Quality control procedure for a general diagnostic x-ray machine

International Nuclear Information System (INIS)

Md Saion Salikin; Mazlyfarina Mohamad

2001-01-01

Performance tests of a particular medical diagnostic x-ray machine have to be carried out regularly in order to ensure that the machine always complies with the required standard. A performance report which is prepared based on the performance tests on the x-ray machine is used as one of the requirement by the authority for issuance and renewal licence to operate and use of the x-ray machine in a clinic or hospital. The Ministry of Health will only issue a licence to the clinic or hospital to use and operate x-ray machines, if the machines have complied with the standards. The clinic or hospital may get the service to carry out performance tests on a diagnostic x-ray machine from any licence H holder, issued by the authority under Atomic Energy Licensing Act 1984. A comparative study between the standard procedure and other procedures on performance test of a general diagnostic x-ray machine is carried out and presented in brief in this paper. The criteria for compliance or otherwise as required by the Ministry of Health Malaysia is discussed and explained in brief. (Author)

Current diagnostic procedures for diagnosing vertigo and dizziness

Science.gov (United States)

Walther, Leif Erik

2017-01-01

Vertigo is a multisensory syndrome that otolaryngologists are confronted with every day. With regard to the complex functions of the sense of orientation, vertigo is considered today as a disorder of the sense of direction, a disturbed spatial perception of the body. Beside the frequent classical syndromes for which vertigo is the leading symptom (e.g. positional vertigo, vestibular neuritis, Menière’s disease), vertigo may occur as main or accompanying symptom of a multitude of ENT-related diseases involving the inner ear. It also concerns for example acute and chronic viral or bacterial infections of the ear with serous or bacterial labyrinthitis, disorders due to injury (e.g. barotrauma, fracture of the oto-base, contusion of the labyrinth), chronic-inflammatory bone processes as well as inner ear affections in the perioperative course. In the last years, diagnostics of vertigo have experienced a paradigm shift due to new diagnostic possibilities. In the diagnostics of emergency cases, peripheral and central disorders of vertigo (acute vestibular syndrome) may be differentiated with simple algorithms. The introduction of modern vestibular test procedures (video head impulse test, vestibular evoked myogenic potentials) in the clinical practice led to new diagnostic options that for the first time allow a complex objective assessment of all components of the vestibular organ with relatively low effort. Combined with established methods, a frequency-specific assessment of the function of vestibular reflexes is possible. New classifications allow a clinically better differentiation of vertigo syndromes. Modern radiological procedures such as for example intratympanic gadolinium application for Menière’s disease with visualization of an endolymphatic hydrops also influence current medical standards. Recent methodical developments significantly contributed to the possibilities that nowadays vertigo can be better and more quickly clarified in particular in

Advances in nucleic acid-based diagnostics of bacterial infections

DEFF Research Database (Denmark)

Barken, Kim Bundvig; Haagensen, Janus Anders Juul; Tolker-Nielsen, Tim

2007-01-01

Methods for rapid detection of infectious bacteria and antimicrobial-resistant pathogens have evolved significantly over the last decade. Many of the new procedures are nucleic acid-based and replace conventional diagnostic methods like culturing which is time consuming especially with fastidious...... of these pathogens is important to isolate patients and prevent further spreading of the diseases. Newly developed diagnostic procedures are superior with respect to turnaround time, sensitivity and specificity. Methods like multiplex real time PCR and different array-based technologies offer the possibility...

Office-Based Procedures for the Diagnosis and Treatment of Laryngeal Pathology.

Science.gov (United States)

Wellenstein, David J; Schutte, Henrieke W; Takes, Robert P; Honings, Jimmie; Marres, Henri A M; Burns, James A; van den Broek, Guido B

2017-09-18

Since the development of distal chip endoscopes with a working channel, diagnostic and therapeutic possibilities in the outpatient clinic in the management of laryngeal pathology have increased. Which of these office-based procedures are currently available, and their clinical indications and possible advantages, remains unclear. Review of literature on office-based procedures in laryngology and head and neck oncology. Flexible endoscopic biopsy (FEB), vocal cord injection, and laser surgery are well-established office-based procedures that can be performed under topical anesthesia. These procedures demonstrate good patient tolerability and multiple advantages. Office-based procedures under topical anesthesia are currently an established method in the management of laryngeal pathology. These procedures offer medical and economic advantages compared with operating room-performed procedures. Furthermore, office-based procedures enhance the speed and timing of the diagnostic and therapeutic process. Copyright © 2017 The Voice Foundation. All rights reserved.

Updating Allergy and/or Hypersensitivity Diagnostic Procedures in the WHO ICD-11 Revision.

Science.gov (United States)

Tanno, Luciana Kase; Calderon, Moises A; Li, James; Casale, Thomas; Demoly, Pascal

2016-01-01

The classification of allergy and/or hypersensitivity conditions for the World Health Organization (WHO) International Classification of Diseases (ICD)-11 provides the appropriate corresponding codes for allergic diseases, assuming that the final diagnosis is correct. This classification should be linked to in vitro and in vivo diagnostic procedures. Considering the impact for our specialty, we decided to review the codification of these procedures into the ICD aiming to have a baseline and to suggest changes and/or submit new proposals. For that, we prepared a list of the relevant allergy and/or hypersensitivity diagnostic procedures that health care professionals are dealing with on a daily basis. This was based on the main current guidelines and selected all possible and relevant corresponding terms from the ICD-10 (2015 version) and the ICD-11 β phase foundation (June 2015 version). More than 90% of very specific and important diagnostic procedures currently used by the allergists' community on a daily basis are missing. We observed that some concepts usually used by the allergist community on a daily basis are not fully recognized by other specialties. The whole scheme and the correspondence in the ICD-10 (2015 version) and ICD-11 foundation (June 2015 version) provided us a big picture of the missing or imprecise terms and how they are scattered in the current ICD-11 framework, allowing us to submit new proposals to increase the visibility of the allergy and/or hypersensitivity conditions and diagnostic procedures. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. All rights reserved.

Developing an automated database for monitoring ultrasound- and computed tomography-guided procedure complications and diagnostic yield.

Science.gov (United States)

Itri, Jason N; Jones, Lisa P; Kim, Woojin; Boonn, William W; Kolansky, Ana S; Hilton, Susan; Zafar, Hanna M

2014-04-01

Monitoring complications and diagnostic yield for image-guided procedures is an important component of maintaining high quality patient care promoted by professional societies in radiology and accreditation organizations such as the American College of Radiology (ACR) and Joint Commission. These outcome metrics can be used as part of a comprehensive quality assurance/quality improvement program to reduce variation in clinical practice, provide opportunities to engage in practice quality improvement, and contribute to developing national benchmarks and standards. The purpose of this article is to describe the development and successful implementation of an automated web-based software application to monitor procedural outcomes for US- and CT-guided procedures in an academic radiology department. The open source tools PHP: Hypertext Preprocessor (PHP) and MySQL were used to extract relevant procedural information from the Radiology Information System (RIS), auto-populate the procedure log database, and develop a user interface that generates real-time reports of complication rates and diagnostic yield by site and by operator. Utilizing structured radiology report templates resulted in significantly improved accuracy of information auto-populated from radiology reports, as well as greater compliance with manual data entry. An automated web-based procedure log database is an effective tool to reliably track complication rates and diagnostic yield for US- and CT-guided procedures performed in a radiology department.

Diagnostical Procedure for Logistical Management in Turistical Entities

Directory of Open Access Journals (Sweden)

Libia Arlen Fergusson-Álvarez

2016-06-01

Full Text Available This research aims to design a diagnostic procedure of the logistics management for turistical entities, they could be hotels or not. This procedure was validated in Commercial Branch Caracol Santiago de Cuba and finally, different actions for the detected problems were proposed with the objective of improving the logistics management of the organization. To develop this research various tools and techniques served as support, such as: surveys, SPSS software (Statistical Package for Social Sciences 15.0 version and Decision 1.0 version, exponential smoothing, Cronbach's Alpha, the coefficient of Kendall W, financial and logistical indicators, the ABC or Pareto Method, the matrices for the classification of stocks and suppliers, among others. This research made possible the design of a diagnostic procedure for logistical management for turistical entities. And it was validated in the Comercial Branch Caracol Santiago, which allowed the proposition of improvement actions for increasing customer satisfaction.

[Evaluation of quality of HIV diagnostic procedures in Poland].

Science.gov (United States)

Parczewski, Miłosz; Madaliński, Kazimierz; Leszczyszyn-Pynka, Magdalena; Boroń-Kaczmarska, Anna

2010-01-01

The aim of this work was quality assessment of HIV diagnostic procedures in Poland, including human and technical resources as well as laboratory practice. Sixty questionnaires were distributed among diagnostic centers to obtain qualitative data. Basing on the survey data serological control using coded panels of HIV-1/2 samples was performed. Thirty-one filled questionnaires were received (50.8%). Surveyed laboratories perform from 350 to 5500 serological screening tests per year. In most of laboratories fourth generation assays are available, while Blood Donation Centers screen the blood both with serological assays and by HIV-RNA detection. Sanitary and Epidemiological Stations and academic laboratories hold the ISO/IEC 17025 or IS0 9001:2001 accreditation, five of the surveyed centers participate in Labquality assurance and two in Quality Control in Molecular Diagnostics programs. Data of control serological testing were received from 21 centers. In the quality control assessment 194 analyses were performed with 91 true negative, 2 false negative, 96 true positive and 5 false positive results. False negative rate of % and false positive rate of 5.2% was noted for this study. Currently, virtually no guidelines related to the HIV-diagnostics quality assurance and control in Poland are in delineated. Development of the national unified quality control system, basing on the central institution is highly desirable. National certification within the frames of the quality control and assurance program should be mandatory for all the diagnostic labs, and aim at improvement of reliability of the result distributed among clinicians and patients.

9 CFR 147.8 - Procedures for preparing egg yolk samples for diagnostic tests.

Science.gov (United States)

2010-01-01

... samples for diagnostic tests. 147.8 Section 147.8 Animals and Animal Products ANIMAL AND PLANT HEALTH... IMPROVEMENT PLAN Blood Testing Procedures § 147.8 Procedures for preparing egg yolk samples for diagnostic... for diagnostic testing. (b) The authorized laboratory must identify each egg as to the breeding flock...

Cumulative ionizing radiation during coronary diagnostic and interventional procedures

International Nuclear Information System (INIS)

Oyarzun C, Carlos; Ramirez, Alfredo

2001-01-01

The diagnostic ability of ionizing radiation is well known and has led to the development of high speed, high resolution axial tomography, for which we must assume that the patient population is being exposed to ionizing radiation that could become great. In cardiology, especially, we attend patients that have to undergo two or three angio graph, diagnostic and other therapeutic procedures, accumulating radiation doses that are ignored and are not recorded. The skin doses are shown that were received by 18 patients in procedures that included coronary angiography and that were measured with cesium thermoluminescent detectors, varying from 54 to 877 mSv. per procedure. We propose that a personal register be set up in Chile to record the magnitude of the radiation received by a patient (CO)

Nanotechnology based diagnostics for neurological disorders

Energy Technology Data Exchange (ETDEWEB)

Kurek, Nicholas S; Chandra, Sathees B., E-mail: schandra@roosevelt.edu [Department of Biological, Chemical and Physical Sciences, Roosevelt University, Chicago, IL (United States)

2012-07-01

Nanotechnology involves probing and manipulating matter at the molecular level. Nanotechnology based molecular diagnostics have the potential to alleviate the suffering caused by many diseases, including neurological disorders, due to the unique properties of nanomaterials. Most neurological illnesses are multifactorial conditions and many of these are also classified as neurobehavioral disorders. Alzheimer's disease, Parkinson's disease, Huntington disease, cerebral ischemia, epilepsy, schizophrenia and autism spectrum disorders like Rett syndrome are some examples of neurological disorders that could be better treated, diagnosed, prevented and possibly cured using nanotechnology. In order to improve the quality of life for disease afflicted people, a wide range of nanomaterials that include gold and silica nanoparticles, quantum dots and DNA along with countless other forms of nanotechnology have been investigated regarding their usefulness in advancing molecular diagnostics. Other small scaled materials like viruses and proteins also have potential for use as molecular diagnostic tools. Information obtained from nanotechnology based diagnostics can be stored and manipulated using bioinformatics software. More advanced nanotechnology based diagnostic procedures for the acquisition of even greater proteomic and genomic knowledge can then be developed along with better ways to fight various diseases. Nanotechnology also has numerous applications besides those related to biotechnology and medicine. In this article, we will discuss and analyze many novel nanotechnology based diagnostic techniques at our disposal today. (author)

Nanotechnology based diagnostics for neurological disorders

Energy Technology Data Exchange (ETDEWEB)

Kurek, Nicholas S.; Chandra, Sathees B., E-mail: schandra@roosevelt.edu [Department of Biological, Chemical and Physical Sciences, Roosevelt University, Chicago, IL (United States)

2012-07-01

Nanotechnology involves probing and manipulating matter at the molecular level. Nanotechnology based molecular diagnostics have the potential to alleviate the suffering caused by many diseases, including neurological disorders, due to the unique properties of nanomaterials. Most neurological illnesses are multifactorial conditions and many of these are also classified as neurobehavioral disorders. Alzheimer's disease, Parkinson's disease, Huntington disease, cerebral ischemia, epilepsy, schizophrenia and autism spectrum disorders like Rett syndrome are some examples of neurological disorders that could be better treated, diagnosed, prevented and possibly cured using nanotechnology. In order to improve the quality of life for disease afflicted people, a wide range of nanomaterials that include gold and silica nanoparticles, quantum dots and DNA along with countless other forms of nanotechnology have been investigated regarding their usefulness in advancing molecular diagnostics. Other small scaled materials like viruses and proteins also have potential for use as molecular diagnostic tools. Information obtained from nanotechnology based diagnostics can be stored and manipulated using bioinformatics software. More advanced nanotechnology based diagnostic procedures for the acquisition of even greater proteomic and genomic knowledge can then be developed along with better ways to fight various diseases. Nanotechnology also has numerous applications besides those related to biotechnology and medicine. In this article, we will discuss and analyze many novel nanotechnology based diagnostic techniques at our disposal today. (author)

Nanotechnology based diagnostics for neurological disorders

International Nuclear Information System (INIS)

Kurek, Nicholas S.; Chandra, Sathees B.

2012-01-01

Nanotechnology involves probing and manipulating matter at the molecular level. Nanotechnology based molecular diagnostics have the potential to alleviate the suffering caused by many diseases, including neurological disorders, due to the unique properties of nanomaterials. Most neurological illnesses are multifactorial conditions and many of these are also classified as neurobehavioral disorders. Alzheimer's disease, Parkinson's disease, Huntington disease, cerebral ischemia, epilepsy, schizophrenia and autism spectrum disorders like Rett syndrome are some examples of neurological disorders that could be better treated, diagnosed, prevented and possibly cured using nanotechnology. In order to improve the quality of life for disease afflicted people, a wide range of nanomaterials that include gold and silica nanoparticles, quantum dots and DNA along with countless other forms of nanotechnology have been investigated regarding their usefulness in advancing molecular diagnostics. Other small scaled materials like viruses and proteins also have potential for use as molecular diagnostic tools. Information obtained from nanotechnology based diagnostics can be stored and manipulated using bioinformatics software. More advanced nanotechnology based diagnostic procedures for the acquisition of even greater proteomic and genomic knowledge can then be developed along with better ways to fight various diseases. Nanotechnology also has numerous applications besides those related to biotechnology and medicine. In this article, we will discuss and analyze many novel nanotechnology based diagnostic techniques at our disposal today. (author)

Genetic risk from diagnostic X-ray procedures

International Nuclear Information System (INIS)

Stephan, G.

1980-01-01

This essay introduces epidemiologic studies concerned with the question whether diagnostic X-ray procedures might be the cause of an increased genetic risk. All studies have selected Down's syndrome (mongolism) as genetic indicator. They indiscriminately present the opinion of the respective author. Approximately one half of the studies conclude that radiation exposure will not influence the spontaneous incidence of Down's syndrome in diagnostics, the other half finds a positive relationship between frequent radiation exposure and the incidence of the syndrome. For various reasons, explained in detail, the results of the studies under discussion are suitable for forming hypotheses, but should not be viewed as providing evidence. (orig.) [de

Anaesthesiological aspects of thorax-diagnostic procedures in intensive-care units

International Nuclear Information System (INIS)

Schulte am Esch, J.

1989-01-01

Diagnostic procedures of the thorax in intensive-care units are conventional X-ray chest images, chest images by digital luminescence radiography, sonography and transoesophageal Doppler echocardiography. In addition to these bedside methods the stationary usable techniques, such as computed tomography, digital subtraction angiography and the seldom in intensive care patients used computed nuclear spin resonance tomography (NMR) are applicable. The selection of the above mentioned techniques depends on the availability and the quality of the methods as well as the qualifications of the involved staff. The diagnostic procedures of the chest must be arranged depending on the decision if patients have to be transported or not. In conclusion it can be stated that in spite of growing technical preconditions the availability of the methods in immobile patients and the diagnostic potency of the techniques have to be examined. (orig.) [de

MRI-guided stereotactic neurosurgical procedures in a diagnostic MRI suite: Background and safe practice recommendations.

Science.gov (United States)

Larson, Paul S; Willie, Jon T; Vadivelu, Sudhakar; Azmi-Ghadimi, Hooman; Nichols, Amy; Fauerbach, Loretta Litz; Johnson, Helen Boehm; Graham, Denise

2017-07-01

The development of navigation technology facilitating MRI-guided stereotactic neurosurgery has enabled neurosurgeons to perform a variety of procedures ranging from deep brain stimulation to laser ablation entirely within an intraoperative or diagnostic MRI suite while having real-time visualization of brain anatomy. Prior to this technology, some of these procedures required multisite workflow patterns that presented significant risk to the patient during transport. For those facilities with access to this technology, safe practice guidelines exist only for procedures performed within an intraoperative MRI. There are currently no safe practice guidelines or parameters available for facilities looking to integrate this technology into practice in conventional MRI suites. Performing neurosurgical procedures in a diagnostic MRI suite does require precautionary measures. The relative novelty of technology and workflows for direct MRI-guided procedures requires consideration of safe practice recommendations, including those pertaining to infection control and magnet safety issues. This article proposes a framework of safe practice recommendations designed for assessing readiness and optimization of MRI-guided neurosurgical interventions in the diagnostic MRI suite in an effort to mitigate patient risk. The framework is based on existing clinical evidence, recommendations, and guidelines related to infection control and prevention, health care-associated infections, and magnet safety, as well as the clinical and practical experience of neurosurgeons utilizing this technology. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.

Radiation injury of the skin following diagnostic and interventional fluoroscopic procedures

International Nuclear Information System (INIS)

Koenig, T.R.; Wagner, L.K.; Mettler, F.A.

2001-01-01

Many radiation injuries to the skin, resulting from diagnostic and interventional fluoroscopic procedures, have been reported in recent years. In some cases skin damage was severe and debilitating. We analyzed 72 reports of skin injuries for progression and location of injury, type and number of procedures, and contributing patient and operator factors. Most cases (46) were related to coronary angiography and percutaneous transluminal coronary angioplasty (PTCA). A smaller number was documented after cardiac radiofrequency catheter ablation (12), transjugular intrahepatic portosystemic shunt (TIPS) placement (7), neuroradiological interventions (3) and other procedures (4). Important factors leading to skin injuries were long exposure times over the same skin area, use of high dose rates, irradiation through thick tissue masses, hypersensitivity to radiation, and positioning of arms or breasts into the radiation entrance beam. Physicians were frequently unaware of the high radiation doses involved and did not recognize the injuries as radiation induced. Based on these findings, recommendations to reduce dose and improve patient care are provided. (author)

Analysis of risk in computerized tomography and other diagnostic radiology procedures

International Nuclear Information System (INIS)

Mossman, K.L.

1982-01-01

Medical practice entails continuous risks to the patient taken in good faith by the physician for the benefit of the patient. Risk of radiation induced cancer death approximates 10(-4) per cGy (rad). Assuming an average whole body dose of 0.1 cGy for many diagnostic X-ray procedures, the probability of radiation-induced cancer death is about 10(-5). The purpose of this paper is to compare the risks of common diagnostic X-ray procedures including computerized tomography (CT) with risks of smoking or automobile travel. Such comparisons should be constructive in putting radiation in perspective and facilitating explanation of risk/benefit to patients

Simulation-based education leads to decreased use of fluoroscopy in diagnostic coronary angiography.

Science.gov (United States)

Prenner, Stuart B; Wayne, Diane B; Sweis, Ranya N; Cohen, Elaine R; Feinglass, Joe M; Schimmel, Daniel R

2017-08-02

The aim of this study is to determine whether simulation-based education (SBE) translates into reduced procedure time, radiation, and contrast use in actual clinical care. As a high volume procedure often performed by novice cardiology fellows, diagnostic coronary angiography represents an excellent target for SBE. Reports of SBE in interventional cardiology are limited and there is little understanding of the potential downstream clinical impact of these interventions. All diagnostic coronary angiograms performed at a single center between January 1, 2011 and June 30, 2015 were analyzed. Random effects linear regression models were used to compare outcomes between procedures performed by 12 cardiology fellows who underwent simulation-based training and those performed by 20 traditionally trained fellows. Thirty-two cardiology fellows performed 2,783 diagnostic coronary angiograms. Procedures performed by fellows trained with SBE were shorter (mean of 23.98 min vs. 24.94 min, P = 0.034) and were performed with decreased radiation (mean of 56,348 mGycm 2 vs. 66,120 mGycm 2 , P < 0.001). After controlling for year in training, procedure year, access site, and supervising attending physician, training on the simulator was independently associated with 117 fewer seconds of fluoroscopy time per procedure (P = 0.04). Diagnostic coronary angiography SBE is associated with decreased use of fluoroscopy in downstream clinical care. SBE may be a useful tool to reduce radiation exposure in the cardiac catheterization laboratory. © 2017 Wiley Periodicals, Inc.

Learning Diagnostic Diagrams in Transport-Based Data-Collection Systems

DEFF Research Database (Denmark)

Tran, Vu The; Eklund, Peter; Cook, Chris

2014-01-01

Insights about service improvement in a transit network can be gained by studying transit service reliability. In this paper, a general procedure for constructing a transit service reliability diagnostic (Tsrd) diagram based on a Bayesian network is proposed to automatically build a behavioural...

Pain related to cancer treatments and diagnostic procedures: a no man's land?

Science.gov (United States)

Ripamonti, C I; Bossi, P; Santini, D; Fallon, M

2014-06-01

While guidelines are available for the management of cancer-related pain, little attention is given to the assessment and treatment of pain caused by treatments and diagnostic procedures in cancer patients. We evaluated the literature on pain related to cancer treatment and diagnostic procedures within a critical analysis. The data available are sparse, suggesting that little attention has been directed at this important aspect of oncology. This points to potentially suboptimal patient management. Appropriate studies are necessary in order to understand the incidence and appropriate management of pain, both during and/or after oncological treatments and diagnostic procedures. At the same time, Health Care Professionals should have heightened awareness of the causes and treatment of pain with the aim of anticipating and managing pain most appropriately for each individual patient. This is clearly an important component of holistic patient care before, during, and after oncological treatment. © The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Bootstrap-based procedures for inference in nonparametric receiver-operating characteristic curve regression analysis.

Science.gov (United States)

Rodríguez-Álvarez, María Xosé; Roca-Pardiñas, Javier; Cadarso-Suárez, Carmen; Tahoces, Pablo G

2018-03-01

Prior to using a diagnostic test in a routine clinical setting, the rigorous evaluation of its diagnostic accuracy is essential. The receiver-operating characteristic curve is the measure of accuracy most widely used for continuous diagnostic tests. However, the possible impact of extra information about the patient (or even the environment) on diagnostic accuracy also needs to be assessed. In this paper, we focus on an estimator for the covariate-specific receiver-operating characteristic curve based on direct regression modelling and nonparametric smoothing techniques. This approach defines the class of generalised additive models for the receiver-operating characteristic curve. The main aim of the paper is to offer new inferential procedures for testing the effect of covariates on the conditional receiver-operating characteristic curve within the above-mentioned class. Specifically, two different bootstrap-based tests are suggested to check (a) the possible effect of continuous covariates on the receiver-operating characteristic curve and (b) the presence of factor-by-curve interaction terms. The validity of the proposed bootstrap-based procedures is supported by simulations. To facilitate the application of these new procedures in practice, an R-package, known as npROCRegression, is provided and briefly described. Finally, data derived from a computer-aided diagnostic system for the automatic detection of tumour masses in breast cancer is analysed.

Tune-Based Halo Diagnostics

International Nuclear Information System (INIS)

Cameron, Peter

2003-01-01

Tune-based halo diagnostics can be divided into two categories -- diagnostics for halo prevention, and diagnostics for halo measurement. Diagnostics for halo prevention are standard fare in accumulators, synchrotrons, and storage rings, and again can be divided into two categories -- diagnostics to measure the tune distribution (primarily to avoid resonances), and diagnostics to identify instabilities (which will not be discussed here). These diagnostic systems include kicked (coherent) tune measurement, phase-locked loop (PLL) tune measurement, Schottky tune measurement, beam transfer function (BTF) measurements, and measurement of transverse quadrupole mode envelope oscillations. We refer briefly to tune diagnostics used at RHIC and intended for the SNS, and then present experimental results. Tune-based diagnostics for halo measurement (as opposed to prevention) are considerably more difficult. We present one brief example of tune-based halo measurement

Diagnostic criteria and reporting procedures for pre-eclampsia

DEFF Research Database (Denmark)

Klemmensen, Ase K; Olsen, Sjurdur F.; Wengel, Christina M

2005-01-01

OBJECTIVE: A precondition for the rational use of obstetric databases in biomedical research is detailed knowledge on how data are being generated. We identified the diagnostic procedures and criteria for pre-eclampsia (PE) and assessed the level of obstetric training of the personnel responsible...... of pregnancy diagnoses to the National Patient Registry differed widely in training. For complicated pregnancies, departments ranged from having only specialists reporting all cases to secretaries reporting up to 50%. Cut off limits of blood pressure (BP) and protein loss used to diagnose pre-eclampsia showed...... large differences across departments. The diagnoses given to three case stories showed little correlation to the criteria the departments reported using. CONCLUSION: Even in a small country like Denmark with 34 obstetrical departments, there was little consensus on the diagnostic criteria for pre-eclampsia...

Radiation doses from medical diagnostic procedures in Canada

Energy Technology Data Exchange (ETDEWEB)

Aldrich, J E; Lentle, B C; Vo, C [British Columbia Univ., Vancouver, BC (Canada). Dept. of Radiology

1997-03-01

This document sets out to record and analyze the doses incurred in Canada from medical procedures involving the use of ionizing radiation in a typical year. Excluded are those doses incurred during therapeutic irradiation, since they differ in scale to such a large degree and because they are used almost exclusively in treating cancer. In this we are following a precedent set by the United Nations Scientific Committee on the Effects of Ionizing Radiation. Although the International Commission on Radiological Protection (ICRP) notes that dose limits should not be applied to medical exposures, it also observes that doses in different settings for the same procedure may vary by as much as two orders of magnitude, and that there are considerable opportunities for dose reductions in diagnostic radiology. Because these data do not stand in isolation the report also encompasses a review of the relevant literature and some background comment on the evolving technology of the radiological sciences. Because there is a somewhat incomplete perception of the changes taking place in diagnostic methods we have also provided some introductory explanations of the relevant technologies. In addition, there is an analysis of at least some of the limitations on the completeness of the data which are reported here. (author).

Radiation doses from medical diagnostic procedures in Canada

International Nuclear Information System (INIS)

Aldrich, J.E.; Lentle, B.C.; Vo, C.

1997-03-01

This document sets out to record and analyze the doses incurred in Canada from medical procedures involving the use of ionizing radiation in a typical year. Excluded are those doses incurred during therapeutic irradiation, since they differ in scale to such a large degree and because they are used almost exclusively in treating cancer. In this we are following a precedent set by the United Nations Scientific Committee on the Effects of Ionizing Radiation. Although the International Commission on Radiological Protection (ICRP) notes that dose limits should not be applied to medical exposures, it also observes that doses in different settings for the same procedure may vary by as much as two orders of magnitude, and that there are considerable opportunities for dose reductions in diagnostic radiology. Because these data do not stand in isolation the report also encompasses a review of the relevant literature and some background comment on the evolving technology of the radiological sciences. Because there is a somewhat incomplete perception of the changes taking place in diagnostic methods we have also provided some introductory explanations of the relevant technologies. In addition, there is an analysis of at least some of the limitations on the completeness of the data which are reported here. (author)

The effectiveness of drama therapy on preparation for diagnostic and therapeutic procedures in children suffering from cancer

Directory of Open Access Journals (Sweden)

Ľubica Ilievová

2015-10-01

Full Text Available Introduction: The integral part of the treatment of pediatric oncological patients is a range of diagnostic and therapeutic procedures. These procedures are often associated with the fear and anxiety of the suffering child. We investigated whether a psychological preparation through drama therapy and the therapeutic puppet may reduce the anxiety related to diagnostic and therapeutic procedures in the preschool or early school children suffering from cancer.Methods: Twenty consecutive pediatric patients of preschool and early school age, with the diagnosis of lymphoblastic leukemia, were included in the study. The patients were alternatingly assigned to experimental or control group, and subjected or not subjected to drama therapy, respectively. We measured the changes in heart rate, blood pressure and respiratory rate as indicators of anxiety and fear, before and after the diagnostic or therapeutic procedures.Results: Heart rate, blood pressure, and respiratory rate in pediatric oncological patients before and after the diagnostic or therapeutic procedure were significantly lower in the experimental group of patients.Conclusion: Our results show that psychological preparation using drama therapy and therapeutic puppet reduced the fear and anxiety related to diagnostic or therapeutic procedures in pediatric oncological patients.Key words: drama therapy; therapeutic puppet; children; oncology; psychology 

Additional radiation dose to population due to X-ray diagnostic procedures

International Nuclear Information System (INIS)

Chougule, A.

