laboratory test results in detecting acute appendicitis. Methods: Clinical features and laboratory test results were prospectively recorded in a consecutive series of 1,101 patients presenting with abdominal

  6. Multiple linear combination (MLC) regression tests for common variants adapted to linkage disequilibrium structure.

    Science.gov (United States)

    Yoo, Yun Joo; Sun, Lei; Poirier, Julia G; Paterson, Andrew D; Bull, Shelley B

    2017-02-01

    By jointly analyzing multiple variants within a gene, instead of one at a time, gene-based multiple regression can improve power, robustness, and interpretation in genetic association analysis. We investigate multiple linear combination (MLC) test statistics for analysis of common variants under realistic trait models with linkage disequilibrium (LD) based on HapMap Asian haplotypes. MLC is a directional test that exploits LD structure in a gene to construct clusters of closely correlated variants recoded such that the majority of pairwise correlations are positive. It combines variant effects within the same cluster linearly, and aggregates cluster-specific effects in a quadratic sum of squares and cross-products, producing a test statistic with reduced degrees of freedom (df) equal to the number of clusters. By simulation studies of 1000 genes from across the genome, we demonstrate that MLC is a well-powered and robust choice among existing methods across a broad range of gene structures. Compared to minimum P-value, variance-component, and principal-component methods, the mean power of MLC is never much lower than that of other methods, and can be higher, particularly with multiple causal variants. Moreover, the variation in gene-specific MLC test size and power across 1000 genes is less than that of other methods, suggesting it is a complementary approach for discovery in genome-wide analysis. The cluster construction of the MLC test statistics helps reveal within-gene LD structure, allowing interpretation of clustered variants as haplotypic effects, while multiple regression helps to distinguish direct and indirect associations. © 2016 The Authors Genetic Epidemiology Published by Wiley Periodicals, Inc.

  7. Multiple aneurysm of unknown aetiology in childhood: Complications and diagnostic possibilities

    International Nuclear Information System (INIS)

    Lanfermann, H.; Benz-Bohm, G.; Schaper, J.; Gross-Fengels, W.

    1990-01-01

    A 6,5-year old boy with already known multiple aneurysm of all major arteries presented with acute abdominal pain. As demonstrated by ultrasound a big aneurysm of the left renal artery thrombosed in the course of three days. As a result, the left kidney developed severe ischaemia. Although computed tomography and scintigraphy were applied, a plan for a definitive therapeutic procedere could be established only by arterial angiography. Both Ehlers-Danlos' syndrome and Kawasaki's syndrome were excluded. There were no facts suggesting an infective aetiology. Four other cases with multiple aneurysms of unknown aetiology in childhood have so far been described in literature. (orig.) [de

  8. Radiation dose reduction through combining positron emission tomography/computed tomography (PET/CT) and diagnostic CT in children and young adults with lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Qi, Zhihua; Gates, Erica L.; Trout, Andrew T. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); O' Brien, Maureen M. [Cincinnati Children' s Hospital Medical Center, Division of Oncology, Cancer and Blood Disease Institute, Cincinnati, OH (United States)

    2018-02-15

    Both [F-18]2-fluoro-2-deoxyglucose positron emission tomography/computed tomography ({sup 18}F-FDG PET/CT) and diagnostic CT are at times required for lymphoma staging. This means some body segments are exposed twice to X-rays for generation of CT data (diagnostic CT + localization CT). To describe a combined PET/diagnostic CT approach that modulates CT tube current along the z-axis, providing diagnostic CT of some body segments and localization CT of the remaining body segments, thereby reducing patient radiation dose. We retrospectively compared total patient radiation dose between combined PET/diagnostic CT and separately acquired PET/CT and diagnostic CT exams. When available, we calculated effective doses for both approaches in the same patient; otherwise, we used data from patients of similar size. To confirm image quality, we compared image noise (Hounsfield unit [HU] standard deviation) as measured in the liver on both combined and separately acquired diagnostic CT images. We used t-tests for dose comparisons and two one-sided tests for image-quality equivalence testing. Mean total effective dose for the CT component of the combined and separately acquired diagnostic CT exams were 6.20±2.69 and 8.17±2.61 mSv, respectively (P<0.0001). Average dose savings with the combined approach was 24.8±17.8% (2.60±2.51 mSv [range: 0.32-4.72 mSv]) of total CT effective dose. Image noise was not statistically significantly different between approaches (12.2±1.8 HU vs. 11.7±1.5 HU for the combined and separately acquired diagnostic CT images, respectively). A combined PET/diagnostic CT approach as described offers dose savings at similar image quality for children and young adults with lymphoma who have indications for both PET and diagnostic CT examinations. (orig.)

  9. Radiation dose reduction through combining positron emission tomography/computed tomography (PET/CT) and diagnostic CT in children and young adults with lymphoma

    International Nuclear Information System (INIS)

    Qi, Zhihua; Gates, Erica L.; Trout, Andrew T.; O'Brien, Maureen M.

    2018-01-01

    Both [F-18]2-fluoro-2-deoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) and diagnostic CT are at times required for lymphoma staging. This means some body segments are exposed twice to X-rays for generation of CT data (diagnostic CT + localization CT). To describe a combined PET/diagnostic CT approach that modulates CT tube current along the z-axis, providing diagnostic CT of some body segments and localization CT of the remaining body segments, thereby reducing patient radiation dose. We retrospectively compared total patient radiation dose between combined PET/diagnostic CT and separately acquired PET/CT and diagnostic CT exams. When available, we calculated effective doses for both approaches in the same patient; otherwise, we used data from patients of similar size. To confirm image quality, we compared image noise (Hounsfield unit [HU] standard deviation) as measured in the liver on both combined and separately acquired diagnostic CT images. We used t-tests for dose comparisons and two one-sided tests for image-quality equivalence testing. Mean total effective dose for the CT component of the combined and separately acquired diagnostic CT exams were 6.20±2.69 and 8.17±2.61 mSv, respectively (P<0.0001). Average dose savings with the combined approach was 24.8±17.8% (2.60±2.51 mSv [range: 0.32-4.72 mSv]) of total CT effective dose. Image noise was not statistically significantly different between approaches (12.2±1.8 HU vs. 11.7±1.5 HU for the combined and separately acquired diagnostic CT images, respectively). A combined PET/diagnostic CT approach as described offers dose savings at similar image quality for children and young adults with lymphoma who have indications for both PET and diagnostic CT examinations. (orig.)

  10. [DIAGNOSTIC VALUE OF COMBINED USE OF COMBINED METHOD OF ENZYME IMMUNOASSAY AND POLYMERASE CHAIN REACTION TO DETECT OF INTRAUTERINE FETAL INFECTION BY PARVOVIRUS B19].

    Science.gov (United States)

    Bondarenko, N P; Lakatosh, V P; Lakatosh, P V; Malanchuk, O B; Poladich, I V

    2015-01-01

    The combined method of diagnosis parvovirus infection during pregnancy by maternal serum enzyme immunoassay and deoxyribonucleic acid isolation parvovirus B19 polymerase chain reaction in amnniotic fluid and fetal cord blood newborns, can diagnose vertical transmission and anticipate a negative effect on the fetus parvovirus. Lack of maternal IgM antibodies in serum due to parvovirus seroconversion during pregnancy does not exclude the persistence of the virus in the fetus. To analyze the diagnostic value of the method for determining the LHP parvovirus B19 DNA in the amniotic fluid, umbilical cord blood of newborns to determine vertical transmission of parvovirus infection when infected mothers B19 during pregnancy.

  11. New Exercise-Dipyridamole Combined Test for Nuclear Cardiology in Insufficient Effort: Appropriate Diagnostic Sensitivity Keeping Exercise Prognosis

    Directory of Open Access Journals (Sweden)

    Inés Vidal Cortinas

    2015-08-01

    Full Text Available AbstractBackground:Myocardial perfusion scintigraphy (MPS in patients not reaching 85% of the maximum predicted heart rate (MPHR has reduced sensitivity.Objectives:In an attempt to maintain diagnostic sensitivity without losing functional exercise data, a new exercise and dipyridamole combined protocol (EDCP was developed. Our aim was to evaluate the feasibility and safety of this protocol and to compare its diagnostic sensitivity against standard exercise and dipyridamole protocols.Methods:In patients not reaching a sufficient exercise (SE test and with no contraindications, 0.56 mg/kg of dipyridamole were IV administered over 1 minute simultaneously with exercise, followed by 99mTc-MIBI injection.Results:Of 155 patients, 41 had MPS with EDCP, 47 had a SE test (≥ 85% MPHR and 67 underwent the dipyridamole alone test (DIP. They all underwent coronary angiography within 3 months. The three stress methods for diagnosis of coronary lesions had their sensitivity compared. For stenosis ≥ 70%, EDCP yielded 97% sensitivity, SE 90% and DIP 95% (p = 0.43. For lesions ≥ 50%, the sensitivities were 94%, 88% and 95%, respectively (p = 0.35. Side effects of EDCP were present in only 12% of the patients, significantly less than with DIP (p < 0.001.Conclusions:The proposed combined protocol is a valid and safe method that yields adequate diagnostic sensitivity, keeping exercise prognostic information in patients unable to reach target heart rate, with fewer side effects than the DIP.

  12. New Exercise-Dipyridamole Combined Test for Nuclear Cardiology in Insufficient Effort: Appropriate Diagnostic Sensitivity Keeping Exercise Prognosis

    Energy Technology Data Exchange (ETDEWEB)

    Cortinas, Inés Vidal, E-mail: invi@montevideo.com.uy; Beretta, Mario; Alonso, Omar; Mut, Fernando [Departamento de Medicina Nuclear do Hospital ‘Asociación Española’, Br. Artigas 1515, Montevideo (Uruguay)

    2015-08-15

    Myocardial perfusion scintigraphy (MPS) in patients not reaching 85% of the maximum predicted heart rate (MPHR) has reduced sensitivity. In an attempt to maintain diagnostic sensitivity without losing functional exercise data, a new exercise and dipyridamole combined protocol (EDCP) was developed. Our aim was to evaluate the feasibility and safety of this protocol and to compare its diagnostic sensitivity against standard exercise and dipyridamole protocols. In patients not reaching a sufficient exercise (SE) test and with no contraindications, 0.56 mg/kg of dipyridamole were IV administered over 1 minute simultaneously with exercise, followed by 99mTc-MIBI injection. Of 155 patients, 41 had MPS with EDCP, 47 had a SE test (≥ 85% MPHR) and 67 underwent the dipyridamole alone test (DIP). They all underwent coronary angiography within 3 months. The three stress methods for diagnosis of coronary lesions had their sensitivity compared. For stenosis ≥ 70%, EDCP yielded 97% sensitivity, SE 90% and DIP 95% (p = 0.43). For lesions ≥ 50%, the sensitivities were 94%, 88% and 95%, respectively (p = 0.35). Side effects of EDCP were present in only 12% of the patients, significantly less than with DIP (p < 0.001). The proposed combined protocol is a valid and safe method that yields adequate diagnostic sensitivity, keeping exercise prognostic information in patients unable to reach target heart rate, with fewer side effects than the DIP.

  13. THE SEARCH OF OPTIMAL COMBINATION OF ANTIGENS FOR SEROLOGICAL DIAGNOSTICS OF TUBERCULOSIS

    Directory of Open Access Journals (Sweden)

    E. V. Vasilyeva

    2013-01-01

    Full Text Available Abstract. The four chimeric recombinant antigens CBD-CFP10, CBD-ESAT6, ESAT6-CFP10 and CBD-P38 contained aminoacid sequences of full-size proteins ESAT6, CFP10 and matured protein P38 of M. tuberculosis, joined with aminoacid sequences of cellulose bind domain of endogluconase A (CBD from Cellumonas fimi have been obtained by gene engineering methods. Recombinant proteins were purified by affine chromatography in column with Ni-NTA-sepharose 6В-CL and as PPDN-3 were used for detection of their antigenic activity in indirect ELISA for TB serological diagnostics. The sera from patients with lung tuberculosis (n = 321, from persons who had professional contacts with TB patients (n = 42, from healthy blood donors (n = 366 and from patients with lung diseases of non-TB etiology were tested. It was detected that there was positive correlation between antibodies level for all studied antigens compared by pair. It has been demonstrated that although antigens were different by antigenic and immunobiological characteristics they add each other in the content of antigenic diagnostics compositions. Thus, all these antigens can be used in the test kits for serological diagnostics of TB. Using of these antigens will allow to detect persons infected by TB and patients with active tuberculosis. 

  14. Statistical models for quantifying diagnostic accuracy with multiple lesions per patient

    NARCIS (Netherlands)

    Zwinderman, Aeilko H.; Glas, Afina S.; Bossuyt, Patrick M.; Florie, Jasper; Bipat, Shandra; Stoker, Jaap

    2008-01-01

    We propose random-effects models to summarize and quantify the accuracy of the diagnosis of multiple lesions on a single image without assuming independence between lesions. The number of false-positive lesions was assumed to be distributed as a Poisson mixture, and the proportion of true-positive

  15. Parallel point-multiplication architecture using combined group operations for high-speed cryptographic applications.

    Directory of Open Access Journals (Sweden)

    Md Selim Hossain

    Full Text Available In this paper, we propose a novel parallel architecture for fast hardware implementation of elliptic curve point multiplication (ECPM, which is the key operation of an elliptic curve cryptography processor. The point multiplication over binary fields is synthesized on both FPGA and ASIC technology by designing fast elliptic curve group operations in Jacobian projective coordinates. A novel combined point doubling and point addition (PDPA architecture is proposed for group operations to achieve high speed and low hardware requirements for ECPM. It has been implemented over the binary field which is recommended by the National Institute of Standards and Technology (NIST. The proposed ECPM supports two Koblitz and random curves for the key sizes 233 and 163 bits. For group operations, a finite-field arithmetic operation, e.g. multiplication, is designed on a polynomial basis. The delay of a 233-bit point multiplication is only 3.05 and 3.56 μs, in a Xilinx Virtex-7 FPGA, for Koblitz and random curves, respectively, and 0.81 μs in an ASIC 65-nm technology, which are the fastest hardware implementation results reported in the literature to date. In addition, a 163-bit point multiplication is also implemented in FPGA and ASIC for fair comparison which takes around 0.33 and 0.46 μs, respectively. The area-time product of the proposed point multiplication is very low compared to similar designs. The performance ([Formula: see text] and Area × Time × Energy (ATE product of the proposed design are far better than the most significant studies found in the literature.

  16. Atorvastatin calcium in combination with methylprednisolone for the treatment of multiple sclerosis relapse.

    Science.gov (United States)

    Li, Xiao-ling; Zhang, Zhen-chang; Zhang, Bo; Jiang, Hua; Yu, Chun-mei; Zhang, Wen-jing; Yan, Xiang; Wang, Man-xia

    2014-12-01

    This study aimed to investigate the efficacy of combined atorvastatin calcium and methylprednisolone for the treatment of multiple sclerosis relapse. Patients with multiple sclerosis (MS) at the relapse phase were randomized to receive either combined treatment of atorvastatin calcium and methylprednisolone (n = 19) or methylprednisolone alone (n = 19). Expanded Disability Status Scale (EDSS) was administered at baseline, 1 week, 2 weeks, 4 weeks, 3 months, and 6 months after treatment initiation. The number and volume of brain lesions were evaluated using magnetic resonance imaging at baseline and 6 months. The levels of IL-13, IL-35, IFN-γ, and IL-10 in the cerebrospinal fluid were examined using the enzyme-linked immunosorbent assay method. There was no significant difference in EDSS scores at 1, 2, and 4 weeks. At 3 and 6 months, the combined treatment group showed significantly lower EDSS scores than the monotherapy group (P atorvastatin calcium and methylprednisolone can improve the outcomes of MS relapse compared with glucocorticosteroid alone. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. [Cognitive training combined with aerobic exercises in multiple sclerosis patients: a pilot study].

    Science.gov (United States)

    Jimenez-Morales, R M; Herrera-Jimenez, L F; Macias-Delgado, Y; Perez-Medinilla, Y T; Diaz-Diaz, S M; Forn, C

    2017-06-01

    The scientific evidences associated to the effectiveness of different techniques of cognitive rehabilitation are still contradictory. To compare a program of combined training (physical and cognitive) in front of a program of physical training and to observe their effectiveness about the optimization of the cognitive functions in patients with multiple sclerosis (MS). It was carried out an experimental study in 32 patients with MS. The patients were distributed in two groups: 16 to the experimental group (combined cognitive training with aerobic exercises) and 16 patients to the control group (aerobic exercises). The intervention was planned for six weeks combining cognitive tasks by means of a game of dynamic board of cubes and signs (TaDiCS ®) and a program of aerobic exercises. The Brief Repeatable Battery of Neuropsychological Test and the Stroop Test were applied to evaluate the cognitive yield. Also, the Beck Depression Inventory was administered. There were found significant differences in the intergrupal analysis after the intervention in the variable learning and visuoespacial long term memory (p = 0.000), attention (p = 0.026) and inhibitory control (p = 0.007). Also, in the intragroup analysis there were found significant differences in these variables and information processing speed in the group that received the combined training. These patients also showed a significant improvement in the emotional state (p = 0.043). The cognitive training combined with the aerobic exercises is effective to improve the cognitive performance.

  18. Differential diagnostic value of combined detection of serum CA153, CEA and TPA levels in patients with breast tumor

    International Nuclear Information System (INIS)

    Ding Wei

    2007-01-01

    Objective: To assess the differential diagnostic value of combined detection of serum CA153, CEA and TPA levels in patients with breast tumor. Methods: Serum levels of CA153, CEA and TPA were measured with RIA in 269 patients with breast tumor and 150 controls. Results: The serum levels of CA153, CEA and TPA in patients with breast cancer were significantly higher than those in the patients with benign breast tumor and controls. The positive rate of CA153 was 63.8% in the patients with breast cancer and that of CEA and TPA was 22.4% and 62.1% respectively, with combined detection of CA153 and CEA, the positive rate was 69.8%, with CA153 and TPA combined, the positive rate was 87.1%, with the three marker combined, the positive rate was 90.5%. The specificity was 77.9% with CA153, 77.9% with CA153 and CEA, 71.9% with CA153 and TPA, and 73.4% with all the three markers combined. Conclusion: The positive rate was increased remarkably with combined detection of CA153, CEA and TPA, however the specificity was not much changed, so the combined detection was valuable for differential diagnosis. (authors)

  19. Next-generation ELISA diagnostic assay for Chagas Disease based on the combination of short peptidic epitopes

    DEFF Research Database (Denmark)

    Mucci, Juan; Carmona, Santiago J.; Volcovich, Romina

    2017-01-01

    Chagas Disease, caused by the protozoan Trypanosoma cruzi, is a major health and economic problem in Latin America for which no vaccine or appropriate drugs for large-scale public health interventions are yet available. Accurate diagnosis is essential for the early identification and follow up....... cruzi linear B-cell epitopes using high-density peptide chips, leading to the identification of several hundred novel sequence signatures associated to chronic Chagas Disease. Here, we performed a serological assessment of 27 selected epitopes and of their use in a novel multipeptide-based diagnostic...... method. A combination of 7 of these peptides were finally evaluated in ELISA format against a panel of 199 sera samples (Chagas-positive and negative, including sera from Leishmaniasis-positive subjects). The multipeptide formulation displayed a high diagnostic performance, with a sensitivity of 96...

  20. Combination of diagnostic medial calcaneal nerve block followed by pulsed radiofrequency for plantar fascitis pain: A new modality

    Directory of Open Access Journals (Sweden)

    Deepak Thapa

    2014-01-01

    Full Text Available Plantar fasciitis (PF is the most common cause of chronic heel pain which may be bilateral in 20 to 30% of patients. It is a very painful and disabling condition which can affect the quality of life. The management includes both pharmacological and operative procedures with no single proven effective treatment modality. In the present case series, we managed three patients with PF (one with bilateral PF. Following a diagnostic medial calcaneal nerve (MCN block at its origin, we observed reduction in verbal numerical rating scale (VNRS in all the three patients. Two patients has relapse of PF pain which was managed with MCN block followed with pulsed radio frequency (PRF. All the patients were pain-free at the time of reporting. This case series highlights the possible role of combination of diagnostic MCN block near its origin followed with PRF as a new modality in management of patients with PF.

  1. Combination of diagnostic medial calcaneal nerve block followed by pulsed radiofrequency for plantar fascitis pain: A new modality

    Science.gov (United States)

    Thapa, Deepak; Ahuja, Vanita

    2014-01-01

    Plantar fasciitis (PF) is the most common cause of chronic heel pain which may be bilateral in 20 to 30% of patients. It is a very painful and disabling condition which can affect the quality of life. The management includes both pharmacological and operative procedures with no single proven effective treatment modality. In the present case series, we managed three patients with PF (one with bilateral PF). Following a diagnostic medial calcaneal nerve (MCN) block at its origin, we observed reduction in verbal numerical rating scale (VNRS) in all the three patients. Two patients has relapse of PF pain which was managed with MCN block followed with pulsed radio frequency (PRF). All the patients were pain-free at the time of reporting. This case series highlights the possible role of combination of diagnostic MCN block near its origin followed with PRF as a new modality in management of patients with PF. PMID:24963184

  2. Radiation dose reduction through combining positron emission tomography/computed tomography (PET/CT) and diagnostic CT in children and young adults with lymphoma.

    Science.gov (United States)

    Qi, Zhihua; Gates, Erica L; O'Brien, Maureen M; Trout, Andrew T

    2018-02-01

    Both [F-18]2-fluoro-2-deoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) and diagnostic CT are at times required for lymphoma staging. This means some body segments are exposed twice to X-rays for generation of CT data (diagnostic CT + localization CT). To describe a combined PET/diagnostic CT approach that modulates CT tube current along the z-axis, providing diagnostic CT of some body segments and localization CT of the remaining body segments, thereby reducing patient radiation dose. We retrospectively compared total patient radiation dose between combined PET/diagnostic CT and separately acquired PET/CT and diagnostic CT exams. When available, we calculated effective doses for both approaches in the same patient; otherwise, we used data from patients of similar size. To confirm image quality, we compared image noise (Hounsfield unit [HU] standard deviation) as measured in the liver on both combined and separately acquired diagnostic CT images. We used t-tests for dose comparisons and two one-sided tests for image-quality equivalence testing. Mean total effective dose for the CT component of the combined and separately acquired diagnostic CT exams were 6.20±2.69 and 8.17±2.61 mSv, respectively (PCT effective dose. Image noise was not statistically significantly different between approaches (12.2±1.8 HU vs. 11.7±1.5 HU for the combined and separately acquired diagnostic CT images, respectively). A combined PET/diagnostic CT approach as described offers dose savings at similar image quality for children and young adults with lymphoma who have indications for both PET and diagnostic CT examinations.

  3. Diesel combustion and emissions formation using multiple 2-D imaging diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Dec, J.E. [Sandia National Labs., Livermore, CA (United States)

    1997-12-31

    Understanding how emissions are formed during diesel combustion is central to developing new engines that can comply with increasingly stringent emission standards while maintaining or improving performance levels. Laser-based planar imaging diagnostics are uniquely capable of providing the temporally and spatially resolved information required for this understanding. Using an optically accessible research engine, a variety of two-dimensional (2-D) imaging diagnostics have been applied to investigators of direct-injection (DI) diesel combustion and emissions formation. These optical measurements have included the following laser-sheet imaging data: Mie scattering to determine liquid-phase fuel distributions, Rayleigh scattering for quantitative vapor-phase-fuel/air mixture images, laser induced incandescence (LII) for relative soot concentrations, simultaneous LII and Rayleigh scattering for relative soot particle-size distributions, planar laser-induced fluorescence (PLIF) to obtain early PAH (polyaromatic hydrocarbon) distributions, PLIF images of the OH radical that show the diffusion flame structure, and PLIF images of the NO radical showing the onset of NO{sub x} production. In addition, natural-emission chemiluminescence images were obtained to investigate autoignition. The experimental setup is described, and the image data showing the most relevant results are presented. Then the conceptual model of diesel combustion is summarized in a series of idealized schematics depicting the temporal and spatial evolution of a reacting diesel fuel jet during the time period investigated. Finally, recent PLIF images of the NO distribution are presented and shown to support the timing and location of NO formation hypothesized from the conceptual model.

  4. Voting-based consensus clustering for combining multiple clusterings of chemical structures

    Directory of Open Access Journals (Sweden)

    Saeed Faisal

    2012-12-01

    Full Text Available Abstract Background Although many consensus clustering methods have been successfully used for combining multiple classifiers in many areas such as machine learning, applied statistics, pattern recognition and bioinformatics, few consensus clustering methods have been applied for combining multiple clusterings of chemical structures. It is known that any individual clustering method will not always give the best results for all types of applications. So, in this paper, three voting and graph-based consensus clusterings were used for combining multiple clusterings of chemical structures to enhance the ability of separating biologically active molecules from inactive ones in each cluster. Results The cumulative voting-based aggregation algorithm (CVAA, cluster-based similarity partitioning algorithm (CSPA and hyper-graph partitioning algorithm (HGPA were examined. The F-measure and Quality Partition Index method (QPI were used to evaluate the clusterings and the results were compared to the Ward’s clustering method. The MDL Drug Data Report (MDDR dataset was used for experiments and was represented by two 2D fingerprints, ALOGP and ECFP_4. The performance of voting-based consensus clustering method outperformed the Ward’s method using F-measure and QPI method for both ALOGP and ECFP_4 fingerprints, while the graph-based consensus clustering methods outperformed the Ward’s method only for ALOGP using QPI. The Jaccard and Euclidean distance measures were the methods of choice to generate the ensembles, which give the highest values for both criteria. Conclusions The results of the experiments show that consensus clustering methods can improve the effectiveness of chemical structures clusterings. The cumulative voting-based aggregation algorithm (CVAA was the method of choice among consensus clustering methods.

  5. Comorbidity in multiple sclerosis is associated with diagnostic delays and increased mortality

    DEFF Research Database (Denmark)

    Thormann, Anja; Sorensen, Per Soelberg; Koch-Henriksen, Nils

    2017-01-01

    Objective: To investigate the effect of chronic comorbidity on the time of diagnosis of multiple sclerosis (MS) and on mortality in MS. Methods: We conducted a population-based, nationwide cohort study including all incident MS cases in Denmark with first MS symptom between 1980 and 2005. To inve......Objective: To investigate the effect of chronic comorbidity on the time of diagnosis of multiple sclerosis (MS) and on mortality in MS. Methods: We conducted a population-based, nationwide cohort study including all incident MS cases in Denmark with first MS symptom between 1980 and 2005.......007). Conclusions: An increased awareness of both the necessity of neurologic evaluation of new neurologic symptoms in persons with preexisting chronic disease and of optimum treatment of comorbidity in MS is critical....

  6. Comparing Multiple-Group Multinomial Log-Linear Models for Multidimensional Skill Distributions in the General Diagnostic Model. Research Report. ETS RR-08-35

    Science.gov (United States)

    Xu, Xueli; von Davier, Matthias

    2008-01-01

    The general diagnostic model (GDM) utilizes located latent classes for modeling a multidimensional proficiency variable. In this paper, the GDM is extended by employing a log-linear model for multiple populations that assumes constraints on parameters across multiple groups. This constrained model is compared to log-linear models that assume…

  7. Peripheral (Seventh Nerve Palsy and Multiple Sclerosis: A Diagnostic Dilemma - A Case Report

    Directory of Open Access Journals (Sweden)

    Christian Saleh

    2016-01-01

    Full Text Available During the last decades, only a few cases on the association between peripheral demyelinating diseases and multiple sclerosis (MS have been reported. We describe the case of a young man who was initially diagnosed with Bell's palsy, and only after performing a brain MRI was the diagnosis of MS made. We review the literature and discuss some pitfalls which may lead to missing the diagnosis of MS.

  8. Research on the reliability of friction system under combined additive and multiplicative random excitations

    Science.gov (United States)

    Sun, Jiaojiao; Xu, Wei; Lin, Zifei

    2018-01-01

    In this paper, the reliability of a non-linearly damped friction oscillator under combined additive and multiplicative Gaussian white noise excitations is investigated. The stochastic averaging method, which is usually applied to the research of smooth system, has been extended to the study of the reliability of non-smooth friction system. The results indicate that the reliability of friction system can be improved by Coulomb friction and reduced by random excitations. In particular, the effect of the external random excitation on the reliability is larger than the effect of the parametric random excitation. The validity of the analytical results is verified by the numerical results.

  9. Combined use of flexible ureteroscopic lithotripsy with micro-percutaneous nephrolithotomy in pediatric multiple kidney stones.

    Science.gov (United States)

    Li, Jun; Wang, Wenying; Du, Yuan; Tian, Ye

    2018-03-28

    We investigated the clinical value of treating pediatric multiple kidney stones with extensive distribution using flexible ureteroscopic lithotripsy (FUL) combined with micro-percutaneous nephrolithotomy (micro-PNL). In total, 21 pediatric patients with multiple renal calculi between May 2016 and June 2017 received FUL combined with micro-PNL. The group included 13 boys and eight girls; the patients' mean age was 3.8 years (range 1-8 years). The maximum stone diameter ranged from 1.0 to 1.5 cm. FUL was first performed in the lithotomy position to fragment stones that were located in the renal pelvis, and upper and mid-renal calyx. Patients were then moved to a prone position, and micro-PNL was performed to treat lower pole stones that could not be reached by the flexible ureteroscope during FUL. Percutaneous renal access to the lower calyx was achieved using a 4.8F "all-seeing needle" with ultrasound guidance, and stone fragmentation was performed with a 200-μm holmium laser at different settings to disintegrate 1- to 2-mm fragments. All 21 pediatric patients with multiple kidney stones underwent combined FUL and micro-PNL. The stone free rate (SFR) was 85.7% (18/21). The mean surgical time was 45 min (range 30-70 min). The mean volume of irrigation fluid used was 480 mL (range 300-1200 mL). The mean surgical time for FUL and micro-PNL was 31 min and 14 min, respectively, and the mean volume of fluid used for FUL and micro-PNL was 360 mL and 120 mL, respectively. According to the modified Clavien classification, grade 1 and 2 postoperative complications occurred in five and one patients, respectively. The mean decrease in the level of hemoglobin was 0.4 g/dL (0-0.7 g/dL), and no patients required a transfusion. The average hospital stay was 3 days (range 2-5 days). Combined FUL and micro-PNL is a safe, effective, and minimally invasive operation to remove multiple renal calculi with extensive distribution in children in selected cases. Copyright © 2018

  10. Enhanced DET-Based Fault Signature Analysis for Reliable Diagnosis of Single and Multiple-Combined Bearing Defects

    Directory of Open Access Journals (Sweden)

    In-Kyu Jeong

    2015-01-01

    Full Text Available To early identify cylindrical roller bearing failures, this paper proposes a comprehensive bearing fault diagnosis method, which consists of spectral kurtosis analysis for finding the most informative subband signal well representing abnormal symptoms about the bearing failures, fault signature calculation using this subband signal, enhanced distance evaluation technique- (EDET- based fault signature analysis that outputs the most discriminative fault features for accurate diagnosis, and identification of various single and multiple-combined cylindrical roller bearing defects using the simplified fuzzy adaptive resonance map (SFAM. The proposed comprehensive bearing fault diagnosis methodology is effective for accurate bearing fault diagnosis, yielding an average classification accuracy of 90.35%. In this paper, the proposed EDET specifically addresses shortcomings in the conventional distance evaluation technique (DET by accurately estimating the sensitivity of each fault signature for each class. To verify the efficacy of the EDET-based fault signature analysis for accurate diagnosis, a diagnostic performance comparison is carried between the proposed EDET and the conventional DET in terms of average classification accuracy. In fact, the proposed EDET achieves up to 106.85% performance improvement over the conventional DET in average classification accuracy.

  11. Hybrid operating room concept for combined diagnostics, intervention and surgery in acute type A dissection.

    Science.gov (United States)

    Tsagakis, Konstantinos; Konorza, Thomas; Dohle, Daniel Sebastian; Kottenberg, Eva; Buck, Thomas; Thielmann, Matthias; Erbel, Raimund; Jakob, Heinz

    2013-02-01

    In acute type A dissection (AAAD), it is commonly decided to carry out immediate surgical repair without invasive diagnostics. The hybrid operating room (Hybrid OR) concept encompasses simultaneous haemodynamic control, non-invasive and invasive diagnostics and immediate surgical and/or interventional treatment. Results over a seven-year period are presented here. From March 2004 to March 2011, 1883 cardiological and surgical patients were treated in a Hybrid OR. Of these, 124 patients (age 60 ± 13, 64% male) diagnosed with AAAD were operated upon. External computed tomography (CT) was available for 87% (108/124) of cases and angiography in 15% (19/124). Preoperative transoesophageal echocardiography (TEE) was done in all patients and angiography in 57% (71/124). Surgery was performed without angiography in 27% (34/124), of which 14% (17/124) was due to shock. Postoperative control angiography followed in 18% (22/124) due to suspected ongoing malperfusion. Preoperative angiography was performed in 71 patients, and no angiography related complications were observed during the procedure. A total of 32% (23/71) of these underwent coronary artery bypass graft (CABG)--for newly-diagnosed coronary artery disease in 21% of cases and for coronary malperfusion in 11%. Visceral/peripheral malperfusion syndromes, necessitating primary endovascular intervention, were detected in 23% (16/71). Ascending aorta replacement was performed in 100% (124/124) of patients, arch replacement in 88% (109/124) and descending aorta repair in 35% (44/124). Five postoperative endovascular interventions became necessary due to persistent malperfusion. In-hospital mortality was 13% (12/90) in patients who had undergone preoperative invasive diagnostics and 24% (8/34) in patients who had not. The Hybrid OR concept enables the exact diagnosis of coronary status and downstream malperfusion sites and influences the design of surgical and/or endovascular treatment, without time delay and at

  12. Multiple and high-throughput droplet reactions via combination of microsampling technique and microfluidic chip

    KAUST Repository

    Wu, Jinbo

    2012-11-20

    Microdroplets offer unique compartments for accommodating a large number of chemical and biological reactions in tiny volume with precise control. A major concern in droplet-based microfluidics is the difficulty to address droplets individually and achieve high throughput at the same time. Here, we have combined an improved cartridge sampling technique with a microfluidic chip to perform droplet screenings and aggressive reaction with minimal (nanoliter-scale) reagent consumption. The droplet composition, distance, volume (nanoliter to subnanoliter scale), number, and sequence could be precisely and digitally programmed through the improved sampling technique, while sample evaporation and cross-contamination are effectively eliminated. Our combined device provides a simple model to utilize multiple droplets for various reactions with low reagent consumption and high throughput. © 2012 American Chemical Society.

  13. Antinuclear antibodies giving the 'multiple nuclear dots' or the 'rim-like/membranous' patterns: diagnostic accuracy for primary biliary cirrhosis.

    Science.gov (United States)

    Granito, A; Muratori, P; Muratori, L; Pappas, G; Cassani, F; Worthington, J; Guidi, M; Ferri, S; DE Molo, C; Lenzi, M; Chapman, R W; Bianchi, F B

    2006-12-01

    Serum antinuclear antibodies giving the 'multiple nuclear dots' or the 'rim-like/membranous' patterns are frequently detected by indirect immunofluorescence on HEp-2 cells in patients with primary biliary cirrhosis. To assess the accuracy of multiple nuclear dot and rim-like/membranous antinuclear antibodies for the diagnosis of primary biliary cirrhosis. Sera from 4371 consecutive patients referred to our laboratory were analysed under code for antinuclear antibodies testing by indirect immunofluorescence on HEp-2 cells. Review of the clinical records of the 4371 patients allowed identification of 101 patients with antimitochondrial antibody-positive primary biliary cirrhosis and 22 with antimitochondrial antibody-negative variant. Multiple nuclear dot and/or rim-like/membranous patterns were found in 59 (1.3%) of the 4371 patients: 31 antimitochondrial antibody-positive primary biliary cirrhosis, 17 antimitochondrial antibody-negative primary biliary cirrhosis and 11 non-primary biliary cirrhosis. The specificity for primary biliary cirrhosis of both the antinuclear antibodies pattern was 99%. Positive predictive value and likelihood ratio for a positive test were 86% (95% CI: 72.7-94) and 221 (95% CI: 91.7-544) for multiple nuclear dot, 79% (95% CI: 62.2-90.1) and 132 (95% CI: 56.8-312.7) for rim-like/membranous, respectively. Multiple nuclear dot and rim-like/membranous antinuclear antibodies are rare findings. Their positivity strongly suggests the diagnosis of primary biliary cirrhosis, irrespective of antimitochondrial antibody status. The high specificity for primary biliary cirrhosis makes them a useful diagnostic tool especially in antimitochondrial antibody-negative patients.

  14. Rational combination treatment with histone deacetylase inhibitors and immunomodulatory drugs in multiple myeloma

    International Nuclear Information System (INIS)

    Hideshima, T; Cottini, F; Ohguchi, H; Jakubikova, J; Gorgun, G; Mimura, N; Tai, Y-T; Munshi, N C; Richardson, P G; Anderson, K C

    2015-01-01

    Immunomodulatory drugs (IMiDs) thalidomide, lenalidomide (Len) and pomalidomide trigger anti-tumor activities in multiple myeloma (MM) by targetting cereblon and thereby impacting IZF1/3, c-Myc and IRF4. Histone deacetylase inhibitors (HDACi) also downregulate c-Myc. We therefore determined whether IMiDs with HDACi trigger significant MM cell growth inhibition by inhibiting or downregulating c-Myc. Combination treatment of Len with non-selective HDACi suberoylanilide hydroxamic acid or class-I HDAC-selective inhibitor MS275 induces synergic cytotoxicity, associated with downregulation of c-Myc. Unexpectedly, we observed that decreased levels of cereblon (CRBN), a primary target protein of IMiDs, was triggered by these agents. Indeed, sequential treatment of MM cells with MS275 followed by Len shows less efficacy than simultaneous treatment with this combination. Importantly ACY1215, an HDAC6 inhibitor with minimal effects on class-I HDACs, together with Len induces synergistic MM cytotoxicity without alteration of CRBN expression. Our results showed that only modest class-I HDAC inhibition is able to induce synergistic MM cytotoxicity in combination with Len. These studies may provide the framework for utilizing HDACi in combination with Len to both avoid CRBN downregulation and enhance anti-MM activities

  15. Rational combination treatment with histone deacetylase inhibitors and immunomodulatory drugs in multiple myeloma.

    Science.gov (United States)

    Hideshima, T; Cottini, F; Ohguchi, H; Jakubikova, J; Gorgun, G; Mimura, N; Tai, Y-T; Munshi, N C; Richardson, P G; Anderson, K C

    2015-05-15

    Immunomodulatory drugs (IMiDs) thalidomide, lenalidomide (Len) and pomalidomide trigger anti-tumor activities in multiple myeloma (MM) by targetting cereblon and thereby impacting IZF1/3, c-Myc and IRF4. Histone deacetylase inhibitors (HDACi) also downregulate c-Myc. We therefore determined whether IMiDs with HDACi trigger significant MM cell growth inhibition by inhibiting or downregulating c-Myc. Combination treatment of Len with non-selective HDACi suberoylanilide hydroxamic acid or class-I HDAC-selective inhibitor MS275 induces synergic cytotoxicity, associated with downregulation of c-Myc. Unexpectedly, we observed that decreased levels of cereblon (CRBN), a primary target protein of IMiDs, was triggered by these agents. Indeed, sequential treatment of MM cells with MS275 followed by Len shows less efficacy than simultaneous treatment with this combination. Importantly ACY1215, an HDAC6 inhibitor with minimal effects on class-I HDACs, together with Len induces synergistic MM cytotoxicity without alteration of CRBN expression. Our results showed that only modest class-I HDAC inhibition is able to induce synergistic MM cytotoxicity in combination with Len. These studies may provide the framework for utilizing HDACi in combination with Len to both avoid CRBN downregulation and enhance anti-MM activities.

  16. Differentiating between heat pain intensities: the combined effect of multiple autonomic parameters.

    Science.gov (United States)

    Treister, Roi; Kliger, Mark; Zuckerman, Galit; Goor Aryeh, Itay; Eisenberg, Elon

    2012-09-01

    Although it is well known that pain induces changes in autonomic parameters, the extent to which these changes correlate with the experience of pain is under debate. The aim of the present study was to compare a combination of multiple autonomic parameters and each parameter alone in their ability to differentiate among 4 categories of pain intensity. Tonic heat stimuli (1minute) were individually adjusted to induce no pain, low, medium, and high pain in 45 healthy volunteers. Electrocardiogram, photoplethysmogram, and galvanic skin response were recorded, and the following parameters were calculated: heart rate; heart rate variability-high frequency (0.15 to 0.4Hz) spectral power; skin conductance level; number of skin conduction fluctuations; and photoplethysmographic pulse wave amplitude. A combination of parameters was created by fitting an ordinal cumulative logit model to the data and using linear coefficients of the model. Friedman test with post-hoc Wilcoxon test were used to compare between pain intensity categories for every parameter alone and for their linear combination. All of the parameters successfully differentiated between no pain and all other pain categories. However, none of the parameters differentiated between all 3 pain categories (i.e., low and medium; medium and high; low and high). In contrast, the linear combination of parameters significantly differentiated not only between pain and no pain, but also between all pain categories (Ppain assessment. Copyright © 2012 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  17. Diagnostic evaluation of dysphagia in multiple sclerosis patients using a Persian version of DYMUS questionnaire.

    Science.gov (United States)

    Pajouh, Sahar Danesh; Moradi, Negin; Shaterzadeh Yazdi, Mohammad Jafar; Latifi, Seyed Mahmoud; Mehravar, Mohammad; Majdinasab, Nastaran; Olapour, Ali Reza; Soltani, Majid; Khanchezar, Fatemeh

    2017-10-01

    Multiple sclerosis is a chronic neurological disease that may cause swallowing disorders. Dysphagia is a common problem, which patients with different levels of disability may encounter, but it is usually underestimated; therefore, effective assessments need to be performed before any serious complications. The aim of this study was to identify the frequency and characteristics of dysphagia in multiple sclerosis patients of Khuzestan MS society, using a Persian version of Dysphagia in Multiple Sclerosis (DYMUS) questionnaire. 105 consecutive MS patients (84 F and 21 M, mean age 33.8 ± 8.5 years, mean disease duration 3.5 ± 3.1 years, mean Expanded Disability Status Scale (EDSS) 1.8 ± 1.3) participated in the study and the DYMUS questionnaire was administered by a trained speech therapist. The results have shown that 55 MS patients (52.4%) had dysphagia and the dysphagia was significantly associated with the disease course of MS (p = 0.02). However, significant associations between DYMUS values and EDSS, disease duration, age, and gender were not observed. (Respectively, p = 0.4, p = 0.09, p = 0.1, p = 1.0). In the dysphagia group, based on dysphagia severity, 17.1% and 35.2% of patients had mild and alarming dysphagia, respectively. Although, the patients with alarming dysphagia had longer disease duration, higher EDSS score and more with SP, PP and PR disease course than the patients with mild dysphagia, these differences were not significant. The oropharyngeal dysphagia in MS patients is very common even in early stages of the disease; therefore, it is important to assess these patients carefully and to initiate a treatment program if needed. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Flow Cytometry Method as a Diagnostic Tool for Pleural Fluid Involvement in a Patient with Multiple Myeloma

    Directory of Open Access Journals (Sweden)

    MUZAFFER KEKLIK

    2012-01-01

    Full Text Available

    Multiple myeloma is a malignant proliferation of plasma cells that mainly affects bone marrow. Pleural effusions secondary to pleural myelomatous involvement have rarely been reported in the literature. As it is rarely detected, we aimed to report a case in which pleural effusion of a multiple myeloma was confirmed as true myelomatous involvement by flow cytometry method. A 52-years old man presented to our clinic with chest and back pain lasting for 3 months. On the chest radiography, pleural fluid was detected in left hemithorax. Pleural fluid flow cytometry was performed. In the flow cytometry, CD56, CD38 and CD138 found to be positive, while CD19 was negative. True myelomatous pleural effusions are very uncommon, with fewer than 100 cases reported worldwide. Flow cytometry is a potentially useful diagnostic tool for clinical practice. We presented our case; as it has been rarely reported, although flow cytometer is a simple method for detection of pleural fluid involvement in multiple myeloma.

  19. Flow Cytometry Method as a Diagnostic Tool for Pleural Fluid Involvement in a Patient with Multiple Myeloma

    Directory of Open Access Journals (Sweden)

    Muzaffer Keklik

    2012-10-01

    Full Text Available Multiple myeloma is a malignant proliferation of plasma cells that mainly affects bone marrow. Pleural effusions secondary to pleural myelomatous involvement have rarely been reported in the literature. As it is rarely detected, we aimed to report a case in which pleural effusion of a multiple myeloma was confirmed as true myelomatous involvement by flow cytometry method. A 52-years old man presented to our clinic with chest and back pain lasting for 3 months. On the chest radiography, pleural fluid was detected in left hemithorax. Pleural fluid flow cytometry was performed. In the flow cytometry, CD56, CD38 and CD138 found to be positive, while CD19 was negative. True myelomatous pleural effusions are very uncommon, with fewer than 100 cases reported worldwide. Flow cytometry is a potentially useful diagnostic tool for clinical practice. We presented our case; as it has been rarely reported, although flow cytometer is a simple method for detection of pleural fluid involvement in multiple myeloma.

  20. Diagnostic study of multiple double layer formation in expanding RF plasma

    Science.gov (United States)

    Chakraborty, Shamik; Paul, Manash Kumar; Roy, Jitendra Nath; Nath, Aparna

    2018-03-01

    Intensely luminous double layers develop and then expand in size in a visibly glowing RF discharge produced using a plasma source consisting of a semi-transparent cylindrical mesh with a central electrode, in a linear plasma chamber. Although RF discharge is known to be independent of device geometry in the absence of magnetic field, the initiation of RF discharge using such a plasma source results in electron drift and further expansion of the plasma in the vessel. The dynamics of complex plasma structures are studied through electric probe diagnostics in the expanding RF plasma. The measurements made to study the parametric dependence of evolution of double layer structures are analyzed and presented here. The plasma parameter measurements suggest that the complex potential structures initially form with low potential difference between the layers and then gradually expand producing burst oscillations. The present study provides interesting information about the stability of plasma sheath and charge particle dynamics in it that are important to understand the underlying basic sheath physics along with applications in plasma acceleration and propulsion.

  1. Taeniasis-cysticercosis in Southern Ecuador: assessment of infection status using multiple laboratory diagnostic tools

    Directory of Open Access Journals (Sweden)

    R Rodriguez-Hidalgo

    2006-11-01

    Full Text Available Taenia solium-taeniasis and cysticercosis were studied in the human and porcine populations of a rural community in the Southern Ecuadorian Andes. From the 1059 inhabitants, 800 serum samples and 958 stool samples could be collected. In addition, 646 from the estimated 1148 pigs were tongue inspected. Circulating antigen was detected by enzyme linked immunosorbent assay (Ag-ELISA in 2.25% of the human population, whereas intestinal taeniasis was detected in 1.46% by the formalin-ether technique. Following treatment and recovery of tapeworm fragments these were all identified as T. solium. Porcine cysticercosis was diagnosed in 3.56% of the pigs by tongue inspection. In addition, enzyme linked immunoelectrotransfer blot (EITB was performed on a subset group of 100 humans to confirm the results of the Ag-ELISA. One hundred serum samples from pigs were also analysed by EITB. It appeared that 43 and 74% of humans and pigs had antibodies against T. solium cysticerci, respectively. It is concluded that contrary to the high exposure of the human population to T. solium that is suggested by EITB, the number of active cysticercosis cases, diagnosed by Ag-ELISA, was low, which may indicate endemic stability. The further use of complementary diagnostic methods for a better understanding of the epidemiology of T. solium is suggested.

  2. Taeniasis-cysticercosis in Southern Ecuador: assessment of infection status using multiple laboratory diagnostic tools.

    Science.gov (United States)

    Rodriguez-Hidalgo, R; Benitez-Ortiz, W; Praet, N; Saa, L R; Vercruysse, J; Brandt, J; Dorny, P

    2006-11-01

    Taenia solium-taeniasis and cysticercosis were studied in the human and porcine populations of a rural community in the Southern Ecuadorian Andes. From the 1059 inhabitants, 800 serum samples and 958 stool samples could be collected. In addition, 646 from the estimated 1148 pigs were tongue inspected. Circulating antigen was detected by enzyme linked immunosorbent assay (Ag-ELISA) in 2.25% of the human population, whereas intestinal taeniasis was detected in 1.46% by the formalin-ether technique. Following treatment and recovery of tapeworm fragments these were all identified as T. solium. Porcine cysticercosis was diagnosed in 3.56% of the pigs by tongue inspection. In addition, enzyme linked immunoelectrotransfer blot (EITB) was performed on a subset group of 100 humans to confirm the results of the Ag-ELISA. One hundred serum samples from pigs were also analysed by EITB. It appeared that 43 and 74% of humans and pigs had antibodies against T. solium cysticerci, respectively. It is concluded that contrary to the high exposure of the human population to T. solium that is suggested by EITB, the number of active cysticercosis cases, diagnosed by Ag-ELISA, was low, which may indicate endemic stability. The further use of complementary diagnostic methods for a better understanding of the epidemiology of T. solium is suggested.

  3. Combined influence of multiple climatic factors on the incidence of bacterial foodborne diseases.

    Science.gov (United States)

    Park, Myoung Su; Park, Ki Hwan; Bahk, Gyung Jin

    2018-01-01

    Information regarding the relationship between the incidence of foodborne diseases (FBD) and climatic factors is useful in designing preventive strategies for FBD based on anticipated future climate change. To better predict the effect of climate change on foodborne pathogens, the present study investigated the combined influence of multiple climatic factors on bacterial FBD incidence in South Korea. During 2011-2015, the relationships between 8 climatic factors and the incidences of 13 bacterial FBD, were determined based on inpatient stays, on a monthly basis using the Pearson correlation analyses, multicollinearity tests, principal component analysis (PCA), and the seasonal autoregressive integrated moving average (SARIMA) modeling. Of the 8 climatic variables, the combination of temperature, relative humidity, precipitation, insolation, and cloudiness was significantly associated with salmonellosis (Pclimatic factors. These findings indicate that the relationships between multiple climatic factors and bacterial FBD incidence can be valuable for the development of prediction models for future patterns of diseases in response to changes in climate. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Validation and calibration of structural models that combine information from multiple sources.

    Science.gov (United States)

    Dahabreh, Issa J; Wong, John B; Trikalinos, Thomas A

    2017-02-01

    Mathematical models that attempt to capture structural relationships between their components and combine information from multiple sources are increasingly used in medicine. Areas covered: We provide an overview of methods for model validation and calibration and survey studies comparing alternative approaches. Expert commentary: Model validation entails a confrontation of models with data, background knowledge, and other models, and can inform judgments about model credibility. Calibration involves selecting parameter values to improve the agreement of model outputs with data. When the goal of modeling is quantitative inference on the effects of interventions or forecasting, calibration can be viewed as estimation. This view clarifies issues related to parameter identifiability and facilitates formal model validation and the examination of consistency among different sources of information. In contrast, when the goal of modeling is the generation of qualitative insights about the modeled phenomenon, calibration is a rather informal process for selecting inputs that result in model behavior that roughly reproduces select aspects of the modeled phenomenon and cannot be equated to an estimation procedure. Current empirical research on validation and calibration methods consists primarily of methodological appraisals or case-studies of alternative techniques and cannot address the numerous complex and multifaceted methodological decisions that modelers must make. Further research is needed on different approaches for developing and validating complex models that combine evidence from multiple sources.

  5. Combining morphometric evidence from multiple registration methods using dempster-shafer theory

    Science.gov (United States)

    Rajagopalan, Vidya; Wyatt, Christopher

    2010-03-01

    In tensor-based morphometry (TBM) group-wise differences in brain structure are measured using high degreeof- freedom registration and some form of statistical test. However, it is known that TBM results are sensitive to both the registration method and statistical test used. Given the lack of an objective model of group variation is it difficult to determine a best registration method for TBM. The use of statistical tests is also problematic given the corrections required for multiple testing and the notorius difficulty selecting and intepreting signigance values. This paper presents an approach to address both of these issues by combining multiple registration methods using Dempster-Shafer Evidence theory to produce belief maps of categorical changes between groups. This approach is applied to the comparison brain morphometry in aging, a typical application of TBM, using the determinant of the Jacobian as a measure of volume change. We show that the Dempster-Shafer combination produces a unique and easy to interpret belief map of regional changes between and within groups without the complications associated with hypothesis testing.

  6. Magnetic Resonance Imaging (MRI) with retrograde intralumen contrast enhancement of the rectum in diagnostics of rectovaginal fistulas after combination therapy of rectal cancer. Experience of application

    Science.gov (United States)

    Usova, A.; Frolova, I.; Afanasev, S.; Tarasova, A.; Molchanov, S.

    2016-02-01

    Experiment of use of MRI in diagnostics of rectovaginal fistulas after combination therapy of rectal cancer is shown on clinical examples. We used retrograde contrasting of a rectum with 150ml ultrasonic gel to make MRI more informative in case of low diagnostic efficiency of ultrasound, colonoscopy and gynecological examination.

  7. Combining information from multiple flood projections in a hierarchical Bayesian framework

    Science.gov (United States)

    Le Vine, Nataliya

    2016-04-01

    This study demonstrates, in the context of flood frequency analysis, the potential of a recently proposed hierarchical Bayesian approach to combine information from multiple models. The approach explicitly accommodates shared multimodel discrepancy as well as the probabilistic nature of the flood estimates, and treats the available models as a sample from a hypothetical complete (but unobserved) set of models. The methodology is applied to flood estimates from multiple hydrological projections (the Future Flows Hydrology data set) for 135 catchments in the UK. The advantages of the approach are shown to be: (1) to ensure adequate "baseline" with which to compare future changes; (2) to reduce flood estimate uncertainty; (3) to maximize use of statistical information in circumstances where multiple weak predictions individually lack power, but collectively provide meaningful information; (4) to diminish the importance of model consistency when model biases are large; and (5) to explicitly consider the influence of the (model performance) stationarity assumption. Moreover, the analysis indicates that reducing shared model discrepancy is the key to further reduction of uncertainty in the flood frequency analysis. The findings are of value regarding how conclusions about changing exposure to flooding are drawn, and to flood frequency change attribution studies.

  8. Combined gait disorder: a diagnostic challenge –a case report

    Directory of Open Access Journals (Sweden)

    Ioana Stanescu

    2017-02-01

    Full Text Available Gait disorders are a major cause of functional impairment and morbidity, especially in the elderly population. Prevalence of gait disorders is higher in persons over 60: is estimated to be around 15% at 60 years of age and more than 50% in people > 80 years. Most gait disorders are multifactorial and have both neurologic and non-neurologic components. Neurological gait abnormalities result from focal or diffuse lesions occurring in the neural pathways linking the cortical motor centers to the peripheral neuromuscular systems. Nonneurological gait abnormalities include gait limitations caused by musculoskeletal, cardiac, or respiratory diseases. Assessment of a gait abnormality should include history, clinical presentation and additional diagnostic tests. Finding the ethiology of a gait disorder could be a challenge for the practitioners in many cases, requiring interdisciplinary cooperation.

  9. Modern approaches to diagnostics of combined degenerative hip and spine pathology

    Directory of Open Access Journals (Sweden)

    V. V. Khominets

    2014-01-01

    Full Text Available The results of standard radiographs of 90 patients with hip-spine syndrome associated with one unilateral or bilateral III stage hip osteoarthhrosis were analyzed with the aim to improve the diagnostics of pathological changes in the "hip joint-pelvis- spine" complex. 12 parameters of sagittal spinal-pelvic balance and 3 parameters of frontal one were studied and the degenerative changes in spinal motional segments were evaluated. The statistical processing of obtained data was made. It was stated that the most frequent variant of sagittal spinal-pelvic profile is hyperlordosic one, followed by formation of degenerative changes especially in dorsal regions of spine (р=0,076.The strategy of patient examination with hip-spine syndrome was established from clinical and radiographic positions.

  10. Neural Dynamics of Multiple Object Processing in Mild Cognitive Impairment and Alzheimer's Disease: Future Early Diagnostic Biomarkers?

    Science.gov (United States)

    Bagattini, Chiara; Mazza, Veronica; Panizza, Laura; Ferrari, Clarissa; Bonomini, Cristina; Brignani, Debora

    2017-01-01

    The aim of this study was to investigate the behavioral and electrophysiological dynamics of multiple object processing (MOP) in mild cognitive impairment (MCI) and Alzheimer's disease (AD), and to test whether its neural signatures may represent reliable diagnostic biomarkers. Behavioral performance and event-related potentials [N2pc and contralateral delay activity (CDA)] were measured in AD, MCI, and healthy controls during a MOP task, which consisted in enumerating a variable number of targets presented among distractors. AD patients showed an overall decline in accuracy for both small and large target quantities, whereas in MCI patients, only enumeration of large quantities was impaired. N2pc, a neural marker of attentive individuation, was spared in both AD and MCI patients. In contrast, CDA, which indexes visual short term memory abilities, was altered in both groups of patients, with a non-linear pattern of amplitude modulation along the continuum of the disease: a reduction in AD and an increase in MCI. These results indicate that AD pathology shows a progressive decline in MOP, which is associated to the decay of visual short-term memory mechanisms. Crucially, CDA may be considered as a useful neural signature both to distinguish between healthy and pathological aging and to characterize the different stages along the AD continuum, possibly becoming a reliable candidate for an early diagnostic biomarker of AD pathology.

  11. Application of 99mTc-MIBI for diagnostic evaluation of multiple myeloma and lymphoma

    International Nuclear Information System (INIS)

    Kostadinova, I.; Garcheva, M.; Petrov, T.

    1995-01-01

    An attempt is made to determine the stage of multiple myeloma (MM), Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) after applying 99 mTc-MIBI, as well as to proof the residual vital tissue after chemo- and radiotherapy. 15 patients with these diseases and 3 controls are examined. An increased tracer uptake was found at 7 of the patients along the bones (in MM) or focal intake at typical places (in HL and NHL) as a sign of an active disease. In comparison with X-ray and bone scintigraphy, the whole body examination with 99m Tc-MIBI allows visualization of more pathological sites. The preliminary results show that more patients with MM, HL and NHL can be examined in order to determine activity and stage of the disease and to differentiate between active and fibrous tissues after chemo and radio therapy. 6 refs., 2 figs. (author)

  12. Comparing diagnostic accuracy of bedside ultrasound and radiography for bone fracture screening in multiple trauma patients at the ED.