2006-01-01

Full text of publication follows: Discovery of X rays has revolutionised the medical diagnosis but the fact that the diagnostic radiological procedures contribute about 80 to 90 % of the radiation dose to population as compared to other man made radiation sources cannot be ignored especially when X ray diagnostic facilities are being made available to larger section of the society. The estimated frequency of radiological procedures in India is 12,000 procedures/ year/100,000 population, though it is quite less as compared to developed countries, its increasing day by day. As part of the project, a radiation protection survey of X ray installations and patient radiation dose measurement during various radiological procedures was undertaken. 193 X ray installations were surveyed and the radiation doses received by the patient during various radiological procedure was measured. For measurement of radiation doses, CaSO 4 : Dy thermoluminescence (T.L.) discs of size 13.3 mm diameter and 0.8 mm thickness were used. Pre annealed T.L. discs were fixed by adhesive tape on the patient skin at the center of entrance beam before the exposure. After exposure the T.L. discs were estimated f or entrance skin dose during that particular projection/ examination. 10,000 measurements at different centers during various radiological procedures were done. It was found that chest radiography accounts for 37 % of all radiological procedures and further it was observed that 70 % of the chest X rays were normal with out any pathology indicating scope for curtailing the unwarranted radiological procedures. The special investigations like barium swallow, barium meal and fallow through accounts for about 1.5 % of the total radiological procedures. The entrance skin dose [E.S.D.] during chest radiography was 0.3 + 0.1 mGy where as during K.U.B. and cervical spine radiography it was 6.2 + 1.1 mGy and 5.1 + 0.9 mGy respectively. The details of frequency of various radiological procedures and the

Prenatal radiation exposures at diagnostic procedures: methods to identify exposed pregnant patients

International Nuclear Information System (INIS)

Pettersson, H.; Sandborg, M.; Nilsson, J.; Olsson, S.

2002-01-01

Knowledge about frequency and doses to embryo/foetus from diagnostic radiology is of great importance both in the sense of estimating the radiation risks but also for optimizing the diagnostic procedures and making decisions regarding alternative procedures. In addition, the pregnant patient has the right to know the magnitude and type of radiation risks expected as a result of foetus exposure. From a risk perspective epidemiological data have shown that the embryo/foetus together with children experience higher radiation sensitivity in terms of induced leukemia and cancer compared to an adult population. Recent estimates give cancer excess lifetime mortality risks for whole body exposures of children and foetus (0-15 y age) of 0.06% (ICRP84, 2000) up to 0.14% per 10 mSv (BEIR-V 1990). In addition to the risk of cancer induction effects of cell killing, e.g. CNS abnormalities, cataracts, malformations, growth retardation, may occur. However, these effects are believed to have a threshold, about 100-200 mGy (ICRP84, 2000), and such foetus doses are rarely reached in diagnostic radiology procedures. There are 2 principal situations where foetus exposures may occur in diagnostic radiology; 1. The pregnancy of the patient is known at the time of examination, but due to the medical indications the examination can not be postponed or put forward in time, and there are no suitable alternative non-radiological procedures. 2. The pregnancy of the patient is not known at the time of examination, either due to the fact that the patient is unaware of her pregnancy or the medical personnel failed to obtain this information. The former situation may occur during the first few weeks from conception, whereas the latter situation may cover a greater gestation period

Diagnostic reference activities for nuclear medicine procedures in Australia and New Zealand

International Nuclear Information System (INIS)

Smart, R.C.; Towson, J.E.

2000-01-01

In July 1998 a survey of diagnostic nuclear medicine procedures in Australia and New Zealand was undertaken on behalf of the Australian and New Zealand Society of Nuclear Medicine (ANZSNM) and the Australasian Radiation Protection Society (ARPS) in order to establish diagnostic reference activities. A total of 96 responses were received representing 154 practices, comprising 45 public hospital departments, 21 private hospital departments, 87 private practices and 1 unspecified practice. The survey requested the usual activities administered for a standard adult, the method used to determine the activity for children and the minimum activities used for paediatric patients. Data was obtained for 80 different imaging procedures and for 17 non-imaging tracer studies. For those procedures for which information was available from 10 or more practices, 68 in total, the reference activity was calculated as the 75th percentile of the distribution of activities. The Most Common Activity, the Reference Activity, together with the effective dose in both male and female patients, is tabulated for all these procedures. Copyright (2000) Australasian Radiation Protection Society Inc

Bronchoscopic diagnostic procedures and microbiological examinations in proving endobronchial tuberculosis

Directory of Open Access Journals (Sweden)

Abdullah Şimşek

Full Text Available ABSTRACT Objective: To determine the proportional distribution of endobronchial tuberculosis (EBTB subtypes and to evaluate the types of bronchoscopic diagnostic procedures that can prove granulomatous inflammation. Methods: This was a retrospective study of 18 HIV-negative patients with biopsy-proven EBTB treated between 2010 and 2014. Results: The most common EBTB subtypes, as classified by the bronchoscopic features, were tumorous and granular (in 22.2% for both. Sputum smear microscopy was performed in 11 patients and was positive for AFB in 4 (36.3%. Sputum culture was also performed in 11 patients and was positive for Mycobacterium tuberculosis in 10 (90.9%. Smear microscopy of BAL fluid (BALF was performed in 16 patients and was positive for AFB in 10 (62.5%. Culture of BALF was also performed in 16 patients and was positive for M. tuberculosis in 15 (93.7%. Culture of BALF was positive for M. tuberculosis in 93.7% of the 16 patients tested. Among the 18 patients with EBTB, granulomatous inflammation was proven by the following bronchoscopic diagnostic procedures: bronchial mucosal biopsy, in 8 (44.4%; bronchial brushing, in 7 (38.8%; fine-needle aspiration biopsy, in 2 (11.1%; and BAL, in 2 (11.1%. Bronchial anthracofibrosis was observed in 5 (27.7% of the 18 cases evaluated. Conclusions: In our sample of EBTB patients, the most common subtypes were the tumorous and granular subtypes. We recommend that sputum samples and BALF samples be evaluated by smear microscopy for AFB and by culture for M. tuberculosis, which could increase the rates of early diagnosis of EBTB. We also recommend that bronchial brushing be employed together with other bronchoscopic diagnostic procedures in patients suspected of having EBTB.

Renal diagnostic nuclear medicine procedures in progressive systemic scleroderma (PSS)

Energy Technology Data Exchange (ETDEWEB)

Ammari, B.; Hotze, A.; Gruenwald, F.; Biersack, H.J.; Blitz, H.; Kuester, W.; Kreysel, H.W.

1989-02-01

The involvement of kidneys in progressive systemic scleroderma (PSS) is one of the most frequent causes of death in this disease. Using clinical criteria and laboratory tests only the frequency of kidney involvement would be clearly underestimated. Invasive diagnostic procedures such as biopsy and angiography can not be applied in those patients. Nuclear medicine techniques (hippurate clearance, DMSA-scan), however, offer non invasive and sensitive methods in the diagnosis of renal involvement in PSS patients. In our study 46 of 76 patients (60%) revealed pathologic findings. The mentioned diagnostic techniques show a high sensitivity and are in agreement with pathological findings described in PSS.

Renal diagnostic nuclear medicine procedures in progressive systemic scleroderma (PSS)

International Nuclear Information System (INIS)

Ammari, B.; Hotze, A.; Gruenwald, F.; Biersack, H.J.; Blitz, H.; Kuester, W.; Kreysel, H.W.

1989-01-01

The involvement of kidneys in progressive systemic scleroderma (PSS) is one of the most frequent causes of death in this disease. Using clinical criteria and laboratory tests only the frequency of kidney involvement would be clearly underestimated. Invasive diagnostic procedures such as biopsy and angiography can not be applied in those patients. Nuclear medicine techniques (hippurate clearance, DMSA-scan), however, offer non invasive and sensitive methods in the diagnosis of renal involvement in PSS patients. In our study 46 of 76 patients (60%) revealed pathologic findings. The mentioned diagnostic techniques show a high sensitivity and are in agreement with pathological findings described in PSS. (orig.) [de

Risk and safety requirements for diagnostic and therapeutic procedures in allergology

DEFF Research Database (Denmark)

Kowalski, Marek L; Ansotegui, Ignacio; Aberer, Werner

2016-01-01

One of the major concerns in the practice of allergy is related to the safety of procedures for the diagnosis and treatment of allergic disease. Management (diagnosis and treatment) of hypersensitivity disorders involves often intentional exposure to potentially allergenic substances (during skin...... attempted to present general requirements necessary to assure the safety of these procedures. Following review of available literature a group of allergy experts within the World Allergy Organization (WAO), representing various continents and areas of allergy expertise, presents this report on risk...... associated with diagnostic and therapeutic procedures in allergology and proposes a consensus on safety requirements for performing procedures in allergy offices. Optimal safety measures including appropriate location, type and required time of supervision, availability of safety equipment, access...

Diagnostic x-ray equipment compliance and facility survey. Recommended procedures for equipment and facility testing

International Nuclear Information System (INIS)

1994-01-01

The Radiation Protection Bureau has set out guidelines for the testing of diagnostic x-ray equipment and facilities. This guide provides information for the x-ray inspector, test engineer, technologist, medical physicist and any other person responsible for verifying the regulatory compliance or safety of diagnostic x-ray equipment and facilities. Diagnostic x-radiation is an essential part of present day medical practice. The largest contributor of irradiation to the general population comes from diagnostic x-radiation. Although individual irradiations are usually small, there is a concern of possible excess cancer risk when large populations are irradiated. Unnecessary irradiations to patients from radiological procedures can be significantly reduced with little or no decrease in the value of medical diagnostic information. This can be achieved by using well designed x-ray equipment which is installed, used and maintained by trained personnel, and by the adoption of standardized procedures. In general, when patient surface dose is reduced, there is a corresponding decrease in dose to x-ray equipment operators and other health care personnel. 2 tabs., 4 figs

Diagnostic x-ray equipment compliance and facility survey. Recommended procedures for equipment and facility testing

Energy Technology Data Exchange (ETDEWEB)

NONE

1994-12-31

The Radiation Protection Bureau has set out guidelines for the testing of diagnostic x-ray equipment and facilities. This guide provides information for the x-ray inspector, test engineer, technologist, medical physicist and any other person responsible for verifying the regulatory compliance or safety of diagnostic x-ray equipment and facilities. Diagnostic x-radiation is an essential part of present day medical practice. The largest contributor of irradiation to the general population comes from diagnostic x-radiation. Although individual irradiations are usually small, there is a concern of possible excess cancer risk when large populations are irradiated. Unnecessary irradiations to patients from radiological procedures can be significantly reduced with little or no decrease in the value of medical diagnostic information. This can be achieved by using well designed x-ray equipment which is installed, used and maintained by trained personnel, and by the adoption of standardized procedures. In general, when patient surface dose is reduced, there is a corresponding decrease in dose to x-ray equipment operators and other health care personnel. 2 tabs., 4 figs.

Quality control procedures of dental diagnostic radiology systems

International Nuclear Information System (INIS)

Andrade, Paula Serra Sasaki

2007-01-01

This work presents quality control reference procedures for dental diagnostic radiology systems, following the recommendations of the Publication 453 of the Brazilian Health Ministry (PF453), to be applied in dental clinics, in order to achieve an improvement in the radiological image qualities and the patient dose reduction. All tests were applied in an intraoral X rays system, following the methodology developed and the requirements of the PF 453. In order to verify the best quality of the image in relation to the smaller exposition time an object test was also developed in this work. The use of this object allowed the reduction of the exposition time of 0.5 seconds, the maximum value of the linear region of the characteristic curve, for 0.2 seconds. The tested X rays system showed a very good agreement with the applied procedures, detaching the reduction of the skin entrance dose using the film-holding devices. However, the size of the field increased and exceeded the maximum value of 6 cm recommended in the standard. The importance of the quality control in dental diagnostic radiology systems is essential due to the constant use of X radiation in dental clinics. The PF453 recommends the frequency of at least two years for the constancy tests. However, it is suggested that the professional, surgeon-dentist, should be responsible for the internal control of the image quality obtained from the X rays device. This can be done through monthly exposures of the object test developed in this work. (author)

Unintentional exposure to radiation during pregnancy from nuclear medical diagnostic procedures

International Nuclear Information System (INIS)

Moka, D.

2005-01-01

The administration of radiopharmaceuticals during pregnancy is contraindicated due to a lack of vital indications. However, if prenatal exposure to radiation should occur in the framework of a nuclear medical diagnostic procedure then fortunately no longterm side-effects would normally be expected. Radiation damage in the preimplantation phase leads to early abortion. However, if the further course of pregnancy remains uncomplicated then no subsequent side-effects need be expected. On a conservative estimate, it would require doses exceeding 50 mGy to cause radiation damage within the uterus after the preimplantation phase. However, the standard radioactivities applied for diagnostic purposes in nuclear medicine, can be obtained with doses of less than 20 mGy. On the basis of current knowledge, therefore, there is no reason to terminate pregnancy on medical grounds after diagnostic exposure to radiopharmaceuticals. (orig.)

Prenatal Radiation exposures at diagnostic procedures: methods to identify exposed pregnant patients

International Nuclear Information System (INIS)

Pettersson, H.; Sandborg, M.; Nilsson, J.; Olsson, S.; Hellman, S.; Helmrot, E.; Persliden, J.; Cederlund, T.

2003-01-01

Knowledge about frequency and doses to embryo/foetus from diagnostic radiology is of great importance both in the sense of estimating the radiation risks but also for optimizing the diagnostic procedures and making decisions regarding alternative procedures. In addition, the pregnant patient has a right to know the magnitude and type of radiation risks expected as a result of foetus exposure. From a risk perspective epidemiological data has shown that the embryo/foetus together with children experience higher radiation sensitivity in terms of induced leukemia and cancer compared to an adult population. Recent estimates give cancer excess lifetime mortality risks for whole body exposures of children and foetus (0-15 y age) of 0.06% up to 0.14% per 10 mSv. In addition to the risk of cancer induction effects of cell killing, e.g. CNS abnormalities, cataracts, malformations, growth retardation, may occur. However, these effects are believed to have a threshold, about 100-200 mGy, and such foetus doses are rarely reached in diagnostic radiology procedures. There are 2 principal situations where foetus exposures may occur in diagnostic radiology; The pregnancy of the patient is known at the time of examination, but due to the medical indications the examination can not be postponed or put forward in time, and there are no suitable alternative non-radiological procedures. The pregnancy of the patient is not known at the time of examination, either due to the fact that the patient is unaware of her pregnancy or the medical personnel failed to obtain this information. The former situation may occur during the first few weeks from conception, whereas the latter situation may cover a greater gestation period. The frequency of foetus exposure is not well documented. In Sweden, there are well-established routines to track down pregnant patients before examinations are being performed. However, there are no general obligations or routines to document the cases either (i) when

Radiation dose to the pediatric population of Slovak Republic from diagnostic nuclear medicine procedures

International Nuclear Information System (INIS)

Ftacnikova, S.; Fueriova, A.

1996-01-01

The increased number of in vitro diagnostic nuclear medicine examinations has created the need for more precise determination of radiation dose to the population, specially to the children. A questionnaire survey has been performed on all nuclear medicine facilities in Slovak Republic through 1982 to 1994 with a special attention to pediatric patients in 1994. The information obtained was about the age distribution, number of different types of examinations, radiopharmaceuticals used and the value of mean administered radioactivity per exam. These data were used to evaluate the mean effective dose per exam and per capita, the collective effective dose for special type of examinations, for different radiopharmaceuticals and for radionuclides used in diagnostic procedures. In calculations we used the best available biokinetic models of the distribution of radiopharmaceuticals in organs as a function of age. The results show that the Slovak Republic appeared favorable in comparison to other countries in the judicious use of diagnostic nuclear medicine procedures performed on pediatric population. (author)

Patient radiation dose in diagnostic and interventional procedures for intracranial aneurysms: Experience at a single center

International Nuclear Information System (INIS)

Chun, Chang Woo; Kim, Bum Soo; Lee, Cheol Hyoun; Ihn, Yon Kwon; Shin, Yong Sam

2014-01-01

To assess patient radiation doses during cerebral angiography and embolization of intracranial aneurysms in a large sample size from a single center. We studied a sample of 439 diagnostic and 149 therapeutic procedures for intracranial aneurysms in 480 patients (331 females, 149 males; median age, 57 years; range, 21-88 years), which were performed in 2012 with a biplane unit. Parameters including fluoroscopic time, dose-area product (DAP), and total angiographic image frames were obtained and analyzed. Mean fluoroscopic time, total mean DAP, and total image frames were 12.6 minutes, 136.6 +/- 44.8 Gy-cm 2 , and 251 +/- 49 frames for diagnostic procedures, 52.9 minutes, 226.0 +/- 129.2 Gy-cm 2 , and 241 frames for therapeutic procedures, and 52.2 minutes, 334.5 +/- 184.6 Gy-cm 2 , and 408 frames for when both procedures were performed during the same session. The third quartiles for diagnostic reference levels (DRLs) were 14.0, 61.1, and 66.1 minutes for fluoroscopy time, 154.2, 272.8, and 393.8 Gy-cm 2 for DAP, and 272, 276, and 535 for numbers of image frames in diagnostic, therapeutic, and both procedures in the same session, respectively. The proportions of fluoroscopy in DAP for the procedures were 11.4%, 50.5%, and 36.1%, respectively, for the three groups. The mean DAP for each 3-dimensional rotational angiographic acquisition was 19.2 +/- 3.2 Gy-cm 2 . On average, rotational angiography was used 1.4 +/- 0.6 times/session (range, 1-4; n = 580). Radiation dose in our study as measured by DAP, fluoroscopy time and image frames did not differ significantly from other reported DRL studies for cerebral angiography, and DAP was lower with fewer angiographic image frames for embolization. A national registry of radiation-dose data is a necessary next step to refine the dose reference level.

Activities of radiopharmaceuticals administered for diagnostic and therapeutic procedures in nuclear medicine in Argentina: results of a national survey

International Nuclear Information System (INIS)

Bomben, Ana M.; Chiliutti, Claudia A.

2004-01-01

Nuclear medicine in Argentine is carried out at 292 centres, distributed all over the country, mainly concentrated in the capital cities of the provinces. With the purpose of knowing the activity levels of radiopharmaceuticals that were administered to patients for diagnostic and therapeutic procedures in nuclear medicine, a national survey was conducted, during 2001 and 2002. This survey was answered voluntarily by 107 centres. Sixty-four percent of the participants centres are equipped with SPECT system while the other centres have a gamma camera or scintiscanner. There were 37 nuclear medicine procedures, chosen among those most frequently performed, were included in the survey. In those diagnostic procedures were included tests for: bone, brain, thyroid, kidney, liver, lung and cardiovascular system; and also activities administered for some therapeutic procedures. The nuclear medicine physicians reported the different radiopharmaceutical activities administered to typical adult patients. In this paper are presented the average radiopharmaceutical activity administered for each of the diagnostic and therapeutic procedures included in the survey and the range and distribution of values. In order to place these data in a frame of reference, these average values were compared to the guidance levels for diagnostic procedures in nuclear medicine mentioned at the Safety Series no. 115. From this comparison it was noticed that the activities administered in the 40% of the diagnostic procedures included in the survey were between ±30% of the reference values. For those nuclear medicine procedures that could not be compared with the above mentioned guidance levels, the comparison was made with values published by UNSCEAR or standards recommended by international bodies. As a result of this study, it is important to point out the need to continue the gathering of data in a wider scale survey to increase the knowledge about national trends. It is also essential to widely

Innovation in diagnostic imaging services: assessing the potential for value-based reimbursement.

Science.gov (United States)

Garrison, Louis P; Bresnahan, Brian W; Higashi, Mitchell K; Hollingworth, William; Jarvik, Jeffrey G

2011-09-01

Innovation in the field of diagnostic imaging is based primarily on the availability of new and improved equipment that opens the door for new clinical applications. Payments for these imaging procedures are subject to complex Medicare price control schemes, affecting incentives for appropriate use and innovation. Achieving a "dynamically efficient" health care system-one that elicits a socially optimal amount of innovation-requires that innovators be rewarded in relation to the value they add and can demonstrate with evidence. The authors examine how and whether value-based reimbursement for diagnostic imaging services might better reward innovation explicitly for expected improvements in health and economic outcomes. Copyright © 2011 AUR. Published by Elsevier Inc. All rights reserved.

Value of noninvasive diagnostic procedures in cardiology: typical findings in hypertrophic obstructive cardiomyopathy

International Nuclear Information System (INIS)

Riebeling, V.; Bubenheimer, P.

1984-01-01

Routine chest X-ray often yields poor information for diagnosis of heart disease. The diagnostic value of invasive procedures in cardiology is generally accepted. The patient's as well as the physician's risk of the examination, however, has to be considered. A high number of heart diseases, e.g. hypertrophic obstructive cardiomyopathy (HOCM) is mainly detected by noninvasive procedures such as auscultation, electrocardiography, phonomechanocardiography, echocardiography, physical manoeuvres, and pharmacological provocation tests. Typical findings in hypertrophic obstructive cardiomyopathy are demonstrated. (orig.) [de

New perineal injection technique for pudendal nerve infiltration in diagnostic and therapeutic procedures

NARCIS (Netherlands)

Weinschenk, Stefan; Hollmann, Markus W.; Strowitzki, Thomas

2016-01-01

Pudendal nerve injection is used as a diagnostic procedure in the vulvar region and for therapeutic purposes, such as in vulvodynia. Here, we provide a new, easy-to-perform perineal injection technique. We analyzed 105 perineal injections into the pudendal nerve with a local anesthetic (LA),

Prenatal diagnostic procedures used in pregnancies with congenital malformations in 14 regions of Europe

NARCIS (Netherlands)

Garne, E; Loane, M; de Vigan, C; Scarano, G; de Walle, H; Gillerot, Y; Stoll, C; Addor, MC; Stone, D; Gener, B; Feijoo, M; Mosquera-Tenreiro, C; Gatt, M; Queisser-Luft, A; Baena, N; Dolk, H

2004-01-01

Objective To investigate outcomes of ultrasound investigations (US) and invasive diagnostic procedures in cases of congenital malformations (CM), and to compare the use of invasive prenatal test techniques (amniocentesis (AC) versus chorionic villus sampling (CVS)) among European populations. Design

Sonography as a new diagnostic procedure for investigating abnormalities of the shoulder

International Nuclear Information System (INIS)

Rapf, C.; Furtschegger, A.; Resch, H.; Innsbruck Univ.

1986-01-01

Eighty-one sonographic examinations of patients with complaints relating to the shoulder joint have shown that this is the method next in value to radiological examination. So far, lesions of the rotator cuff and of the long head of the biceps could only be demonstrated by invasive procedures such as arthrography or arthroscopy. In these situations, sonography attains a similar accuracy. Diffuse lesions can also be diagnosed correctly, making arthrography and arthroscopy unnecessary. In addition, sonography can demonstrate inflammatory and degenerative changes and incomplete sub-acromial and intermediary tears of the rotator cuff, unlike conventional diagnostic methods. In future, arthrography and arthroscopy will only be necessary as additional diagnostic methods if sonography remains inconclusive. (orig.) [de

Prenatal diagnosis--principles of diagnostic procedures and genetic counseling.

Directory of Open Access Journals (Sweden)

Ryszard Slezak

2008-04-01

Full Text Available The frequency of inherited malformations as well as genetic disorders in newborns account for around 3-5%. These frequency is much higher in early stages of pregnancy, because serious malformations and genetic disorders usually lead to spontaneous abortion. Prenatal diagnosis allowed identification of malformations and/or some genetic syndromes in fetuses during the first trimester of pregnancy. Thereafter, taking into account the severity of the disorders the decision should be taken in regard of subsequent course of the pregnancy taking into account a possibilities of treatment, parent's acceptation of a handicapped child but also, in some cases the possibility of termination of the pregnancy. In prenatal testing, both screening and diagnostic procedures are included. Screening procedures such as first and second trimester biochemical and/or ultrasound screening, first trimester combined ultrasound/biochemical screening and integrated screening should be widely offered to pregnant women. However, interpretation of screening results requires awareness of both sensitivity and predictive value of these procedures. In prenatal diagnosis ultrasound/MRI searching as well as genetic procedures are offered to pregnant women. A variety of approaches for genetic prenatal analyses are now available, including preimplantation diagnosis, chorion villi sampling, amniocentesis, fetal blood sampling as well as promising experimental procedures (e.g. fetal cell and DNA isolation from maternal blood. An incredible progress in genetic methods opened new possibilities for valuable genetic diagnosis. Although karyotyping is widely accepted as golden standard, the discussion is ongoing throughout Europe concerning shifting to new genetic techniques which allow obtaining rapid results in prenatal diagnosis of aneuploidy (e.g. RAPID-FISH, MLPA, quantitative PCR.

Determining and managing fetal radiation dose from diagnostic radiology procedures in Turkey

International Nuclear Information System (INIS)

Ozbayrak, Mustafa; Cavdar, Iffet; Seven, Mehmet; Uslu, Lebriz; Yeyin, Nami; Tanyildizi, Handan; Abuqbeitah, Mohammad; Acikgoz, A. Serdar; Tuten, Abdullah; Demir, Mustafa

2015-01-01

We intended to calculate approximate fetal doses in pregnant women who underwent diagnostic radiology procedures and to evaluate the safety of their pregnancies. We contacted hospitals in different cities in Turkey where requests for fetal dose calculation are usually sent. Fetal radiation exposure was calculated for 304 cases in 218 pregnant women with gestational ages ranging from 5 days to 19 weeks, 2 days. FetDose software (ver. 4.0) was used in fetal dose calculations for radiographic and computed tomography (CT) procedures. The body was divided into three zones according to distance from the fetus. The first zone consisted of the head area, the lower extremities below the knee, and the upper extremities; the second consisted of the cervicothoracic region and upper thighs; and the third consisted of the abdominopelvic area. Fetal doses from radiologic procedures between zones were compared using the Kruskal-Wallis test and a Bonferroni-corrected Mann-Whitney U-test. The average fetal doses from radiography and CT in the first zone were 0.05 ± 0.01 mGy and 0.81 ± 0.04 mGy, respectively; 0.21 ± 0.05 mGy and 1.77 ± 0.22 mGy, respectively, in the second zone; and 6.42 ± 0.82 mGy and 22.94 ± 1.28 mGy, respectively, in the third zone (p < 0.001). Our results showed that fetal radiation exposures in our group of pregnant women did not reach the level (50 mGy) that is known to increase risk for congenital anomalies. Fetal radiation exposure in the diagnostic radiology procedures in our study did not reach risk levels that might have indicated abortion

Determining and managing fetal radiation dose from diagnostic radiology procedures in Turkey

Energy Technology Data Exchange (ETDEWEB)

Ozbayrak, Mustafa; Cavdar, Iffet; Seven, Mehmet; Uslu, Lebriz; Yeyin, Nami; Tanyildizi, Handan; Abuqbeitah, Mohammad; Acikgoz, A. Serdar; Tuten, Abdullah; Demir, Mustafa [Istanbul University, Istanbul (Turkmenistan)

2015-12-15

We intended to calculate approximate fetal doses in pregnant women who underwent diagnostic radiology procedures and to evaluate the safety of their pregnancies. We contacted hospitals in different cities in Turkey where requests for fetal dose calculation are usually sent. Fetal radiation exposure was calculated for 304 cases in 218 pregnant women with gestational ages ranging from 5 days to 19 weeks, 2 days. FetDose software (ver. 4.0) was used in fetal dose calculations for radiographic and computed tomography (CT) procedures. The body was divided into three zones according to distance from the fetus. The first zone consisted of the head area, the lower extremities below the knee, and the upper extremities; the second consisted of the cervicothoracic region and upper thighs; and the third consisted of the abdominopelvic area. Fetal doses from radiologic procedures between zones were compared using the Kruskal-Wallis test and a Bonferroni-corrected Mann-Whitney U-test. The average fetal doses from radiography and CT in the first zone were 0.05 ± 0.01 mGy and 0.81 ± 0.04 mGy, respectively; 0.21 ± 0.05 mGy and 1.77 ± 0.22 mGy, respectively, in the second zone; and 6.42 ± 0.82 mGy and 22.94 ± 1.28 mGy, respectively, in the third zone (p < 0.001). Our results showed that fetal radiation exposures in our group of pregnant women did not reach the level (50 mGy) that is known to increase risk for congenital anomalies. Fetal radiation exposure in the diagnostic radiology procedures in our study did not reach risk levels that might have indicated abortion.