    Science.gov (United States)

    Bolandparvaz, Shahram; Moharamzadeh, Payman; Jamali, Kazem; Pouraghaei, Mahboob; Fadaie, Maryam; Sefidbakht, Sepideh; Shahsavari, Kavous

    2013-11-01

    Long bone fractures are currently diagnosed using radiography, but radiography has some disadvantages (radiation and being time consuming). The present study compared the diagnostic accuracy of bedside ultrasound and radiography in multiple trauma patients at the emergency department (ED). The study assessed 80 injured patients with multiple trauma from February 2011 to July 2012. The patients were older than 18 years and triaged to the cardiopulmonary resuscitation ward of the ED. Bedside ultrasound and radiography were conducted for them. The findings were separately and blindly assessed by 2 radiologists. Sensitivity, specificity, the positive and negative predictive value, and κ coefficient were measured to assess the accuracy and validity of ultrasound as compared with radiography. The sensitivity of ultrasound for diagnosis of limb bone fractures was not high enough and ranged between 55% and 75% depending on the fracture site. The specificity of this diagnostic method had an acceptable range of 62% to 84%. Ultrasound negative prediction value was higher than other indices under study and ranged between 73% and 83%, but its positive prediction value varied between 33.3% and 71%. The κ coefficient for diagnosis of long bone fractures of upper limb (κ = 0.58) and upper limb joints (κ = 0.47) and long bones of lower limb (κ = 0.52) was within the medium range. However, the value for diagnosing fractures of lower limb joints (κ = 0.47) was relatively low. Bedside ultrasound is not a reliable method for diagnosing fractures of upper and lower limb bones compared with radiography. © 2013 Elsevier Inc. All rights reserved.

  13. Combining higher-order resummation with multiple NLO calculations and parton showers in GENEVA

    Energy Technology Data Exchange (ETDEWEB)

    Alioli, Simone; Bauer, Christian W.; Berggren, Calvin; Vermilion, Christopher K.; Walsh, Jonathan R.; Zuberi, Saba [California Univ., Berkeley, CA (United States). Ernest Orlando Lawrence Berkeley National Laboratory; Hornig, Andrew [Washington Univ., Seattle, WA (United States). Dept. of Physics; Tackmann, Frank J. [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany). Gruppe Theorie

    2012-11-15

    We extend the lowest-order matching of tree-level matrix elements with parton showers to give a complete description at the next higher perturbative accuracy in {alpha}{sub s} at both small and large jet resolutions, which has not been achieved so far. This requires the combination of the higher-order resummation of large Sudakov logarithms at small values of the jet resolution variable with the full next-to-leading order (NLO) matrix-element corrections at large values. As a by-product, this combination naturally leads to a smooth connection of the NLO calculations for different jet multiplicities. In this paper, we focus on the general construction of our method and discuss its application to e{sup +}e{sup -} and pp collisions. We present first results of the implementation in the GENEVA Monte Carlo framework. We employ N-jettiness as the jet resolution variable, combining its next-to-next-to-leading logarithmic resummation with fully exclusive NLO matrix elements, and PYTHIA 8 as the backend for further parton showering and hadronization. For hadronic collisions, we take Drell-Yan production as an example to apply our construction. For e{sup +}e{sup -} {yields} jets, taking {alpha}{sub s}(m{sub Z}) = 0.1135 from fits to LEP thrust data, together with the PYTHIA 8 hadronization model, we obtain good agreement with LEP data for a variety of 2-jet observables.

  14. Diagnosis of soil-transmitted helminthiasis in an Amazonic community of Peru using multiple diagnostic techniques.

    Science.gov (United States)

    Machicado, Jorge D; Marcos, Luis A; Tello, Raul; Canales, Marco; Terashima, Angelica; Gotuzzo, Eduardo

    2012-06-01

    An observational descriptive study was conducted in a Shipibo-Conibo/Ese'Eja community of the rainforest in Peru to compare the Kato-Katz method and the spontaneous sedimentation in tube technique (SSTT) for the diagnosis of intestinal parasites as well as to report the prevalence of soil-transmitted helminth (STH) infections in this area. A total of 73 stool samples were collected and analysed by several parasitological techniques, including Kato-Katz, SSTT, modified Baermann technique (MBT), agar plate culture, Harada-Mori culture and the direct smear examination. Kato-Katz and SSTT had the same rate of detection for Ascaris lumbricoides (5%), Trichuris trichiura (5%), hookworm (14%) and Hymenolepis nana (26%). The detection rate for Strongyloides stercoralis larvae was 16% by SSTT and 0% by Kato-Katz, but 18% by agar plate culture and 16% by MBT. The SSTT also had the advantage of detecting multiple intestinal protozoa such as Blastocystis hominis (40%), Giardia intestinalis (29%) and Entamoeba histolytica/E. dispar (16%). The most common intestinal parasites found in this community were B. hominis, G. intestinalis, H. nana, S. stercoralis and hookworm. In conclusion, the SSTT is not inferior to Kato-Katz for the diagnosis of common STH infections but is largely superior for detecting intestinal protozoa and S. stercoralis larvae. Copyright © 2012 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

  15. Indications for and comparative diagnostic value of combined ultrasound and X-ray mammography

    International Nuclear Information System (INIS)

    Novak, D.

    1983-01-01

    A standardised method of ultrasound mammography is described. In order to achieve the same position, form, and shape of the breast as during roentgen mammography a Lucite plate in horizontal, and vertical position us used. Ultrasound contact scanning of the whole breast is carried out in cranio-caudal as well as in medio-lateral direction of the ultrasound beam. Ultrasound scanning is performed with the compression of the breast corresponding to the compression during roentgen mammography. It was found that the ultrasound breast examination combined with X-ray mammography optimizes the differentiation between benign and malignant masses and therefore may reduce the incidence of breast biopsy. A combined use of both examination modalities in the evaluation of the breast is advocated. (orig.)

  16. Diagnostic value of digital radiography compared to conventional screen-film system combinations

    International Nuclear Information System (INIS)

    Krug, B.; Zaehringer, M.; Lackner, K.

    1997-01-01

    Digital projection radiography provides digital data in X-ray examinations, which used to be carried out by examinations screen-film system combinations. The technological basis and clinical performances of digital luminescent radiography (DLR) and digital radiography are reviewed. Digital projection radiography does not allow to reduce selenium exposure significantly, compared to screen-film system combinations. Digital luminescent radiography can be used for the entire spectrum of analogous projection radiography the only exception being extremely subtile structural changes. The clinical experiences with digital selenium radiography achieved so far in chest X-rays are promising and the technique is expected to be increasing used in other anatomic regions as well. (orig.) [de

  17. BLINCK?A diagnostic algorithm for skin cancer diagnosis combining clinical features with dermatoscopy findings

    OpenAIRE

    Bourne, Peter; Rosendahl, Cliff; Keir, Jeff; Cameron, Alan

    2012-01-01

    Background: Deciding whether a skin lesion requires biopsy to exclude skin cancer is often challenging for primary care clinicians in Australia. There are several published algorithms designed to assist with the diagnosis of skin cancer but apart from the clinical ABCD rule, these algorithms only evaluate the dermatoscopic features of a lesion. Objectives: The BLINCK algorithm explores the effect of combining clinical history and examination with fundamental dermatoscopic assessment in primar...

  18. Meta-analysis methods for combining multiple expression profiles: comparisons, statistical characterization and an application guideline.

    Science.gov (United States)

    Chang, Lun-Ching; Lin, Hui-Min; Sibille, Etienne; Tseng, George C

    2013-12-21

    As high-throughput genomic technologies become accurate and affordable, an increasing number of data sets have been accumulated in the public domain and genomic information integration and meta-analysis have become routine in biomedical research. In this paper, we focus on microarray meta-analysis, where multiple microarray studies with relevant biological hypotheses are combined in order to improve candidate marker detection. Many methods have been developed and applied in the literature, but their performance and properties have only been minimally investigated. There is currently no clear conclusion or guideline as to the proper choice of a meta-analysis method given an application; the decision essentially requires both statistical and biological considerations. We performed 12 microarray meta-analysis methods for combining multiple simulated expression profiles, and such methods can be categorized for different hypothesis setting purposes: (1) HS(A): DE genes with non-zero effect sizes in all studies, (2) HS(B): DE genes with non-zero effect sizes in one or more studies and (3) HS(r): DE gene with non-zero effect in "majority" of studies. We then performed a comprehensive comparative analysis through six large-scale real applications using four quantitative statistical evaluation criteria: detection capability, biological association, stability and robustness. We elucidated hypothesis settings behind the methods and further apply multi-dimensional scaling (MDS) and an entropy measure to characterize the meta-analysis methods and data structure, respectively. The aggregated results from the simulation study categorized the 12 methods into three hypothesis settings (HS(A), HS(B), and HS(r)). Evaluation in real data and results from MDS and entropy analyses provided an insightful and practical guideline to the choice of the most suitable method in a given application. All source files for simulation and real data are available on the author's publication website.

  19. Myelodysplastic syndromes: advantages of a combined cytogenetic and molecular diagnostic workup.

    Science.gov (United States)

    Ciabatti, Elena; Valetto, Angelo; Bertini, Veronica; Ferreri, Maria Immacolata; Guazzelli, Alice; Grassi, Susanna; Guerrini, Francesca; Petrini, Iacopo; Metelli, Maria Rita; Caligo, Maria Adelaide; Rossi, Simona; Galimberti, Sara

    2017-10-03

    In this study we present a new diagnostic workup for the myelodysplastic syndromes (MDS) including FISH, aCGH, and somatic mutation assays in addition to the conventional cytogenetics (CC). We analyzed 61 patients by CC, FISH for chromosome 5, 7, 8 and PDGFR rearrangements, aCGH, and PCR for ASXL1, EZH2, TP53, TET2, RUNX1, DNMT3A, SF3B1 somatic mutations. Moreover, we quantified WT1 and RPS14 gene expression levels, in order to find their possible adjunctive value and their possible clinical impact. CC analysis showed 32% of patients with at least one aberration. FISH analysis detected chromosomal aberrations in 24% of patients and recovered 5 cases (13.5%) at normal karyotype (two 5q- syndromes, one del(7) case, two cases with PDGFR rearrangement). The aGCH detected 10 "new" unbalanced cases in respect of the CC, including one with alteration of the ETV6 gene. After mutational analysis, 33 patients (54%) presented at least one mutation and represented the only marker of clonality in 36% of all patients. The statistical analysis confirmed the prognostic role of CC either on overall or on progression-free-survival. In addition, deletions detected by aCGH and WT1 over-expression negatively conditioned survival. In conclusion, our work showed that 1) the addition of FISH (at least for chr. 5 and 7) can improve the definition of the risk score; 2) mutational analysis, especially for the TP53 and SF3B1, could better define the type of MDS and represent a "clinical warning"; 3) the aCGH use could be probably applied to selected cases (with suboptimal response or failure).

  20. Verifying Identities of Plant-Based Multivitamins Using Phytochemical Fingerprinting in Combination with Multiple Bioassays.

    Science.gov (United States)

    Lim, Yeni; Ahn, Yoon Hee; Yoo, Jae Keun; Park, Kyoung Sik; Kwon, Oran

    2017-09-01

    Sales of multivitamins have been growing rapidly and the concept of natural multivitamin, plant-based multivitamin, or both has been introduced in the market, leading consumers to anticipate additional health benefits from phytochemicals that accompany the vitamins. However, the lack of labeling requirements might lead to fraudulent claims. Therefore, the objective of this study was to develop a strategy to verify identity of plant-based multivitamins. Phytochemical fingerprinting was used to discriminate identities. In addition, multiple bioassays were performed to determine total antioxidant capacity. A statistical computation model was then used to measure contributions of phytochemicals and vitamins to antioxidant activities. Fifteen multivitamins were purchased from the local markets in Seoul, Korea and classified into three groups according to the number of plant ingredients. Pearson correlation analysis among antioxidant capacities, amount phenols, and number of plant ingredients revealed that ferric reducing antioxidant power (FRAP) and 2,2-diphenyl-1-picryhydrazyl (DPPH) assay results had the highest correlation with total phenol content. This suggests that FRAP and DPPH assays are useful for characterizing plant-derived multivitamins. Furthermore, net effect linear regression analysis confirmed that the contribution of phytochemicals to total antioxidant capacities was always relatively higher than that of vitamins. Taken together, the results suggest that phytochemical fingerprinting in combination with multiple bioassays could be used as a strategy to determine whether plant-derived multivitamins could provide additional health benefits beyond their nutritional value.

  1. Conceptual study of SCRUM and CCPM combined application in multiple project flexible management

    Directory of Open Access Journals (Sweden)

    Ilton Marchi de Almeida

    2016-11-01

    Full Text Available Project Management (PM has gained a major role in the viability of organizational strategic objectives. The development of products and services has been under increasing market pressure, demanding frequent releases in ever-shorter time periods. To meet these new requirements, PM has to provide the information needed to make decisions in multiple complex projects that are exposed to uncertainty and volatility. Regarding the opportunities to improve PM practices in order to deal with this unstable and ambiguous environment, the aim of this paper is to propose, by means of a conceptual literature analysis, the combined application of two PM methodologies: Critical Chain Project Management (CCPM, and SCRUM. The results of this study indicate that integration of these methodologies can enhance the benefits and mitigate the weaknesses of each of them. This hybrid model could enable better articulation and coordination of project tasks, allowing more effective decisions to be made in multiple project environments affected by volatility, uncertainty, complexity and ambiguity (VUCA.

  2. Diagnostic accuracy of combined coronary angiography and adenosine stress myocardial perfusion imaging using 320-detector computed tomography: pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Nasis, Arthur; Ko, Brian S.; Leung, Michael C.; Antonis, Paul R.; Wong, Dennis T.; Kyi, Leo; Cameron, James D.; Meredith, Ian T.; Seneviratne, Sujith K. [Southern Health and Monash University, Monash Cardiovascular Research Centre, Monash Heart, Department of Medicine Monash Medical Centre (MMC), Melbourne (Australia); Nandurkar, Dee; Troupis, John M. [MMC, Southern Health, Department of Diagnostic Imaging, Melbourne (Australia)

    2013-07-15

    To determine the diagnostic accuracy of combined 320-detector row computed tomography coronary angiography (CTA) and adenosine stress CT myocardial perfusion imaging (CTP) in detecting perfusion abnormalities caused by obstructive coronary artery disease (CAD). Twenty patients with suspected CAD who underwent initial investigation with single-photon-emission computed tomography myocardial perfusion imaging (SPECT-MPI) were recruited and underwent prospectively-gated 320-detector CTA/CTP and invasive angiography. Two blinded cardiologists evaluated invasive angiography images quantitatively (QCA). A blinded nuclear physician analysed SPECT-MPI images for fixed and reversible perfusion defects. Two blinded cardiologists assessed CTA/CTP studies qualitatively. Vessels/territories with both >50 % stenosis on QCA and corresponding perfusion defect on SPECT-MPI were defined as ischaemic and formed the reference standard. All patients completed the CTA/CTP protocol with diagnostic image quality. Of 60 vessels/territories, 17 (28 %) were ischaemic according to QCA/SPECT-MPI criteria. Sensitivity, specificity, PPV, NPV and area under the ROC curve for CTA/CTP was 94 %, 98 %, 94 %, 98 % and 0.96 (P < 0.001) on a per-vessel/territory basis. Mean CTA/CTP radiation dose was 9.2 {+-} 7.4 mSv compared with 13.2 {+-} 2.2 mSv for SPECT-MPI (P < 0.001). Combined 320-detector CTA/CTP is accurate in identifying obstructive CAD causing perfusion abnormalities compared with combined QCA/SPECT-MPI, achieved with lower radiation dose than SPECT-MPI. (orig.)

  3. Diagnostic accuracy of combined coronary angiography and adenosine stress myocardial perfusion imaging using 320-detector computed tomography: pilot study

    International Nuclear Information System (INIS)

    Nasis, Arthur; Ko, Brian S.; Leung, Michael C.; Antonis, Paul R.; Wong, Dennis T.; Kyi, Leo; Cameron, James D.; Meredith, Ian T.; Seneviratne, Sujith K.; Nandurkar, Dee; Troupis, John M.

    2013-01-01

    To determine the diagnostic accuracy of combined 320-detector row computed tomography coronary angiography (CTA) and adenosine stress CT myocardial perfusion imaging (CTP) in detecting perfusion abnormalities caused by obstructive coronary artery disease (CAD). Twenty patients with suspected CAD who underwent initial investigation with single-photon-emission computed tomography myocardial perfusion imaging (SPECT-MPI) were recruited and underwent prospectively-gated 320-detector CTA/CTP and invasive angiography. Two blinded cardiologists evaluated invasive angiography images quantitatively (QCA). A blinded nuclear physician analysed SPECT-MPI images for fixed and reversible perfusion defects. Two blinded cardiologists assessed CTA/CTP studies qualitatively. Vessels/territories with both >50 % stenosis on QCA and corresponding perfusion defect on SPECT-MPI were defined as ischaemic and formed the reference standard. All patients completed the CTA/CTP protocol with diagnostic image quality. Of 60 vessels/territories, 17 (28 %) were ischaemic according to QCA/SPECT-MPI criteria. Sensitivity, specificity, PPV, NPV and area under the ROC curve for CTA/CTP was 94 %, 98 %, 94 %, 98 % and 0.96 (P < 0.001) on a per-vessel/territory basis. Mean CTA/CTP radiation dose was 9.2 ± 7.4 mSv compared with 13.2 ± 2.2 mSv for SPECT-MPI (P < 0.001). Combined 320-detector CTA/CTP is accurate in identifying obstructive CAD causing perfusion abnormalities compared with combined QCA/SPECT-MPI, achieved with lower radiation dose than SPECT-MPI. (orig.)

  4. Applicability of Alignment and Combination Rules to Burst Pressure Prediction of Multiple-flawed Steam Generator Tube

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Myeong Woo; Kim, Ji Seok; Kim, Yun Jae [Korea University, Seoul (Korea, Republic of); Jeon, Jun Young [Doosan Heavy Industries and Consruction, Seoul (Korea, Republic of); Lee, Dong Min [Korea Plant Service and Engineering, Technical Research and Development Institute, Naju (Korea, Republic of)

    2016-05-15

    Alignment and combination rules are provided by various codes and standards. These rules are used to determine whether multiple flaws should be treated as non-aligned or as coplanar, and independent or combined flaws. Experimental results on steam generator (SG) tube specimens containing multiple axial part-through-wall (PTW) flaws at room temperature (RT) are compared with assessment results based on the alignment and combination rules of the codes and standards. In case of axial collinear flaws, ASME, JSME, and BS7910 treated multiple flaws as independent flaws and API 579, A16, and FKM treated multiple flaws as combined single flaw. Assessment results of combined flaws were conservative. In case of axial non-aligned flaws, almost flaws were aligned and assessment results well correlate with experimental data. In case of axial parallel flaws, both effective flaw lengths of aligned flaws and separated flaws was are same because of each flaw length were same. This study investigates the applicability of alignment and combination rules for multiple flaws on the failure behavior of Alloy 690TT steam generator (SG) tubes that widely used in the nuclear power plan. Experimental data of burst tests on Alloy 690TT tubes with single and multiple flaws that conducted at room temperature (RT) by Kim el al. compared with the alignment rules of these codes and standards. Burst pressure of SG tubes with flaws are predicted using limit load solutions that provide by EPRI Handbook.

  5. Diagnostic performance of combined single photon emission computed tomographic scintimammography and ultrasonography based on computer-aided diagnosis for breast cancer

    International Nuclear Information System (INIS)

    Hwang, Kyung Hoon; Choi, Duck Joo; Choe, Won Sick; Lee, Jun Gu; Kim, Jong Hyo; Lee, Hyung Ji; Om, Kyong Sik; Lee, Byeong Il

    2007-01-01

    We investigated whether the diagnostic performance of SPECT scintimammography (SMM) can be improved by adding computer-aided diagnosis (CAD) of ultrasonography (US). We reviewed breast SPECT SMM images and corresponding US images from 40 patients with breast masses (21 malignant and 19 benign tumors.) The quantitative data of SPECT SMM were obtained as the uptake ratio of lesion to contralateral normal breast. The morphologic features of the breast lesions on US were extracted and quantitated using the automated CAD software program. The diagnostic performance of SPECT SMM and CAD of US alone was determined using receiver operating characteristic (ROC) curve analysis. The best discriminating parameter (D-value) combining SPECT SMM and the CAD of US was created. The sensitivity, specificity and accuracy of combined two diagnostic modalities were compared to those of a single one. Both SPECT SMM and CAD of US showed a relatively good diagnostic performance (area under curve=0.846 and 0.831, respectively). Combining the results of SPECT SMM and CAD of US resulted in improved diagnostic performance (area under curve=0.860), but there was no statistical difference in sensitivity, specificity and accuracy between the combined method and a single modality. It seems that combining the results of SPECT SMM and CAD of breast US do not significantly improve the diagnostic performance for diagnosis of breast cancer, compared with that of SPECT SMM alone. However, SPECT SMM and CAD of US may complement each other in differential diagnosis of breast cancer

  6. Combined assessment of DYRK1A, BDNF and homocysteine levels as diagnostic marker for Alzheimer's disease.

    Science.gov (United States)

    Janel, N; Alexopoulos, P; Badel, A; Lamari, F; Camproux, A C; Lagarde, J; Simon, S; Feraudet-Tarisse, C; Lamourette, P; Arbones, M; Paul, J L; Dubois, B; Potier, M C; Sarazin, M; Delabar, J M

    2017-06-20

    Early identification of Alzheimer's disease (AD) risk factors would aid development of interventions to delay the onset of dementia, but current biomarkers are invasive and/or costly to assess. Validated plasma biomarkers would circumvent these challenges. We previously identified the kinase DYRK1A in plasma. To validate DYRK1A as a biomarker for AD diagnosis, we assessed the levels of DYRK1A and the related markers brain-derived neurotrophic factor (BDNF) and homocysteine in two unrelated AD patient cohorts with age-matched controls. Receiver-operating characteristic curves and logistic regression analyses showed that combined assessment of DYRK1A, BDNF and homocysteine has a sensitivity of 0.952, a specificity of 0.889 and an accuracy of 0.933 in testing for AD. The blood levels of these markers provide a diagnosis assessment profile. Combined assessment of these three markers outperforms most of the previous markers and could become a useful substitute to the current panel of AD biomarkers. These results associate a decreased level of DYRK1A with AD and challenge the use of DYRK1A inhibitors in peripheral tissues as treatment. These measures will be useful for diagnosis purposes.

  7. A clinical study of multiple trauma combined with acute lung injury

    Directory of Open Access Journals (Sweden)

    Tao Liang

    2016-11-01

    Full Text Available Objective: To study the changes of the contents of inflammatory mediators in serum of polytrauma patients with acute lung injury (ALI and their correlation with the disease. Methods: Patients suffering from multiple trauma combined with ALI were selected as ALI group (n = 54. Patients suffering from multiple trauma without ALI were considered as the control group (n = 117. The severity of the disease of patients in the two groups was assessed. Arterial blood was extracted for blood gas analysis. Venous blood was extracted to detect the contents of inflammatory mediators tumor necrosis factor-a, interleukin-1b (IL-1b, IL-10, granulocyte-macrophage colony stimulating factor, NO, endothelin-1. Results: The scores of injury severity score [(25.42 ± 3.58 vs. (17.03 ± 2.25], systemic inflammatory response syndrome [(3.85 ± 0.52 vs. (2.20 ± 0.36] and acute physiology and chronic health evaluation II [(92.63 ± 11.04 vs. (60.46 ± 8.87] in patients in ALI group were all significantly higher than those in the control group and its correcting shock time [(8.39 ± 1.05 vs. (5.15 ± 0.72 h] was longer than that of the control group. The amount of blood transfusion [(674.69 ± 93.52 vs. (402.55 ± 57.65 mL] was greater than that in the control group. The contents of the arterial partial pressure of oxygen [(76.65 ± 9.68 vs. (86.51 ± 10.56 mmHg], arterial blood pressure of carbon dioxide [(27.76 ± 4.82 vs. (36.78 ± 5.82 mmHg] and arterial partial pressure of oxygen/fraction of inspired oxygen [(236.94 ± 36.49 vs. (353.95 ± 47.76] were all significantly lower than those in the control group. The contents of serum tumor necrosis factor-a, IL-1b, IL- 10, granulocyte-macrophage colony stimulating factor, NO and endothelin-1 were obviously higher than those of control group and also positively correlated with the scores of injury severity score, systemic inflammatory response syndrome and acute physiology and chronic health evaluation II. Conclusions

  8. Analysis of Dynamic Performance of a Kalman Filter for Combining Multiple MEMS Gyroscopes

    Directory of Open Access Journals (Sweden)

    Liang Xue

    2014-11-01

    Full Text Available In this paper, the dynamic performance of a Kalman filter (KF was analyzed, which is used to combine multiple measurements of a gyroscopes array to reduce the noise and improve the accuracy of the individual sensors. A principle for accuracy improvement by the KF was briefly presented to obtain an optimal estimate of input rate signal. In particular, the influences of some crucial factors on the KF dynamic performance were analyzed by simulations such as the factors input signal frequency, signal sampling, and KF filtering rate. Finally, a system that was comprised of a six-gyroscope array was designed and implemented to test the dynamic performance. Experimental results indicated that the 1σ error for the combined rate signal was reduced to about 0.2°/s in the constant rate test, which was a reduction by a factor of more than eight compared to the single gyroscope. The 1σ error was also reduced from 1.6°/s to 0.48°/s in the swing test. It showed that the estimated angular rate signal could well reflect the dynamic characteristic of the input signal in dynamic conditions.

  9. Combined visual and motor evoked potentials predict multiple sclerosis disability after 20 years.

    Science.gov (United States)

    Schlaeger, Regina; Schindler, Christian; Grize, Leticia; Dellas, Sophie; Radue, Ernst W; Kappos, Ludwig; Fuhr, Peter

    2014-09-01

    The development of predictors of multiple sclerosis (MS) disability is difficult due to the complex interplay of pathophysiological and adaptive processes. The purpose of this study was to investigate whether combined evoked potential (EP)-measures allow prediction of MS disability after 20 years. We examined 28 patients with clinically definite MS according to Poser's criteria with Expanded Disability Status Scale (EDSS) scores, combined visual and motor EPs at entry (T0), 6 (T1), 12 (T2) and 24 (T3) months, and a cranial magnetic resonance imaging (MRI) scan at T0 and T2. EDSS testing was repeated at year 14 (T4) and year 20 (T5). Spearman rank correlation was used. We performed a multivariable regression analysis to examine predictive relationships of the sum of z-transformed EP latencies (s-EPT0) and other baseline variables with EDSST5. We found that s-EPT0 correlated with EDSST5 (rho=0.72, pdisability in MS. © The Author(s) 2014.

  10. Smart Sensor for Online Detection of Multiple-Combined Faults in VSD-Fed Induction Motors

    Science.gov (United States)

    Garcia-Ramirez, Armando G.; Osornio-Rios, Roque A.; Granados-Lieberman, David; Garcia-Perez, Arturo; Romero-Troncoso, Rene J.

    2012-01-01

    Induction motors fed through variable speed drives (VSD) are widely used in different industrial processes. Nowadays, the industry demands the integration of smart sensors to improve the fault detection in order to reduce cost, maintenance and power consumption. Induction motors can develop one or more faults at the same time that can be produce severe damages. The combined fault identification in induction motors is a demanding task, but it has been rarely considered in spite of being a common situation, because it is difficult to identify two or more faults simultaneously. This work presents a smart sensor for online detection of simple and multiple-combined faults in induction motors fed through a VSD in a wide frequency range covering low frequencies from 3 Hz and high frequencies up to 60 Hz based on a primary sensor being a commercially available current clamp or a hall-effect sensor. The proposed smart sensor implements a methodology based on the fast Fourier transform (FFT), RMS calculation and artificial neural networks (ANN), which are processed online using digital hardware signal processing based on field programmable gate array (FPGA).

  11. Vorinostat in combination with lenalidomide and dexamethasone in patients with relapsed or refractory multiple myeloma

    International Nuclear Information System (INIS)

    Siegel, D S; Richardson, P; Dimopoulos, M; Moreau, P; Mitsiades, C; Weber, D; Houp, J; Gause, C; Vuocolo, S; Eid, J; Graef, T; Anderson, K C

    2014-01-01

    The addition of vorinostat to lenalidomide/dexamethasone represents a novel combination therapy in multiple myeloma (MM), informed by laboratory studies suggesting synergy. This was a phase I, multicenter, open-label, non-randomized, dose-escalating study in patients with relapsed or relapsed and refractory MM. Clinical evaluation, electrocardiogram, laboratory studies and adverse events were obtained and assessed. The maximum-tolerated dose was not reached owing to a non-occurrence of two dose-limiting toxicities per six patients tested at any of the dosing levels. Patients tolerated the highest dose tested (Level 5) and this was considered the maximum administered dose: at 400 mg vorinostat on days 1–7 and 15–21, 25 mg lenalidomide on days 1–21 and 40 mg dexamethasone on days 1, 8, 15 and 22, per 28-day cycle. Drug-related adverse events were reported in 90% of patients serious adverse experiences were reported in 45% of the patients and 22% of all patients had adverse experiences considered, possibly related to study drug by the investigators. A confirmed partial response or better was reported for 14/30 patients (47%) evaluable for efficacy, including 31% of patients previously treated with lenalidomide. Vorinostat in combination with lenalidomide and dexamethasone proved tolerable with appropriate supportive care, with encouraging activity observed

  12. Next-generation ELISA diagnostic assay for Chagas Disease based on the combination of short peptidic epitopes.

    Directory of Open Access Journals (Sweden)

    Juan Mucci

    2017-10-01

    Full Text Available Chagas Disease, caused by the protozoan Trypanosoma cruzi, is a major health and economic problem in Latin America for which no vaccine or appropriate drugs for large-scale public health interventions are yet available. Accurate diagnosis is essential for the early identification and follow up of vector-borne cases and to prevent transmission of the disease by way of blood transfusions and organ transplantation. Diagnosis is routinely performed using serological methods, some of which require the production of parasite lysates, parasite antigenic fractions or purified recombinant antigens. Although available serological tests give satisfactory results, the production of reliable reagents remains laborious and expensive. Short peptides spanning linear B-cell epitopes have proven ideal serodiagnostic reagents in a wide range of diseases. Recently, we have conducted a large-scale screening of T. cruzi linear B-cell epitopes using high-density peptide chips, leading to the identification of several hundred novel sequence signatures associated to chronic Chagas Disease. Here, we performed a serological assessment of 27 selected epitopes and of their use in a novel multipeptide-based diagnostic method. A combination of 7 of these peptides were finally evaluated in ELISA format against a panel of 199 sera samples (Chagas-positive and negative, including sera from Leishmaniasis-positive subjects. The multipeptide formulation displayed a high diagnostic performance, with a sensitivity of 96.3% and a specificity of 99.15%. Therefore, the use of synthetic peptides as diagnostic tools are an attractive alternative in Chagas' disease diagnosis.

  13. Combining multiple regression and principal component analysis for accurate predictions for column ozone in Peninsular Malaysia

    Science.gov (United States)

    Rajab, Jasim M.; MatJafri, M. Z.; Lim, H. S.

    2013-06-01

    This study encompasses columnar ozone modelling in the peninsular Malaysia. Data of eight atmospheric parameters [air surface temperature (AST), carbon monoxide (CO), methane (CH4), water vapour (H2Ovapour), skin surface temperature (SSKT), atmosphere temperature (AT), relative humidity (RH), and mean surface pressure (MSP)] data set, retrieved from NASA's Atmospheric Infrared Sounder (AIRS), for the entire period (2003-2008) was employed to develop models to predict the value of columnar ozone (O3) in study area. The combined method, which is based on using both multiple regressions combined with principal component analysis (PCA) modelling, was used to predict columnar ozone. This combined approach was utilized to improve the prediction accuracy of columnar ozone. Separate analysis was carried out for north east monsoon (NEM) and south west monsoon (SWM) seasons. The O3 was negatively correlated with CH4, H2Ovapour, RH, and MSP, whereas it was positively correlated with CO, AST, SSKT, and AT during both the NEM and SWM season periods. Multiple regression analysis was used to fit the columnar ozone data using the atmospheric parameter's variables as predictors. A variable selection method based on high loading of varimax rotated principal components was used to acquire subsets of the predictor variables to be comprised in the linear regression model of the atmospheric parameter's variables. It was found that the increase in columnar O3 value is associated with an increase in the values of AST, SSKT, AT, and CO and with a drop in the levels of CH4, H2Ovapour, RH, and MSP. The result of fitting the best models for the columnar O3 value using eight of the independent variables gave about the same values of the R (≈0.93) and R2 (≈0.86) for both the NEM and SWM seasons. The common variables that appeared in both regression equations were SSKT, CH4 and RH, and the principal precursor of the columnar O3 value in both the NEM and SWM seasons was SSKT.

  14. The Effects of Combined Treadmill Training and Pharmacological Treatment on Management of Multiple Sclerosis Female Patients

    Directory of Open Access Journals (Sweden)

    Ali Asghar Arastoo

    2013-04-01

    Full Text Available Objectives: To compare the effectiveness of two treatment methods of ‘combination pharmacological treatment and treadmill training’ and ‘pharmacological treatment’ on management of multiple sclerosis (MS female patients. Methods: In this quasi experimental and interventional study a sample of 20 MS patients (mean age: 36.75 years with Expanded Disability Status Scale scores (EDSS 1.0 to 4.0 were randomly assigned to a ‘pharmacologic treatment’ (Ph group and a combination group of ‘pharmacologic treatment& treadmill training’ (PhTT. All these individuals used the drugs of choice ‘Rebif’ and ‘Avonex’. The intervention consisted of 8-weeks (24 sessions of treadmill training (30 minutes each, at 40-75% of age-predicted maximum heart rate for the PhTT group. The Ph group followed their own routine treatment program. Balance, speed and endurance of walking, quality of life and fatigue were measured by Berg Balance Score, 10 meter timed walk test, 2 minute walk test, and Fatigue Severity Scale (FFS. Data were analyzed by paired t test and one way ANOVA. Results: Comparison of results indicated that pre and post intervention led to significant improvements in the balance score (P=0.001, 10m walk time (P=0.001, walking endurance (P=0.007, and FFS (P=0.04 in the PhTT group. In contrast, no significant changes were observed in the Ph group’s balance score, 10m timed walk and fatigue, while there was a significant decrease in the 2min walking distance (P=0.015 in this group. Discussion: These results suggest that treadmill training in combination with pharmacological treatment improve balance and walking capacity and level of fatigue in women with mild to moderate MS.

  15. Optimizing Placement of Weather Stations: Exploring Objective Functions of Meaningful Combinations of Multiple Weather Variables

    Science.gov (United States)

    Snyder, A.; Dietterich, T.; Selker, J. S.

    2017-12-01

    Many regions of the world lack ground-based weather data due to inadequate or unreliable weather station networks. For example, most countries in Sub-Saharan Africa have unreliable, sparse networks of weather stations. The absence of these data can have consequences on weather forecasting, prediction of severe weather events, agricultural planning, and climate change monitoring. The Trans-African Hydro-Meteorological Observatory (TAHMO.org) project seeks to address these problems by deploying and operating a large network of weather stations throughout Sub-Saharan Africa. To design the TAHMO network, we must determine where to place weather stations within each country. We should consider how we can create accurate spatio-temporal maps of weather data and how to balance the desired accuracy of each weather variable of interest (precipitation, temperature, relative humidity, etc.). We can express this problem as a joint optimization of multiple weather variables, given a fixed number of weather stations. We use reanalysis data as the best representation of the "true" weather patterns that occur in the region of interest. For each possible combination of sites, we interpolate the reanalysis data between selected locations and calculate the mean average error between the reanalysis ("true") data and the interpolated data. In order to formulate our multi-variate optimization problem, we explore different methods of weighting each weather variable in our objective function. These methods include systematic variation of weights to determine which weather variables have the strongest influence on the network design, as well as combinations targeted for specific purposes. For example, we can use computed evapotranspiration as a metric that combines many weather variables in a way that is meaningful for agricultural and hydrological applications. We compare the errors of the weather station networks produced by each optimization problem formulation. We also compare these

  16. Diagnostic value of combined determination of serum tumor markers (NSE, CA-242, TPA, CEA) levels in patients with lung cancer

    International Nuclear Information System (INIS)

    Liu Juzhen; Cai Tietie; Qin Shana

    2007-01-01

    Objective: To investigate the diagnostic value of combined determination of serum NSE, CA242, tissue polypeptide antigen (TPA) and CEA levels in patients with primary lung cancer. Methods: Serum NSE, CA242, TPA and CEA levels were determined with ELISA in (1) 102 patients with various types of primary lung carcinoma (adenocarcinoma 38, squamous cell carcinoma 32, small cell lung carcinoma 32) (2) 33 patients with open lung T. B. and (3) 30 controls. Results: (1) In patients with lung cancer, serum levels of all the four markers were increased and significantly higher than their respective values in patients with open lung T.B. and controls. (2) Positive rate of combined any two markers were 75% for adenocarcinoma, 50% for squamous cell carcinoma and 65% for small cell lung carcinoma, while false positive rate was only 9% for T.B patients and none for the controls. (3) The most appropriate single marker for each specific type of lung cancer was: NSE for SCLC (sensitivity 72%, specificity 97%, CA242 for adenocarcinoma sensitivity 62%, specificity 90%). Conclusion: Combined determination of these tumor markers would improve the sensitivity and specificity for diagnosis of primary lung carcinoma. (authors)

  17. Diagnostic value of combined determination of serum AFP, CEA, CA199, SF levels in patients with primary hepatic carcinoma

    International Nuclear Information System (INIS)

    Wu Jiaming; Rui Zhilian

    2005-01-01

    Objective: To investigate the diagnostic value of combined detection of four tumor markers in patients with possible malignant change in liver disorders. Methods: Serum AFP, CEA, CA199 and SF levels were determined with chemiluminescence immunoassay (CLIA) in 49 patients with primary liver carcinoma, 7 patients with metastatic liver carcinoma, 40 patients with hepatic cirrhosis, 47 patients with HBV hepatitis and 30 controls. Results: The serum levels of AFP, CEA, SF in patients with primary hepatic cancer and serum levels of AFP, SF in patients with hepatic cirrhosis were all significantly higher than those in controls (P 0.05). Moreover, positive rate of combined determination of AFP, CEA, CA199, SF in patients with primary hepatic cancer was significantly higher than that in patients with metastatic liver cancer. Conclusion: With combined determination of these four tumor markers, the detection rate of primary hepatic carcinoma could be enhanced to above 95%. Also, differential diagnosis between primary and metastatic hepatic cancers could be facilitated. (authors)

  18. Combined use of Kappa Free Light Chain Index and Isoelectrofocusing of Cerebro-Spinal Fluid in Diagnosing Multiple Sclerosis: Performances and Costs.

    Science.gov (United States)

    Crespi, Ilaria; Sulas, Maria Giovanna; Mora, Riccardo; Naldi, Paola; Vecchio, Domizia; Comi, Cristoforo; Cantello, Roberto; Bellomo, Giorgio

    2017-03-01

    Isoelectrofocusing (IEF) to detect oligoclonal bands (OBCs) in cerebrospinal fluid (CSF) is the gold standard approach for evaluating intrathecal immunoglobulin synthesis in multiple sclerosis (MS) but the kappa free light chain index (KFLCi) is emerging as an alternative marker, and the combined/sequential uses of IEF and KFLCi have never been challenged. CSF and serum albumin, IgG, kFLC and lFLC were measured by nephelometry; albumin, IgG and kFLC quotients as well as Link and kFLC indexes were calculated; OCBs were evaluated by immunofixation. A total of 150 consecutive patients: 48 with MS, 32 with other neurological inflammatory diseases (NID), 62 with neurological non-inflammatory diseases (NNID), and 8 without any detectable neurological disease (NND) were investigated. Both IEF and KFLCi showed a similar accuracy as diagnostic tests for multiple sclerosis. The high sensitivity and specificity associated with the lower cost of KFLCi suggested to use this test first, followed by IEF as a confirmative procedure. The sequential use of IEF and KFLCi showed high diagnostic efficiency with cost reduction of 43 and 21%, if compared to the contemporary use of both tests, or the unique use of IEF in all patients. The "sequential testing" using KFLCi followed by IEF in MS represents an optimal procedure with accurate performance and lower costs.

  19. Diagnostic value of combined tet of cPSA, IGF-1 and TGFα for prostate cancer

    International Nuclear Information System (INIS)

    Dai Feng; Yang Qingling

    2006-01-01

    To assess the clinical value of serum complexed prostate specific antigen (cPSA), insulinlike growth factor(IGF-1),transforming growth factor a (TGFα) in the diagnosis of pros- tate cancer (PCα), serum samples were obtained from 46 men with PCa, 64 men with untreated benign prostatic hyperplasia(BPH) and 73 men of a healthy control group. The levels of cPSA, IGF-1 and TGFα were determined by autoimmunochemistry luminescence method, IRMA and RIA method. Postoperative observation was conducted for the change of cPSA, IGF-1 and TGFa in the serum from men with PCa obtained in one month, three months and six months after the operations. Results showed that the levels of cPSA, IGF-1 and TGFα in PCa serum were significantly higher than the BPH group and control group(P 0.05). The combined test of cPSA, IGF-1 and TGFα is meaningful for the prevision, diagnosis and therapy of PCa. (authors)

  20. Meaning and challenges in the practice of multiple therapeutic massage modalities: a combined methods study.

    Science.gov (United States)

    Porcino, Antony J; Boon, Heather S; Page, Stacey A; Verhoef, Marja J

    2011-09-20

    Therapeutic massage and bodywork (TMB) practitioners are predominantly trained in programs that are not uniformly standardized, and in variable combinations of therapies. To date no studies have explored this variability in training and how this affects clinical practice. Combined methods, consisting of a quantitative, population-based survey and qualitative interviews with practitioners trained in multiple therapies, were used to explore the training and practice of TMB practitioners in Alberta, Canada. Of the 5242 distributed surveys, 791 were returned (15.1%). Practitioners were predominantly female (91.7%), worked in a range of environments, primarily private (44.4%) and home clinics (35.4%), and were not significantly different from other surveyed massage therapist populations. Seventy-seven distinct TMB therapies were identified. Most practitioners were trained in two or more therapies (94.4%), with a median of 8 and range of 40 therapies. Training programs varied widely in number and type of TMB components, training length, or both. Nineteen interviews were conducted. Participants described highly variable training backgrounds, resulting in practitioners learning unique combinations of therapy techniques. All practitioners reported providing individualized patient treatment based on a responsive feedback process throughout practice that they described as being critical to appropriately address the needs of patients. They also felt that research treatment protocols were different from clinical practice because researchers do not usually sufficiently acknowledge the individualized nature of TMB care provision. The training received, the number of therapies trained in, and the practice descriptors of TMB practitioners are all highly variable. In addition, clinical experience and continuing education may further alter or enhance treatment techniques. Practitioners individualize each patient's treatment through a highly adaptive process. Therefore, treatment

  1. Incremental Diagnostic Performance of Combined Parameters in the Detection of Severe Coronary Artery Disease Using Exercise Gated Myocardial Perfusion Imaging.

    Directory of Open Access Journals (Sweden)

    Chia-Ju Liu

    Full Text Available Myocardial perfusion imaging (MPI using gated single-photon emission tomography (gSPECT may underestimate the severity of coronary artery disease (CAD. This study aimed to evaluate the significance of combined parameters derived from gSPECT, as well as treadmill stress test parameters, in the detection of severe CAD.A total of 211 consecutive patients referred for exercise MPI between June 2011 and June 2013 (who received invasive coronary angiography within six months after MPI were retrospectively reviewed. Exercise MPI was performed with Bruce protocol and 201Tl injected at peak exercise. Gated SPECT was performed using a cadmium-zinc-telluride camera and processed by QPS/QGS software. Perfusion defect abnormalities such as sum stress score (SSS; sum difference score, algorithm-derived total perfusion deficits, transient ischemic dilatation ratios of end-diastolic volumes and end-systolic volumes, post-stress changes in ejection fraction, and lung/heart ratio (LHR were calculated. Treadmill parameters, including ST depression (STD at the 1st and 3rd minutes of recovery stage (1'STD and 3'STD, maximal STD corrected by heart rate increment (ST/HR, heart rate decline in 1st and 3rd minutes of recovery stage, recovery heart rate ratio (HR ratio, systolic and mean blood pressure ratios (SBP ratio and MAP ratio during recovery phase were recorded. Diagnostic performances of these parameters were analyzed with receiver operating characteristic (ROC analysis and logistic regression for detection of left main (≥ 50% or 3-vessel disease (all ≥ 70% luminal stenosis on invasive angiography.Among various MPI and treadmill parameters used for detection of severe CAD, SSS and ST/HR had the highest AUC (0.78, 0.73, p = NS and best cut-off values (SSS > 6, ST/HR > 17.39 10-2mV/bpm, respectively. By univariate logistic regression, all parameters except 1'HRR, 3'HRR, SBP and MAP ratios increased the odds ratio of severe CAD. Only increased L/H ratio, 3'STD

  2. A Novel Electrochemical Microfluidic Chip Combined with Multiple Biomarkers for Early Diagnosis of Gastric Cancer

    Science.gov (United States)

    Xie, Yao; Zhi, Xiao; Su, Haichuan; Wang, Kan; Yan, Zhen; He, Nongyue; Zhang, Jingpu; Chen, Di; Cui, Daxiang

    2015-12-01

    Early diagnosis is very important to improve the survival rate of patients with gastric cancer and to understand the biology of cancer. In order to meet the clinical demands for early diagnosis of gastric cancer, we developed a disposable easy-to-use electrochemical microfluidic chip combined with multiple antibodies against six kinds of biomarkers (carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), Helicobacter pylori CagA protein (H.P.), P53oncoprotein (P53), pepsinogen I (PG I), and PG-II). The six kinds of biomarkers related to gastric cancer can be detected sensitively and synchronously in a short time. The specially designed three electrodes system enables cross-contamination to be avoided effectively. The linear ranges of detection of the electrochemical microfluidic chip were as follows: 0.37-90 ng mL-1 for CEA, 10.75-172 U mL-1 for CA19-9, 10-160 U L-1 for H.P., 35-560 ng mL-1 for P53, 37.5-600 ng mL-1 for PG I, and 2.5-80 ng mL-1for PG II. This method owns better sensitivity compared with enzyme-linked immunosorbent assay (ELISA) results of 394 specimens of gastric cancer sera. Furthermore, we established a multi-index prediction model based on the six kinds of biomarkers for predicting risk of gastric cancer. In conclusion, the electrochemical microfluidic chip for detecting multiple biomarkers has great potential in applications such as early screening of gastric cancer patients, and therapeutic evaluation, and real-time dynamic monitoring the progress of gastric cancer in near future.

  3. Combining multiple ecosystem productivity measurements to constrain carbon uptake estimates in semiarid grasslands and shrublands

    Science.gov (United States)

    Maurer, G. E.; Krofcheck, D. J.; Collins, S. L.; Litvak, M. E.

    2016-12-01

    Recent observational and modeling studies have indicated that semiarid ecosystems are more dynamic contributors to the global carbon budget than once thought. Semiarid carbon fluxes, however, are generally small, with high interannual and spatial variability, which suggests that validating their global significance may depend on examining multiple productivity measures and their associated uncertainties and inconsistencies. We examined ecosystem productivity from eddy covariance (NEE), harvest (NPP), and terrestrial biome models (NEPm) at two very similar grassland sites and one creosote shrubland site in the Sevilleta National Wildlife Refuge of central New Mexico, USA. Our goal was to assess site and methodological correspondence in annual carbon uptake, patterns of interannual variability, and measurement uncertainty. One grassland site was a perennial carbon source losing 30 g C m-2 per year on average, while the other two sites were carbon sources or sinks depending on the year, with average net uptake of 5 and 25 g C m-2 per year at the grassland and shrubland site, respectively. Uncertainty values for cumulative annual NEE overlapped between the three sites in most years. When combined, aboveground and belowground annual NPP measurements were 15% higher than annual NEE values and did not confirm a loss of carbon at any site in any year. Despite differences in mean site carbon balance, year-to-year changes in cumulative annual NEE and NPP were similar at all sites with years 2010 and 2013 being favorable for carbon uptake and 2011 and 2012 being unfavorable at all sites. Modeled NEPm data for a number of nearby grid cells reproduced only a fraction of the observed range in carbon uptake and its interannual variability. These three sites are highly similar in location and climate and multiple carbon flux measurements confirm the high interannual variability in carbon flux. The exact magnitude of these fluxes, however, remains difficult to discern.

  4. Prevalence and Diagnostic Performance of Isolated and Combined NEXUS Chest CT Decision Criteria.

    Science.gov (United States)

    Raja, Ali S; Mower, William R; Nishijima, Daniel K; Hendey, Gregory W; Baumann, Brigitte M; Medak, Anthony J; Rodriguez, Robert M

    2016-08-01

    The use of chest computed tomography (CT) to evaluate emergency department patients with adult blunt trauma is rising. The NEXUS Chest CT decision instruments are highly sensitive identifiers of adult blunt trauma patients with thoracic injuries. However, many patients without injury exhibit one of more of the criteria so cannot be classified "low risk." We sought to determine screening performance of both individual and combined NEXUS Chest CT criteria as predictors of thoracic injury to inform chest CT imaging decisions in "non-low-risk" patients. This was a secondary analysis of data on patients in the derivation and validation cohorts of the prospective, observational NEXUS Chest CT study, performed September 2011 to May 2014 in 11 Level I trauma centers. Institutional review board approval was obtained at all study sites. Adult blunt trauma patients receiving chest CT were included. The primary outcome was injury and major clinical injury prevalence and screening performance in patients with combinations of one, two, or three of seven individual NEXUS Chest CT criteria. Across the 11 study sites, rates of chest CT performance ranged from 15.5% to 77.2% (median = 43.6%). We found injuries in 1,493/5,169 patients (28.9%) who had chest CT; 269 patients (5.2%) had major clinical injury (e.g., pneumothorax requiring chest tube). With sensitivity of 73.7 (95% confidence interval [CI] = 68.1 to 78.6) and specificity of 83.9 (95% CI = 83.6 to 84.2) for major clinical injury, abnormal chest-x-ray (CXR) was the single most important screening criterion. When patients had only abnormal CXR, injury and major clinical injury prevalences were 60.7% (95% CI = 52.2% to 68.6%) and 12.9% (95% CI = 8.3% to 19.4%), respectively. Injury and major clinical injury prevalences when any other single criterion alone (other than abnormal CXR) was present were 16.8% (95% CI = 15.2% to 18.6%) and 1.1% (95% CI = 0.1% to 1.8%), respectively. Injury and major clinical injury prevalences

  5. More Than Just Accuracy: A Novel Method to Incorporate Multiple Test Attributes in Evaluating Diagnostic Tests Including Point of Care Tests.

    Science.gov (United States)

    Thompson, Matthew; Weigl, Bernhard; Fitzpatrick, Annette; Ide, Nicole

    2016-01-01

    Current frameworks for evaluating diagnostic tests are constrained by a focus on diagnostic accuracy, and assume that all aspects of the testing process and test attributes are discrete and equally important. Determining the balance between the benefits and harms associated with new or existing tests has been overlooked. Yet, this is critically important information for stakeholders involved in developing, testing, and implementing tests. This is particularly important for point of care tests (POCTs) where tradeoffs exist between numerous aspects of the testing process and test attributes. We developed a new model that multiple stakeholders (e.g., clinicians, patients, researchers, test developers, industry, regulators, and health care funders) can use to visualize the multiple attributes of tests, the interactions that occur between these attributes, and their impacts on health outcomes. We use multiple examples to illustrate interactions between test attributes (test availability, test experience, and test results) and outcomes, including several POCTs. The model could be used to prioritize research and development efforts, and inform regulatory submissions for new diagnostics. It could potentially provide a way to incorporate the relative weights that various subgroups or clinical settings might place on different test attributes. Our model provides a novel way that multiple stakeholders can use to visualize test attributes, their interactions, and impacts on individual and population outcomes. We anticipate that this will facilitate more informed decision making around diagnostic tests.

  6. Combined therapy of interferon plus ribavirin promotes multiple adaptive solutions in hepatitis C virus.

    Science.gov (United States)

    Cuevas, José M; Torres-Puente, Manuela; Jiménez-Hernández, Nuria; Bracho, María A; García-Robles, Inmaculada; Carnicer, Fernando; Olmo, Juan Del; Ortega, Enrique; González-Candelas, Fernando; Moya, Andrés

    2009-04-01

    Hepatitis C virus (HCV) presents several regions involved potentially in evading antiviral treatment and host immune system. Two regions, known as PKR-BD and V3 domains, have been proposed to be involved in resistance to interferon. Additionally, hypervariable regions in the envelope E2 glycoprotein are also good candidates to participate in evasion from the immune system. In this study, we have used a cohort of 22 non-responder patients to combined therapy (interferon alpha-2a plus ribavirin) for which samples obtained just before initiation of therapy and after 6 or/and 12 months of treatment were available. A range of 25-100 clones per patient, genome region and time sample were obtained. The predominant amino acid sequences for each time sample and patient were determined. Next, the sequences of the PKR-BD and V3 domains and the hypervariable regions from different time samples were compared for each patient. The highest levels of variability were detected at the three hypervariable regions of the E2 protein and, to a lower extent, at the V3 domain of the NS5A protein. However, no clear patterns of adaptation to the host immune system or to antiviral treatment were detected. In summary, although high levels of variability are correlated to viral adaptive response, antiviral treatment does not seem to promote convergent adaptive changes. Consequently, other regions must be involved in evasion strategies likely based on a combination of multiple mechanisms, in which pools of changes along the HCV genome could confer viruses the ability to overcome strong selective pressures. (c) 2009 Wiley-Liss, Inc.

  7. Multiple dose study of the combined radiosensitizers Ro 03-8799 (pimonidazole) and SR 2508 (etanidazole)

    International Nuclear Information System (INIS)

    Bleehen, N.M.; Newman, H.F.; Maughan, T.S.; Workman, P.

    1989-01-01

    The hypoxic cell radiosensitizers Ro 03-8799 and SR 2508 have different clinical toxicities. The former produces an acute but transient central nervous system syndrome, whereas the latter produces cumulative peripheral neuropathy. Following single dose studies, an escalating multiple dose schedule using both drugs in combination showed no unexpected adverse reactions at lower doses. This study identifies the clinical tolerance and pharmacokinetics when doses in the region of the maximal tolerated dose are given to 26 patients receiving infusions of 0.75 g/m2 Ro 03-8799 and 2 g/m2 SR 2508 three times per week. At 15 doses, 3/4 patients experienced WHO grade 2 peripheral neuropathy, whereas at 12 doses 1/9 developed grade 2 and 6/9 developed grade 1 neuropathies. This represents a lower dose of SR 2508 than can be given alone suggesting that some interaction between the two drugs does exist in terms of chronic peripheral neurotoxicity. Pharmacokinetic studies show no adverse interactions between the two drugs and minimal inter-patient variation. From bivariate analysis, cumulative AUC for Ro 03-8799 has the most significant correlation with the development of peripheral neuropathy. Tumor drug concentrations normalized to the administered dose show mean values of 34 micrograms/g Ro 03-8799 and 76 micrograms/g SR 2508 30 minutes after infusion. These could be expected to produce a single dose sensitizer enhancement ratio of 1.5. The combination of the two sensitizers at the maximum tolerable dose may be expected to give an increased therapeutic efficacy over either drug alone

  8. Combination of five diagnostic tests to estimate the prevalence of hookworm infection among school-aged children from a rural area of colombia.

    Science.gov (United States)

    Barreto, Rafael E; Narváez, Javier; Sepúlveda, Natalia A; Velásquez, Fabián C; Díaz, Sandra C; López, Myriam Consuelo; Reyes, Patricia; Moncada, Ligia I

    2017-09-01

    Public health programs for the control of soil-transmitted helminthiases require valid diagnostic tests for surveillance and parasitic control evaluation. However, there is currently no agreement about what test should be used as a gold standard for the diagnosis of hookworm infection. Still, in presence of concurrent data for multiple tests it is possible to use statistical models to estimate measures of test performance and prevalence. The aim of this study was to estimate the diagnostic accuracy of five parallel tests (direct microscopic examination, Kato-Katz, Harada-Mori, modified Ritchie-Frick, and culture in agar plate) to detect hookworm infections in a sample of school-aged children from a rural area in Colombia. We used both, a frequentist approach, and Bayesian latent class models to estimate the sensitivity and specificity of five tests for hookworm detection, and to estimate the prevalence of hookworm infection in absence of a Gold Standard. The Kato-Katz and agar plate methods had an overall agreement of 95% and kappa coefficient of 0.76. Different models estimated a sensitivity between 76% and 92% for the agar plate technique, and 52% to 87% for the Kato-Katz technique. The other tests had lower sensitivity. All tests had specificity between 95% and 98%. The prevalence estimated by the Kato-Katz and Agar plate methods for different subpopulations varied between 10% and 14%, and was consistent with the prevalence estimated from the combination of all tests. The Harada-Mori, Ritchie-Frick and direct examination techniques resulted in lower and disparate prevalence estimates. Bayesian approaches assuming imperfect specificity resulted in lower prevalence estimates than the frequentist approach. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Combined Use of Tc-99m MIBI Scan and MRI for Evaluation of Active Lesions in Multiple Myeloma

    International Nuclear Information System (INIS)

    Mititelu, R.; Marinescu, G.; Iriciuc, M.; Rimbu, A.; Ghita, S.; Mazilu, C.; Murgoci, P.; Codorean, I.

    2006-01-01

    Full text: Multiple Myeloma is a malignancy of plasma cells, in which neoplastic bone involvement is one of the leading symptoms. Many researchers have been trying to develop new imaging modalities and new methods for detecting the bone involvement, mainly because apart from the fact that bone marrow infiltration is one of the diagnostic criteria, typical radiographic findings can be found only in 60 70% of pts with first diagnosis of MM, and 10% of pts can present only osteoporosis-like changes. Purpose To evaluate the efficacy of 99mTc-MIBI whole-body scan in diagnosis of Multiple Myeloma, in correlation with other imaging modalities, and mainly with MRI. Material and Method: We performed a retrospective review of 29 cases of Multiple Myeloma Patients, all of them in active stage of the disease. All of them underwent 99mTc-MIBI whole body scan, MRI examination of the spine and a bone scan. Diagnosis and staging of the disease was made by using standard criteria. MRI was performed mainly for imaging spinal cord compression and for morphological characterization of lesions. We obtained saggital and transverse images which included T1-weighted spin-echo, T2-weighted turbo spin-echo and STIR sequences. We performed whole body MIBI scan in anterior and posterior views, 10 - 20 min after IV injection of 500-550 MBq of 99mTc-MIBI, using a dual head gamma-camera Philips- Axis. Results: We obtained pathologic changes in 25/29 pts that underwent whole-body MIBI scan(86.75%), and in 27/29(89.65%) for the MRI. Bone scan shown pathologic uptake of radiotracer in 18/29 pts(62.06%). In 4 pts that demonstrated pathologic increased uptake of MIBI we found photopenic lesions on the bone scan which were missed at the first interpretation of the bone scan; these lesions were reported only after comparative evaluation of bone scan and MIBI scan.We found three different patterns of pathologic MIBI uptake: focal increased uptake of MIBI in different sites (9 pts), diffuse increased

  10. Combination of various data analysis techniques for efficient track reconstruction in very high multiplicity events

    Science.gov (United States)

    Siklér, Ferenc

    2017-08-01

    A novel combination of established data analysis techniques for reconstructing charged-particles in high energy collisions is proposed. It uses all information available in a collision event while keeping competing choices open as long as possible. Suitable track candidates are selected by transforming measured hits to a binned, three- or four-dimensional, track parameter space. It is accomplished by the use of templates taking advantage of the translational and rotational symmetries of the detectors. Track candidates and their corresponding hits, the nodes, form a usually highly connected network, a bipartite graph, where we allow for multiple hit to track assignments, edges. In order to get a manageable problem, the graph is cut into very many minigraphs by removing a few of its vulnerable components, edges and nodes. Finally the hits are distributed among the track candidates by exploring a deterministic decision tree. A depth-limited search is performed maximizing the number of hits on tracks, and minimizing the sum of track-fit χ2. Simplified but realistic models of LHC silicon trackers including the relevant physics processes are used to test and study the performance (efficiency, purity, timing) of the proposed method in the case of single or many simultaneous proton-proton collisions (high pileup), and for single heavy-ion collisions at the highest available energies.