Overview of radiation protection programme in nuclear medicine facility for diagnostic procedures

International Nuclear Information System (INIS)

Ahmed, Ezzeldein Mohammed Nour Mohammed

2015-02-01

This project was conducted to review Radiation Protection Program in Nuclear Medicine facility for diagnostic procedures which will provide guide for meeting the standard and regulatory requirements in diagnostic nuclear medicine. The main objective of this project is to keep dose to staff, patient and public as low as reasonably achievable (ALARA). The specific objectives were to review the Radiation Protection Program (RPP) in diagnostic nuclear medicine and to make some recommendation for improving the level of radiation protection in diagnostic nuclear medicine that will help to control normal exposure and prevent or mitigate potential exposure. The methodology used is review of various documents. The review showed that if the Radiation Protection Program is inadequate it leads to unjustified exposure to radiation. Finally, this study stated some recommendations that if implemented could improve the level of radiation protection in nuclear medicine department. One of the most important recommendations is that a qualified Radiation Protection Officer (RPO) should be appointed to lay down and oversee a radiation protection in the nuclear medicine department. The RPO must be given the full authority and the adequate time to enable him to perform his duties effectively. (au)

Development of procedures to ensure quality and integrity in Tandem Mirror Experiment-Upgrade (TMX-U) diagnostics systems

International Nuclear Information System (INIS)

Coutts, G.W.; Coon, M.L.; Hinz, A.F.; Hornady, R.S.; Lang, D.D.; Lund, N.P.

1983-01-01

The diagnostic systems for Tandem Mirror Experiment-Upgrade (TMX-U) have grown from eleven initial systems to more than twenty systems. During operation, diagnostic system modifications are sometimes required to complete experimental objectives. Also, during operations new diagnostic systems are being developed and implemented. To ensure and maintain the quality and integrity of the data signals, a set of plans and systematic actions are being developed. This paper reviews the procedures set in place to maintain the integrity of existing data systems and ensure the performance objectives of new diagnostics being added

New perspective for radiation protection in diagnostic procedure in Paraguay

International Nuclear Information System (INIS)

Sosky, R.A.; Gamarra, M.

2001-01-01

The Government in Paraguay approved by Decree Law 10754, dated October 6, 2000, its National Regulation on Basic Safety Standards for Radiation Protection and the Safety of Radiation Sources, based on the IAEA Safety Standards 115. The primary goal of Patient Protection is to ensure that both Regulatory Authorities and all Responsible parties in Medical Practices observe procedural process in conducting their responsibilities on regulatory and administrative affairs. On one side the Government, 'Department de Proteccion Radiologica', under the Health Ministry and Comision Nacional de Energia Atomica, and on the other side, the medical practitioner who prescribes or conducts diagnostic or therapeutic treatment, both ensure that the exposure of patients be the minimum. This document describes how the Regulatory Authorities intend to implement this recent act and on the other hand take the advantage of this Conference to understand better this subject, especially on the following subjects: essential requirement for licensing, inspection and enforcement programme in the country's capital and in the interior, where there are more difficulties; workers and medical training and lessons learned applying to developing countries. (author)

Patient dose assessment in different diagnostic procedures in nuclear medicine

International Nuclear Information System (INIS)

Sena, E. de; Bejar, M.J.; Berenguer, R.; Ruano, R.; Tamayo, P.

2001-01-01

Effective doses have been estimated for 314 patients under diagnostic procedures in a Nuclear Medicine Department using data reported in ICRP-80 and RIDIC (Radiation Internal Dose Information Center). Data on administered activity, radiopharmaceutical and administration route, age and sex of the patients have been collected. Doses in the most exposed critical organ for every protocol, doses in uterus, doses in fetus versus the stage of pregnancy (in case the female patient was pregnant) and doses for nursing infants have been also estimated. Ga-67 studies give the highest effective doses per protocol followed by cardiac SPECT procedures using Tl-201 chloride. Ga-67 studies also give the highest absorbed doses in uterus. Due to not administering different activities, depending on height and weight of adults, women receive doses about 20% higher than men. This would be a practice to modify in the future in order to optimise doses. (author)

Patient dose assessment in different diagnostic procedures in nuclear medicine

Energy Technology Data Exchange (ETDEWEB)

Sena, E de; Bejar, M J; Berenguer, R [Servicio de Radiofisica y Proteccion Radiologica, Salamanca (Spain); Ruano, R; Tamayo, P [Servicio de Medicina Nuclear, Hospital Universitario de Salamanca (Spain)

2001-03-01

Effective doses have been estimated for 314 patients under diagnostic procedures in a Nuclear Medicine Department using data reported in ICRP-80 and RIDIC (Radiation Internal Dose Information Center). Data on administered activity, radiopharmaceutical and administration route, age and sex of the patients have been collected. Doses in the most exposed critical organ for every protocol, doses in uterus, doses in fetus versus the stage of pregnancy (in case the female patient was pregnant) and doses for nursing infants have been also estimated. Ga-67 studies give the highest effective doses per protocol followed by cardiac SPECT procedures using Tl-201 chloride. Ga-67 studies also give the highest absorbed doses in uterus. Due to not administering different activities, depending on height and weight of adults, women receive doses about 20% higher than men. This would be a practice to modify in the future in order to optimise doses. (author)

Diagnosing alcoholism in high-risk drinking drivers: comparing different diagnostic procedures with estimated prevalence of hazardous alcohol use

NARCIS (Netherlands)

Korzec, A.; Bär, M.; Koeter, M. W.; de Kieviet, W.

2001-01-01

In several European countries, drivers under influence (DUI), suspected of an alcohol use disorder (AUD, 'alcoholism') are referred for diagnostic examination. The accuracy of diagnostic procedures used in diagnosing AUD in the DUI population is unknown. The aim of this study was to compare three

Prosthetic joint infection development of an evidence-based diagnostic algorithm.

Science.gov (United States)

Mühlhofer, Heinrich M L; Pohlig, Florian; Kanz, Karl-Georg; Lenze, Ulrich; Lenze, Florian; Toepfer, Andreas; Kelch, Sarah; Harrasser, Norbert; von Eisenhart-Rothe, Rüdiger; Schauwecker, Johannes

2017-03-09

Increasing rates of prosthetic joint infection (PJI) have presented challenges for general practitioners, orthopedic surgeons and the health care system in the recent years. The diagnosis of PJI is complex; multiple diagnostic tools are used in the attempt to correctly diagnose PJI. Evidence-based algorithms can help to identify PJI using standardized diagnostic steps. We reviewed relevant publications between 1990 and 2015 using a systematic literature search in MEDLINE and PUBMED. The selected search results were then classified into levels of evidence. The keywords were prosthetic joint infection, biofilm, diagnosis, sonication, antibiotic treatment, implant-associated infection, Staph. aureus, rifampicin, implant retention, pcr, maldi-tof, serology, synovial fluid, c-reactive protein level, total hip arthroplasty (THA), total knee arthroplasty (TKA) and combinations of these terms. From an initial 768 publications, 156 publications were stringently reviewed. Publications with class I-III recommendations (EAST) were considered. We developed an algorithm for the diagnostic approach to display the complex diagnosis of PJI in a clear and logically structured process according to ISO 5807. The evidence-based standardized algorithm combines modern clinical requirements and evidence-based treatment principles. The algorithm provides a detailed transparent standard operating procedure (SOP) for diagnosing PJI. Thus, consistently high, examiner-independent process quality is assured to meet the demands of modern quality management in PJI diagnosis.

Software for the estimation of organ equivalent and effective doses from diagnostic radiology procedures

International Nuclear Information System (INIS)

Osei, Ernest K; Barnett, Rob

2009-01-01

Diagnostic radiological imaging such as conventional radiography, fluoroscopy and computed tomography (CT) examinations will continue to provide tremendous benefits in modern healthcare. The benefit derived by the patient should far outweigh the risk associated with a properly conducted imaging examination. Nonetheless, it is very important to be able to quantify the risk associated with any radiological examination of patients, and effective dose has been considered a useful indicator of patient exposure. Quantification of the risks associated with radiological imaging is very important as such information will be helpful to physicians and their patients for comparing risks from various imaging examinations and for making informed decisions whenever there is a need for any radiological imaging. The determination of equivalent and effective doses in diagnostic radiology is of interest as a basis for estimates of risk from medical exposures. In this paper we describe a simple computer program OrgDose, which calculates the doses to 27 organs in the body and then calculates the organ equivalent and effective doses and the risk from various procedures in the radiology department including conventional radiography, fluoroscopy and computed tomography examinations. The program will be a useful tool for the medical and paramedical personnel who are involved with assessing organ and effective doses and risks from diagnostic radiology procedures.

A diagnostic expert system for NPP based on hybrid knowledge approach

International Nuclear Information System (INIS)

Yang, Joon On; Chang, Soon Heung

1989-01-01

This paper describes a diagnostic expert system, HYPOSS (Hybrid Knowledge Based Plant Operation Supporting System), which has been developed to support operators' decision making during the transients of nuclear power plant. HYPOSS adopts the hybrid knowledge approach which combines shallow and deep knowledge to couple the merits of both approaches. In HYPOSS, four types of knowledge are used according to the steps of diagnosis procedure: structural, functional, behavioral and heuristic knowledge. The structural and functional knowledge is represented by three fundamental primitives and five types of functions respectively. The behavioral knowledge is represented using constraints. The inference procedure is based on the human problem solving behavior modeled in HYPOSS. For the validation of HYPOSS, several tests have been performed based on the data produced by a plant simulator. The results of validation studies showed a good applicability of HYPOSS to the anomaly diagnosis of nuclear power plant

42 CFR 413.122 - Payment for hospital outpatient radiology services and other diagnostic procedures.

Science.gov (United States)

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for hospital outpatient radiology services... radiology services and other diagnostic procedures. (a) Basis and purpose. (1) This section implements section 1833(n) of the Act and establishes the method for determining Medicare payments for radiology...

Verification of examination procedures in clinical laboratory for imprecision, trueness and diagnostic accuracy according to ISO 15189:2012: a pragmatic approach.

Science.gov (United States)

Antonelli, Giorgia; Padoan, Andrea; Aita, Ada; Sciacovelli, Laura; Plebani, Mario

2017-08-28

Background The International Standard ISO 15189 is recognized as a valuable guide in ensuring high quality clinical laboratory services and promoting the harmonization of accreditation programmes in laboratory medicine. Examination procedures must be verified in order to guarantee that their performance characteristics are congruent with the intended scope of the test. The aim of the present study was to propose a practice model for implementing procedures employed for the verification of validated examination procedures already used for at least 2 years in our laboratory, in agreement with the ISO 15189 requirement at the Section 5.5.1.2. Methods In order to identify the operative procedure to be used, approved documents were identified, together with the definition of performance characteristics to be evaluated for the different methods; the examination procedures used in laboratory were analyzed and checked for performance specifications reported by manufacturers. Then, operative flow charts were identified to compare the laboratory performance characteristics with those declared by manufacturers. Results The choice of performance characteristics for verification was based on approved documents used as guidance, and the specific purpose tests undertaken, a consideration being made of: imprecision and trueness for quantitative methods; diagnostic accuracy for qualitative methods; imprecision together with diagnostic accuracy for semi-quantitative methods. Conclusions The described approach, balancing technological possibilities, risks and costs and assuring the compliance of the fundamental component of result accuracy, appears promising as an easily applicable and flexible procedure helping laboratories to comply with the ISO 15189 requirements.

Diagnostic system and diagnostic experiences at the Paks Nuclear Power Plant

International Nuclear Information System (INIS)

Katona, Tamas

1986-01-01

The major functions of the diagnostic system of the first two units of the Paks Nuclear Power Plant are as follows: monitoring the mechanical integrity of the reactor and the primary coolant circuit by means of vibration diagnostics; leakage detection of the primary coolant circuit by means of high frequency sonic analysis; loose parts monitoring based on the analysis of high frequency signals of acceleration detectors; and monitoring the vibration state of the turbines and rotary machines by the latter method or by a procedure based on the detection of mechanical vibrations. Up-to-date vibration diagnostics is based on the information supplied by either acceleration detectors or pressure fluctuation detectors, or in-core and ex-core neutron detectors. (V.N.)

Education and training in radiological protection for diagnostic and interventional procedures ICRP 113 in brief

International Nuclear Information System (INIS)

Salama, S.; Gomaa, M. A.; Alshoufi, J.H.

2013-01-01

The international commission on radiological protection (ICRP) is the primary body in protection against ionizing radiation. Among its latest publication is ICRP publication 113 e ducation and training in radiological protection for diagnostic and interventional procedures . This document introduces diagnostic and interventional medical procedures using ionizing radiations in deep details. The document is approved by the commission in October 2010 and translated into Arabic at December 2011. This work is a continuation of the efforts series to translate some of the most important of the radiological protection references into the Arabic; aiming to maximize the benefit. The previous translation include WHO handbook on indoor radon: a public health perspective, issued by world health organization 2009 and Radiation Protection in Medicine, ICRP Publication 105 2007 that translated into Arabic with support of Arab atomic energy authority at 2011.

EEG Analysis during complex diagnostic tasks in Nuclear Power Plants - Simulator-based Experimental Study

Energy Technology Data Exchange (ETDEWEB)

Ha, Jun Su; Seong, Poong Hyun [Korea Advanced Institute of Science and Technology, Taejon (Korea, Republic of)

2005-07-01

In literature, there are a lot of studies based on EEG signals during cognitive activities of human-beings but most of them dealt with simple cognitive activities such as transforming letters into Morse code, subtraction, reading, semantic memory search, visual search, memorizing a set of words and so on. In this work, EEG signals were analyzed during complex diagnostic tasks in NPP simulator-based environment. Investigated are the theta, alpha, beta, and gamma band EEG powers during the diagnostic tasks. The experimental design and procedure are represented in section 2 and the results are shown in section 3. Finally some considerations are discussed and the direction for the further work is proposed in section 4.

EEG Analysis during complex diagnostic tasks in Nuclear Power Plants - Simulator-based Experimental Study

International Nuclear Information System (INIS)

Ha, Jun Su; Seong, Poong Hyun

2005-01-01

In literature, there are a lot of studies based on EEG signals during cognitive activities of human-beings but most of them dealt with simple cognitive activities such as transforming letters into Morse code, subtraction, reading, semantic memory search, visual search, memorizing a set of words and so on. In this work, EEG signals were analyzed during complex diagnostic tasks in NPP simulator-based environment. Investigated are the theta, alpha, beta, and gamma band EEG powers during the diagnostic tasks. The experimental design and procedure are represented in section 2 and the results are shown in section 3. Finally some considerations are discussed and the direction for the further work is proposed in section 4

Diagnostic procedures of the solitary pulmonary nodule

International Nuclear Information System (INIS)

Aoe, Keisuke; Hiraki, Akio; Kohara, Hiroyuki

2003-01-01

The spread of computed tomography (CT) brought the frequent further examinations of the solitary pulmonary nodules (SPN). To aim the evaluation of initial data on examinations of SPN for differential diagnosis, we studied retrospective cases. Thirty-one cases of SPN less than 20 mm in diameter were compared in clinical findings and CT image findings and were examined the diagnostic procedures in recent three years in National Sanyo Hospital. The 31 patients consisted of 14 males and 17 females ranging 44 to 79 years old, median 65 years old. The causes of SPN were lung cancer (11 patients), cryptococcosis (4 patients), tuberculoma (3 patients), non-tuberculous mycobacteria (2 patients), pneumoconiosis (2 patients), pneumonia scar (one patient), hamartoma (one patient), and unknown (7 patients). There were no significant differences in laboratory findings between lung cancer and the others. CT findings showed significant differences in four categories. All patients underwent fiberoptic bronchoscopy (FB) examinations and 12 patients were determined the diagnosis initial FB. Five patients were established their diagnosis using videoassociated thoracoscopic surgeries. (author)

American Pancreatic Association Practice Guidelines in Chronic Pancreatitis: Evidence-Based Report on Diagnostic Guidelines

Science.gov (United States)

Conwell, Darwin L.; Lee, Linda S.; Yadav, Dhiraj; Longnecker, Daniel S.; Miller, Frank H.; Mortele, Koenraad J.; Levy, Michael J.; Kwon, Richard; Lieb, John G.; Stevens, Tyler; Toskes, Philip P.; Gardner, Timothy B.; Gelrud, Andres; Wu, Bechien U.; Forsmark, Christopher E.; Vege, Santhi S.

2016-01-01

The diagnosis of chronic pancreatitis remains challenging in early stages of the disease. This report defines the diagnostic criteria useful in the assessment of patients with suspected and established chronic pancreatitis. All current diagnostic procedures are reviewed and evidence based statements are provided about their utility and limitations. Diagnostic criteria for chronic pancreatitis are classified as definitive, probable or insufficient evidence. A diagnostic (STEP-wise; S-survey, T-tomography, E-endoscopy and P-pancreas function testing) algorithm is proposed that proceeds from a non-invasive to a more invasive approach. This algorithm maximizes specificity (low false positive rate) in subjects with chronic abdominal pain and equivocal imaging changes. Futhermore, a nomenclature is suggested to further characterize patients with established chronic pancreatitis based on TIGAR-O (T-toxic, I-idiopathic, G-genetic, A- autoimmune, R-recurrent and O-obstructive) etiology, gland morphology (Cambridge criteria) and physiologic state (exocrine, endocrine function) for uniformity across future multi-center research collaborations. This guideline will serve as a baseline manuscript that will be modified as new evidence becomes available and our knowledge of chronic pancreatitis improves. PMID:25333398

American Pancreatic Association Practice Guidelines in Chronic Pancreatitis: evidence-based report on diagnostic guidelines.

Science.gov (United States)

Conwell, Darwin L; Lee, Linda S; Yadav, Dhiraj; Longnecker, Daniel S; Miller, Frank H; Mortele, Koenraad J; Levy, Michael J; Kwon, Richard; Lieb, John G; Stevens, Tyler; Toskes, Phillip P; Gardner, Timothy B; Gelrud, Andres; Wu, Bechien U; Forsmark, Christopher E; Vege, Santhi S

2014-11-01

The diagnosis of chronic pancreatitis remains challenging in early stages of the disease. This report defines the diagnostic criteria useful in the assessment of patients with suspected and established chronic pancreatitis. All current diagnostic procedures are reviewed, and evidence-based statements are provided about their utility and limitations. Diagnostic criteria for chronic pancreatitis are classified as definitive, probable, or insufficient evidence. A diagnostic (STEP-wise; survey, tomography, endoscopy, and pancreas function testing) algorithm is proposed that proceeds from a noninvasive to a more invasive approach. This algorithm maximizes specificity (low false-positive rate) in subjects with chronic abdominal pain and equivocal imaging changes. Furthermore, a nomenclature is suggested to further characterize patients with established chronic pancreatitis based on TIGAR-O (toxic, idiopathic, genetic, autoimmune, recurrent, and obstructive) etiology, gland morphology (Cambridge criteria), and physiologic state (exocrine, endocrine function) for uniformity across future multicenter research collaborations. This guideline will serve as a baseline manuscript that will be modified as new evidence becomes available and our knowledge of chronic pancreatitis improves.

A Framework to Debug Diagnostic Matrices

Science.gov (United States)

Kodal, Anuradha; Robinson, Peter; Patterson-Hine, Ann

2013-01-01

Diagnostics is an important concept in system health and monitoring of space operations. Many of the existing diagnostic algorithms utilize system knowledge in the form of diagnostic matrix (D-matrix, also popularly known as diagnostic dictionary, fault signature matrix or reachability matrix) gleaned from physical models. But, sometimes, this may not be coherent to obtain high diagnostic performance. In such a case, it is important to modify this D-matrix based on knowledge obtained from other sources such as time-series data stream (simulated or maintenance data) within the context of a framework that includes the diagnostic/inference algorithm. A systematic and sequential update procedure, diagnostic modeling evaluator (DME) is proposed to modify D-matrix and wrapper logic considering least expensive solution first. This iterative procedure includes conditions ranging from modifying 0s and 1s in the matrix, or adding/removing the rows (failure sources) columns (tests). We will experiment this framework on datasets from DX challenge 2009.

Risk and safety requirements for diagnostic and therapeutic procedures in allergology: World Allergy Organization Statement

Directory of Open Access Journals (Sweden)

Marek L. Kowalski

2016-10-01

Full Text Available Abstract One of the major concerns in the practice of allergy is related to the safety of procedures for the diagnosis and treatment of allergic disease. Management (diagnosis and treatment of hypersensitivity disorders involves often intentional exposure to potentially allergenic substances (during skin testing, deliberate induction in the office of allergic symptoms to offending compounds (provocation tests or intentional application of potentially dangerous substances (allergy vaccine to sensitized patients. These situations may be associated with a significant risk of unwanted, excessive or even dangerous reactions, which in many instances cannot be completely avoided. However, adverse reactions can be minimized or even avoided if a physician is fully aware of potential risk and is prepared to appropriately handle the situation. Information on the risk of diagnostic and therapeutic procedures in allergic diseases has been accumulated in the medical literature for decades; however, except for allergen specific immunotherapy, it has never been presented in a systematic fashion. Up to now no single document addressed the risk of the most commonly used medical procedures in the allergy office nor attempted to present general requirements necessary to assure the safety of these procedures. Following review of available literature a group of allergy experts within the World Allergy Organization (WAO, representing various continents and areas of allergy expertise, presents this report on risk associated with diagnostic and therapeutic procedures in allergology and proposes a consensus on safety requirements for performing procedures in allergy offices. Optimal safety measures including appropriate location, type and required time of supervision, availability of safety equipment, access to specialized emergency services, etc. for various procedures have been recommended. This document should be useful for allergists with already established

The Medical Exposure to Ionizing Radiation and Protection of the Patient in Medical Imaging Procedures for Diagnostic and Therapeutic Purposes (Excluding Radiotherapy) using X-Rays in Israel - Risk - Cost and Benefit

International Nuclear Information System (INIS)

Ben-Shlomo, A.

1998-10-01

Diagnostic and therapeutic radiology is playing a major role in modern medicine. The utilization of devices emitting ionizing radiation for medical diagnostic and therapeutic purposes is classified into three categories: a. Radiotherapy procedures for the treatment of malignant and benign tumors. b. Nuclear medicine procedures using radiopharmaceuticals that are introduced into the patient's body for diagnostic and therapeutic purposes. c. Diagnostic and therapeutic x-ray imaging procedures. This group includes conventional radiography, conventional fluoroscopy, cardiac catheterization, angiography, CT, mammography, dental, and fluoroscopy operation procedures. A survey was carried out on a sample of three major Israeli hospitals in order to: 1. Determine the status of radiation protection of patients in Israel with regard to the use of x-rays in medical imaging and interventional radiology. 2. Assess the extent of exposure of the population to medical x-rays, and assess the collective risk in Israel in this relation (based on Icr-60). 3. Carry out a cost-benefit optimization procedure related to the means that should be used to reduce the exposure of Israeli patients under x-ray procedures. 4. Establish a of practical recommendations to reduce the x-ray radiation exposure of patients and to increase the image quality. 5. Establish a number of basic rules to be utilized by health policy makers in Israel

The Medical Exposure to Ionizing Radiation and Protection of the Patient in Medical Imaging Procedures for Diagnostic and Therapeutic Purposes (Excluding Radiotherapy) using X-Rays in Israel - Risk - Cost and Benefit

Energy Technology Data Exchange (ETDEWEB)

Ben-Shlomo, A

1998-10-01

Diagnostic and therapeutic radiology is playing a major role in modern medicine. The utilization of devices emitting ionizing radiation for medical diagnostic and therapeutic purposes is classified into three categories: a. Radiotherapy procedures for the treatment of malignant and benign tumors. b. Nuclear medicine procedures using radiopharmaceuticals that are introduced into the patient's body for diagnostic and therapeutic purposes. c. Diagnostic and therapeutic x-ray imaging procedures. This group includes conventional radiography, conventional fluoroscopy, cardiac catheterization, angiography, CT, mammography, dental, and fluoroscopy operation procedures. A survey was carried out on a sample of three major Israeli hospitals in order to: 1. Determine the status of radiation protection of patients in Israel with regard to the use of x-rays in medical imaging and interventional radiology. 2. Assess the extent of exposure of the population to medical x-rays, and assess the collective risk in Israel in this relation (based on Icr-60). 3. Carry out a cost-benefit optimization procedure related to the means that should be used to reduce the exposure of Israeli patients under x-ray procedures. 4. Establish a of practical recommendations to reduce the x-ray radiation exposure of patients and to increase the image quality. 5. Establish a number of basic rules to be utilized by health policy makers in Israel.

Lost in Translation? Ethical Challenges of Implementing a New Diagnostic Procedure.

Science.gov (United States)

Schmitz, Dagmar

2016-01-01

Since cell-free DNA (cfDNA) fragments of placental origin can be isolated and analyzed from the blood of pregnant women. Applications of this finding have been developed and implemented in clinical care pathways worldwide at an unprecedented pace and manner. Implementation patterns, however, exhibit considerable insufficiencies. Different "motors" of implementation processes, like the market or various regulatory institutions, can be identified at a national level. Each "motor" entails characteristic ethical challenges which are exemplified impressively by a rising number of case reports.Empirical data demonstrate that there are significant "losses" in the respective translational processes, especially when the results from clinical research are to be translated into the clinical reality of NIPT (the so called "second roadblock" (T2)). These "losses" are perceived in the fields of knowledge transfer, professional standardization and ethical debate. Recommendations of professional organizations often fail to reach general practitioners. Blindsided by the new diagnostic procedure in their clinical practice, professionals in prenatal care express their insecurities with regard to its handling. Ethical debate appears to adhere to pre-existing (and partly already proven to be insufficient) normative frameworks for prenatal testing. While all of these deficits are typical for the implementation processes of many new molecular diagnostic procedures, especially in NIPT, they show a high variability between different nations.A critical assessment of the preferred strategy of implementation against the background of already existing national ethical frameworks is indispensable, if potential adverse effects are to be diminished. The described translational losses seem to be significantly reducible by granting the translational process in roadblock T2 more time.

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.

Case-Based Fault Diagnostic System

International Nuclear Information System (INIS)

Mohamed, A.H.

2014-01-01

Nowadays, case-based fault diagnostic (CBFD) systems have become important and widely applied problem solving technologies. They are based on the assumption that “similar faults have similar diagnosis”. On the other hand, CBFD systems still suffer from some limitations. Common ones of them are: (1) failure of CBFD to have the needed diagnosis for the new faults that have no similar cases in the case library. (2) Limited memorization when increasing the number of stored cases in the library. The proposed research introduces incorporating the neural network into the case based system to enable the system to diagnose all the faults. Neural networks have proved their success in the classification and diagnosis problems. The suggested system uses the neural network to diagnose the new faults (cases) that cannot be diagnosed by the traditional CBR diagnostic system. Besides, the proposed system can use the another neural network to control adding and deleting the cases in the library to manage the size of the cases in the case library. However, the suggested system has improved the performance of the case based fault diagnostic system when applied for the motor rolling bearing as a case of study

NaI(Tl) scintillator detectors stripping procedure for air kerma measurements of diagnostic X-ray beams

Science.gov (United States)

Oliveira, L. S. R.; Conti, C. C.; Amorim, A. S.; Balthar, M. C. V.

2013-03-01

Air kerma is an essential quantity for the calibration of national standards used in diagnostic radiology and the measurement of operating parameters used in radiation protection. Its measurement within the appropriate limits of accuracy, uncertainty and reproducibility is important for the characterization and control of the radiation field for the dosimetry of the patients submitted to diagnostic radiology and, also, for the assessment of the system which produces radiological images. Only the incident beam must be considered for the calculation of the air kerma. Therefore, for energy spectrum, counts apart the total energy deposition in the detector must be subtracted. It is necessary to establish a procedure to sort out the different contributions to the original spectrum and remove the counts representing scattered photons in the detector's materials, partial energy deposition due to the interactions in the detector active volume and, also, the escape peaks contributions. The main goal of this work is to present spectrum stripping procedure, using the MCNP Monte Carlo computer code, for NaI(Tl) scintillation detectors to calculate the air kerma due to an X-ray beam usually used in medical radiology. The comparison between the spectrum before stripping procedure against the reference value showed a discrepancy of more than 63%, while the comparison with the same spectrum after the stripping procedure showed a discrepancy of less than 0.2%.