  11. Clinical significance of reduced cerebral metabolism in multiple sclerosis. A combined PET and MRI study

    International Nuclear Information System (INIS)

    Sun, Xiayan; Tanaka, Makoto; Kondo, Susumu; Okamoto, Koichi; Hirai, Shunsaku

    1998-01-01

    Magnetic resonance imaging (MRI) in patients with multiple sclerosis (MS) has provided major insights into the disease's natural history, and many studies have focussed on possible correlations between MRI findings and the clinical manifestations of MS. In contrast, there are few reports on possible relationships between functional imaging data and cognitive function. The present study assessed the relationship between clinical presentation and combined anatomical and functional imaging data in MS. Twenty patients with definite MS underwent MRI and positron emission tomography (PET) to evaluate cerebral blood flow (rCBF) and oxygen metabolism (rCMRO 2 ). The relationships between these neuroimaging findings and clinical data, including the Expanded Disability Status Scale (EDSS), Mini-mental status scale, Hasegawa Dementia Scale and relapse time, were evaluated with Spearman's rank correlation coefficients. A general reduction in rCBF and rCMRO 2 in the gray and white matter were found in the MS patients. EDSS was correlated with the number and size of the lesions on MRI and was negatively correlated with rCMRO 2 . A correlation between the decrease in rCMRO 2 and the level of cognitive impairment was also found. The severity of cerebral hypometabolism was also related to the number of relapses. Morphological and functional findings obtained by MRI and PET are closely related to the clinical status in MS. Our results suggest that measurement of cerebral metabolism in MS has the potential to be an objective marker for monitoring disease activity and to provide prognostic information. (author)

  12. A Multiple-star Combined Solution Program - Application to the Population II Binary μ Cas

    Science.gov (United States)

    Gudehus, D. H.

    2001-05-01

    A multiple-star combined-solution computer program which can simultaneously fit astrometric, speckle, and spectroscopic data, and solve for the orbital parameters, parallax, proper motion, and masses has been written and is now publicly available. Some features of the program are the ability to scale the weights at run time, hold selected parameters constant, handle up to five spectroscopic subcomponents for the primary and the secondary each, account for the light travel time across the system, account for apsidal motion, plot the results, and write the residuals in position to a standard file for further analysis. The spectroscopic subcomponent data can be represented by reflex velocities and/or by independent measurements. A companion editing program which can manage the data files is included in the package. The program has been applied to the Population II binary μ Cas to derive improved masses and an estimate of the primordial helium abundance. The source code, executables, sample data files, and documentation for OpenVMS and Unix, including Linux, are available at http://www.chara.gsu.edu/\\rlap\\ \\ gudehus/binary.html.

  13. Multiple Diagnostic Imaging of a Patient with Solid Pseudopapillary Tumour of the Pancreas: EUS, CT and FDG PET/CT

    International Nuclear Information System (INIS)

    Chong, Ari; Ha, Jungmin; Kwon, Seong Young

    2014-01-01

    ). F-18 FDG PET/CT imaging findings of SPNP are rarely reported. Dong et al. reported varying SUVmax values ranging from 2.5 to 29.1 in eight patients with SPNP. They reported that tumours with high cellularity were associated with increased SUVmax. In our report, we described a patient with SPNP who was evaluated using multiple diagnostic imaging modalities, including PET/CT, CT, ultrasonography and endoscopic ultrasonography

  14. Systemic administration of mesenchymal stem cells combined with parathyroid hormone therapy synergistically regenerates multiple rib fractures.

    Science.gov (United States)

    Cohn Yakubovich, Doron; Sheyn, Dmitriy; Bez, Maxim; Schary, Yeshai; Yalon, Eran; Sirhan, Afeef; Amira, May; Yaya, Alin; De Mel, Sandra; Da, Xiaoyu; Ben-David, Shiran; Tawackoli, Wafa; Ley, Eric J; Gazit, Dan; Gazit, Zulma; Pelled, Gadi

    2017-03-09

    A devastating condition that leads to trauma-related morbidity, multiple rib fractures, remain a serious unmet clinical need. Systemic administration of mesenchymal stem cells (MSCs) has been shown to regenerate various tissues. We hypothesized that parathyroid hormone (PTH) therapy would enhance MSC homing and differentiation, ultimately leading to bone formation that would bridge rib fractures. The combination of human MSCs (hMSCs) and a clinically relevant PTH dose was studied using immunosuppressed rats. Segmental defects were created in animals' fifth and sixth ribs. The rats were divided into four groups: a negative control group, in which animals received vehicle alone; the PTH-only group, in which animals received daily subcutaneous injections of 4 μg/kg teriparatide, a pharmaceutical derivative of PTH; the hMSC-only group, in which each animal received five injections of 2 × 10 6 hMSCs; and the hMSC + PTH group, in which animals received both treatments. Longitudinal in vivo monitoring of bone formation was performed biweekly using micro-computed tomography (μCT), followed by histological analysis. Fluorescently-dyed hMSCs were counted using confocal microscopy imaging of histological samples harvested 8 weeks after surgery. PTH significantly augmented the number of hMSCs that homed to the fracture site. Immunofluorescence of osteogenic markers, osteocalcin and bone sialoprotein, showed that PTH induced cell differentiation in both exogenously administered cells and resident cells. μCT scans revealed a significant increase in bone volume only in the hMSC + PTH group, beginning by the 4 th week after surgery. Eight weeks after surgery, 35% of ribs in the hMSC + PTH group had complete bone bridging, whereas there was complete bridging in only 6.25% of ribs (one rib) in the PTH-only group and in none of the ribs in the other groups. Based on the μCT scans, biomechanical analysis using the micro-finite element method demonstrated that

  15. The multiplicative effect of combining alcohol with energy drinks on adolescent gambling.

    Science.gov (United States)

    Vieno, Alessio; Canale, Natale; Potente, Roberta; Scalese, Marco; Griffiths, Mark D; Molinaro, Sabrina

    2018-07-01

    There has been increased concern about the negative effects of adolescents consuming a combination of alcohol mixed with energy drinks (AmED). To date, few studies have focused on AmED use and gambling. The present study analyzed the multiplicative effect of AmED consumption, compared to alcohol alone, on the likelihood of at-risk or problem gambling during adolescence. Data from the ESPAD®Italia 2015 study, a cross-sectional survey conducted in a nationally representative sample of students (ages 15 to 19years) were used to examine the association between self-reported AmED use (≥6 times,≥10 times, and ≥20 times during the last month) and self-reported gambling severity. Multivariate models were used to calculate adjusted prevalence ratios to evaluate the association between alcohol use, AmED use, and gambling among a representative sample of adolescents who reported gambling in the last year and completed a gambling severity scale (n=4495). Among the 19% students classed as at-risk and problem gamblers, 43.9% were classed as AmED consumers, while 23.6% were classed as alcohol consumers (i.e. did not mix alcohol with energy drinks). In multivariate analyses that controlled for covariates, AmED consumers were three times more likely to be at-risk and problem gamblers (OR=3.05) compared to non-consuming adolescents, while the effect became less pronounced with considering those who consumed alcohol without the addition of energy drinks (OR=1.37). The present study clearly established that consuming AmED might pose a significantly greater risk of experiencing gambling-related problems among adolescents. Copyright © 2018 Elsevier Ltd. All rights reserved.

  16. Combining multiple sources of data to inform conservation of Lesser Prairie-Chicken populations

    Science.gov (United States)

    Ross, Beth; Haukos, David A.; Hagen, Christian A.; Pitman, James

    2018-01-01

    Conservation of small populations is often based on limited data from spatially and temporally restricted studies, resulting in management actions based on an incomplete assessment of the population drivers. If fluctuations in abundance are related to changes in weather, proper management is especially important, because extreme weather events could disproportionately affect population abundance. Conservation assessments, especially for vulnerable populations, are aided by a knowledge of how extreme events influence population status and trends. Although important for conservation efforts, data may be limited for small or vulnerable populations. Integrated population models maximize information from various sources of data to yield population estimates that fully incorporate uncertainty from multiple data sources while allowing for the explicit incorporation of environmental covariates of interest. Our goal was to assess the relative influence of population drivers for the Lesser Prairie-Chicken (Tympanuchus pallidicinctus) in the core of its range, western and southern Kansas, USA. We used data from roadside lek count surveys, nest monitoring surveys, and survival data from telemetry monitoring combined with climate (Palmer drought severity index) data in an integrated population model. Our results indicate that variability in population growth rate was most influenced by variability in juvenile survival. The Palmer drought severity index had no measurable direct effects on adult survival or mean number of offspring per female; however, there were declines in population growth rate following severe drought. Because declines in population growth rate occurred at a broad spatial scale, declines in response to drought were likely due to decreases in chick and juvenile survival rather than emigration outside of the study area. Overall, our model highlights the importance of accounting for environmental and demographic sources of variability, and provides a thorough

  17. Simultaneous rotational and vibrational CARS generation through a multiple-frequency combination technique

    International Nuclear Information System (INIS)

    Alden, M.; Bengtsson, P.E.; Edner, H.

    1987-01-01

    One most promising laser technique for probing combustion processes is coherent anti-Stokes Raman scattering (CARS), which due to its coherent nature and signal strength is applied in several real-world applications. Until today almost all CARS experiments are based on probing the population of molecular vibrational energy levels. However, there are several reasons rotational CARS, i.e. probing of rotational energy levels, may provide a complement to or even a better choice than vibrational CARS. Recently an alternative way to produce rotational CARS spectra is proposed, which is based on a multiple-frequency combination technique. The energy-level diagram for this process is presented. Two dye laser beams at ω/sub r/, and one fix frequency laser beam at ω/sub g/ are employed. ω/sub r,1/ and ω/sub r,2/ are two frequencies of many possible pairs with a frequency difference matching a rotational transition in a molecule. The excitation induced by ω/sub r,1/ and ω/sub r,2/ is then scattered by the narrowband ω/sub g/ beam resulting in a CARS beam ω/sub g/ at ω/sub g/ + ω/sub r,1/ - ω/sub r,2/. An interesting feature with this technique is that it is possible to generate simultaneously a rotational and vibrational CARS spectrum by using a double-folded boxcars phase matching approach. The authors believe that the proposed technique for producing rotational and vibration CARS spectra could be of interest, e.g., when measuring in highly turbulent flows. In this case the rotational CARS spectra could use for temperature measurements in the cooler parts, whereas vibrational CARS are to be preferred when measuring in the hotter parts

  18. Combined therapies to treat complex diseases: The role of the gut microbiota in multiple sclerosis.

    Science.gov (United States)

    Calvo-Barreiro, Laura; Eixarch, Herena; Montalban, Xavier; Espejo, Carmen

    2018-02-01

    The commensal microbiota has emerged as an environmental risk factor for multiple sclerosis (MS). Studies in experimental autoimmune encephalomyelitis (EAE) models have shown that the commensal microbiota is an essential player in triggering autoimmune demyelination. Likewise, the commensal microbiota modulates the host immune system, alters the integrity and function of biological barriers and has a direct effect on several types of central nervous system (CNS)-resident cells. Moreover, a characteristic gut dysbiosis has been recognized as a consistent feature during the clinical course of MS, and the MS-related microbiota is gradually being elucidated. This review highlights animal studies in which commensal microbiota modulation was tested in EAE, as well as the mechanisms of action and influence of the commensal microbiota not only in the local milieu but also in the innate and adaptive immune system and the CNS. Regarding human research, this review focuses on studies that show how the commensal microbiota might act as a pathogenic environmental risk factor by directing immune responses towards characteristic pathogenic profiles of MS. We speculate how specific microbiome signatures could be obtained and used as potential pathogenic events and biomarkers for the clinical course of MS. Finally, we review recently published and ongoing clinical trials in MS patients regarding the immunomodulatory properties exerted by some microorganisms. Because MS is a complex disease with a large variety of associated environmental risk factors, we suggest that current treatments combined with strategies that modulate the commensal microbiota would constitute a broader immunotherapeutic approach and improve the clinical outcome for MS patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Combined use of fine-needle aspiration biopsy, MIBI scans and frozen section biopsy offers the best diagnostic accuracy in the assessment of the hypofunctioning solitary thyroid nodule

    International Nuclear Information System (INIS)

    Hurtado-Lopez, Luis Mauricio; Arellano-Montano, Sara; Torres-Acosta, Evelyn Migdalia; Zaldivar-Ramirez, Felipe Rafael; Duarte-Torres, Reyna Margarita; Alonso-de-Ruiz, Patricia; Martinez-Duncker, Ivan; Martinez-Duncker, Carlos

    2004-01-01

    The probability of malignancy is increased in hypofunctioning solitary thyroid nodules (HFNs). Fine-needle aspiration biopsy (FNA), 99m Tc-methoxyisobutylisonitrile (MIBI) and frozen section biopsy (FS) have limited independent diagnostic accuracy for the differential diagnosis of HFNs. The goal of this study was to assess the accuracy of the three independent diagnostic methods in distinguishing between benign and malignant disease. A total of 130 patients with an HFN on the 99m Tc-pertechnetate scan were included in this study. FNA, MIBI scans, FS, thyroidectomy and histological analysis of surgical specimens for final diagnosis were performed in all patients. Of the 130 patients, 80 (61.54%) had benign lesions and 50 (38.46%), malignant lesions. FNA was diagnostic in 78/130 (60%) patients and non-diagnostic in 52/130 (40%) patients. None of the patients with a negative MIBI scan had a final histological diagnosis of malignancy, and MIBI scans were negative in 38.46% of patients with non-diagnostic FNA results. FS was diagnostic in 104/130 (80%) patients and non-diagnostic in 26/130 (20%) patients. Sensitivity, specificity, positive and negative predictive values and positive and negative likelihood ratios were 81.3%, 97.8%, 96%, 88%, 36.95 and 0.19 respectively for FNA; 100%, 61.3%, 61.7%, 100%, 2.58 and 0 respectively for MIBI; and 80.5%, 100%, 100%, 89%, 0 and 0.2 respectively for FS. Use of both MIBI scans and FS in patients with non-diagnostic FNA rendered a specificity and sensitivity of 100%. MIBI scans exclude malignancy in a significant proportion of patients with non-diagnostic FNAs (38% in this study). Cystic nodules with a positive MIBI scan should be further investigated even when the FNA result indicates a benign lesion. Combined use of FNA, MIBI and FS offers the best diagnostic accuracy. (orig.)

  20. The diagnostic sensitivity of dengue rapid test assays is significantly enhanced by using a combined antigen and antibody testing approach.

    Directory of Open Access Journals (Sweden)

    Scott R Fry

    2011-06-01

    Full Text Available BACKGROUND: Serological tests for IgM and IgG are routinely used in clinical laboratories for the rapid diagnosis of dengue and can differentiate between primary and secondary infections. Dengue virus non-structural protein 1 (NS1 has been identified as an early marker for acute dengue, and is typically present between days 1-9 post-onset of illness but following seroconversion it can be difficult to detect in serum. AIMS: To evaluate the performance of a newly developed Panbio® Dengue Early Rapid test for NS1 and determine if it can improve diagnostic sensitivity when used in combination with a commercial IgM/IgG rapid test. METHODOLOGY: The clinical performance of the Dengue Early Rapid was evaluated in a retrospective study in Vietnam with 198 acute laboratory-confirmed positive and 100 negative samples. The performance of the Dengue Early Rapid in combination with the IgM/IgG Rapid test was also evaluated in Malaysia with 263 laboratory-confirmed positive and 30 negative samples. KEY RESULTS: In Vietnam the sensitivity and specificity of the test was 69.2% (95% CI: 62.8% to 75.6% and 96% (95% CI: 92.2% to 99.8 respectively. In Malaysia the performance was similar with 68.9% sensitivity (95% CI: 61.8% to 76.1% and 96.7% specificity (95% CI: 82.8% to 99.9% compared to RT-PCR. Importantly, when the Dengue Early Rapid test was used in combination with the IgM/IgG test the sensitivity increased to 93.0%. When the two tests were compared at each day post-onset of illness there was clear differentiation between the antigen and antibody markers. CONCLUSIONS: This study highlights that using dengue NS1 antigen detection in combination with anti-glycoprotein E IgM and IgG serology can significantly increase the sensitivity of acute dengue diagnosis and extends the possible window of detection to include very early acute samples and enhances the clinical utility of rapid immunochromatographic testing for dengue.

  1. Combined PET/MRI in cerebral and paediatric diagnostics; Kombinierte PET/MRT-Diagnostik bei zerebralen und paediatrischen Fragestellungen

    Energy Technology Data Exchange (ETDEWEB)

    Pfluger, T.; Vollmar, C.; Porn, U.; Schmid, R.; Dresel, S.; Leinsinger, G.; Schmid, I.; Winkler, P.; Fischer, S.; Hahn, K. [Klinik und Poliklinik fuer Nuklearmedizin, Ludwig-Maximilians-Univ. Muenchen (Germany)

    2002-07-01

    The aim of this overview is presentation of MRI and PET as synergistic modalities for combined analysis of morphology and function. For operative planning in epilepsy surgery, definition of the epileptogenic focus based on functional PET diagnostics and morphological MRI is decisive. For staging and follow-up examinations in oncology, MRI should be complemented by PET for the assessment of tumor vitality. In paediatric oncology patients we could demonstrate a therapy relevant increase of sensitivity/specificity with combined PET/MRI in contrast to single modalities. In the brain, full spectrum of digital image registration and three-dimensional reconstruction should be used. In extracranial cases, image fusion is disturbing due to a partial loss of image information of single modalities by the fusion process. (orig.) [German] Ziel dieser Uebersicht ist die Darstellung der MRT und PET als synergistische Verfahren zur Analyse von Morphologie und Funktion. Zur Resektionsplanung im Rahmen der Epilepsiechirurgie ist die Definition des Epilepsiefokus anhand der funktionellen PET-Diagnostik und die exakte Kenntnis der zerebralen Morphologie aus der MRT ganz entscheidend. Im Rahmen des onkologischen Stagings und bei Verlaufskontrollen ist wegen der geringeren Spezifitaet der MRT die additive PET zur Beurteilung der Tumorvitalitaet erforderlich. Anhand eines paediatrisch-onkologischen Patientengutes konnten wir zeigen, dass mit der kombinierten PET/MRT-Diagnostik eine therapierelevante Steigerung der Sensitivitaet/Spezifitaet gegenueber den Einzeluntersuchungen moeglich ist. Bei zerebralen Fragestellungen sollte das gesamte Spektrum der digitalen Bildfusion mit direkter Ueberlagerung mehrerer Modalitaeten und anschliessender dreidimensionaler Rekonstruktion ausgeschoepft werden. Bei extrakraniellen Fragestellungen ist die direkte Bildueberlagerung eher hinderlich, da die Bildinformation der Einzelmodalitaeten durch die Fusion teilweise verloren geht. (orig.)

  2. Diagnostic value of T-Spot TB combined with INF-γ and IL-27 in tuberculous pleurisy.

    Science.gov (United States)

    Zhang, Meng; Xiong, Dedong; Li, Hongxia; Wang, Zonglan; Li, Renzhe

    2018-02-01

    The purpose of the present study was to investigate the diagnostic value of T cells spot test (T-Spot TB) combined with interferon-γ (INF-γ) and interleukin-27 (IL-27) in tuberculous pleurisy. Sixty patients with tuberculous pleurisy (observation group) and 60 patients with non-tuberculous pleurisy (control group) were enrolled in this study. T-Spot TB was performed to detect the pleural effusion of two groups of patients. Levels of IFN-γ and IL-27 in serum and pleural effusion were detected by enzyme-linked immunosorbent assay (ELISA). Relative expression of IFN-γ mRNA and IL-27 mRNA in peripheral blood mononuclear cells were detected by RT-PCR. Positive rate of T-Spot TB in observation group was 96.7% (58 cases), which was significantly higher than that in control group (pSpot TB with INF-γ and IL-27 has significant application value in the clinical diagnosis of tuberculous pleurisy, and should be popularized.

  3. Combining principles of Cognitive Load Theory and diagnostic error analysis for designing job aids: Effects on motivation and diagnostic performance in a process control task.

    Science.gov (United States)

    Kluge, Annette; Grauel, Britta; Burkolter, Dina

    2013-03-01

    Two studies are presented in which the design of a procedural aid and the impact of an additional decision aid for process control were assessed. In Study 1, a procedural aid was developed that avoids imposing unnecessary extraneous cognitive load on novices when controlling a complex technical system. This newly designed procedural aid positively affected germane load, attention, satisfaction, motivation, knowledge acquisition and diagnostic speed for novel faults. In Study 2, the effect of a decision aid for use before the procedural aid was investigated, which was developed based on an analysis of diagnostic errors committed in Study 1. Results showed that novices were able to diagnose both novel faults and practised faults, and were even faster at diagnosing novel faults. This research contributes to the question of how to optimally support novices in dealing with technical faults in process control. Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  4. Curvelet-domain multiple matching method combined with cubic B-spline function

    Science.gov (United States)

    Wang, Tong; Wang, Deli; Tian, Mi; Hu, Bin; Liu, Chengming

    2018-05-01

    Since the large amount of surface-related multiple existed in the marine data would influence the results of data processing and interpretation seriously, many researchers had attempted to develop effective methods to remove them. The most successful surface-related multiple elimination method was proposed based on data-driven theory. However, the elimination effect was unsatisfactory due to the existence of amplitude and phase errors. Although the subsequent curvelet-domain multiple-primary separation method achieved better results, poor computational efficiency prevented its application. In this paper, we adopt the cubic B-spline function to improve the traditional curvelet multiple matching method. First, select a little number of unknowns as the basis points of the matching coefficient; second, apply the cubic B-spline function on these basis points to reconstruct the matching array; third, build constraint solving equation based on the relationships of predicted multiple, matching coefficients, and actual data; finally, use the BFGS algorithm to iterate and realize the fast-solving sparse constraint of multiple matching algorithm. Moreover, the soft-threshold method is used to make the method perform better. With the cubic B-spline function, the differences between predicted multiple and original data diminish, which results in less processing time to obtain optimal solutions and fewer iterative loops in the solving procedure based on the L1 norm constraint. The applications to synthetic and field-derived data both validate the practicability and validity of the method.

  5. The diagnostic value of the combination of patient characteristics, history, and clinical shoulder tests for the diagnosis of rotator cuff tear

    NARCIS (Netherlands)

    van Kampen, D.A.; van den Berg, T.; van der Woude, H.J.; Castelein, R.M.; Scholtes, V.A.B.; Terwee, C.B.; Willems, W.J.

    2014-01-01

    Background: It is unknown which combination of patient information and clinical tests might be optimal for the diagnosis of rotator cuff tears. This study aimed to determine the diagnostic value of nine individual clinical tests for evaluating rotator cuff tear and to develop a prediction model for

  6. A Review of the State-of-the-Art on Combining Multiple NDT Techniques in Terms of Precise Fault Detection

    Directory of Open Access Journals (Sweden)

    Ashish Khaira

    2017-06-01

    Full Text Available The present industrial scenario demands optimum quality, feasible processing time and enhanced machine availability to cope-up with continuously increasing customer expectations. To achieve this target, it is mandatory to ensure the optimum performance and higher availability of machinery. Therefore, the present work begins with, review of the research work of different researchers, which includes the applied combinations from year 2000-2016 proceed with discussion on the parameters being checked before making combination of NDT and finally, covers the maintenance performance parameters for quantifying improvement in performance after combining NDT. The result indicates that very few researches uses combination of NDT’s, in areas like aeronautical, compressors etc., and most of the works done in composites to be tested without using any decision making technique.  The researchers and practitioners can use the outcome of this work as a guideline for combining multiple NDT technique to achieve precise fault prediction and forecasting of upcoming failures.

  7. Variation in type and frequency of diagnostic imaging during trauma care across multiple time points by patient insurance type

    International Nuclear Information System (INIS)

    Bell, Nathaniel; Repáraz, Laura; Fry, William R.; Smith, R. Stephen; Luis, Alejandro

    2016-01-01

    not-for-profit verified Level I Trauma Center receive fewer radiographic studies than patients with commercial indemnity plans, even after adjusting for clinical and demographic confounders. There is less disparity in care during the first 24-hours, which suggests that patient pathology is the determining factor for radiographic evaluation during the acute care phase. Results from this study offer initial evidence of disparity in diagnostic imaging across multiple insurance groups over different periods of trauma care

  8. The Combined Quantification and Interpretation of Multiple Quantitative Magnetic Resonance Imaging Metrics Enlightens Longitudinal Changes Compatible with Brain Repair in Relapsing-Remitting Multiple Sclerosis Patients.

    Science.gov (United States)

    Bonnier, Guillaume; Maréchal, Benedicte; Fartaria, Mário João; Falkowskiy, Pavel; Marques, José P; Simioni, Samanta; Schluep, Myriam; Du Pasquier, Renaud; Thiran, Jean-Philippe; Krueger, Gunnar; Granziera, Cristina

    2017-01-01

    Quantitative and semi-quantitative MRI (qMRI) metrics provide complementary specificity and differential sensitivity to pathological brain changes compatible with brain inflammation, degeneration, and repair. Moreover, advanced magnetic resonance imaging (MRI) metrics with overlapping elements amplify the true tissue-related information and limit measurement noise. In this work, we combined multiple advanced MRI parameters to assess focal and diffuse brain changes over 2 years in a group of early-stage relapsing-remitting MS patients. Thirty relapsing-remitting MS patients with less than 5 years disease duration and nine healthy subjects underwent 3T MRI at baseline and after 2 years including T1, T2, T2* relaxometry, and magnetization transfer imaging. To assess longitudinal changes in normal-appearing (NA) tissue and lesions, we used analyses of variance and Bonferroni correction for multiple comparisons. Multivariate linear regression was used to assess the correlation between clinical outcome and multiparametric MRI changes in lesions and NA tissue. In patients, we measured a significant longitudinal decrease of mean T2 relaxation times in NA white matter ( p  = 0.005) and a decrease of T1 relaxation times in the pallidum ( p  decrease in T1 relaxation time ( p -value  0.4, p  < 0.05). In summary, the combination of multiple advanced MRI provided evidence of changes compatible with focal and diffuse brain repair at early MS stages as suggested by histopathological studies.

  9. Individual and combined effects of multiple global change drivers on terrestrial phosphorus pools: A meta-analysis.

    Science.gov (United States)

    Yue, Kai; Yang, Wanqin; Peng, Yan; Peng, Changhui; Tan, Bo; Xu, Zhenfeng; Zhang, Li; Ni, Xiangyin; Zhou, Wei; Wu, Fuzhong

    2018-07-15

    Human activity-induced global change drivers have dramatically changed terrestrial phosphorus (P) dynamics. However, our understanding of the interactive effects of multiple global change drivers on terrestrial P pools remains elusive, limiting their incorporation into ecological and biogeochemical models. We conducted a meta-analysis using 1751 observations extracted from 283 published articles to evaluate the individual, combined, and interactive effects of elevated CO 2 , warming, N addition, P addition, increased rainfall, and drought on P pools of plant (at both single-plant and plant-community levels), soil and microbial biomass. Our results suggested that (1) terrestrial P pools showed the most sensitive responses to the individual effects of warming and P addition; (2) P pools were consistently stimulated by P addition alone or in combination with simultaneous N addition; (3) environmental and experimental setting factors such as ecosystem type, climate, and latitude could significantly influence both the individual and combined effects; and (4) the interactive effects of two-driver pairs across multiple global change drivers are more likely to be additive rather than synergistic or antagonistic. Our findings highlighting the importance of additive interactive effects among multiple global change drivers on terrestrial P pools would be useful for incorporating P as controls on ecological processes such as photosynthesis and plant growth into ecosystem models used to analyze effects of multiple drivers under future global change. Copyright © 2018 Elsevier B.V. All rights reserved.

  10. Application of the 2012 revised diagnostic definitions for paediatric multiple sclerosis and immune-mediated central nervous system demyelination disorders

    NARCIS (Netherlands)

    van Pelt, E. Danielle; Neuteboom, Rinze F.; Ketelslegers, Immy A.; Boon, Maartje; Catsman-Berrevoets, Coriene E.; Hintzen, Rogier Q.

    Background Recently, the International Paediatric Multiple Sclerosis Study Group (IPMSSG) definitions for the diagnosis of immune-mediated acquired demyelinating syndromes (ADS) of the central nervous system, including paediatric multiple sclerosis (MS), have been revised. Objective To evaluate the

  11. Combined diagnostic performance of coronary computed tomography angiography and computed tomography derived fractional flow reserve for the evaluation of myocardial ischemia: A meta-analysis.

    Science.gov (United States)

    Tan, Xiao Wei; Zheng, Qishi; Shi, Luming; Gao, Fei; Allen, John Carson; Coenen, Adriaan; Baumann, Stefan; Schoepf, U Joseph; Kassab, Ghassan S; Lim, Soo Teik; Wong, Aaron Sung Lung; Tan, Jack Wei Chieh; Yeo, Khung Keong; Chin, Chee Tang; Ho, Kay Woon; Tan, Swee Yaw; Chua, Terrance Siang Jin; Chan, Edwin Shih Yen; Tan, Ru San; Zhong, Liang

    2017-06-01

    To evaluate the combined diagnostic accuracy of coronary computed tomography angiography (CCTA) and computed tomography derived fractional flow reserve (FFRct) in patients with suspected or known coronary artery disease (CAD). PubMed, The Cochrane library, Embase and OpenGray were searched to identify studies comparing diagnostic accuracy of CCTA and FFRct. Diagnostic test measurements of FFRct were either extracted directly from the published papers or calculated from provided information. Bivariate models were conducted to synthesize the diagnostic performance of combined CCTA and FFRct at both "per-vessel" and "per-patient" levels. 7 articles were included for analysis. The combined diagnostic outcomes from "both positive" strategy, i.e. a subject was considered as "positive" only when both CCTA and FFRct were "positive", demonstrated relative high specificity (per-vessel: 0.91; per-patient: 0.81), high positive likelihood ratio (LR+, per-vessel: 7.93; per-patient: 4.26), high negative likelihood ratio (LR-, per-vessel: 0.30; per patient: 0.24) and high accuracy (per-vessel: 0.91; per-patient: 0.81) while "either positive" strategy, i.e. a subject was considered as "positive" when either CCTA or FFRct was "positive", demonstrated relative high sensitivity (per-vessel: 0.97; per-patient: 0.98), low LR+ (per-vessel: 1.50; per-patient: 1.17), low LR- (per-vessel: 0.07; per-patient: 0.09) and low accuracy (per-vessel: 0.57; per-patient: 0.54). "Both positive" strategy showed better diagnostic performance to rule in patients with non-significant stenosis compared to "either positive" strategy, as it efficiently reduces the proportion of testing false positive subjects. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Improved diagnostic accuracy of Alzheimer's disease by combining regional cortical thickness and default mode network functional connectivity: Validated in the Alzheimer's disease neuroimaging initiative set

    International Nuclear Information System (INIS)

    Park, Ji Eun; Park, Bum Woo; Kim, Sang Joon; Kim, Ho Sung; Choi, Choong Gon; Jung, Seung Jung; Oh, Joo Young; Shim, Woo Hyun; Lee, Jae Hong; Roh, Jee Hoon

    2017-01-01

    To identify potential imaging biomarkers of Alzheimer's disease by combining brain cortical thickness (CThk) and functional connectivity and to validate this model's diagnostic accuracy in a validation set. Data from 98 subjects was retrospectively reviewed, including a study set (n = 63) and a validation set from the Alzheimer's Disease Neuroimaging Initiative (n = 35). From each subject, data for CThk and functional connectivity of the default mode network was extracted from structural T1-weighted and resting-state functional magnetic resonance imaging. Cortical regions with significant differences between patients and healthy controls in the correlation of CThk and functional connectivity were identified in the study set. The diagnostic accuracy of functional connectivity measures combined with CThk in the identified regions was evaluated against that in the medial temporal lobes using the validation set and application of a support vector machine. Group-wise differences in the correlation of CThk and default mode network functional connectivity were identified in the superior temporal (p < 0.001) and supramarginal gyrus (p = 0.007) of the left cerebral hemisphere. Default mode network functional connectivity combined with the CThk of those two regions were more accurate than that combined with the CThk of both medial temporal lobes (91.7% vs. 75%). Combining functional information with CThk of the superior temporal and supramarginal gyri in the left cerebral hemisphere improves diagnostic accuracy, making it a potential imaging biomarker for Alzheimer's disease

  13. Combining MCDA and risk analysis: dealing with scaling issues in the multiplicative AHP

    DEFF Research Database (Denmark)

    Barfod, Michael Bruhn; van den Honert, Rob; Salling, Kim Bang

    the progression factor 2 is used for calculating scores of alternatives and √2 for calculation of criteria weights when transforming the verbal judgments stemming from pair wise comparisons. However, depending on the decision context, the decision-makers aversion towards risk, etc., it is most likely......This paper proposes a new decision support system (DSS) for applying risk analysis and stochastic simulation to the multiplicative AHP in order to deal with issues concerning the progression factors. The multiplicative AHP makes use of direct rating on a logarithmic scale, and for this purpose...

  14. Developing a compact multiple laser diode combiner with a single fiber stub output for handheld IoT devices

    Science.gov (United States)

    Lee, Minseok; June, Seunghyeok; Kim, Sehwan

    2018-01-01

    Many biomedical applications require an efficient combination and localization of multiple discrete light sources ( e.g., fluorescence and absorbance imaging). We present a compact 6 channel combiner that couples the output of independent solid-state light sources into a single 400-μm-diameter fiber stub for handheld Internet of Things (IoT) devices. We demonstrate average coupling efficiencies > 80% for each of the 6 laser diodes installed into the prototype. The design supports the use of continuous wave and intensity-modulated laser diodes. This fiber-stub-type beam combiner could be used to construct custom multi-wavelength sources for tissue oximeters, microscopes and molecular imaging technologies. In order to validate its suitability, we applied the developed fiber-stub-type beam combiner to a multi-wavelength light source for a handheld IoT device and demonstrated its feasibility for smart healthcare through a tumor-mimicking silicon phantom.

  15. Transverse combining of nonrelativistic beams in a multiple beam induction linac

    International Nuclear Information System (INIS)

    Celata, C.M.; Faltens, A.; Judd, D.L.; Smith, L.; Tiefenback, M.G.

    1987-01-01

    Emittance growth of beams during transverse combining has been studied computationally and experimentally for Heavy Ion Fusion applications, and the theory and results are presented. A hardware design is also discussed

  16. INTRODUCTION TO A COMBINED MULTIPLE LINEAR REGRESSION AND ARMA MODELING APPROACH FOR BEACH BACTERIA PREDICTION

    Science.gov (United States)

    Due to the complexity of the processes contributing to beach bacteria concentrations, many researchers rely on statistical modeling, among which multiple linear regression (MLR) modeling is most widely used. Despite its ease of use and interpretation, there may be time dependence...

  17. Combined Statistical Analyses for Long-Term Stability Data with Multiple Storage Conditions : A Simulation Study

    NARCIS (Netherlands)

    Almalik, Osama; Nijhuis, Michiel B.; van den Heuvel, Edwin R.

    2014-01-01

    Shelf-life estimation usually requires that at least three registration batches are tested for stability at multiple storage conditions. The shelf-life estimates are often obtained by linear regression analysis per storage condition, an approach implicitly suggested by ICH guideline Q1E. A linear

  18. Tracking Iron in Multiple Sclerosis: A Combined Imaging and Histopathological Study at 7 Tesla

    Science.gov (United States)

    Bagnato, Francesca; Hametner, Simon; Yao, Bing; van Gelderen, Peter; Merkle, Hellmut; Cantor, Fredric K.; Lassmann, Hans; Duyn, Jeff H.

    2011-01-01

    Previous authors have shown that the transverse relaxivity R[subscript 2][superscript *] and frequency shifts that characterize gradient echo signal decay in magnetic resonance imaging are closely associated with the distribution of iron and myelin in the brain's white matter. In multiple sclerosis, iron accumulation in brain tissue may reflect a…

  19. On Combining Multiple-Instance Learning and Active Learning for Computer-Aided Detection of Tuberculosis

    NARCIS (Netherlands)

    Melendez Rodriguez, J.C.; Ginneken, B. van; Maduskar, P.; Philipsen, R.H.H.M.; Ayles, H.; Sanchez, C.I.

    2016-01-01

    The major advantage of multiple-instance learning (MIL) applied to a computer-aided detection (CAD) system is that it allows optimizing the latter with case-level labels instead of accurate lesion outlines as traditionally required for a supervised approach. As shown in previous work, a MIL-based

  20. Appropriate targeting of artemisinin-based combination therapy by community health workers using malaria rapid diagnostic tests

    DEFF Research Database (Denmark)

    Ndyomugyenyi, Richard; Magnussen, Pascal; Lal, Sham

    2016-01-01

    OBJECTIVE: To compare the impact of malaria rapid diagnostic tests (mRDTs), used by community health workers (CHWs), on the proportion of children ...-randomized trials were conducted in two contrasting areas of moderate-to-high and low malaria transmission in rural Uganda. Each trial examined the effectiveness of mRDTs in the management of malaria and targeting of ACTs by CHWs comparing two diagnostic approaches: (i) presumptive clinical diagnosis of malaria...

  1. Combining higher-order resummation with multiple NLO calculations and parton showers in the Geneva Monte Carlo framework

    International Nuclear Information System (INIS)

    Alioli, Simone; Bauer, Christian W.; Berggren, Calvin; Vermilion, Christopher K.; Walsh, Jonathan R.; Zuberi, Saba; Hornig, Andrew; Tackmann, Frank J.

    2013-05-01

    We discuss the GENEVA Monte Carlo framework, which combines higher-order resummation (NNLL) of large Sudakov logarithms with multiple next-to-leading-order (NLO) matrix-element corrections and parton showering (using PYTHIA 8) to give a complete description at the next higher perturbative accuracy in α s at both small and large jet resolution scales. Results for e + e - →jets compared to LEP data and pp→(Z/γ * →l + l - )+jets are presented.

  2. Diagnostic accuracy and recall rates for digital mammography and digital mammography combined with one-view and two-view tomosynthesis: results of an enriched reader study.

    Science.gov (United States)

    Rafferty, Elizabeth A; Park, Jeong Mi; Philpotts, Liane E; Poplack, Steven P; Sumkin, Jules H; Halpern, Elkan F; Niklason, Loren T

    2014-02-01

    The purpose of this study was to compare two methods of combining tomosynthesis with digital mammography by assessing diagnostic accuracy and recall rates for digital mammography alone and digital mammography combined with one-view tomosynthesis and two-view tomosynthesis. Three hundred ten cases including biopsy-proven malignancies (51), biopsy-proven benign findings (47), recalled screening cases (138), and negative screening cases (74) were reviewed by 15 radiologists sequentially using digital mammography, adding one-view tomosynthesis, and then two-view tomosynthesis. Cases were assessed for recall and assigned a BI-RADS score and probability of malignancy for each imaging method. Diagnostic accuracy was assessed using receiver operating characteristic (ROC) analysis. Screening recall rates were compared using pooled logistical regression analysis. A p value of tomosynthesis, and DM plus two-view tomosynthesis was 0.828, 0.864, and 0.895, respectively. Both one-view and two-view tomosynthesis plus DM were significantly better than DM alone (Δ AUCs 0.036 [p = 0.009] and 0.068 [p tomosynthesis, and DM plus two-view tomosynthesis were 44.2%, 27.2%, and 24.0%, respectively. Combined with DM, one-view and two-view tomosynthesis both showed significantly lower noncancer recall rates than digital mammography alone (p tomosynthesis showed a significantly lower recall rate than digital mammography with one-view tomosynthesis (p tomosynthesis compared with digital mammography alone. Compared with digital mammography, diagnostic sensitivity for invasive cancers increased with the addition of both one-view (Δ12.0%, p tomosynthesis. The addition of one-view tomosynthesis to conventional digital mammography improved diagnostic accuracy and reduced the recall rate; however, the addition of two-view tomosynthesis provided twice the performance gain in diagnostic accuracy while further reducing the recall rate.

  3. Combining multiple hypothesis testing and affinity propagation clustering leads to accurate, robust and sample size independent classification on gene expression data

    Directory of Open Access Journals (Sweden)

    Sakellariou Argiris

    2012-10-01

    Full Text Available Abstract Background A feature selection method in microarray gene expression data should be independent of platform, disease and dataset size. Our hypothesis is that among the statistically significant ranked genes in a gene list, there should be clusters of genes that share similar biological functions related to the investigated disease. Thus, instead of keeping N top ranked genes, it would be more appropriate to define and keep a number of gene cluster exemplars. Results We propose a hybrid FS method (mAP-KL, which combines multiple hypothesis testing and affinity propagation (AP-clustering algorithm along with the Krzanowski & Lai cluster quality index, to select a small yet informative subset of genes. We applied mAP-KL on real microarray data, as well as on simulated data, and compared its performance against 13 other feature selection approaches. Across a variety of diseases and number of samples, mAP-KL presents competitive classification results, particularly in neuromuscular diseases, where its overall AUC score was 0.91. Furthermore, mAP-KL generates concise yet biologically relevant and informative N-gene expression signatures, which can serve as a valuable tool for diagnostic and prognostic purposes, as well as a source of potential disease biomarkers in a broad range of diseases. Conclusions mAP-KL is a data-driven and classifier-independent hybrid feature selection method, which applies to any disease classification problem based on microarray data, regardless of the available samples. Combining multiple hypothesis testing and AP leads to subsets of genes, which classify unknown samples from both, small and large patient cohorts with high accuracy.

  4. Combining Multiple Types of Intelligence to Generate Probability Maps of Moving Targets

    Science.gov (United States)

    2013-09-01

    normalization coefficient k similar to Demspter-Shafer’s combination rule. d. Mass Mean This rule of combination is the most straightforward one... coefficient , we can state that without normalizing, the updated distribution is: fupdate t   qk k t M 1 qk n k t M        (3.3) 36...Lawrence, KS. Chen, Z. (2003). Bayesian filtering: From Kalman filters to particle filters and beyond. Technical report, McMaster University. Dempster

  5. Diagnostic value of combined determination of serum CA19-9 and TGF-β contents in patients with pancreatic cancer

    International Nuclear Information System (INIS)

    Gong Zheng

    2008-01-01

    Objective: To study the clinical diagnostic value of combined determination of serum contents of CA19-9 and TGF-β in patients with pancreatic cancer. Methods: Serum CA19-9 (with RIA) and TGF-β (with ELISA) contents were deter- mined in 30 patients with pancreatic cancer and 35 controls. Results: The serum CA19-9 and TGF-β contents in patients with pancreatic cancer were significantly higher than those in controls (P<0.01). The diagnostic sensitivity of CA19-9 for pancreatic cancer was 70.8%, lower than that of TGF-β (80.2%, P<0.05). The diagnostic specificity of CA19-9 and TGF-β was 90.2% and 93.4% respectively. Conclusion: Both determinations of serum CA19-9 and TGF-β contents would yield high specificity for diagnosis of pancreatic cancer. Sensitity of TGF-β determination was higher than that of CA19-9 determination. Combined determination of CA19-9 and TGF-β would improve the diagnostic accuracy in patients with pancreatic cancer. (authors)

  6. Optical Coherence Tomography-A New Diagnostic Tool to Evaluate Axonal Degeneration in Multiple Sclerosis: A Review

    Directory of Open Access Journals (Sweden)

    Nilüfer Kale

    2010-09-01

    Full Text Available Multiple sclerosis is an inflammatory demyelinating disorder of the central nervous system with a wide spectrum of clinical signs and symptoms. Multiple sclerosis lesions have a predilection for the optic nerves, periventricular white matter, brainstem, spinal cord, and cerebellum. The mechanisms responsible for multiple sclerosis are complex and heterogeneous across patients and disease stages. No specific markers exist for the definite diagnosis and prognosis of multiple sclerosis. The afferent visual pathway, which extends from the retina to the primary visual cortex including the optic nerve, is one of the most commonly affected sites in multiple sclerosis (94-99%. Pathology of affected optic nerves exhibits inflammation, demyelination, gliosis, axonal injury, and thinning of the retinal nerve fiber layer (RNFL. The RNFL is composed of unmyelinated axons, and measuring RNFL thickness is a viable method to monitor axonal loss reflecting disease progression. Optical coherence tomography is a noninvasive and reproducible tool in assessing the impact of multiple sclerosis on the thickness of the RNFL. Assessment of the afferent visual pathway using clinical, imaging and electrophysiological methods provides insights into the pathophysiology of multiple sclerosis and may also serve a prognostic role in multiple sclerosis

  7. A hybrid model for combining case-control and cohort studies in systematic reviews of diagnostic tests

    Science.gov (United States)

    Chen, Yong; Liu, Yulun; Ning, Jing; Cormier, Janice; Chu, Haitao

    2014-01-01

    Systematic reviews of diagnostic tests often involve a mixture of case-control and cohort studies. The standard methods for evaluating diagnostic accuracy only focus on sensitivity and specificity and ignore the information on disease prevalence contained in cohort studies. Consequently, such methods cannot provide estimates of measures related to disease prevalence, such as population averaged or overall positive and negative predictive values, which reflect the clinical utility of a diagnostic test. In this paper, we propose a hybrid approach that jointly models the disease prevalence along with the diagnostic test sensitivity and specificity in cohort studies, and the sensitivity and specificity in case-control studies. In order to overcome the potential computational difficulties in the standard full likelihood inference of the proposed hybrid model, we propose an alternative inference procedure based on the composite likelihood. Such composite likelihood based inference does not suffer computational problems and maintains high relative efficiency. In addition, it is more robust to model mis-specifications compared to the standard full likelihood inference. We apply our approach to a review of the performance of contemporary diagnostic imaging modalities for detecting metastases in patients with melanoma. PMID:25897179

  8. Combined embolization with multiple materials for the treatment of esophagogastric varices: an analysis of clinical therapeutic effect

    International Nuclear Information System (INIS)

    Lu Yanping; Qin Haopu; Zhang Mengzeng

    2011-01-01

    Objective: To evaluate the clinical efficacy of percutaneous transhepatic combined embolization with multiple materials in treating esophagogastric varices. Methods: A total of 48 patients with esophagogastric varices complicated by bleeding due to ruptured varices were enrolled in this study. Percutaneous transhepatic combined embolization with Gelfoam, ethanol and stainless steel coils was carried out in all patients. The clinical results were analyzed. Results: Superselective catheterization and subsequent combined embolization procedure were successfully completed in all patients. In 17 patients with acute upper gastrointestinal bleeding, one died seven days after the treatment because of general failure. Postoperative gastroscopic examination was performed in 33 patients, which showed that esophagogastric varices were completely obliterated in 27 patients and markedly improved in six patients. A total of 35 patients were followed up for 4-36 months. During the follow-up period rebleeding occurred in 5 and death in 2 patients. Conclusion: For the treatment of esophagogastric varices, combined embolization with multiple materials is mini-invasive, safe and effective. It is of value to popularize this technique in clinical practice. (authors)

  9. Understanding the Impact of Exposure Patterns on Risks from Combined Exposures to Multiple Chemicals

    Science.gov (United States)

    The talk was invited so there is no formal abstract. However, the focus of the talk is on the use of exposure information in the evaluation of risks from combined exposures to chemicals. The talk presents a bit of history and several case studies. All empirical data presented hav...

  10. Combination Treatment of People with Multiple Sclerosis based on Collaboration between Conventional Healthcare Providers and Alternative Practitioners

    DEFF Research Database (Denmark)

    Skovgaard, Lasse; Launsø, Laila; Pedersen, Inge Kryger

    2011-01-01

    The use of alternative and complementary medicine (CAM) is prevalent among People with Multiple Sclerosis (PwMS) in Denmark as well as in other Western countries. Many PwMS combine conventional treatments and CAM; however there is little research-based knowledge about the outcomes that PwMS achieve...... from combined treatments. The purpose of this article is to describe which outcomes PwMS have experienced from combination treatment based on collaboration between conventional healthcare providers and CAM practitioners. A second purpose is to identify and study aspects of the courses of treatment...... that have generally characterized the achieved outcomes. During the course of their treatment, 59 PwMS participated in semi-structured individual or group interviews. The analyses show that the participants’ experienced outcomes can be classified in four ways 1) short-term positive outcomes; 2) long...

  11. Combining qualitative and quantitative operational research methods to inform quality improvement in pathways that span multiple settings.

    Science.gov (United States)

    Crowe, Sonya; Brown, Katherine; Tregay, Jenifer; Wray, Jo; Knowles, Rachel; Ridout, Deborah A; Bull, Catherine; Utley, Martin

    2017-08-01

    Improving integration and continuity of care across sectors within resource constraints is a priority in many health systems. Qualitative operational research methods of problem structuring have been used to address quality improvement in services involving multiple sectors but not in combination with quantitative operational research methods that enable targeting of interventions according to patient risk. We aimed to combine these methods to augment and inform an improvement initiative concerning infants with congenital heart disease (CHD) whose complex care pathway spans multiple sectors. Soft systems methodology was used to consider systematically changes to services from the perspectives of community, primary, secondary and tertiary care professionals and a patient group, incorporating relevant evidence. Classification and regression tree (CART) analysis of national audit datasets was conducted along with data visualisation designed to inform service improvement within the context of limited resources. A 'Rich Picture' was developed capturing the main features of services for infants with CHD pertinent to service improvement. This was used, along with a graphical summary of the CART analysis, to guide discussions about targeting interventions at specific patient risk groups. Agreement was reached across representatives of relevant health professions and patients on a coherent set of targeted recommendations for quality improvement. These fed into national decisions about service provision and commissioning. When tackling complex problems in service provision across multiple settings, it is important to acknowledge and work with multiple perspectives systematically and to consider targeting service improvements in response to confined resources. Our research demonstrates that applying a combination of qualitative and quantitative operational research methods is one approach to doing so that warrants further consideration. Published by the BMJ Publishing Group

  12. Combining qualitative and quantitative operational research methods to inform quality improvement in pathways that span multiple settings

    Science.gov (United States)

    Crowe, Sonya; Brown, Katherine; Tregay, Jenifer; Wray, Jo; Knowles, Rachel; Ridout, Deborah A; Bull, Catherine; Utley, Martin

    2017-01-01

    Background Improving integration and continuity of care across sectors within resource constraints is a priority in many health systems. Qualitative operational research methods of problem structuring have been used to address quality improvement in services involving multiple sectors but not in combination with quantitative operational research methods that enable targeting of interventions according to patient risk. We aimed to combine these methods to augment and inform an improvement initiative concerning infants with congenital heart disease (CHD) whose complex care pathway spans multiple sectors. Methods Soft systems methodology was used to consider systematically changes to services from the perspectives of community, primary, secondary and tertiary care professionals and a patient group, incorporating relevant evidence. Classification and regression tree (CART) analysis of national audit datasets was conducted along with data visualisation designed to inform service improvement within the context of limited resources. Results A ‘Rich Picture’ was developed capturing the main features of services for infants with CHD pertinent to service improvement. This was used, along with a graphical summary of the CART analysis, to guide discussions about targeting interventions at specific patient risk groups. Agreement was reached across representatives of relevant health professions and patients on a coherent set of targeted recommendations for quality improvement. These fed into national decisions about service provision and commissioning. Conclusions When tackling complex problems in service provision across multiple settings, it is important to acknowledge and work with multiple perspectives systematically and to consider targeting service improvements in response to confined resources. Our research demonstrates that applying a combination of qualitative and quantitative operational research methods is one approach to doing so that warrants further

  13. Lesion type and reader experience affect the diagnostic accuracy of breast MRI: A multiple reader ROC study

    Energy Technology Data Exchange (ETDEWEB)

    Baltzer, Pascal A.T., E-mail: patbaltzer@gmail.com [Department of Biomedical Imaging and Imge-guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna (Austria); Kaiser, Werner Alois [Department of Diagnostic and Interventional Radiology, University Hospital Jena, Erlanger Allee 101, 07740 Jena (Germany); Dietzel, Matthias, E-mail: dietzelmatthias2@hotmail.com [Department of Neuroradiology, University Hospital Erlangen, Schwabachanlage 6, 91054 Erlangen (Germany)

    2015-01-15

    Highlights: • The main findings of our study are, that reader experience and lesion type (i.e., mass versus non-mass enhancement) are independent predictors of the diagnostic accuracy of breast MRI. • Specifically, benign and malignant non-mass lesions cannot be differentiated with sufficient accuracy, especially if readers are not experienced. • We conclude that future research in breast MRI should focus on non-mass lesions, as these are the problem makers in modern breast MRI. - Abstract: Purpose: To evaluate the influence of lesion type (mass versus non-mass) and reader experience on the diagnostic performance of breast MRI (BMRI) in a non-screening setting. Materials and methods: Consecutive patients (mean age, 55 ± 12 years) with breast lesions that were verified by biopsy or surgery, and who had had BMRI as part of their diagnostic workup, were eligible for this retrospective single-center study. Cancers diagnosed by biopsy before BMRI were excluded to eliminate biological and interpretation bias due to biopsy or chemotherapy effects (n = 103). Six blinded readers (experience level, high (HE, n = 2); intermediate (IE, n = 2); and low (LE, n = 2)) evaluated all examinations and assigned independent MRI BI-RADS ratings. Lesion type (mass, non-mass, focal) was noted. Receiver operating characteristics (ROC) and logistic regression analysis was performed to compare diagnostic accuracies. Results: There were 259 histologically verified lesions (123 malignant, 136 benign) investigated. There were 169 mass (103 malignant, 66 benign) and 48 non-mass lesions (19 malignant, 29 benign). Another 42 lesions that met the inclusion criteria were biopsied due to conventional findings (i.e., microcalcifications, architectural distortions), but did not enhance on MRI (41 benign, one DCIS). ROC analysis revealed a total area under the curve (AUC) between 0.834 (LE) and 0.935 (HI). Logistic regression identified a significant effect of non-mass lesions (P < 0.0001) and

  14. Introduction of a New Diagnostic Method for Breast Cancer Based on Fine Needle Aspiration (FNA) Test Data and Combining Intelligent Systems

    OpenAIRE

    Fiuzy, Mohammad; Haddadnia, Javad; Mollania, Nasrin; Hashemian, Maryam; Hassanpour, Kazem

    2012-01-01

    Background Accurate Diagnosis of Breast Cancer is of prime importance. Fine Needle Aspiration test or "FNA”, which has been used for several years in Europe, is a simple, inexpensive, noninvasive and accurate technique for detecting breast cancer. Expending the suitable features of the Fine Needle Aspiration results is the most important diagnostic problem in early stages of breast cancer. In this study, we introduced a new algorithm that can detect breast cancer based on combining artificial...

  15. Review: Multiple sclerosis and physical exercise: recommendations for the application of resistance-, endurance- and combined training

    DEFF Research Database (Denmark)

    Dalgas, U; Stenager, E; Ingemann-Hansen, T

    2008-01-01

    This review summarizes the existing knowledge regarding the effects of physical exercise in patients suffering from multiple sclerosis (MS). Furthermore, recommendations are given regarding exercise prescription for MS patients and for future study directions. Previously, MS patients were advised...... not to participate in physical exercise. During recent years, it has been increasingly acknowledged that exercise benefits MS patients. The requirement for exercise in MS patients is emphasized by their physiological profile, which probably reflects both the effects of the disease per se and the reversible effects...

  16. How invasive is TMJ double-contrast arthrography in combination with cinematography? Patient discomfort versus known diagnostic gain.

    Science.gov (United States)

    Engelke, W; Mommaerts, M

    1990-04-01

    There is no doubt that double-contrast TMJ fluoroscopic tomography enables a differential diagnosis and treatment in internal derangement pathosis. Its indication is, apart from the expected diagnostic gain, also determined by the degree of its invasiveness, and other alternative diagnostics being available (nuclear magnetic resonance). Data on patient discomfort and complications were gathered in 63 arthrotomographies; pain sensations and mandibular mobility, during and after the procedure in particular, were studied. We consider, along with Westesson, the procedure to be less invasive than commonly considered, once the surgeon-radiologist has gained enough experience.

  17. Value of five noninvasive diagnostic techniques and their combinations in diagnosis of liver fibrosis in patients with chronic hepatitis B

    Directory of Open Access Journals (Sweden)

    ZHANG Xu

    2016-10-01

    Full Text Available Objective To investigate the correlation of aspartate aminotransferase to platelet ratio index (APRI, FIB-4, Forns index, S index, and FibroScan with the degree of liver fibrosis, the diagnostic value of these techniques used alone or in combination, and the clinical value of these noninvasive techniques in the assessment of the degree of liver fibrosis in patients with chronic hepatitis B (CHB. Methods A retrospective analysis was performed for the clinical data of 91 patients with pathologically confirmed CHB who visited General Hospital of Ningxia Medical University and underwent liver biopsy from January 2009 to April 2015. According to the Scheuer pathological stage and liver fibrosis stage (S, the patients were divided into non-liver fibrosis group (a liver fibrosis stage of S0, 32 patients, mild liver fibrosis group (a liver fibrosis stage of <S2, 30 patients, and marked liver fibrosis group (a liver fibrosis stage of ≥S2, 29 patients. The APRI, FIB-4, Forns index, and S index were calculated, and liver stiffness was measured by FibroScan. An analysis of variance was used for the comparison of normally distributed continuous data between three groups, and the Dunnett t-test was used for further comparison between any two groups. The Spearman correlation analysis was also performed. Sensitivity, specificity, and area under the receiver operating characteristic curve (AUC were used to evaluate the value of these noninvasive techniques in the diagnosis of liver fibrosis. Results There were significant differences in age, albumin, aspartate aminotransferase, alanine aminotransferase, and platelet count between the three groups (F=3.552, 4.035, 4.374, and 5.992, all P<0.05, and there were significant differences in these parameters between the non-liver fibrosis group and the mild and marked liver fibrosis groups (P<0.05. There were significant differences in APRI, FIB-4, Forns index, S index, and FibroScan between the three groups (F

  18. Ensemble approach combining multiple methods improves human transcription start site prediction

    LENUS (Irish Health Repository)

    Dineen, David G

    2010-11-30

    Abstract Background The computational prediction of transcription start sites is an important unsolved problem. Some recent progress has been made, but many promoters, particularly those not associated with CpG islands, are still difficult to locate using current methods. These methods use different features and training sets, along with a variety of machine learning techniques and result in different prediction sets. Results We demonstrate the heterogeneity of current prediction sets, and take advantage of this heterogeneity to construct a two-level classifier (\\'Profisi Ensemble\\') using predictions from 7 programs, along with 2 other data sources. Support vector machines using \\'full\\' and \\'reduced\\' data sets are combined in an either\\/or approach. We achieve a 14% increase in performance over the current state-of-the-art, as benchmarked by a third-party tool. Conclusions Supervised learning methods are a useful way to combine predictions from diverse sources.