NaI(Tl) scintillator detectors stripping procedure for air kerma measurements of diagnostic X-ray beams

Energy Technology Data Exchange (ETDEWEB)

Oliveira, L.S.R. [Centro Tecnológico do Exército, CTEx (Brazilian Army Technological Center), Av. das Américas n° 28705, 23085-470 Rio de Janeiro (Brazil); Instituto de Radioprotecão e Dosimetria, CNEN/IRD (Institute for Radioprotection and Dosimetry, CNEN/IRD), Av. Salvador Allende s/no, P.O. Box 37750, 22783-127 Barra da Tijuca, Rio de Janeiro (Brazil); Conti, C.C., E-mail: ccconti@ird.gov.br [Instituto de Radioprotecão e Dosimetria, CNEN/IRD (Institute for Radioprotection and Dosimetry, CNEN/IRD), Av. Salvador Allende s/no, P.O. Box 37750, 22783-127 Barra da Tijuca, Rio de Janeiro (Brazil); Amorim, A.S.; Balthar, M.C.V. [Centro Tecnológico do Exército, CTEx (Brazilian Army Technological Center), Av. das Américas n° 28705, 23085-470 Rio de Janeiro (Brazil)

2013-03-21

Air kerma is an essential quantity for the calibration of national standards used in diagnostic radiology and the measurement of operating parameters used in radiation protection. Its measurement within the appropriate limits of accuracy, uncertainty and reproducibility is important for the characterization and control of the radiation field for the dosimetry of the patients submitted to diagnostic radiology and, also, for the assessment of the system which produces radiological images. Only the incident beam must be considered for the calculation of the air kerma. Therefore, for energy spectrum, counts apart the total energy deposition in the detector must be subtracted. It is necessary to establish a procedure to sort out the different contributions to the original spectrum and remove the counts representing scattered photons in the detector’s materials, partial energy deposition due to the interactions in the detector active volume and, also, the escape peaks contributions. The main goal of this work is to present spectrum stripping procedure, using the MCNP Monte Carlo computer code, for NaI(Tl) scintillation detectors to calculate the air kerma due to an X-ray beam usually used in medical radiology. The comparison between the spectrum before stripping procedure against the reference value showed a discrepancy of more than 63%, while the comparison with the same spectrum after the stripping procedure showed a discrepancy of less than 0.2%.

Image standards in Tissue-Based Diagnosis (Diagnostic Surgical Pathology

Directory of Open Access Journals (Sweden)

Vollmer Ekkehard

2008-04-01

Full Text Available Abstract Background Progress in automated image analysis, virtual microscopy, hospital information systems, and interdisciplinary data exchange require image standards to be applied in tissue-based diagnosis. Aims To describe the theoretical background, practical experiences and comparable solutions in other medical fields to promote image standards applicable for diagnostic pathology. Theory and experiences Images used in tissue-based diagnosis present with pathology – specific characteristics. It seems appropriate to discuss their characteristics and potential standardization in relation to the levels of hierarchy in which they appear. All levels can be divided into legal, medical, and technological properties. Standards applied to the first level include regulations or aims to be fulfilled. In legal properties, they have to regulate features of privacy, image documentation, transmission, and presentation; in medical properties, features of disease – image combination, human – diagnostics, automated information extraction, archive retrieval and access; and in technological properties features of image acquisition, display, formats, transfer speed, safety, and system dynamics. The next lower second level has to implement the prescriptions of the upper one, i.e. describe how they are implemented. Legal aspects should demand secure encryption for privacy of all patient related data, image archives that include all images used for diagnostics for a period of 10 years at minimum, accurate annotations of dates and viewing, and precise hardware and software information. Medical aspects should demand standardized patients' files such as DICOM 3 or HL 7 including history and previous examinations, information of image display hardware and software, of image resolution and fields of view, of relation between sizes of biological objects and image sizes, and of access to archives and retrieval. Technological aspects should deal with image

Radiation protection problems by diagnostic procedures of pediatric nuclear medicine

International Nuclear Information System (INIS)

Kletter, K.

1994-01-01

Special dosimetry considerations are necessary in the application of radiopharmaceuticals in pediatric nuclear medicine. The influence of differences in irradiation geometry and biokinetic parameters on the radiation dose in children and adults is discussed. Assuming an equal activity concentration, both factors lead rather to a reduced radiation dose than an increased radiation burden in children compared to adults. However, the same radiation dose in children and adults may lead to a different detriment. This is explained by differences in life expectancy and radiation sensitivity for both groups. From special formulas an age dependent reduction factor can be calculated for the application of radiopharmaceuticals in pediatric nuclear medicine. Radiation exposure to hospital staff and parents from children, undergoing nuclear medicine diagnostic or therapeutic procedures, is low. (author)

Evaluating the Performance Diagnostic Checklist-Human Services to Assess Incorrect Error-Correction Procedures by Preschool Paraprofessionals

Science.gov (United States)

Bowe, Melissa; Sellers, Tyra P.

2018-01-01

The Performance Diagnostic Checklist-Human Services (PDC-HS) has been used to assess variables contributing to undesirable staff performance. In this study, three preschool teachers completed the PDC-HS to identify the factors contributing to four paraprofessionals' inaccurate implementation of error-correction procedures during discrete trial…

On Informatics Diagnostics and Informatics Therapeutics - Good Medical Informatics Research Is Needed Here.

Science.gov (United States)

Haux, Reinhold

2017-01-01

In the era of digitization some new procedures play an increasing role for diagnosis as well as for therapy: informatics diagnostics and informatics therapeutics. Challenges for such procedures are described. It is discussed, when research on such diagnostics and therapeutics can be regarded as good research. Examples are mentioned for informatics diagnostics and informatics therapeutics, which are based on health-enabling technologies.

Refining a complex diagnostic construct: subtyping Dysthymia with the Shedler-Westen Assessment Procedure-II.

Science.gov (United States)

Huprich, Steven K; Defife, Jared; Westen, Drew

2014-01-01

We sought to determine whether meaningful subtypes of Dysthymic patients could be identified when grouping them by similar personality profiles. A random, national sample of psychiatrists and clinical psychologists (n=1201) described a randomly selected current patient with personality pathology using the descriptors in the Shedler-Westen Assessment Procedure-II (SWAP-II), completed assessments of patients' adaptive functioning, and provided DSM-IV Axis I and II diagnoses. We applied Q-factor cluster analyses to those patients diagnosed with Dysthymic Disorder. Four clusters were identified-High Functioning, Anxious/Dysphoric, Emotionally Dysregulated, and Narcissistic. These factor scores corresponded with a priori hypotheses regarding diagnostic comorbidity and level of adaptive functioning. We compared these groups to diagnostic constructs described and empirically identified in the past literature. The results converge with past and current ideas about the ways in which chronic depression and personality are related and offer an enhanced means by which to understand a heterogeneous diagnostic category that is empirically grounded and clinically useful. © 2013 Published by Elsevier B.V.

Adaptive techniques for diagnostics of vibrating structures

International Nuclear Information System (INIS)

Skormin, V.A.; Sankar, S.

1983-01-01

An adaptive diagnostic procedure for vibrating structures based on correspondence between current estimates of stiffness matrix and structure status is proposed. Procedure employs adaptive mathematical description of the vibrating structure in frequency domain, statistical techniques for detection and location of changes of structure properties, 'recognition' and prediction of defects. (orig.)

Diagnostic Procedures to Detect Chlamydia trachomatis Infections

Directory of Open Access Journals (Sweden)

Thomas Meyer

2016-08-01

Full Text Available The intracellular life style of chlamydia and the ability to cause persistent infections with low-grade replication requires tests with high analytical sensitivity to directly detect C. trachomatis (CT in medical samples. Nucleic acid amplification tests (NAATs are the most sensitive assays with a specificity similar to cell culture and are considered the method of choice for CT detection. In addition, NAATs can be performed on various clinical specimens that do not depend on specific transport and storage conditions, since NAATs do not require infectious bacteria. In the case of lower genital tract infections, first void urine and vaginal swabs are the recommended specimens for testing males and females, respectively. Infections of anorectal, oropharyngeal and ocular epithelia should also be tested by NAAT analysis of corresponding mucosal swabs. In particular, anorectal infections of men who have sex with men (MSM should include evaluation of lymphogranuloma venereum (LGV by identification of genotypes L1, L2 or L3. Detection of CT antigens by enzyme immunoassay (EIAs or rapid diagnostic tests (RDTs are unsuitable due to insufficient sensitivity and specificity. Recent PCR-based RDTs, however, are non-inferior to standard NAATs, and might be used at the point-of-care. Serology finds application in the diagnostic work-up of suspected chronic CT infection but is inappropriate to diagnose acute infections.

Standardized Procedure Content And Data Structure Based On Human Factors Requirements For Computer-Based Procedures

International Nuclear Information System (INIS)

Bly, Aaron; Oxstrand, Johanna; Le Blanc, Katya L

2015-01-01

Most activities that involve human interaction with systems in a nuclear power plant are guided by procedures. Traditionally, the use of procedures has been a paper-based process that supports safe operation of the nuclear power industry. However, the nuclear industry is constantly trying to find ways to decrease the human error rate, especially the human errors associated with procedure use. Advances in digital technology make computer-based procedures (CBPs) a valid option that provides further enhancement of safety by improving human performance related to procedure use. The transition from paper-based procedures (PBPs) to CBPs creates a need for a computer-based procedure system (CBPS). A CBPS needs to have the ability to perform logical operations in order to adjust to the inputs received from either users or real time data from plant status databases. Without the ability for logical operations the procedure is just an electronic copy of the paper-based procedure. In order to provide the CBPS with the information it needs to display the procedure steps to the user, special care is needed in the format used to deliver all data and instructions to create the steps. The procedure should be broken down into basic elements and formatted in a standard method for the CBPS. One way to build the underlying data architecture is to use an Extensible Markup Language (XML) schema, which utilizes basic elements to build each step in the smart procedure. The attributes of each step will determine the type of functionality that the system will generate for that step. The CBPS will provide the context for the step to deliver referential information, request a decision, or accept input from the user. The XML schema needs to provide all data necessary for the system to accurately perform each step without the need for the procedure writer to reprogram the CBPS. The research team at the Idaho National Laboratory has developed a prototype CBPS for field workers as well as the

Standardized Procedure Content And Data Structure Based On Human Factors Requirements For Computer-Based Procedures

Energy Technology Data Exchange (ETDEWEB)

Bly, Aaron; Oxstrand, Johanna; Le Blanc, Katya L

2015-02-01

Most activities that involve human interaction with systems in a nuclear power plant are guided by procedures. Traditionally, the use of procedures has been a paper-based process that supports safe operation of the nuclear power industry. However, the nuclear industry is constantly trying to find ways to decrease the human error rate, especially the human errors associated with procedure use. Advances in digital technology make computer-based procedures (CBPs) a valid option that provides further enhancement of safety by improving human performance related to procedure use. The transition from paper-based procedures (PBPs) to CBPs creates a need for a computer-based procedure system (CBPS). A CBPS needs to have the ability to perform logical operations in order to adjust to the inputs received from either users or real time data from plant status databases. Without the ability for logical operations the procedure is just an electronic copy of the paper-based procedure. In order to provide the CBPS with the information it needs to display the procedure steps to the user, special care is needed in the format used to deliver all data and instructions to create the steps. The procedure should be broken down into basic elements and formatted in a standard method for the CBPS. One way to build the underlying data architecture is to use an Extensible Markup Language (XML) schema, which utilizes basic elements to build each step in the smart procedure. The attributes of each step will determine the type of functionality that the system will generate for that step. The CBPS will provide the context for the step to deliver referential information, request a decision, or accept input from the user. The XML schema needs to provide all data necessary for the system to accurately perform each step without the need for the procedure writer to reprogram the CBPS. The research team at the Idaho National Laboratory has developed a prototype CBPS for field workers as well as the

Diagnostic reliability of MMPI-2 computer-based test interpretations.

Science.gov (United States)

Pant, Hina; McCabe, Brian J; Deskovitz, Mark A; Weed, Nathan C; Williams, John E

2014-09-01

Reflecting the common use of the MMPI-2 to provide diagnostic considerations, computer-based test interpretations (CBTIs) also typically offer diagnostic suggestions. However, these diagnostic suggestions can sometimes be shown to vary widely across different CBTI programs even for identical MMPI-2 profiles. The present study evaluated the diagnostic reliability of 6 commercially available CBTIs using a 20-item Q-sort task developed for this study. Four raters each sorted diagnostic classifications based on these 6 CBTI reports for 20 MMPI-2 profiles. Two questions were addressed. First, do users of CBTIs understand the diagnostic information contained within the reports similarly? Overall, diagnostic sorts of the CBTIs showed moderate inter-interpreter diagnostic reliability (mean r = .56), with sorts for the 1/2/3 profile showing the highest inter-interpreter diagnostic reliability (mean r = .67). Second, do different CBTIs programs vary with respect to diagnostic suggestions? It was found that diagnostic sorts of the CBTIs had a mean inter-CBTI diagnostic reliability of r = .56, indicating moderate but not strong agreement across CBTIs in terms of diagnostic suggestions. The strongest inter-CBTI diagnostic agreement was found for sorts of the 1/2/3 profile CBTIs (mean r = .71). Limitations and future directions are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved.

The radiopharmaceuticals in nuclear medicine diagnostic procedures and the problem of radiation protection

Energy Technology Data Exchange (ETDEWEB)

Ftacnikova, S [Inst. of Preventive and Clinical Medicine, 83301 Bratislava (Slovakia)

1996-12-31

In this paper equivalent dose from Auger electron emitters was reevaluated. The presented approach represents a practical step toward the estimation of equivalent dose for incorporated Auger electron emitters, an aspects that has not been given adequate consideration so far. Given the widespread use of this class of radionuclides in nuclear medicine and in biomedical research, the formalism and practical calculation presented here may be of value to assessing the risk associated with this radionuclides (in diagnostic nuclear medicine procedures), as well as predicting their therapeutic efficiency. (J.K.) 2 tabs., 11 refs.

Web-based video monitoring of CT and MRI procedures

Science.gov (United States)

Ratib, Osman M.; Dahlbom, Magdalena; Kho, Hwa T.; Valentino, Daniel J.; McCoy, J. Michael

2000-05-01

A web-based video transmission of images from CT and MRI consoles was implemented in an Intranet environment for real- time monitoring of ongoing procedures. Images captured from the consoles are compressed to video resolution and broadcasted through a web server. When called upon, the attending radiologists can view these live images on any computer within the secured Intranet network. With adequate compression, these images can be displayed simultaneously in different locations at a rate of 2 to 5 images/sec through standard LAN. The quality of the images being insufficient for diagnostic purposes, our users survey showed that they were suitable for supervising a procedure, positioning the imaging slices and for routine quality checking before completion of a study. The system was implemented at UCLA to monitor 9 CTs and 6 MRIs distributed in 4 buildings. This system significantly improved the radiologists productivity by saving precious time spent in trips between reading rooms and examination rooms. It also improved patient throughput by reducing the waiting time for the radiologists to come to check a study before moving the patient from the scanner.

Knowledge based diagnostics in nuclear power plants

International Nuclear Information System (INIS)

Baldeweg, F.; Fiedler, U.; Weiss, F.P.; Werner, M.

1987-01-01

In this paper a special process diagnostic system (PDS) is presented. It must be seen as the result of a long term work on computerized process surveillance and control; it includes a model based system for noise analysis of mechanical vibrations, which has recently been enhanced by using of knowledge based technique (expert systems). The paper discusses the process diagnostic frame concept and emphasize the vibration analysis expert system

Development of a diagnosis- and procedure-based risk model for 30-day outcome after pediatric cardiac surgery.

Science.gov (United States)

Crowe, Sonya; Brown, Kate L; Pagel, Christina; Muthialu, Nagarajan; Cunningham, David; Gibbs, John; Bull, Catherine; Franklin, Rodney; Utley, Martin; Tsang, Victor T

2013-05-01

The study objective was to develop a risk model incorporating diagnostic information to adjust for case-mix severity during routine monitoring of outcomes for pediatric cardiac surgery. Data from the Central Cardiac Audit Database for all pediatric cardiac surgery procedures performed in the United Kingdom between 2000 and 2010 were included: 70% for model development and 30% for validation. Units of analysis were 30-day episodes after the first surgical procedure. We used logistic regression for 30-day mortality. Risk factors considered included procedural information based on Central Cardiac Audit Database "specific procedures," diagnostic information defined by 24 "primary" cardiac diagnoses and "univentricular" status, and other patient characteristics. Of the 27,140 30-day episodes in the development set, 25,613 were survivals, 834 were deaths, and 693 were of unknown status (mortality, 3.2%). The risk model includes procedure, cardiac diagnosis, univentricular status, age band (neonate, infant, child), continuous age, continuous weight, presence of non-Down syndrome comorbidity, bypass, and year of operation 2007 or later (because of decreasing mortality). A risk score was calculated for 95% of cases in the validation set (weight missing in 5%). The model discriminated well; the C-index for validation set was 0.77 (0.81 for post-2007 data). Removal of all but procedural information gave a reduced C-index of 0.72. The model performed well across the spectrum of predicted risk, but there was evidence of underestimation of mortality risk in neonates undergoing operation from 2007. The risk model performs well. Diagnostic information added useful discriminatory power. A future application is risk adjustment during routine monitoring of outcomes in the United Kingdom to assist quality assurance. Copyright © 2013 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Experimental Investigation on Admittance-Based Piezoelectric Sensor Diagnostic Process

Energy Technology Data Exchange (ETDEWEB)

Jo, Hyejin; Park, Tongil; Park, Gyuhae [Chonnam National University, Gwangju (Korea, Republic of)

2015-01-15

Structural health monitoring (SHM) techniques based on the use of active-sensing piezoelectric (PZT) materials have received considerable attention. The validation of the PZT functionality during SHM operation is critical to successfully implementing a reliable SHM system. In this study, we investigated several parameters that affect the admittance-based sensor diagnostic process. We experimentally identified the temperature dependency of the active-sensor diagnostic process. We found that the admittance-based sensor diagnostic process can differentiate the adhesion conditions of bonding materials that are used to install a PZT on a structure, which is important when designing a sensor diagnostic process for an SHM system.

Algorithm for Video Summarization of Bronchoscopy Procedures

Directory of Open Access Journals (Sweden)

Leszczuk Mikołaj I

2011-12-01

Full Text Available Abstract Background The duration of bronchoscopy examinations varies considerably depending on the diagnostic and therapeutic procedures used. It can last more than 20 minutes if a complex diagnostic work-up is included. With wide access to videobronchoscopy, the whole procedure can be recorded as a video sequence. Common practice relies on an active attitude of the bronchoscopist who initiates the recording process and usually chooses to archive only selected views and sequences. However, it may be important to record the full bronchoscopy procedure as documentation when liability issues are at stake. Furthermore, an automatic recording of the whole procedure enables the bronchoscopist to focus solely on the performed procedures. Video recordings registered during bronchoscopies include a considerable number of frames of poor quality due to blurry or unfocused images. It seems that such frames are unavoidable due to the relatively tight endobronchial space, rapid movements of the respiratory tract due to breathing or coughing, and secretions which occur commonly in the bronchi, especially in patients suffering from pulmonary disorders. Methods The use of recorded bronchoscopy video sequences for diagnostic, reference and educational purposes could be considerably extended with efficient, flexible summarization algorithms. Thus, the authors developed a prototype system to create shortcuts (called summaries or abstracts of bronchoscopy video recordings. Such a system, based on models described in previously published papers, employs image analysis methods to exclude frames or sequences of limited diagnostic or education value. Results The algorithm for the selection or exclusion of specific frames or shots from video sequences recorded during bronchoscopy procedures is based on several criteria, including automatic detection of "non-informative", frames showing the branching of the airways and frames including pathological lesions. Conclusions

Student and intern awareness of ionising radiation exposure from common diagnostic imaging procedures

International Nuclear Information System (INIS)

Zhou, G. Z.; Wong, D. D.; Nguyen, L. K.; Mendelson, R. M.

2010-01-01

Full text: This study aims to evaluate medical student and intern awareness of ionising radiation exposure from common diagnostic imaging procedures and to suggest how education could be improved. Fourth to sixth year medical students enrolled at a Western Australian university and interns from three teaching hospitals in Perth were recruited. Participants were asked to complete a questionnaire consisting of 26 questions on their background, knowledge of ionising radiation doses and learning preferences for future teaching on this subject. A total of 331 completed questionnaires were received (95.9%). Of the 17 questions assessing knowledge of ionising radiation, a mean score of 6.0 was obtained by respondents (95% CI 5.8-6.2). Up to 54.8% of respondents underestimated the radiation dose from commonly requested radiological procedures. Respondents (11.3 and 25.5%) incorrectly believed that ultrasound and MRI emit ionising radiation, respectively. Of the four subgroups of respondents, the intern doctor subgroup performed significantly better (mean score 6.9, P< 0.0001, 95% CI 6.5-7.3) than each of the three medical student subgroups. When asked for the preferred method of teaching for future radiation awareness, a combination of lectures, tutorials and workshops was preferred. This study has clearly shown that awareness of ionising radiation from diagnostic imaging is lacking among senior medical students and interns. The results highlight the need for improved education to minimise unnecessary exposure of patients and the community to radiation. Further studies are required to determine the most effective form of education.

Pericardiectomy as a diagnostic and therapeutic procedure.

Science.gov (United States)

Konik, Ewa; Geske, Jeffrey; Edwards, William; Gersh, Bernard

2016-11-14

A 70-year-old man presented with recent onset, predominantly right-sided heart failure. Echocardiogram demonstrated features of hypertensive heart disease and was suggestive of, but non-diagnostic for, constrictive pericarditis (CP). CT demonstrated mild pericardial thickening. Right heart catheterisation showed elevation and equalisation of diastolic pressures in all cardiac chambers with early rapid filling, minimal ventricular interdependence, and no dissociation of intrathoracic and intracardiac pressures. While several features pointed towards CP, the minimal ventricular interdependence and no dissociation of intrathoracic and intracardiac pressures suggested other pathology. Diagnostic pericardiectomy was performed, after which the central venous pressure decreased from 22 to 12 mm Hg. Pathology revealed pericardial fibrosis. The patient experienced sustained resolution of his heart failure. A potential explanation for lack of CP criteria was the presence of hypertensive heart disease. CP needs to be considered when approaching patients with heart failure as diagnostic evaluation can be multifaceted and treatment curative. 2016 BMJ Publishing Group Ltd.

Evidence-based development of a diagnosis-dependent therapy planning system and its implementation in modern diagnostic software.

Science.gov (United States)

Ahlers, M O; Jakstat, H A

2005-07-01

The prerequisite for structured individual therapy of craniomandibular dysfunctions is differential diagnostics. Suggestions for the structured recording of findings and their structured evaluation beyond the global diagnosis of "craniomandibular disorders" have been published. Only this structured approach enables computerization of the diagnostic process. The respective software is available for use in practice (CMDcheck for CMD screening, CMDfact for the differential diagnostics). Based on this structured diagnostics, knowledge-based therapy planning is also conceivable. The prerequisite for this would be a model of achieving consensus on the indicated forms of therapy related to the diagnosis. Therefore, a procedure for evidence-based achievement of consensus on suitable forms of therapy in CMD was developed first in multicentric cooperation, and then implemented in corresponding software. The clinical knowledge of experienced specialists was included consciously for the consensus achievement process. At the same time, anonymized mathematical statistical evaluations were used for control and objectification. Different examiners form different departments of several universities working independently of one another assigned the theoretically conceiveable therapeutic alternatives to the already published diagnostic scheme. After anonymization, the correlation of these assignments was then calculated mathematically. For achieving consensus in those cases for which no agreement initally existed, agreement was subsequently arrived at in the course of a consensus conference on the basis of literature evaluations and the discussion of clinical case examples. This consensus in turn finally served as the basis of a therapy planner implemented in the above-mentioned diagnostic software CMDfact. Contributing to quality assurance, the principles of programming this assistant as well as the interface for linking into the diagnostic software are documented and also published

A Self-Diagnostic System for the M6 Accelerometer

Science.gov (United States)

Flanagan, Patrick M.; Lekki, John

2001-01-01

The design of a Self-Diagnostic (SD) accelerometer system for the Space Shuttle Main Engine is presented. This retrofit system connects diagnostic electronic hardware and software to the current M6 accelerometer system. This paper discusses the general operation of the M6 accelerometer SD system and procedures for developing and evaluating the SD system. Signal processing techniques using M6 accelerometer diagnostic data are explained. Test results include diagnostic data responding to changing ambient temperature, mounting torque and base mounting impedance.

[Causes, Diagnostic and Therapeutical Procedures of Malassimilation].

Science.gov (United States)

Schröder, Torsten; Kistenmacher, Alina; Smollich, Martin; Sina, Christian

2018-05-01

Patients with malassimilation suffer from disturbed exploitation of available nutrients, which can affect macro- and micronutrients. Malassimilation can be subdivided in maldigestion and malabsorption. Many different disorders, especially gastrointestinal diseases, can lead to malassimilation. The wide variety of differential diagnoses necessitates big diagnostic as well as financial efforts in order to assure good clinical care. This review provides an overview on diagnostic as well as therapeutic processes of patients with malassimilation and gives practical advice for their physicians and therapists. © Georg Thieme Verlag KG Stuttgart · New York.

Knowledge acquisition for nuclear power plant unit diagnostic system

International Nuclear Information System (INIS)

Li Xiaodong; Xi Shuren

2003-01-01

The process of acquiring knowledge and building a knowledge base is critical to realize fault diagnostic system at unit level in a nuclear power plant. It directly determines whether the diagnostic system can be applied eventually in a commercial plant. A means to acquire knowledge and its procedures was presented in this paper for fault diagnostic system in a nuclear power plant. The work can be carried out step by step and it is feasible in a commercial nuclear power plant. The knowledge base of the fault diagnostic system for a nuclear power plant can be built after the staff finish the tasks according to the framework presented in this paper

Thyroid Radiation Dose to Patients from Diagnostic Radiology Procedures over Eight Decades: 1930-2010.

Science.gov (United States)

Chang, Lienard A; Miller, Donald L; Lee, Choonsik; Melo, Dunstana R; Villoing, Daphnée; Drozdovitch, Vladimir; Thierry-Chef, Isabelle; Winters, Sarah J; Labrake, Michael; Myers, Charles F; Lim, Hyeyeun; Kitahara, Cari M; Linet, Martha S; Simon, Steven L

2017-12-01

This study summarizes and compares estimates of radiation absorbed dose to the thyroid gland for typical patients who underwent diagnostic radiology examinations in the years from 1930 to 2010. The authors estimated the thyroid dose for common examinations, including radiography, mammography, dental radiography, fluoroscopy, nuclear medicine, and computed tomography (CT). For the most part, a clear downward trend in thyroid dose over time for each procedure was observed. Historically, the highest thyroid doses came from the nuclear medicine thyroid scans in the 1960s (630 mGy), full-mouth series dental radiography (390 mGy) in the early years of the use of x rays in dentistry (1930s), and the barium swallow (esophagram) fluoroscopic exam also in the 1930s (140 mGy). Thyroid uptake nuclear medicine examinations and pancreatic scans also gave relatively high doses to the thyroid (64 mGy and 21 mGy, respectively, in the 1960s). In the 21st century, the highest thyroid doses still result from nuclear medicine thyroid scans (130 mGy), but high thyroid doses are also associated with chest/abdomen/pelvis CT scans (18 and 19 mGy for males and females, respectively). Thyroid doses from CT scans did not exhibit the same downward trend as observed for other examinations. The largest thyroid doses from conventional radiography came from cervical spine and skull examinations. Thyroid doses from mammography (which began in the 1960s) were generally a fraction of 1 mGy. The highest average doses to the thyroid from mammography were about 0.42 mGy, with modestly larger doses associated with imaging of breasts with large compressed thicknesses. Thyroid doses from dental radiographic procedures have decreased markedly throughout the decades, from an average of 390 mGy for a full-mouth series in the 1930s to an average of 0.31 mGy today. Upper GI series fluoroscopy examinations resulted in up to two orders of magnitude lower thyroid doses than the barium swallow. There are

Diagnostic imaging procedures during pregnancy: what are the fetal risks?

International Nuclear Information System (INIS)

Taylor, K.

2008-01-01

An important facet of health care is the counsel of patients seeking a better understanding of their medical treatment. One of the most challenging scenarios is the management of female patients exposed to ionizing radiation while pregnant. It requires careful consideration of both maternal benefit and fetal risk. Given the increased frequency of diagnostic examinations involving ionizing radiation, this situation has become commonplace. This paper reviews current literature discussing the risk associated with prenatal exposure to ionizing radiation. The fetal dose received during common radiological procedures is reported in order to emphasize that these doses do not exceed threshold levels for deterministic effects. The definitive cancer risk associated with radiation exposure in utero has yet to be established. This paper will also show that physicians who deal with pregnant women are generally uninformed or misinformed of the doses and risks associated with the exams that they prescribe. This lack of information could be leading to inappropriate advice and actions with respect to patient care. (author)

Diagnostic imaging procedures during pregnancy: what are the fetal risks?

Energy Technology Data Exchange (ETDEWEB)

Taylor, K. [McMaster Univ., Hamilton, Ontario (Canada)

2008-07-01

An important facet of health care is the counsel of patients seeking a better understanding of their medical treatment. One of the most challenging scenarios is the management of female patients exposed to ionizing radiation while pregnant. It requires careful consideration of both maternal benefit and fetal risk. Given the increased frequency of diagnostic examinations involving ionizing radiation, this situation has become commonplace. This paper reviews current literature discussing the risk associated with prenatal exposure to ionizing radiation. The fetal dose received during common radiological procedures is reported in order to emphasize that these doses do not exceed threshold levels for deterministic effects. The definitive cancer risk associated with radiation exposure in utero has yet to be established. This paper will also show that physicians who deal with pregnant women are generally uninformed or misinformed of the doses and risks associated with the exams that they prescribe. This lack of information could be leading to inappropriate advice and actions with respect to patient care. (author)

Graphene-based nanoprobes for molecular diagnostics.