  19. A physics based method for combining multiple anatomy models with application to medical simulation.

    Science.gov (United States)

    Zhu, Yanong; Magee, Derek; Ratnalingam, Rishya; Kessel, David

    2009-01-01

    We present a physics based approach to the construction of anatomy models by combining components from different sources; different image modalities, protocols, and patients. Given an initial anatomy, a mass-spring model is generated which mimics the physical properties of the solid anatomy components. This helps maintain valid spatial relationships between the components, as well as the validity of their shapes. Combination can be either replacing/modifying an existing component, or inserting a new component. The external forces that deform the model components to fit the new shape are estimated from Gradient Vector Flow and Distance Transform maps. We demonstrate the applicability and validity of the described approach in the area of medical simulation, by showing the processes of non-rigid surface alignment, component replacement, and component insertion.

  20. An online hybrid brain-computer interface combining multiple physiological signals for webpage browse.

    Science.gov (United States)

    Long Chen; Zhongpeng Wang; Feng He; Jiajia Yang; Hongzhi Qi; Peng Zhou; Baikun Wan; Dong Ming

    2015-08-01

    The hybrid brain computer interface (hBCI) could provide higher information transfer rate than did the classical BCIs. It included more than one brain-computer or human-machine interact paradigms, such as the combination of the P300 and SSVEP paradigms. Research firstly constructed independent subsystems of three different paradigms and tested each of them with online experiments. Then we constructed a serial hybrid BCI system which combined these paradigms to achieve the functions of typing letters, moving and clicking cursor, and switching among them for the purpose of browsing webpages. Five subjects were involved in this study. They all successfully realized these functions in the online tests. The subjects could achieve an accuracy above 90% after training, which met the requirement in operating the system efficiently. The results demonstrated that it was an efficient system capable of robustness, which provided an approach for the clinic application.

  1. Combining Multiple Features for Text-Independent Writer Identification and Verification

    OpenAIRE

    Bulacu , Marius; Schomaker , Lambert

    2006-01-01

    http://www.suvisoft.com; In recent years, we proposed a number of new and very effective features for automatic writer identification and verification. They are probability distribution functions (PDFs) extracted from the handwriting images and characterize writer individuality independently of the textual content of the written samples. In this paper, we perform an extensive analysis of feature combinations. In our fusion scheme, the final unique distance between two handwritten samples is c...

  2. Imputation and quality control steps for combining multiple genome-wide datasets

    Directory of Open Access Journals (Sweden)

    Shefali S Verma

    2014-12-01

    Full Text Available The electronic MEdical Records and GEnomics (eMERGE network brings together DNA biobanks linked to electronic health records (EHRs from multiple institutions. Approximately 52,000 DNA samples from distinct individuals have been genotyped using genome-wide SNP arrays across the nine sites of the network. The eMERGE Coordinating Center and the Genomics Workgroup developed a pipeline to impute and merge genomic data across the different SNP arrays to maximize sample size and power to detect associations with a variety of clinical endpoints. The 1000 Genomes cosmopolitan reference panel was used for imputation. Imputation results were evaluated using the following metrics: accuracy of imputation, allelic R2 (estimated correlation between the imputed and true genotypes, and the relationship between allelic R2 and minor allele frequency. Computation time and memory resources required by two different software packages (BEAGLE and IMPUTE2 were also evaluated. A number of challenges were encountered due to the complexity of using two different imputation software packages, multiple ancestral populations, and many different genotyping platforms. We present lessons learned and describe the pipeline implemented here to impute and merge genomic data sets. The eMERGE imputed dataset will serve as a valuable resource for discovery, leveraging the clinical data that can be mined from the EHR.

  3. Multiple Criteria Decision Making Combined with VRP: A Categorized Bibliographic Study

    Directory of Open Access Journals (Sweden)

    Yahia Zare Mehrjerdi

    2015-08-01

    Full Text Available In this research author reviews references related to the topic of multi criterion (goal programming, multiple objective linear and nonlinear programming, bi-criterion programming, Multi Attribute Decision Making, Compromise Programming, Surrogate Worth Trade-off Method and various versions of vehicle routing problem (VRP, Multi depot VRP (MDVRP, VRP with time windows (VRPWTW, Stochastic VRP (SVRP, Capacitated VRP (CVRP, Fuzzy VRP (FVRP, Location VRP (LVRP, Backhauling VRP(BHVRP, Facility Location VRP (FLVRP, and Inventory control VRP (ICVRP. Although, VRP is a research area with rich research works and powerful researchers there found only 81 articles that relates various vehicle routing type problems with various multiple objectives techniques. This author found that there is no research done in some areas of VRP (i.e., FVRP, ICVRP, LRP and CVRP. It is interesting to see that this research area was completely an unattractive to master students (with zero research reported and a somewhat attractive area to doctoral students (with 6 researches reported. Among the many multi criterion programming techniques available only three of them (goal programming, bi-criterion programming, linear and nonlinear multi objective programming are being employed to solve the problem.

  4. Combined neutron activation analysis techniques for multiple purposes at Portuguese research reactor

    International Nuclear Information System (INIS)

    Dung, H.M.; Freitas, M.C.; Beasley, D.; Almeida, S.M.; Dionisio, I; Canha, N.H.; Galinha, C.; Marques, J.G.

    2010-01-01

    Full text: Developments of the neutron activation analysis (NAA) techniques using Compton suppression system (CSS), fast pneumatic irradiation facility (SIPRA), epithermal neutron and automatic sample changers (ASCs) associated with the traditional NAA for trace element determination in various sample types are described with reference to specific conditions at the 1 MW Portuguese research reactor (RPI). Experiences in application of k o -IAEA software for data processing in order to deduce the results are also discussed. A selected number of sample types which are intended to the application in biological and environmental areas as well as industrial and material samples are demonstrated which provide challenges in the irradiation, measurement and the interpretation of data to which in most cases a combined solution should be made. The role that each NAA technique can play in the combined scheme along with their optimized characteristics has been studied and shown. The combined NAA techniques at RPI established for on-going and potential projects as well as analysis service with respect to the element scope (48), typically Ag, Al, As, Au, Ba, Br, Ca, Cd, Ce, CI, Co, Cr, Cs, Cu, Dy, Er, Eu, F, Fe, Ga, Hf, Hg, I, In, K, La, Mg, Mn, Mo, Na, Rb, Sb, Sc, Se, Si, Sm, Sn, Sr, Ta, Tb, Th, Ti, U, V, W, Vb, Zn and Zr along with detection limits, accuracies and precision's have been evaluated as a trace analysis method meeting the requirements of the intended applications

  5. A unified classifier for robust face recognition based on combining multiple subspace algorithms

    Science.gov (United States)

    Ijaz Bajwa, Usama; Ahmad Taj, Imtiaz; Waqas Anwar, Muhammad

    2012-10-01

    Face recognition being the fastest growing biometric technology has expanded manifold in the last few years. Various new algorithms and commercial systems have been proposed and developed. However, none of the proposed or developed algorithm is a complete solution because it may work very well on one set of images with say illumination changes but may not work properly on another set of image variations like expression variations. This study is motivated by the fact that any single classifier cannot claim to show generally better performance against all facial image variations. To overcome this shortcoming and achieve generality, combining several classifiers using various strategies has been studied extensively also incorporating the question of suitability of any classifier for this task. The study is based on the outcome of a comprehensive comparative analysis conducted on a combination of six subspace extraction algorithms and four distance metrics on three facial databases. The analysis leads to the selection of the most suitable classifiers which performs better on one task or the other. These classifiers are then combined together onto an ensemble classifier by two different strategies of weighted sum and re-ranking. The results of the ensemble classifier show that these strategies can be effectively used to construct a single classifier that can successfully handle varying facial image conditions of illumination, aging and facial expressions.

  6. Simultaneous Analysis of Multiple Elements by Combined Ion-Beam Methods

    International Nuclear Information System (INIS)

    Jiang, Weilin; Weber, William J.; Thevuthasan, Theva; Shutthanandan, Shuttha; J. L. Duggan and I.L. Morgan

    2001-01-01

    Rutherford backscattering spectrometry (RBS) and nuclear reaction analysis (NRA) in channeling geometry have been combined to study the accumulation and recovery of Au2+-induced disorder on both sublattices in 6H-SiC. Conventional He+ RBS/channeling is used to analyze the Ga disorder and Au profiles in Au2+-implanted GaN and the disorder on both the Sr and Ti sublattices in Au2+-implanted SrTiO3. Results on the disorder accumulation in these materials, disorder recovery in 6H-SiC, as well as the mobility of Au implants in GaN are presented and discussed

  7. Centrifugo-pneumatic multi-liquid aliquoting - parallel aliquoting and combination of multiple liquids in centrifugal microfluidics.

    Science.gov (United States)

    Schwemmer, F; Hutzenlaub, T; Buselmeier, D; Paust, N; von Stetten, F; Mark, D; Zengerle, R; Kosse, D

    2015-08-07

    The generation of mixtures with precisely metered volumes is essential for reproducible automation of laboratory workflows. Splitting a given liquid into well-defined metered sub-volumes, the so-called aliquoting, has been frequently demonstrated on centrifugal microfluidics. However, so far no solution exists for assays that require simultaneous aliquoting of multiple, different liquids and the subsequent pairwise combination of aliquots with full fluidic separation before combination. Here, we introduce the centrifugo-pneumatic multi-liquid aliquoting designed for parallel aliquoting and pairwise combination of multiple liquids. All pumping and aliquoting steps are based on a combination of centrifugal forces and pneumatic forces. The pneumatic forces are thereby provided intrinsically by centrifugal transport of the assay liquids into dead end chambers to compress the enclosed air. As an example, we demonstrate simultaneous aliquoting of 1.) a common assay reagent into twenty 5 μl aliquots and 2.) five different sample liquids, each into four aliquots of 5 μl. Subsequently, the reagent and sample aliquots are simultaneously transported and combined into twenty collection chambers. All coefficients of variation for metered volumes were between 0.4%-1.0% for intra-run variations and 0.5%-1.2% for inter-run variations. The aliquoting structure is compatible to common assay reagents with a wide range of liquid and material properties, demonstrated here for contact angles between 20° and 60°, densities between 789 and 1855 kg m(-3) and viscosities between 0.89 and 4.1 mPa s. The centrifugo-pneumatic multi-liquid aliquoting is implemented as a passive fluidic structure into a single fluidic layer. Fabrication is compatible to scalable fabrication technologies such as injection molding or thermoforming and does not require any additional fabrication steps such as hydrophilic or hydrophobic coatings or integration of active valves.

  8. Examining the benefits of combining two learning strategies on recall of functional information in persons with multiple sclerosis.

    Science.gov (United States)

    Goverover, Yael; Basso, Michael; Wood, Hali; Chiaravalloti, Nancy; DeLuca, John

    2011-12-01

    Forgetfulness occurs commonly in people with multiple sclerosis (MS), but few treatments alleviate this problem. This study examined the combined effect of two cognitive rehabilitation strategies to improve learning and memory in MS: self-generation and spaced learning. The hypothesis was that the combination of spaced learning and self-generation would yield better learning and memory recall performance than spaced learning alone. Using a within groups design, 20 participants with MS and 18 healthy controls (HC) were presented with three tasks (learning names, appointment, and object location), each in three learning conditions (Massed, Spaced Learning, and combination of spaced and generated information). Participants were required to recall the information they learned in each of these conditions immediately and 30 min following the initial presentation. The combination of spaced learning and self-generation yielded better recall than did spaced learning alone. In turn, spaced learning resulted in better recall than the massed rehearsal condition. These findings reveal that the combination of these two learning strategies may possess utility as a cognitive rehabilitation strategy.

  9. Security and reliability analysis of diversity combining techniques in SIMO mixed RF/FSO with multiple users

    KAUST Repository

    Abd El-Malek, Ahmed H.; Salhab, Anas M.; Zummo, Salam A.; Alouini, Mohamed-Slim

    2016-01-01

    In this paper, we investigate the impact of different diversity combining techniques on the security and reliability analysis of a single-input-multiple-output (SIMO) mixed radio frequency (RF)/free space optical (FSO) relay network with opportunistic multiuser scheduling. In this model, the user of the best channel among multiple users communicates with a multiple antennas relay node over an RF link, and then, the relay node employs amplify-and-forward (AF) protocol in retransmitting the user data to the destination over an FSO link. Moreover, the authorized transmission is assumed to be attacked by a single passive RF eavesdropper equipped with multiple antennas. Therefore, the system security reliability trade-off analysis is investigated. Closed-form expressions for the system outage probability and the system intercept probability are derived. Then, the newly derived expressions are simplified to their asymptotic formulas at the high signal-to-noise- ratio (SNR) region. Numerical results are presented to validate the achieved exact and asymptotic results and to illustrate the impact of various system parameters on the system performance. © 2016 IEEE.

  10. Security and reliability analysis of diversity combining techniques in SIMO mixed RF/FSO with multiple users

    KAUST Repository

    Abd El-Malek, Ahmed H.

    2016-07-26

    In this paper, we investigate the impact of different diversity combining techniques on the security and reliability analysis of a single-input-multiple-output (SIMO) mixed radio frequency (RF)/free space optical (FSO) relay network with opportunistic multiuser scheduling. In this model, the user of the best channel among multiple users communicates with a multiple antennas relay node over an RF link, and then, the relay node employs amplify-and-forward (AF) protocol in retransmitting the user data to the destination over an FSO link. Moreover, the authorized transmission is assumed to be attacked by a single passive RF eavesdropper equipped with multiple antennas. Therefore, the system security reliability trade-off analysis is investigated. Closed-form expressions for the system outage probability and the system intercept probability are derived. Then, the newly derived expressions are simplified to their asymptotic formulas at the high signal-to-noise- ratio (SNR) region. Numerical results are presented to validate the achieved exact and asymptotic results and to illustrate the impact of various system parameters on the system performance. © 2016 IEEE.

  11. Combining multiple earthquake models in real time for earthquake early warning

    Science.gov (United States)

    Minson, Sarah E.; Wu, Stephen; Beck, James L; Heaton, Thomas H.

    2017-01-01

    The ultimate goal of earthquake early warning (EEW) is to provide local shaking information to users before the strong shaking from an earthquake reaches their location. This is accomplished by operating one or more real‐time analyses that attempt to predict shaking intensity, often by estimating the earthquake’s location and magnitude and then predicting the ground motion from that point source. Other EEW algorithms use finite rupture models or may directly estimate ground motion without first solving for an earthquake source. EEW performance could be improved if the information from these diverse and independent prediction models could be combined into one unified, ground‐motion prediction. In this article, we set the forecast shaking at each location as the common ground to combine all these predictions and introduce a Bayesian approach to creating better ground‐motion predictions. We also describe how this methodology could be used to build a new generation of EEW systems that provide optimal decisions customized for each user based on the user’s individual false‐alarm tolerance and the time necessary for that user to react.

  12. Combining multiple ChIP-seq peak detection systems using combinatorial fusion.

    Science.gov (United States)

    Schweikert, Christina; Brown, Stuart; Tang, Zuojian; Smith, Phillip R; Hsu, D Frank

    2012-01-01

    Due to the recent rapid development in ChIP-seq technologies, which uses high-throughput next-generation DNA sequencing to identify the targets of Chromatin Immunoprecipitation, there is an increasing amount of sequencing data being generated that provides us with greater opportunity to analyze genome-wide protein-DNA interactions. In particular, we are interested in evaluating and enhancing computational and statistical techniques for locating protein binding sites. Many peak detection systems have been developed; in this study, we utilize the following six: CisGenome, MACS, PeakSeq, QuEST, SISSRs, and TRLocator. We define two methods to merge and rescore the regions of two peak detection systems and analyze the performance based on average precision and coverage of transcription start sites. The results indicate that ChIP-seq peak detection can be improved by fusion using score or rank combination. Our method of combination and fusion analysis would provide a means for generic assessment of available technologies and systems and assist researchers in choosing an appropriate system (or fusion method) for analyzing ChIP-seq data. This analysis offers an alternate approach for increasing true positive rates, while decreasing false positive rates and hence improving the ChIP-seq peak identification process.

  13. Comparison of diagnostic efficacy between CLE, tissue sampling, and CLE combined with tissue sampling for undetermined pancreaticobiliary strictures: a meta-analysis.

    Science.gov (United States)

    Gao, Ya-Dong; Qu, Ya-Wei; Liu, Hai-Feng

    2018-04-01

    The accurate diagnosis of undetermined pancreaticobiliary strictures remains challenging. Current ERCP-guided tissue sampling methods are of low sensitivity. Confocal laser endomicroscopy (CLE) is a new procedure and allows real optical biopsies that may improve the diagnosis of undetermined pancreaticobiliary strictures. The aim of this meta-analysis was to determine the diagnostic yield of CLE, tissue sampling, and CLE combined with tissue sampling for undetermined pancreaticobiliary strictures. Pubmed, Embase, and the Cochrane Library database were reviewed for relevant studies. Pooled estimates of sensitivity and specificity with 95% confidence intervals (CIs) were calculated using the random-effects meta-analysis model. The summary receiver-operating characteristic (SROC) curve was constructed, and the area under the receiver operating characteristic curve (AUC) was calculated. Twelve studies involving 591 patients were enrolled in our analysis. The overall sensitivity and the specificity estimate of CLE for discriminating benign and malignant pancreaticobiliary strictures were 87% (95%CI, 83-91%) and 76% (95%CI, 70-81%), respectively. The AUC to assess the diagnostic efficacy was 0.8705. For tissue sampling, the overall sensitivity and the specificity estimate were 64% (95%CI, 57-70%) and 94% (95%CI, 90-97%), respectively. The AUC to assess the diagnostic efficacy was 0.8040. A combination of both methods increased the sensitivity (93%; 95%CI, 88-96%) with a specificity of 82% (95%CI, 74-89%). The AUC to assess the diagnostic efficacy was 0.9377. There was no publication bias by Deeks' Funnel Plot with p = .936. Compared with tissue sampling, CLE may increase the sensitivity for the diagnosis of malignant pancreaticobiliary strictures. A combination of both can effectively diagnose malignant pancreaticobiliary strictures.

  14. The Combined Quantification and Interpretation of Multiple Quantitative Magnetic Resonance Imaging Metrics Enlightens Longitudinal Changes Compatible with Brain Repair in Relapsing-Remitting Multiple Sclerosis Patients

    Directory of Open Access Journals (Sweden)

    Guillaume Bonnier

    2017-09-01

    Full Text Available ObjectiveQuantitative and semi-quantitative MRI (qMRI metrics provide complementary specificity and differential sensitivity to pathological brain changes compatible with brain inflammation, degeneration, and repair. Moreover, advanced magnetic resonance imaging (MRI metrics with overlapping elements amplify the true tissue-related information and limit measurement noise. In this work, we combined multiple advanced MRI parameters to assess focal and diffuse brain changes over 2 years in a group of early-stage relapsing-remitting MS patients.MethodsThirty relapsing-remitting MS patients with less than 5 years disease duration and nine healthy subjects underwent 3T MRI at baseline and after 2 years including T1, T2, T2* relaxometry, and magnetization transfer imaging. To assess longitudinal changes in normal-appearing (NA tissue and lesions, we used analyses of variance and Bonferroni correction for multiple comparisons. Multivariate linear regression was used to assess the correlation between clinical outcome and multiparametric MRI changes in lesions and NA tissue.ResultsIn patients, we measured a significant longitudinal decrease of mean T2 relaxation times in NA white matter (p = 0.005 and a decrease of T1 relaxation times in the pallidum (p < 0.05, which are compatible with edema reabsorption and/or iron deposition. No longitudinal changes in qMRI metrics were observed in controls. In MS lesions, we measured a decrease in T1 relaxation time (p-value < 2.2e−16 and a significant increase in MTR (p-value < 1e−6, suggesting repair mechanisms, such as remyelination, increased axonal density, and/or a gliosis. Last, the evolution of advanced MRI metrics—and not changes in lesions or brain volume—were correlated to motor and cognitive tests scores evolution (Adj-R2 > 0.4, p < 0.05. In summary, the combination of multiple advanced MRI provided evidence of changes compatible with focal and diffuse brain repair at

  15. Combining electrophoresis with detection under ultraviolet light and multiple ultrafiltration for isolation of humic fluorescence fractions.

    Science.gov (United States)

    Trubetskaya, Olga E; Shaloiko, Lubov A; Demin, Dmitrii V; Marchenkov, Victor V; Proskuryakov, Ivan I; Coelho, Christian; Trubetskoj, Oleg A

    2011-04-01

    Polyacrylamide gel electrophoresis of chernozem soil humic acids (HAs) followed by observation under UV (312 nm) excitation light reveals new low molecular weight (MW) fluorescent fractions. Ultrafiltration of HAs sample in 7 M urea on a membrane of low nominal MW retention (NMWR, 5 kDa) was repetitively used for separation of fluorescent and non-fluorescent species. Thirty ultrafiltrates and the final retentate R were obtained. Fluorescence maxima of separate ultrafiltrates were different and non-monotonously changed in the range of 475-505 nm. Fluorescence maxima of less than 490 nm were detected only in the four first utrafiltrates. For further physical-chemical analyses all utrafiltrates were combined into a fraction called UFchernozem soil HAs complex. Copyright © 2011 Elsevier B.V. All rights reserved.

  16. Heart failure analysis dashboard for patient's remote monitoring combining multiple artificial intelligence technologies.

    Science.gov (United States)

    Guidi, G; Pettenati, M C; Miniati, R; Iadanza, E

    2012-01-01

    In this paper we describe an Heart Failure analysis Dashboard that, combined with a handy device for the automatic acquisition of a set of patient's clinical parameters, allows to support telemonitoring functions. The Dashboard's intelligent core is a Computer Decision Support System designed to assist the clinical decision of non-specialist caring personnel, and it is based on three functional parts: Diagnosis, Prognosis, and Follow-up management. Four Artificial Intelligence-based techniques are compared for providing diagnosis function: a Neural Network, a Support Vector Machine, a Classification Tree and a Fuzzy Expert System whose rules are produced by a Genetic Algorithm. State of the art algorithms are used to support a score-based prognosis function. The patient's Follow-up is used to refine the diagnosis.

  17. Analysis of Multiple Data Hiding Combined Coloured Visual Cryptography and LSB

    Science.gov (United States)

    Maulana, Halim; Rahman Syahputra, Edy

    2017-12-01

    Currently the level of data security becoming a major factor in data transfer. As we know every process of sending data through any medium the risk of that data gets hacked will still be there. Some techniques for securing data such as steganography and cryptography also often used as a solution for securing data. But it does not last long because it has been found out the weaknesses of the algorithm so that the security be assured. So, in need of variety of new algorithms to be able to protect the data so that data security can be guaranteed. In this study tries to combine two visual algorithms that steganography and cryptography. Where in these experiments will try to secure two pieces of data type that is the type of image data and text data where both the data is regarded as a message so to obtain the correct information receiver should get that two types of data.

  18. Multiple congenital brachymetatarsia. A one-stage combined shortening and lengthening procedure without iliac bone graft.

    Science.gov (United States)

    Kim, J S; Baek, G H; Chung, M S; Yoon, P W

    2004-09-01

    We performed nine metatarsal and three proximal phalangeal lengthenings in five patients with congenital brachymetatarsia of the first and one or two other metatarsal bones, by a one-stage combined shortening and lengthening procedure using intercalcary autogenous bone grafts from adjacent shortened metatarsal bones. Instead of the isolated lengthening of the first and the other metatarsal bones, we shortened the adjacent normal metatarsal and used the excised bone to lengthen the short toes, except for the great toe, to restore the normal parabola. One skin incision was used. All the operations were performed bilaterally and the patients were followed up for a mean period of 69.5 months (29 to 107). They all regained a nearly normal parabola and were satisfied with the cosmetic results. Our technique is straightforward and produces good cosmetic results. Satisfactory, bony union is achieved, morbidity is low, and no additional surgery is required for the removal of metal implants.

  19. Research on improving image recognition robustness by combining multiple features with associative memory

    Science.gov (United States)

    Guo, Dongwei; Wang, Zhe

    2018-05-01

    Convolutional neural networks (CNN) achieve great success in computer vision, it can learn hierarchical representation from raw pixels and has outstanding performance in various image recognition tasks [1]. However, CNN is easy to be fraudulent in terms of it is possible to produce images totally unrecognizable to human eyes that CNNs believe with near certainty are familiar objects. [2]. In this paper, an associative memory model based on multiple features is proposed. Within this model, feature extraction and classification are carried out by CNN, T-SNE and exponential bidirectional associative memory neural network (EBAM). The geometric features extracted from CNN and the digital features extracted from T-SNE are associated by EBAM. Thus we ensure the recognition of robustness by a comprehensive assessment of the two features. In our model, we can get only 8% error rate with fraudulent data. In systems that require a high safety factor or some key areas, strong robustness is extremely important, if we can ensure the image recognition robustness, network security will be greatly improved and the social production efficiency will be extremely enhanced.

  20. Encapsulation of Multiple Microalgal Cells via a Combination of Biomimetic Mineralization and LbL Coating

    Directory of Open Access Journals (Sweden)

    Minjeong Kim

    2018-02-01

    Full Text Available The encapsulation of living cells is appealing for its various applications to cell-based sensors, bioreactors, biocatalysts, and bioenergy. In this work, we introduce the encapsulation of multiple microalgal cells in hollow polymer shells of rhombohedral shape by the following sequential processes: embedding of microalgae in CaCO3 crystals; layer-by-layer (LbL coating of polyelectrolytes; and removal of sacrificial crystals. The microcapsule size was controlled by the alteration of CaCO3 crystal size, which is dependent on CaCl2/Na2CO3 concentration. The microalgal cells could be embedded in CaCO3 crystals by a two-step process: heterogeneous nucleation of crystal on the cell surface followed by cell embedment by the subsequent growth of crystal. The surfaces of the microalgal cells were highly favorable for the crystal growth of calcite; thus, micrometer-sized microalgae could be perfectly occluded in the calcite crystal without changing its rhombohedral shape. The surfaces of the microcapsules, moreover, could be decorated with gold nanoparticles, Fe3O4 magnetic nanoparticles, and carbon nanotubes (CNTs, by which we would expect the functionalities of a light-triggered release, magnetic separation, and enhanced mechanical and electrical strength, respectively. This approach, entailing the encapsulation of microalgae in semi-permeable and hollow polymer microcapsules, has the potential for application to microbial-cell immobilization for high-biomass-concentration cultivation as well as various other bioapplications.

  1. Encapsulation of Multiple Microalgal Cells via a Combination of Biomimetic Mineralization and LbL Coating.

    Science.gov (United States)

    Kim, Minjeong; Choi, Myoung Gil; Ra, Ho Won; Park, Seung Bin; Kim, Yong-Joo; Lee, Kyubock

    2018-02-13

    The encapsulation of living cells is appealing for its various applications to cell-based sensors, bioreactors, biocatalysts, and bioenergy. In this work, we introduce the encapsulation of multiple microalgal cells in hollow polymer shells of rhombohedral shape by the following sequential processes: embedding of microalgae in CaCO₃ crystals; layer-by-layer (LbL) coating of polyelectrolytes; and removal of sacrificial crystals. The microcapsule size was controlled by the alteration of CaCO₃ crystal size, which is dependent on CaCl₂/Na₂CO₃ concentration. The microalgal cells could be embedded in CaCO₃ crystals by a two-step process: heterogeneous nucleation of crystal on the cell surface followed by cell embedment by the subsequent growth of crystal. The surfaces of the microalgal cells were highly favorable for the crystal growth of calcite; thus, micrometer-sized microalgae could be perfectly occluded in the calcite crystal without changing its rhombohedral shape. The surfaces of the microcapsules, moreover, could be decorated with gold nanoparticles, Fe₃O₄ magnetic nanoparticles, and carbon nanotubes (CNTs), by which we would expect the functionalities of a light-triggered release, magnetic separation, and enhanced mechanical and electrical strength, respectively. This approach, entailing the encapsulation of microalgae in semi-permeable and hollow polymer microcapsules, has the potential for application to microbial-cell immobilization for high-biomass-concentration cultivation as well as various other bioapplications.

  2. Combining Multiple Forms Of Visual Information To Specify Contact Relations In Spatial Layout

    Science.gov (United States)

    Sedgwick, Hal A.

    1990-03-01

    An expert system, called Layout2, has been described, which models a subset of available visual information for spatial layout. The system is used to examine detailed interactions between multiple, partially redundant forms of information in an environment-centered geometrical model of an environment obeying certain rather general constraints. This paper discusses the extension of Layout2 to include generalized contact relations between surfaces. In an environment-centered model, the representation of viewer-centered distance is replaced by the representation of environmental location. This location information is propagated through the representation of the environment by a network of contact relations between contiguous surfaces. Perspective information interacts with other forms of information to specify these contact relations. The experimental study of human perception of contact relations in extended spatial layouts is also discussed. Differences between human results and Layout2 results reveal limitations in the human ability to register available information; they also point to the existence of certain forms of information not yet formalized in Layout2.

  3. Glioblastoma multiforme and papillary thyroid carcinoma - A rare combination of multiple primary malignancies

    Directory of Open Access Journals (Sweden)

    Swaroopa Pulivarthi

    2015-01-01

    Full Text Available We are describing a 19-year-old white woman who presented with two synchronous primary cancers, namely glioblastoma multiforme and papillary thyroid cancer. The patient was admitted with dizziness, headache, and vomiting. CT head revealed acute intraparenchymal hematoma in the right cingulate gyrus and the splenium of the corpus callosum. Carotid and cerebral angiogram were unremarkable. MRI of the brain demonstrated a non-enhancing and non-hemorrhagic component of the lesion along the lateral margin of the hemorrhage just medial to the atrium of the right lateral ventricle that was suspicious for a tumor or metastasis. Brain biopsy confirmed it as glioblastoma mutiforme. CT chest was done to rule out primary cancer that revealed a 11 mm hypodense lesion in the left lobe of the thyroid and ultrasound-guided fine-needle aspiration biopsy confirmed it as papillary thyroid carcinoma. We should evaluate for multiple primary malignancies in young patients who are found to have primary index cancer.

  4. Combining Multiple Data Acquisition Systems to Study Corticospinal Output and Multi-segment Biomechanics.

    Science.gov (United States)

    Asmussen, Michael J; Bailey, Aaron Z; Keir, Peter J; Potvin, Jim; Bergel, Tim; Nelson, Aimee J

    2016-01-09

    Transcranial magnetic stimulation techniques allow for an in-depth investigation into the neural mechanisms that underpin human behavior. To date, the use of TMS to study human movement, has been limited by the challenges related to precisely timing the delivery of TMS to features of the unfolding movement and, also, by accurately characterizing kinematics and kinetics. To overcome these technical challenges, TMS delivery and acquisition systems should be integrated with an online motion tracking system. The present manuscript details technical innovations that integrate multiple acquisition systems to facilitate and advance the use of TMS to study human movement. Using commercially available software and hardware systems, a step-by-step approach to both the hardware assembly and the software scripts necessary to perform TMS studies triggered by specific features of a movement is provided. The approach is focused on the study of upper limb, planar, multi-joint reaching movements. However, the same integrative system is amenable to a multitude of sophisticated studies of human motor control.

  5. Reducing the computational requirements for simulating tunnel fires by combining multiscale modelling and multiple processor calculation

    DEFF Research Database (Denmark)

    Vermesi, Izabella; Rein, Guillermo; Colella, Francesco

    2017-01-01

    Multiscale modelling of tunnel fires that uses a coupled 3D (fire area) and 1D (the rest of the tunnel) model is seen as the solution to the numerical problem of the large domains associated with long tunnels. The present study demonstrates the feasibility of the implementation of this method...... in FDS version 6.0, a widely used fire-specific, open source CFD software. Furthermore, it compares the reduction in simulation time given by multiscale modelling with the one given by the use of multiple processor calculation. This was done using a 1200m long tunnel with a rectangular cross......-section as a demonstration case. The multiscale implementation consisted of placing a 30MW fire in the centre of a 400m long 3D domain, along with two 400m long 1D ducts on each side of it, that were again bounded by two nodes each. A fixed volume flow was defined in the upstream duct and the two models were coupled...

  6. [Multiple sites extrapodal actinomycetoma: Favorable outcome to treatment with a combination of cotrimoxazole and NSAI].

    Science.gov (United States)

    Diallo, B; Barro-Traoré, F; Bamba, S; Sanou-Lamien, A; Traoré, S S; Andonaba, J-B; Konaté, I; Niamba, P; Traoré, A; Guiguemdé, T R

    2015-12-01

    Mycetoma is a bacteriological or fungal infectious disease affecting the skin and/or soft tissues, which can be complicated by bone involvement. The most common feature is a tumor of the foot, but extrapodal localizations have been described. We report one case of a 47-year-old man who presented with tumefaction of a leg with multiple skin fistulae. Histopathological examination permitted to confirm the diagnosis of actinomycetoma and TDM showed the degree of bone and soft tissues involvement. Our case was characterized by the very inflammatory aspect of the tumor, its localization to the leg without foot involvement, the modest functional signs compared to the importance of radiological bone involvements, the deep destruction of the fibula while the tibia was apparently intact and the good response to treatment. In spite of its characteristic features, diagnosis of mycetoma is still late in our country, often with bone and/or articular spread. Priority may be given to measures for reduction of mycetoma diagnosis lateness. Copyright © 2015. Published by Elsevier Masson SAS.

  7. Identification of Multiple Cryptococcal Fungicidal Drug Targets by Combined Gene Dosing and Drug Affinity Responsive Target Stability Screening

    Directory of Open Access Journals (Sweden)

    Yoon-Dong Park

    2016-08-01

    Full Text Available Cryptococcus neoformans is a pathogenic fungus that is responsible for up to half a million cases of meningitis globally, especially in immunocompromised individuals. Common fungistatic drugs, such as fluconazole, are less toxic for patients but have low efficacy for initial therapy of the disease. Effective therapy against the disease is provided by the fungicidal drug amphotericin B; however, due to its high toxicity and the difficulty in administering its intravenous formulation, it is imperative to find new therapies targeting the fungus. The antiparasitic drug bithionol has been recently identified as having potent fungicidal activity. In this study, we used a combined gene dosing and drug affinity responsive target stability (GD-DARTS screen as well as protein modeling to identify a common drug binding site of bithionol within multiple NAD-dependent dehydrogenase drug targets. This combination genetic and proteomic method thus provides a powerful method for identifying novel fungicidal drug targets for further development.

  8. Numerical experiment to estimate the validity of negative ion diagnostic using photo-detachment combined with Langmuir probing

    Energy Technology Data Exchange (ETDEWEB)

    Oudini, N. [Laboratoire des plasmas de décharges, Centre de Développement des Technologies Avancées, Cité du 20 Aout BP 17 Baba Hassen, 16081 Algiers (Algeria); Sirse, N.; Ellingboe, A. R. [Plasma Research Laboratory, School of Physical Sciences and NCPST, Dublin City University, Dublin 9 (Ireland); Benallal, R. [Unité de Recherche Matériaux et Energies Renouvelables, BP 119, Université Abou Bekr Belkaïd, Tlemcen 13000 (Algeria); Taccogna, F. [Istituto di Metodologie Inorganiche e di Plasmi, CNR, via Amendola 122/D, 70126 Bari (Italy); Aanesland, A. [Laboratoire de Physique des Plasmas, (CNRS, Ecole Polytechnique, Sorbonne Universités, UPMC Univ Paris 06, Univ Paris-Sud), École Polytechnique, 91128 Palaiseau Cedex (France); Bendib, A. [Laboratoire d' Electronique Quantique, Faculté de Physique, USTHB, El Alia BP 32, Bab Ezzouar, 16111 Algiers (Algeria)

    2015-07-15

    This paper presents a critical assessment of the theory of photo-detachment diagnostic method used to probe the negative ion density and electronegativity α = n{sub -}/n{sub e}. In this method, a laser pulse is used to photo-detach all negative ions located within the electropositive channel (laser spot region). The negative ion density is estimated based on the assumption that the increase of the current collected by an electrostatic probe biased positively to the plasma is a result of only the creation of photo-detached electrons. In parallel, the background electron density and temperature are considered as constants during this diagnostics. While the numerical experiments performed here show that the background electron density and temperature increase due to the formation of an electrostatic potential barrier around the electropositive channel. The time scale of potential barrier rise is about 2 ns, which is comparable to the time required to completely photo-detach the negative ions in the electropositive channel (∼3 ns). We find that neglecting the effect of the potential barrier on the background plasma leads to an erroneous determination of the negative ion density. Moreover, the background electron velocity distribution function within the electropositive channel is not Maxwellian. This is due to the acceleration of these electrons through the electrostatic potential barrier. In this work, the validity of the photo-detachment diagnostic assumptions is questioned and our results illustrate the weakness of these assumptions.

  9. Effectiveness of combining plasma exchange with continuous hemodiafiltration on acute Fatty liver of pregnancy complicated by multiple organ dysfunction.

    Science.gov (United States)

    Chu, Yu-Feng; Meng, Mei; Zeng, Juan; Zhou, Hai-Yan; Jiang, Jin-Jiao; Ren, Hong-Sheng; Zhang, Ji-Cheng; Zhu, Wen-Ying; Wang, Chun-Ting

    2012-06-01

    Acute fatty liver of pregnancy (AFLP) is a rare disease of progressive hepatic insufficiency and secondary systemic complications that induce significant maternal risk. The application of combining plasma exchange (PE) and continuous hemodiafiltration (CHDF) is a novel concept for patients with AFLP. Since 2002, we have utilized the combination of PE with CHDF as adjunctive medical therapy for 11 AFLP patients with multiple organ dysfunction. Before PE and CHDF initiation, four patients had signs and symptoms of encephalopathy, four required ventilatory support, and all 11 were developing liver failure, significant renal compromise, and coagulopathy. PE combined with CHDF for patients was initiated a mean of 2 days postpartum (range, days 0-3). Daily or every other day PE combined with CHDF was undertaken on two to eight occasions for each of the 11 patients. Ten patients responded with composite clinical and laboratory improvement and were discharged to the ward, then cured and discharged from hospital; one patient died of septic shock. Average duration of hospitalization was 17 days (range, days 9-38) from time of admission to discharge; the average duration of intensive care unit was 10 days (range, days 4-23). No significant PE- and CHDF-related complications occurred. These results indicate that combing PE and CHDF in a series-parallel circuit is an effective and safe treatment for patients with severe AFLP. This finding may have important implications for the development of an effective treatment for patients with AFLP suffering multiple organ dysfunction. © 2012, Copyright the Authors. Artificial Organs © 2012, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  10. Synchronized multiple regression of diagnostic radiation-induced rather than spontaneous: disseminated primary intracranial germinoma in a woman: a case report

    Directory of Open Access Journals (Sweden)

    Natsumeda Manabu

    2011-01-01

    Full Text Available Abstract Introduction Examples of the spontaneous regression of primary intracranial germinomas can be found in the literature. We present the case of a patient with disseminated lesions of primary intracranial germinoma which synchronously shrunk following diagnostic irradiation. We will discuss whether this regression was spontaneous or radiation-induced. Case presentation A 43-year-old Japanese woman presented to our hospital complaining of memory problems over a period of one year and blurred vision over a period of three months. Following magnetic resonance imaging, she was found to have a massive lesion in the third ventricle and small lesions in the pineal region, fourth ventricle, and in the anterior horn of the left lateral ventricle. Prior to an open biopsy to confirm the pathology of the lesions, she underwent a single cranial computed tomography scan and a single cranial digital subtraction angiography for a transcranial biopsy. Fourteen days after the first magnetic resonance image - 12 and eight days after the computed tomography scan and digital subtraction angiography, respectively - a pre-operative magnetic resonance image was taken, which showed a notable synchronous shrinkage of the third ventricle tumor, as well as shrinkage of the lesions in the pineal region and in the fourth ventricle. She did not undergo steroid administration until after a biopsy that confirmed the pathological diagnosis of pure germinoma. She then underwent whole craniospinal irradiation and went into a complete remission. Conclusions In our case report, we state that diagnostic radiation can induce the regression of germinomas; this is the most reasonable explanation for the synchronous multiple regression observed in this case of germinoma. Clinicians should keep this non-spontaneous regression in mind and monitor germinoma lesions with minimal exposure to diagnostic radiation before diagnostic confirmation, and also before radiation treatment with or

  11. Diagnostic role of (99)Tc(m)-MDP SPECT/CT combined SPECT/MRI Multi modality imaging for early and atypical bone metastases.

    Science.gov (United States)

    Chen, Xiao-Liang; Li, Qian; Cao, Lin; Jiang, Shi-Xi

    2014-01-01

    The bone metastasis appeared early before the bone imaging for most of the above patients. (99)Tc(m)-MDP ((99)Tc(m) marked methylene diphosphonate) bone imaging could diagnosis the bone metastasis with highly sensitivity, but with lower specificity. The aim of this study is to explore the diagnostic value of (99)Tc(m)-MDP SPECT/CT combined SPECT/MRI Multi modality imaging for the early period atypical bone metastases. 15 to 30 mCi (99)Tc(m)-MDP was intravenously injected to the 34 malignant patients diagnosed as doubtful early bone metastases. SPECT, CT and SPECT/CT images were captured and analyzed consequently. For the patients diagnosed as early period atypical bone metastases by SPECT/CT, combining the SPECT/CT and MRI together as the SPECT/MRI integrated image. The obtained SPECT/MRI image was analyzed and compared with the pathogenic results of patients. The results indicated that 34 early period doubtful metastatic focus, including 34 SPECT positive focus, 17 focus without special changes by using CT method, 11 bone metastases focus by using SPECT/CT method, 23 doubtful bone metastases focus, 8 doubtful bone metastases focus, 14 doubtful bone metastases focus and 2 focus without clear image. Totally, SPECT/CT combined with SPECT/MRI method diagnosed 30 bone metastatic focus and 4 doubtfully metastatic focus. In conclusion, (99)Tc(m)-MDP SPECT/CT combined SPECT/MRI Multi modality imaging shows a higher diagnostic value for the early period bone metastases, which also enhances the diagnostic accuracy rate.

  12. Striking multiple synergies created by combining reduced graphene oxides and carbon nanotubes for polymer nanocomposites

    International Nuclear Information System (INIS)

    Song Ping’an; Liu Lina; Fu Shenyuan; Yu Youming; Jin Chunde; Wu Qiang; Zhang Yan; Li Qian

    2013-01-01

    The extraordinary properties of carbon nanotubes (CNTs) and graphene stimulate the development of advanced composites. Recently, several studies have reported significant synergies in the mechanical, electrical and thermal conductivity properties of polymer nanocomposites by incorporating their nanohybrids. In this work, we created polypropylene nanocomposites with homogeneous dispersion of CNTs and reduced graphene oxides via a facile polymer-latex-coating plus melt-mixing strategy, and investigated their synergistic effects in their viscoelastic, gas barrier, and flammability properties. Interestingly, the results show remarkable synergies, enhancing their melt modulus and viscosity, O 2 barrier, and flame retardancy properties and respectively exhibiting a synergy percentage of 15.9%, 45.3%, and 20.3%. As previously reported, we also observed remarkable synergistic effects in their tensile strength (14.3%) and Young’s modulus (27.1%), electrical conductivity (32.3%) and thermal conductivity (34.6%). These impressive results clearly point towards a new strategy to create advanced materials by adding binary combinations of different types of nanofillers. (paper)

  13. IPeak: An open source tool to combine results from multiple MS/MS search engines.

    Science.gov (United States)

    Wen, Bo; Du, Chaoqin; Li, Guilin; Ghali, Fawaz; Jones, Andrew R; Käll, Lukas; Xu, Shaohang; Zhou, Ruo; Ren, Zhe; Feng, Qiang; Xu, Xun; Wang, Jun

    2015-09-01

    Liquid chromatography coupled tandem mass spectrometry (LC-MS/MS) is an important technique for detecting peptides in proteomics studies. Here, we present an open source software tool, termed IPeak, a peptide identification pipeline that is designed to combine the Percolator post-processing algorithm and multi-search strategy to enhance the sensitivity of peptide identifications without compromising accuracy. IPeak provides a graphical user interface (GUI) as well as a command-line interface, which is implemented in JAVA and can work on all three major operating system platforms: Windows, Linux/Unix and OS X. IPeak has been designed to work with the mzIdentML standard from the Proteomics Standards Initiative (PSI) as an input and output, and also been fully integrated into the associated mzidLibrary project, providing access to the overall pipeline, as well as modules for calling Percolator on individual search engine result files. The integration thus enables IPeak (and Percolator) to be used in conjunction with any software packages implementing the mzIdentML data standard. IPeak is freely available and can be downloaded under an Apache 2.0 license at https://code.google.com/p/mzidentml-lib/. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  14. Behavioral phenotypes in schizophrenic animal models with multiple combinations of genetic and environmental factors.

    Science.gov (United States)

    Hida, Hirotake; Mouri, Akihiro; Noda, Yukihiro

    2013-01-01

    Schizophrenia is a multifactorial psychiatric disorder in which both genetic and environmental factors play a role. Genetic [e.g., Disrupted-in-schizophrenia 1 (DISC1), Neuregulin-1 (NRG1)] and environmental factors (e.g., maternal viral infection, obstetric complications, social stress) may act during the developmental period to increase the incidence of schizophrenia. In animal models, interactions between susceptibility genes and the environment can be controlled in ways not possible in humans; therefore, such models are useful for investigating interactions between or within factors in the pathogenesis and pathophysiology of schizophrenia. We provide an overview of schizophrenic animal models investigating interactions between or within factors. First, we reviewed gene-environment interaction animal models, in which schizophrenic candidate gene mutant mice were subjected to perinatal immune activation or adolescent stress. Next, environment-environment interaction animal models, in which mice were subjected to a combination of perinatal immune activation and adolescent administration of drugs, were described. These animal models showed interaction between or within factors; behavioral changes, which were obscured by each factor, were marked by interaction of factors and vice versa. Appropriate behavioral approaches with such models will be invaluable for translational research on novel compounds, and also for providing insight into the pathogenesis and pathophysiology of schizophrenia.

  15. Formalized Conflicts Detection Based on the Analysis of Multiple Emails: An Approach Combining Statistics and Ontologies

    Science.gov (United States)

    Zakaria, Chahnez; Curé, Olivier; Salzano, Gabriella; Smaïli, Kamel

    In Computer Supported Cooperative Work (CSCW), it is crucial for project leaders to detect conflicting situations as early as possible. Generally, this task is performed manually by studying a set of documents exchanged between team members. In this paper, we propose a full-fledged automatic solution that identifies documents, subjects and actors involved in relational conflicts. Our approach detects conflicts in emails, probably the most popular type of documents in CSCW, but the methods used can handle other text-based documents. These methods rely on the combination of statistical and ontological operations. The proposed solution is decomposed in several steps: (i) we enrich a simple negative emotion ontology with terms occuring in the corpus of emails, (ii) we categorize each conflicting email according to the concepts of this ontology and (iii) we identify emails, subjects and team members involved in conflicting emails using possibilistic description logic and a set of proposed measures. Each of these steps are evaluated and validated on concrete examples. Moreover, this approach's framework is generic and can be easily adapted to domains other than conflicts, e.g. security issues, and extended with operations making use of our proposed set of measures.

  16. Revealing the uncultivated majority: combining DNA stable-isotope probing, multiple displacement amplification and metagenomic analyses of uncultivated Methylocystis in acidic peatlands.

    Science.gov (United States)

    Chen, Yin; Dumont, Marc G; Neufeld, Josh D; Bodrossy, Levente; Stralis-Pavese, Nancy; McNamara, Niall P; Ostle, Nick; Briones, Maria J I; Murrell, J Colin

    2008-10-01

    Peatlands represent an enormous carbon reservoir and have a potential impact on the global climate because of the active methanogenesis and methanotrophy in these soils. Uncultivated methanotrophs from seven European peatlands were studied using a combination of molecular methods. Screening for methanotroph diversity using a particulate methane monooxygenase-based diagnostic gene array revealed that Methylocystis-related species were dominant in six of the seven peatlands studied. The abundance and methane oxidation activity of Methylocystis spp. were further confirmed by DNA stable-isotope probing analysis of a sample taken from the Moor House peatland (England). After ultracentrifugation, (13)C-labelled DNA, containing genomic DNA of these Methylocystis spp., was separated from (12)C DNA and subjected to multiple displacement amplification (MDA) to generate sufficient DNA for the preparation of a fosmid metagenomic library. Potential bias of MDA was detected by fingerprint analysis of 16S rRNA using denaturing gradient gel electrophoresis for low-template amplification (0.01 ng template). Sufficient template (1-5 ng) was used in MDA to circumvent this bias and chimeric artefacts were minimized by using an enzymatic treatment of MDA-generated DNA with S1 nuclease and DNA polymerase I. Screening of the metagenomic library revealed one fosmid containing methanol dehydrogenase and two fosmids containing 16S rRNA genes from these Methylocystis-related species as well as one fosmid containing a 16S rRNA gene related to that of Methylocella/Methylocapsa. Sequencing of the 14 kb methanol dehydrogenase-containing fosmid allowed the assembly of a gene cluster encoding polypeptides involved in bacterial methanol utilization (mxaFJGIRSAC). This combination of DNA stable-isotope probing, MDA and metagenomics provided access to genomic information of a relatively large DNA fragment of these thus far uncultivated, predominant and active methanotrophs in peatland soil.

  17. Combined Inoculation with Multiple Arbuscular Mycorrhizal Fungi Improves Growth, Nutrient Uptake and Photosynthesis in Cucumber Seedlings

    Directory of Open Access Journals (Sweden)

    Shuangchen Chen

    2017-12-01

    Full Text Available Mycorrhizal inoculation stimulates growth, photosynthesis and nutrient uptake in a wide range of host plants. However, the ultimate effects of arbuscular mycorrhyzal (AM symbiosis vary with the plants and fungal species involved in the association. Therefore, identification of the appropriate combinations of AM fungi (AMF that interact synergistically to improve their benefits is of high significance. Here, three AM fungal compositions namely VT (Claroideoglomus sp., Funneliformis sp., Diversispora sp., Glomus sp., and Rhizophagus sp. and BF (Glomus intraradices, G. microageregatum BEG and G. Claroideum BEG 210, and Funneliformis mosseae (Fm were investigated with respect to the growth, gas exchange parameters, enzymes activities in Calvin cycles and related gene expression in cucumber seedlings. The results showed that VT, BF and Fm could successfully colonize cucumber root to a different degree with the colonization rates 82.38, 74.65, and 70.32% at 46 days post inoculation, respectively. The plant height, stem diameter, dry weight, root to shoot ratio of cucumber seedlings inoculated with AMF increased significantly compared with the non-inoculated control. Moreover, AMF colonization greatly increased the root activity, chlorophyll content, net photosynthetic rate, light saturated rate of the CO2 assimilation (Asat, maximum carboxylation rate (Vcmax and maximum ribulose-1,5-bis-phosphate (RuBP regeneration rate (Jmax, which were increased by 52.81, 30.75, 58.76, 47.00, 69.15, and 65.53% when inoculated with VT, respectively. The activities of some key enzymes such RuBP carboxylase/oxygenase (RuBisCO, D-fructose-1,6-bisphosphatase (FBPase, D-fructose-6-phosphatase (F6P and ribulose-5-phosphate kinase (Ru5PK, and related gene expression involved in the Calvin cycle including RCA, FBPase, FBPA, SBPase, rbcS and rbcL were upregulated by AMF colonization. AMF inoculation also improved macro- and micro nutrient contents such as N, P, K, S, Ca, Cu

  18. Reduce manual curation by combining gene predictions from multiple annotation engines, a case study of start codon prediction.

    Directory of Open Access Journals (Sweden)

    Thomas H A Ederveen

    Full Text Available Nowadays, prokaryotic genomes are sequenced faster than the capacity to manually curate gene annotations. Automated genome annotation engines provide users a straight-forward and complete solution for predicting ORF coordinates and function. For many labs, the use of AGEs is therefore essential to decrease the time necessary for annotating a given prokaryotic genome. However, it is not uncommon for AGEs to provide different and sometimes conflicting predictions. Combining multiple AGEs might allow for more accurate predictions. Here we analyzed the ab initio open reading frame (ORF calling performance of different AGEs based on curated genome annotations of eight strains from different bacterial species with GC% ranging from 35-52%. We present a case study which demonstrates a novel way of comparative genome annotation, using combinations of AGEs in a pre-defined order (or path to predict ORF start codons. The order of AGE combinations is from high to low specificity, where the specificity is based on the eight genome annotations. For each AGE combination we are able to derive a so-called projected confidence value, which is the average specificity of ORF start codon prediction based on the eight genomes. The projected confidence enables estimating likeliness of a correct prediction for a particular ORF start codon by a particular AGE combination, pinpointing ORFs notoriously difficult to predict start codons. We correctly predict start codons for 90.5±4.8% of the genes in a genome (based on the eight genomes with an accuracy of 81.1±7.6%. Our consensus-path methodology allows a marked improvement over majority voting (9.7±4.4% and with an optimal path ORF start prediction sensitivity is gained while maintaining a high specificity.

  19. Remediation of multiple heavy metal-contaminated soil through the combination of soil washing and in situ immobilization.

    Science.gov (United States)

    Zhai, Xiuqing; Li, Zhongwu; Huang, Bin; Luo, Ninglin; Huang, Mei; Zhang, Qiu; Zeng, Guangming

    2018-09-01

    The remediation of heavy metal-contaminated soils is a great challenge for global environmental sciences and engineering. To control the ecological risks of heavy metal-contaminated soil more effectively, the present study focused on the combination of soil washing (with FeCl 3 ) and in situ immobilization (with lime, biochar, and black carbon). The results showed that the removal rate of Cd, Pb, Zn, and Cu was 62.9%, 52.1%, 30.0%, and 16.7%, respectively, when washed with FeCl 3 . After the combined remediation (immobilization with 1% (w/w) lime), the contaminated soils showed 36.5%, 73.6%, 70.9%, and 53.4% reductions in the bioavailability of Cd, Cu, Pb, and Zn (extracted with 0.11M acetic acid), respectively, than those of the soils washed with FeCl 3 only. However, the immobilization with 1% (w/w) biochar or 1% (w/w) carbon black after washing exhibited low effects on stabilizing the metals. The differences in effects between the immobilization with lime, biochar, and carbon black indicated that the soil pH had a significant influence on the lability of heavy metals during the combined remediation process. The activity of the soil enzymes (urease, sucrase, and catalase) showed that the addition of all the materials, including lime, biochar, and carbon black, exhibited positive effects on microbial remediation after soil washing. Furthermore, lime was the most effective material, indicating that low soil pH and high acid-soluble metal concentrations might restrain the activity of soil enzymes. Soil pH and nutrition were the major considerations for microbial remediation during the combined remediation. These findings suggest that the combination of soil washing and in situ immobilization is an effective method to amend the soils contaminated with multiple heavy metals. Copyright © 2018 Elsevier B.V. All rights reserved.

  20. Clinical diagnostic value of combined determination of serum tPSA, cPSA and IGF-I levels in patients with prostatic disorders

    International Nuclear Information System (INIS)

    Zhang Bashan; Zhang Zigang; Lai Fudi

    2008-01-01

    Objective: To investigate the diagnostic value of combined determination of serum total prostatic specific antigen (tPSA), complex prostatic specific antigen (cPSA) and IGF-I levels in patients with prostatic disorders. Methods: Serum tPSA, cPSA (with CLIA) and IGF-I (with IRMA) levels were determined in 41 patients with prostatic carcinoma, 60 patients with benign prosta- tic hypertrophy (BPH) and 55 controls. Results: The serum tPSA, cPSA and IGF-I levels in patients with prostatic cancer were significantly higher than those in patients with BPH and controls (P<0.01). Taking the cut-off values of 4ng/ml, 3.6ng/ml and 150 for tPSA, cPSA and IGF-I respectively, the combined determination of these three items would yield a sensitivity of 88.6%, specificity of 84.9%, positive predicative value of 83% and negative predicative value of 90.0% for diagnosis of prostatic cancer. Conclusion: Combined determination of tPSA, cPSA and IGF-I would yield better sensitive and accurate diagnostic rate in patients with prostatic cancer, especially in those with laboratory values within the 'grey zone'. (authors)

  1. Study on the diagnostic value of combined determination of serum CA125, CA199 and SIL-2R levels in patients with endometriosis

    International Nuclear Information System (INIS)

    Yang Jingxiu; Shi Shaohong; Wang Yuping; Xie Xueqin; Qin Jibao

    2005-01-01

    Objective: To investigate the diagnostic values of combined determination of serum CA125, CA199 and SIL-2R levels in patients with endometriosis. Methods: Serum CA125, CA199 were measured with RIA and SIL-2R levels with ELISA in 54 patients with endometriosis and 35 controls. Results: The serum levels of CA125, CA199 and SIL-2R in patients with endometriosis were significantly higher than those in controls (P<0.01). The sensitivity and speciality of CA125 for endometriosis was 70.2% and 80.4% respectively, the sensitivity and speciality of CA199 for endometriosis was 62.4% and 71.8% respectively, the sensitivity and speciality of SIL-2R was 89.5% and 60.2% respectively. The sensitivity of the combined determination of CA125, CA199 and SIL-2R for endometriosis was 86.8% being significantly higher than that of CA125 and CA199 respectively. Conclusion: Combined determination of the serum CA125, CA199 and SIL-2R levels in serum can increase the diagnostic sensitivity for endometriosis. (authors)

  2. Multiple comorbidities of 21 psychological disorders and relationships with psychosocial variables: a study of the online assessment and diagnostic system within a web-based population.

    Science.gov (United States)

    Al-Asadi, Ali M; Klein, Britt; Meyer, Denny

    2015-02-26

    While research in the area of e-mental health has received considerable attention over the last decade, there are still many areas that have not been addressed. One such area is the comorbidity of psychological disorders in a Web-based sample using online assessment and diagnostic tools, and the relationships between comorbidities and psychosocial variables. We aimed to identify comorbidities of psychological disorders of an online sample using an online diagnostic tool. Based on diagnoses made by an automated online assessment and diagnostic system administered to a large group of online participants, multiple comorbidities (co-occurrences) of 21 psychological disorders for males and females were identified. We examined the relationships between dyadic comorbidities of anxiety and depressive disorders and the psychosocial variables sex, age, suicidal ideation, social support, and quality of life. An online complex algorithm based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision, was used to assign primary and secondary diagnoses of 21 psychological disorders to 12,665 online participants. The frequency of co-occurrences of psychological disorders for males and females were calculated for all disorders. A series of hierarchical loglinear analyses were performed to examine the relationships between the dyadic comorbidities of depression and various anxiety disorders and the variables suicidal ideation, social support, quality of life, sex, and age. A 21-by-21 frequency of co-occurrences of psychological disorders matrix revealed the presence of multiple significant dyadic comorbidities for males and females. Also, for those with some of the dyadic depression and the anxiety disorders, the odds for having suicidal ideation, reporting inadequate social support, and poorer quality of life increased for those with two-disorder comorbidity than for those with only one of the same two disorders. Comorbidities of

  3. ¹⁸F-FDG PET/CT: a review of diagnostic and prognostic features in multiple myeloma and related disorders.