Science.gov (United States)

Chen, Shixing; Li, Fuwu; Fan, Chunhai; Song, Shiping

2015-10-07

In recent years, graphene has received widespread attention owing to its extraordinary electrical, chemical, optical, mechanical and structural properties. Lately, considerable interest has been focused on exploring the potential applications of graphene in life sciences, particularly in disease-related molecular diagnostics. In particular, the coupling of functional molecules with graphene as a nanoprobe offers an excellent platform to realize the detection of biomarkers, such as nucleic acids, proteins and other bioactive molecules, with high performance. This article reviews emerging graphene-based nanoprobes in electrical, optical and other assay methods and their application in various strategies of molecular diagnostics. In particular, this review focuses on the construction of graphene-based nanoprobes and their special advantages for the detection of various bioactive molecules. Properties of graphene-based materials and their functionalization are also comprehensively discussed in view of the development of nanoprobes. Finally, future challenges and perspectives of graphene-based nanoprobes are discussed.

Diagnostics of machine parts by means of reverse engineering procedures

Directory of Open Access Journals (Sweden)

Jacek Rysinski

2015-05-01

Full Text Available In this article, an application of a three-dimensional scanner for building a special diagnostic stand is described. An experimental method of detection of material defects is discussed. The considered defects are connected with cooperation of particular surfaces of machine parts. In the discussed experiments, particularly the dimensions of pitting holes can be evaluated. Availability of laboratory facilities required that the investigations were performed using geared wheels. The three-dimensional model which represents a degenerated surface, obtained based upon the diagnostic measurements, was compared with the pattern of an undamaged surface. The latter was generated by means of our pre-processor. The pre-processor enables generation of files which are compatible with the majority of the computer-aided design system formats. Therefore, the analyses were performed by means of commercial system inventor and computer-aided three-dimensional interactive application.

42 CFR 410.32 - Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions.

Science.gov (United States)

2010-10-01

... Procedural Terminology published by the American Medical Association. (3) Levels of supervision. Except where... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.32 Diagnostic x-ray tests, diagnostic laboratory...

Diagnostic tests based on human basophils

DEFF Research Database (Denmark)

Kleine-Tebbe, Jörg; Erdmann, Stephan; Knol, Edward F

2006-01-01

-maximal responses, termed 'intrinsic sensitivity'. These variables give rise to shifts in the dose-response curves which, in a diagnostic setting where only a single antigen concentration is employed, may produce false-negative data. Thus, in order to meaningfully utilize the current basophil activation tests....... Diagnostic studies using CD63 or CD203c in hymenoptera, food and drug allergy are critically discussed. Basophil-based tests are indicated for allergy testing in selected cases but should only be performed by experienced laboratories....

IMPAIRED MOBILITY OF VOCAL FOLDS – DIAGNOSTIC PROCEDURES AND TREATMENT, part 2

Directory of Open Access Journals (Sweden)

Karlo Pintarić

2015-09-01

Full Text Available Paresis or paralysis of one or both vocal cords affects phonation, swallowing and breathing. The major cause for reduced mobility or even immobility is innervation damage, less often mechanical disorder.The main procedures in the diagnostics of disordered vocal fold mobility are indirect laryngoscopy and videoendostroboscopy. Different imaging techniques (especially computerized tomography are of great value in searching for a cause of the impaired mobility.In unilateral vocal fold immobility, the treatment is focused on the improvement of voice quality and the prevention of aspiration during swallowing. In bilateral paralysis, it is crucial to find a balance between effective breathing and sufficient voice quality. The treatment of unilateral paralysis is started with voice therapy and swallowing rehabilitation. If these procedures are not enough surgical treatment for the medialization of the paralyzed vocal fold is applied. In the case of breathing difficulties in bilateral vocal fold immobility there is a possibility of surgical lateralization of one or both folds or a surgical excision of a part or the entire vocal fold. Surgical reinnervation, functional electrostimulation of certain laryngeal muscles and gene therapy are developing treatment modalities.

Bronchoscopic diagnostic procedures and microbiological examinations in proving endobronchial tuberculosis.

Science.gov (United States)

Şimşek, Abdullah; Yapıcı, İlhami; Babalık, Mesiha; Şimşek, Zekiye; Kolsuz, Mustafa

2016-01-01

To determine the proportional distribution of endobronchial tuberculosis (EBTB) subtypes and to evaluate the types of bronchoscopic diagnostic procedures that can prove granulomatous inflammation. This was a retrospective study of 18 HIV-negative patients with biopsy-proven EBTB treated between 2010 and 2014. The most common EBTB subtypes, as classified by the bronchoscopic features, were tumorous and granular (in 22.2% for both). Sputum smear microscopy was performed in 11 patients and was positive for AFB in 4 (36.3%). Sputum culture was also performed in 11 patients and was positive for Mycobacterium tuberculosis in 10 (90.9%). Smear microscopy of BAL fluid (BALF) was performed in 16 patients and was positive for AFB in 10 (62.5%). Culture of BALF was also performed in 16 patients and was positive for M. tuberculosis in 15 (93.7%). Culture of BALF was positive for M. tuberculosis in 93.7% of the 16 patients tested. Among the 18 patients with EBTB, granulomatous inflammation was proven by the following bronchoscopic diagnostic procedures: bronchial mucosal biopsy, in 8 (44.4%); bronchial brushing, in 7 (38.8%); fine-needle aspiration biopsy, in 2 (11.1%); and BAL, in 2 (11.1%). Bronchial anthracofibrosis was observed in 5 (27.7%) of the 18 cases evaluated. In our sample of EBTB patients, the most common subtypes were the tumorous and granular subtypes. We recommend that sputum samples and BALF samples be evaluated by smear microscopy for AFB and by culture for M. tuberculosis, which could increase the rates of early diagnosis of EBTB. We also recommend that bronchial brushing be employed together with other bronchoscopic diagnostic procedures in patients suspected of having EBTB. Determinar a distribuição proporcional dos subtipos de tuberculose endobrônquica (TBEB) e avaliar os tipos de procedimentos diagnósticos broncoscópicos que podem revelar inflamação granulomatosa. Este foi um estudo retrospectivo com 18 pacientes HIV negativos com TBEB comprovada

Diagnostic challenges of childhood asthma.

Science.gov (United States)

Bakirtas, Arzu

2017-01-01

Diagnosis of asthma in childhood is challenging. Both underdiagnosis and overdiagnosis of asthma are important issues. The present review gives information about challenging factors for an accurate diagnosis of childhood asthma. Although underdiagnosis of asthma in childhood has always been the most important diagnostic problem, overdiagnosis of asthma has also been increasingly recognized. This is probably due to diagnosis of asthma based on symptoms and signs alone. Demonstration of variable airflow obstruction by lung function tests is the most common asthma diagnostic tests used in practice and is therefore strongly recommended in children who can cooperate. Recently, an asthma guideline combining the clinical and economic evidences with sensitivity and specificity of diagnostic procedures was developed to improve accuracy of diagnosis and to avoid overdiagnosis. This guideline provided an algorithmic clinical and cost-effective approach and included fractional exhaled nitric oxide measurement as one of the diagnostic tests in addition to lung function. Diagnosis of asthma in children should be made by combining relevant history with at least two confirmatory diagnostic tests whenever possible. Diagnosis based on short-period treatment trials should be limited to young children who are unable to cooperate with these tests.

Reactor noise diagnostics based on multivariate autoregressive modeling: Application to LOFT [Loss-of-Fluid-Test] reactor process noise

International Nuclear Information System (INIS)

Gloeckler, O.; Upadhyaya, B.R.

1987-01-01

Multivariate noise analysis of power reactor operating signals is useful for plant diagnostics, for isolating process and sensor anomalies, and for automated plant monitoring. In order to develop a reliable procedure, the previously established techniques for empirical modeling of fluctuation signals in power reactors have been improved. Application of the complete algorithm to operational data from the Loss-of-Fluid-Test (LOFT) Reactor showed that earlier conjectures (based on physical modeling) regarding the perturbation sources in a Pressurized Water Reactor (PWR) affecting coolant temperature and neutron power fluctuations can be systematically explained. This advanced methodology has important implication regarding plant diagnostics, and system or sensor anomaly isolation. 6 refs., 24 figs

Exposure of the French paediatric population to ionising radiation from diagnostic medical procedures in 2010

International Nuclear Information System (INIS)

Etard, Cecile; Aubert, Bernard; Mezzarobba, Myriam; Bernier, Marie-Odile

2014-01-01

Medical examination is the main source of artificial radiation exposure. Because children present an increased sensitivity to ionising radiation, radiology practices at a national level in paediatrics should be monitored. This study describes the ionising radiation exposure from diagnostic medical examinations of the French paediatric population in 2010. Data on frequency of examinations were provided by the French National Health Insurance through a representative sample including 107,627 children ages 0-15 years. Effective doses for each type of procedure were obtained from the published French literature. Median and mean effective doses were calculated for the studied population. About a third of the children were exposed to at least one examination using ionising radiation in 2010. Conventional radiology, dental exams, CT scans and nuclear medicine and interventional radiology represent respectively 55.3%, 42.3%, 2.1% and 0.3% of the procedures. Children 10-15 years old and babies from birth to 1 year are the most exposed populations, with respectively 1,098 and 734 examinations per 1,000 children per year. Before 1 year of age, chest and pelvis radiographs are the most common imaging tests, 54% and 32%, respectively. Only 1% of the studied population is exposed to CT scan, with 62% of these children exposed to a head-and-neck procedure. The annual median and mean effective doses were respectively 0.03 mSv and 0.7 mSv for the exposed children. This study gives updated reference data on French paediatric exposure to medical ionising radiation that can be used for public health or epidemiological purposes. Paediatric diagnostic use appears much lower than that of the whole French population as estimated in a previous study. (orig.)

Exposure of the French paediatric population to ionising radiation from diagnostic medical procedures in 2010

Energy Technology Data Exchange (ETDEWEB)

Etard, Cecile; Aubert, Bernard [Institut de Radioprotection et de Surete Nucleaire, Medical Expertise Unit, Fontenay-aux-Roses (France); Mezzarobba, Myriam [Institut de Radioprotection et de Surete Nucleaire, Laboratory of Epidemiology, Fontenay-aux-Roses (France); Bernier, Marie-Odile [Institut de Radioprotection et de Surete Nucleaire, Laboratory of Epidemiology, Fontenay-aux-Roses (France); Institut de Radioprotection et de Surete Nucleaire, IRSN/PRP-HOM/SRBE/LEPID, Laboratoire d' Epidemiologie, Fontenay-aux-Roses (France)

2014-12-15

Medical examination is the main source of artificial radiation exposure. Because children present an increased sensitivity to ionising radiation, radiology practices at a national level in paediatrics should be monitored. This study describes the ionising radiation exposure from diagnostic medical examinations of the French paediatric population in 2010. Data on frequency of examinations were provided by the French National Health Insurance through a representative sample including 107,627 children ages 0-15 years. Effective doses for each type of procedure were obtained from the published French literature. Median and mean effective doses were calculated for the studied population. About a third of the children were exposed to at least one examination using ionising radiation in 2010. Conventional radiology, dental exams, CT scans and nuclear medicine and interventional radiology represent respectively 55.3%, 42.3%, 2.1% and 0.3% of the procedures. Children 10-15 years old and babies from birth to 1 year are the most exposed populations, with respectively 1,098 and 734 examinations per 1,000 children per year. Before 1 year of age, chest and pelvis radiographs are the most common imaging tests, 54% and 32%, respectively. Only 1% of the studied population is exposed to CT scan, with 62% of these children exposed to a head-and-neck procedure. The annual median and mean effective doses were respectively 0.03 mSv and 0.7 mSv for the exposed children. This study gives updated reference data on French paediatric exposure to medical ionising radiation that can be used for public health or epidemiological purposes. Paediatric diagnostic use appears much lower than that of the whole French population as estimated in a previous study. (orig.)

Towards the definition of Institutional diagnostic reference levels in paediatric interventional cardiology procedures in Greece.

Science.gov (United States)

Kottou, S; Kollaros, N; Plemmenos, C; Mastorakou, I; Apostolopoulou, S C; Tsapaki, V

2018-02-01

This study aimed to evaluate paediatric radiation doses in a dedicated cardiology hospital, with the objective of characterising patterns in dose variation. The ultimate purpose was to define Local (Institutional) Diagnostic Reference Levels (LDRLs) for different types of paediatric cardiac interventional procedures (IC), according to patient age. From a total of 710 cases performed during three consecutive years, by operators with more than 15 years of experience, the age was noted in only 477 IC procedures. The median values obtained for Fluoroscopy Time (FT), Number of Frames (N) and Kerma Area Product (P KA ) by age range were 5.8 min, 1322 and 2.0 Gy.cm 2 for definition of LDRLs presents challenges mainly due to the multiple clinical and technical factors affecting the outcome. On the other hand the lack of paediatric IC DRLs makes the identification of good practices more difficult. A consensus is needed on IC procedures nomenclature and grouping in order to allow a common assessment and comparison of doses. Copyright © 2018 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Can and should value-based pricing be applied to molecular diagnostics?

Science.gov (United States)

Garau, Martina; Towse, Adrian; Garrison, Louis; Housman, Laura; Ossa, Diego

2013-01-01

Current pricing and reimbursement systems for diagnostics are not efficient. Prices for diagnostics are often driven by administrative practices and expected production cost. The purpose of the paper is to discuss how a value-based pricing framework being used to ensure efficient use and price of medicines could also be applied to diagnostics. Diagnostics not only facilitates health gain and cost savings, but also information to guide patients' decisions on interventions and their future 'behaviors'. For value assessment processes we recommend a two-part approach. Companion diagnostics introduced at the launch of the drug should be assessed through new drug assessment processes considering a broad range of value elements and a balanced analysis of diagnostic impacts. A separate diagnostic-dedicated committee using value-based pricing principles should review other diagnostics lying outside the companion diagnostics-and-drug 'at-launch' situation.

Intelligent model-based diagnostics for vehicle health management

Science.gov (United States)

Luo, Jianhui; Tu, Fang; Azam, Mohammad S.; Pattipati, Krishna R.; Willett, Peter K.; Qiao, Liu; Kawamoto, Masayuki

2003-08-01

The recent advances in sensor technology, remote communication and computational capabilities, and standardized hardware/software interfaces are creating a dramatic shift in the way the health of vehicles is monitored and managed. These advances facilitate remote monitoring, diagnosis and condition-based maintenance of automotive systems. With the increased sophistication of electronic control systems in vehicles, there is a concomitant increased difficulty in the identification of the malfunction phenomena. Consequently, the current rule-based diagnostic systems are difficult to develop, validate and maintain. New intelligent model-based diagnostic methodologies that exploit the advances in sensor, telecommunications, computing and software technologies are needed. In this paper, we will investigate hybrid model-based techniques that seamlessly employ quantitative (analytical) models and graph-based dependency models for intelligent diagnosis. Automotive engineers have found quantitative simulation (e.g. MATLAB/SIMULINK) to be a vital tool in the development of advanced control systems. The hybrid method exploits this capability to improve the diagnostic system's accuracy and consistency, utilizes existing validated knowledge on rule-based methods, enables remote diagnosis, and responds to the challenges of increased system complexity. The solution is generic and has the potential for application in a wide range of systems.

Evidence-based diagnostics: adult septic arthritis.

Science.gov (United States)

Carpenter, Christopher R; Schuur, Jeremiah D; Everett, Worth W; Pines, Jesse M

2011-08-01

Acutely swollen or painful joints are common complaints in the emergency department (ED). Septic arthritis in adults is a challenging diagnosis, but prompt differentiation of a bacterial etiology is crucial to minimize morbidity and mortality. The objective was to perform a systematic review describing the diagnostic characteristics of history, physical examination, and bedside laboratory tests for nongonococcal septic arthritis. A secondary objective was to quantify test and treatment thresholds using derived estimates of sensitivity and specificity, as well as best-evidence diagnostic and treatment risks and anticipated benefits from appropriate therapy. Two electronic search engines (PUBMED and EMBASE) were used in conjunction with a selected bibliography and scientific abstract hand search. Inclusion criteria included adult trials of patients presenting with monoarticular complaints if they reported sufficient detail to reconstruct partial or complete 2 × 2 contingency tables for experimental diagnostic test characteristics using an acceptable criterion standard. Evidence was rated by two investigators using the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS). When more than one similarly designed trial existed for a diagnostic test, meta-analysis was conducted using a random effects model. Interval likelihood ratios (LRs) were computed when possible. To illustrate one method to quantify theoretical points in the probability of disease whereby clinicians might cease testing altogether and either withhold treatment (test threshold) or initiate definitive therapy in lieu of further diagnostics (treatment threshold), an interactive spreadsheet was designed and sample calculations were provided based on research estimates of diagnostic accuracy, diagnostic risk, and therapeutic risk/benefits. The prevalence of nongonococcal septic arthritis in ED patients with a single acutely painful joint is approximately 27% (95% confidence interval [CI] = 17

TFTR diagnostic control and data acquisition system

International Nuclear Information System (INIS)

Sauthoff, N.R.; Daniels, R.E.; PPL Computer Division

1985-01-01

General computerized control and data-handling support for TFTR diagnostics is presented within the context of the Central Instrumentation, Control and Data Acquisition (CICADA) System. Procedures, hardware, the interactive man--machine interface, event-driven task scheduling, system-wide arming and data acquisition, and a hierarchical data base of raw data and results are described. Similarities in data structures involved in control, monitoring, and data acquisition afford a simplification of the system functions, based on ''groups'' of devices. Emphases and optimizations appropriate for fusion diagnostic system designs are provided. An off-line data reduction computer system is under development

Model of Procedure Usage – Results from a Qualitative Study to Inform Design of Computer-Based Procedures

Energy Technology Data Exchange (ETDEWEB)

Johanna H Oxstrand; Katya L Le Blanc

2012-07-01

The nuclear industry is constantly trying to find ways to decrease the human error rate, especially the human errors associated with procedure use. As a step toward the goal of improving procedure use performance, researchers, together with the nuclear industry, have been looking at replacing the current paper-based procedures with computer-based procedure systems. The concept of computer-based procedures is not new by any means; however most research has focused on procedures used in the main control room. Procedures reviewed in these efforts are mainly emergency operating procedures and normal operating procedures. Based on lessons learned for these previous efforts we are now exploring a more unknown application for computer based procedures - field procedures, i.e. procedures used by nuclear equipment operators and maintenance technicians. The Idaho National Laboratory, the Institute for Energy Technology, and participants from the U.S. commercial nuclear industry are collaborating in an applied research effort with the objective of developing requirements and specifications for a computer-based procedure system to be used by field operators. The goal is to identify the types of human errors that can be mitigated by using computer-based procedures and how to best design the computer-based procedures to do this. The underlying philosophy in the research effort is “Stop – Start – Continue”, i.e. what features from the use of paper-based procedures should we not incorporate (Stop), what should we keep (Continue), and what new features or work processes should be added (Start). One step in identifying the Stop – Start – Continue was to conduct a baseline study where affordances related to the current usage of paper-based procedures were identified. The purpose of the study was to develop a model of paper based procedure use which will help to identify desirable features for computer based procedure prototypes. Affordances such as note taking, markups

Degree of vertical integration between the undergraduate program and clinical internship with respect to cervical and cranial diagnostic and therapeutic procedures taught at the canadian memorial chiropractic college.

Science.gov (United States)

Leppington, Charmody; Gleberzon, Brian; Fortunato, Lisa; Doucet, Nicolea; Vandervalk, Kyle

2012-01-01

The purpose of this study was to determine if diagnostic and therapeutic procedures for the cervical and cranial spine taught to students during the undergraduate program at Canadian Memorial Chiropractic College are required to be used during their internship by their supervising clinicians and, if so, to what extent these procedures are used. Course manuals and course syllabi from the Applied Chiropractic and Clinical Diagnosis faculty of the undergraduate chiropractic program for the academic year 2009-2010 were consulted and a list of all diagnostic and therapeutic procedures for the cranial and cervical spine was compiled. This survey asked clinicians to indicate if they themselves used or if they required the students they were supervising to use each procedure listed and, if so, to what extent each procedure was used. Demographic information of each clinician was also obtained. In general, most diagnostic procedures of the head and neck were seldom used, with the exception of postural observation and palpation. By contrast, most cervical orthopaedic tests were often used, with the exception of tests for vertigo. Most therapeutic procedures were used frequently with the exception of prone cervical and "muscle" adjustments. There was a low degree of vertical integration for cranial procedures as compared to a much higher degree of vertical integration for cervical procedures between the undergraduate and clinical internship programs taught. Vertical integration is an important element of curricular planning and these results may be helpful to aid educators to more appropriately allocate classroom instruction.

Consensus guidelines for the use of bowel preparation prior to colonic diagnostic procedures: colonoscopy and small bowel video capsule endoscopy

NARCIS (Netherlands)

Mathus-Vliegen, Elisabeth; Pellisé, Maria; Heresbach, Denis; Fischbach, Wolfgang; Dixon, Tricia; Belsey, Jonathan; Parente, Fabrizio; Rio-Tinto, Ricardo; Brown, Alistair; Toth, Ervin; Crosta, Cristiano; Layer, Peter; Epstein, Owen; Boustiere, Christian

2013-01-01

Adequate bowel preparation prior to colonic diagnostic procedures is essential to ensure adequate visualisation. This consensus aims to provide guidance as to the appropriate use of bowel preparation for a range of defined clinical circumstances. A consensus group from across Europe was convened and

Diagnostic imaging in intensive care patients

International Nuclear Information System (INIS)

Afione, Cristina; Binda, Maria del C.

2004-01-01

Purpose: To determine the role of imaging diagnostic methods in the location of infection causes of unknown origin in the critical care patient. Material and methods: A comprehensive medical literature search has been done. Recommendations for the diagnostic imaging of septic focus in intensive care patients are presented for each case, with analysis based on evidence. The degree of evidence utilized has been that of Oxford Center for Evidence-based Medicine. Results: Nosocomial infection is the most frequent complication in the intensive care unit (25 to 33%) with high sepsis incidence rate. In order to locate the infection focus, imaging methods play an important role, as a diagnostic tool and to guide therapeutic procedures. The most frequent causes of infection are: ventilation associated pneumonia, sinusitis, intra-abdominal infections and an acute acalculous cholecystitis. This paper analyses the diagnostic imaging of hospital infection, with the evaluation of choice methods for each one and proposes an algorithm to assess the septic patient. Conclusion: There are evidences, with different degrees of recommendation, for the use of diagnostic imaging methods for infectious focuses in critical care patients. The studies have been selected based on their diagnostic precision, on the capacity of the medical team and on the availability of resources, considering the risk-benefit balance for the best safety of the patient. (author)

Unintentional exposure to radiation during pregnancy from nuclear medical diagnostic procedures; Unabsichtliche Strahlenexposition in der Schwangerschaft durch nuklearmedizinische Diagnostik

Energy Technology Data Exchange (ETDEWEB)

Moka, D. [Gemeinschaftspraxis fuer Radiologie und Nuklearmedizin, Essen (Germany)

2005-12-01

The administration of radiopharmaceuticals during pregnancy is contraindicated due to a lack of vital indications. However, if prenatal exposure to radiation should occur in the framework of a nuclear medical diagnostic procedure then fortunately no longterm side-effects would normally be expected. Radiation damage in the preimplantation phase leads to early abortion. However, if the further course of pregnancy remains uncomplicated then no subsequent side-effects need be expected. On a conservative estimate, it would require doses exceeding 50 mGy to cause radiation damage within the uterus after the preimplantation phase. However, the standard radioactivities applied for diagnostic purposes in nuclear medicine, can be obtained with doses of less than 20 mGy. On the basis of current knowledge, therefore, there is no reason to terminate pregnancy on medical grounds after diagnostic exposure to radiopharmaceuticals. (orig.)

Acquiring, Representing, and Evaluating a Competence Model of Diagnostic Strategy.

Science.gov (United States)

Clancey, William J.

This paper describes NEOMYCIN, a computer program that models one physician's diagnostic reasoning within a limited area of medicine. NEOMYCIN's knowledge base and reasoning procedure constitute a model of how human knowledge is organized and how it is used in diagnosis. The hypothesis is tested that such a procedure can be used to simulate both…

Endoscopic Laser-Based 3D Imaging for Functional Voice Diagnostics

Directory of Open Access Journals (Sweden)

Marion Semmler

2017-06-01

Full Text Available Recently, we reported on the in vivo application of a miniaturized measuring device for 3D visualization of the superior vocal fold vibrations from high-speed recordings in combination with a laser projection unit (LPU. As a long-term vision for this proof of principle, we strive to integrate the further developed laserendoscopy as a diagnostic method in daily clinical routine. The new LPU mainly comprises a Nd:YAG laser source (532 nm/CW/2 ω and a diffractive optical element (DOE generating a regular laser grid (31 × 31 laser points that is projected on the vocal folds. By means of stereo triangulation, the 3D coordinates of the laser points are reconstructed from the endoscopic high-speed footage. The new design of the laserendoscope constitutes a compromise between robust image processing and laser safety regulations. The algorithms for calibration and analysis are now optimized with respect to their overall duration and the number of required interactions, which is objectively assessed using binary classifiers. The sensitivity and specificity of the calibration procedure are increased by 40.1% and 22.3%, which is statistically significant. The overall duration for the laser point detection is reduced by 41.9%. The suggested semi-automatic reconstruction software represents an important stepping-stone towards potential real time processing and a comprehensive, objective diagnostic tool of evidence-based medicine.

Application of diagnostic system for diesel engine

International Nuclear Information System (INIS)

Yoshinaga, Takeshi; Hayashi, Haruji; Usui, Hiromi; Tsuruzono, Atsuya; Matsuda, Takafumi

2008-01-01

The Japan Atomic Power Company (JAPC) began to implement Condition Based Maintenance (CBM) for rotating components (pumps, fans and electric motors) from 1999 and, also has begun to apply diesel engine diagnostic techniques at our three nuclear power plants since 2004. This paper provides a description of the CBM methods used for diesel engines in nuclear standby service, a summary of the procedures to introduce these diagnostic techniques to our nuclear power plants, and experience with the application of these methods to JAPC nuclear power plants. (author)

Improving diagnostic accuracy using agent-based distributed data mining system.

Science.gov (United States)

Sridhar, S

2013-09-01

The use of data mining techniques to improve the diagnostic system accuracy is investigated in this paper. The data mining algorithms aim to discover patterns and extract useful knowledge from facts recorded in databases. Generally, the expert systems are constructed for automating diagnostic procedures. The learning component uses the data mining algorithms to extract the expert system rules from the database automatically. Learning algorithms can assist the clinicians in extracting knowledge automatically. As the number and variety of data sources is dramatically increasing, another way to acquire knowledge from databases is to apply various data mining algorithms that extract knowledge from data. As data sets are inherently distributed, the distributed system uses agents to transport the trained classifiers and uses meta learning to combine the knowledge. Commonsense reasoning is also used in association with distributed data mining to obtain better results. Combining human expert knowledge and data mining knowledge improves the performance of the diagnostic system. This work suggests a framework of combining the human knowledge and knowledge gained by better data mining algorithms on a renal and gallstone data set.

The nuclear medical diagnostic procedures at the hospitals in Sofia over a period of ten years - from 1990 to 2000 - structure, number and doses

International Nuclear Information System (INIS)

Adelina, P.; Ingilizova, K.; Paskalev, Z

2003-01-01

The aim of this study is to analyze the structure and the number of nuclear diagnostic procedures at hospitals in Sofia over a period of ten years (from 1990 to 2000); to calculate the effective doses received by patients; to compare the results from different hospitals. We have developed a form in order to collect the necessary information from hospitals (nuclear laboratories). The information has been collected according to examined organ, applied radioactive pharmaceutical and injected activity (MBq), patient's age and sex. The effective doses have been calculated using transition coefficients for each of the applied radioactive pharmaceuticals and for each of the diagnostic procedures. We have received the information and calculated the doses. We have compared the data from different hospitals (nuclear laboratories). The results show that the doctors in different hospitals have used different radioactive pharmaceuticals and applied different activities for one and the same procedure. (orig.)