    Science.gov (United States)

    Dammacco, Franco; Rubini, Giuseppe; Ferrari, Cristina; Vacca, Angelo; Racanelli, Vito

    2015-02-01

    Conventional radiographic skeletal survey has been for many years the gold standard to detect the occurrence of osteolytic lesions in patients with multiple myeloma (MM). However, the introduction of more sensitive imaging procedures has resulted in an updated anatomic and functional Durie and Salmon "plus" staging system and has remarkably changed the diagnostic and prognostic approach to this tumor. It is now established that (18)fluorine-fluorodeoxyglucose ((18)F-FDG) positron-emission tomography (PET) combined with low-dose computed tomography (CT), shortly designated PET/CT, exhibits a higher screening and diagnostic sensitivity and specificity over the skeleton X-ray. In patients with monoclonal gammopathy of undetermined significance and in those with smoldering MM, PET/CT is consistently unable to detect focal and/or diffuse marrow abnormalities. Conversely, based on a systematic review of 18 studies comprising almost 800 MM patients, PET/CT was able to detect MM osteolytic lesions with a sensitivity of approximately 80-90% and a specificity of 80-100%. Importantly, a poor degree of concordance has also been emphasized between PET/CT and whole-body magnetic resonance imaging (WB-MRI) in that when both techniques were applied to the same patients, double-positive results were recorded in approximately 30% of the cases, but in the majority of them, a higher number of lesions were revealed with PET/CT than with MRI. Double-negative results, on the other hand, were found in about 22% of the patients. Because PET/CT is able to identify tumor foci throughout the body, it can be usefully applied to the study of solitary bone plasmacytoma and extra-medullary plasmacytoma: In both conditions, the detection of additional, previously overlooked sites of skeletal involvement would falsify the diagnosis of single-district disease, upstage the tumor, and therefore require a different therapeutic approach. In addition, although PET/CT is poorly sensitive to diffuse bone

  4. Evaluation of Multiple Diagnostic Indicators in Comparison to the Intestinal Biopsy as the Golden Standard in Diagnosing Celiac Disease in Children

    Directory of Open Access Journals (Sweden)

    Elisabet Hollén

    2016-11-01

    Full Text Available Celiac disease (CD is a chronic small intestinal enteropathy triggered by gluten in genetically predisposed individuals. The susceptibility is strongly associated with certain human leukocyte antigen (HLA-genes, but efforts are being made in trying to find non-HLA genes that are predictive for the disease. The criteria for diagnosing CD were previously based primarily on histologic evaluation of small intestinal biopsies, but nowadays are often based only on blood tests and symptoms. In this context, we elucidated the accuracy of three diagnostic indicators for CD, alone or in combination. Genetic analyses of HLA-type and nine single nucleotide polymorphisms (SNPs known to be associated with CD were performed in 177 children previously investigated for the suspicion of CD. CD was confirmed in 109 children, while 68 were considered non-celiacs. The antibodies and urinary nitrite/nitrate concentrations of all of them were measured. The combinations of all the variables used in the study would classify 93% of the study population in the correct diagnostic group. The single best predictors were antibodies (i.e., anti-endomysium immunoglobulin A (IgA (EMA and transglutaminase IgA (TGA, followed by HLA-type and nitric oxide (NO-metabolites. The nine SNPs used did not contribute to the right diagnoses. Although our control group consisted of children with mostly gastrointestinal symptoms, the presented methodology predicted a correct classification in more than 90% of the cases.

  5. [Effectiveness of multiple small-diameter drilling decompression combined with hip arthroscopy for early osteonecrosis of the femoral head].

    Science.gov (United States)

    Li, Ji; Li, Zhongli; Su, Xiangzheng; Liu, Chunhui; Zhang, Hao; Wang, Ketao

    2017-09-01

    To evaluate the effectiveness of multiple small-diameter drilling decompression combined with hip arthroscopy for early oeteonecrosis of the femoral head (ONFH). Between March 2010 and December 2013, 91 patients with early ONFH were treated with the operation of multiple small-diameter drilling decompression combined with hip arthroscopy in 39 cases (53 hips, group A) or with drilling decompression alone in 52 cases (74 hips, group B). The patients in 2 groups had obvious hip pain and limited motion before operation. There was no significant difference in gender, age, etiology, effected side, stage of osteonecrosis, and preoperative Harris score between 2 groups ( P >0.05). All operations succeeded and all incisions healed by first intention. The operation time was significantly longer in group A [(73.3±10.6) minutes] than in group B [(41.5±7.2) minutes] ( t =8.726, P =0.000). Temporary of sciatic nerve apraxia after operation occurred in 2 patients of group A, and no complication occurred in other patients. Patients were followed up 24-52 months (mean, 39.3 months) in group A and 24-48 months (mean, 34.6 months) in group B. At last follow-up, the Harris scores were 83.34±8.76 in group A and 76.61±9.22 in group B, showing significant differences when compared between 2 groups ( t =-4.247, P =0.029) and when compared with preoperative values in 2 groups ( t =-10.327, P =0.001; t =-8.216, P =0.008). X-ray films showed that the collapse of the femoral head was observed in 6 hips (1 hip at stage Ⅰand 5 hips at stage Ⅱ) in group A, and in 16 hips (4 hips at stageⅠand 12 hips at stage Ⅱ) in group B; and hip arthroplasty was performed. The total effective rates were 88.68% (47/53) in group A and 78.38% (58/74) in group B, respectively; showing significant difference between 2 groups ( χ 2 =5.241, P =0.041). Multiple small-diameter drilling decompression combined with hip arthroscopy is effective in pain relief, improvement of hip function, slowing-down the

  6. Analysis of E. rutaecarpa Alkaloids Constituents In Vitro and In Vivo by UPLC-Q-TOF-MS Combined with Diagnostic Fragment

    Directory of Open Access Journals (Sweden)

    Shenshen Yang

    2016-01-01

    Full Text Available Evodia rutaecarpa (Juss. Benth. (Rutaceae dried ripe fruit is used for dispelling colds, soothing liver, and analgesia. Pharmacological research has proved that alkaloids are the main active ingredients of E. rutaecarpa. This study aimed to rapidly classify and identify the alkaloids constituents of E. rutaecarpa by using UPLC-Q-TOF-MS coupled with diagnostic fragments. Furthermore, the effects of the material base of E. rutaecarpa bioactive ingredients in vivo were examined such that the transitional components in the blood of rats intragastrically given E. rutaecarpa were analyzed and identified. In this study, the type of alcohol extraction of E. rutaecarpa and the corresponding blood sample were used for the analysis by UPLC-Q-TOF-MS in positive ion mode. After reviewing much of the literature and collected information on the fragments, we obtained some diagnostic fragments of the alkaloids. Combining the diagnostic fragments with the technology of UPLC-Q-TOF-MS, we identified the compounds of E. rutaecarpa and blood samples and compared the ion fragment information with that of the alkaloids in E. rutaecarpa. A total of 17 alkaloids components and 6 blood components were identified. The proposed method was rapid, accurate, and sensitive. Therefore, this technique can reliably and practically analyze the chemical constituents in traditional Chinese medicine (TCM.

  7. Molecular diagnostics of a single drug-resistant multiple myeloma case using targeted next-generation sequencing

    Directory of Open Access Journals (Sweden)

    Ikeda H

    2015-10-01

    Full Text Available Hiroshi Ikeda,1 Kazuya Ishiguro,1 Tetsuyuki Igarashi,1 Yuka Aoki,1 Toshiaki Hayashi,1 Tadao Ishida,1 Yasushi Sasaki,1,2 Takashi Tokino,2 Yasuhisa Shinomura1 1Department of Gastroenterology, Rheumatology and Clinical Immunology, 2Medical Genome Sciences, Research Institute for Frontier Medicine, Sapporo Medical University, Sapporo, Japan Abstract: A 69-year-old man was diagnosed with IgG λ-type multiple myeloma (MM, Stage II in October 2010. He was treated with one cycle of high-dose dexamethasone. After three cycles of bortezomib, the patient exhibited slow elevations in the free light-chain levels and developed a significant new increase of serum M protein. Bone marrow cytogenetic analysis revealed a complex karyotype characteristic of malignant plasma cells. To better understand the molecular pathogenesis of this patient, we sequenced for mutations in the entire coding regions of 409 cancer-related genes using a semiconductor-based sequencing platform. Sequencing analysis revealed eight nonsynonymous somatic mutations in addition to several copy number variants, including CCND1 and RB1. These alterations may play roles in the pathobiology of this disease. This targeted next-generation sequencing can allow for the prediction of drug resistance and facilitate improvements in the treatment of MM patients. Keywords: multiple myeloma, drug resistance, genome-wide sequencing, semiconductor sequencer, target therapy

  8. Nuclear/Nucleolar morphometry and DNA image cytometry as a combined diagnostic tool in pathology of prostatic carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kavantzas, N.; Agapitos, E.; Lazaris, A. C.; Pavlopulos, P.M.; Sofikitis, N.; Davaris, P. [National University of Athens, Dept. of Pathology, Medical School, Athens (Greece)

    2001-12-01

    Paraffin tissue sections from 50 patients with prostate adenocarcinoma were used to study nuclear and nucleolar morphometric features by image analysis. The results were compared to DNA ploidy and Gleason grade. In the examined histological samples nuclear and nucleolar areas were positively interrelated. It was also noticed that the higher the percentage of nucleolated nuclei, the bigger the nuclear and nucleolar areas. The morphometric characteristics did not differ significantly among the four grades of the examined specimens. In well-differentiated carcinomas the DNA index was lower than in the rest at a statistically significant level. Hypodiploid carcinomas were found to possess significantly bigger nuclear areas than any other DNA index group. Morphonuclear evidence of anaplasia and DNA aneuploidy may be used as diagnostic tools in prostate cancer in addition to Gleason grade.

  9. Nuclear/Nucleolar morphometry and DNA image cytometry as a combined diagnostic tool in pathology of prostatic carcinoma

    International Nuclear Information System (INIS)

    Kavantzas, N.; Agapitos, E.; Lazaris, A. C.; Pavlopulos, P.M.; Sofikitis, N.; Davaris, P.

    2001-01-01

    Paraffin tissue sections from 50 patients with prostate adenocarcinoma were used to study nuclear and nucleolar morphometric features by image analysis. The results were compared to DNA ploidy and Gleason grade. In the examined histological samples nuclear and nucleolar areas were positively interrelated. It was also noticed that the higher the percentage of nucleolated nuclei, the bigger the nuclear and nucleolar areas. The morphometric characteristics did not differ significantly among the four grades of the examined specimens. In well-differentiated carcinomas the DNA index was lower than in the rest at a statistically significant level. Hypodiploid carcinomas were found to possess significantly bigger nuclear areas than any other DNA index group. Morphonuclear evidence of anaplasia and DNA aneuploidy may be used as diagnostic tools in prostate cancer in addition to Gleason grade

  10. Apprasial of the diagnostic value of combined detection of serum tumor markers (AFP, CEA, SF, TSA) for common malignancies

    International Nuclear Information System (INIS)

    Han Jingyin

    2005-01-01

    Objective: To assess the detection rate of common malignancies with combined determination of four serum tumor markers (AFP, CEA, SF, TSA). Methods: Serum AFP, CEA, SF (with RIA) and TSA (with biochemical method) contents were determined in 612 patients with various kinds of proved malignancies. Results: Positive rates of combined determination of these four tumor markers for detection of common malignancies were: 95.2%(79/83) for liver carcinoma, 92.6% (125/135) for lung carcinoma, 88.5% (115/130) for gastric cancer, 83.3% (60/72) for colorectal cancer, 84.2% (85/101) for breast cancer, 90.0% (9/10) for chorionepithelioma and 88.9% (72/81) for ovarian cancer. Conclusion: Combined determination of these four tumor markers for screening malignancies is simple, cheap, practical and worth popularization. (authors)

  11. Multiple primary malignancies of the liver and the colon: a complex diagnostic and decisional process with a final unanswered question.

    Science.gov (United States)

    Portolani, Nazario; Baiocchi, Gianluca; Baronchelli, Carla; Gheza, Federico; Giulini, Stefano Maria

    2014-03-29

    We herein present the case of a 78-year-old man with an incidental finding of a solid hepatic mass without symptoms and only a laparotomic cholecystectomy for acute cholecystitis in the past surgical history. A colonoscopy, a magnetic resonance imaging scan, a positron emission tomography scan, and a computed tomography scan completed the preoperative workup: a neoplastic lesion 4.3×3 cm in size was diagnosed at segments IV and V, associated with a neoplastic involvement of the splenic flexure without signs of colonic occlusion. After colonic resection, a frozen section on a granulomatous-like tissue at gastric border suggested a diagnosis of an adenocarcinoma of bilio-pancreatic type, changing the surgical strategy to include gastric resection and hepatic pedicle node dissection. The discussion turns around the idea that a final diagnosis of colon cancer with regional nodal involvement (pT3N1) and metastatic gallbladder cancer with multiple peritoneal seedings cannot be excluded.

  12. Combined Hydration and Antibiotics with Lisinopril to Mitigate Acute and Delayed High-dose Radiation Injuries to Multiple Organs.

    Science.gov (United States)

    Fish, Brian L; Gao, Feng; Narayanan, Jayashree; Bergom, Carmen; Jacobs, Elizabeth R; Cohen, Eric P; Moulder, John E; Orschell, Christie M; Medhora, Meetha

    2016-11-01

    The NIAID Radiation and Nuclear Countermeasures Program is developing medical agents to mitigate the acute and delayed effects of radiation that may occur from a radionuclear attack or accident. To date, most such medical countermeasures have been developed for single organ injuries. Angiotensin converting enzyme (ACE) inhibitors have been used to mitigate radiation-induced lung, skin, brain, and renal injuries in rats. ACE inhibitors have also been reported to decrease normal tissue complication in radiation oncology patients. In the current study, the authors have developed a rat partial-body irradiation (leg-out PBI) model with minimal bone marrow sparing (one leg shielded) that results in acute and late injuries to multiple organs. In this model, the ACE inhibitor lisinopril (at ~24 mg m d started orally in the drinking water at 7 d after irradiation and continued to ≥150 d) mitigated late effects in the lungs and kidneys after 12.5-Gy leg-out PBI. Also in this model, a short course of saline hydration and antibiotics mitigated acute radiation syndrome following doses as high as 13 Gy. Combining this supportive care with the lisinopril regimen mitigated overall morbidity for up to 150 d after 13-Gy leg-out PBI. Furthermore, lisinopril was an effective mitigator in the presence of the growth factor G-CSF (100 μg kg d from days 1-14), which is FDA-approved for use in a radionuclear event. In summary, by combining lisinopril (FDA-approved for other indications) with hydration and antibiotics, acute and delayed radiation injuries in multiple organs were mitigated.

  13. Combined genetic algorithm and multiple linear regression (GA-MLR) optimizer: Application to multi-exponential fluorescence decay surface.

    Science.gov (United States)

    Fisz, Jacek J

    2006-12-07

    The optimization approach based on the genetic algorithm (GA) combined with multiple linear regression (MLR) method, is discussed. The GA-MLR optimizer is designed for the nonlinear least-squares problems in which the model functions are linear combinations of nonlinear functions. GA optimizes the nonlinear parameters, and the linear parameters are calculated from MLR. GA-MLR is an intuitive optimization approach and it exploits all advantages of the genetic algorithm technique. This optimization method results from an appropriate combination of two well-known optimization methods. The MLR method is embedded in the GA optimizer and linear and nonlinear model parameters are optimized in parallel. The MLR method is the only one strictly mathematical "tool" involved in GA-MLR. The GA-MLR approach simplifies and accelerates considerably the optimization process because the linear parameters are not the fitted ones. Its properties are exemplified by the analysis of the kinetic biexponential fluorescence decay surface corresponding to a two-excited-state interconversion process. A short discussion of the variable projection (VP) algorithm, designed for the same class of the optimization problems, is presented. VP is a very advanced mathematical formalism that involves the methods of nonlinear functionals, algebra of linear projectors, and the formalism of Fréchet derivatives and pseudo-inverses. Additional explanatory comments are added on the application of recently introduced the GA-NR optimizer to simultaneous recovery of linear and weakly nonlinear parameters occurring in the same optimization problem together with nonlinear parameters. The GA-NR optimizer combines the GA method with the NR method, in which the minimum-value condition for the quadratic approximation to chi(2), obtained from the Taylor series expansion of chi(2), is recovered by means of the Newton-Raphson algorithm. The application of the GA-NR optimizer to model functions which are multi

  14. Low field-low cost: Can low-field magnetic resonance systems replace high-field magnetic resonance systems in the diagnostic assessment of multiple sclerosis patients?

    International Nuclear Information System (INIS)

    Ertl-Wagner, B.B.; Reith, W.; Sartor, K.

    2001-01-01

    As low-field MR imaging is becoming a widely used imaging technique, we aimed at a prospective assessment of differences in imaging quality between low- and high-field MR imaging in multiple sclerosis patients possibly interfering with diagnostic or therapeutic decision making. Twenty patients with clinically proven multiple sclerosis were examined with optimized imaging protocols in a 1.5- and a 0.23-T MR scanner within 48 h. Images were assessed independently by two neuroradiologists. No statistically significant interrater discrepancies were observed. A significantly lower number of white matter lesions could be identified in low-field MR imaging both on T1- and on T2-weighted images (T2: high field 700, low field 481; T1: high field 253, low field 177). A total of 114 enhancing lesions were discerned in the high-field MR imaging as opposed to 45 enhancing lesions in low-field MR imaging. Blood-brain barrier disruption was identified in 11 of 20 patients in the high-field MR imaging, but only in 4 of 20 patients in low-field MR imaging. Since a significantly lower lesion load is identified in low-field MR imaging than in high-field MR imaging, and blood-brain barrier disruption is frequently missed, caution must be exercised in interpreting a normal low-field MR imaging scan in a patient with clinical signs of multiple sclerosis and in interpreting a scan without enhancing lesions in a patient with known multiple sclerosis and clinical signs of exacerbation. (orig.)

  15. Combined use of aortic dissection detection risk score and D-dimer in the diagnostic workup of suspected acute aortic dissection.

    Science.gov (United States)

    Nazerian, Peiman; Morello, Fulvio; Vanni, Simone; Bono, Alessia; Castelli, Matteo; Forno, Daniela; Gigli, Chiara; Soardo, Flavia; Carbone, Federica; Lupia, Enrico; Grifoni, Stefano

    2014-07-15

    Acute aortic dissection (AD) represents a diagnostic conundrum. Validated algorithms are particularly needed to identify patients where AD could be ruled out without aortic imaging. We evaluated the diagnostic accuracy of a strategy combining the aortic dissection detection (ADD) risk score with D-dimer, a sensitive biomarker of AD. Patients from two clinical centers with suspected AD were prospectively enrolled in a registry, from January 2008 to March 2013. The ADD risk score was calculated by retrospective blinded chart review. For D-dimer, a cutoff of 500 ng/ml was applied. AD was diagnosed in 233 of 1035 (22.5%) patients. The ADD risk score was 0 in 322 (31.1%), 1 in 508 (49.1%) and >1 in 205 (19.8%) patients. The sensitivity and the failure rate of D-dimer were 100% and 0% in patients with ADD score 0, versus 97.5% (95% CI 91.4-99.6%) and 4.2% (95% CI 0.7-12.5%) in patients with ADD risk score >1. In patients with ADD risk score ≤ 1, the sensitivity and the failure rate of D-dimer were 98.7% (95% CI 95.3-99.8%) and 0.8% (95% CI 0.1-2.6%). The diagnostic efficiency of D-dimer in patients with ADD risk score 0 and ≤ 1 was 8.9% (95% CI 7.2-10.7%) and 23.6% (95% CI 21.1-26.2%) respectively. In a large cohort of patients with suspected AD, the presence of ADD risk score 0 or ≤ 1 combined with a negative D-dimer accurately and efficiently ruled out AD. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. Improving diagnostic sensitivity of combined dermoscopy and reflectance confocal microscopy imaging through double reader concordance evaluation in telemedicine settings: A retrospective study of 1000 equivocal cases.

    Directory of Open Access Journals (Sweden)

    A M Witkowski

    Full Text Available Reflectance confocal microscopy (RCM is an imaging device that permits non-invasive visualization of cellular morphology and has been shown to improve diagnostic accuracy of dermoscopically equivocal cutaneous lesions. The application of double reader concordance evaluation of dermoscopy-RCM image sets in retrospective settings and its potential application to telemedicine evaluation has not been tested in a large study population.To improve diagnostic sensitivity of RCM image diagnosis using a double reader concordance evaluation approach; to reduce mismanagement of equivocal cutaneous lesions in retrospective consultation and telemedicine settings.1000 combined dermoscopy-RCM image sets were evaluated in blind by 10 readers with advanced training and internship in dermoscopy and RCM evaluation. We compared sensitivity and specificity of single reader evaluation versus double reader concordance evaluation as well as the effect of diagnostic confidence on lesion management in a retrospective setting.Single reader evaluation resulted in an overall sensitivity of 95.2% and specificity of 76.3%, with misdiagnosis of 8 melanomas, 4 basal cell carcinomas and 2 squamous cell carcinomas. Combined double reader evaluation resulted in an overall sensitivity of 98.3% and specificity of 65.5%, with misdiagnosis of 1 in-situ melanoma and 2 basal cell carcinomas.Evaluation of dermoscopy-RCM image sets of cutaneous lesions by single reader evaluation in retrospective settings is limited by sensitivity levels that may result in potential mismanagement of malignant lesions. Double reader blind concordance evaluation may improve the sensitivity of diagnosis and management safety. The use of a second check can be implemented in telemedicine settings where expert consultation and second opinions may be required.

  17. Patients with intolerance reactions to total knee replacement: combined assessment of allergy diagnostics, periprosthetic histology, and peri-implant cytokine expression pattern.

    Science.gov (United States)

    Thomas, Peter; von der Helm, Christine; Schopf, Christoph; Mazoochian, Farhad; Frommelt, Lars; Gollwitzer, Hans; Schneider, Josef; Flaig, Michael; Krenn, Veit; Thomas, Benjamin; Summer, Burkhard

    2015-01-01

    We performed a combined approach to identify suspected allergy to knee arthroplasty (TKR): patch test (PT), lymphocyte transformation test (LTT), histopathology (overall grading; T- and B-lymphocytes, macrophages, and neutrophils), and semiquantitative Real-time-PCR-based periprosthetic inflammatory mediator analysis (IFNγ, TNFα, IL1-β, IL-2, IL-6, IL-8, IL-10, IL17, and TGFβ). We analyzed 25 TKR patients with yet unexplained complications like pain, effusion, and reduced range of motion. They consisted of 20 patients with proven metal sensitization (11 with PT reactions; 9 with only LTT reactivity). Control specimens were from 5 complicated TKR patients without metal sensitization, 12 OA patients before arthroplasty, and 8 PT patients without arthroplasty. Lymphocytic infiltrates were seen and fibrotic (Type IV membrane) tissue response was most frequent in the metal sensitive patients, for example, in 81% of the PT positive patients. The latter also had marked periprosthetic IFNγ expression. 8/9 patients with revision surgery using Ti-coated/oxinium based implants reported symptom relief. Our findings demonstrate that combining allergy diagnostics with histopathology and periprosthetic cytokine assessment could allow us to design better diagnostic strategies.

  18. Patients with Intolerance Reactions to Total Knee Replacement: Combined Assessment of Allergy Diagnostics, Periprosthetic Histology, and Peri-implant Cytokine Expression Pattern

    Directory of Open Access Journals (Sweden)

    Peter Thomas

    2015-01-01

    Full Text Available We performed a combined approach to identify suspected allergy to knee arthroplasty (TKR: patch test (PT, lymphocyte transformation test (LTT, histopathology (overall grading; T- and B-lymphocytes, macrophages, and neutrophils, and semiquantitative Real-time-PCR-based periprosthetic inflammatory mediator analysis (IFNγ, TNFα, IL1-β, IL-2, IL-6, IL-8, IL-10, IL17, and TGFβ. We analyzed 25 TKR patients with yet unexplained complications like pain, effusion, and reduced range of motion. They consisted of 20 patients with proven metal sensitization (11 with PT reactions; 9 with only LTT reactivity. Control specimens were from 5 complicated TKR patients without metal sensitization, 12 OA patients before arthroplasty, and 8 PT patients without arthroplasty. Lymphocytic infiltrates were seen and fibrotic (Type IV membrane tissue response was most frequent in the metal sensitive patients, for example, in 81% of the PT positive patients. The latter also had marked periprosthetic IFNγ expression. 8/9 patients with revision surgery using Ti-coated/oxinium based implants reported symptom relief. Our findings demonstrate that combining allergy diagnostics with histopathology and periprosthetic cytokine assessment could allow us to design better diagnostic strategies.

  19. The additional diagnostic value of a single-session combined scintigraphic and ultrasonographic examination in patients with thyroid and parathyroid diseases.

    Science.gov (United States)

    Gedik, G K; Bozkurt, F M; Ugur, O; Grassetto, G; Rubello, D

    2008-09-01

    The aim of this study was to investigate the diagnostic efficacy and the clinical impact of scintigraphy combined with ultrasonography (USG) in the management of thyroid and parathyroid disorders in a large series of patients. A total of 387 consecutive patients referred to the Nuclear Medicine Department of Hacettepe University in the period from January to September 2007 for investigating a thyroid (N. 339 patients: 232 females and 107 males, mean age+/-SD=48.9+/-13.6 years) or a parathyroid disease (N. 48 patients: 34 females and 14 males, mean age+/-SD=47.4+/-9.6 years) were prospectively evaluated, systematically performing both scintigraphy and USG in a single-day session. All the examinations were independently reviewed by two nuclear medicine physicians; in cases of discrepancy (3%) a final diagnosis was reached by consensus. For thyroid pathologies, USG results were considered to provide additional diagnostic information over scintigraphy: 1) if more nodules were identified; 2) if an irregular hyperactive area at scintigraphy suspicious for the presence of a nodule was clearly characterized at USG; 3) if a nodule missed at scintigraphy because of small size (thyroid diseases, scintigraphy was considered to provide additional diagnostic information over USG, if the functional status of a diffuse or uni- or multi-nodular goiter were clearly defined at scintigraphy. In parathyroid diseases, scintigraphy was considered to provide additional diagnostic information over USG, if the differential diagnosis between a lymph node or a muscle or a vessel depicted at USG was clearly defined as a parathyroid enlargement at scintigraphy. Lastly, the clinical impact of the single-day combined scintigraphic/USG protocol was evaluated. USG. In the thyroid diseases group, USG was particularly useful: 1) to detect additional nodules in glands with suppressed thyroid tissue; 2) to disclose small thyroid nodules (thyroid diseases group, scintigraphy was particularly useful: 1

  20. Assessment of the performances of AcuStar HIT and the combination with heparin-induced multiple electrode aggregometry: a retrospective study.

    Science.gov (United States)

    Minet, V; Bailly, N; Douxfils, J; Osselaer, J C; Laloy, J; Chatelain, C; Elalamy, I; Chatelain, B; Dogné, J M; Mullier, F

    2013-09-01

    Early diagnosis of immune heparin-induced thrombocytopenia (HIT) is challenging. HemosIL® AcuStar HIT and heparin-induced multiple electrode aggregometry (HIMEA) were recently proposed as rapid diagnostic methods. We conducted a study to assess performances of AcuStar HIT-IgG (PF4-H) and AcuStar HIT-Ab (PF4-H). The secondary objective was to compare the performances of the combination of Acustar HIT and HIMEA with standardised clinical diagnosis. Sera of 104 suspected HIT patients were retrospectively tested with AcuStar HIT. HIMEA was performed on available sera (n=81). The clinical diagnosis was established by analysing in a standardized manner the patient's medical records. These tests were also compared with PF4-Enhanced®, LTA, and SRA in subsets of patients. Thresholds were determined using ROC curve analysis with clinical outcome as reference. Using the recommended thresholds (1.00AU), the negative predictive value (NPV) of HIT-IgG and HIT-Ab were 100.0% (95% CI: 95.9%-100.0% and 95.7%-100.0%). The positive predictive value (PPV) were 64.3% (95% CI: 35.1%-87.2.2%) and 45.0% (95% CI: 23.2%-68.6%), respectively. Using our thresholds (HIT-IgG: 2.89AU, HIT-Ab: 9.41AU), NPV of HIT-IgG and HIT-Ab were 100.0% (95% CI: 96.0%-100.0% and 96.1%-100.0%). PPV were 75.0% (95% CI: 42.7%-94.5%) and 81.8% (95% CI: 48.3%-97.7%), respectively. Of the 79 patients with a medium-high pretest probability score, 67 were negative using HIT-IgG (PF4-H) test at our thresholds. HIMEA was performed on HIT-IgG positive patients. Using this combination, only one patient on 79 was incorrectly diagnosed. Acustar HIT showed good performances to exclude the diagnosis of HIT. Combination with HIMEA improves PPV. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Metaanalysis of the Performance of a Combined Treponemal and Nontreponemal Rapid Diagnostic Test for Syphilis and Yaws.

    Science.gov (United States)

    Marks, Michael; Yin, Yue-Ping; Chen, Xiang-Sheng; Castro, Arnold; Causer, Louise; Guy, Rebecca; Wangnapi, Regina; Mitjà, Oriol; Aziz, Abdul; Castro, Rita; da Luz Martins Pereira, Filomena; Taleo, Fasihah; Guinard, Jérôme; Bélec, Laurent; Tun, Ye; Bottomley, Christian; Ballard, Ronald C; Mabey, David C W

    2016-09-01

    The human treponematoses are important causes of disease. Mother-to-child transmission of syphilis remains a major cause of stillbirth and neonatal death. There are also almost 100 000 cases of endemic treponemal disease reported annually, predominantly yaws. Rapid diagnostic tests (RDTs) would improve access to screening for these diseases. Most RDTs cannot distinguish current and previous infection. The Dual Path Platform (DPP) Syphilis Screen & Confirm test includes both a treponemal (T1) and nontreponemal (T2) component and may improve the accuracy of diagnosis. We conducted a metaanalysis of published and unpublished evaluations of the DPP-RDT for the diagnosis of syphilis and yaws. We calculated the sensitivity, specificity, and overall agreement of the test compared with reference laboratory tests. Nine evaluations, including 7267 tests, were included. Sensitivity was higher in patients with higher titer rapid plasma reagin (≥1:16) for both the T1 (98.2% vs 90.1%, P syphilis and yaws, although the sensitivity is decreased at lower antibody titers. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America.

  2. Quantification of diagnostic biomarkers to detect multiple sclerosis lesions employing 1H-MRSI at 3T

    International Nuclear Information System (INIS)

    Vafaeyan, H.; Ebrahimzadeh, S.A.; Rahimian, N.; Harirchian, M.H.; Alavijeh, S. Karimi; Rad, H. Saligheh; Madadi, A.; Faeghi, F.

    2015-01-01

    Proton magnetic resonance spectroscopic imaging ( 1 H-MRSI) enables the quantification of metabolite concentration ratios in the brain. The major purpose of the current work is to characterize NAA/Cho, NAA/Cr and Myo/Cr in multiple sclerosis (MS) patients, and to estimate their reproducibility in healthy controls. Twelve MS patients and five healthy volunteers were imaged using 1 H-MRSI at 3T. Eddy current correction was performed using a single-voxel non-water suppressed acquisition on an external water phantom. Time-domain quantification was carried out using subtract-QUEST technique, and based on an optimal simulated metabolite database. Reproducibility was evaluated on the same quantified ratios in five normal subjects. An optimal database was created for the quantification of the MRSI data, consisting of choline (Cho), creatine (Cr), N-acetyl aspartate (NAA), lactate (Lac), lipids, myo-inositol (Myo) and glutamine + glutamate (Glx). Decreasing of NAA/Cr and NAA/Cho ratios, as well as an increase in Myo/Cr ratio were observed for MS patients in comparison with control group. Reproducibility of NAA/Cr, NAA/Cho and Myo/Cr in control group was 0.98, 0.87 and 0.64, respectively, expressed as the squared correlation coefficient R 2 between duplicate experiments. We showed that MRSI alongside the time-domain quantification of spectral ratios offers a sensitive and reproducible framework to differentiate MS patients from normals.

  3. Student certainty answering misconception question: study of Three-Tier Multiple-Choice Diagnostic Test in Acid-Base and Solubility Equilibrium

    Science.gov (United States)

    Ardiansah; Masykuri, M.; Rahardjo, S. B.

    2018-04-01

    Students’ concept comprehension in three-tier multiple-choice diagnostic test related to student confidence level. The confidence level related to certainty and student’s self-efficacy. The purpose of this research was to find out students’ certainty in misconception test. This research was quantitative-qualitative research method counting students’ confidence level. The research participants were 484 students that were studying acid-base and equilibrium solubility subject. Data was collected using three-tier multiple-choice (3TMC) with thirty questions and students’ questionnaire. The findings showed that #6 item gives the highest misconception percentage and high student confidence about the counting of ultra-dilute solution’s pH. Other findings were that 1) the student tendency chosen the misconception answer is to increase over item number, 2) student certainty decreased in terms of answering the 3TMC, and 3) student self-efficacy and achievement were related each other in the research. The findings suggest some implications and limitations for further research.

  4. Diagnostic performance of whole-body MRI for the detection of persistent or relapsing disease in multiple myeloma after stem cell transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Bannas, Peter; Hentschel, Hannah B.; Bley, Thorsten A.; Derlin, Thorsten; Yamamura, Jin; Adam, Gerhard; Weber, Christoph [University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology, Hamburg (Germany); Treszl, Andras; Eulenburg, Christine [University Medical Center Hamburg-Eppendorf, Department of Medical Biometry and Epidemiology, Hamburg (Germany); Stuebig, Thomas; Kroeger, Nicolaus [University Medical Center Hamburg-Eppendorf, Department of Stem Cell Transplantation, Hamburg (Germany)

    2012-09-15

    To compare the diagnostic performance of whole-body MRI (WBMRI) with haematological parameters for detecting persistent or relapsing disease in patients with multiple myeloma after stem cell transplantation. Sixty-six WBMRI acquisitions were performed in 33 patients with multiple myeloma at two time points after stem cell transplantation. Extent of disease and inter-test dynamics of intra- and extramedullary myeloma manifestations were compared (kappa statistics) with Uniform Response Criteria, comprising haematological parameters. Using data from 66 sequential WBMRI acquisitions in 33 patients, 10 patients (30.3 %) were classified as having progressive disease and 23 (69.7 %) as being in remission. Eight (80 %) of the ten patients with progressive disease revealed intramedullary lesions, and two patients (20 %) had intra- and extramedullary lesions. WBMRI and laboratory tests were concordant in 26/33 (78.8 %) patients. We found an agreement of 51.2 %, 95 % confidence interval 19.8 %-82.6 %, between results from WBMRI and haematological parameters. WBMRI had a sensitivity of 63.6 %, specificity of 86.4 %, PPV of 70.0 %, NPV of 82.6 % and accuracy of 78.8 % for detection of remission. WBMRI allows the detection and exact localisation of intra- and extramedullary myeloma manifestations after stem cell transplantation, but shows only moderate agreement with routinely performed laboratory tests for determination of remission. (orig.)

  5. The Effect of Multiple Sulfatase Deficiency (MSD) on Dental Development: Can We Use the Teeth as an Early Diagnostic Tool?

    Science.gov (United States)

    Zilberman, Uri; Bibi, Haim

    2016-01-01

    Multiple sulfatase deficiency (MSD) is a rare autosomal recessive inborn error of metabolism due to reduced catalytic activity of the different sulfatase. Affected individuals show neurologic deterioration with mental retardation, skeletal anomalies, organomegaly, and skin changes as in X-linked ichthyosis. The only organ that was not examined in MSD patients is the dentition. To evaluate the effect of the metabolic error on dental development in a patient with the intermediate severe late-infantile form of MSD (S155P). Histological and chemical study were performed on three deciduous and five permanent teeth from MSD patient and pair-matched normal patients. Tooth germ size and enamel thickness were reduced in both deciduous and permanent MSD teeth, and the scalloping feature of the DEJ was missing in MSD teeth causing enamel to break off from the dentin. The mineral components in the enamel and dentin were different. The metabolic error insults the teeth in the stage of organogenesis in both the deciduous and permanent dentition. The end result is teeth with very sharp cusp tips, thin hypomineralized enamel, and exposed dentin due to the break off of enamel. These findings are different from all other types of MPS syndromes.Clinically the phenotype of intermediate severe late-infantile form of MSD appeared during the third year of life. In children of parents that are carriers, we can diagnose the disease as early as birth using X-ray radiograph of the anterior upper region or as early as 6-8 months when the first deciduous tooth erupt and consider very early treatment to ameliorate the symptoms.

  6. Advanced Light-Duty SI Engine Fuels Research: Multiple Optical Diagnostics of Well-mixed and Stratified Operation.

    Energy Technology Data Exchange (ETDEWEB)

    Sjoberg, Carl Magnus Goran [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Vuilleumier, David [Sandia National Lab. (SNL-CA), Livermore, CA (United States)

    2018-02-01

    Ever tighter fuel economy standards and concerns about energy security motivate efforts to improve engine efficiency and to develop alternative fuels. This project contributes to the science base needed by industry to develop highly efficient direct injection spark ignition (DISI) engines that also beneficially exploit the different properties of alternative fuels. Here, the emphasis is on lean operation, which can provide higher efficiencies than traditional non-dilute stoichiometric operation. Since lean operation can lead to issues with ignition stability, slow flame propagation and low combustion efficiency, the focus is on techniques that can overcome these challenges. Specifically, fuel stratification is used to ensure ignition and completeness of combustion but this technique has soot and NOx emissions challenges. For ultra-lean well-mixed operation, turbulent deflagration can be combined with controlled end-gas autoignition to render mixed-mode combustion for sufficiently fast heat release. However, such mixed-mode combustion requires very stable inflammation, motivating studies on the effects of near-spark flow and turbulence, and the use of small amounts of fuel stratification near the spark plug.

  7. Combinations of elevated tissue miRNA-17-92 cluster expression and serum prostate-specific antigen as potential diagnostic biomarkers for prostate cancer.

    Science.gov (United States)

    Feng, Sujuan; Qian, Xiaosong; Li, Han; Zhang, Xiaodong

    2017-12-01

    The aim of the present study was to investigate the effectiveness of the miR-17-92 cluster as a disease progression marker in prostate cancer (PCa). Reverse transcription-quantitative polymerase chain reaction analysis was used to detect the microRNA (miR)-17-92 cluster expression levels in tissues from patients with PCa or benign prostatic hyperplasia (BPH), in addition to in PCa and BPH cell lines. Spearman correlation was used for comparison and estimation of correlations between miRNA expression levels and clinicopathological characteristics such as the Gleason score and prostate-specific antigen (PSA). Receiver operating curve (ROC) analysis was performed for evaluation of specificity and sensitivity of miR-17-92 cluster expression levels for discriminating patients with PCa from patients with BPH. Kaplan-Meier analysis was plotted to investigate the predictive potential of miR-17-92 cluster for PCa biochemical recurrence. Expression of the majority of miRNAs in the miR-17-92 cluster was identified to be significantly increased in PCa tissues and cell lines. Bivariate correlation analysis indicated that the high expression of unregulated miRNAs was positively correlated with Gleason grade, but had no significant association with PSA. ROC curves demonstrated that high expression of miR-17-92 cluster predicted a higher diagnostic accuracy compared with PSA. Improved discriminating quotients were observed when combinations of unregulated miRNAs with PSA were used. Survival analysis confirmed a high combined miRNA score of miR-17-92 cluster was associated with shorter biochemical recurrence interval. miR-17-92 cluster could be a potential diagnostic and prognostic biomarker for PCa, and the combination of the miR-17-92 cluster and serum PSA may enhance the accuracy for diagnosis of PCa.

  8. Combined assessment of DYRK1A, BDNF and homocysteine levels as diagnostic marker for Alzheimer’s disease

    Science.gov (United States)

    Janel, N; Alexopoulos, P; Badel, A; Lamari, F; Camproux, A C; Lagarde, J; Simon, S; Feraudet-Tarisse, C; Lamourette, P; Arbones, M; Paul, J L; Dubois, B; Potier, M C; Sarazin, M; Delabar, J M

    2017-01-01

    Early identification of Alzheimer’s disease (AD) risk factors would aid development of interventions to delay the onset of dementia, but current biomarkers are invasive and/or costly to assess. Validated plasma biomarkers would circumvent these challenges. We previously identified the kinase DYRK1A in plasma. To validate DYRK1A as a biomarker for AD diagnosis, we assessed the levels of DYRK1A and the related markers brain-derived neurotrophic factor (BDNF) and homocysteine in two unrelated AD patient cohorts with age-matched controls. Receiver-operating characteristic curves and logistic regression analyses showed that combined assessment of DYRK1A, BDNF and homocysteine has a sensitivity of 0.952, a specificity of 0.889 and an accuracy of 0.933 in testing for AD. The blood levels of these markers provide a diagnosis assessment profile. Combined assessment of these three markers outperforms most of the previous markers and could become a useful substitute to the current panel of AD biomarkers. These results associate a decreased level of DYRK1A with AD and challenge the use of DYRK1A inhibitors in peripheral tissues as treatment. These measures will be useful for diagnosis purposes. PMID:28632203

  9. The combination of ovarian volume and outline has better diagnostic accuracy than prostate-specific antigen (PSA) concentrations in women with polycystic ovarian syndrome (PCOs).

    Science.gov (United States)

    Bili, Eleni; Bili, Authors Eleni; Dampala, Kaliopi; Iakovou, Ioannis; Tsolakidis, Dimitrios; Giannakou, Anastasia; Tarlatzis, Basil C

    2014-08-01

    The aim of this study was to determine the performance of prostate specific antigen (PSA) and ultrasound parameters, such as ovarian volume and outline, in the diagnosis of polycystic ovary syndrome (PCOS). This prospective, observational, case-controlled study included 43 women with PCOS, and 40 controls. Between day 3 and 5 of the menstrual cycle, fasting serum samples were collected and transvaginal ultrasound was performed. The diagnostic performance of each parameter [total PSA (tPSA), total-to-free PSA ratio (tPSA:fPSA), ovarian volume, ovarian outline] was estimated by means of receiver operating characteristic (ROC) analysis, along with area under the curve (AUC), threshold, sensitivity, specificity as well as positive (+) and negative (-) likelihood ratios (LRs). Multivariate logistical regression models, using ovarian volume and ovarian outline, were constructed. The tPSA and tPSA:fPSA ratio resulted in AUC of 0.74 and 0.70, respectively, with moderate specificity/sensitivity and insufficient LR+/- values. In the multivariate logistic regression model, the combination of ovarian volume and outline had a sensitivity of 97.7% and a specificity of 97.5% in the diagnosis of PCOS, with +LR and -LR values of 39.1 and 0.02, respectively. In women with PCOS, tPSA and tPSA:fPSA ratio have similar diagnostic performance. The use of a multivariate logistic regression model, incorporating ovarian volume and outline, offers very good diagnostic accuracy in distinguishing women with PCOS patients from controls. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  10. Combining multiple FDG-PET radiotherapy target segmentation methods to reduce the effect of variable performance of individual segmentation methods

    Energy Technology Data Exchange (ETDEWEB)

    McGurk, Ross J. [Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 (United States); Bowsher, James; Das, Shiva K. [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Lee, John A [Molecular Imaging and Experimental Radiotherapy Unit, Universite Catholique de Louvain, 1200 Brussels (Belgium)

    2013-04-15

    different between 128 Multiplication-Sign 128 and 256 Multiplication-Sign 256 grid sizes for either method (MJV, p= 0.0519; STAPLE, p= 0.5672) but was for SMASD values (MJV, p < 0.0001; STAPLE, p= 0.0164). The best individual method varied depending on object characteristics. However, both MJV and STAPLE provided essentially equivalent accuracy to using the best independent method in every situation, with mean differences in DSC of 0.01-0.03, and 0.05-0.12 mm for SMASD. Conclusions: Combining segmentations offers a robust approach to object segmentation in PET. Both MJV and STAPLE improved accuracy and were robust against the widely varying performance of individual segmentation methods. Differences between MJV and STAPLE are such that either offers good performance when combining volumes. Neither method requires a training dataset but MJV is simpler to interpret, easy to implement and fast.

  11. Ion temperature profiles from the plasma center to the edge of ASDEX combining high and low energy CX-diagnostics

    International Nuclear Information System (INIS)

    Verbeek, H.; Heinrich, O.; Schneider, R.; Fahrbach, H.U.; Herrmann, W.; Neuhauser, J.; Stroth, U.; Reiter, D.

    1992-01-01

    The charge exchange (CX) neutral energy distribution from ASDEX measured with the conventional neutral particle analyzers (NPA) at energies >500 eV are combined with the low energy CX spectra from the low energy neutral analyzer (LENA). In the region of overlap their shapes fit each other very well. With the 3D EIRENE code the neutral gas was simulated and ion temperature (T i ) profiles from the center to the edge are obtained. The T i values at the separatrix and the edge based on the LENA data are considerably lower than those suggested earlier from the NPA data. This is attributed to the different energy ranges - high energies for the NPA, low energies for LENA - that are used for the T i evaluation. (orig.)

  12. Combination therapy with mitoxantrone and plasma exchange in aggressive relapsing remitting multiple sclerosis: A preliminary clinical study

    Directory of Open Access Journals (Sweden)

    Nasim Tabrizi

    2012-01-01

    Full Text Available Background: The efficacy of mitoxantrone induction therapy in rapidly worsening multiple sclerosis (MS is well established. Plasma exchange is also applied as an adjuvant in exacerbations of relapsing MS. The aim of this study was to compare the efficacy of combination therapy with mitoxantrone and plasma exchange versus mitoxantrone alone in patients with aggressive MS. Materials and Methods: Forty patients with aggressive relapsing remitting MS were randomly put into two groups. The first group underwent monthly plasma exchange for three successive months, followed by 12 mg/m 2 mitoxantrone at the end of each course and two more doses of 6 mg/m 2 mitoxantrone in 3-month intervals. The second group received the same doses of mitoxantrone only without plasma exchange. At the end of 8 months treatment course, clinical reassessment and neuroimaging was performed and treatment was continued with interferon-β. Results: At the end of induction therapy, Expanded Disability Status Scale score was significantly improved in both groups (P < 0.001. Number of demyelinating and gadolinium-enhancing plaques in brain magnetic resonance imaging (MRI was prominently reduced in group 2 (P ≤ 0.05, but the changes were not statistically significant in group 1, except for juxtacortical plaques. Conclusion: Administration of mitoxantrone as an induction therapy in patients of aggressive relapsing remitting MS results in significant improvement of their clinical state and MRI activity. However, combination of plasma exchange with mitoxantrone gives no more benefits than mitoxantrone alone and sometimes worsens the situation possibly by reduction of mitoxantrone efficacy as a result of plasma exchange.

  13. The Multimorbidity Cluster Analysis Tool: Identifying Combinations and Permutations of Multiple Chronic Diseases Using a Record-Level Computational Analysis

    Directory of Open Access Journals (Sweden)

    Kathryn Nicholson

    2017-12-01

    Full Text Available Introduction: Multimorbidity, or the co-occurrence of multiple chronic health conditions within an individual, is an increasingly dominant presence and burden in modern health care systems.  To fully capture its complexity, further research is needed to uncover the patterns and consequences of these co-occurring health states.  As such, the Multimorbidity Cluster Analysis Tool and the accompanying Multimorbidity Cluster Analysis Toolkit have been created to allow researchers to identify distinct clusters that exist within a sample of participants or patients living with multimorbidity.  Development: The Tool and Toolkit were developed at Western University in London, Ontario, Canada.  This open-access computational program (JAVA code and executable file was developed and tested to support an analysis of thousands of individual records and up to 100 disease diagnoses or categories.  Application: The computational program can be adapted to the methodological elements of a research project, including type of data, type of chronic disease reporting, measurement of multimorbidity, sample size and research setting.  The computational program will identify all existing, and mutually exclusive, combinations and permutations within the dataset.  An application of this computational program is provided as an example, in which more than 75,000 individual records and 20 chronic disease categories resulted in the detection of 10,411 unique combinations and 24,647 unique permutations among female and male patients.  Discussion: The Tool and Toolkit are now available for use by researchers interested in exploring the complexities of multimorbidity.  Its careful use, and the comparison between results, will be valuable additions to the nuanced understanding of multimorbidity.

  14. PET-CT for nuclear medicine diagnostics of multiple myeloma; PET-CT in der nuklearmedizinischen Diagnostik des multiplen Myeloms

    Energy Technology Data Exchange (ETDEWEB)

    Dimitrakopoulou-Strauss, A. [Deutsches Krebsforschungszentrum (DKFZ), Klinische Kooperationseinheit Nuklearmedizin, Heidelberg (Germany)

    2014-06-15

    Functional or morphofunctional imaging modalities are used in myeloma patients for the diagnosis and therapy management within research protocols. Despite new staging criteria, which take into account the viability of a myeloma lesion, positron emission tomography (PET) is not used routinely. The impact of PET is therefore open. The role of PET and PET computed tomography (PET-CT) for the diagnosis and therapy management is discussed. The use of PET with 18F-fluorodeoxyglucose (FDG) allows the measurement of viable myeloma lesions and correlates with the stage of disease. A negative FDG examination correlates with a better prognosis. Furthermore, the number of focal lesions as well as the whole functional volume of myeloma lesions in FDG have a prognostic impact. Several studies have demonstrated the impact of FDG for the assessment of therapy monitoring and show that FDG is an earlier indicator for therapy response as compared to magnetic resonance imaging (MRI). The CT component of the new hybrid systems allows the assessment of osteolytic lesions in CT and their viability in FDG. The combination of PET with an MRT scanner allows the simultaneous measurement of bone marrow infiltration, focal lesions and their viability. The use of modern hybrid scanners, such as PET-CT and PET-MRT facilitates the simultaneous measurement of viable myeloma lesions, osteolytic lesions and bone marrow infiltration in the whole body; therefore, it is expected that these imaging modalities will play a greater role both in diagnosis and therapy management. (orig.) [German] Funktionelle oder morphologisch-funktionelle bildgebende Verfahren werden in der Diagnostik und im Therapiemanagement des multiplen Myeloms (MM) primaer fuer wissenschaftliche Zwecke eingesetzt. Ein routinemaessiger klinischer Einsatz ist trotz neuer Stadieneinteilung nicht erfolgt. Die Wertigkeit der Positronenemissionstomographie (PET) ist noch offen. Die Rolle von PET und PET-CT fuer die Diagnostik und das

  15. Assessment of the diagnostic value of combined determination of serum CA199 CA125 and CEA in patients with cancer of pancreas

    International Nuclear Information System (INIS)

    Wu Congshan; Liu Xugui

    2005-01-01

    Objective: To assess the diagnostic value of combined determination of serum CA199, CA125 and CEA for cancer of pancreas. Methods: Serum CA199, CA125 and CEA levels were detected with CLIA in 32 patients with cancer of pancreas and 36 controls. Results: Positive detection rate of CA199 in patients with cancer of pancreas was 90.6% (29/32). Positive rate for CA125 and CEA was 65.6% (21/32) and 46.9% (15/32) respectively. With combined determination of these 3 tumor markers, the positive rate was 96.9% (31/32). The mean content of serum CA199 after successful operation (32.5±8.4U/ml) was significantly lower than that before operation (840.2 ± 102.5U/ml) (P<0.01). Conclusion: Combined determination of CA199, CA125 and CEA would improve the detection rate of cancer of pancreas and post-operative changes of CA199 could be of prognostic value. (authors)

  16. Clinical diagnostic value of combined determination of serum RF, AKA and anti-CCP antibody levels in patients with rheumatoid arthritis

    International Nuclear Information System (INIS)

    Zhao Hongcan; Xiang Guoqian

    2005-01-01

    Objective; To investigate the clinical usefulness of combined determination of serum rheumatic factor (RF), anti-keratin antibody (AKA) and anti-cyclic citrullinated peptide antibody (anti-CCP antibody) levels for early diagnosis in patients with rheumatoid arthritis (RA). Methods: Serum RF ( with rate-nephelometry), AKA (with indirect immuno-fluorescence) and anti-CCP antibody (with ELISA) levels were determined in 40 patients with RA, 30 patients with SLE and 30 controls. Results: For diagnosis of RA; the sensitivity and specificity of RF was 70.0% and 90.0% respectively, the sensitivity and specificity of AKA was 35.0% and 96.7%, the sensitivity and specificity of anti-CCP-antibody was 85% and 93.3% respectively. With combined determination of RF, AKA and anti-CCP antibody, the sensitivity and specificity would be the highest, being 97.07 and 99.8% respectively. Conclusion: RF, AKA and anti-CCP antibody were useful diagnostic serum markers for rheumatoid arthritis and combined determination of these markers would be very useful for early diagnosis. (authors)

  17. Clinical diagnostic significance of combined detection of serum and pleural effusion levels of CEA, NSE, CYFRA21-1, SCC-Ag in patients with lung cancer

    International Nuclear Information System (INIS)

    Bian Baoxiang; Hu Nan; Wu Fenglei; Yang Chengxi

    2008-01-01

    Objective: To appraise the clinical diagnostic significance of combined detection of serum and chest fluid levels of CEA, NSE, CYFRA21-1 and SCC-Ag in patients with lung cancer. Methods: Serum and pleural effusion contents of CEA, NSE, CYFRA21-1 and SCC-Ag were determined with RIA in 54 patients with lung cancer and 35 patients with benign lung disorders. Results: The serum and pleural effusion contents of CEA, NSE, CYFRA21-1 and SCC-Ag in patients with lung cancer were significantly higher than those in patients with benign lung disorders (P<0.01). The contents of CEA, NSE, CYFRA21-1 and SCC-Ag in patients pleural effusion were significantly higher than those in patients serum (P<0.01). For combined detection of CEA, NSE, CYFRA21-1 and SCC-Ag in serum and pleural effusion, the positive rate was 83.33% and 92.59% respectively. Conclusion: Combined detection of CEA, NSE, CYFRA21-1 and SCC-Ag contents in serum and pleural effusion can increase the positive rate of lung cancer diagnosis. (authors)

  18. The diagnostic value of both troponin T and creatinine kinase isoenzyme (CK-MB in detecting combined renal and myocardial injuries in asphyxiated infants.

    Directory of Open Access Journals (Sweden)

    Wilson E Sadoh

    Full Text Available Troponin T (cTnT and Creatinine Kinase Isoenzyme (CK-MB are both markers of myocardial injuries. However, CK-MB is also elevated in acute kidney injury.The diagnostic value of both cTnT and cardiac CK-MB in combined myocardial and acute kidney injuries (AKI in asphyxiated neonates was evaluated.40 asphyxiated infants and 40 non-asphyxiated controls were consecutively recruited. Serum levels of cTnT, CK-MB and creatinine were measured. Myocardial injury and AKI were defined as cTnT >95th percentile of the control and serum creatinine >1.0 mg/dl respectively.Of the 40 subjects, 9 (22.50%, 8 (20.00% and 4 (10.00% had myocardial injury, AKI and combined AKI and myocardial injuries respectively. The mean cTnT and CK-MB values were highest in infants with combined AKI and myocardial injuries. The Mean cTnT in infants with AKI, myocardial injury and combined AKI and myocardial injuries were 0.010±0.0007 ng/ml, 0.067±0.040 ng/ml and 0.084±0.067 ng/ml respectively, p = 0.006. The mean CK-MB in infants with AKI, myocardial injury and combined AKI and myocardial injuries were 2.78±0.22 ng/ml, 1.28±0.11 ng/ml and 4.58±0.52 ng/ml respectively, p = <0.0001.In severe perinatal asphyxia, renal and myocardial injuries could co-exist. Elevated cTnT signifies the presence of myocardial injury. Elevated CK-MB indicates either myocardial injury, AKI or both. Therefore renal injury should be excluded in asphyxiated infants with elevated CK-MB.

  19. The early diagnostic value of oral acetazolamide load combined with SPECT rCBF imaging in patients with transient ischemia attack in brain

    International Nuclear Information System (INIS)

    Liu Xintong; Zheng Zhiping; Qiao Suixian; Tang Anwu

    2001-01-01

    Objective: In order to assess the diagnostic value of acetazolamide (ACZ) combined with rCBF-SPECT imaging in patients with transient ischemia attack (TIA). Methods: SPECT imaging was performed before and after oral ACZ with visual and semiquantitative analysis of the images. Blood gas analysis was done before and after ACZ administration either. Results: After ACZ loading, in normal group, 99 Tc m -ECD was distributed symmetrically on correspondent parts of the brain and rCBF was generally increased. The blood pH was decreased and blood PCO 2 was increased, respectively in TIA group, the positive rate of hypoperfusion foci on SPECT images were increased from 5/6 to 6/6 in symptomatic patients and from 60% to 92% in asymptomatic patients. The total positive rate was 93%. Conclusion: Oral ACZ before SPECT imaging is a simple, reliable way for early diagnosis in patients with TIA

  20. Retrievals of Surface Air Temperature Using Multiple Satellite Data Combinations over Complex Terrain in the Korean Peninsula

    Science.gov (United States)

    Jang, K.; Won, M.; Yoon, S.; Lim, J.

    2016-12-01

    Surface air temperature (Tair) is a fundamental factor for terrestrial environments and plays a major role in the fields of applied meteorology, climatology, and ecology. The satellite remotely sensed data offers the opportunity to estimate Tair on the earth's surface with high spatial and temporal resolutions. The Moderate Resolution Imaging Spectroradiometer (MODIS) provides effective Tair retrievals although restricted to clear sky condition. MODIS Tair over complex terrain can result in significant retrieval errors due to the retrieval height mismatch to the elevation of local weather stations. In this study, we propose the methodology to estimate Tair over complex terrain for all sky conditions using multiple satellite data fusion based on the pixel-wise regression method. The combination of synergistic information from MODIS Tair and the brightness temperature (Tb) retrievals at 37 GHz frequency from the satellite microwave sensor were used for analysis. The air temperature lapse rate was applied to estimate the near-surface Tair considering the complex terrain such as mountainous regions. The retrieval results produced from this study showed a good agreement (RMSE Administration (KMA). The gaps in the MODIS Tair data due to cloud contamination were successfully filled using the proposed method which yielded similar accuracy as retrievals of clear sky. The results of this study indicate that the satellite data fusion can continuously produce Tair retrievals with reasonable accuracy and that the application of the temperature lapse rate can lead to improvement of the reliability over complex terrains such as the Korean Peninsula.

  1. The Immersive Virtual Reality Experience: A Typology of Users Revealed Through Multiple Correspondence Analysis Combined with Cluster Analysis Technique.

    Science.gov (United States)

    Rosa, Pedro J; Morais, Diogo; Gamito, Pedro; Oliveira, Jorge; Saraiva, Tomaz

    2016-03-01

    Immersive virtual reality is thought to be advantageous by leading to higher levels of presence. However, and despite users getting actively involved in immersive three-dimensional virtual environments that incorporate sound and motion, there are individual factors, such as age, video game knowledge, and the predisposition to immersion, that may be associated with the quality of virtual reality experience. Moreover, one particular concern for users engaged in immersive virtual reality environments (VREs) is the possibility of side effects, such as cybersickness. The literature suggests that at least 60% of virtual reality users report having felt symptoms of cybersickness, which reduces the quality of the virtual reality experience. The aim of this study was thus to profile the right user to be involved in a VRE through head-mounted display. To examine which user characteristics are associated with the most effective virtual reality experience (lower cybersickness), a multiple correspondence analysis combined with cluster analysis technique was performed. Results revealed three distinct profiles, showing that the PC gamer profile is more associated with higher levels of virtual reality effectiveness, that is, higher predisposition to be immersed and reduced cybersickness symptoms in the VRE than console gamer and nongamer. These findings can be a useful orientation in clinical practice and future research as they help identify which users are more predisposed to benefit from immersive VREs.