Target Diagnostic Instrument-Based Controls Framework for the National Ignition Facility

International Nuclear Information System (INIS)

Shelton, R; O'Brien, D; Nelson, J; Kamperschroer, J

2007-01-01

NIF target diagnostics are being developed to observe and measure the extreme physics of targets irradiated by the 192-beam laser. The response time of target materials can be on the order of 100ps--the time it takes light to travel 3 cm--temperatures more than 100 times hotter than the surface of the sun, and pressures that exceed 109 atmospheres. Optical and x-ray diagnostics were developed and fielded to observe and record the results of the first 4-beam experiments at NIF. Hard and soft x-ray spectra were measured, and time-integrated and gated x-ray images of hydrodynamics experiments were recorded. Optical diagnostics recorded backscatter from the target, and VISAR laser velocimetry measurements were taken of laser-shocked target surfaces. Additional diagnostics are being developed and commissioned to observe and diagnose ignition implosions, including various neutron and activation diagnostics. NIF's diagnostics are being developed at LLNL and with collaborators at other sites. To accommodate the growing number of target diagnostics, an Instrument-Based Controls hardware-software framework has been developed to facilitate development and ease integration into the NIF Integrated Computer Control System (ICCS). Individual WindowsXP PC controllers for each digitizer, power supply and camera (i.e., instruments) execute controls software unique to each instrument model. Each hardware-software controller manages a single instrument, in contrast to the complexity of combining all the controls software needed for a diagnostic into a single controller. Because of this simplification, controllers can be more easily tested on the actual hardware, evaluating all normal and off-normal conditions. Each target diagnostic is then supported by a number of instruments, each with its own hardware-software instrument-based controller. Advantages of the instrument-based control architecture and framework include reusability, testability, and improved reliability of the deployed

Target Diagnostic Instrument-Based Controls Framework for the National Ignition Facility

Energy Technology Data Exchange (ETDEWEB)

Shelton, R; O' Brien, D; Nelson, J; Kamperschroer, J

2007-05-07

NIF target diagnostics are being developed to observe and measure the extreme physics of targets irradiated by the 192-beam laser. The response time of target materials can be on the order of 100ps--the time it takes light to travel 3 cm--temperatures more than 100 times hotter than the surface of the sun, and pressures that exceed 109 atmospheres. Optical and x-ray diagnostics were developed and fielded to observe and record the results of the first 4-beam experiments at NIF. Hard and soft x-ray spectra were measured, and time-integrated and gated x-ray images of hydrodynamics experiments were recorded. Optical diagnostics recorded backscatter from the target, and VISAR laser velocimetry measurements were taken of laser-shocked target surfaces. Additional diagnostics are being developed and commissioned to observe and diagnose ignition implosions, including various neutron and activation diagnostics. NIF's diagnostics are being developed at LLNL and with collaborators at other sites. To accommodate the growing number of target diagnostics, an Instrument-Based Controls hardware-software framework has been developed to facilitate development and ease integration into the NIF Integrated Computer Control System (ICCS). Individual WindowsXP PC controllers for each digitizer, power supply and camera (i.e., instruments) execute controls software unique to each instrument model. Each hardware-software controller manages a single instrument, in contrast to the complexity of combining all the controls software needed for a diagnostic into a single controller. Because of this simplification, controllers can be more easily tested on the actual hardware, evaluating all normal and off-normal conditions. Each target diagnostic is then supported by a number of instruments, each with its own hardware-software instrument-based controller. Advantages of the instrument-based control architecture and framework include reusability, testability, and improved reliability of the

Sensitivity of the diagnostic radiological index of protection to procedural factors in fluoroscopy

Energy Technology Data Exchange (ETDEWEB)

Jones, A. Kyle, E-mail: kyle.jones@mdanderson.org [Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States); Pasciak, Alexander S. [Department of Radiology, The University of Tennessee Medical Center at Knoxville, Knoxville, Tennessee 37922 (United States); Wagner, Louis K. [Department of Diagnostic and Interventional Imaging, The John P. and Katharine G. McGovern Medical School, Houston, Texas 77030 (United States)

2016-07-15

Purpose: To evaluate the sensitivity of the diagnostic radiological index of protection (DRIP), used to quantify the protective value of radioprotective garments, to procedural factors in fluoroscopy in an effort to determine an appropriate set of scatter-mimicking primary beams to be used in measuring the DRIP. Methods: Monte Carlo simulations were performed to determine the shape of the scattered x-ray spectra incident on the operator in different clinical fluoroscopy scenarios, including interventional radiology and interventional cardiology (IC). Two clinical simulations studied the sensitivity of the scattered spectrum to gantry angle and patient size, while technical factors were varied according to measured automatic dose rate control (ADRC) data. Factorial simulations studied the sensitivity of the scattered spectrum to gantry angle, field of view, patient size, and beam quality for constant technical factors. Average energy (E{sub avg}) was the figure of merit used to condense fluence in each energy bin to a single numerical index. Results: Beam quality had the strongest influence on the scattered spectrum in fluoroscopy. Many procedural factors affect the scattered spectrum indirectly through their effect on primary beam quality through ADRC, e.g., gantry angle and patient size. Lateral C-arm rotation, common in IC, increased the energy of the scattered spectrum, regardless of the direction of rotation. The effect of patient size on scattered radiation depended on ADRC characteristics, patient size, and procedure type. Conclusions: The scattered spectrum striking the operator in fluoroscopy is most strongly influenced by primary beam quality, particularly kV. Use cases for protective garments should be classified by typical procedural primary beam qualities, which are governed by the ADRC according to the impacts of patient size, anatomical location, and gantry angle.

Patient dosimetry in diagnostic radiology

International Nuclear Information System (INIS)

Shrimpton, P.C.

2000-01-01

Full text: X-ray examinations remain an essential and widely used diagnostic tool in medicine and hence the most significant source of exposure to man-made radiation for populations. Patterns of practice in diagnostic radiology continue to evolve, with overall growth in the numbers of procedures worldwide and, particularly in developed countries, increasing importance for complex procedures such as computed tomography (CT) and interventional techniques. In order to maximise the benefits from x-rays relative to the associated radiation risks, there is a need to ensure the prior justification of all examinations and the optimisation of patient protection such that doses are as low as reasonably practicable to meet specific clinical requirements. Accordingly, patient dosimetry is a fundamental requirement in diagnostic radiology. Detailed measurements for the assessment of risks or comparison of different types of procedure require the estimation of organ and effective doses. Such comprehensive dosimetry necessarily involves the simulation of clinical practice using anthropomorphic phantoms, with either measurements in a physical phantom or calculations utilising a mathematical phantom. Simpler measurements for the routine monitoring of dose in x-ray departments can be based on practical quantities such as entrance surface dose, dose-area product and, for CT, weighted CT dose index and dose-length product. Widescale surveys reveal significant variations between departments in the typical doses for a given type of procedure and potential scope for dose reductions. In order to promote improvements in practice, the results of periodic dose surveys in departments should be compared with appropriate standards, such as diagnostic reference levels for adult and paediatric patients, that are set nationally or locally for the purposes of promoting critical review of the equipment and techniques in use. Patient dosimetry should form an essential element of routine quality

Preliminary survey on the distribution of medical equipment and frequency of diagnostic and therapeutic procedures in Brazil: a contribution to the UNSCEAR report

International Nuclear Information System (INIS)

Biazotto, Bruna; Taboza de Oliveira, Alexandre; Baptista de Freitas, Marcelo

2008-01-01

Information about Brazil published in the UNSCEAR 2000 report are still scarce when compared to others countries. In this study, a survey on the distribution of medical equipment (X-ray generators, ultrasound, CT and MRI scanners, nuclear medicine equipment and teletherapy and brachytherapy units) and frequency of diagnostic and therapeutic procedures at the various Brazilian States was carried out. The overall information was obtained from a national database supported by the Brazilian Ministry of Health through the Computer Science Department of the National Health System (SUS - Sistema Unico de Saude). The distribution of equipment and the annual frequency of each type of procedure were analyzed considering the five geographical regions that form the country and their respective population. Temporal and regional trends in the annual frequency of procedures for 2000-2007 were also summarized in this study. National annual frequencies for the total of all medical X-ray examinations (259.0 examinations per 1000 population) were evaluated. Some examples can be given from chest, mammography and CT examinations: 67.4, 30.2 and 7.2 per 1000 population, respectively. In addition, annual frequencies for other modalities of diagnostic imaging have also been estimated: 61.5, 1.6 and 1.4 per 1000 population for ultrasound, nuclear medicine and MRI procedures, respectively. A total of 38.7 therapeutic procedures per 1000 population (teletherapy and brachytherapy) are annually performed in the country. The health services localized in Brazil comprised a total number of 253.1 diagnostic imaging equipment per million population, without considering dental X-ray. Amongst them, X-ray equipment used in common radiological examinations (chest, skull, spine, etc.) stands for 39% (97.7 per million). As expected, a significant decrease in the offer of equipment is observed when technologically more sophisticated equipment is concerned: magnetic resonance (3.5 per million), gamma

Towards diagnostic metagenomics of Campylobacter in fecal samples

DEFF Research Database (Denmark)

Andersen, Sandra Christine; Kiil, Kristoffer; Harder, Christoffer Bugge

2017-01-01

The development of diagnostic metagenomics is driven by the need for universal, culture-independent methods for detection and characterization of pathogens to substitute the time-consuming, organism-specific, and often culture-based laboratory procedures for epidemiological source-tracing. Some...... of the challenges in diagnostic metagenomics are, that it requires a great next-generation sequencing depth and unautomated data analysis. DNA from human fecal samples spiked with 7.75 × 101-7.75 × 107 colony forming unit (CFU)/ml Campylobacter jejuni and chicken fecal samples spiked with 1 × 102-1 × 106 CFU...... Campylobacter in all the clinical samples. Sensitivity in diagnostic metagenomics is improving and has reached a clinically relevant level. There are still challenges to overcome before real-time diagnostic metagenomics can replace quantitative polymerase chain reaction (qPCR) or culture-based surveillance...

Perceived risk of prenatal diagnostic procedure-related miscarriage and Down syndrome among pregnant women.

Science.gov (United States)

Caughey, Aaron B; Washington, A Eugene; Kuppermann, Miriam

2008-03-01

The objective of the study was to identify correlates of perceived risk of carrying a Down syndrome-affected fetus or experiencing a procedure-related miscarriage among a diverse group of pregnant women. We conducted a cross-sectional survey of 1081 English-, Spanish-, or Chinese-speaking women receiving prenatal care in the San Francisco Bay area. Perceived risk of procedure-related miscarriage or carrying a Down syndrome-affected fetus was assessed using a linear rating scale from 0 (no risk) to 1 (high risk). Bivariate and multivariable analyses were used to explore associations between maternal characteristics including age, race/ethnicity, and socioeconomic status and perceived risks of carrying a Down syndrome-affected fetus or experiencing a procedure-related miscarriage. Women aged 35 years old or older had a higher perceived risk of Down syndrome than younger women (0.28 vs 0.22 on a scale from 0 to 1, P self-perceived health status (+0.08, P = .045). Latinas (+0.11, P = .008), women with an annual income less than $35,000 (+0.09, P = .003), and those who had difficulty conceiving (+0.09, P = .026) had higher perceived procedure-related miscarriage risk. Among women aged 35 years or older, perceived risk of carrying a Down syndrome-affected fetus was associated with the inclination to undergo prenatal diagnosis. Women's perceived risks of carrying a Down syndrome-affected fetus or having a procedure-related miscarriage are associated with numerous characteristics that have not been shown to be associated with the actual risks of these events. These perceived risks are associated with prenatal diagnostic test inclination. Understanding patients' risk perceptions and effectively communicating risk is critical to helping patients make informed decisions regarding use of invasive prenatal testing.

Efficient Noninferiority Testing Procedures for Simultaneously Assessing Sensitivity and Specificity of Two Diagnostic Tests

Directory of Open Access Journals (Sweden)

Guogen Shan

2015-01-01

Full Text Available Sensitivity and specificity are often used to assess the performance of a diagnostic test with binary outcomes. Wald-type test statistics have been proposed for testing sensitivity and specificity individually. In the presence of a gold standard, simultaneous comparison between two diagnostic tests for noninferiority of sensitivity and specificity based on an asymptotic approach has been studied by Chen et al. (2003. However, the asymptotic approach may suffer from unsatisfactory type I error control as observed from many studies, especially in small to medium sample settings. In this paper, we compare three unconditional approaches for simultaneously testing sensitivity and specificity. They are approaches based on estimation, maximization, and a combination of estimation and maximization. Although the estimation approach does not guarantee type I error, it has satisfactory performance with regard to type I error control. The other two unconditional approaches are exact. The approach based on estimation and maximization is generally more powerful than the approach based on maximization.

CT fluoroscopy-guided renal tumour cutting needle biopsy. Retrospective evaluation of diagnostic yield, safety, and risk factors for diagnostic failure

International Nuclear Information System (INIS)

Iguchi, Toshihiro; Hiraki, Takao; Matsui, Yusuke; Fujiwara, Hiroyasu; Sakurai, Jun; Masaoka, Yoshihisa; Gobara, Hideo; Kanazawa, Susumu

2018-01-01

To evaluate retrospectively the diagnostic yield, safety, and risk factors for diagnostic failure of computed tomography (CT) fluoroscopy-guided renal tumour biopsy. Biopsies were performed for 208 tumours (mean diameter 2.3 cm; median diameter 2.1 cm; range 0.9-8.5 cm) in 199 patients. One hundred and ninety-nine tumours were ≤4 cm. All 208 initial procedures were divided into diagnostic success and failure groups. Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for diagnostic failure. After performing 208 initial and nine repeat biopsies, 180 malignancies and 15 benign tumours were pathologically diagnosed, whereas 13 were not diagnosed. In 117 procedures, 118 Grade I and one Grade IIIa adverse events (AEs) occurred. Neither Grade ≥IIIb AEs nor tumour seeding were observed within a median follow-up period of 13.7 months. Logistic regression analysis revealed only small tumour size (≤1.5 cm; odds ratio 3.750; 95% confidence interval 1.362-10.326; P = 0.011) to be a significant risk factor for diagnostic failure. CT fluoroscopy-guided renal tumour biopsy is a safe procedure with a high diagnostic yield. A small tumour size (≤1.5 cm) is a significant risk factor for diagnostic failure. (orig.)

CT fluoroscopy-guided renal tumour cutting needle biopsy. Retrospective evaluation of diagnostic yield, safety, and risk factors for diagnostic failure

Energy Technology Data Exchange (ETDEWEB)

Iguchi, Toshihiro; Hiraki, Takao; Matsui, Yusuke; Fujiwara, Hiroyasu; Sakurai, Jun; Masaoka, Yoshihisa; Gobara, Hideo; Kanazawa, Susumu [Okayama University Medical School, Department of Radiology, Okayama (Japan)

2018-01-15

To evaluate retrospectively the diagnostic yield, safety, and risk factors for diagnostic failure of computed tomography (CT) fluoroscopy-guided renal tumour biopsy. Biopsies were performed for 208 tumours (mean diameter 2.3 cm; median diameter 2.1 cm; range 0.9-8.5 cm) in 199 patients. One hundred and ninety-nine tumours were ≤4 cm. All 208 initial procedures were divided into diagnostic success and failure groups. Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for diagnostic failure. After performing 208 initial and nine repeat biopsies, 180 malignancies and 15 benign tumours were pathologically diagnosed, whereas 13 were not diagnosed. In 117 procedures, 118 Grade I and one Grade IIIa adverse events (AEs) occurred. Neither Grade ≥IIIb AEs nor tumour seeding were observed within a median follow-up period of 13.7 months. Logistic regression analysis revealed only small tumour size (≤1.5 cm; odds ratio 3.750; 95% confidence interval 1.362-10.326; P = 0.011) to be a significant risk factor for diagnostic failure. CT fluoroscopy-guided renal tumour biopsy is a safe procedure with a high diagnostic yield. A small tumour size (≤1.5 cm) is a significant risk factor for diagnostic failure. (orig.)

Pelvicalyceal system duplication with ectopic ureter – diagnostic difficulties associated with the imaging procedure. Two cases report

Directory of Open Access Journals (Sweden)

Agnieszka Pukajło-Marczyk

2014-09-01

Full Text Available Urinary tract abnormalities are the most frequently occurring developmental anomaly in children. Pelvicalyceal system duplication is one of them and signifies the existence of two urine diverting separate systems. This anomaly occurs in 10% of population, usually in girls, and is associated with complete or partial ureter duplication. The frequency of total ureter duplication, which in 20–40% of patients is found as bilateral, is 1:125 children (0.8% of the population. The most frequent malformation is asymptomatic, diagnosed coincidentally casually and does not require any treatment. In some patients with pelvicalyceal system duplication, vesicoureteral reflux (VUR and ectopic ureter may coexist. Malposition of ureter’s orifice into the bladder predispose to urinary retention, development of hydronephrosis and urinary tract infection (UTI. Ectopic ureterocele is recognized in 6–20% of children with recurrent UTI. The reason why children are referred to the hospital is UTI or hydronephrosis revealed by ultrasound imaging. When the ultrasound image of pelvicalyceal system duplication is ambiguous, micturating cystourethrography (MCU and scintigraphy become the primary diagnostic procedure, or urography – in more complicated cases. In the case of ectopic ureter, the danger of inappropriate catheterization, i.e. directly into its lumen, may occur. Though very rare, this may cause some diagnostic difficulties and lead to injury of the urinary tract. For this reason, we want to further discuss this complication following a diagnostic procedure on the example of two cases of pelvicalyceal system duplication with ectopic ureter.

Monte Carlo based estimation of organ and effective doses to patients undergoing hysterosalpingography and retrograde urethrography fluoroscopy procedures

Science.gov (United States)

Ngaile, J. E.; Msaki, P. K.; Kazema, R. R.

2018-04-01

Contrast investigations of hysterosalpingography (HSG) and retrograde urethrography (RUG) fluoroscopy procedures remain the dominant diagnostic tools for the investigation of infertility in females and urethral strictures in males, respectively, owing to the scarcity and high cost of services of alternative diagnostic technologies. In light of the radiological risks associated with contrast based investigations of the genitourinary tract systems, there is a need to assess the magnitude of radiation burden imparted to patients undergoing HSG and RUG fluoroscopy procedures in Tanzania. The air kerma area product (KAP), fluoroscopy time, number of images, organ dose and effective dose to patients undergoing HSG and RUG procedures were obtained from four hospitals. The KAP was measured using a flat transmission ionization chamber, while the organ and effective doses were estimated using the knowledge of the patient characteristics, patient related exposure parameters, geometry of examination, KAP and Monte Carlo calculations (PCXMC). The median values of KAP for the HSG and RUG were 2.2 Gy cm2 and 3.3 Gy cm2, respectively. The median organ doses in the present study for the ovaries, urinary bladder and uterus for the HSG procedures, were 1.0 mGy, 4.0 mGy and 1.6 mGy, respectively, while for urinary bladder and testes of the RUG were 3.4 mGy and 5.9 mGy, respectively. The median values of effective doses for the HSG and RUG procedures were 0.65 mSv and 0.59 mSv, respectively. The median values of effective dose per hospital for the HSG and RUG procedures had a range of 1.6-2.8 mSv and 1.9-5.6 mSv, respectively, while the overall differences between individual effective doses across the four hospitals varied by factors of up to 22.0 and 46.7, respectively for the HSG and RUG procedures. The proposed diagnostic reference levels (DRLs) for the HSG and RUG were for KAP 2.8 Gy cm2 and 3.9 Gy cm2, for fluoroscopy time 0.8 min and 0.9 min, and for number of images 5 and 4

Nucleic acid-based diagnostics for infectious diseases in public health affairs.

Science.gov (United States)

Yu, Albert Cheung-Hoi; Vatcher, Greg; Yue, Xin; Dong, Yan; Li, Mao Hua; Tam, Patrick H K; Tsang, Parker Y L; Wong, April K Y; Hui, Michael H K; Yang, Bin; Tang, Hao; Lau, Lok-Ting

2012-06-01

Infectious diseases, mostly caused by bacteria and viruses but also a result of fungal and parasitic infection, have been one of the most important public health concerns throughout human history. The first step in combating these pathogens is to get a timely and accurate diagnosis at an affordable cost. Many kinds of diagnostics have been developed, such as pathogen culture, biochemical tests and serological tests, to help detect and fight against the causative agents of diseases. However, these diagnostic tests are generally unsatisfactory because they are not particularly sensitive and specific and are unable to deliver speedy results. Nucleic acid-based diagnostics, detecting pathogens through the identification of their genomic sequences, have shown promise to overcome the above limitations and become more widely adopted in clinical tests. Here we review some of the most popular nucleic acid-based diagnostics and focus on their adaptability and applicability to routine clinical usage. We also compare and contrast the characteristics of different types of nucleic acid-based diagnostics.

Failure diagnostics of rotational machines and machine groups in the Paks Nuclear Power Plant

International Nuclear Information System (INIS)

Nagy, I.; Kiss, G.

1997-01-01

Machine failure diagnostic system based on vibration analysis is described. The design of the measurements, the measurement procedure, and the evaluation of the results are presented. The common diagnostic technology for groups of rotation machinery has several advantages. The rules used for the evaluation of three-directional vibration measurements are shown, and the identification criteria of some specific failures are demonstrated. The steps of expert decision making and the diagnosis procedure are discussed through practical examples. (R.P.)

Intelligent DNA-based molecular diagnostics using linked genetic markers

Energy Technology Data Exchange (ETDEWEB)

Pathak, D.K.; Perlin, M.W.; Hoffman, E.P.

1994-12-31

This paper describes a knowledge-based system for molecular diagnostics, and its application to fully automated diagnosis of X-linked genetic disorders. Molecular diagnostic information is used in clinical practice for determining genetic risks, such as carrier determination and prenatal diagnosis. Initially, blood samples are obtained from related individuals, and PCR amplification is performed. Linkage-based molecular diagnosis then entails three data analysis steps. First, for every individual, the alleles (i.e., DNA composition) are determined at specified chromosomal locations. Second, the flow of genetic material among the individuals is established. Third, the probability that a given individual is either a carrier of the disease or affected by the disease is determined. The current practice is to perform each of these three steps manually, which is costly, time consuming, labor-intensive, and error-prone. As such, the knowledge-intensive data analysis and interpretation supersede the actual experimentation effort as the major bottleneck in molecular diagnostics. By examining the human problem solving for the task, we have designed and implemented a prototype knowledge-based system capable of fully automating linkage-based molecular diagnostics in X-linked genetic disorders, including Duchenne Muscular Dystrophy (DMD). Our system uses knowledge-based interpretation of gel electrophoresis images to determine individual DNA marker labels, a constraint satisfaction search for consistent genetic flow among individuals, and a blackboard-style problem solver for risk assessment. We describe the system`s successful diagnosis of DMD carrier and affected individuals from raw clinical data.

Value measurement of nuclear medicine procedures

International Nuclear Information System (INIS)

Potchen, E.J.; Harris, G.I.; Schonbein, W.R.; Rashford, N.J.

1977-01-01

The difficulty in measuring the benefit component for cost/benefit analysis of diagnostic procedures in medicine is portrayed as a complex issue relating the objective of intent to a classification of types of decisions a physician must make in evaluating a patient's problem. Ultimately, it seems desirable to develop measuring instruments such as attitude measurement tools by which the relative value of alternative diagnostic procedures could be measured in terms of what they contribute to diminishing the patient's personal perception of disease. Even without this idealized objective, it is reasonable to assume that diagnostic tests which do not contain information, defined as a change in the randomness of a state of knowledge, could not be expected to ultimately benefit the patient. Thus diagnostic information should provide a rational direction for the physician to modify the course of the patient's illness. Since information can be measured as a change in randomness of a knowledge state, we can determine the information content of a specific nuclear medicine procedure when faced with an array of diagnostic problems. These measurements remain to be made for clinical nuclear medicine procedures and are currently under study

Diagnostic guidlines for occupational epicondylitis

Directory of Open Access Journals (Sweden)

Patrycja Krawczyk-Szulc

2015-07-01

Full Text Available Making final decisions on the occupational etiology of musculoskeletal diseases is often difficult and problematic at every stage of the diagnostic procedure. Taking into account the need to facilitate decision-making about the causal relationship between the diagnosed disease entity and the working conditions guidelines for the recognition of work-related musculoskeletal diseases have been developed. This paper presents the guidelines for the diagnosis of occupational etiology of humeral epicondylitis, one of the most common occupational disease of the musculoskeletal system in Poland. The developed guidelines have been based on the literature data concerning occupational risk factors of humeral epicondylitis, workload classification, including repetitive movements, awkward postures, and force. Some criteria applied in ergonomic evaluation methods were also included. The presented diagnostic guidelines define approximate benchmarks for stating (after excluding non-occupational etiology that the identified humeral epicondylitis, is related to the way of working. Crucial work factors that should be analyzed include an operating time of movements overloading tendons connecting to the epicondyle, repetition and force used to perform occupational activities. The developed guidelines are aimed to facilitate occupational physicians diagnostic and certification procedures in case of humeral epicondylitis and determination whether there is a likelihood of its occupational etiology. Med Pr 2015;66(3:443–450

Bayesian analysis of longitudinal Johne's disease diagnostic data without a gold standard test

DEFF Research Database (Denmark)

Wang, C.; Turnbull, B.W.; Nielsen, Søren Saxmose

2011-01-01

the posterior estimates of the model parameters that provide the basis for inference concerning the accuracy of the diagnostic procedure. Based on the Bayesian approach, the posterior probability distribution of the change-point onset time can be obtained and used as a criterion for infection diagnosis......-point process with a Weibull survival hazard function was used to model the progression of the hidden disease status. The model adjusted for the fixed effects of covariate variables and random effects of subject on the diagnostic testing procedure. Markov chain Monte Carlo methods were used to compute....... An application is presented to an analysis of ELISA and fecal culture test outcomes in the diagnostic testing of paratuberculosis (Johne's disease) for a Danish longitudinal study from January 2000 to March 2003. The posterior probability criterion based on the Bayesian model with 4 repeated observations has...

Bayesian based Diagnostic Model for Condition based Maintenance of Offshore Wind Farms

DEFF Research Database (Denmark)

Asgarpour, Masoud; Sørensen, John Dalsgaard

2018-01-01

Operation and maintenance costs are a major contributor to the Levelized Cost of Energy for electricity produced by offshore wind and can be significantly reduced if existing corrective actions are performed as efficiently as possible and if future corrective actions are avoided by performing...... sufficient preventive actions. This paper presents an applied and generic diagnostic model for fault detection and condition based maintenance of offshore wind components. The diagnostic model is based on two probabilistic matrices; first, a confidence matrix, representing the probability of detection using...... for a wind turbine component based on vibration, temperature, and oil particle fault detection methods. The last part of the paper will have a discussion of the case study results and present conclusions....

Efficacy of clinical diagnostic procedures utilized in nuclear medicine. Nine month progress report

Energy Technology Data Exchange (ETDEWEB)

None

1978-01-01

This study is designed to determine the efficacy of nuclear medicine procedures in clinical practice. Several methods of determining efficacy will be evaluated to determine those most suitable. Nuclear medicine methods will be confined to the study of lung diseases by pulmonary perfusion and ventilation. In addition to evaluating the above methods data will be obtained to determine the sensitivity, specificity, predictive value and efficiency of the test under consideration. These values, corrected for prevalence of the disease processes under consideration will then be compared to the values obtained by the MACRO and MICRO methods and will help to bound the clinical reliability of the diagnostic method depending on the degree to which the several methods trend together. Depending on the practicality of these two methods, in addition to the determination of efficacy, cost effectiveness factors and benefit-risk estimates which are used to apply to radiation effects will be determined for nuclear medicine studies of the brain, bone, heart, liver and thyroid subsequently. The measurement techniques will then be utilized to establish guidelines for the most useful applications of the given procedure so that clinicians will be able to obtain a pretest estimate of the utility of the nuclear medicine test.

Triggering radiation alarm at security checks. Patients should be informed even after diagnostic nuclear medicine procedures.

Science.gov (United States)

Palumbo, Barbara; Neumann, Irmgard; Havlik, Ernst; Palumbo, Renato; Sinzinger, Helmut

2009-01-01

During the last few years an increasing number of nuclear medicine patients in various countries evoked a radiation alarm after therapeutic or diagnostic procedures, and even after passive exposure. A prospective calculation of activity retention in the patient's body is difficult due to extremely high variation of uptake and kinetics. Furthermore, different sensitivities and distances of the detectors make a prospective calculation even more difficult. In this article a number of cases are being reported, related problems are discussed and the surprisingly very limited literature reviewed. In order to minimize problems after eventually triggering alarms, we strongly recommend that each patient receives a certificate providing personal data, tracer, dose, half-life of the radionuclide, type and date of procedure applied as well as the nuclear medicine unit to contact for further information. Furthermore, a closer cooperation and exchange of information between the authorities and local nuclear medicine societies, would be welcome.

The impact of altering filling pressures in diagnostic outpatient hysteroscopy on the procedure completion rates and associated pain: a randomised double-blind controlled trial.

Science.gov (United States)

Haggag, Hisham M; Hassan, AbdelGany M A

2016-02-01

Several studies have compared different distension media and analgesics to optimise the efficiency of outpatient hysteroscopy. However, studies comparing different uterine filling pressures are scarce. The objective of this study was to evaluate and compare different uterine filling pressures during diagnostic outpatient hysteroscopy in an attempt to find the optimal pressure allowing adequate visualisation while minimising pain and increasing patient satisfaction. This was a double-blind randomised controlled trial. A total of 240 women who had diagnostic outpatient hysteroscopy were randomly divided into three equal groups: the uterine filling pressure was 30 mm Hg in group 1, 50 mm Hg in group 2 and 80 mm Hg in group 3. The primary outcome was adequate visualisation, and secondary outcomes were the proportion of completed procedures, pain perceived during the procedure, immediately after the procedure and 30 min later. Adequate visualisation was lower in group 1 (88.7% vs 97.5% and 98.7%; P = 0.009), but was not different between groups 2 and 3 (P > 0.999). The proportion of completed procedures was not different among the groups. There was a progressive increase in pain scores from the lower to the higher pressure groups during the procedure, immediately after the procedure and 30 min after completing the procedure. Uterine filling pressure of 50 mm Hg was associated with better visualisation than 30 mm Hg and lower pain scores than that of 80 mmHg with no difference in the proportion of completed procedures. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Acute abdomen. Diagnostic radiology according to principal signs

International Nuclear Information System (INIS)

Krestin, G.P.