  2. Discounting of Monetary Rewards that are Both Delayed and Probabilistic: Delay and Probability Combine Multiplicatively, not Additively

    Science.gov (United States)

    Vanderveldt, Ariana; Green, Leonard; Myerson, Joel

    2014-01-01

    The value of an outcome is affected both by the delay until its receipt (delay discounting) and by the likelihood of its receipt (probability discounting). Despite being well-described by the same hyperboloid function, delay and probability discounting involve fundamentally different processes, as revealed, for example, by the differential effects of reward amount. Previous research has focused on the discounting of delayed and probabilistic rewards separately, with little research examining more complex situations in which rewards are both delayed and probabilistic. In two experiments, participants made choices between smaller rewards that were both immediate and certain and larger rewards that were both delayed and probabilistic. Analyses revealed significant interactions between delay and probability factors inconsistent with an additive model. In contrast, a hyperboloid discounting model in which delay and probability were combined multiplicatively provided an excellent fit to the data. These results suggest that the hyperboloid is a good descriptor of decision making in complicated monetary choice situations like those people encounter in everyday life. PMID:24933696

  3. A phase I study of vorinostat combined with bortezomib in Japanese patients with relapsed or refractory multiple myeloma.

    Science.gov (United States)

    Ogawa, Yoshiaki; Ogura, Michinori; Tobinai, Kensei; Ando, Kiyoshi; Suzuki, Tatsuya; Watanabe, Takashi; Ohmachi, Ken; Uchida, Toshiki; Hanson, Mary E; Tanaka, Yoshinobu; Koh, Yasuhiro; Shimamoto, Takashi; Hotta, Tomomitsu

    2016-01-01

    This study was undertaken to evaluate safety and pharmacokinetics and to determine treatment doses of vorinostat plus bortezomib in Japanese patients with relapsed or refractory multiple myeloma (MM). Of 9 originally enrolled patients, 2 were refractory to bortezomib, and both experienced dose-limiting toxicity (DLT), prompting a protocol amendment to exclude bortezomib-refractory individuals. Patients not considered bortezomib refractory (N = 7) received 21-day cycles of 1.3 mg/m(2) intravenous bortezomib (Days 1, 4, 8, and 11) and oral vorinostat 400 mg (Days 1 through 14) and were further evaluated. Vorinostat and bortezomib treatment doses were determined by DLT and safety, tolerability, and treatment response were assessed. Of 7 enrolled patients, 6 were evaluated, and one developed DLTs. The most common adverse events were leukopenia, neutropenia, thrombocytopenia, diarrhea, nausea, decreased appetite, and vomiting. Combination of vorinostat plus bortezomib did not increase vorinostat exposure at Day 11 [AUC0-24 h ratio (95% CI) = 1.08 (0.80, 1.45)]; geometric mean AUC0-24 h ratio for bortezomib (90% CI) was 1.96 (1.24-3.12). Objective therapeutic response occurred in 3 patients, including 1 complete response and 2 partial responses. Vorinostat 400 mg plus bortezomib 1.3 mg/m(2) was safe and well-tolerated in Japanese patients with relapsed or refractory MM not considered bortezomib refractory (NCT00858234).

  4. Combining Diffusion Tensor Metrics and DSC Perfusion Imaging: Can It Improve the Diagnostic Accuracy in Differentiating Tumefactive Demyelination from High-Grade Glioma?

    Science.gov (United States)

    Hiremath, S B; Muraleedharan, A; Kumar, S; Nagesh, C; Kesavadas, C; Abraham, M; Kapilamoorthy, T R; Thomas, B

    2017-04-01

    Tumefactive demyelinating lesions with atypical features can mimic high-grade gliomas on conventional imaging sequences. The aim of this study was to assess the role of conventional imaging, DTI metrics ( p:q tensor decomposition), and DSC perfusion in differentiating tumefactive demyelinating lesions and high-grade gliomas. Fourteen patients with tumefactive demyelinating lesions and 21 patients with high-grade gliomas underwent brain MR imaging with conventional, DTI, and DSC perfusion imaging. Imaging sequences were assessed for differentiation of the lesions. DTI metrics in the enhancing areas and perilesional hyperintensity were obtained by ROI analysis, and the relative CBV values in enhancing areas were calculated on DSC perfusion imaging. Conventional imaging sequences had a sensitivity of 80.9% and specificity of 57.1% in differentiating high-grade gliomas ( P = .049) from tumefactive demyelinating lesions. DTI metrics ( p : q tensor decomposition) and DSC perfusion demonstrated a statistically significant difference in the mean values of ADC, the isotropic component of the diffusion tensor, the anisotropic component of the diffusion tensor, the total magnitude of the diffusion tensor, and rCBV among enhancing portions in tumefactive demyelinating lesions and high-grade gliomas ( P ≤ .02), with the highest specificity for ADC, the anisotropic component of the diffusion tensor, and relative CBV (92.9%). Mean fractional anisotropy values showed no significant statistical difference between tumefactive demyelinating lesions and high-grade gliomas. The combination of DTI and DSC parameters improved the diagnostic accuracy (area under the curve = 0.901). Addition of a heterogeneous enhancement pattern to DTI and DSC parameters improved it further (area under the curve = 0.966). The sensitivity increased from 71.4% to 85.7% after the addition of the enhancement pattern. DTI and DSC perfusion add profoundly to conventional imaging in differentiating tumefactive

  5. Diagnostic accuracy of combined FP-CIT, IBZM, and MIBG scintigraphy in the differential diagnosis of degenerative parkinsonism: a multidimensional statistical approach.

    Science.gov (United States)

    Südmeyer, Martin; Antke, Christina; Zizek, Tanja; Beu, Markus; Nikolaus, Susanne; Wojtecki, Lars; Schnitzler, Alfons; Müller, Hans-Wilhelm

    2011-05-01

    In vivo molecular imaging of pre- and postsynaptic nigrostriatal neuronal degeneration and sympathetic cardiac innervation with SPECT is used to distinguish idiopathic Parkinson disease (PD) from atypical parkinsonian disorder (APD). However, the diagnostic accuracy of these imaging approaches as stand-alone procedures is often unsatisfying. The aim of this study was therefore to evaluate to which extent diagnostic accuracy can be increased by their combined use together with a multidimensional statistical algorithm. The SPECT radiotracers (123)I-(S)-2-hydroxy-3-iodo-6-methoxy-N-[1-ethyl-2-pyrrodinyl)-methyl]benzamide (IBZM), (123)I-N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)nortropan (FP-CIT), and meta-(123)I-iodobenzylguanidine (MIBG) were used to assess striatal postsynaptic D(2) receptor binding, striatal presynaptic dopamine transporter binding, and myocardial adrenergic innervation, respectively. Thirty-one PD and 17 APD patients were prospectively investigated. PD and APD diagnoses were established using consensus criteria and reevaluated after 37.4 ± 12.4 and 26 ± 11.6 mo in PD and APD, respectively. Test accuracy (TA) for PD-APD differentiation was computed for all logical (Boolean) combinations of imaging modalities by receiver-operating-characteristic analysis--that is, after multidimensional optimization of cutoff values. Analysis showed moderate TA for PD-APD differentiation using each molecular approach alone (IBZM, 79%; MIBG, 73%; and FP-CIT, 73%). For combined use, the highest TA resulted under the assumption that at least 2 of the 3 biologic markers had to be positive for APD using the following cutoff values: 1.46 or less for IBZM, less than 2.10 for FP-CIT, and greater than 1.43 for MIBG. This algorithm distinguished APD from PD with a sensitivity of 94%, specificity of 94% (TA, 94%), positive predictive value of 89%, and negative predictive value of 97%. Results suggest that the multidimensional combination of FP-CIT, IBZM, and MIBG

  6. Combined optical emission and resonant absorption diagnostics of an Ar-O{sub 2}-Ce-reactive magnetron sputtering discharge

    Energy Technology Data Exchange (ETDEWEB)

    El Mel, A.A. [Chimie des Interactions Plasma-Surface (ChIPS), Research Institute for Materials Science and Engineering, Université de Mons, Place du Parc 23, Mons B-7000 (Belgium); Institut des Matériaux Jean Rouxel, Université de Nantes, CNRS, 2 rue de la Houssinière B.P. 32229, Nantes Cedex 3 44322 (France); Ershov, S. [Chimie des Interactions Plasma-Surface (ChIPS), Research Institute for Materials Science and Engineering, Université de Mons, Place du Parc 23, Mons B-7000 (Belgium); Britun, N., E-mail: nikolay.britun@umons.ac.be [Chimie des Interactions Plasma-Surface (ChIPS), Research Institute for Materials Science and Engineering, Université de Mons, Place du Parc 23, Mons B-7000 (Belgium); Ricard, A. [Université de Toulouse, UPS, INPT, LAPLACE (Laboratoire Plasma et Conversion d' Energie), 118 route de Narbonne, Toulouse Cedex 9 F-31062 (France); Konstantinidis, S. [Chimie des Interactions Plasma-Surface (ChIPS), Research Institute for Materials Science and Engineering, Université de Mons, Place du Parc 23, Mons B-7000 (Belgium); Snyders, R. [Chimie des Interactions Plasma-Surface (ChIPS), Research Institute for Materials Science and Engineering, Université de Mons, Place du Parc 23, Mons B-7000 (Belgium); Materia Nova Research Center, Parc Initialis, Avenue Copernic 1, Mons B-7000 (Belgium)

    2015-01-01

    We report the results on combined optical characterization of Ar-O{sub 2}-Ce magnetron sputtering discharges by optical emission and resonant absorption spectroscopy. In this study, a DC magnetron sputtering system equipped with a movable planar magnetron source with a Ce target is used. The intensities of Ar, O, and Ce emission lines, as well as the absolute densities of Ar metastable and Ce ground state atoms are analyzed as a function of the distance from the magnetron target, applied DC power, O{sub 2} content, etc. The absolute number density of the Ar{sup m} is found to decrease exponentially as a function of the target-to-substrate distance. The rate of this decrease is dependent on the sputtering regime, which should be due to the different collisional quenching rates of Ar{sup m} by O{sub 2} molecules at different oxygen contents. Quantitatively, the absolute number density of Ar{sup m} is found to be equal to ≈ 3 × 10{sup 8} cm{sup −3} in the metallic, and ≈ 5 × 10{sup 7} cm{sup −3} in the oxidized regime of sputtering, whereas Ce ground state densities at the similar conditions are found to be few times lower. The absolute densities of species are consistent with the corresponding deposition rates, which decrease sharply during the transition from metallic to poisoned sputtering regime. - Highlights: • Optical emission and resonant absorption spectroscopy are employed to study Ar-O{sub 2}-Ce magnetron sputtering discharges. • The density of argon metastables is found to decrease exponentially when increasing the target-to-substrate distance. • The collision-quenching rates of Ar{sup m} by O{sub 2} molecules at different oxygen contents is demonstrated. • The deposition rates of cerium and cerium oxide thin films decrease sharply during the transition from the metallic to the poisoned sputtering regime.

  7. Diagnostic performance of a multiple real-time PCR assay in patients with suspected sepsis hospitalized in an internal medicine ward.

    Science.gov (United States)

    Pasqualini, Leonella; Mencacci, Antonella; Leli, Christian; Montagna, Paolo; Cardaccia, Angela; Cenci, Elio; Montecarlo, Ines; Pirro, Matteo; di Filippo, Francesco; Cistaro, Emma; Schillaci, Giuseppe; Bistoni, Francesco; Mannarino, Elmo

    2012-04-01

    Early identification of causative pathogen in sepsis patients is pivotal to improve clinical outcome. SeptiFast (SF), a commercially available system for molecular diagnosis of sepsis based on PCR, has been mostly used in patients hospitalized in hematology and intensive care units. We evaluated the diagnostic accuracy and clinical usefulness of SF, compared to blood culture (BC), in 391 patients with suspected sepsis, hospitalized in a department of internal medicine. A causative pathogen was identified in 85 patients (22%). Sixty pathogens were detected by SF and 57 by BC. No significant differences were found between the two methods in the rates of pathogen detection (P = 0.74), even after excluding 9 pathogens which were isolated by BC and were not included in the SF master list (P = 0.096). The combination of SF and BC significantly improved the diagnostic yield in comparison to BC alone (P < 0.001). Compared to BC, SF showed a significantly lower contamination rate (0 versus 19 cases; P < 0.001) with a higher specificity for pathogen identification (1.00, 95% confidence interval [CI] of 0.99 to 1.00, versus 0.94, 95% CI of 0.90 to 0.96; P = 0.005) and a higher positive predictive value (1.00, 95% CI of 1.00 to 0.92%, versus 0.75, 95% CI of 0.63 to 0.83; P = 0.005). In the subgroup of patients (n = 191) who had been receiving antibiotic treatment for ≥24 h, SF identified more pathogens (16 versus 6; P = 0.049) compared to BC. These results suggest that, in patients with suspected sepsis, hospitalized in an internal medicine ward, SF could be a highly valuable adjunct to conventional BC, particularly in patients under antibiotic treatment.

  8. Diagnostic value of whole-body low-dose computed tomography (WBLDCT) in bone lesions detection in patients with multiple myeloma (MM)

    Energy Technology Data Exchange (ETDEWEB)

    Ippolito, Davide, E-mail: davide.atena@tiscalinet.it [School of Medicine, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza (MB) (Italy); Department of Diagnostic Radiology, H. San Gerardo, Via Pergolesi 33, 20900 Monza (MB) (Italy); Besostri, Valeria, E-mail: valeriabesostri@gmail.com [School of Medicine, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza (MB) (Italy); Department of Diagnostic Radiology, H. San Gerardo, Via Pergolesi 33, 20900 Monza (MB) (Italy); Bonaffini, Pietro Andrea, E-mail: pa.bonaffini@gmail.com [School of Medicine, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza (MB) (Italy); Department of Diagnostic Radiology, H. San Gerardo, Via Pergolesi 33, 20900 Monza (MB) (Italy); Rossini, Fausto, E-mail: valeriabesostri@hotmail.it [Department of Hematology, H. San Gerardo, Via Pergolesi 33, 20900 Monza (MB) (Italy); Di Lelio, Alessandro, E-mail: valebeso@libero.it [Department of Diagnostic Radiology, H. San Gerardo, Via Pergolesi 33, 20900 Monza (MB) (Italy); Sironi, Sandro, E-mail: sandrosironi@libero.it [School of Medicine, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza (MB) (Italy); Department of Diagnostic Radiology, H. San Gerardo, Via Pergolesi 33, 20900 Monza (MB) (Italy)

    2013-12-01

    Purpose: To assess the role of whole-body low-dose computed tomography (WBLDCT) in the diagnosis and staging of patients with suspicion of multiple myeloma (MM). Materials and methods: A total of 138 patients (76 male and 62 female; mean age 63.5 years, range 50–81 years), with early MM, underwent WBLDCT protocol study, performed on 16-slice scanner (Brilliance, Philips Medical System, Eindhoven, The Netherlands): tube voltage 120 kV; tube current time product 40 mAs. Diagnosis of osteolytic lesions was performed on the basis of axial and multiplanar reformatted images, whereas the assessment of spinal misalignment and fracture was done by using multiplanar reformatted images. The overall dose delivered to each patient was 4.2 mSv. Every patient gave personal informed consent, as required by our institution guidelines. Results: The diagnosis was established either by histopathology or imaging follow-up (size increase of over a period time). In all 138 patients, image resolution was diagnostic, enabling correct classification of multiple myeloma patients. WBLDCT showed a total of 328 pathologic bone findings in 81/138 patients. CT scanning resulted in complete evaluation of the bone lesions in these areas of the skeleton: skull (42), humerus (15), femur (20), ribs (7), scapulae (13), pelvis (35), clavicle (13), sternum (10), cervical (39), dorsal (65), lombar (48) and sacral rachis (21). In 40/81 bone involvement detected by CT was the only CRAB criterion present. Furthermore, WBLDCT demonstrated pleuro-pulmonary lesions in 20 patients (11 infective, 9 as MM localizations) and 1 renal neoplasia. Conclusion: WBLDCT, detecting bone marrow localizations and demonstrating extra-osseous findings, with a fast scanning time and high resolution images, is a reliable imaging-based tool for a proper management of MM patients.

  9. Added diagnostic benefit of 16-row whole-body spiral CT in patients with multiple trauma differentiated by region and injury severity according to the ATLS registered concept

    International Nuclear Information System (INIS)

    Maurer, M.H.; Knopke, S.; Schroeder, R.J.

    2008-01-01

    Purpose: to determine the added diagnostic benefit of using MS-CT in multiple trauma patients differentiated by severity of injury and affected body region. Materials and methods: a retrospective analysis was performed of the 16-row whole-body spiral CT findings in 275 multiple trauma patients (73% men, 27% women; age 39.6 ± 18.9 years) with regard to additional findings and new findings obtained with CT compared to the findings obtained by conventional projection radiography and abdominal ultrasound in the emergency room. The additional and new findings were differentiated by body region (head, face, chest, pelvis, abdomen, spine) and the degree of severity according to the three classes of injuries distinguished by the ATLS registered concept (class 1: simple injury, class 2: potentially life threatening, class 3: immediately life threatening). Results: a total of 921 additional findings (findings potentially relevant for further diagnosis and therapy in addition to the findings obtained by conventional radiography or ultrasound) were obtained by MS-CT in all patients. The distribution by number of patients and body region was as follows: 22 neck, 76 face, 125 chest, 112 abdomen, 50 pelvis, and 91 spine. Most additional findings were categorized as potentially life threatening (ATLS class 2). In addition, there were 439 completely new findings, involving the head in 128 patients (mostly ATLS class 3), the face in 18, the chest in 47, the abdomen in 26, and the spine in 9 patients. Most new findings involving the face, abdomen, and spine were ATLS class 2 injuries. (orig.)

  10. Diagnostic value of combined magnetic resonance imaging examination of brachial plexus and electrophysiological studies in multifocal motor neuropathy

    Directory of Open Access Journals (Sweden)

    Basta Ivana

    2014-01-01

    Full Text Available Background/Aim. Multifocal motor neuropathy (MMN is an immune-mediated disorder characterized by slowly progressive asymetrical weakness of limbs without sensory loss. The objective of this study was to investigate the involvement of brachial plexus using combined cervical magnetic stimulation and magnetic resonance imaging (MRI of plexus brachialis in patients with MMN. We payed special attention to the nerve roots forming nerves inervating weak muscles, but without detectable conduction block (CB using conventional nerve conduction studies. Methods. Nine patients with proven MMN were included in the study. In all of them MRI of the cervical spine and brachial plexus was performed using a Siemens Avanto 1.5 T unit, applying T1 and turbo spinecho T1 sequence, axial turbo spin-echo T2 sequence and a coronal fat-saturated turbo spin-echo T2 sequence. Results. In all the patients severe asymmetric distal weakness of muscles inervated by radial, ulnar, median and peroneal nerves was observed and the most striking presentation was bilateral wrist and finger drop. Three of them had additional proximal weakness of muscles inervated by axillar and femoral nerves. The majority of the patients had slightly increased cerebrospinal fluid (CSF protein content. Six of the patients had positive serum polyclonal IgM anti-GM1 antibodies. Electromyoneurography (EMG showed neurogenic changes, the most severe in distal muscles inervated by radial nerves. All the patients had persistent partial CBs outside the usual sites of nerve compression in radial, ulnar, median and peroneal nerves. In three of the patients cervical magnetic stimulation suggested proximal CBs between cervical root emergence and Erb’s point (prolonged motor root conduction time. In all the patients T2-weighted MRI revealed increased signal intensity in at least one cervical root, truncus or fasciculus of brachial plexus. Conclusion. We found clinical correlation between muscle weakness

  11. [Diagnostic performance of T-SPOT.TB on peripheral blood in combination with adenosine deaminase on pleural fluid for the diagnosis of tuberculous pleurisy within different age group].

    Science.gov (United States)

    Xu, H Y; Zhang, D Q; Ye, J R; Su, S S; Xie, Y P; Chen, C S; Li, Y P

    2017-06-27

    .911. The combination test of 2 tests had the sensitivity of 96.1% and the specificity of 90.2% respectively in the elderly patients. The AUC of T-SPOT.TB in the elderly patients was 0.747, AUC of T-SPOT.TB combined with ADA was 0.911. Conclusion: Peripheral blood T-SPOT.TB combined with pleural fluid ADA can improve the diagnostic performance for TB pleurisy with different ages, especially for elderly patients who can't tolerate pleural biopsy.

  12. Calculation of axial secular frequencies in a nonlinear ion trap with hexapole, octupole, decapole and dodecapole superpositions by the combined methods of multiple scales and Lindstedt-Poincare

    International Nuclear Information System (INIS)

    Doroudi, A.; Emampour, M.; Emampour, M.

    2012-01-01

    In this paper a combination of the method of multiple scales and the method of Lindstedt-Poincare which is a perturbative technique is used for calculation of axial secular frequencies of a nonlinear ion trap in the presence of second ,third, fourth and fifth order nonlinear terms of the potential distribution within the trap. The frequencies are calculated. The calculated frequencies are compared with the results of multiple scales method and the exact results.

  13. Co-existence of Blau syndrome and NAID? Diagnostic challenges associated with presence of multiple pathogenic variants in NOD2 gene: a case report.

    Science.gov (United States)

    Dziedzic, Magdalena; Marjańska, Agata; Bąbol-Pokora, Katarzyna; Urbańczyk, Anna; Grześk, Elżbieta; Młynarski, Wojciech; Kołtan, Sylwia

    2017-07-27

    Pediatric autoinflammatory diseases are rare and still poorly understood conditions resulting from defective genetic control of innate immune system, inter alia from anomalies of NOD2 gene. The product of this gene is Nod2 protein, taking part in maintenance of immune homeostasis. Clinical form of resultant autoinflammatory condition depends on NOD2 genotype; usually patients with NOD2 defects present with Blau syndrome, NOD2-associated autoinflammatory disease (NAID) or Crohn's disease. We present the case of a 7-year-old girl with co-existing symptoms of two rare diseases, Blau syndrome and NAID. Overlapping manifestations of two syndromes raised a significant diagnostic challenge, until next-generation molecular test (NGS) identified presence of three pathogenic variants of NOD2 gene: P268S, IVS8 +158 , 1007 fs, and established the ultimate diagnosis. Presence of multiple genetical abnormalities resulted in an ambiguous clinical presentation with overlapping symptoms of Blau syndrome and NAID. Final diagnosis of autoinflammatory disease opened new therapeutic possibilities, including the use of biological treatments.

  14. Survey of diagnostic and treatment practices for multiple sclerosis (MS) in Europe. Part 2: Progressive MS, paediatric MS, pregnancy and general management.

    Science.gov (United States)

    Fernández, O; Delvecchio, M; Edan, G; Fredrikson, S; Giovannoni, G; Hartung, H-P; Havrdova, E; Kappos, L; Pozzilli, C; Soerensen, P S; Tackenberg, B; Vermersch, P; Comi, G

    2018-05-01

    The European Charcot Foundation supported the development of a set of surveys to understand current practice patterns for the diagnosis and management of multiple sclerosis (MS) in Europe. Part 2 of the report summarizes survey results related to secondary progressive MS (SPMS), primary progressive MS (PPMS), pregnancy, paediatric MS and overall patient management. A steering committee of MS neurologists developed case- and practice-based questions for two sequential surveys distributed to MS neurologists throughout Europe. Respondents generally favoured changing rather than stopping disease-modifying treatment (DMT) in patients transitioning from relapsing-remitting MS to SPMS, particularly with active disease. Respondents would not initiate DMT in patients with typical PPMS symptoms, although the presence of ≥1 spinal cord or brain gadolinium-enhancing lesion might affect that decision. For patients considering pregnancy, respondents were equally divided on whether to stop treatment before or after conception. Respondents strongly favoured starting DMT in paediatric MS with active disease; recommended treatments included interferon, glatiramer acetate and, in John Cunningham virus negative patients, natalizumab. Additional results regarding practice-based questions and management are summarized. Results of part 2 of the survey of diagnostic and treatment practices for MS in Europe largely mirror results for part 1, with neurologists in general agreement about the treatment and management of SPMS, PPMS, pregnancy and paediatric MS as well as the general management of MS. However, there are also many areas of disagreement, indicating the need for evidence-based recommendations and/or guidelines. © 2018 EAN.

  15. Imaging 2015 Mw 7.8 Gorkha Earthquake and Its Aftershock Sequence Combining Multiple Calibrated Global Seismic Arrays

    Science.gov (United States)

    LI, B.; Ghosh, A.

    2016-12-01

    and hazard assessment after destructive large earthquakes. Existing multiple global seismic arrays, when properly calibrated and used in combinations, provide a high resolution image of rupture of large earthquakes and spatiotemporal distribution of aftershocks.

  16. Barcoding against a paradox? Combined molecular species delineations reveal multiple cryptic lineages in elusive meiofaunal sea slugs

    Directory of Open Access Journals (Sweden)

    Jörger Katharina M

    2012-12-01

    Full Text Available Abstract Background Many marine meiofaunal species are reported to have wide distributions, which creates a paradox considering their hypothesized low dispersal abilities. Correlated with this paradox is an especially high taxonomic deficit for meiofauna, partly related to a lower taxonomic effort and partly to a high number of putative cryptic species. Molecular-based species delineation and barcoding approaches have been advocated for meiofaunal biodiversity assessments to speed up description processes and uncover cryptic lineages. However, these approaches show sensitivity to sampling coverage (taxonomic and geographic and the success rate has never been explored on mesopsammic Mollusca. Results We collected the meiofaunal sea-slug Pontohedyle (Acochlidia, Heterobranchia from 28 localities worldwide. With a traditional morphological approach, all specimens fall into two morphospecies. However, with a multi-marker genetic approach, we reveal multiple lineages that are reciprocally monophyletic on single and concatenated gene trees in phylogenetic analyses. These lineages are largely concordant with geographical and oceanographic parameters, leading to our primary species hypothesis (PSH. In parallel, we apply four independent methods of molecular based species delineation: General Mixed Yule Coalescent model (GMYC, statistical parsimony, Bayesian Species Delineation (BPP and Automatic Barcode Gap Discovery (ABGD. The secondary species hypothesis (SSH is gained by relying only on uncontradicted results of the different approaches (‘minimum consensus approach’, resulting in the discovery of a radiation of (at least 12 mainly cryptic species, 9 of them new to science, some sympatric and some allopatric with respect to ocean boundaries. However, the meiofaunal paradox still persists in some Pontohedyle species identified here with wide coastal and trans-archipelago distributions. Conclusions Our study confirms extensive, morphologically

  17. HIV Maintains an Evolving and Dispersed Population in Multiple Tissues during Suppressive Combined Antiretroviral Therapy in Individuals with Cancer.

    Science.gov (United States)

    Rose, Rebecca; Lamers, Susanna L; Nolan, David J; Maidji, Ekaterina; Faria, N R; Pybus, Oliver G; Dollar, James J; Maruniak, Samuel A; McAvoy, Andrew C; Salemi, Marco; Stoddart, Cheryl A; Singer, Elyse J; McGrath, Michael S

    2016-10-15

    While combined antiretroviral therapy (cART) can result in undetectable plasma viral loads, it does not eradicate HIV infection. Furthermore, HIV-infected individuals while on cART remain at an increased risk of developing serious comorbidities, such as cancer, neurological disease, and atherosclerosis, suggesting that during cART, tissue-based HIV may contribute to such pathologies. We obtained DNA and RNA env, nef, and pol sequences using single-genome sequencing from postmortem tissues of three HIV(+) cART-treated (cART(+)) individuals with undetectable viral load and metastatic cancer at death and performed time-scaled Bayesian evolutionary analyses. We used a sensitive in situ hybridization technique to visualize HIV gag-pol mRNA transcripts in cerebellum and lymph node tissues from one patient. Tissue-associated virus evolved at similar rates in cART(+) and cART-naive (cART(-)) patients. Phylogenetic trees were characterized by two distinct features: (i) branching patterns consistent with constant viral evolution and dispersal among tissues and (ii) very recently derived clades containing both DNA and RNA sequences from multiple tissues. Rapid expansion of virus near death corresponded to wide-spread metastasis. HIV RNA(+) cells clustered in cerebellum tissue but were dispersed in lymph node tissue, mirroring the evolutionary patterns observed for that patient. Activated, infiltrating macrophages were associated with HIV RNA. Our data provide evidence that tissues serve as a sanctuary for wild-type HIV during cART and suggest the importance of macrophages as an alternative reservoir and mechanism of virus spread. Combined antiretroviral therapy (cART) reduces plasma HIV to undetectable levels; however, removal of cART results in plasma HIV rebound, thus highlighting its inability to entirely rid the body of infection. Additionally, HIV-infected individuals on cART remain at high risk of serious diseases, which suggests a contribution from residual HIV. In

  18. Daratumumab-mediated lysis of primary multiple myeloma cells is enhanced in combination with the human anti-KIR antibody IPH2102 and lenalidomide

    DEFF Research Database (Denmark)

    Nijhof, I. S.; Lammerts van Bueren, J. J.; van Kessel, B.

    2015-01-01

    Despite recent treatment improvements, multiple myeloma remains an incurable disease. Since antibody-dependent cell-mediated cytotoxicity is an important effector mechanism of daratumumab, we explored the possibility of improving daratumumab-mediated cell-mediated cytotoxicity by blocking natural...... killer cell inhibitory receptors with the human monoclonal anti-KIR antibody IPH2102, next to activation of natural killer cells with the immune modulatory drug lenalidomide. In 4-hour antibody-dependent cell-mediated cytotoxicity assays, IPH2102 did not induce lysis of multiple myeloma cell lines...... effective treatment strategies can be designed for multiple myeloma by combining daratumumab with agents that independently modulate natural killer cell function....

  19. Clinical diagnostic value of combined determination of serum TSGF, CEA, CYFRA21-1 and NSE levels in patients with lung cancer

    International Nuclear Information System (INIS)

    Sun Qihe; Sun Bin

    2008-01-01

    Objective: To explore the clinical diagnostic value of combined determination of serum TSGF, CEA, CYFRA21-1 and NSE levels in patients with lung cancer. Methods: The four serum tumor markers were determined with RIA or other methods in 179 patients with lung cancer, 48 patients with benign lung diseases and 51 controls. Results: The serum levels of all these four markers in the cancer patients were significantly higher (P<0.05-P<0.01) than those in patients with benign pulmonary disorders with the exception of: (1) Serum TSGF, CEA and NSE levels in patients with stage I and II squamous cell carcinoma (n=37) and (2) serum NSE levels in patients with stage I and II adenocarcinoma (n=32). As a whole, the levels of the markers increased along with the increase of the severity of the disease. Conclusion: For the early diagnosis of lung cancer, serum CYFRA21-1 levels determination is the most specific and serum NSE levels determination for diagnosis in patients with NSCLC is the least sensitive. The combined determination of tumor markers is the best choice. (authors)

  20. Diagnostic value of combined determination of serum and chest fluid adenosine deaminase (ADA), IL-2, IL-6, IL-10 contents for differentiation of tuberculous from malignant pleural effusion

    International Nuclear Information System (INIS)

    Wu Jiaming; Wang Limin

    2005-01-01

    Objective: To investigate the possible diagnostic value of combined determination of serum and chest fluid contents of ADA, IL-2, IL-6, IL-10 in patients with tuberculous and malignant pleural effusion. Methods: Serum and chest fluid ADA (with biochemical method), IL-2, IL-6, IL-10 (with ELISA) contents were measured in 56 patients with tuberculosis pleural effusion, 53 patients with malignant effusion and 30 controls (in serum only). The receiving operative characteristic (ROC) curve for each parameter was analyzed for study of respective area under curse (Auc). Results: The serum IL-6 levels in both groups of patients were significantly higher than those in the controls (P<0.05). The chest fluid contents of ADA, IL-2, IL-6 and IL-10 in patients with tuberculous effusion were all significantly higher than those in patients with malignancies (P<0.05). The Auc in the ROC was largest in the case of ADA, followed by IL-10, IL-6 with IL-2 the least. Conclusion: Determination of chest fluid ADA, IL-2, IL-6, IL-10 contents was helpful in the differentiation of tuberculous from malignant pleural effusion. Combined determination of chest fluid ADA and IL-10 provided the highest accuracy rate for differentional diagnosis. (authors)

  1. Incremental Cancer Detection of Locoregional Restaging with Diagnostic Mammography Combined with Whole-Breast and Regional Nodal Ultrasound in Women with Newly Diagnosed Breast Cancer.

    Science.gov (United States)

    Candelaria, Rosalind P; Huang, Monica L; Adrada, Beatriz E; Bassett, Roland; Hunt, Kelly K; Kuerer, Henry M; Smith, Benjamin D; Chavez-MacGregor, Mariana; Yang, Wei Tse

    2017-02-01

    This study aims to determine if locoregional restaging with diagnostic mammography and ultrasound (US) of the whole breast and regional nodes performed for quality assurance in women with newly diagnosed breast cancer who were referred to a tertiary care center yields incremental cancer detection. An institutional review board-approved retrospective, single-institution database review was performed on the first 1000 women referred to our center in 2010 with a provisional breast cancer diagnosis. Locoregional restaging consisted of diagnostic full-field digital mammography combined with US of the whole breast and regional nodal basins. Bilateral whole-breast US was performed in women with contralateral mammographic abnormality or had heterogeneously or extremely dense parenchyma. Demographic, clinical, and pathologic factors were analyzed. Final analyses included 401 women. Of the 401 women, 138 (34%) did not have their outside images available for review upon referral. The median age was 54 years (range 21-92); the median tumor size was 2.9 cm (range 0.6-18.0) for women whose disease was upstaged and 2.2 cm (range 0.4-15.0) for women whose disease was not upstaged. Incremental cancer detection rates were 15.5% (62 of 401) in the ipsilateral breast and 3.9% (6 of 154) in the contralateral breast (P breast and regional nodal US that is performed for standardization of the imaging workup for newly diagnosed breast cancer patients can reduce underestimation of disease burden and impact therapeutic planning. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  2. Diagnostic value of combining {sup 11}C-choline and {sup 18}F-FDG PET/CT in hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Castilla-Lievre, Maria-Angela [University Department Hepatinov, Assistance-Publique Hopitaux de Paris, Department of Nuclear Medicine, Hopital Antoine Beclere, Clamart (France); IMIV - UMR 1023 Inserm/CEA/Universite Paris Sud - ERL 9218 CNRS, Orsay (France); Franco, Dominique [Universite Paris-Sud, Department of Surgery, Hopital Antoine Beclere, University Department Hepatinov, Assistance-Publique Hopitaux de Paris, Clamart (France); Gervais, Philippe; Kuhnast, Bertrand; Desarnaud, Serge; Helal, Badia-Ourkia [IMIV - UMR 1023 Inserm/CEA/Universite Paris Sud - ERL 9218 CNRS, Orsay (France); CEA, DSV, I2BM, Service Hospitalier Frederic Joliot, Orsay (France); Agostini, Helene [University Department Hepatinov, Assistance-Publique Hopitaux de Paris, Clinical Research Unit of Hopitaux universitaires Paris-Sud, Hopital Kremlin Bicetre (France); Marthey, Lysiane [Universite Paris-Sud, Department of Gastroenterology, Hopital Antoine Beclere, University Department Hepatinov, Assistance-Publique Hopitaux de Paris, Clamart (France)

    2016-05-15

    In this prospective study, our goal was to emphasize the diagnostic value of combining {sup 11}C-choline and {sup 18}F-FDG PET/CT for hepatocellular carcinoma (HCC) in patients with chronic liver disease. Thirty-three consecutive patients were enrolled. All patients were suspected to have HCC based on CT and/or MRI imaging. A final diagnosis was obtained by histopathological examination or by imaging alone according to American Association for the Study of Liver Disease criteria. All patients underwent PET/CT with both tracers within a median of 5 days. All lesions showing higher tracer uptake than normal liver were considered positive for HCC. We examined how tracer uptake was related to biological (serum α-fetoprotein levels) and pathological (differentiation status, peritumoral capsule and vascular invasion) prognostic markers of HCC, as well as clinical observations at 6 months (recurrence and death). Twenty-eight HCC, four cholangiocarcinomas and one adenoma were diagnosed. In the HCC patients, the sensitivity of {sup 11}C-choline, {sup 18}F-FDG and combined {sup 11}C-choline and {sup 18}F-FDG PET/CT for the detection of HCC was 75 %, 36 % and 93 %, respectively. Serum α-fetoprotein levels >200 ng/ml were more frequent among patients with {sup 18}F-FDG-positive lesions than those with {sup 18}F-FDG-negative lesions (p < 0.05). Early recurrence (n=2) or early death (n=5) occurred more frequently in patients with {sup 18}F-FDG-positive lesions than in those with {sup 18}F-FDG-negative lesions (p < 0.05). The combined use of {sup 11}C-choline and {sup 18}F-FDG PET/CT detected HCC with high sensitivity. This approach appears to be of potential prognostic value and may facilitate the selection of patients for surgical resection or liver transplantation. (orig.)

  3. Using Meta-Analysis to Inform the Design of Subsequent Studies of Diagnostic Test Accuracy

    Science.gov (United States)

    Hinchliffe, Sally R.; Crowther, Michael J.; Phillips, Robert S.; Sutton, Alex J.

    2013-01-01

    An individual diagnostic accuracy study rarely provides enough information to make conclusive recommendations about the accuracy of a diagnostic test; particularly when the study is small. Meta-analysis methods provide a way of combining information from multiple studies, reducing uncertainty in the result and hopefully providing substantial…

  4. Assessment of glucose metabolism and cellular proliferation in multiple myeloma: a first report on combined 18F-FDG and 18F-FLT PET/CT imaging.

    Science.gov (United States)

    Sachpekidis, C; Goldschmidt, H; Kopka, K; Kopp-Schneider, A; Dimitrakopoulou-Strauss, A

    2018-04-10

    Despite the significant upgrading in recent years of the role of 18 F-FDG PET/CT in multiple myeloma (MM) diagnostics, there is a still unmet need for myeloma-specific radiotracers. 3'-Deoxy-3'-[ 18 F]fluorothymidine ( 18 F-FLT) is the most studied cellular proliferation PET agent, considered a potentially new myeloma functional imaging tracer. The aim of this pilot study was to evaluate 18 F-FLT PET/CT in imaging of MM patients, in the context of its combined use with 18 F-FDG PET/CT. Eight patients, four suffering from symptomatic MM and four suffering from smoldering MM (SMM), were enrolled in the study. All patients underwent 18 F-FDG PET/CT and 18 F-FLT PET/CT imaging by means of static (whole body) and dynamic PET/CT of the lower abdomen and pelvis (dPET/CT) in two consecutive days. The evaluation of PET/CT studies was based on qualitative evaluation, semi-quantitative (SUV) calculation, and quantitative analysis based on two-tissue compartment modeling. 18 F-FDG PET/CT demonstrated focal, 18 F-FDG avid, MM-indicative bone marrow lesions in five patients. In contrary, 18 F-FLT PET/CT showed focal, 18 F-FLT avid, myeloma-indicative lesions in only two patients. In total, 48 18 F-FDG avid, focal, MM-indicative lesions were detected with 18 F-FDG PET/CT, while 17 18 F-FLT avid, focal, MM-indicative lesions were detected with 18 F-FLT PET/CT. The number of myeloma-indicative lesions was significantly higher for 18 F-FDG PET/CT than for 18 F-FLT PET/CT. A common finding was a mismatch of focally increased 18 F-FDG uptake and reduced 18 F-FLT uptake (lower than the surrounding bone marrow). Moreover, 18 F-FLT PET/CT was characterized by high background activity in the bone marrow compartment, further complicating the evaluation of bone marrow lesions. Semi-quantitative evaluation revealed that both SUV mean and SUV max were significantly higher for 18 F-FLT than for 18 F-FDG in both MM lesions and reference tissue. SUV values were higher in MM lesions than in

  5. Improving multiple-point-based a priori models for inverse problems by combining Sequential Simulation with the Frequency Matching Method

    DEFF Research Database (Denmark)

    Cordua, Knud Skou; Hansen, Thomas Mejer; Lange, Katrine

    In order to move beyond simplified covariance based a priori models, which are typically used for inverse problems, more complex multiple-point-based a priori models have to be considered. By means of marginal probability distributions ‘learned’ from a training image, sequential simulation has...... proven to be an efficient way of obtaining multiple realizations that honor the same multiple-point statistics as the training image. The frequency matching method provides an alternative way of formulating multiple-point-based a priori models. In this strategy the pattern frequency distributions (i.......e. marginals) of the training image and a subsurface model are matched in order to obtain a solution with the same multiple-point statistics as the training image. Sequential Gibbs sampling is a simulation strategy that provides an efficient way of applying sequential simulation based algorithms as a priori...

  6. Introduction of a New Diagnostic Method for Breast Cancer Based on Fine Needle Aspiration (FNA) Test Data and Combining Intelligent Systems

    Science.gov (United States)

    Fiuzy, Mohammad; Haddadnia, Javad; Mollania, Nasrin; Hashemian, Maryam; Hassanpour, Kazem

    2012-01-01

    Background Accurate Diagnosis of Breast Cancer is of prime importance. Fine Needle Aspiration test or "FNA”, which has been used for several years in Europe, is a simple, inexpensive, noninvasive and accurate technique for detecting breast cancer. Expending the suitable features of the Fine Needle Aspiration results is the most important diagnostic problem in early stages of breast cancer. In this study, we introduced a new algorithm that can detect breast cancer based on combining artificial intelligent system and Fine Needle Aspiration (FNA). Methods We studied the Features of Wisconsin Data Base Cancer which contained about 569 FNA test samples (212 patient samples (malignant) and 357 healthy samples (benign)). In this research, we combined Artificial Intelligence Approaches, such as Evolutionary Algorithm (EA) with Genetic Algorithm (GA), and also used Exact Classifier Systems (here by Fuzzy C-Means (FCM)) to separate malignant from benign samples. Furthermore, we examined artificial Neural Networks (NN) to identify the model and structure. This research proposed a new algorithm for an accurate diagnosis of breast cancer. Results According to Wisconsin Data Base Cancer (WDBC) data base, 62.75% of samples were benign, and 37.25% were malignant. After applying the proposed algorithm, we achieved high detection accuracy of about "96.579%” on 205 patients who were diagnosed as having breast cancer. It was found that the method had 93% sensitivity, 73% specialty, 65% positive predictive value, and 95% negative predictive value, respectively. If done by experts, Fine Needle Aspiration (FNA) can be a reliable replacement for open biopsy in palpable breast masses. Evaluation of FNA samples during aspiration can decrease insufficient samples. FNA can be the first line of diagnosis in women with breast masses, at least in deprived regions, and may increase health standards and clinical supervision of patients. Conclusion Such a smart, economical, non-invasive, rapid

  7. Combined effects of multiple large-scale hydraulic engineering on water stages in the middle Yangtze River

    Science.gov (United States)

    Han, Jianqiao; Sun, Zhaohua; Li, Yitian; Yang, Yunping

    2017-12-01

    Investigation of water stages influenced by human projects provides better understanding of riverine geomorphological processes and river management. Based on hydrological data collected over 60 years, an extreme stage-extreme discharge analysis and a specific-gauge analysis were performed to research the individual and combined effects of multiple engineering projects on a long-term time series of water stages in the middle Yangtze River. Conclusions are as follows. (1) In accordance with the operation years of the Jingjiang cutoff (CF), the Gezhouba Dam (GD), and the Three Gorges Dam (TGD), the time series (1955-2012) was divided into periods of P1 (1955-1970), P2 (1971-1980), P3 (1981-2002), and P4 (2003 - 2012). Water stage changes during P1-P2, P2-P3, and P3-P4 are varied because of the differences in the types and scales of these projects. The stage decreased at Shashi and increased at Luoshan owing to the operation of the CF. Additionally, after the GD was constructed, the low-flow stage decreased in the upstream reach of Chenglingji and increased in its downstream reach, whereas the flood stage merely decreased at Yichang. Moreover, the TGD resulted in an overall decrease in low-flow stages and a limited increase in flood stages because of the differential adjustments of river geometry and resistance between the low-flow channel and flood channel. (2) Although differences existed in the scouring mechanisms between streamwise erosion associated with dams and headward erosion associated with cutoffs, particular bed textures in the gravel reach led to a similar adjustment that stage reduction at Shashi was the greatest of all stations, which caused the flow slope and sediment transport capacity to decrease in the sandy reach. (3) These engineering projects caused changes in average low-flow and flood stages that varied between Yichang (- 1.58 and - 0.08 m respectively), Shashi (- 3.54 and - 0.12 m), and Luoshan (1.15 and 0.97 m) from P1 to P4. However, less

  8. Exploring multiple feature combination strategies with a recurrent neural network architecture for off-line handwriting recognition

    Science.gov (United States)

    Mioulet, L.; Bideault, G.; Chatelain, C.; Paquet, T.; Brunessaux, S.

    2015-01-01

    The BLSTM-CTC is a novel recurrent neural network architecture that has outperformed previous state of the art algorithms in tasks such as speech recognition or handwriting recognition. It has the ability to process long term dependencies in temporal signals in order to label unsegmented data. This paper describes different ways of combining features using a BLSTM-CTC architecture. Not only do we explore the low level combination (feature space combination) but we also explore high level combination (decoding combination) and mid-level (internal system representation combination). The results are compared on the RIMES word database. Our results show that the low level combination works best, thanks to the powerful data modeling of the LSTM neurons.

  9. Restaging of patients with lymphoma. Comparison of low dose CT (20 mAs) with contrast enhanced diagnostic CT in combined [18F]-FDG PET/CT

    International Nuclear Information System (INIS)

    Fougere, C. la; Pfluger, T.; Schneider, V.; Hacker, M.; Broeckel, N.; Bartenstein, P.; Tiling, R.; Morhard, D.; Hundt, W.; Becker, C.

    2008-01-01

    Aim: assessment of the clinical benefit of i.v. contrast enhanced diagnostic CT (CE-CT) compared to low dose CT with 20 mAs (LD-CT) without contrast medium in combined [ 18 F]-FDG PET/CT examinations in restaging of patients with lymphoma. Patients, methods: 45 patients with non-Hodgkin lymphoma (n = 35) and Hodgkin's disease (n = 10) were included into this study. PET, LD-CT and CE-CT were analyzed separately as well as side-by-side. Lymphoma involvement was evaluated separately for seven regions. Indeterminate diagnoses were accepted whenever there was a discrepancy between PET and CT findings. Results for combined reading were calculated by rating indeterminate diagnoses according the suggestions of either CT or PET. Each patient had a clinical follow-up evaluation for > 6 months. Results: region-based evaluation suggested a sensitivity/specificity of 66/93% for LD-CT, 87%/91% for CE-CT, 95%/96% for PET, 94%/99% for PET/LD-CT and 96%/99% for PET/CE-CT. The data for PET/CT were obtained by rating indeterminate results according to the suggestions of PET, which turned out to be superior to CT. Lymphoma staging was changed in two patients using PET/CE-CT as compared to PET/LD-CT. Conclusion: overall, there was no significant difference between PET/LD-CT and PET/CE-CT. However, PET/CE-CT yielded a more precise lesion delineation than PET/LD-CT. This was due to the improved image quality of CE-CT and might lead to a more accurate investigation of lymphoma. (orig.)

  10. Towards subsidized malaria rapid diagnostic tests. Lessons learned from programmes to subsidise artemisinin-based combination therapies in the private sector: a review.

    Science.gov (United States)

    Lussiana, Cristina

    2016-09-01

    The idea of a private sector subsidy programme of artemisinin-based combination therapies (ACTs) was first proposed in 2004. Since then, several countries around the world have hosted pilot projects or programmes on subsidized ACTs and/or the Affordable Medicines Facility-malaria programme (AMFm). Overall the private sector subsidy programmes of ACTs have been effective in increasing availability of ACTs in the private sector and driving down average prices but struggled to crowd out antimalarial monotherapies. The results obtained from this ambitious strategy should inform policy makers in the designing of future interventions aimed to control malaria morbidity and mortality. Among the interventions recently proposed, a subsidy of rapid diagnostic tests (RDTs) in the private sector has been recommended by governments and international donors to cope with over-treatment with ACTs and to delay the emergence of resistance to artemisinin. In order to improve the cost-effectiveness of co-paid RDTs, we should build on the lessons we learned from almost 10 years of private sector subsidy programmes of ACTs in malaria-endemic countries. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  11. The current and future state of companion diagnostics

    Science.gov (United States)

    Agarwal, Amit; Ressler, Dan; Snyder, Glenn

    2015-01-01

    Companion diagnostics are an indispensable part of personalized medicine and will likely continue to rapidly increase in number and application to disease areas. The first companion diagnostics were launched in the 1980s and in the face of significant initial skepticism from drug developers as to whether segmenting a drug’s market through a diagnostic was advisable. The commercial success of drugs such as Herceptin® (trastuzumab) and Gleevec® (imatinib), which both require testing with companion diagnostics before they can be prescribed, has moved the entire companion diagnostic field forward. From an initial start of a handful of oncology drugs with corresponding diagnostics, the field has expanded to include multiple therapeutic areas, and the number of combinations has grown by 12-fold. Based on drugs in clinical trials, the rapid growth will likely continue for the foreseeable future. This expansion of companion diagnostics will also have a global component as markets in Europe will evolve in a similar but not identical pattern as the US. One of the greatest challenges to future growth in companion diagnostics is aligning the incentives of all stakeholders. A major driver of growth will continue to be the economic incentives for drug developers to pair their products with diagnostics. However, diagnostic companies are caught between the conflicting demands of two major stakeholders, pharmaceutical companies on one hand and payers/providers on the other. Regulators are also becoming more demanding in aligning development time lines between drugs and diagnostics. In order to survive and prosper, diagnostic companies will need to think more broadly about companion diagnostics than the historical match between a specific drug and a single diagnostic. They will also have to continue the process of consolidation and global expansion that the industry has already begun. Despite these potential obstacles, companion diagnostics have become one of the hottest areas

  12. Radiation risk to the patient: a case study involving multiple diagnostic X ray exposures given over a period of 25 years

    International Nuclear Information System (INIS)

    Rainbow, A.J.; McMaster Univ., Hamilton, ON; Roginski, P.; McGeen, W.

    1992-01-01

    The cumulative somatic dose index (SDI) for a number of diagnostic X ray examinations was made for a 60 year old male. The history of diagnostic X ray exposure for this patient from 1957 to 1983 showed 29 diagnostic X ray examinations including more than 100 films and 15 minutes of fluoroscopy. The total cumulative SDI to this patient was 214 mGy (about 21 rad). More than half this dose, 142 mGy, was contributed from upper GI and barium enema examinations which used fluoroscopy, with 88 mGy from the fluoroscopy alone. Using the recently revised risk coefficient for fatal cancer following whole-body irradiation of adult workers recommended by the International Commission on Radiological Protection in 1990, the authors estimate a 0.9% cancer morality risk to this patient resulting from the 29 diagnostic X ray examinations. (author)

  13. Differentiation of orbital lymphoma and idiopathic orbital inflammatory pseudotumor: combined diagnostic value of conventional MRI and histogram analysis of ADC maps.

    Science.gov (United States)

    Ren, Jiliang; Yuan, Ying; Wu, Yingwei; Tao, Xiaofeng

    2018-05-02

    The overlap of morphological feature and mean ADC value restricted clinical application of MRI in the differential diagnosis of orbital lymphoma and idiopathic orbital inflammatory pseudotumor (IOIP). In this paper, we aimed to retrospectively evaluate the combined diagnostic value of conventional magnetic resonance imaging (MRI) and whole-tumor histogram analysis of apparent diffusion coefficient (ADC) maps in the differentiation of the two lesions. In total, 18 patients with orbital lymphoma and 22 patients with IOIP were included, who underwent both conventional MRI and diffusion weighted imaging before treatment. Conventional MRI features and histogram parameters derived from ADC maps, including mean ADC (ADC mean ), median ADC (ADC median ), skewness, kurtosis, 10th, 25th, 75th and 90th percentiles of ADC (ADC 10 , ADC 25 , ADC 75 , ADC 90 ) were evaluated and compared between orbital lymphoma and IOIP. Multivariate logistic regression analysis was used to identify the most valuable variables for discriminating. Differential model was built upon the selected variables and receiver operating characteristic (ROC) analysis was also performed to determine the differential ability of the model. Multivariate logistic regression showed ADC 10 (P = 0.023) and involvement of orbit preseptal space (P = 0.029) were the most promising indexes in the discrimination of orbital lymphoma and IOIP. The logistic model defined by ADC 10 and involvement of orbit preseptal space was built, which achieved an AUC of 0.939, with sensitivity of 77.30% and specificity of 94.40%. Conventional MRI feature of involvement of orbit preseptal space and ADC histogram parameter of ADC 10 are valuable in differential diagnosis of orbital lymphoma and IOIP.

  14. [Have Case Loads of Radical Surgery for Prostate Cancer Been Concentrated in Hospitals with Robotic Equipment ?--Analyses with Questionnaire Survey and Diagnostic Procedure Combination (DPC) Data].

    Science.gov (United States)

    Tsukamoto, Taiji; Tanaka, Shigeru

    2016-04-01

    We investigated whether installation of robot-assisted surgical equipment in hospitals resulted in concentration of the case loads of radical prostatectomy. We selected 11 areas with populations of around 1 million or more where there were one or more hospitals with robotic equipment and 4 or more without it. In addition, annual changes of case loads for prostatectomy over 4 years from 2010 to 2013 were clearly determined in these areas. The case loads were determined based on the results of a questionnaire survey for the hospitals with robots and on the Diagnostic Procedures Combination data provided by the Ministry of Health, Labor and Wealth for those without such equipment. The concentration of the case loads was principally defined as when hospitals with robots had more predominant proportion of cases than those without them in the comparison between case loads prior to instillation of robots (or in the initial year of the study) and those in the final years. The 11 selected areas included 44 hospitals with robots and 156 without them. Concentration of case loads was found in 5 areas. In 4 areas, installation of robots did not have a specific relation to the distribution pattern s of case loads in hospitals with or without the equipment. The remaining 2 areas tended to have a weak but not definite concentration of case loads. In the areas in which installation did not influence case loads the further analysis revealed that their case loads had already been concentrated in the initial year (2010) of the study. Although the current results were found in a single department of the hospital, robotic installation may result in concentration of prostatectomy case loads for such hospitals in some areas. The current results are intriguing when we consider the future roles of acute care hospitals and beds in our country where the number of aged patients having chronic diseases will increase. In conclusion, installation of robotic equipment may result in concentration

  15. Willingness-to-pay for a rapid malaria diagnostic test and artemisinin-based combination therapy from private drug shops in Mukono district, Uganda

    Science.gov (United States)

    Hansen, Kristian Schultz; Pedrazzoli, Debora; Mbonye, Anthony; Clarke, Sian; Cundill, Bonnie; Magnussen, Pascal; Yeung, Shunmay

    2013-01-01

    In Uganda, as in many parts of Africa, the majority of the population seek treatment for malaria in drug shops as their first point of care; however, parasitological diagnosis is not usually offered in these outlets. Rapid diagnostic tests (RDTs) for malaria have attracted interest in recent years as a tool to improve malaria diagnosis, since they have proved accurate and easy to perform with minimal training. Although RDTs could feasibly be performed by drug shop vendors, it is not known how much customers would be willing to pay for an RDT if offered in these settings. We conducted a contingent valuation survey among drug shop customers in Mukono District, Uganda. Exit interviews were undertaken with customers aged 15 years and above after leaving a drug shop having purchased an antimalarial and/or paracetamol. The bidding game technique was used to elicit the willingness-to-pay (WTP) for an RDT and a course of artemisinin-based combination therapy (ACT) with and without RDT confirmation. Factors associated with WTP were investigated using linear regression. The geometric mean WTP for an RDT was US$0.53, US$1.82 for a course of ACT and US$2.05 for a course of ACT after a positive RDT. Factors strongly associated with a higher WTP for these commodities included having a higher socio-economic status, no fever/malaria in the household in the past 2 weeks and if a malaria diagnosis had been obtained from a qualified health worker prior to visiting the drug shop. The findings further suggest that the WTP for an RDT and a course of ACT among drug shop customers is considerably lower than prevailing and estimated end-user prices for these commodities. Increasing the uptake of ACTs in drug shops and restricting the sale of ACTs to parasitologically confirmed malaria will therefore require additional measures. PMID:22589226

  16. Multiple methods of surgical treatment combined with primary IOL implantation on traumatic lens subluxation/dislocation in patients with secondary glaucoma

    OpenAIRE

    Wang, Rui; Bi, Chun-Chao; Lei, Chun-Ling; Sun, Wen-Tao; Wang, Shan-Shan; Dong, Xiao-Juan

    2014-01-01

    AIM:To describe clinical findings and complications from cases of traumatic lens subluxation/dislocation in patients with secondary glaucoma, and discuss the multiple treating methods of operation combined with primary intraocular lens (IOL) implantation.METHODS:Non-comparative retrospective observational case series. Participants:30 cases (30 eyes) of lens subluxation/dislocation in patients with secondary glaucoma were investigated which accepted the surgical treatment by author in the Opht...

  17. Diagnostic value of combined esophageal multi-channel intraluminal impedance and pH monitoring for gastroesophageal reflux in critically ill patients

    Directory of Open Access Journals (Sweden)

    Yi JIN

    2016-06-01

    Full Text Available Objective  To compare the diagnostic value of using 24-hour combined esophageal multichannel intraluminal impedance and pH monitoring (MII-pH in the diagnosis of gastro-esophageal reflux (GER and pH monitoring alone in critically ill patients. Methods  A prospective observational study was performed including 116 critically ill adult patients admitted to ICU of Peking Haidian Hospital from Jul. 2013 to Dec. 2014. All the patients underwent 24-hour combined MⅡ-pH monitoring. GER episodes were recorded and its pH was recorded (acidic, weakly acidic and weakly alkaline and its composition was recorded (liquid, mixed and gas reflux. The results of the MⅡ-pH and the pH were monitored and compared. The demographic characteristics and clinical information were recorded. Results  MⅡ-pH was monitored for 5024 episodes of GER in 115 of 116(99.1% patients, with a mean of 43.28±3.96 episodes per patient (median, 34 episodes; range, 0-196 episodes. The pH monitoring detected 1868 episodes (100% acid in only 54 of 116(46.6% patients, with a mean of 7.66±1.65 episodes per patient (median, 0 episodes; range, 0-81 episodes. The number of episode of all reflux and liquid reflux diagnosed by pH monitoring alone was less than those diagnosed by MⅡ-pH monitoring (P=0.000, and there was no correlation in the episodes number of all reflux and liquid reflux between the two techniques (r=0.119, 0.231. Only a moderate correlation was found in the number of episodes of acidic reflux between the two techniques (r=0.656. Conclusion  MⅡ-pH monitoring is more sensitive than pH monitoring alone for establishing the diagnosis of GER. DOI: 10.11855/j.issn.0577-7402.2016.05.12

  18. Improved diagnostic accuracy of Alzheimer's disease by combining regional cortical thickness and default mode network functional connectivity: Validated in the Alzheimer's disease neuroimaging initiative set

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ji Eun; Park, Bum Woo; Kim, Sang Joon; Kim, Ho Sung; Choi, Choong Gon; Jung, Seung Jung; Oh, Joo Young; Shim, Woo Hyun [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Lee, Jae Hong; Roh, Jee Hoon [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2017-11-15

    To identify potential imaging biomarkers of Alzheimer's disease by combining brain cortical thickness (CThk) and functional connectivity and to validate this model's diagnostic accuracy in a validation set. Data from 98 subjects was retrospectively reviewed, including a study set (n = 63) and a validation set from the Alzheimer's Disease Neuroimaging Initiative (n = 35). From each subject, data for CThk and functional connectivity of the default mode network was extracted from structural T1-weighted and resting-state functional magnetic resonance imaging. Cortical regions with significant differences between patients and healthy controls in the correlation of CThk and functional connectivity were identified in the study set. The diagnostic accuracy of functional connectivity measures combined with CThk in the identified regions was evaluated against that in the medial temporal lobes using the validation set and application of a support vector machine. Group-wise differences in the correlation of CThk and default mode network functional connectivity were identified in the superior temporal (p < 0.001) and supramarginal gyrus (p = 0.007) of the left cerebral hemisphere. Default mode network functional connectivity combined with the CThk of those two regions were more accurate than that combined with the CThk of both medial temporal lobes (91.7% vs. 75%). Combining functional information with CThk of the superior temporal and supramarginal gyri in the left cerebral hemisphere improves diagnostic accuracy, making it a potential imaging biomarker for Alzheimer's disease.

  19. Diagnosis of asthma: diagnostic testing.

    Science.gov (United States)

    Brigham, Emily P; West, Natalie E

    2015-09-01

    Asthma is a heterogeneous disease, encompassing both atopic and non-atopic phenotypes. Diagnosis of asthma is based on the combined presence of typical symptoms and objective tests of lung function. Objective diagnostic testing consists of 2 components: (1) demonstration of airway obstruction, and (2) documentation of variability in degree of obstruction. A review of current guidelines and literature was performed regarding diagnostic testing for asthma. Spirometry with bronchodilator reversibility testing remains the mainstay of asthma diagnostic testing for children and adults. Repetition of the test over several time points may be necessary to confirm airway obstruction and variability thereof. Repeated peak flow measurement is relatively simple to implement in a clinical and home setting. Bronchial challenge testing is reserved for patients in whom the aforementioned testing has been unrevealing but clinical suspicion remains, though is associated with low specificity. Demonstration of eosinophilic inflammation, via fractional exhaled nitric oxide measurement, or atopy, may be supportive of atopic asthma, though diagnostic utility is limited particularly in nonatopic asthma. All efforts should be made to confirm the diagnosis of asthma in those who are being presumptively treated but have not had objective measurements of variability in the degree of obstruction. Multiple testing modalities are available for objective confirmation of airway obstruction and variability thereof, consistent with a diagnosis of asthma in the appropriate clinical context. Providers should be aware that both these characteristics may be present in other disease states, and may not be specific to a diagnosis of asthma. © 2015 ARS-AAOA, LLC.

  20. Single-electron multiplication statistics as a combination of Poissonian pulse height distributions using constraint regression methods

    International Nuclear Information System (INIS)

    Ballini, J.-P.; Cazes, P.; Turpin, P.-Y.

    1976-01-01

    Analysing the histogram of anode pulse amplitudes allows a discussion of the hypothesis that has been proposed to account for the statistical processes of secondary multiplication in a photomultiplier. In an earlier work, good agreement was obtained between experimental and reconstructed spectra, assuming a first dynode distribution including two Poisson distributions of distinct mean values. This first approximation led to a search for a method which could give the weights of several Poisson distributions of distinct mean values. Three methods have been briefly exposed: classical linear regression, constraint regression (d'Esopo's method), and regression on variables subject to error. The use of these methods gives an approach of the frequency function which represents the dispersion of the punctual mean gain around the whole first dynode mean gain value. Comparison between this function and the one employed in Polya distribution allows the statement that the latter is inadequate to describe the statistical process of secondary multiplication. Numerous spectra obtained with two kinds of photomultiplier working under different physical conditions have been analysed. Then two points are discussed: - Does the frequency function represent the dynode structure and the interdynode collection process. - Is the model (the multiplication process of all dynodes but the first one, is Poissonian) valid whatever the photomultiplier and the utilization conditions. (Auth.)

  1. Discrimination of Medicine Radix Astragali from Different Geographic Origins Using Multiple Spectroscopies Combined with Data Fusion Methods

    Science.gov (United States)

    Wang, Hai-Yan; Song, Chao; Sha, Min; Liu, Jun; Li, Li-Ping; Zhang, Zheng-Yong

    2018-05-01

    Raman spectra and ultraviolet-visible absorption spectra of four different geographic origins of Radix Astragali were collected. These data were analyzed using kernel principal component analysis combined with sparse representation classification. The results showed that the recognition rate reached 70.44% using Raman spectra for data input and 90.34% using ultraviolet-visible absorption spectra for data input. A new fusion method based on Raman combined with ultraviolet-visible data was investigated and the recognition rate was increased to 96.43%. The experimental results suggested that the proposed data fusion method effectively improved the utilization rate of the original data.

  2. A new method for incoherent combining of far-field laser beams based on multiple faculae recognition

    Science.gov (United States)

    Ye, Demao; Li, Sichao; Yan, Zhihui; Zhang, Zenan; Liu, Yuan

    2018-03-01

    Compared to coherent beam combining, incoherent beam combining can complete the output of high power laser beam with high efficiency, simple structure, low cost and high thermal damage resistance, and it is easy to realize in engineering. Higher target power is achieved by incoherent beam combination which using technology of multi-channel optical path correction. However, each channel forms a spot in the far field respectively, which cannot form higher laser power density with low overlap ratio of faculae. In order to improve the combat effectiveness of the system, it is necessary to overlap different faculae that improve the target energy density. Hence, a novel method for incoherent combining of far-field laser beams is present. The method compromises piezoelectric ceramic technology and evaluation algorithm of faculae coincidence degree which based on high precision multi-channel optical path correction. The results show that the faculae recognition algorithm is low-latency(less than 10ms), which can meet the needs of practical engineering. Furthermore, the real time focusing ability of far field faculae is improved which was beneficial to the engineering of high-energy laser weapon or other laser jamming systems.

  3. Multiple-height microstructure fabricated by deep reactive ion etching and soft resist masks combined with UV curing

    International Nuclear Information System (INIS)

    Sato, R; Sawada, T; Kumagai, S; Sasaki, M

    2014-01-01

    Multiple-height microstructures are realized by deep reactive ion etching and UV-cured photoresist used in the embedded mask process. Although the UV-cured photoresist is a soft mask, its material property becomes stable against resist thinner and UV exposure. A layered resist pattern can be realized by stacking normal photoresist on the UV-cured photoresist. The normal photoresist can be selectively removed by the flush exposure and developing after the first Si etching. This technique is applied to two MEMS devices

  4. [Treatment of Chemotherapy Related Leukocytopenia by Oral Administration of Multiple Leucogenic Drugs Combined with G-CSF: an Experimental Study].

    Science.gov (United States)

    Zhang, Xi-ping; Zhang, Xiang; Yang, Hong-jian; Zou, De-hong; He, Xiang-ming; Yu, Xing-fei; Li, Yong-feng

    2015-07-01

    To evaluate efficacies of three commonly used oral drugs including Berbamine Hydrochloride Tablet (B), Qijiao Shengbai Capsule (Q), and Leucogen Tablet (L) (by single drug, two drugs or three drugs) combined with granulocyte colony-stimulating factor (G-CSF) for treat ment of chemotherapy related leukocytopenia in mice. Totally 156 Kunming male mice were divided into the normal control group (A, n=24), the model group (B, n=24), the G-CSF group (C, n =24), the G-CSF+Q group (D, n=12), G-CSF+ B (E, n=12), the G-CSF+L group (F, n=12), the G-CSF + Q + B group (G, n=12), the G-CSF + Q + L group (H, n=12), the G-CSF + L + B group (I, n=12), and the G-CSF + L + Q + B (J, n=12). Mouse models of chemotherapy related leukocytopenia were established by intraperitoneal injection of cyclophosphamide (CTX). A G-CSF group was set up as a positive control. Mice were treated by a single oral drug, a single oral drug combined with G-CSF, and two or three drugs combined with G-CSF respectively, and the death rate calculated. Hemocytes [such as white blood cells (WBC) and its classification, red blood cells (RBC), platelet (PLT), hemoglobin (Hb)] were calculated by hematology analyzer. Mice were anatomized and important organs weighed. Organ indices were calculated. There was no statistical difference in the mortality rate among all groups (P > 0.05). Compared with Group B, WBC was elevated in all other groups (P drug B and L (P chemotherapy related leukopenia or decreased three blood series was to administrate three commonly oral drugs combined with G-CSF. Authors speculated that G-CSF and Q might have a certain effect on CTX induced immune inhibition.

  5. A Review of the State-of-the-Art on Combining Multiple NDT Techniques in Terms of Precise Fault Detection

    OpenAIRE

    Ashish Khaira; Ravi Kumar Dwivedi

    2017-01-01

    The present industrial scenario demands optimum quality, feasible processing time and enhanced machine availability to cope-up with continuously increasing customer expectations. To achieve this target, it is mandatory to ensure the optimum performance and higher availability of machinery. Therefore, the present work begins with, review of the research work of different researchers, which includes the applied combinations from year 2000-2016 proceed with discussion on the parameters being che...

  6. Body-force-driven multiplicity and stability of combined free and forced convection in rotating curved ducts: Coriolis force

    Science.gov (United States)

    Yang, T.; Wang, L.

    A numerical study is made on the fully developed bifurcation structure and stability of forced convection in a rotating curved duct of square cross-section. Solution structure is determined as variation of a parameter that indicates the effect of rotation (Coriolis-force-driven multiplicity). Three solutions for the flows in a stationary curved duct obtained in the work of Yang and Wang [1] are used as initial solutions of continuation calculations to unfold the solution branches. Twenty-one solution branches are found comparing with five obtained by Selmi and Nandakumar [2]. Dynamic responses of the multiple solutions to finite random disturbances are examined by the direct transient computation. Results show that characteristics of physically realizable fully developed flows changes significantly with variation of effect of rotation. Fourteen sub-ranges are identified according to characteristics of physically realizable solutions. As rotation effect changes, possible physically realizable fully-developed flows can be stable steady 2-cell state, stable multi-cell state, temporal periodic oscillation between symmetric/asymmetric 2-cell/4-cell flows, temporal oscillation with intermittency, temporal chaotic oscillation and temporal oscillation with pseudo intermittency. Among these possible physically realizable fully developed flows, stable multi-cell state and stable steady 2-cell state exist as dual stable. And oscillation with pseudo intermittency is a new phenomenon. In addition to the temporal oscillation with intermittency, sudden shift from stationary stable solution to temporal chaotic oscillation is identified to be another way of onset of chaos.

  7. Multiple Primary Tumors

    African Journals Online (AJOL)

    2017-12-05

    Dec 5, 2017 ... Multiple primary tumors occur in clinical practice causing diagnostic dilemma. It is not very .... was estrogen receptor negative, progesterone receptor negative, and ... cervical, ovarian, and urinary bladder cancers. Multiple.

  8. Therapeutic effects of visual standard channel combined with F4.8 visual puncture super-mini percutaneous nephrolithotomy on multiple renal calculi.

    Science.gov (United States)

    Cui, Zhenyu; Gao, Yanjun; Yang, Wenzeng; Zhao, Chunli; Ma, Tao; Shi, Xiaoqiang

    2018-01-01

    To evaluate the therapeutic effects of visual standard channel combined with F4.8 visual puncture super-mini percutaneous nephrolithotomy (SMP) on multiple renal calculi. The clinical data of 46 patients with multiple renal calculi treated in Affiliated Hospital of Hebei University from October 2015 to September 2016 were retrospectively analyzed. There were 28 males and 18 females aged from 25 to 65 years old, with an average of 42.6. The stone diameters were 3.0-5.2 cm, (4.3 ± 0.8) cm on average. F4.8 visual puncture-assisted balloon expansion was used to establish a standard channel. After visible stones were removed through nephroscopy combined with ultrasound lithotripsy, the stones of other parts were treated through F4.8 visual puncture SMP with holmium laser. Indices such as the total time of channel establishment, surgical time, decreased value of hemoglobin, phase-I stone clearance rate and surgical complications were summarized. Single standard channel was successfully established in all cases with the assistance of F4.8 visual puncture, of whom 24 were combined with a single microchannel, 16 were combined with double microchannels, and six were combined with three microchannels. All patients were placed with nephrostomy tube which was not placed in the microchannels. Both F5 double J tubes were placed after surgery. The time for establishing a standard channel through F4.8 visual puncture was (6.8 ± 1.8) min, and that for establishing a single F4.8 visual puncture microchannel was (4.5 ± 0.9) min. The surgical time was (92 ± 15) min. The phase-I stone clearance rate was 91.3% (42/46), and the decreased value of hemoglobin was (12.21 ± 2.5) g/L. There were 8 cases of postoperative fever which was relieved after anti-inflammatory treatment. Four cases had 0.5-0.8 cm of stone residue in the lower calyx, and all stones were discharged one month after surgery by in vitro shock wave lithotripsy combined with position nephrolithotomy, without stone

  9. Characterization of forsythoside A metabolites in rats by a combination of UHPLC-LTQ-Orbitrap mass spectrometer with multiple data processing techniques.

    Science.gov (United States)

    Wang, Fei; Cao, Guang-Shang; Li, Yun; Xu, Lu-Lu; Wang, Zhi-Bin; Liu, Ying; Lu, Jian-Qiu; Zhang, Jia-Yu

    2018-05-01

    Forsythoside A (FTA), the main active constituent isolated from Fructus Forsythiae, has various biological functions including anti-oxidant, anti-viral and anti-microbial activities. However, while research on FTA has been mainly focused on the treatment of diseases on a material basis, FTA metabolites in vivo have not been comprehensively evaluated. Here, a rapid and sensitive method using a UHPLC-LTQ-Orbitrap mass spectrometer with multiple data processing techniques including high-resolution extracted ion chromatograms, multiple mass defect filters and diagnostic product ions was developed for the screening and identification of FTA metabolites in rats. As the result, a total of 43 metabolites were identified in biological samples including 42 metabolites in urine, 22 metabolites in plasma and 15 metabolites in feces. These results demonstrated that FTA underwent a series of in vivo metabolic reactions including methylation, dimethylation, sulfation, glucuronidation, diglucuronidation, cysteine conjugation and their composite reactions. The research enhanced our understanding of FTA metabolism and built a foundation for further toxicity and safety studies. Copyright © 2017 John Wiley & Sons, Ltd.

  10. Diagnostic utility of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) and its combination with the Addenbrooke's Cognitive Examination-Revised (ACE-R) in a memory clinic-based population.

    Science.gov (United States)

    Hancock, P; Larner, A J

    2009-06-01

    The study aimed to assess the clinical utility of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) in patients referred to memory clinics, alone and in combination with the Addenbrooke's Cognitive Examination-Revised (ACE-R) and the Mini-mental State Examination (MMSE). This pragmatic prospective study was based on consecutive referrals attending with an informant (n = 144) to two memory clinics over a 12-month period. Patients were diagnosed using standard clinical diagnostic criteria for dementia (DSM-IV) as gold standard (dementia prevalence = 59%). The IQCODE was administered to informants, and the ACE-R and/or MMSE to most patients. The IQCODE proved acceptable to informants, and was quick and easy to use. Using traditional parameters of diagnostic utility (sensitivity, specificity, positive predictive value, likelihood ratios), the performance of the IQCODE at optimal test accuracy was highly sensitive (0.86) for the diagnosis of dementia but specificity was poor (0.39) with suboptimal positive predictive value (0.67) and small or unimportant likelihood ratios. Overall diagnostic accuracy based on area under the receiver operating characteristic (ROC) curve was 0.71. Combining the IQCODE with either ACE-R or MMSE greatly improved accuracy, specificity and positive predictive value when the tests were used in series, but not when used in parallel. In a memory clinic based population, the IQCODE proved sensitive for the diagnosis of dementia but overall diagnostic accuracy was suboptimal. Combining the IQCODE in series with the ACE-R or MMSE greatly improved diagnostic utility.

  11. Development and Application of a Two-Tier Multiple-Choice Diagnostic Test for High School Students' Understanding of Cell Division and Reproduction

    Science.gov (United States)

    Sesli, Ertugrul; Kara, Yilmaz

    2012-01-01

    This study involved the development and application of a two-tier diagnostic test for measuring students' understanding of cell division and reproduction. The instrument development procedure had three general steps: defining the content boundaries of the test, collecting information on students' misconceptions, and instrument development.…

  12. Physical and Cognitive Functioning After 3 Years Can Be Predicted Using Information From the Diagnostic Process in Recently Diagnosed Multiple Sclerosis

    NARCIS (Netherlands)

    de Groot, V.; Beckerman, H.; Uitdehaag, B.M.J.; Hintzen, R.Q.; Minneboo, A.; Heymans, M.W.; Lankhorst, G.J.; Polman, C.H.; Bouter, L.M.

    2009-01-01

    de Groot V, Beckerman H, Uitdehaag BM, Hintzen RQ, Minneboo A, Heymans MW, Lankhorst GJ, Polman CH, Bouter LM, on behalf of the Functional Prognostication and Disability (FuPro) Study Group. Physical and cognitive functioning after 3 years can be predicted using information from the diagnostic

  13. The combination of energy-dependent internal adaptation mechanisms and external factors enables Listeria monocytogenes to express a strong starvation survival response during multiple-nutrient starvation.

    Science.gov (United States)

    Lungu, Bwalya; Saldivar, Joshua C; Story, Robert; Ricke, Steven C; Johnson, Michael G

    2010-05-01

    The goal of this study was to characterize the starvation survival response (SSR) of a wild-type Listeria monocytogenes 10403S and an isogenic DeltasigB mutant strain during multiple-nutrient starvation conditions over 28 days. This study examined the effects of inhibitors of protein synthesis, the proton motive force, substrate level phosphorylation, and oxidative phosphorylation on the SSR of L. monocytogenes 10403S and a DeltasigB mutant during multiple-nutrient starvation. The effects of starvation buffer changes on viability were also examined. During multiple-nutrient starvation, both strains expressed a strong SSR, suggesting that L. monocytogenes possesses SigB-independent mechanism(s) for survival during multiple-nutrient starvation. Neither strain was able to express an SSR following starvation buffer changes, indicating that the nutrients/factors present in the starvation buffer could be a source of energy for cell maintenance and survival. Neither the wild-type nor the DeltasigB mutant strain was able to elicit an SSR when exposed to the protein synthesis inhibitor chloramphenicol within the first 4 h of starvation. However, both strains expressed an SSR when exposed to chloramphenicol after 6 h or more of starvation, suggesting that the majority of proteins required to elicit an effective SSR in L. monocytogenes are likely produced somewhere between 4 and 6 h of starvation. The varying SSRs of both strains to the different metabolic inhibitors under aerobic or anaerobic conditions suggested that (1) energy derived from the proton motive force is important for an effective SSR, (2) L. monocytogenes utilizes an anaerobic electron transport during multiple-nutrient starvation conditions, and (3) the glycolytic pathway is an important energy source during multiple-nutrient starvation when oxygen is available, and less important under anaerobic conditions. Collectively, the data suggest that the combination of energy-dependent internal adaptation mechanisms

  14. Patterns of relapse and outcome of elderly multiple myeloma patients treated as front-line therapy with novel agents combinations

    Directory of Open Access Journals (Sweden)

    Aurelio Lopez

    2015-01-01

    Full Text Available We report the characteristics of relapse, treatment response, and outcomes of 145 elderly patients with multiple myeloma in first relapse after front-line treatment with VMP or VTP. Reappearance of CRAB symptoms (113 patients and more aggressive forms of disease (32 patients were the most common patterns of relapse. After second-line therapy, 75 (51.7% patients achieved at partial response and 16 (11% complete response (CR. Overall survival was longer among patients receiving VMP as front-line induction (21.4 vs. 14.4 months, P=0.037, in patients achieving CR (28.3 vs. 14.8 months; P=0.04, and in patients without aggressive relapse (28.6 vs. 7.6 months; P=0.0007.

  15. Enhanced therapeutic effect of multiple injections of HSV-TK + GCV gene therapy in combination with ionizing radiation in a mouse mammary tumor model

    International Nuclear Information System (INIS)

    Vlachaki, Maria T.; Chhikara, Madhu; Aguilar, Laura; Zhu Xiaohong; Chiu, Kam J.; Woo, Shiao; Teh, Bin S.; Thompson, Timothy C.; Butler, E. Brian; Aguilar-Cordova, Estuardo

    2001-01-01

    Purpose: Standard therapies for breast cancer lack tumor specificity and have significant risk for recurrence and toxicities. Herpes simplex virus-thymidine kinase (HSV-tk) gene therapy combined with radiation therapy (XRT) may be effective because of complementary mechanisms and distinct toxicity profiles. HSV-tk gene therapy followed by systemic administration of ganciclovir (GCV) enhances radiation-induced DNA damage by generating high local concentrations of phosphorylated nucleotide analogs that increase radiation-induced DNA breaks and interfere with DNA repair mechanisms. In addition, radiation-induced membrane damage enhances the 'bystander effect' by facilitating transfer of nucleotide analogs to neighboring nontransduced cells and by promoting local and systemic immune responses. This study assesses the effect of single and multiple courses of HSV-tk gene therapy in combination with ionizing radiation in a mouse mammary cancer model. Methods and Materials: Mouse mammary TM40D tumors transplanted s.c. in syngeneic immunocompetent BALB-c mice were treated with either adenoviral-mediated HSV-tk gene therapy or local radiation or the combination of gene and radiation therapy. A vector consisting of a replication-deficient (E1-deleted) adenovirus type 5 was injected intratumorally to administer the HSV-tk gene, and GCV was initiated 24 h later for a total of 6 days. Radiation was given as a single dose of 5 Gy 48 h after the HSV-tk injection. A metastatic model was developed by tail vein injection of TM40D cells on the same day that the s.c. tumors were established. Systemic antitumor effect was evaluated by counting the number of lung nodules after treating only the primary tumors with gene therapy, radiation, or the combination of gene and radiation therapy. To assess the therapeutic efficacy of multiple courses of this combinatorial approach, one, two, and three courses of HSV-tk + GCV gene therapy, in combination with radiation, were compared to HSV-tk or

  16. Narrowing of the Diagnostic Gap of Acute Gastroenteritis in Children 0-6 Years of Age Using a Combination of Classical and Molecular Techniques, Delivers Challenges in Syndromic Approach Diagnostics.

    Science.gov (United States)

    Steyer, Andrej; Jevšnik, Monika; Petrovec, Miroslav; Pokorn, Marko; Grosek, Štefan; Fratnik Steyer, Adela; Šoba, Barbara; Uršič, Tina; Cerar Kišek, Tjaša; Kolenc, Marko; Trkov, Marija; Šparl, Petra; Duraisamy, Raja; Lipkin, W Ian; Terzić, Sara; Kolnik, Mojca; Mrvič, Tatjana; Kapoor, Amit; Strle, Franc

    2016-09-01

    Twenty-five percent to 50% of acute gastroenteritis (AGE) cases remain etiologically undiagnosed. Our main aim was to determine the most appropriate list of enteric pathogens to be included in the daily diagnostics scheme of AGE, ensuring the lowest possible diagnostic gap. Two hundred ninety seven children ≤6 years of age, admitted to hospital in Slovenia, October 2011 to October 2012, with AGE, and 88 ≤6 years old healthy children were included in the study. A broad spectrum of enteric pathogens was targeted with molecular methods, including 8 viruses, 6 bacteria and 2 parasites. At least one enteric pathogen was detected in 91.2% of cases with AGE and 27.3% of controls. Viruses were the most prevalent (82.5% and 15.9%), followed by bacteria (27.3% and 10.2%) and parasites (3.0% and 1.1%) in cases and controls, respectively. A high proportion (41.8%) of mixed infections was observed in the cases. For cases with undetermined etiology (8.8%), stool samples were analyzed with next generation sequencing, and a potential viral pathogen was detected in 17 additional samples (5.8%). Our study suggests that tests for rotaviruses, noroviruses genogroup II, adenoviruses 40/41, astroviruses, Campylobacter spp. and Salmonella sp. should be included in the initial diagnostic algorithm, which revealed the etiology in 83.5% of children tested. The use of molecular methods in diagnostics of gastroenteritis is preferable because of their high sensitivity, specificity, fast performance and the possibility of establishing the concentration of the target. The latter may be valuable for assessing the clinical significance of the detected enteric, particularly viral pathogens.

  17. Formation of multiple stoichiometric phases in binary systems by combined bulk and grain boundary diffusion: Experiments and model

    International Nuclear Information System (INIS)

    Svoboda, J.; Fischer, F.D.; Schillinger, W.

    2013-01-01

    The thermodynamic extremal principle has been used by the authors to treat the evolution of binary and multicomponent systems under the assumption that all phases are nearly stoichiometric. Up to now only bulk diffusion has been taken into account. The concept is now extended to combined bulk and grain boundary diffusion possible in each newly formed phase. The grains are approximated by cylinders allowing interface diffusion along the top and bottom of the grains and grain boundary diffusion along the mantle with different interface/grain boundary diffusion coefficients. A consistent analysis yields an effective diffusion coefficient taking into account the combined interface/grain boundary and bulk diffusion of each individual component. The current concept is applied to the Cu–Sn couple which has been studied by a number of researchers. The results of simulations are compared with experiments at 200 °C on solid systems reported in the literature as well as with our experiments at 250 °C with liquid Sn.

  18. Semi-quantitative prediction of a multiple API solid dosage form with a combination of vibrational spectroscopy methods.

    Science.gov (United States)

    Hertrampf, A; Sousa, R M; Menezes, J C; Herdling, T

    2016-05-30

    Quality control (QC) in the pharmaceutical industry is a key activity in ensuring medicines have the required quality, safety and efficacy for their intended use. QC departments at pharmaceutical companies are responsible for all release testing of final products but also all incoming raw materials. Near-infrared spectroscopy (NIRS) and Raman spectroscopy are important techniques for fast and accurate identification and qualification of pharmaceutical samples. Tablets containing two different active pharmaceutical ingredients (API) [bisoprolol, hydrochlorothiazide] in different commercially available dosages were analysed using Raman- and NIR Spectroscopy. The goal was to define multivariate models based on each vibrational spectroscopy to discriminate between different dosages (identity) and predict their dosage (semi-quantitative). Furthermore the combination of spectroscopic techniques was investigated. Therefore, two different multiblock techniques based on PLS have been applied: multiblock PLS (MB-PLS) and sequential-orthogonalised PLS (SO-PLS). NIRS showed better results compared to Raman spectroscopy for both identification and quantitation. The multiblock techniques investigated showed that each spectroscopy contains information not present or captured with the other spectroscopic technique, thus demonstrating that there is a potential benefit in their combined use for both identification and quantitation purposes. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. Improvement of diagnostic efficiency in distinguishing the benign and malignant thyroid nodules via conventional ultrasound combined with ultrasound contrast and elastography.

    Science.gov (United States)

    Liu, Mei-Juan; Men, Yan-Ming; Zhang, Yong-Lin; Zhang, Yu-Xi; Liu, Hao

    2017-07-01

    We aimed to evaluate the diagnostic values of conventional ultrasound (US), ultrasound contrast (UC) and ultrasound elastography (UE) in distinguishing the benign and malignant thyroid nodules. A total of 100 patients with thyroid nodules receiving operative treatment were selected; they underwent the conventional US, UE and UC examinations before operation, respectively. The nodules received pathological examination after operation to distinguish benign from malignant lesions. The sensitivity, specificity and diagnostic accordance rate of each diagnostic method was evaluated by receiver operating characteristic (ROC) curve, and the area under the curve (AUC) of ROC was calculated. The manifestations of malignant thyroid nodules in conventional US examination were mostly the hypoecho, heterogeneous echo, irregular shape, unclear boundary, aspect ratio benign and malignant nodules in 2, 3 and 4 points were statistically significant (Pbenign and malignant thyroid nodules.

  20. Clinical significance of combined detection of multiple serum antibodies (AsAb, EmAb, AcAb, AoAb, ToxAb) in infertile women

    International Nuclear Information System (INIS)

    Chen Jing; Jiang Li; Lu Ya

    2005-01-01

    Objective: To determine the clinical significance of combined detection of multiple serum antibodies in infertile women. Methods; Serum multiple antibodies were examined in 120 infertile women, including 88 failed to get pregnancy and 32 with repeated spontaneous abortion. The antibodies tested were: (1) anti-sperm antibody (AsAb) (2) endometrial antibody (EmAb) (3) anti-cardiophospholipid antibody (AcAb) (4) Anti-ovarian antibody (AoAb) and Toxoplasmosis antibody (ToxAb). Results: In 48 of the infertile women, none of the five antibodies were positive (40% of 120). The rest were: one antibody positive--38/120 or 31.6%; two antibodies positive--31/120 or 25.83%, three and four antibodies positive--4/120 or 3.33%. None of the women were positive with all five antibodies. Conclusion: Immune factor was the chief cause of infertility in women. (authors)

  1. Combined Orthodontic-surgical Treatment for Skeletal Class III Malocclusion with Multiple Impacted Permanent and Supernumerary Teeth: Case Report.

    Science.gov (United States)

    Xue, Dai Juan And Feng

    2014-01-01

    In this report we describe a combined orthodontic and surgical treatment for a 14-year-old boy with severe skeletal class III deformity and dental problem. His upper posterior primary teeth in the left side were over-retained and 6 maxillary teeth (bilateral central incisors and canines, left first and second premolars) were impacted, together with 5 supernumerary teeth in both arches. The treatment protocol involved extraction of all the supernumerary and deciduous teeth, surgical exposure and orthodontic traction of the impacted teeth, a bimaxillary orthognathic approach including Lefort I osteotomy. Bilateral sagittal split ramus osteotomy (BSSRO) and genioplasty was performed to correct skeletal problem. After treatment, all of the impacted teeth were brought to proper alignment in the maxillary arch. A satisfied profile and good posterior occlusion was achieved. Treatment mechanics and consideration during different stages are discussed.

  2. Subcutaneous Administration of Bortezomib in Combination with Thalidomide and Dexamethasone for Treatment of Newly Diagnosed Multiple Myeloma Patients

    Directory of Open Access Journals (Sweden)

    Shenghao Wu

    2015-01-01

    Full Text Available Objective. To investigate the efficacy and safety of the treatment of the newly diagnosed multiple myeloma (MM patients with the therapy of subcutaneous (subQ administration of bortezomib and dexamethasone plus thalidomide (VTD regimen. Methods. A total of 60 newly diagnosed MM patients were analyzed. 30 patients received improved VTD regimen (improved VTD group with the subQ injection of bortezomib and the other 30 patients received conventional VTD regimen (VTD group.The efficacy and safety of two groups were analyzed retrospectively. Results. The overall remission (OR after eight cycles of treatment was 73.3% in the VTD group and 76.7% in the improved VTD group (P>0.05. No significant differences in time to 1-year estimate of overall survival (72% versus 75%, P=0.848 and progression-free survival (median 22 months versus 25 months; P=0.725 between two groups. The main toxicities related to therapy were leukopenia, neutropenia, thrombocytopenia, asthenia, fatigue, and renal and urinary disorders. Grade 3 and higher adverse events were significantly less common in the improved VTD group (50% than VTD group (80%, P=0.015. Conclusions. The improved VTD regimen by changing bortezomib from intravenous administration to subcutaneous injection has noninferior efficacy to standard VTD regimen, with an improved safety profile and reduced adverse events.

  3. Stimulation of Toll-like receptor-1/2 combined with Velcade increases cytotoxicity to human multiple myeloma cells

    International Nuclear Information System (INIS)

    Abdi, J; Mutis, T; Garssen, J; Redegeld, F

    2013-01-01

    An increasing body of evidence supports the important role of adhesion to bone marrow microenvironment components for survival and drug resistance of multiple myeloma (MM) cells. Previous studies suggested that stimulation of Toll-like receptors by endogenous ligands released during inflammation and tissue damage may be pro-tumorigenic, but no studies have been performed in relation to modulation of cell adhesion and drug cytotoxicity. Here, we investigated the effect of TLR1/2 activation on adhesion of human myeloma cells to fibronectin, and their sensitivity to the proteasome inhibitor Velcade. It was found that TLR1/2 activation with Pam3CSK4 increased the cytotoxicity of Velcade in L363, OPM-2 and U266 human myeloma cells. This effect was not related to a decreased adhesion of the cells to fibronectin, but TLR1/2 activation stimulated the caspase-3 activity in Velcade-treated myeloma cells, which may be responsible for the enhanced cell death. Inhibitors of NF-κB and MAPK reduced the stimulatory effect. These findings indicate that TLR activation of MM cells could bypass protective effects of cell adhesion and suggest that TLR signaling may also have antitumorigenic potential

  4. Effect of 8-Week Aquatic, Land- based and Combined (Aquatic-Land Training Programs On Walking Capacity in Women with Multiple Sclerosis (MS: A Burdenko Approach

    Directory of Open Access Journals (Sweden)

    Raheleh Ghaffari

    2017-10-01

    Full Text Available Multiple sclerosis (MS is a chronic disease affecting all aspects of life in patients with this disease and causes a wide range of functional problems, including reduced walking capacity. The aim of this study was to compare the effects of 8 weeks aquatic, land-based and combined (aquatic-land (exercise programs according to Burdenko method on the walking capacity measured by 6-Minute Walk Test (6MWT. This was a pre- post design study. Thirty one women diagnosed with MS, age range 30-50 years, EDSS0.05. According to the results of this study, the combined and land-based exercises can be suggested for people with MS in order to improve their walking capacity. These methods can be suggested as appropriate non-pharmacologic complementary therapies in the rehabilitation centers.

  5. A CLINICAL CASE: DIAGNOSTICS OF SHERESHEVSKY TERNER SYNDROME WITH MULTIPLE CONGENITAL ANOMALIES IN MAIN ARTERIES OF A 4 YEAR OLD CHILD, SUFFERING FROM ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    A.N. Tsygin

    2007-01-01

    Full Text Available The article provides a substantiation for the differential diagnostics of the symptomatic arterial hypertension of a 4 year old child, suffering from the arterial hypertension of the presumably renoparenchymal origin. In the course of the clinical examination, the researchers found out coarctation of aorta and hypoplasia of the right renal artery as a part of Shereshevsky-Terner syndrome.Key words: arterial hypertension, Shereshevsky-Terner syndrome, coarctation of aorta, renovascular hypertension.

  6. Non-invasive diagnostic workup of patients with suspected stable angina by combined computed tomography coronary angiography and magnetic resonance perfusion imaging

    International Nuclear Information System (INIS)

    Kirschbaum, S.W.; Nieman, K.; Springeling, T.

    2011-01-01

    The background of this study was to evaluate additional adenosine magnetic resonance perfusion (MRP) imaging in the diagnostic workup of patients with suspected stable angina with computed tomography coronary angiography (CTCA) as first-line diagnostic modality. Two hundred and thirty symptomatic patients (male, 52%; age, 56 year) with suspected stable angina underwent CTCA. In patients with a stenosis of >50% as visually assessed, MRP was performed and the quantitative myocardial perfusion reserve index (MPRI) was calculated. Coronary flow reserve (CFR) using invasive coronary flow measurements served as the standard of reference. CTCA showed non-significant coronary artery disease (CAD) in 151/230 (66%) patients and significant CAD in 79/230 patients (34%), of whom 50 subsequently underwent MRP and CFR. MRP showed reduced perfusion in 32 patients (64%), which was confirmed by CFR in 27 (84%). All 18 cases of normal MRP (36%) were confirmed by CFR. The positive likelihood ratio of MRP for the presence of functional significant disease in patients with a lesion on CTCA was 4.49 (95% confidence interval [CI] 2.12-9.99). The negative likelihood ratio was 0.05 (95% CI 0.01-0.34). CTCA as first-line diagnostic modality excluded coronary artery disease in a high percentage of patients referred for diagnostic workup of suspected stable angina. MRP made a significant contribution to the detection of functional significant lesions in patients with a positive CTCA. (author)

  7. Clinical application of optical coherence tomography in combination with functional diagnostics: advantages and limitations for diagnosis and assessment of therapy outcome in central serous chorioretinopathy.

    Science.gov (United States)

    Schliesser, Joshua A; Gallimore, Gary; Kunjukunju, Nancy; Sabates, Nelson R; Koulen, Peter; Sabates, Felix N

    2014-01-01

    While identifying functional and structural parameters of the retina in central serous chorioretinopathy (CSCR) patients, this study investigated how an optical coherence tomography (OCT)-based diagnosis can be significantly supplemented with functional diagnostic tools and to what degree the determination of disease severity and therapy outcome can benefit from diagnostics complementary to OCT. CSCR patients were evaluated prospectively with microperimetry (MP) and spectral domain optical coherence tomography (SD-OCT) to determine retinal sensitivity function and retinal thickness as outcome measures along with measures of visual acuity (VA). Patients received clinical care that involved focal laser photocoagulation or pharmacotherapy targeting inflammation and neovascularization. Correlation of clinical parameters with a focus on functional parameters, VA, and mean retinal sensitivity, as well as on the structural parameter mean retinal thickness, showed that functional measures were similar in diagnostic power. A moderate correlation was found between OCT data and the standard functional assessment of VA; however, a strong correlation between OCT and MP data showed that diagnostic measures cannot always be used interchangeably, but that complementary use is of higher clinical value. The study indicates that integrating SD-OCT with MP provides a more complete diagnosis with high clinical relevance for complex, difficult to quantify diseases such as CSCR.

  8. Current approach to the diagnosis of IgG4-related disease - Combination of comprehensive diagnostic and organ-specific criteria.

    Science.gov (United States)

    Umehara, Hisanori; Okazaki, Kazuichi; Nakamura, Takuji; Satoh-Nakamura, Tomomi; Nakajima, Akio; Kawano, Mitsuhiro; Mimori, Tsuneyo; Chiba, Tsutomu

    2017-05-01

    IgG4-related disease (IgG4-RD) is a fascinating clinical entity proposed by Japanese investigators, and includes a wide variety of diseases, formerly diagnosed as Mikulicz's disease (MD), autoimmune pancreatitis (AIP), interstitial nephritis, prostatitis, retroperitoneal fibrosis, etc. Although all clinicians in every field of medicine may encounter this new disease, a unifying diagnostic criterion has not been established. In 2011, the Japanese IgG4 team, organized by the Ministry of Health, Labor and Welfare (MHLW) of Japan, published comprehensive diagnostic criteria for IgG4-RD. Several problems with these criteria have arisen in clinical practice, however, including the difficulty obtaining biopsy samples from some patients, and the sensitivity and the specificity of techniques used to measure serum IgG4 concentrations. Although serum IgG4 concentration is an important clinical marker for IgG4-RD, its diagnostic utility in differentiating IgG4-RD from other diseases, called IgG4-RD mimickers, remains unclear. This review describes the current optimal approach for the diagnosis of IgG4-RD, based on both comprehensive and organ-specific diagnostic criteria, in patients with diseases such as IgG4-related pancreatitis (AIP), sclerosing cholangitis, and renal, lung and orbital diseases.

  9. Combining vibrational linear-by-part dynamics and kinetic-based decoupling of the dynamics for multiple elastoplastic smooth impacts

    Energy Technology Data Exchange (ETDEWEB)

    Barjau, Ana, E-mail: ana.barjau@upc.edu; Batlle, Joaquim A., E-mail: agullo.batlle@upc.edu; Font-Llagunes, Josep M., E-mail: josep.m.font@upc.edu [Universitat Politècnica de Catalunya, Department of Mechanical Engineering and Biomedical Engineering Research Centre (Spain)

    2015-11-15

    This article proposes a linear-by-part approach for elastoplastic 3D multiple-point smooth impacts in multibody systems with perfect constraints. The model is an extension of a previous version, restricted to the perfectly elastic case, able to account for the high sensitivity to initial conditions and for redundancy without assuming any particular collision sequence (Barjau et al., Multibody Syst. Dyn. 31:497–517, 2014). Energy losses associated with compression and expansion in percussive analysis is a matter as complex as the physical phenomena involved, at the nanoscale level, for different materials. Simplified models can be developed for specific purposes, which can retain the most relevant trends of internal damping and at the same time be suitable for a particular analytical approach of impact mechanics. In the context of this article, energy dissipation due to material deformation is introduced through a linear-by-part elastoplastic model consisting on two elementary sets of springs and dry-friction dampers. The first set accounts for inelastic behavior (energy loss without permanent indentation), whereas the second one introduces plasticity (that is, permanent indentation). In inelastic and plastic collisions, instantaneous unilateral constraints may appear, thus reducing the number of degrees of freedom (DOF) of the system. The calculation of the corresponding normal contact force at the constrained points is then necessary in order to detect whether the constraint holds or disappears (either because a new compression or an expansion phase starts, or because contact is lost). Different simulated application examples are presented and thoroughly discussed.

  10. Identifying conditions for inducible protein production in E. coli: combining a fed-batch and multiple induction approach

    Directory of Open Access Journals (Sweden)

    Choi Young J

    2006-08-01

    Full Text Available Abstract Background In the interest of generating large amounts of recombinant protein, inducible systems have been studied to maximize both the growth of the culture and the production of foreign proteins. Even though thermo-inducible systems were developed in the late 1970's, the number of studies that focus on strategies for the implementation at bioreactor scale is limited. In this work, the bacteriophage lambda PL promoter is once again investigated as an inducible element but for the production of green fluorescent protein (GFP. Culture temperature, induction point, induction duration and number of inductions were considered as factors to maximize GFP production in a 20-L bioreactor. Results It was found that cultures carried out at 37°C resulted in a growth-associated production of GFP without the need of an induction at 42°C. Specific production was similar to what was achieved when separating the growth and production phases. Shake flask cultures were used to screen for desirable operating conditions. It was found that multiple inductions increased the production of GFP. Induction decreased the growth rate and substrate yield coefficients; therefore, two time domains (before and after induction having different kinetic parameters were created to fit a model to the data collected. Conclusion Based on two batch runs and the simulation of culture dynamics, a pre-defined feeding and induction strategy was developed to increase the volumetric yield of a temperature regulated expression system and was successfully implemented in a 20-L bioreactor. An overall cell density of 5.95 g DW l-1 was achieved without detriment to the cell specific production of GFP; however, the production of GFP was underestimated in the simulations due to a significant contribution of non-growth associated product formation under limiting nutrient conditions.

  11. Increasing the Fine Flaky Graphite Recovery in Flotation via a Combined MultipleTreatments Technique of Middlings

    Directory of Open Access Journals (Sweden)

    Weijun Peng

    2017-11-01

    Full Text Available As the residual flaky graphite ores become miscellaneous and fine, a single treatment technique for the middlings from the flotation process of graphite ore cannot efficiently recover the valuable graphite in the multistage grinding-flotation technology. In the study, the existence form of graphite and relationship of graphite with the associated gangue minerals were estimated by optical microscope analysis. The results indicated that the fine flaky graphite particles embedded with gangue minerals like a honeycomb, making it difficult to be beneficiated using the typical flotation technique. A combination technique of individual process and concentrated returning for the treatment of middlings was used to increase the graphite recovery based on the co-existing relationship between graphite and gangue minerals in the middlings. The graphite recovery of the final concentrate upgraded from 51.81% to 91.14% at a fixed carbon (FC content of 92.01% by a beneficiation process consisted of once coarse (94.41% passing 74 μm and rougher, five stages regrinding and six stages cleaning. The proposed treatment technique for middlings is of great significance to increase the recovery of fine flaky graphite.

  12. Combining Multiple Hypothesis Testing with Machine Learning Increases the Statistical Power of Genome-wide Association Studies

    Science.gov (United States)

    Mieth, Bettina; Kloft, Marius; Rodríguez, Juan Antonio; Sonnenburg, Sören; Vobruba, Robin; Morcillo-Suárez, Carlos; Farré, Xavier; Marigorta, Urko M.; Fehr, Ernst; Dickhaus, Thorsten; Blanchard, Gilles; Schunk, Daniel; Navarro, Arcadi; Müller, Klaus-Robert

    2016-01-01

    The standard approach to the analysis of genome-wide association studies (GWAS) is based on testing each position in the genome individually for statistical significance of its association with the phenotype under investigation. To improve the analysis of GWAS, we propose a combination of machine learning and statistical testing that takes correlation structures within the set of SNPs under investigation in a mathematically well-controlled manner into account. The novel two-step algorithm, COMBI, first trains a support vector machine to determine a subset of candidate SNPs and then performs hypothesis tests for these SNPs together with an adequate threshold correction. Applying COMBI to data from a WTCCC study (2007) and measuring performance as replication by independent GWAS published within the 2008–2015 period, we show that our method outperforms ordinary raw p-value thresholding as well as other state-of-the-art methods. COMBI presents higher power and precision than the examined alternatives while yielding fewer false (i.e. non-replicated) and more true (i.e. replicated) discoveries when its results are validated on later GWAS studies. More than 80% of the discoveries made by COMBI upon WTCCC data have been validated by independent studies. Implementations of the COMBI method are available as a part of the GWASpi toolbox 2.0. PMID:27892471

  13. A rare combination of type 3 autoimmune polyendocrine syndrome (APS-3) or multiple autoimmune syndrome (MAS-3).

    Science.gov (United States)

    Betterle, Corrado; Garelli, Silvia; Coco, Graziella; Burra, Patrizia

    2014-06-01

    Type 3 autoimmune polyendocrine syndrome (APS-3) is defined by the presence of an autoimmune thyroid disease and another autoimmune illness, excluding Addison's disease; this is a frequent combination. We report the case of a 55 years old female patient with APS-3, with seven clinical or latent autoimmune manifestations. At 49 years of age she was admitted at the General Hospital for leukopenia, weight loss, tremors, anxiety and diarrhea. The personal history revealed ulcerative colitis and, during the last year, episodes of fever with migrant arthralgia and cutaneous lesions. The patient was evaluated for thyroid function and imaging, mielobiopsy, glycaemic control, gastrointestinal and rheumatologic disorders with specific biochemical tests, imaging and endoscopic procedures. We concluded that the patient was affected by APS-3, characterized by the association of Graves' disease, autoimmune leukopenia, latent autoimmune diabetes of the adult (LADA), autoimmune gastritis, ulcerative colitis, Sjögren's and anti-phospholipid syndromes. The patient started low doses of corticosteroid drugs for leukopenia, underwent (131)I therapy for hyperthyroidism and later started substitutive thyroid therapy with l-thyroxine, insulin therapy for LADA, mesalazine for ulcerative colitis and artificial tears for Sjögren's syndrome. In this article we report a complex case of APS-3, characterized by the association of seven different autoimmune diseases, which required a complex therapeutic strategy.

  14. A combined QC methodology in Ebro Delta HF radar system: real time web monitoring of diagnostic parameters and offline validation of current data

    Science.gov (United States)

    Lorente, Pablo; Piedracoba, Silvia; Soto-Navarro, Javier; Ruiz, Maria Isabel; Alvarez Fanjul, Enrique

    2015-04-01

    Over recent years, special attention has been focused on the development of protocols for near real-time quality control (QC) of HF radar derived current measurements. However, no agreement has been worldwide achieved to date to establish a standardized QC methodology, although a number of valuable international initiatives have been launched. In this context, Puertos del Estado (PdE) aims to implement a fully operational HF radar network with four different Codar SeaSonde HF radar systems by means of: - The development of a best-practices robust protocol for data processing and QC procedures to routinely monitor sites performance under a wide variety of ocean conditions. - The execution of validation works with in-situ observations to assess the accuracy of HF radar-derived current measurements. The main goal of the present work is to show this combined methodology for the specific case of Ebro HF radar (although easily expandable to the rest of PdE radar systems), deployed to manage Ebro River deltaic area and promote the conservation of an important aquatic ecosystem exposed to a severe erosion and reshape. To this aim, a web interface has been developed to efficiently monitor in real time the evolution of several diagnostic parameters provided by the manufacturer (CODAR) and used as indicators of HF radar system health. This web, updated automatically every hour, examines sites performance on different time basis in terms of: - Hardware parameters: power and temperature. - Radial parameters, among others: Signal-to-Noise Ratio (SNR), number of radial vectors provided by time step, maximum radial range and bearing. - Total uncertainty metrics provided by CODAR: zonal and meridional standard deviations and covariance between both components. - Additionally, a widget embedded in the web interface executes queries against PdE database, providing the chance to compare current time series observed by Tarragona buoy (located within Ebro HF radar spatial domain) and

  15. Multiple methods of surgical treatment combined with primary IOL implantation on traumatic lens subluxation/dislocation in patients with secondary glaucoma.

    Science.gov (United States)

    Wang, Rui; Bi, Chun-Chao; Lei, Chun-Ling; Sun, Wen-Tao; Wang, Shan-Shan; Dong, Xiao-Juan

    2014-01-01

    To describe clinical findings and complications from cases of traumatic lens subluxation/dislocation in patients with secondary glaucoma, and discuss the multiple treating methods of operation combined with primary intraocular lens (IOL) implantation. Non-comparative retrospective observational case series. 30 cases (30 eyes) of lens subluxation/dislocation in patients with secondary glaucoma were investigated which accepted the surgical treatment by author in the Ophthalmology of Xi'an No.4 Hospital from 2007 to 2011. According to the different situations of lens subluxation/dislocation, various surgical procedures were performed such as crystalline lens phacoemulsification, crystalline lens phacoemulsification combined anterior vitrectomy, intracapsular cataract extraction combined anterior vitrectomy, lensectomy combined anterior vitrectomy though peripheral transparent cornea incision, pars plana lensectomy combined pars plana vitrectomy, and intravitreal cavity crystalline lens phacofragmentation combined pars plana vitrectomy. And whether to implement trabeculectomy depended on the different situations of secondary glaucoma. The posterior chamber intraocular lenses (PC-IOLs) were implanted in the capsular-bag or trassclerally sutured in the sulus decided by whether the capsular were present. visual acuity, intraocular pressure, the situation of intraocular lens and complications after the operations. The follow-up time was 11-36mo (21.4±7.13). Postoperative visual acuity of all eyes were improved; 28 cases maintained IOP below 21 mm Hg; 2 cases had slightly IOL subluxation, 4 cases had slightly tilted lens optical area; 1 case had postoperative choroidal detachment; 4 cases had postoperative corneal edema more than 1wk, but eventually recovered transparent; 2 cases had mild postoperative vitreous hemorrhage, and absorbed 4wk later. There was no postoperative retinal detachment, IOL dislocation, and endophthalmitis. To take early treatment of traumatic lens

  16. Combination of robot-assisted and conventional body-weight-supported treadmill training improves gait in persons with multiple sclerosis: a pilot study.

    Science.gov (United States)

    Ruiz, Jennifer; Labas, Michele P; Triche, Elizabeth W; Lo, Albert C

    2013-12-01

    The majority of persons with multiple sclerosis (MS) experience problems with gait, which they characterize as highly disabling impairments that adversely impact their quality of life. Thus, it is crucial to develop effective therapies to improve mobility for these individuals. The purpose of this study was to determine whether combination gait training, using robot-assisted treadmill training followed by conventional body-weight-supported treadmill training within the same session, improved gait and balance in individuals with MS. This study tested combination gait training in 7 persons with MS. The participants were randomized into the immediate therapy group (IT group) or the delayed therapy group (DT group). In phase I of the trial, the IT group received treatment while the DT group served as a concurrent comparison group. In phase II of the trial, the DT group received treatment identical to the treatment received by the IT group in phase I. Outcome measures included the 6-Minute Walk Test (6MWT), the Timed 25-Foot Walk Test, velocity, cadence, and the Functional Reach Test (FRT). Nonparametric statistical techniques were used for analysis. Combination gait training resulted in significantly greater improvements in the 6MWT for the IT group (median change = +59 m) compared with Phase I DT group (median change = -8 m) (P = 0.08) and FRT (median change = +3.3 cm in IT vs -0.8 cm in the DT group phase I; P = 0.03). Significant overall pre-post improvements following combination gait training were found in 6MWT (+32 m; P = 0.02) and FRT (+3.3 cm; P = 0.06) for IT and Phase II DT groups combined. Combination of robot with body-weight-supported treadmill training gait training is feasible and improved 6MWT and FRT distances in persons with MS.Video Abstract available (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A62) for more insights from the authors.

  17. Improved statistical signal detection in pharmacovigilance by combining multiple strength-of-evidence aspects in vigiRank.

    Science.gov (United States)

    Caster, Ola; Juhlin, Kristina; Watson, Sarah; Norén, G Niklas

    2014-08-01

    operating characteristics curve (AUC) over screening based on the Information Component (IC) and raw numbers of reports, respectively (0.775 vs. 0.736 and 0.707, cross-validated). Accounting for multiple aspects of strength of evidence has clear conceptual and empirical advantages over disproportionality analysis. vigiRank is a first-of-its-kind predictive model to factor in report quality and content in first-pass screening to better meet tomorrow's post-marketing drug safety surveillance needs.

  18. Optimizing Transcriptome Assemblies for Eleusine indica Leaf and Seedling by Combining Multiple Assemblies from Three De Novo Assemblers

    Directory of Open Access Journals (Sweden)

    Shu Chen

    2015-03-01

    Full Text Available Due to rapid advances in sequencing technology, increasing amounts of genomic and transcriptomic data are available for plant species, presenting enormous challenges for biocomputing analysis. A crucial first step for a successful transcriptomics-based study is the building of a high-quality assembly. Here, we utilized three different de novo assemblers (Trinity, Velvet, and CLC and the EvidentialGene pipeline tr2aacds to assemble two optimized transcript sets for the notorious weed species, . Two RNA sequencing (RNA-seq datasets from leaf and aboveground seedlings were processed using three assemblers, which resulted in 20 assemblies for each dataset. The contig numbers and N50 values of each assembly were compared to study the effect of read number, k-mer size, and in silico normalization on assembly output. The 20 assemblies were then processed through the tr2aacds pipeline to remove redundant transcripts and to select the transcript set with the best coding potential. Each assembly contributed a considerable proportion to the final transcript combination with the exception of the CLC-k14. Thus each assembler and parameter set did assemble better contigs for certain transcripts. The redundancy, total contig number, N50, fully assembled contig number, and transcripts related to target-site herbicide resistance were evaluated for the EvidentialGene and Trinity assemblies. Comparing the EvidentialGene set with the Trinity assembly revealed improved quality and reduced redundancy in both leaf and seedling EvidentialGene sets. The optimized transcriptome references will be useful for studying herbicide resistance in and the evolutionary process in the three allotetraploid offspring.

  19. Fine mapping of multiple QTL using combined linkage and linkage disequilibrium mapping – A comparison of single QTL and multi QTL methods

    Directory of Open Access Journals (Sweden)

    Meuwissen Theo HE

    2007-04-01

    Full Text Available Abstract Two previously described QTL mapping methods, which combine linkage analysis (LA and linkage disequilibrium analysis (LD, were compared for their ability to detect and map multiple QTL. The methods were tested on five different simulated data sets in which the exact QTL positions were known. Every simulated data set contained two QTL, but the distances between these QTL were varied from 15 to 150 cM. The results show that the single QTL mapping method (LDLA gave good results as long as the distance between the QTL was large (> 90 cM. When the distance between the QTL was reduced, the single QTL method had problems positioning the two QTL and tended to position only one QTL, i.e. a "ghost" QTL, in between the two real QTL positions. The multi QTL mapping method (MP-LDLA gave good results for all evaluated distances between the QTL. For the large distances between the QTL (> 90 cM the single QTL method more often positioned the QTL in the correct marker bracket, but considering the broader likelihood peaks of the single point method it could be argued that the multi QTL method was more precise. Since the distances were reduced the multi QTL method was clearly more accurate than the single QTL method. The two methods combine well, and together provide a good tool to position single or multiple QTL in practical situations, where the number of QTL and their positions are unknown.

  20. BiRD (Biaxin [clarithromycin]/Revlimid [lenalidomide]/dexamethasone) combination therapy results in high complete- and overall-response rates in treatment-naive symptomatic multiple myeloma.

    Science.gov (United States)

    Niesvizky, Ruben; Jayabalan, David S; Christos, Paul J; Furst, Jessica R; Naib, Tara; Ely, Scott; Jalbrzikowski, Jessica; Pearse, Roger N; Zafar, Faiza; Pekle, Karen; Larow, April; Lent, Richard; Mark, Tomer; Cho, Hearn J; Shore, Tsiporah; Tepler, Jeffrey; Harpel, John; Schuster, Michael W; Mathew, Susan; Leonard, John P; Mazumdar, Madhu; Chen-Kiang, Selina; Coleman, Morton

    2008-02-01

    This trial determined the safety and efficacy of the combination regimen clarithromycin (Biaxin), lenalidomide (Revlimid), and dexamethasone (BiRD) as first-line therapy for multiple myeloma. Patients received BiRD in 28-day cycles. Dexamethasone (40 mg) was given orally once weekly, clarithromycin (500 mg) was given orally twice daily, and lenalidomide (25 mg) was given orally daily on days 1 to 21. Objective response was defined by standard criteria (ie, decrease in serum monoclonal protein [M-protein] by at least 50%, and a decrease in urine M-protein by at least 90%). Of the 72 patients enrolled, 65 had an objective response (90.3%). A combined stringent and conventional complete response rate of 38.9% was achieved, and 73.6% of the patients achieved at least a 90% decrease in M-protein levels. This regimen did not interfere with hematopoietic stem-cell harvest. Fifty-two patients who did not go on to receive transplants received continued therapy (complete response, 37%; very good partial response, 33%). The major adverse events were thromboembolic events, corticosteroid-related morbidity, and cytopenias. BiRD is an effective regimen with manageable side effects in the treatment of symptomatic, newly diagnosed multiple myeloma. This trial was registered at www.clinicaltrials.gov as #NCT00151203.

  1. Combined phylogeny and neighborhood analysis of the evolution of the ABC transporters conferring multiple drug resistance in hemiascomycete yeasts

    Directory of Open Access Journals (Sweden)

    Goffeau André

    2009-10-01

    Full Text Available Abstract Background Pleiotropic Drug Resistant transporters (PDR are members of the ATP-Binding Cassette (ABC subfamily which export antifungals and other xenobiotics in fungi and plants. This subfamily of transmembrane transporters has nine known members in Saccharomyces cerevisiae. We have analyzed the complex evolution of the pleiotropic drug resistance proteins (Pdrp subfamily where gene duplications and deletions occur independently in individual genomes. This study was carried out on 62 Pdrp from nine hemiascomycetous species, seven of which span 6 of the 14 clades of the Saccharomyces complex while the two others species, Debaryomyces hansenii and Yarrowia lipolytica, are further apart from an evolutive point of view. Results Combined phylogenetic and neighborhood analyses enabled us to identify five Pdrp clusters in the Saccharomyces complex. Three of them comprise orthologs of the Pdrp sensu stricto, Pdr5p, Pdr10p, Pdr12p, Pdr15p, Snq2p and YNR070wp. The evolutive pathway of the orthologs of Snq2 and YNR070w is particularly complex due to a tandem gene array in Eremothecium gossypii, Kluyveromyces lactis and Saccharomyces (Lachancea kluyveri. This pathway and different cases of duplications and deletions were clarified by using a neighborhood analysis based on synteny. For the two distant species, Yarrowia lipolytica and Debaryomyces hansenii, no neighborhood evidence is available for these clusters and many homologs of Pdr5 and Pdr15 are phylogenetically assigned to species-based clusters. Two other clusters comprise the orthologs of the sensu lato Pdrp, Aus1p/Pdr11p and YOL075cp respectively. The evolutionary pathway of these clusters is simpler. Nevertheless, orthologs of these genes are missing in some species. Conclusion Numerous duplications were traced among the Hemiascomycetous Pdrp studied. The role of the Whole Genome Duplication (WGD is sorted out and our analyses confirm the common ancestrality of Pdr5p and Pdr15p. A tandem

  2. Combined phylogeny and neighborhood analysis of the evolution of the ABC transporters conferring multiple drug resistance in hemiascomycete yeasts.