1994-01-01

The acute abdomen is a frequent and very often dangerous syndrome which requires sophisticated diagnostic evaluation. A decisive factor determining the following case history is efficient and exact diagnosis, calling for experienced clinical and diagnostic experts for efficient application of available methods, and correct interpretation of findings. The book offers: 1. Practice-oriented diagnostic strategies, based on 13 principal signs and constellations derived from clinical experience, presented in each chapter as a combination of - suitable differential diagnostic procedures and methods,- exhaustive description of the clinical signs and diagnostic findings specific of the various symptoms,- algorithmic presentations. 2. A special chapter on the pediatric acute abdomen. 3. The most important findings shown in more than 250 original pictures. 4. A graphical design and presentation of the information which permits quick access to the important content. (orig./CB) [de

Estimate of the Effective Dose Equivalent to the Cypriot Population due to Diagnostic Nuclear Medicine Procedures in the Public Sector

Energy Technology Data Exchange (ETDEWEB)

Christofides, S [Medical Physics Department, Nicosia General Hospital (Cyprus)

1994-12-31

The Effective Dose Equivalent (EDE) to the Cypriot population due to Diagnostic Nuclear Medicine procedures has been estimated from data published by the Government of Cyprus, in its Health and Hospital Statistics Series for the years 1990, 1991, and 1992. The average EDE per patient was estimated to be 3,09, 3,75 and 4,01 microSievert for 1990, 1991 and 1992 respectively, while the per caput EDE was estimated to be 11,75, 15,16 and 17,09 microSieverts for 1990, 1991 and 1992 respectively, from the procedures in the public sector. (author). 11 refs, 4 tabs.

Estimate of the Effective Dose Equivalent to the Cypriot Population due to Diagnostic Nuclear Medicine Procedures in the Public Sector

International Nuclear Information System (INIS)

Christofides, S.

1994-01-01

The Effective Dose Equivalent (EDE) to the Cypriot population due to Diagnostic Nuclear Medicine procedures has been estimated from data published by the Government of Cyprus, in its Health and Hospital Statistics Series for the years 1990, 1991, and 1992. The average EDE per patient was estimated to be 3,09, 3,75 and 4,01 microSievert for 1990, 1991 and 1992 respectively, while the per caput EDE was estimated to be 11,75, 15,16 and 17,09 microSieverts for 1990, 1991 and 1992 respectively, from the procedures in the public sector. (author)

GPIB based instrumentation and control system for ADITYA Thomson Scattering Diagnostic

Energy Technology Data Exchange (ETDEWEB)

Patel, Kiran, E-mail: kkpatel@ipr.res.in; Pillai, Vishal; Singh, Neha; Chaudhary, Vishnu; Thomas, Jinto; Kumar, Ajai

2016-11-15

The ADITYA Thomson Scattering Diagnostic is a single point Ruby laser based system with a spectrometer for spectral dispersion and photomultiplier tubes for the detection of scattered light. The system uses CAMAC (Computer Automated Measurement And Control) based control and data acquisition system, which synchronizes the Ruby laser, detectors and the digitizer. Previously used serial based CAMAC controller is upgraded to GPIB (General Purpose Interface Bus) based CAMAC controller for configuration and data transfer. The communication protocols for different instruments are converted to a single GPIB based for better interface. The entire control and data acquisition program is developed on LabVIEW platform for versatile operation of diagnostics with improved user friendly GUI (Graphical User Interfaces) and allows user to remotely update the laser firing time with respect to the plasma shot. The software is in handshake with the Tokamak main control program through network to minimize manual interventions for the operation of the diagnostics. The upgraded system improved the performance of the diagnostics in comparison to earlier in terms of better data transmission rate, easy to maintain and program is upgradable.

GPIB based instrumentation and control system for ADITYA Thomson Scattering Diagnostic

International Nuclear Information System (INIS)

Patel, Kiran; Pillai, Vishal; Singh, Neha; Chaudhary, Vishnu; Thomas, Jinto; Kumar, Ajai

2016-01-01

The ADITYA Thomson Scattering Diagnostic is a single point Ruby laser based system with a spectrometer for spectral dispersion and photomultiplier tubes for the detection of scattered light. The system uses CAMAC (Computer Automated Measurement And Control) based control and data acquisition system, which synchronizes the Ruby laser, detectors and the digitizer. Previously used serial based CAMAC controller is upgraded to GPIB (General Purpose Interface Bus) based CAMAC controller for configuration and data transfer. The communication protocols for different instruments are converted to a single GPIB based for better interface. The entire control and data acquisition program is developed on LabVIEW platform for versatile operation of diagnostics with improved user friendly GUI (Graphical User Interfaces) and allows user to remotely update the laser firing time with respect to the plasma shot. The software is in handshake with the Tokamak main control program through network to minimize manual interventions for the operation of the diagnostics. The upgraded system improved the performance of the diagnostics in comparison to earlier in terms of better data transmission rate, easy to maintain and program is upgradable.

CT fluoroscopy-guided renal tumour cutting needle biopsy: retrospective evaluation of diagnostic yield, safety, and risk factors for diagnostic failure.

Science.gov (United States)

Iguchi, Toshihiro; Hiraki, Takao; Matsui, Yusuke; Fujiwara, Hiroyasu; Sakurai, Jun; Masaoka, Yoshihisa; Gobara, Hideo; Kanazawa, Susumu

2018-01-01

To evaluate retrospectively the diagnostic yield, safety, and risk factors for diagnostic failure of computed tomography (CT) fluoroscopy-guided renal tumour biopsy. Biopsies were performed for 208 tumours (mean diameter 2.3 cm; median diameter 2.1 cm; range 0.9-8.5 cm) in 199 patients. One hundred and ninety-nine tumours were ≤4 cm. All 208 initial procedures were divided into diagnostic success and failure groups. Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for diagnostic failure. After performing 208 initial and nine repeat biopsies, 180 malignancies and 15 benign tumours were pathologically diagnosed, whereas 13 were not diagnosed. In 117 procedures, 118 Grade I and one Grade IIIa adverse events (AEs) occurred. Neither Grade ≥IIIb AEs nor tumour seeding were observed within a median follow-up period of 13.7 months. Logistic regression analysis revealed only small tumour size (≤1.5 cm; odds ratio 3.750; 95% confidence interval 1.362-10.326; P = 0.011) to be a significant risk factor for diagnostic failure. CT fluoroscopy-guided renal tumour biopsy is a safe procedure with a high diagnostic yield. A small tumour size (≤1.5 cm) is a significant risk factor for diagnostic failure. • CT fluoroscopy-guided renal tumour biopsy has a high diagnostic yield. • CT fluoroscopy-guided renal tumour biopsy is safe. • Small tumour size (≤1.5 cm) is a risk factor for diagnostic failure.

Bayesian Based Diagnostic Model for Condition Based Maintenance of Offshore Wind Farms

Directory of Open Access Journals (Sweden)

Masoud Asgarpour

2018-01-01

Full Text Available Operation and maintenance costs are a major contributor to the Levelized Cost of Energy for electricity produced by offshore wind and can be significantly reduced if existing corrective actions are performed as efficiently as possible and if future corrective actions are avoided by performing sufficient preventive actions. This paper presents an applied and generic diagnostic model for fault detection and condition based maintenance of offshore wind components. The diagnostic model is based on two probabilistic matrices; first, a confidence matrix, representing the probability of detection using each fault detection method, and second, a diagnosis matrix, representing the individual outcome of each fault detection method. Once the confidence and diagnosis matrices of a component are defined, the individual diagnoses of each fault detection method are combined into a final verdict on the fault state of that component. Furthermore, this paper introduces a Bayesian updating model based on observations collected by inspections to decrease the uncertainty of initial confidence matrix. The framework and implementation of the presented diagnostic model are further explained within a case study for a wind turbine component based on vibration, temperature, and oil particle fault detection methods. The last part of the paper will have a discussion of the case study results and present conclusions.

Double positivity to bee and wasp venom: improved diagnostic procedure by recombinant allergen-based IgE testing and basophil activation test including data about cross-reactive carbohydrate determinants.

Science.gov (United States)

Eberlein, Bernadette; Krischan, Lilian; Darsow, Ulf; Ollert, Markus; Ring, Johannes

2012-07-01

Specific IgE (sIgE) antibodies to both bee and wasp venom can be due to a sensitivity to both insect venoms or due to cross-reactive carbohydrate determinants (CCDs). Investigating whether a basophil activation test (BAT) with both venoms as well as with bromelain and horseradish peroxidase (HRP) or recombinant allergen-based IgE testing can improve the diagnostic procedure. Twenty-two Hymenoptera-venom allergic patients with sIgE antibodies to both bee and wasp venom were studied. sIgE antibodies to MUXF3 CCD, bromelain, HRP, rApi m 1, and rVes v 5 were determined, and a BAT (Flow2 CAST) with venom extracts, bromelain, and HRP was performed. Further recombinant allergen-based IgE testing was done by using an ELISA, if required. The reactivity of basophils was calculated from the insect venom concentration at half-maximum stimulation. Double positivity/double negativity/single positivity to rApi m 1 and rVes v 5 was seen in 12/1/9 patients. Further recombinant allergen-based IgE testing in the last ones revealed positive results to the other venom in all cases except one. BAT was double positive/double negative/single positive in 6/2/14 patients. Four patients with negative results in sIgE antibodies to CCDs had positive results in BAT. BAT with bromelain/HRP showed a sensitivity of 50%/81% and a specificity of 91%/90%. Component-resolved IgE testing elucidates the pattern of double positivity, showing a majority of true double sensitizations independent of CCD sensitization. BAT seems to add more information about the culprit insect even if the true clinical relevance of BAT is not completely determined because of ethical limitations on diagnostic sting challenges. BAT with HRP is a good method to determine sensitivity to CCDs. Copyright © 2012 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

Interventional chest procedures in pregnancy.

LENUS (Irish Health Repository)

Morgan, Ross K

2011-03-01

Interventional pulmonology encompasses diagnostic and therapeutic bronchoscopic procedures, and pleural interventions. In the last 10 years older techniques have been refined and exciting new technologies have extended the reach and application of the instruments used. The main areas within pulmonary medicine for which these interventions have a role are malignant and nonmalignant airway disease, pleural effusion, pneumothorax, and artificial airways. There are no data from well-designed prospective trials to guide recommendations for interventional pulmonary procedures in pregnancy. The recommendations provided in this article are based on critical review of reported case series, opinion from recognized experts, and personal observations.

Interventional chest procedures in pregnancy.

LENUS (Irish Health Repository)

Morgan, Ross K

2012-02-01

Interventional pulmonology encompasses diagnostic and therapeutic bronchoscopic procedures, and pleural interventions. In the last 10 years older techniques have been refined and exciting new technologies have extended the reach and application of the instruments used. The main areas within pulmonary medicine for which these interventions have a role are malignant and nonmalignant airway disease, pleural effusion, pneumothorax, and artificial airways. There are no data from well-designed prospective trials to guide recommendations for interventional pulmonary procedures in pregnancy. The recommendations provided in this article are based on critical review of reported case series, opinion from recognized experts, and personal observations.

Radiation exposure of population due to medical diagnostic procedures in the USSR

International Nuclear Information System (INIS)

Vorob'ev, E.I.; Stavitskij, R.V.; Knizhnikov, V.A.; Barkhudarov, R.M.; Korsunskij, V.N.; Popov, V.I.; Tarasenko, Yu.I.; Postnikov, V.A.; Frolov, N.V.; Sidorin, V.P.

1984-01-01

The evaluation of radiation doses to population in the ussr on the basis of the data on frequency of 12 main forms of X-ray examinations and the results of measuring absorbed doses on tissue-kquivalent main's phantom are given. The evaluation of radiation exposure due to radiopharmaceutical preparations is based on consumption of 26 types of compounds in 320 national laboratories and i is performed by the methods developed in the framework of the mird committee (usa). In thhe active bone marrow, lungs mammary, glands thyroid and other organs (stomach, liver, spleen, etc.) the equivalent doses are determined and on their base the effective equivalent doses (eed). The average eed from x ray diagnostic examinations is 1.4 mSv per year (140 mrem per year) of which 55.4% falls on X-ray examination, 26.9% on radiography, 17.7% on mass miniature radiography (fluorography). Radionuclide diagnostics contribution is 3.2x10 -2 mSv per year (3.8 mrem per year). Medicinal radiation exposure approximately doubles the natural background, it is comparable with exposure in premises and essentially exceeds the radiation doses to population from other sources

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.

21 CFR 886.1380 - Diagnostic condensing lens.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Diagnostic condensing lens. 886.1380 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1380 Diagnostic condensing lens. (a) Identification. A diagnostic condensing lens is a device used in binocular indirect ophthalmoscopy (a procedure...

Exposure to rays and radiation hazards in connection with diagnostic X-ray procedures in children

International Nuclear Information System (INIS)

Protzer, K.

1988-01-01

In this study, figures and data about radiation exposures for diagnostic purposes are surveyed that were collected in connection with X-ray procedures in children. The data were sorted according to body regions and techniques required for their examination so as to permit separate analyses of procedures in the urogenital tract (intravenous urogramme, micturition cystourethrography), thorax (angiocardiogramme, thoractic aortogramme, examinations using cardiac catheters), gastrointestinal system (fluoroscopy and contrast-enhanced irrigoscopy), pelvis (survey radiography), skull (computed tomography) as well as in miscellaneous group of further origins. The second part of the report discusses the uncertainties surrounding the assessment of radiation hazards and indicated radiation doses. A formula is represented for the calculation of life-time reductions that can be applied to any type of cancer and embraces a number of factors like life expectancy at age X, the patient's age at the time of radiotherapy, the five-year-survival rate for the condition under investigation and the diseased organ. At the end of the study, some methods are pointed out that may be helpful in limiting radiation exposure. (KST) [de

Efficacy of clinical diagnostic procedures utilized in nuclear medicine. Technical progress report, 1 December 1981-30 November 1982

International Nuclear Information System (INIS)

Saenger, E.L.

1982-07-01

The efficacy of nuclear medicine diagnostic procedures was measured. Three levels of efficacy were defined. However, two different methods of evaluating efficacy itself were first compared. Using two methods, logistic regression and entropy-minimax pattern detection, substantial agreement was found between them in several clinical observations. (1) There are no attributes that indicate that any grouping of symptoms, signs, and laboratory findings is capable of suggesting that a patient does or does not have a pulmonary embolus. (2) The lung scan test is the only reliable method which indicates that a patient may have a pulmonary embolus or does not have a pulmonary embolus. (3) The validity of these conclusions and the ability to apply them widely to ongoing clinical practice is based on the prospective design of the Study which included an appropriate distribution of institutions by type, size, and geographic location. Also, the only judgement samples was that of the referring physician

A web-based test of residents' skills in diagnostic radiology

International Nuclear Information System (INIS)

Finlay, K.; Norman, G.R.; Keane, D.R.; Stolberg, H.

2006-01-01

To develop an objective, Web-based tool for evaluating residents' knowledge of diagnostic radiology. We developed and tested a Web-based evaluation tool (the Diagnostic Radiology Skills Test) that consists of 3 tests, one in each of 3 domains of diagnostic radiology: chest, gastrointestinal, and musculoskeletal imaging. Each test comprises 30 cases representing a range of difficulty in the domain, including normal states, normal variants, typical cases of common diagnoses, and cases with more subtle findings. Cases are presented with a long menu of domain-specific possible diagnoses (response options), each coded for diagnostic appropriateness. Our subjects were 21 residents in postgraduate year (PGY) 2 to 5 and 11 experts in diagnostic radiology. Subjects accessed the tool via a Web site on our Web server. Residents test results were compared for reliability and validity across domain, case, and training level. In addition, results were correlated with commonly used established and objective evaluation tools. The tool demonstrated consistent monotonic improvement in performance with training level. It showed acceptable reliability in discriminating between residents at different performance levels, both within and across training levels (r = 0.53 within level and 0.69 across levels). Test results also had concurrent validity against the American College of Radiology In-Training Examination, a widely accepted objective assessment tool (r = 0.65, P < 0.01), and 2 Objective Structured Clinical Examinations (OSCEs) focusing on diagnostic skills (r = 0.78 and r 0.69, P < 0.01, respectively). Our study demonstrates the feasibility of a Web-based, standardized, objective assessment method for evaluating residents' performance. (author)

Interlaboratory diagnostic accuracy of a Salmonella specific PCR-based method

DEFF Research Database (Denmark)

Malorny, B.; Hoorfar, Jeffrey; Hugas, M.

2003-01-01

A collaborative study involving four European laboratories was conducted to investigate the diagnostic accuracy of a Salmonella specific PCR-based method, which was evaluated within the European FOOD-PCR project (http://www.pcr.dk). Each laboratory analysed by the PCR a set of independent obtained...... presumably naturally contaminated samples and compared the results with the microbiological culture method. The PCR-based method comprised a preenrichment step in buffered peptone water followed by a thermal cell lysis using a closed tube resin-based method. Artificially contaminated minced beef and whole......-based diagnostic methods and is currently proposed as international standard document....

Strategies for adding adaptive learning mechanisms to rule-based diagnostic expert systems

Science.gov (United States)

Stclair, D. C.; Sabharwal, C. L.; Bond, W. E.; Hacke, Keith

1988-01-01

Rule-based diagnostic expert systems can be used to perform many of the diagnostic chores necessary in today's complex space systems. These expert systems typically take a set of symptoms as input and produce diagnostic advice as output. The primary objective of such expert systems is to provide accurate and comprehensive advice which can be used to help return the space system in question to nominal operation. The development and maintenance of diagnostic expert systems is time and labor intensive since the services of both knowledge engineer(s) and domain expert(s) are required. The use of adaptive learning mechanisms to increment evaluate and refine rules promises to reduce both time and labor costs associated with such systems. This paper describes the basic adaptive learning mechanisms of strengthening, weakening, generalization, discrimination, and discovery. Next basic strategies are discussed for adding these learning mechanisms to rule-based diagnostic expert systems. These strategies support the incremental evaluation and refinement of rules in the knowledge base by comparing the set of advice given by the expert system (A) with the correct diagnosis (C). Techniques are described for selecting those rules in the in the knowledge base which should participate in adaptive learning. The strategies presented may be used with a wide variety of learning algorithms. Further, these strategies are applicable to a large number of rule-based diagnostic expert systems. They may be used to provide either immediate or deferred updating of the knowledge base.

Consideration on the diagnostic ability of various imaging techniques in relation to renal tumor

International Nuclear Information System (INIS)

Ike, Katsushi

1984-01-01

Radiological diagnosis of renal tumors is being improved with the increased imaging accuracy which has resulted from advancement in the various equipment used and improvement in techniques. However, at the clinical level, diagnostic procedures based on the characteristics of the delineated images are not yet established and the diverse diagnostic procedures are being conducted currently in a stereotyped manner. In this study, the images of 61 cases diagnosed as renal tumor were analysed retrospectively with the purpose of establishing the imaging accuracy, capacity for diagnosis based on image characteristics and a subseguent proper diagnostic procedure. It was found that CT and Angio gave similar diagnostic accuracy. It was further revealed that US images enabled to differentiate renal tumors from the more commonly experienced renal cystic disease. For determination of tunica involucrum infiltration, which is essential to diagnose Stage I and II renal tumors, CT was proved to be superior to Angio. CT and US were also to be so in the determination of metastasis to para-aortic lymph nodes which is a Stage III criterion. In recent years, CT and US imaging accuracies have increased, hence the improvement in the capacity to diagnose non-observable renal tumors is highly expected. (author)

Applying computer-based procedures in nuclear power plants

Energy Technology Data Exchange (ETDEWEB)

Oliveira, Mauro V. de; Carvalho, Paulo V.R. de; Santos, Isaac J.A.L. dos; Grecco, Claudio H.S. [Instituto de Engenharia Nuclear (IEN/CNEN-RJ), Rio de Janeiro, RJ (Brazil). Div. de Instrumentacao e Confiabilidade Humana], e-mail: mvitor@ien.gov.br, e-mail: paulov@ien.gov.br, e-mail: luquetti@ien.gov.br, e-mail: grecco@ien.gov.br; Bruno, Diego S. [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Escola Politecnica. Curso de Engenharia de Controle e Automacao], e-mail: diegosalomonebruno@gmail.com

2009-07-01

Plant operation procedures are used to guide operators in coping with normal, abnormal or emergency situations in a process control system. Historically, the plant procedures have been paper-based (PBP), with the digitalisation trend in these complex systems computer-based procedures (CBPs) are being developed to support procedure use. This work shows briefly the research on CBPs at the Human-System Interface Laboratory (LABIHS). The emergency operation procedure EOP-0 of the LABIHS NPP simulator was implemented in the ImPRO CBP system. The ImPRO system was chosen for test because it is available for download in the Internet. A preliminary operation test using the implemented procedure in the CBP system was realized and the results were compared to the operation through PBP use. (author)

Costs, charges, and revenues for hospital diagnostic imaging procedures: differences by modality and hospital characteristics.

Science.gov (United States)

Sistrom, Christopher Lee; McKay, Niccie L

2005-06-01

This study examined financial data reported by Florida hospitals concerning costs, charges, and revenues related to imaging services. Financial reports to the Florida Hospital Uniform Reporting System by all licensed acute care facilities for fiscal year 2002 were used to calculate four financial indices on a per procedure basis. These included charge, net revenue, operating expense (variable cost), and contribution margin. Analysis, stratified by cost center (imaging modality), tested the effects of bed size, ownership, teaching status, and urban or rural status on the four indices. The mean operating expense and charge per procedure were as follows: computed tomography (CT): $51 and $1565; x-ray and ultrasound: $55 and $410; nuclear medicine (NM): $135 and $1138; and magnetic resonance imaging (MRI): $165 and $2048. With all four modalities, for-profit hospitals had higher charges than not-for-profit and public facilities. Excepting NM, however, the difference by ownership disappeared when considering net revenue. Operating expense did not differ by ownership type or bed size. Operating expense (variable cost) per procedure is considerably lower for CT than for MRI. Consequently, when diagnostically equivalent, CT is preferable to MRI in terms of costs for hospitals. If the cost structure of nonhospital imaging is at all similar to hospitals, the profit potential for performing CT and MRI seems to be substantial, which has relevance to the issue of imaging self-referral.

Diagnostic radiography exposure increases the risk for thyroid microcarcinoma: a population-based case-control study.

Science.gov (United States)

Zhang, Yawei; Chen, Yingtai; Huang, Huang; Sandler, Jason; Dai, Min; Ma, Shuangge; Udelsman, Robert

2015-09-01

Thyroid cancer incidence and diagnostic radiography exposures, particularly computed tomography (CT) scanning and nuclear medicine examinations, have increased substantially in the USA. However, very few epidemiologic studies have directly investigated their associations. A population-based case-control study was conducted in Connecticut in 2010-2011, including 462 histologically confirmed incident thyroid cancer cases and 498 population-based controls. Multivariate unconditional logistic regression models were used to estimate the associations between diagnostic radiography and the risk of thyroid cancer, controlling for potential confounding factors. Exposure to any form of diagnostic radiography was associated with an increased risk of well-differentiated thyroid microcarcinoma [tumor size≤10 mm, odds ratio (OR)=2.76, 95% confidence interval (CI): 1.31-5.81]. The highest risk increase occurred with nuclear medicine examinations (excluding cardiology tests and thyroid uptake studies; OR=5.47, 95% CI: 2.10-14.23), followed by chest CT scanning (OR=4.30, 95% CI: 1.66-11.14), head and neck CT scanning (OR=3.88, 95% CI: 1.75-8.63), upper gastrointestinal series (OR=3.56, 95% CI: 1.54-8.21), lower gastrointestinal series (OR=3.29, 95% CI: 1.41-7.66), kidney radiography involving dye injection into a vein or artery (OR=3.21, 95% CI: 1.20-8.54), mammography (OR=2.95, 95% CI: 1.14-7.61), chest radiography (OR=2.93, 95% CI: 1.37-6.29), and abdomen CT scanning (OR=2.54, 95% CI: 1.02-6.30). No significant associations were found between these imaging modalities and thyroid tumors larger than 10 mm. This study provides the first direct evidence that CT scanning and nuclear medicine examinations are associated with an increased risk of thyroid cancer. The novel finding that an array of diagnostic radiography procedures are associated with thyroid microcarcinomas warrants further investigation.

Case-based reasoning diagnostic technique based on multi-attribute similarity

Energy Technology Data Exchange (ETDEWEB)

Makoto, Takahashi [Tohoku University, Miyagi (Japan); Akio, Gofuku [Okayama University, Okayamaa (Japan)

2014-08-15

Case-based diagnostic technique has been developed based on the multi-attribute similarity. Specific feature of the developed system is to use multiple attributes of process signals for similarity evaluation to retrieve a similar case stored in a case base. The present technique has been applied to the measurement data from Monju with some simulated anomalies. The results of numerical experiments showed that the present technique can be utilizes as one of the methods for a hybrid-type diagnosis system.

Turning the Page: Advancing Paper-Based Microfluidics for Broad Diagnostic Application.

Science.gov (United States)

Gong, Max M; Sinton, David

2017-06-28

Infectious diseases are a major global health issue. Diagnosis is a critical first step in effectively managing their spread. Paper-based microfluidic diagnostics first emerged in 2007 as a low-cost alternative to conventional laboratory testing, with the goal of improving accessibility to medical diagnostics in developing countries. In this review, we examine the advances in paper-based microfluidic diagnostics for medical diagnosis in the context of global health from 2007 to 2016. The theory of fluid transport in paper is first presented. The next section examines the strategies that have been employed to control fluid and analyte transport in paper-based assays. Tasks such as mixing, timing, and sequential fluid delivery have been achieved in paper and have enabled analytical capabilities comparable to those of conventional laboratory methods. The following section examines paper-based sample processing and analysis. The most impactful advancement here has been the translation of nucleic acid analysis to a paper-based format. Smartphone-based analysis is another exciting development with potential for wide dissemination. The last core section of the review highlights emerging health applications, such as male fertility testing and wearable diagnostics. We conclude the review with the future outlook, remaining challenges, and emerging opportunities.

Procedural sedation analgesia

OpenAIRE

Sheta, Saad A

2010-01-01

The number of noninvasive and minimally invasive procedures performed outside of the operating room has grown exponentially over the last several decades. Sedation, analgesia, or both may be needed for many of these interventional or diagnostic procedures. Individualized care is important when determining if a patient requires procedural sedation analgesia (PSA). The patient might need an anti-anxiety drug, pain medicine, immobilization, simple reassurance, or a combination of these interve...

[Small-cell lung cancer: epidemiology, diagnostics and therapy].

Science.gov (United States)

Pešek, Miloš; Mužík, Jan

Authors present actual overview of information on diagnostic and therapeutic procedures in small-cell lung cancer (SCLC). This highly aggressive type of lung cancer is diagnosed in 14.8 % of Czech lung cancer patients. Vast majority of those patients (87 %) suffer from advanced and metastatic disease in the time of diagnosis. In this issue are presented prognostic factors, staging diagnostic procedures and therapeutic recommendations. The backbone of actual SCLC treatment is combined chemotherapy and radiotherapy and less frequently, carefully in selected cases, surgical procedures. SCLC should be have as chemosensitive, chemoresistent or chemorefractory disease. Actual cytostatic combinations used in 1st line treatment, different schedules of chemoradiotherapy, drugs used in second line treatment and schedules and timing of prophylactic brain irradiation are presented. In near future, perspectively, there are some promissible data on antitumour immunotherapy based on anti CTLA-4 and anti PD-1/PE-L1 antibodies also in SCLC patients.Key words: cancer immunotherapy - concomitant chemoradiotherapy - chemotherapy - chest radiotherapy - lung resections - prophylactic brain irradiation - small cell lung cancer.

Recent advances in salivary cancer diagnostics enabled by biosensors and bioelectronics.

Science.gov (United States)

Mishra, Saswat; Saadat, Darius; Kwon, Ohjin; Lee, Yongkuk; Choi, Woon-Seop; Kim, Jong-Hoon; Yeo, Woon-Hong

2016-07-15

There is a high demand for a non-invasive, rapid, and highly accurate tool for disease diagnostics. Recently, saliva based diagnostics for the detection of specific biomarkers has drawn significant attention since the sample extraction is simple, cost-effective, and precise. Compared to blood, saliva contains a similar variety of DNA, RNA, proteins, metabolites, and microbiota that can be compiled into a multiplex of cancer detection markers. The salivary diagnostic method holds great potential for early-stage cancer diagnostics without any complicated and expensive procedures. Here, we review various cancer biomarkers in saliva and compare the biomarkers efficacy with traditional diagnostics and state-of-the-art bioelectronics. We summarize biomarkers in four major groups: genomics, transcriptomics, proteomics, and metabolomics/microbiota. Representative bioelectronic systems for each group are summarized based on various stages of a cancer. Systematic study of oxidative stress establishes the relationship between macromolecules and cancer biomarkers in saliva. We also introduce the most recent examples of salivary diagnostic electronics based on nanotechnologies that can offer rapid, yet highly accurate detection of biomarkers. A concluding section highlights areas of opportunity in the further development and applications of these technologies. Copyright © 2016 Elsevier B.V. All rights reserved.

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.