    Science.gov (United States)

    Seret, Marie-Line; Diffels, Julie F; Goffeau, André; Baret, Philippe V

    2009-10-01

    Pleiotropic Drug Resistant transporters (PDR) are members of the ATP-Binding Cassette (ABC) subfamily which export antifungals and other xenobiotics in fungi and plants. This subfamily of transmembrane transporters has nine known members in Saccharomyces cerevisiae. We have analyzed the complex evolution of the pleiotropic drug resistance proteins (Pdrp) subfamily where gene duplications and deletions occur independently in individual genomes. This study was carried out on 62 Pdrp from nine hemiascomycetous species, seven of which span 6 of the 14 clades of the Saccharomyces complex while the two others species, Debaryomyces hansenii and Yarrowia lipolytica, are further apart from an evolutive point of view. Combined phylogenetic and neighborhood analyses enabled us to identify five Pdrp clusters in the Saccharomyces complex. Three of them comprise orthologs of the Pdrp sensu stricto, Pdr5p, Pdr10p, Pdr12p, Pdr15p, Snq2p and YNR070wp. The evolutive pathway of the orthologs of Snq2 and YNR070w is particularly complex due to a tandem gene array in Eremothecium gossypii, Kluyveromyces lactis and Saccharomyces (Lachancea) kluyveri. This pathway and different cases of duplications and deletions were clarified by using a neighborhood analysis based on synteny. For the two distant species, Yarrowia lipolytica and Debaryomyces hansenii, no neighborhood evidence is available for these clusters and many homologs of Pdr5 and Pdr15 are phylogenetically assigned to species-based clusters. Two other clusters comprise the orthologs of the sensu lato Pdrp, Aus1p/Pdr11p and YOL075cp respectively. The evolutionary pathway of these clusters is simpler. Nevertheless, orthologs of these genes are missing in some species. Numerous duplications were traced among the Hemiascomycetous Pdrp studied. The role of the Whole Genome Duplication (WGD) is sorted out and our analyses confirm the common ancestrality of Pdr5p and Pdr15p. A tandem gene array is observed in Eremothecium gossypii. One

  3. Analysis of gene expression profiles of soft tissue sarcoma using a combination of knowledge-based filtering with integration of multiple statistics.

    Directory of Open Access Journals (Sweden)

    Anna Takahashi

    Full Text Available The diagnosis and treatment of soft tissue sarcomas (STS have been difficult. Of the diverse histological subtypes, undifferentiated pleomorphic sarcoma (UPS is particularly difficult to diagnose accurately, and its classification per se is still controversial. Recent advances in genomic technologies provide an excellent way to address such problems. However, it is often difficult, if not impossible, to identify definitive disease-associated genes using genome-wide analysis alone, primarily because of multiple testing problems. In the present study, we analyzed microarray data from 88 STS patients using a combination method that used knowledge-based filtering and a simulation based on the integration of multiple statistics to reduce multiple testing problems. We identified 25 genes, including hypoxia-related genes (e.g., MIF, SCD1, P4HA1, ENO1, and STAT1 and cell cycle- and DNA repair-related genes (e.g., TACC3, PRDX1, PRKDC, and H2AFY. These genes showed significant differential expression among histological subtypes, including UPS, and showed associations with overall survival. STAT1 showed a strong association with overall survival in UPS patients (logrank p = 1.84 × 10(-6 and adjusted p value 2.99 × 10(-3 after the permutation test. According to the literature, the 25 genes selected are useful not only as markers of differential diagnosis but also as prognostic/predictive markers and/or therapeutic targets for STS. Our combination method can identify genes that are potential prognostic/predictive factors and/or therapeutic targets in STS and possibly in other cancers. These disease-associated genes deserve further preclinical and clinical validation.

  4. Beyond clinical trials: Cross-sectional associations of combination antiretroviral therapy with reports of multiple symptoms and non-adherence among adolescents in South Africa.

    Science.gov (United States)

    Natukunda, H P M; Cluver, L D; Toska, E; Musiime, V; Yakubovich, A R

    2017-10-31

    Studies investigating symptoms associated with combination antiretroviral therapy (cART) use among adolescents in resource-limited settings are rare beyond clinical trials. Identifying adolescents at risk of non-adherence is imperative for HIV/AIDS programming and controlling the epidemic in this key population. To examine which cART regimens were associated with reports of multiple symptoms and past-week non-adherence in a large community-traced sample of HIV-positive adolescents in South Africa (SA). A total of 1 175 HIV-positive ART-experienced adolescents aged 10 - 19 years attending 53 health facilities in the Eastern Cape Province, SA, were interviewed in 2014 - 2015. Ninety percent (n=1 059) were included in the study. Adolescents who reported no medication use and those with unclear or missing data were excluded from further analysis, resulting in a sample for analysis of n=501. Outcomes were reports of multiple symptoms (three or more symptoms in the past 6 months) and past-week ART non-adherence (<95% correct doses in the past week). Multivariable logistic regression analyses controlled for sociodemographic and HIV-related covariates in Stata 13/IC. Of the adolescents included, 54.3% were female. The median age was 14 (interquartile range 12 - 16) years, and 66.5% were vertically infected. The prevalence of multiple symptoms was 59.7% (95% confidence interval (CI) 55.3 - 63.9). Independent of covariates, stavudine (d4T)-containing cART regimens and the fixed-dose combination of tenofovir (TDF) + emtricitabine (FTC) + efavirenz (EFV) were associated with more reports of multiple symptoms (adjusted odds ratio (aOR) 3.38; 95% CI 1.19 - 9.60 and aOR 2.67; 95% CI 1.21 - 5.88, respectively). Lopinavir/ritonavir (LPV/r)-containing regimens were associated with fewer reports of multiple symptoms (aOR 0.47; 95% CI 0.21 - 1.04). For EFV-based regimens, adolescents on d4T + lamivudine (3TC) + EFV were more likely to report multiple symptoms than those on TDF + FTC

  5. Clinical analysis of four serum tumor markers in 458 patients with ovarian tumors: diagnostic value of the combined use of HE4, CA125, CA19-9, and CEA in ovarian tumors

    Directory of Open Access Journals (Sweden)

    Chen F

    2018-05-01

    Full Text Available Fawen Chen,1,2 Jing Shen,3 Jianwei Wang,1 Pengwei Cai,1 Yi Huang3 1Department of Clinical Laboratory, Fujian Provincial Hospital South Branch, 2Department of Blood Transfusion, 3Department of Clinical Laboratory, Fujian Provincial Hospital, Provincial Clinical College of Fujian Medical University, Fuzhou, People’s Republic of China Purpose: To investigate the diagnostic values of human epididymis protein 4 (HE4, carbohydrate antigen 125 (CA125, carbohydrate antigen 19-9 (CA19-9, and carcinoembryonic antigen (CEA for ovarian tumors. Methods: The participants were divided into three groups: 386 healthy women (control group, 262 patients with benign ovarian tumors (the benign group, and 196 patients with malignant pelvic tumors (the malignant group. The serum levels of HE4, CA125, CA19-9, and CEA were analyzed by electrochemiluminescent immunoassay. Results: It showed that serum levels of HE4, CA125, CA19-9, and CEA of patients with ­malignant ovarian tumors were significantly higher than those in the control group and benign group (P<0.01. HE4 had a high specificity (96.56% in malignant ovarian tumors. The tumor markers HE4, CA125, CA19-9, and CEA had a sensitivity of 63.78%, 62.75%, 35.71%, and 38.78%, respectively. The combined use of two or more tumor markers (parallel test had a higher diagnostic sensitivity but lower specificity than a single tumor marker. The combined efficiency of HE4 and CA125 was the highest, with a sensitivity and specificity of 80.10% and 69.08%, respectively. HE4 and CA125 combined with the Risk of Ovarian Malignancy Algorithm provided an efficient means of screening and diagnosis of ovarian malignancies. The diagnostic sensitivity increased to 88.52% when three or four tumor markers were used but showed no significant difference compared with the combination of HE4 and CA125 (P>0.05. Conclusion: The combination of three or four tumor markers did not improve the diagnostic efficacy when compared with the combination

  6. Comparison of the efficacy among multiple chemotherapeutic interventions combined with radiation therapy for patients with cervix cancer after surgery: A network meta-analysis.

    Science.gov (United States)

    Chang, Lei; Guo, Ruixia

    2017-07-25

    Cervix cancer was the second most common cancer in female. However, there was no network meta-analysis (NMA) comparing the efficacy of the multiple chemotherapeutic interventions combined with radiation therapy in patients after operation. Randomized controlled trials were retrieved from PubMed, Embase and Cochrane Library. Overall survival (OS), recurrence-free survival (RFS), incidence of recurrence and distant metastasis were the main outcomes, particularly 5-year OS and PFS were considered as primary outcomes. Furthermore, the hazard ratio (HR) or odds ratio (OR) and their 95% credible intervals (CrIs) were extracted. The surface under cumulative ranking curve (SUCRA) was also used in this NMA. A total of 39 eligible trials with 8,952 patients were included and 22 common chemotherapies were evaluated in this meta-analysis. For OS, cisplatin+fluorouracil+hydroxyurea, fluorouracil+mitomycin C, cisplatin and cisplatin+fluorouracil were better than placebo. As for RFS, cisplatin+fluorouracil, fluorouracil+mitomycin C, and cisplatin alone had the significant superiority compared with placebo. In terms of incidence of recurrence, the optimal drug combination was cisplatin+ifosfamide (0.93) based on SUCRA. Moreover, epirubicin (OR = 0.28, 95% CrI: 0.08-0.91) was the only one had the distinguished potency in reducing the occurrence of distant metastasis with a SUCRA rank probability of 0.88. We recommended cisplatin+fluorouracil+hydroxyurea and cisplatin+docetaxel for their good efficacy in long term survival. Meanwhile, the combination of multiple drugs with different mechanisms worked better.

  7. Acoustic radiation force impulse elastography, FibroScan®, Forns’ index and their combination in the assessment of liver fibrosis in patients with chronic hepatitis B, and the impact of inflammatory activity and steatosis on these diagnostic methods

    Science.gov (United States)

    DONG, DAO-RAN; HAO, MEI-NA; LI, CHENG; PENG, ZE; LIU, XIA; WANG, GUI-PING; MA, AN-LIN

    2015-01-01

    The aim of the present study was to investigate the combination of certain serological markers (Forns’ index; FI), FibroScan® and acoustic radiation force impulse elastography (ARFI) in the assessment of liver fibrosis in patients with hepatitis B, and to explore the impact of inflammatory activity and steatosis on the accuracy of these diagnostic methods. Eighty-one patients who had been diagnosed with hepatitis B were recruited and the stage of fibrosis was determined by biopsy. The diagnostic accuracy of FI, FibroScan and ARFI, as well as that of the combination of these methods, was evaluated based on the conformity of the results from these tests with those of biopsies. The effect of concomitant inflammation on diagnostic accuracy was also investigated by dividing the patients into two groups based on the grade of inflammation (G<2 and G≥2). The overall univariate correlation between steatosis and the diagnostic value of the three methods was also evaluated. There was a significant association between the stage of fibrosis and the results obtained using ARFI and FibroScan (Kruskal-Wallis; P<0.001 for all patients), and FI (t-test, P<0.001 for all patients). The combination of FI with ARFI/FibroScan increased the predictive accuracy with a fibrosis stage of S≥2 or cirrhosis. There was a significant correlation between the grade of inflammation and the results obtained using ARFI and FibroScan (Kruskal-Wallis, P<0.001 for all patients), and FI (t-test; P<0.001 for all patients). No significant correlation was detected between the measurements obtained using ARFI, FibroScan and FI, and steatosis (r=−0.100, P=0.407; r=0.170, P=0.163; and r=0.154, P=0.216, respectively). ARFI was shown to be as effective in the diagnosis of liver fibrosis as FibroScan or FI, and the combination of ARFI or FibroScan with FI may improve the accuracy of diagnosis. The presence of inflammatory activity, but not that of steatosis, may affect the diagnostic accuracy of these

  8. Modelling of JET diagnostics using Bayesian Graphical Models

    Energy Technology Data Exchange (ETDEWEB)

    Svensson, J. [IPP Greifswald, Greifswald (Germany); Ford, O. [Imperial College, London (United Kingdom); McDonald, D.; Hole, M.; Nessi, G. von; Meakins, A.; Brix, M.; Thomsen, H.; Werner, A.; Sirinelli, A.

    2011-07-01

    The mapping between physics parameters (such as densities, currents, flows, temperatures etc) defining the plasma 'state' under a given model and the raw observations of each plasma diagnostic will 1) depend on the particular physics model used, 2) is inherently probabilistic, from uncertainties on both observations and instrumental aspects of the mapping, such as calibrations, instrument functions etc. A flexible and principled way of modelling such interconnected probabilistic systems is through so called Bayesian graphical models. Being an amalgam between graph theory and probability theory, Bayesian graphical models can simulate the complex interconnections between physics models and diagnostic observations from multiple heterogeneous diagnostic systems, making it relatively easy to optimally combine the observations from multiple diagnostics for joint inference on parameters of the underlying physics model, which in itself can be represented as part of the graph. At JET about 10 diagnostic systems have to date been modelled in this way, and has lead to a number of new results, including: the reconstruction of the flux surface topology and q-profiles without any specific equilibrium assumption, using information from a number of different diagnostic systems; profile inversions taking into account the uncertainties in the flux surface positions and a substantial increase in accuracy of JET electron density and temperature profiles, including improved pedestal resolution, through the joint analysis of three diagnostic systems. It is believed that the Bayesian graph approach could potentially be utilised for very large sets of diagnostics, providing a generic data analysis framework for nuclear fusion experiments, that would be able to optimally utilize the information from multiple diagnostics simultaneously, and where the explicit graph representation of the connections to underlying physics models could be used for sophisticated model testing. This

  9. Allocation of multiple, widely spread oil spills associated with one polluter : GC-MS fingerprinting and diagnostic ratios of spilled oil and oiled seabirds

    International Nuclear Information System (INIS)

    Hansen, A.B.; Avnskjold, J.

    2005-01-01

    In January 2005, a Cypriot cargo ship leaked about 5 tons of heavy fuel bunker oil in Kerteminde Bay in the Great Belt, Denmark. The ship was stopped to inspect and collect oil samples from its 2 damaged tanks for forensic oil spill identification by gas chromatography and mass spectrometry. Two weeks following the accident, a series of waterborne and stranded oil spills showed up in the Great Belt area, north and south of the vessel's route. Thousands of oiled seabirds on small islands and coastlines were affected. The Danish Coast Guard suspected that the vessel might be responsible for the observed spills. More than 50 oil samples were collected and sent for forensic analysis at the National Environmental Research Institute. Both waterborne and stranded spill samples showed an almost perfect match of diagnostic ratios and chromatograph with the potential responsible party (PRP) bunker. The spill samples therefore matched the reference oil and were allocated to the spill associated with the Cypriot cargo ship. One sample deviated significantly from the other samples and was not allocated to the ship's accidental spill. Oil samples collected from oiled seabirds showed larger variations between diagnostic ratios and the reference bunker oils. The variations can be attributed to weathering and biodegradation, but also to contamination by non-petrogenic material. It was concluded that the oiled seabirds represented non-match samples that cannot be allocated to the oil spill associated with the Cypriot cargo ship. 14 refs., 3 tabs., 4 figs

  10. Quality of Diagnosis and Treatment Plans After Using the 'Diagnostic Guideline for Anxiety and Challenging Behaviours' in People with Intellectual Disabilities: A Comparative Multiple Case Study Design

    NARCIS (Netherlands)

    Pruijssers, A.; Meijel, B. van; Maaskant, M.; Keeman, N.; Achterberg, T. van

    2016-01-01

    BACKGROUND: People with intellectual disabilities often have a multitude of concurrent problems due to the combination of cognitive impairments, psychiatric disorders (particularly anxiety) and related challenging behaviours. Diagnoses in people with intellectual disabilities are complicated. This

  11. A phase IIb trial of vorinostat in combination with lenalidomide and dexamethasone in patients with multiple myeloma refractory to previous lenalidomide-containing regimens.

    Science.gov (United States)

    Sanchez, Larysa; Vesole, David H; Richter, Joshua R; Biran, Noa; Bilotti, Elizabeth; McBride, Laura; Anand, Palka; Ivanovski, Kristin; Siegel, David S

    2017-02-01

    Clinical trials of vorinostat, a Class I/II histone deacetylase inhibitor, in combination with proteasome inhibitors and immunomodulatory agents have shown activity in relapsed/refractory multiple myeloma. This phase IIb, open-label, single-institution study evaluated the efficacy of vorinostat in combination with lenalidomide and dexamethasone in lenalidomide-refractory patients. Patients were considered lenalidomide-refractory if they had no clinical response (vorinostat 400 mg days 1-7 and 15-21, lenalidomide 25 mg days 1-21, and dexamethasone 40 mg days 1, 8, 15 and 22 in 28-day cycles. Twenty-five patients were enrolled, median age was 65 years and patients had received a median of 5 prior regimens. The overall response rate was 24% (6 partial responses) and clinical benefit rate (≥stable disease) was 80%. Median time to a partial response was 1·9 months and median duration of response was 3·3 months. Median progression-free survival was 5·3 months. Most common grade 3/4 adverse events were neutropenia (48%), thrombocytopenia (32%), anaemia (20%) and gastrointestinal toxicities (16%). In this heavily pre-treated population, vorinostat in combination with lenalidomide and dexamethasone was active in lenalidomide-refractory patients. © 2016 John Wiley & Sons Ltd.

  12. The Diagnostic Drawing Series and the Tree Rating Scale: An Isomorphic Representation of Multiple Personality Disorder, Major Depression, and Schizophrenic Populations.

    Science.gov (United States)

    Morris, Maureen Batza

    1995-01-01

    The tree drawings of 80 subjects, who were diagnosed with either multiple personality disorder, schizophrenia, or major depression, and a control group, were rated. Patterns were examined and graphs were used to depict results. Certain features were found to distinguish each category. The descriptive statistical findings were both consistent and…

  13. Cross-diagnostic validity of the SF-36 physical functioning scale in patients with stroke, multiple sclerosis and amyotrophic lateral sclerosis: a study using Rasch analysis

    NARCIS (Netherlands)

    Dallmeijer, Annet J.; de Groot, Vincent; Roorda, Leo D.; Schepers, Vera P. M.; Lindeman, Eline; van den Berg, Leonard H.; Beelen, Anita; Dekker, Joost

    2007-01-01

    The aim of this study was to investigate unidimensionality and differential item functioning of the SF-36 physical functioning scale (PF10) in patients with various neurological disorders. Patients: Patients post-stroke (n = 198), with multiple sclerosis (n = 151) and amyotrophic lateral sclerosis

  14. Physical and cognitive functioning after 3 years can be predicted using information from the diagnostic process in recently diagnosed multiple sclerosis

    NARCIS (Netherlands)

    de Groot, Vincent; Beckerman, Heleen; Uitdehaag, Bernard M.; Hintzen, Rogier Q.; Minneboo, Arjan; Heymans, Martijn W.; Lankhorst, Gustaaf J.; Polman, Chris H.; Bouter, Lex M.; IJzerman, Maarten Joost

    2009-01-01

    Objective To predict functioning after 3 years in patients with recently diagnosed multiple sclerosis (MS). Design Inception cohort with 3 years of follow-up. At baseline, predictors were obtained from medical history taking, neurologic examination, and magnetic resonance imaging (MRI). Setting

  15. Diagnostic planning in JT-60 project

    International Nuclear Information System (INIS)

    Matoba, Tohru; Suzuki, Yasuo; Funahashi, Akimasa; Itagaki, Tokiyoshi

    1977-08-01

    The diagnostic plans of JT-60 were made along with design of the main machine. Basic requirements of the diagnostic program are (1) multiple measurement of respective plasma parameters, (2) efficient usage of the discharge, (3) capable data acquisition system, (4) high reliability of the diagnostic equipments, and (5) systematic development of new diagnostic techniques. Dimensions of the diagnostic ports were determined in detailed design of the vacuum vessel, anticipating the possible diagnostic methods. The proposed diagnostic systems and the plans are shown in table and figures respectively. Problems in the diagnostics are also described. (auth.)

  16. Long-term Outcome of Multiple Small-diameter Drilling Decompression Combined with Hip Arthroscopy versus Drilling Alone for Early Avascular Necrosis of the Femoral Head.

    Science.gov (United States)

    Li, Ji; Li, Zhong-Li; Zhang, Hao; Su, Xiang-Zheng; Wang, Ke-Tao; Yang, Yi-Meng

    2017-06-20

    Avascular necrosis of femoral head (AVNFH) typically presents in the young adults and progresses quickly without proper treatments. However, the optimum treatments for early stage of AVNFH are still controversial. This study was conducted to evaluate the therapeutic effects of multiple small-diameter drilling decompression combined with hip arthroscopy for early AVNFH compared to drilling alone. This is a nonrandomized retrospective case series study. Between April 2006 and November 2010, 60 patients (98 hips) with early stage AVNFH participated in this study. The patients underwent multiple small-diameter drilling decompression combined with hip arthroscopy in 26 cases/43 hips (Group A) or drilling decompression alone in 34 cases/55 hips (Group B). Patients were followed up at 6, 12, and 24 weeks, and every 6 months thereafter. Radiographs were taken at every follow-up, Harris scores were recorded at the last follow-up, the paired t-test was used to compare the postoperative Harris scores. Surgery effective rate of the two groups was compared using the Chi-square test. All patients were followed up for an average of 57.6 months (range: 17-108 months). Pain relief and improvement of hip function were assessed in all patients at 6 months after the surgery. At the last follow-up, Group A had better outcome with mean Harris' scores improved from 68.23 ± 11.37 to 82.07 ± 2.92 (t = -7.21, P = 0.001) than Group B with mean Harris' scores improved from 69.46 ± 9.71 to 75.79 ± 4.13 (t = -9.47, P = 0.037) (significantly different: t = -2.54, P = 0.017). The total surgery effective rate was also significantly different between Groups A and B (86.0% vs. 74.5%; χ2 = 3.69, P = 0.02). For early stage of AVNFH, multiple small-diameter drilling decompression combined with hip arthroscopy is more effective than drilling decompression alone.

  17. Long-term Outcome of Multiple Small-diameter Drilling Decompression Combined with Hip Arthroscopy versus Drilling Alone for Early Avascular Necrosis of the Femoral Head

    Science.gov (United States)

    Li, Ji; Li, Zhong-Li; Zhang, Hao; Su, Xiang-Zheng; Wang, Ke-Tao; Yang, Yi-Meng

    2017-01-01

    Background: Avascular necrosis of femoral head (AVNFH) typically presents in the young adults and progresses quickly without proper treatments. However, the optimum treatments for early stage of AVNFH are still controversial. This study was conducted to evaluate the therapeutic effects of multiple small-diameter drilling decompression combined with hip arthroscopy for early AVNFH compared to drilling alone. Methods: This is a nonrandomized retrospective case series study. Between April 2006 and November 2010, 60 patients (98 hips) with early stage AVNFH participated in this study. The patients underwent multiple small-diameter drilling decompression combined with hip arthroscopy in 26 cases/43 hips (Group A) or drilling decompression alone in 34 cases/55 hips (Group B). Patients were followed up at 6, 12, and 24 weeks, and every 6 months thereafter. Radiographs were taken at every follow-up, Harris scores were recorded at the last follow-up, the paired t-test was used to compare the postoperative Harris scores. Surgery effective rate of the two groups was compared using the Chi-square test. Results: All patients were followed up for an average of 57.6 months (range: 17–108 months). Pain relief and improvement of hip function were assessed in all patients at 6 months after the surgery. At the last follow-up, Group A had better outcome with mean Harris’ scores improved from 68.23 ± 11.37 to 82.07 ± 2.92 (t = −7.21, P = 0.001) than Group B with mean Harris’ scores improved from 69.46 ± 9.71 to 75.79 ± 4.13 (t = –9.47, P = 0.037) (significantly different: t = –2.54, P = 0.017). The total surgery effective rate was also significantly different between Groups A and B (86.0% vs. 74.5%; χ2 = 3.69, P = 0.02). Conclusion: For early stage of AVNFH, multiple small-diameter drilling decompression combined with hip arthroscopy is more effective than drilling decompression alone. PMID:28584206

  18. Senior high school students’ need analysis of Three-Tier Multiple Choice (3TMC) diagnostic test about acid-base and solubility equilibrium

    Science.gov (United States)

    Ardiansah; Masykuri, M.; Rahardjo, S. B.

    2018-05-01

    Students’ conceptual understanding is the most important comprehension to obtain related comprehension. However, they held their own conception. With this need analysis, we will elicit student need of 3TMC diagnostic test to measure students’ conception about acid-base and solubility equilibrium. The research done by a mixed method using questionnaire analysis based on descriptive of quantitative and qualitative. The research subject was 96 students from 4 senior high schools and 4 chemistry teachers chosen by random sampling technique. Data gathering used a questionnaire with 10 questions for student and 28 questions for teachers. The results showed that 97% of students stated that the development this instrument is needed. In addition, there were several problems obtained in this questionnaire include learning activity, teacher’s test and guessing. In conclusion, this is necessary to develop the 3TMC instrument that can diagnose and measure the student’s conception in acid-base and solubility equilibrium.

  19. Estimating Dbh of Trees Employing Multiple Linear Regression of the best Lidar-Derived Parameter Combination Automated in Python in a Natural Broadleaf Forest in the Philippines

    Science.gov (United States)

    Ibanez, C. A. G.; Carcellar, B. G., III; Paringit, E. C.; Argamosa, R. J. L.; Faelga, R. A. G.; Posilero, M. A. V.; Zaragosa, G. P.; Dimayacyac, N. A.

    2016-06-01

    Diameter-at-Breast-Height Estimation is a prerequisite in various allometric equations estimating important forestry indices like stem volume, basal area, biomass and carbon stock. LiDAR Technology has a means of directly obtaining different forest parameters, except DBH, from the behavior and characteristics of point cloud unique in different forest classes. Extensive tree inventory was done on a two-hectare established sample plot in Mt. Makiling, Laguna for a natural growth forest. Coordinates, height, and canopy cover were measured and types of species were identified to compare to LiDAR derivatives. Multiple linear regression was used to get LiDAR-derived DBH by integrating field-derived DBH and 27 LiDAR-derived parameters at 20m, 10m, and 5m grid resolutions. To know the best combination of parameters in DBH Estimation, all possible combinations of parameters were generated and automated using python scripts and additional regression related libraries such as Numpy, Scipy, and Scikit learn were used. The combination that yields the highest r-squared or coefficient of determination and lowest AIC (Akaike's Information Criterion) and BIC (Bayesian Information Criterion) was determined to be the best equation. The equation is at its best using 11 parameters at 10mgrid size and at of 0.604 r-squared, 154.04 AIC and 175.08 BIC. Combination of parameters may differ among forest classes for further studies. Additional statistical tests can be supplemented to help determine the correlation among parameters such as Kaiser- Meyer-Olkin (KMO) Coefficient and the Barlett's Test for Spherecity (BTS).

  20. Isotope ratio measurements of pg-size plutonium samples using TIMS in combination with the 'Multiple Ion Counting' and filament carburization

    Energy Technology Data Exchange (ETDEWEB)

    Jakopic, Rozle; Richter, Stephan; Kuehn, Heinz; Aregbe, Yetunde [European Commission, Directorate General Joint Research Centre Institute for Reference Materials and Measurements, IRMM Retieseweg 111, B-2440 Geel (Belgium)

    2008-07-01

    A new sample preparation procedure for isotopic measurements using the Triton TIMS (Thermal Ionization Mass Spectrometer) was developed which employed the technique of carburization of rhenium filaments. Carburized filaments were prepared in a special vacuum chamber in which the filaments were heated and exposed to benzene vapor. Ionization efficiency was improved by an order of magnitude. Additionally, a new 'multi-dynamic' measurement technique was developed for Pu isotope ratio measurements using the 'multiple ion counting' (MIC) system. This technique was further combined with the filament carburization technique and applied to the NBL-137 isotopic standard and samples of the NUSIMEP 5 inter-laboratory comparison campaign. The results clearly show an improved precision and accuracy for the 'multi-dynamic' measurement procedure, compared to measurements carried out either in peak-jumping or in static mode using the MIC system with non-carburized filaments. (authors)

  1. VANTAGE 095: An International, Multicenter, Open-Label Study of Vorinostat (MK-0683) in Combination With Bortezomib in Patients With Relapsed and Refractory Multiple Myeloma.

    Science.gov (United States)

    Siegel, David S; Dimopoulos, Meletios; Jagannath, Sundar; Goldschmidt, Hartmut; Durrant, Simon; Kaufman, Jonathan L; Leleu, Xavier; Nagler, Arnon; Offner, Fritz; Graef, Thorsten; Eid, Joseph E; Houp, Jennifer; Gause, Christine; Vuocolo, Scott; Anderson, Kenneth C

    2016-06-01

    The present global, open-label, single-arm, multicenter, phase IIb study was designed to determine the efficacy and tolerability of oral vorinostat combined with standard doses of bortezomib in patients with multiple myeloma considered refractory to novel myeloma agents. Eligible patients were age ≥ 18 years, had received ≥ 2 previous regimens, had disease refractory to ≥ 1 previous bortezomib-containing regimen, and had received ≥ 1 dose of an immunomodulatory drug (thalidomide or lenalidomide)-based regimen. The patients received 21-day cycles of bortezomib (1.3 mg/m(2) intravenously on days 1, 4, 8, and 11) plus oral vorinostat (400 mg/d on days 1-14). Oral dexamethasone, 20 mg, on the day of and the day after each dose of bortezomib could be added for patients with progressive disease after 2 cycles or no change after 4 cycles. The primary endpoint was the objective response rate. The objective response rate was 11.3% (95% confidence interval, 6.6%-17.7%), and the median duration of response was 211 days (range, 64-550 days). The median overall survival duration was 11.2 months (95% confidence interval, 8.5-14.4 months), with a 2-year survival rate of 32%. The frequently reported adverse events were thrombocytopenia (69.7%), nausea (57.0%), diarrhea (53.5%), anemia (52.1%), and fatigue (48.6%); the overall safety profile was consistent with that of bortezomib and vorinostat. The combination of vorinostat and bortezomib is active in patients with multiple myeloma refractory to novel treatment modalities and offers a new therapeutic option for this difficult-to-treat patient population (ClinicalTrials.gov identifier, NCT00773838). Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Multiple methods of surgical treatment combined with primary IOL implantation on traumatic lens subluxation/dislocation in patients with secondary glaucoma

    Directory of Open Access Journals (Sweden)

    Rui Wang

    2014-04-01

    Full Text Available AIM:To describe clinical findings and complications from cases of traumatic lens subluxation/dislocation in patients with secondary glaucoma, and discuss the multiple treating methods of operation combined with primary intraocular lens (IOL implantation.METHODS:Non-comparative retrospective observational case series. Participants:30 cases (30 eyes of lens subluxation/dislocation in patients with secondary glaucoma were investigated which accepted the surgical treatment by author in the Ophthalmology of Xi''an No.4 Hospital from 2007 to 2011. According to the different situations of lens subluxation/dislocation, various surgical procedures were performed such as crystalline lens phacoemulsification, crystalline lens phacoemulsification combined anterior vitrectomy, intracapsular cataract extraction combined anterior vitrectomy, lensectomy combined anterior vitrectomy though peripheral transparent cornea incision, pars plana lensectomy combined pars plana vitrectomy, and intravitreal cavity crystalline lens phacofragmentation combined pars plana vitrectomy. And whether to implement trabeculectomy depended on the different situations of secondary glaucoma. The posterior chamber intraocular lenses (PC-IOLs were implanted in the capsular-bag or trassclerally sutured in the sulus decided by whether the capsular were present. Main outcome measures:visual acuity, intraocular pressure, the situation of intraocular lens and complications after the operations.RESULTS: The follow-up time was 11-36mo (21.4±7.13. Postoperative visual acuity of all eyes were improved; 28 cases maintained IOP below 21 mm Hg; 2 cases had slightly IOL subluxation, 4 cases had slightly tilted lens optical area; 1 case had postoperative choroidal detachment; 4 cases had postoperative corneal edema more than 1wk, but eventually recovered transparent; 2 cases had mild postoperative vitreous hemorrhage, and absorbed 4wk later. There was no postoperative retinal detachment, IOL

  3. Molecular Beacons in Diagnostics

    OpenAIRE

    Tyagi, Sanjay; Kramer, Fred Russell

    2012-01-01

    Recent technical advances have begun to realize the potential of molecular beacons to test for diverse infections in clinical diagnostic laboratories. These include the ability to test for, and quantify, multiple pathogens in the same clinical sample, and to detect antibiotic resistant strains within hours. The design principles of molecular beacons have also spawned a variety of allied technologies.

  4. A novel combination of multiple primary carcinomas: Urinary bladder transitional cell carcinoma, prostate adenocarcinoma and small cell lung carcinoma- report of a case and review of the literature

    Directory of Open Access Journals (Sweden)

    Giannikaki Elpida

    2005-07-01

    Full Text Available Abstract Background The incidence of multiple primary malignant neoplasms increases with age and they are encountered more frequently nowadays than before, the phenomenon is still considered to be rare. Case presentation We report a case of a man in whom urinary bladder transitional cell carcinoma, metachronous prostate adenocarcinoma and small cell lung carcinoma were diagnosed within an eighteen-month period. The only known predisposing factor was that he was heavy smoker (90–100 packets per year. The literature on the phenomenon of multiple primary malignancies in a single patient is reviewed and the data is summarized. Conclusion It is important for the clinicians to keep in mind the possibility of a metachronous (successive or a synchronous (simultaneous malignancy in a cancer patient. It is worthy mentioning this case because clustering of three primary malignancies (synchronous and metachronous is of rare occurrence in a single patient, and, to our knowledge, this is the first report this combination of three carcinomas appearing in the same patient.

  5. ACM-based automatic liver segmentation from 3-D CT images by combining multiple atlases and improved mean-shift techniques.

    Science.gov (United States)

    Ji, Hongwei; He, Jiangping; Yang, Xin; Deklerck, Rudi; Cornelis, Jan

    2013-05-01

    In this paper, we present an autocontext model(ACM)-based automatic liver segmentation algorithm, which combines ACM, multiatlases, and mean-shift techniques to segment liver from 3-D CT images. Our algorithm is a learning-based method and can be divided into two stages. At the first stage, i.e., the training stage, ACM is performed to learn a sequence of classifiers in each atlas space (based on each atlas and other aligned atlases). With the use of multiple atlases, multiple sequences of ACM-based classifiers are obtained. At the second stage, i.e., the segmentation stage, the test image will be segmented in each atlas space by applying each sequence of ACM-based classifiers. The final segmentation result will be obtained by fusing segmentation results from all atlas spaces via a multiclassifier fusion technique. Specially, in order to speed up segmentation, given a test image, we first use an improved mean-shift algorithm to perform over-segmentation and then implement the region-based image labeling instead of the original inefficient pixel-based image labeling. The proposed method is evaluated on the datasets of MICCAI 2007 liver segmentation challenge. The experimental results show that the average volume overlap error and the average surface distance achieved by our method are 8.3% and 1.5 m, respectively, which are comparable to the results reported in the existing state-of-the-art work on liver segmentation.

  6. Combining wrist age and third molars in forensic age estimation: how to calculate the joint age estimate and its error rate in age diagnostics.

    Science.gov (United States)

    Gelbrich, Bianca; Frerking, Carolin; Weiss, Sandra; Schwerdt, Sebastian; Stellzig-Eisenhauer, Angelika; Tausche, Eve; Gelbrich, Götz

    2015-01-01

    Forensic age estimation in living adolescents is based on several methods, e.g. the assessment of skeletal and dental maturation. Combination of several methods is mandatory, since age estimates from a single method are too imprecise due to biological variability. The correlation of the errors of the methods being combined must be known to calculate the precision of combined age estimates. To examine the correlation of the errors of the hand and the third molar method and to demonstrate how to calculate the combined age estimate. Clinical routine radiographs of the hand and dental panoramic images of 383 patients (aged 7.8-19.1 years, 56% female) were assessed. Lack of correlation (r = -0.024, 95% CI = -0.124 to + 0.076, p = 0.64) allows calculating the combined age estimate as the weighted average of the estimates from hand bones and third molars. Combination improved the standard deviations of errors (hand = 0.97, teeth = 1.35 years) to 0.79 years. Uncorrelated errors of the age estimates obtained from both methods allow straightforward determination of the common estimate and its variance. This is also possible when reference data for the hand and the third molar method are established independently from each other, using different samples.

  7. Elotuzumab in combination with thalidomide and low-dose dexamethasone: a phase 2 single-arm safety study in patients with relapsed/refractory multiple myeloma.

    Science.gov (United States)

    Mateos, María-Victoria; Granell, Miguel; Oriol, Albert; Martinez-Lopez, Joaquin; Blade, Joan; Hernandez, Miguel T; Martín, Jesus; Gironella, Mercedes; Lynch, Mark; Bleickardt, Eric; Paliwal, Prashni; Singhal, Anil; San-Miguel, Jesus

    2016-11-01

    Elotuzumab is an immunostimulatory, humanized immunoglobulin G1 monoclonal antibody that selectively targets and kills signalling lymphocytic activation molecule family member 7-expressing myeloma cells. We evaluated the safety and tolerability of elotuzumab 10 mg/kg combined with thalidomide 50-200 mg and dexamethasone 40 mg (with/without cyclophosphamide 50 mg) in patients with relapsed/refractory multiple myeloma (RRMM). The primary endpoint was the proportion of grade ≥3 non-haematological adverse events (AEs); other endpoints included the number of dose reductions/discontinuations and efficacy. Forty patients were treated, who had a median of three previous therapies, including bortezomib (98%) and lenalidomide (73%). Grade ≥3 non-haematological AEs were reported in 63% of patients, most commonly asthenia (35%) and peripheral oedema (25%). Six (15%) patients had an infusion reaction. Twenty-six (65%) patients had ≥1 dose reduction/discontinuation due to an AE, none related to elotuzumab. Overall response rate was 38%; median progression-free survival was 3·9 months. Median overall survival was 16·3 months and the 1-year survival rate was 63%. Minimal incremental toxicity was observed with addition of elotuzumab to thalidomide/dexamethasone with or without cyclophosphamide, and efficacy data suggest clinical benefit in a highly pre-treated population. Elotuzumab combined with thalidomide may provide an additional treatment option for patients with RRMM. © 2016 John Wiley & Sons Ltd.

  8. 12 Weeks of Combined Endurance and Resistance Training Reduces Innate Markers of Inflammation in a Randomized Controlled Clinical Trial in Patients with Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Nathalie Deckx

    2016-01-01

    Full Text Available Previously, we reported that patients with multiple sclerosis (MS demonstrate improved muscle strength, exercise tolerance, and lean tissue mass following a combined endurance and resistance exercise program. However, the effect of exercise on the underlying disease pathogenesis remains elusive. Since recent evidence supports a crucial role of dendritic cells (DC in the pathogenesis of MS, we investigated the effect of a 12-week combined exercise program in MS patients on the number and function of DC. We demonstrate an increased number of plasmacytoid DC (pDC following the exercise program. These pDC display an activated phenotype, as evidenced by increased numbers of circulating CD62L+ and CD80+ pDC. Interestingly, the number of CD80+ pDC positively correlates with the presence of IL-10-producing regulatory type 1 cells (Tr1, an important cell type for maintaining peripheral tolerance to self-antigens. In addition, decreased production of the inflammatory mediators, TNF-α and MMP-9, upon Toll-like receptor (TLR stimulation was found at the end of the exercise program. Overall, our findings suggest that the 12-week exercise program reduces the secretion of inflammatory mediators upon TLR stimulation and promotes the immunoregulatory function of circulating pDC, suggestive for a favorable impact of exercise on the underlying immunopathogenesis of MS.

  9. Treatment of severe fluoroacetamide poisoning in patient with combined multiple organ dysfunction syndrome by evidence-based integrated Chinese and Western medicines: A case report.

    Science.gov (United States)

    Wen, Wanxin; Gao, Hongxia; Kang, Nini; Lu, Aili; Qian, Caiwen; Zhao, Yuanqi

    2017-07-01

    Fluoroacetamide poisoning is the acute and severe disease of human, which leads to nervous, digestive, and cardiovascular system damage or even death in a short period of time. We report a case of a 65-year-old woman with loss of consciousness, nausea, and vomiting who was sent to the hospital by passers-by. She was diagnosed with severe fluoroacetamide poisoning with combined multiple organ dysfunction syndrome. When the diagnosis was unclear, we gave gastric lavage, support and symptomatic treatment, and closely with the vital sign. When the diagnosis was clear, based on the evidence of retrieved, muscle injection of acetamide, calcium gluconate, and vitamin C. Traditional Chinese medicine aspect, oral administration of mung bean soup of glycyrrhizae and Da-Cheng-Qi decoction enema. By setting reasonable treatment for patients, she had no special discomfort and complications after treatment. Besides, through 1-month follow-up, it was confirmed that the treatments were effective. Evidence-based integrated Chinese and Western medicines can effectively improve the therapeutic effects in severe fluoroacetamide-poisoned patients with combined MODS.

  10. Vorinostat or placebo in combination with bortezomib in patients with multiple myeloma (VANTAGE 088): a multicentre, randomised, double-blind study.

    Science.gov (United States)

    Dimopoulos, Meletios; Siegel, David S; Lonial, Sagar; Qi, Junyuan; Hajek, Roman; Facon, Thierry; Rosinol, Laura; Williams, Catherine; Blacklock, Hilary; Goldschmidt, Hartmut; Hungria, Vania; Spencer, Andrew; Palumbo, Antonio; Graef, Thorsten; Eid, Joseph E; Houp, Jennifer; Sun, Linda; Vuocolo, Scott; Anderson, Kenneth C

    2013-10-01

    We aimed to assess efficacy and tolerability of vorinostat in combination with bortezomib for treatment of patients with relapsed or refractory multiple myeloma. In our randomised, double-blind, placebo-controlled, phase 3 trial, we enrolled adults (≥18 years) at 174 university hospitals in 31 countries worldwide. Eligible patients had to have non-refractory multiple myeloma that previously responded to treatment (one to three regimens) but were currently progressing, ECOG performance statuses of 2 or less, and no continuing toxic effects from previous treatment. We excluded patients with known resistance to bortezomib. We randomly allocated patients (1:1) using an interactive voice response system to receive 21 day cycles of bortezomib (1·3 mg/m(2) intravenously on days 1, 4, 8, and 11) in combination with oral vorinostat (400 mg) or matching placebo once-daily on days 1-14. We stratified patients by baseline tumour stage (International Staging System stage 1 or stage ≥2), previous bone-marrow transplantation (yes or no), and number of previous regimens (1 or ≥2). The primary endpoint was progression-free survival (PFS) in the intention-to-treat population. We assessed adverse events in all patients who received at least one dose of study drug. This study is registered with ClinicalTrials.gov, number 00773747. Between Dec 24, 2008, and Sept 8, 2011, we randomly allocated 317 eligible patients to the vorinostat group (315 of whom received at least one dose) and 320 to the placebo group (all of whom received at least one dose). Median PFS was 7·63 months (95% CI 6·87-8·40) in the vorinostat group and 6·83 months (5·67-7·73) in the placebo group (hazard ratio [HR] 0·77, 95% CI 0·64-0·94; p=0·0100). 312 (99%) of 315 patients in the vorinostat group and 315 (98%) of 320 patients in the placebo group had adverse events (300 [95%] adverse events in the vorinostat group and 282 [88%] in the control group were regarded as related to treatment). The most

  11. Efficacy and safety of minor endoscopic sphincterotomy combined with endoscopic papillary large balloon dilation in treatment of elderly patients with multiple large common bile duct stones

    Directory of Open Access Journals (Sweden)

    HE Yongfeng

    2018-02-01

    Full Text Available Objective To investigate the clinical effect and safety of minor endoscopic sphincterotomy (mEST combined with endoscopic papillary large balloon dilation (EPLBD in the treatment of elderly patients with multiple large common bile duct stones. MethodsA retrospective analysis was performed for 229 patients with multiple large common bile duct stones who underwent endoscopic retrograde cholangiopancreatography (ERCP in Endoscopy Center, Ankang Municipal Central Hospital, from January 2012 to December 2016, and the surgical procedure was selected based on the size of stones and the morphology of the common bile duct. According to the endoscopic surgical procedure, the patients were divided into mEST+EPLBD group (treatment group with 136 patients and endoscopic phincterotomy (EST group (control group with 93 patients. The two groups were compared in terms of the success rate of first stone removal, use rate of mechanical lithotripsy (ML, time spent on stone removal, and the incidence rate of complications. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsThere was no significant difference in the success rate of first stone removal between the treatment group and the control group (91.17% vs 87.10%, χ2=0.980, P>0.05, while there were significant differences in the time spent on stone removal (18.2±4.3 min vs 37.4±6.7 min, χ2=37.1526, P<0.01 and use rate of ML (6.71% vs 40.00%, t=24.411, P<0.01. There were no significant differences in the incidence rates of pancreatitis (2.94% vs 6.45%, χ2=1.630, P>0.05 and bleeding (2.21% vs 2.15%, χ2=0.001, P>0.05 between the two groups, and no patient experienced perforation or infection. ConclusionmEST+EPLBD has a good clinical effect in the treatment of elderly patients with multiple large common bile duct stones and can effectively shorten the time spent on stone removal, reduce the

  12. A methodology for combining multiple commercial data sources to improve measurement of the food and alcohol environment: applications of geographical information systems

    Directory of Open Access Journals (Sweden)

    Dara D. Mendez

    2014-11-01

    Full Text Available Commercial data sources have been increasingly used to measure and locate community resources. We describe a methodology for combining and comparing the differences in commercial data of the food and alcohol environment. We used commercial data from two commercial databases (InfoUSA and Dun&Bradstreet for 2003 and 2009 to obtain infor- mation on food and alcohol establishments and developed a matching process using computer algorithms and manual review by applying ArcGIS to geocode addresses, standard industrial classification and North American industry classification tax- onomy for type of establishment and establishment name. We constructed population and area-based density measures (e.g. grocery stores and assessed differences across data sources and used ArcGIS to map the densities. The matching process resulted in 8,705 and 7,078 unique establishments for 2003 and 2009, respectively. There were more establishments cap- tured in the combined dataset than relying on one data source alone, and the additional establishments captured ranged from 1,255 to 2,752 in 2009. The correlations for the density measures between the two data sources was highest for alcohol out- lets (r = 0.75 and 0.79 for per capita and area, respectively and lowest for grocery stores/supermarkets (r = 0.32 for both. This process for applying geographical information systems to combine multiple commercial data sources and develop meas- ures of the food and alcohol environment captured more establishments than relying on one data source alone. This replic- able methodology was found to be useful for understanding the food and alcohol environment when local or public data are limited.

  13. Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) Combined with Positron Emission Tomography-Computed Tomography (PET-CT) and Video-Electroencephalography (VEEG) Have Excellent Diagnostic Value in Preoperative Localization of Epileptic Foci in Children with Epilepsy.

    Science.gov (United States)

    Wang, Gui-Bin; Long, Wei; Li, Xiao-Dong; Xu, Guang-Yin; Lu, Ji-Xiang

    2017-01-01

    BACKGROUND To investigate the effect that dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has on surgical decision making relative to video-electroencephalography (VEEG) and positron emission tomography-computed tomography (PET-CT), and if the differences in these variables translates to differences in surgical outcomes. MATERIAL AND METHODS A total of 166 children with epilepsy undergoing preoperative DCE-MRI, VEEG, and PET-CT examinations, surgical resection of epileptic foci, and intraoperative electrocorticography (ECoG) monitoring were enrolled. All children were followed up for 12 months and grouped by Engles prognostic classification for epilepsy. Based on intraoperative ECoG as gold standard, the diagnostic values of DCE-MRI, VEEG, PET-CT, DCE-MRI combined with VEEG, DCE-MRI combined with PET-CT, and combined application of DCE-MRI, VEEG, and PET-CT in preoperative localization for epileptic foci were evaluated. RESULTS The sensitivity of DCE-MRI, VEEG, and PET-CT was 59.64%, 76.51%, and 93.98%, respectively; the accuracy of DCE-MRI, VEEG, PET-CT, DCE-MRI combined with VEEG, and DCE-MRI combined with PET-CT was 57.58%, 67.72%, 91.03%, 91.23%, and 96.49%, respectively. Localization accuracy rate of the combination of DCE-MRI, VEEG, and PET-CT was 98.25% (56/57), which was higher than that of DCE-MRI combined with VEEG and of DCE-MRI combined with PET-CT. No statistical difference was found in the accuracy rate of localization between these three combined techniques. During the 12-month follow-up, children were grouped into Engles grade I (n=106), II (n=31), III (n=21), and IV (n=8) according to postoperative conditions. CONCLUSIONS All DCE-MRI combined with VEEG, DCE-MRI combined with PET-CT, and DCE-MRI combined with VEEG and PET-CT examinations have excellent accuracy in preoperative localization of epileptic foci and present excellent postoperative efficiency, suggesting that these combined imaging methods are suitable for serving as the

  14. Cable Diagnostic Focused Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Hartlein, R.A.; Hampton, R.N.

    2010-12-30

    This report summarizes an extensive effort made to understand how to effectively use the various diagnostic technologies to establish the condition of medium voltage underground cable circuits. These circuits make up an extensive portion of the electric delivery infrastructure in the United States. Much of this infrastructure is old and experiencing unacceptable failure rates. By deploying efficient diagnostic testing programs, electric utilities can replace or repair circuits that are about to fail, providing an optimal approach to improving electric system reliability. This is an intrinsically complex topic. Underground cable systems are not homogeneous. Cable circuits often contain multiple branches with different cable designs and a range of insulation materials. In addition, each insulation material ages differently as a function of time, temperature and operating environment. To complicate matters further, there are a wide variety of diagnostic technologies available for assessing the condition of cable circuits with a diversity of claims about the effectiveness of each approach. As a result, the benefits of deploying cable diagnostic testing programs have been difficult to establish, leading many utilities to avoid the their use altogether. This project was designed to help address these issues. The information provided is the result of a collaborative effort between Georgia Tech NEETRAC staff, Georgia Tech academic faculty, electric utility industry participants, as well as cable system diagnostic testing service providers and test equipment providers. Report topics include: •How cable systems age and fail, •The various technologies available for detecting potential failure sites, •The advantages and disadvantages of different diagnostic technologies, •Different approaches for utilities to employ cable system diagnostics. The primary deliverables of this project are this report, a Cable Diagnostic Handbook (a subset of this report) and an online

  15. Molecular Diagnostics

    OpenAIRE

    Choe, Hyonmin; Deirmengian, Carl A.; Hickok, Noreen J.; Morrison, Tiffany N.; Tuan, Rocky S.

    2015-01-01

    Orthopaedic infections are complex conditions that require immediate diagnosis and accurate identification of the causative organisms to facilitate appropriate management. Conventional methodologies for diagnosis of these infections sometimes lack accuracy or sufficient rapidity. Current molecular diagnostics are an emerging area of bench-to-bedside research in orthopaedic infections. Examples of promising molecular diagnostics include measurement of a specific biomarker in the synovial fluid...

  16. Video integrated measurement system. [Diagnostic display devices

    Energy Technology Data Exchange (ETDEWEB)

    Spector, B.; Eilbert, L.; Finando, S.; Fukuda, F.

    1982-06-01

    A Video Integrated Measurement (VIM) System is described which incorporates the use of various noninvasive diagnostic procedures (moire contourography, electromyography, posturometry, infrared thermography, etc.), used individually or in combination, for the evaluation of neuromusculoskeletal and other disorders and their management with biofeedback and other therapeutic procedures. The system provides for measuring individual diagnostic and therapeutic modes, or multiple modes by split screen superimposition, of real time (actual) images of the patient and idealized (ideal-normal) models on a video monitor, along with analog and digital data, graphics, color, and other transduced symbolic information. It is concluded that this system provides an innovative and efficient method by which the therapist and patient can interact in biofeedback training/learning processes and holds considerable promise for more effective measurement and treatment of a wide variety of physical and behavioral disorders.

  17. ORION laser target diagnostics

    International Nuclear Information System (INIS)

    Bentley, C. D.; Edwards, R. D.; Andrew, J. E.; James, S. F.; Gardner, M. D.; Comley, A. J.; Vaughan, K.; Horsfield, C. J.; Rubery, M. S.; Rothman, S. D.; Daykin, S.; Masoero, S. J.; Palmer, J. B.; Meadowcroft, A. L.; Williams, B. M.; Gumbrell, E. T.; Fyrth, J. D.; Brown, C. R. D.; Hill, M. P.; Oades, K.

    2012-01-01

    The ORION laser facility is one of the UK's premier laser facilities which became operational at AWE in 2010. Its primary mission is one of stockpile stewardship, ORION will extend the UK's experimental plasma physics capability to the high temperature, high density regime relevant to Atomic Weapons Establishment's (AWE) program. The ORION laser combines ten laser beams operating in the ns regime with two sub ps short pulse chirped pulse amplification beams. This gives the UK a unique combined long pulse/short pulse laser capability which is not only available to AWE personnel but also gives access to our international partners and visiting UK academia. The ORION laser facility is equipped with a comprehensive suite of some 45 diagnostics covering optical, particle, and x-ray diagnostics all able to image the laser target interaction point. This paper focuses on a small selection of these diagnostics.

  18. ORION laser target diagnostics.

    Science.gov (United States)

    Bentley, C D; Edwards, R D; Andrew, J E; James, S F; Gardner, M D; Comley, A J; Vaughan, K; Horsfield, C J; Rubery, M S; Rothman, S D; Daykin, S; Masoero, S J; Palmer, J B; Meadowcroft, A L; Williams, B M; Gumbrell, E T; Fyrth, J D; Brown, C R D; Hill, M P; Oades, K; Wright, M J; Hood, B A; Kemshall, P

    2012-10-01

    The ORION laser facility is one of the UK's premier laser facilities which became operational at AWE in 2010. Its primary mission is one of stockpile stewardship, ORION will extend the UK's experimental plasma physics capability to the high temperature, high density regime relevant to Atomic Weapons Establishment's (AWE) program. The ORION laser combines ten laser beams operating in the ns regime with two sub ps short pulse chirped pulse amplification beams. This gives the UK a unique combined long pulse/short pulse laser capability which is not only available to AWE personnel but also gives access to our international partners and visiting UK academia. The ORION laser facility is equipped with a comprehensive suite of some 45 diagnostics covering optical, particle, and x-ray diagnostics all able to image the laser target interaction point. This paper focuses on a small selection of these diagnostics.

  19. Selected Arterial Infusion Chemotherapy Combined with Target Drugs 
for Non-small Cell Lung Cancer with Multiple Brain Metastase

    Directory of Open Access Journals (Sweden)

    Jinduo LI

    2012-05-01

    Full Text Available Background and objective The aim of this study is to evaluate the efficacy of selected arterial infusion chemotherapy in treating non-small cell lung cancer (NSCLC with multiple brain metastases and corresponding factors to influencing prognosis. Methods From September 2008 to October 2011, a total of 31 patients of NSCLC with multiple brain metastases (≥3 received selected incranial, bronchial and corresponding target arterial infusion chemotherapy combined with EGFR-TKIs. Interventional treatment was performed every four weeks, two-six cycles with synchronized or sequential targeted drugs (erlotinib, gefitinib or icotinib. Follow-up CT and MRI were regularly finished at interval of four weeks after two cycles of interventional treatment were finished or during taking targeted drugs in order to evaluate efficacy of the therapy. The procedure was stopped for the tumor disease was worse or the patient could not tolerate the toxity of drugs any longer. Results 31 patients was performed two to six cycles of interventional therapy, 3cycles at average. Response assessment showed that 5 (16.1% patients got a complete response (CR, 7 (22.6% had a partial response (PR, 11 (35.5% had a stable disease (SD and 8 (25.8% had a progressive disease (PD. The objective response rate (ORR was 38.7%, and the disease control rate was 74.2%. The median progression free survival (PFS and overall survival (OS were 13.1 months and 15.1 months. The 6-month survival rate, one-year survival rate and two-year survival rate were 79%, 61.1%, and 31.1%, respectively. The patients’ OS and PFS were influenced by smoking state, tumor pathology, extracranial metastases, period of targeted drug taking and performance status, not by sex, age, before therapy and the total of brain metastases. Conclusion Selected arterial infusion chemotherapy with targeted drugs is one of the most effective and safe treatment to NSCLC with multiple brain metastases. Smoking status, tumor

  20. Internal correction of spectral interferences and mass bias for selenium metabolism studies using enriched stable isotopes in combination with multiple linear regression.

    Science.gov (United States)

    Lunøe, Kristoffer; Martínez-Sierra, Justo Giner; Gammelgaard, Bente; Alonso, J Ignacio García

    2012-03-01

    The analytical methodology for the in vivo study of selenium metabolism using two enriched selenium isotopes has been modified, allowing for the internal correction of spectral interferences and mass bias both for total selenium and speciation analysis. The method is based on the combination of an already described dual-isotope procedure with a new data treatment strategy based on multiple linear regression. A metabolic enriched isotope ((77)Se) is given orally to the test subject and a second isotope ((74)Se) is employed for quantification. In our approach, all possible polyatomic interferences occurring in the measurement of the isotope composition of selenium by collision cell quadrupole ICP-MS are taken into account and their relative contribution calculated by multiple linear regression after minimisation of the residuals. As a result, all spectral interferences and mass bias are corrected internally allowing the fast and independent quantification of natural abundance selenium ((nat)Se) and enriched (77)Se. In this sense, the calculation of the tracer/tracee ratio in each sample is straightforward. The method has been applied to study the time-related tissue incorporation of (77)Se in male Wistar rats while maintaining the (nat)Se steady-state conditions. Additionally, metabolically relevant information such as selenoprotein synthesis and selenium elimination in urine could be studied using the proposed methodology. In this case, serum proteins were separated by affinity chromatography while reverse phase was employed for urine metabolites. In both cases, (74)Se was used as a post-column isotope dilution spike. The application of multiple linear regression to the whole chromatogram allowed us to calculate the contribution of bromine hydride, selenium hydride, argon polyatomics and mass bias on the observed selenium isotope patterns. By minimising the square sum of residuals for the whole chromatogram, internal correction of spectral interferences and mass