Competence and lastingness in specialized clinical laboratories: technical report about requirements concerning quality of users competence and used processes in immunochemical diagnostic procedures using isotopic and non-isotopic tracer technologies

International Nuclear Information System (INIS)

Wiegel, B.

2005-01-01

From the citizens view this technical report about immunochemical diagnostic procedures using radioactive and nonradioactive tracer technologies describes the requirements in special laboratory diagnostics concerning competency and process control. Governmental or administrational obligations of inspecting both skill and sites to guarantee patients security are pointed out. (orig.)

Dose evaluation in medical staff during diagnostics procedures in interventional radiology; Avaliacao da dose na equipe medica durante procedimentos diagnoticos de radiologia intervencionista

Energy Technology Data Exchange (ETDEWEB)

Bacchim Neto, Fernando A.; Alves, Allan F.F.; Rosa, Maria E.D.; Miranda, Jose R.A. [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil). Instituto de Biociencias. Departamento de Fisica e Biofisica; Moura, Regina [Faculdade de Medicina de Botucatu, SP (Brazil). Departamento de Cirurgia e Ortopedia; Pina, Diana R., E-mail: bacchim@ibb.unesp.br [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil). Faculdade de Medicina. Departamento de Doencas Tropicais e Diagnostico por Imagem

2014-08-15

Studies show that personal dosimeters may underestimate the dose values in interventional physicians, especially in extremities and crystalline. The objective of this work was to study the radiation exposure levels of medical staff in diagnostic interventional radiology procedures. For this purpose LiF:Mg,Ti (TLD-100) dosimeters were placed in different regions of the physician body. When comparing with reference dose levels, the maximum numbers of annual procedures were found. This information is essential to ensure the radiological protection of those professionals. (author)

Determining procedures for simulation-based training in radiology

DEFF Research Database (Denmark)

Nayahangan, Leizl Joy; Nielsen, Kristina Rue; Albrecht-Beste, Elisabeth

2018-01-01

, and basic abdominal ultrasound. CONCLUSION: A needs assessment identified and prioritized 13 technical procedures to include in a simulation-based curriculum. The list may be used as guide for development of training programs. KEY POINTS: • Simulation-based training can supplement training on patients......OBJECTIVES: New training modalities such as simulation are widely accepted in radiology; however, development of effective simulation-based training programs is challenging. They are often unstructured and based on convenience or coincidence. The study objective was to perform a nationwide needs...... assessment to identify and prioritize technical procedures that should be included in a simulation-based curriculum. METHODS: A needs assessment using the Delphi method was completed among 91 key leaders in radiology. Round 1 identified technical procedures that radiologists should learn. Round 2 explored...

Chromatographic quality control procedures for /sup 99m/Tc-diagnostic agents

International Nuclear Information System (INIS)

Marinelli, M.; Pozzato, R.; Garuti, P.; Zucchini, G.L.

1986-01-01

The purpose of this work was to experiment simple and rapid chromatographic systems, based on paper and thin-layer techniques, to test the radiochemical purity of some common /sup 99m/Tc diagnostic agents, and select those systems able to prevent the anomalies due to oxidation and artifact production. The agents were examined under conditions which usually bring about the above mentioned anomalies, then the results were compared with those obtained under controlled conditions. Quali- and quantitative detection of the activity present on the chromatograms was carried out using the equipment available in nuclear medicine departments

Computer-Based Procedures for Field Workers in Nuclear Power Plants: Development of a Model of Procedure Usage and Identification of Requirements

Energy Technology Data Exchange (ETDEWEB)

Katya Le Blanc; Johanna Oxstrand

2012-04-01

The nuclear industry is constantly trying to find ways to decrease the human error rate, especially the human errors associated with procedure use. As a step toward the goal of improving procedure use performance, researchers, together with the nuclear industry, have been looking at replacing the current paper-based procedures with computer-based procedure systems. The concept of computer-based procedures is not new by any means; however most research has focused on procedures used in the main control room. Procedures reviewed in these efforts are mainly emergency operating procedures and normal operating procedures. Based on lessons learned for these previous efforts we are now exploring a more unknown application for computer based procedures - field procedures, i.e. procedures used by nuclear equipment operators and maintenance technicians. The Idaho National Laboratory and participants from the U.S. commercial nuclear industry are collaborating in an applied research effort with the objective of developing requirements and specifications for a computer-based procedure system to be used by field workers. The goal is to identify the types of human errors that can be mitigated by using computer-based procedures and how to best design the computer-based procedures to do so. This paper describes the development of a Model of Procedure Use and the qualitative study on which the model is based. The study was conducted in collaboration with four nuclear utilities and five research institutes. During the qualitative study and the model development requirements and for computer-based procedures were identified.

Rapid development of paper-based fluidic diagnostic devices

CSIR Research Space (South Africa)

Smith, S

2014-11-01

Full Text Available We present a method for rapid and low-cost development of microfluidic diagnostic devices using paper-based techniques. Specifically, the implementation of fluidic flow paths and electronics on paper are demonstrated, with the goal of producing...

Comparative studies of imaging procedures: What is the contribution of CT?

International Nuclear Information System (INIS)

Witte, G.; Buecheler, E.

1990-01-01

Within the field of diagnostic imaging, CT and MR are competing procedures, each of which has particular advantages in specific diagnostic situations. Knowledge of these advantages is helpful in deciding upon a diagnostic procedure. We evaluate the indications for CT according to area of examination. (orig.) [de

Product qualification: a barrier to point-of-care microfluidic-based diagnostics?

Science.gov (United States)

Tantra, Ratna; van Heeren, Henne

2013-06-21

One of the most exciting applications of microfluidics-based diagnostics is its potential use in next generation point-of-care (POC) devices. Many prototypes are already in existence, but, as of yet, few have achieved commercialisation. In this article, we consider the issue surrounding product qualification as a potential barrier to market success. The study discusses, in the context of POC microfluidics-based diagnostics, what the generic issues are and potential solutions. Our findings underline the need for a community-based effort that is necessary to speed up the product qualification process.

IGENPRO knowledge-based digital system for process transient diagnostics and management

International Nuclear Information System (INIS)

Morman, J.A.; Reifman, J.; Vitela, J.E.; Wei, T.Y.C.; Applequist, C.A.; Hippely, P.; Kuk, W.; Tsoukalas, L.H.

1998-01-01

Verification and validation issues have been perceived as important factors in the large scale deployment of knowledge-based digital systems for plant transient diagnostics and management. Research and development (R and D) is being performed on the IGENPRO package to resolve knowledge base issues. The IGENPRO approach is to structure the knowledge bases on generic thermal-hydraulic (T-H) first principles and not use the conventional event-basis structure. This allows for generic comprehensive knowledge, relatively small knowledge bases and above all the possibility of T-H system/plant independence. To demonstrate concept feasibility the knowledge structure has been implemented in the diagnostic module PRODIAG. Promising laboratory testing results have been obtained using data from the full scope Braidwood PWR operator training simulator. This knowledge structure is now being implemented in the transient management module PROMANA to treat unanticipated events and the PROTREN module is being developed to process actual plant data. Achievement of the IGENPRO R and D goals should contribute to the acceptance of knowledge-based digital systems for transient diagnostics and management. (author)

IGENPRO knowledge-based digital system for process transient diagnostics and management

International Nuclear Information System (INIS)

Morman, J.A.; Reifman, J.; Wei, T.Y.C.

1997-01-01

Verification and validation issues have been perceived as important factors in the large scale deployment of knowledge-based digital systems for plant transient diagnostics and management. Research and development (R ampersand D) is being performed on the IGENPRO package to resolve knowledge base issues. The IGENPRO approach is to structure the knowledge bases on generic thermal-hydraulic (T-H) first principles and not use the conventional event-basis structure. This allows for generic comprehensive knowledge, relatively small knowledge bases and above all the possibility of T-H system/plant independence. To demonstrate concept feasibility the knowledge structure has been implemented in the diagnostic module PRODIAG. Promising laboratory testing results have been obtained using data from the full scope Braidwood PWR operator training simulator. This knowledge structure is now being implemented in the transient management module PROMANA to treat unanticipated events and the PROTREN module is being developed to process actual plant data. Achievement of the IGENPRO R ampersand D goals should contribute to the acceptance of knowledge-based digital systems for transient diagnostics and management

Radiological, sonographic and radionuclide diagnostics in headache syndrome

International Nuclear Information System (INIS)

Scheibler, C.; Pink, V.; Luettschwager, L.; Zur, C.

1987-01-01

The complex diagnostics of the headache syndrome is taken as an example for the necessity to apply imaging procedures in a purposeful way in diagnostic strategy. Cooperation of the clinical partners involved is of particular importance in control of the diagnostic process

Fetal Implications of Diagnostic Radiation Exposure During Pregnancy: Evidence-based Recommendations.

Science.gov (United States)

Rimawi, Bassam H; Green, Victoria; Lindsay, Michael

2016-06-01

The purpose of this article is to review the fetal and long-term implications of diagnostic radiation exposure during pregnancy. Evidence-based recommendations for radiologic imaging modalities utilizing exposure of diagnostic radiation during pregnancy, including conventional screen-film mammography, digital mammography, tomosynthesis, and contrast-enhanced mammography are described.

An intelligent diagnostic aid (ida) based upon the simulated and operational experience

International Nuclear Information System (INIS)

Zuenkov, M.; Poletykin, A.; Marsiletti, M.

1999-01-01

A diagnostic system has been developed addressed to timely trouble shooting in process plants during all operational modes. The theory of this diagnostic system is related with the usage of learning methods for automatic generation of knowledge bases. This approach enables the conversion of 'cause to effect' relations into 'effect to possible causes' ones. As applied to technical diagnosis, this allows one to generate troubleshooting rules of the kind 'symptoms to possible diagnosis' through 'failure to symptoms' relations. The problem of diagnostic rule generation is, thus, reduced to obtaining samples of the symptoms, that is the well known problem of failure modelling. The diagnostic rules are derived from the operation of a simulator according to the following procedure: (a) identification of all initiating events and of the corresponding operational modes; (b) simulation of all the selected transients for a time sufficient to identify the uniqueness of the plant response under each of the initiating event; (c) automatic generation of the set of diagnostic rules that, through the use of temporal logic and a filtering Expert System, associate the evolution of the process parameters and their derivatives to the initial perturbation. The plant model running under the simulator is built-up by means of the LEGO code. The LEGO code is a modular package developed at the Research and Development Department of the Italian National Electricity Board (CRA-ENEL) to facilitate modelling of the dynamics of fossil-fuelled and nuclear power plants. The LEGO code consists of a library of pre-programmed, pre-tested and pre-validated modules, that represent power plant components and a master program which allows the user to build-up a model by automatically interconnecting the modules in the arrangement determined by the modeler. The reference plant is Sampierdarena power station, that is a combined cycle plant dedicated to produce both electrical and heat power. The following

Emergency Kausch-Whipple procedure: indications and experiences.

Science.gov (United States)

Standop, Jens; Glowka, Tim; Schmitz, Volker; Schaefer, Nico; Hirner, Andreas; Kalff, Jörg C

2010-03-01

Pancreaticoduodenectomy is a demanding procedure even in selected patients but becomes formidable when performed in cases of emergency. This study analyzed our experience with urgent pancreatoduodenectomies; special emphases were put on the evaluation of diagnostic means and the validation of existing indications for performance of this procedure. Three hundred one patients who underwent pancreatoduodenectomy between 1989 and 2008 were identified from a pancreatic resection database and reviewed for emergency indications. Six patients (2%) underwent emergency pancreatoduodenectomy. Indications included endoscopy-related perforation, postoperative complications, and uncontrollable intraduodenal tumor bleeding. Length of stay and occurrence of nonsurgical complications were increased in emergency compared with elective pancreatoduodenectomies. Although increased, no significant differences were found regarding mortality and surgery-related complications. Indications for emergency pancreatoduodenectomies were based on clinical decisions rather than on radiologic diagnostics. Urgent pancreatic head resections may be considered as an option in selected patients if handling of local complications by interventional measures or limited surgery seems unsafe.

Beam-Based Procedures for RF Guns

CERN Document Server

Krasilnikov, Mikhail; Grabosch, H J; Hartrott, Michael; Hui Han, Jang; Miltchev, Velizar; Oppelt, Anne; Petrosyan, Bagrat; Staykov, Lazar; Stephan, Frank

2005-01-01

A wide range of rf photo injector parameters has to be optimized in order to achieve an electron source performance as required for linac based high gain FELs. Some of the machine parameters can not be precisely controlled by direct measurements, whereas the tolerance on them is extremely tight. Therefore, this should be met with beam-based techniques. Procedures for beam-based alignment (BBA) of the laser on the photo cathode as well as solenoid alignment have been developed. They were applied at the Photo Injector Test facility at DESY Zeuthen (PITZ) and at the photo injector of the VUV-FEL at DESY Hamburg. A field balance of the accelerating mode in the 1 ½ cell gun cavity is one of the key beam dynamics issues of the rf gun. Since no direct field measurement in the half and full cell of the cavity is available for the PITZ gun, a beam-based technique to determine the field balance has been proposed. A beam-based rf phase monitoring procedure has been developed as well.

Design of the measurements validation procedure and the expert system architecture for a cogeneration internal combustion engine

International Nuclear Information System (INIS)

Barelli, L.; Bidini, G.

2005-01-01

A research activity has been initiated to study the development of a diagnostic methodology, for the optimization of energy efficiency and the maximization of the operational time in those conditions, based on artificial intelligence (AI) techniques such as artificial neural network (ANN) and fuzzy logic. The diagnostic procedure, developed specifically for the cogeneration plant located at the Engineering Department of the University of Perugia, must be characterized by a modular architecture to obtain a flexible architecture applicable to different systems. The first part of the study deals with the identifying the principal modules and the corresponding variables necessary to evaluate the module 'health state'. Also the consequent upgrade of the monitoring system is described in this paper. Moreover it describes the structure proposed for the diagnostic procedure, consisting of a procedure for measurement validation and a fuzzy logic-based inference system. The first reveals the presence of abnormal conditions and localizes their source distinguishing between system failure and instrumentation malfunctions. The second provides an evaluation of module health state and the classification of the failures which have possibly occurred. The procedure was implemented in C++

Does a pre-treatment diagnostic interview affect the outcome of internet-based self-help for social anxiety disorder? a randomized controlled trial.

Science.gov (United States)

Boettcher, Johanna; Berger, Thomas; Renneberg, Babette

2012-10-01

Numerous studies suggest that Internet-based self-help treatments are effective in treating anxiety disorders. Trials evaluating such interventions differ in their screening procedures and in the amount of clinician contact in the diagnostic assessment phase. The present study evaluates the impact of a pre-treatment diagnostic interview on the outcome of an Internet-based treatment for Social Anxiety Disorder (SAD). One hundred and nine participants seeking treatment for SAD were randomized to either an interview-group (IG, N = 53) or to a non-interview group (NIG, N = 56). All participants took part in the same 10-week cognitive-behavioural unguided self-help programme. Before receiving access to the programme, participants of the IG underwent a structured diagnostic interview. Participants of the NIG started directly with the programme. Participants in both groups showed significant and substantial improvement on social anxiety measures from pre- to post-assessment (d IG = 1.30-1.63; d NIG = 1.00-1.28) and from pre- to 4-month follow-up assessment (d IG = 1.38-1.87; d NIG = 1.10-1.21). Significant between-groups effects in favour of the IG were found on secondary outcome measures of depression and general distress (d = 0.18-0.42). These findings suggest that Internet-based self-help is effective in treating SAD, whether or not a diagnostic interview is involved. However, the pre-treatment interview seems to facilitate change on secondary outcomes such as depression and general distress.

Application of diagnostic reference levels in medical practice

Energy Technology Data Exchange (ETDEWEB)

Bourguignon, Michel [Faculty of Medicine of Paris, Deputy Director General, Nuclear Safety Authority (ASN), Paris (France)

2006-07-01

Diagnosis reference levels (D.R.L.) are defined in the Council Directive 97/43 EURATOM as 'Dose levels in medical radio diagnosis practices or in the case of radiopharmaceuticals, levels of activity, for typical examinations for groups of standards-sized patients or standards phantoms for broadly defined types of equipment. These levels are expected not to be exceeded for standard procedures when good and normal practice regarding diagnostic and technical performance is applied'. Thus D.R.L. apply only to diagnostic procedures and does not apply to radiotherapy. Radiation protection of patients is based on the application of 2 major radiation protection principles, justification and optimization. The justification principle must be respected first because the best way to protect the patient is not to carry a useless test. Radiation protection of the patient is a continuous process and local dose indicator values in the good range should not prevent the radiologist or nuclear medicine physician to continue to optimize their practice. (N.C.)

Application of diagnostic reference levels in medical practice

International Nuclear Information System (INIS)

Bourguignon, Michel

2006-01-01

Diagnosis reference levels (D.R.L.) are defined in the Council Directive 97/43 EURATOM as 'Dose levels in medical radio diagnosis practices or in the case of radiopharmaceuticals, levels of activity, for typical examinations for groups of standards-sized patients or standards phantoms for broadly defined types of equipment. These levels are expected not to be exceeded for standard procedures when good and normal practice regarding diagnostic and technical performance is applied'. Thus D.R.L. apply only to diagnostic procedures and does not apply to radiotherapy. Radiation protection of patients is based on the application of 2 major radiation protection principles, justification and optimization. The justification principle must be respected first because the best way to protect the patient is not to carry a useless test. Radiation protection of the patient is a continuous process and local dose indicator values in the good range should not prevent the radiologist or nuclear medicine physician to continue to optimize their practice. (N.C.)

The Effect of the Extinction Procedure in Function-Based Intervention

Science.gov (United States)

Janney, Donna M.; Umbreit, John; Ferro, Jolenea B.; Liaupsin, Carl J.; Lane, Kathleen L.

2013-01-01

In this study, we examined the contribution of the extinction procedure in function-based interventions implemented in the general education classrooms of three at-risk elementary-aged students. Function-based interventions included antecedent adjustments, reinforcement procedures, and function-matched extinction procedures. Using a combined ABC…

Computer-based diagnostic decisionmaking.

Science.gov (United States)

Miller, R A

1987-12-01

The three decisionmaking aids described by the authors attack the generic problem of "see no evil, hear no evil, speak no evil"--improving the detection, diagnosis, and therapy of psychiatric disorders in the primary care setting. The three systems represent interventions at different steps in the process of providing appropriate care to psychiatric patients. The DSPW system of Robins and Marcus offers the potential of increasing the recognition of psychiatric disease in the physician's office. Politser's IDS program is representative of the sort of sophisticated microcomputer-based decisionmaking support tools that will become available to physicians in the not-too-distant future. Erdman's study of the impact of explanation capabilities on the acceptability of therapy recommending systems points out the need for careful scientific evaluations of features added to diagnostic and therapeutic systems.

Diagnostic and therapeutic peroral cholangioscopy

Directory of Open Access Journals (Sweden)

Jong Ho Moon

2012-01-01

Full Text Available Peroral cholangioscopy (POC provides direct visualization of the bile duct and facilitates diagnostic or therapeutic intervention. The currently available single-operator POC systems are "Mother-baby" scope system, SpyGlass direct visualization system, and direct POC using a regular ultra-slim upper endoscope. Direct POC using an ultra-slim upper endoscope having a larger 2-mm working channel can provide a valuable and economic solution for evaluating bile-duct lesions. Main diagnostic procedures under direct POC are visual characterization and optically guided target biopsy for the indeterminate bile duct lesion. Image-enhanced endoscopy such as narrow-band imaging has shown promise for more detailed evaluation of mucosal abnormality and can be performed under direct POC. Intracorporeal lithotripsy such as electrohydraulic lithotripsy or laser lithotripsy is a main therapeutic intervention of direct POC for patients with bile duct stones that are resistant to conventional endoscopic stone-removal procedures. Besides, tumor ablation therapy, such as photodynamic therapy and argon plasma coagulation may be also performed using direct POC. Further developments of the endoscope and specialized accessories or devices are expected to facilitate diagnostic and therapeutic role of this cholangioscopic procedure.

Divergence-based tests for model diagnostic

Czech Academy of Sciences Publication Activity Database

Hobza, Tomáš; Esteban, M. D.; Morales, D.; Marhuenda, Y.

2008-01-01

Roč. 78, č. 13 (2008), s. 1702-1710 ISSN 0167-7152 R&D Projects: GA MŠk 1M0572 Grant - others:Instituto Nacional de Estadistica (ES) MTM2006-05693 Institutional research plan: CEZ:AV0Z10750506 Keywords : goodness of fit * devergence statistics * GLM * model checking * bootstrap Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 0.445, year: 2008 http://library.utia.cas.cz/separaty/2008/SI/hobza-divergence-based%20tests%20for%20model%20diagnostic.pdf

Quality control in diagnostic radiology - patient dosimetry

Energy Technology Data Exchange (ETDEWEB)

Prlic, I; Radalj, Z; Brumen, V; Cerovac, H [Institute for Medical Research and Occupational Health, Laboratory for Radiation Protection and Dosimetry, Zagreb (Croatia); Gladic, J [Institute for Physics, Laboratory for Solid State Physics, Zagreb (Croatia); Tercek, V [Clinical Hospital Sisters of Mercy, Health Physics Department, Zagreb (Croatia)

1997-12-31

In order to establish the Quality Criteria for diagnostic radiographic images in the radiology departments in Republic of Croatia we have started the several Quality Control projects on the field. The measurements are performed according to some methodology recommendations in our law but the methodology, measurement principles, measurement equipment, phantoms, measurable parameters for the good use by radiographers, statistical and numerical evaluation, dosimetric philosophy etc. where first recognized as a private/or group hazard of each person involved in the procedure of evaluation of diagnostic radiology images/diagnosis. The important quality elements of the imaging process are: the diagnostic quality of the radiographic image, the radiation dose to the patient and the choice of the radiographic technique. This depends on the x-ray unit (tube) radiation quality, image processing quality and final image evaluation quality. In this paper we will show how the Quality Control measurements can be easily connected to the dose delivered to the patient for the known diagnostic procedure and how this can be used by radiographers in their daily work. The reproducibility of the x-ray generator was checked before the service calibration and after the service calibration. The table of kV dependence and output dose per mAs was calculated and the ESD (entrance surface dose) was measured/calculated for the specific diagnostic procedure. After the phantom calculation were made and the dose prediction for the given procedure was done, measurements were done on the patients (digital dosemeters, TLD and film dosemeter combinations). We are claiming that there is no need to measure each patient if the proper Quality Control measurements are done and the proper table of ESD for each particular x-ray tube in diagnostic departments is calculated for the radiographers daily use. (author). 1 example, 1 fig., 13 refs.

Plasmon-Based Colorimetric Nanosensors for Ultrasensitive Molecular Diagnostics.

Science.gov (United States)

Tang, Longhua; Li, Jinghong

2017-07-28

Colorimetric detection of target analytes with high specificity and sensitivity is of fundamental importance to clinical and personalized point-of-care diagnostics. Because of their extraordinary optical properties, plasmonic nanomaterials have been introduced into colorimetric sensing systems, which provide significantly improved sensitivity in various biosensing applications. Here we review the recent progress on these plasmonic nanoparticles-based colorimetric nanosensors for ultrasensitive molecular diagnostics. According to their different colorimetric signal generation mechanisms, these plasmonic nanosensors are classified into two categories: (1) interparticle distance-dependent colorimetric assay based on target-induced forming cross-linking assembly/aggregate of plasmonic nanoparticles; and (2) size/morphology-dependent colorimetric assay by target-controlled growth/etching of the plasmonic nanoparticles. The sensing fundamentals and cutting-edge applications will be provided for each of them, particularly focusing on signal generation and/or amplification mechanisms that realize ultrasensitive molecular detection. Finally, we also discuss the challenge and give our future perspective in this emerging field.

Symptom based diagnostic system using artificial neural networks

International Nuclear Information System (INIS)

Santosh; Vinod, Gopika; Saraf, R.K.

2003-01-01

Nuclear power plant experiences a number of transients during its operations. In case of such an undesired plant condition generally known as an initiating event, the operator has to carry out diagnostic and corrective actions. The operator's response may be too late to mitigate or minimize the negative consequences in such scenarios. The objective of this work is to develop an operator support system based on artificial neural networks that will assist the operator to identify the initiating events at the earliest stages of their developments. A symptom based diagnostic system has been developed to investigate the initiating events. Neutral networks are utilized for carrying out the event identification by continuously monitoring process parameters. Whenever an event is detected, the system will display the necessary operator actions along with the initiating event. The system will also show the graphical trend of process parameters that are relevant to the event. This paper describes the features of the software that is used to monitor the reactor. (author)

Evaluation of diagnostic procedures in nuclear medicine services of Pernambuco and Alagoas states - Brazil

International Nuclear Information System (INIS)

Silva, Ricardo Braz F. da; Hazin, Clovis A.

2011-01-01

The medical use of ionizing radiation contributes significantly to population exposure to radiation. This study aimed to evaluate the diagnostic procedures carried out in nuclear medicine (SMN) in Pernambuco and Alagoas in order to gather data to subsidize the proposal of reference levels for nuclear medicine in Brazil. Data were collected of the SMN in Pernambuco and Alagoas in the period of 2005 to 2009, according by UNSCEAR. The study used data from IBGE. The results showed that the total number of examinations in the period 2005 to 2009 was 34.828 in Pernambuco and 27.700 in Alagoas, corresponding to 6.966 and 5.540 average annual examinations in Pernambuco and Alagoas, respectively. The total number of examinations performed in both states in 2009 was twice the number carried out in 2005. Scintigraphy is the cardiovascular examination most performed in both states, followed by bone scintigraphy. Tc-99m is the radionuclide used most often, followed by I-131. The number of tests using Tc-99m in 2009 doubled when compared with the examinations performed in 2005. The results indicate that there has been a significant increase in the number of examinations in MN, and that females outnumber males, as far as the use of this diagnostic resource is concerned. The study of the activities of the radionuclides administered to patients in the states of Pernambuco and Alagoas showed that they are high when compared to the values recommended by the IAEA in its Safety Report Series Document No. 40. (author)

Rak piersi w ciąży - odmienności procesu diagnostyki i leczenia = Breast cancer during pregnancy - differences in diagnostic and treatment procedures

Directory of Open Access Journals (Sweden)

Magdalena Sowa

2016-09-01

- differences in diagnostic and treatment procedures Abstract Introduction: Breast cancer during pregnancy is relatively rare. There has been an increasing trend for young women to delay childbearing for the last ten years. Presently the average age of first-time mothers is 30. Age is one of the factors increasing the risk of breast cancer. The defined clinical situation will appear more often considering the fact that women delay their motherhood where as the average age of breast cancer decreases. Objective: The purpose of this article is to present different diagnostic and treatment procedures of breast cancer diagnosed during pregnancy. Main text: The analysis of epidemiological data points the fact breast cancer is the most often appearing one in pregnant women. The fact that physiological changes in females during pregnancy first weeks may mask cancer is particularly dangerous and may essentially delay diagnostic procedures. Cancer diagnosed during pregnancy is always a traumatic and stressful situation for a woman and her family that is why its diagnostic and treatment procedures are considerably individualized whereas the maximum terapeutical effect with the protection of an unbornchild is the priority of activities. Summary: Therapeutic decisions are made after a review of a health condition of a patient, the extent of spread of cancer, gestational age and demands of the patient and her family. In the article, undertaking a literature review, alternative breast cancer diagnostic and treatment procedures during pregnancy were discussed in details.   Key words: brest cancer, pregnancy, diagnostics procedures, treatment

Medical Physics Staffing Needs in Diagnostic Imaging and Radionuclide Therapy: An Activity Based Approach [Endorsed by International Organization for Medical Physics

International Nuclear Information System (INIS)

2018-01-01

Over the last decades, the rapid technological development of diagnostic and interventional radiology and nuclear medicine has made them major tools of modern medicine. However, at the same time the involved risks, the growing number of procedures and the increasing complexity of the procedures require competent professional staff to ensure safe and effective patient diagnosis, treatment and management. Medical physicists (or clinically qualified medical physicists) have been recognized as vital health professionals with important and clear responsibilities related to quality and safety of applications of ionizing radiation in medicine. This publication describes an algorithm developed to determine the recommended staffing levels for clinical medical physics services in medical imaging and radionuclide therapy, based on current best practice, as described in international guidelines.

Evaluating the diagnostic device DETEC-PC for the thyroid uptakes

International Nuclear Information System (INIS)

Alonso Abad, Dolores; Arista Romeu, Eduardo; Alonso Abad, Ariel

2008-01-01

A study is presented for evaluating the diagnostic capacity of the DETEC-PC, detection measurement system for the Thyroid Uptakes. A clinical trial was designed for that effect and all the patients included were evaluated using the DETEC-PC and the well-known radioimmunoassay (RIA) standard diagnostic procedure known by acronym RIA. For the Thyroid Uptakes using the DETEC-PC patients received an oral administration of a solution of radioactive iodine. The radioactive substance is attracted chemically to the gland and ionising radiation detector captures their emissions. The iodine concentration in the Thyroid, as well as the variation of this concentration over time reflects the function of the gland. The RIA is based on the analysis of the values associated with the t3, t4 and tsh hormones, and when these three parameters are in a certain range the patients can be classified. The sample size was calculated in order to estimate the gross coincidence percent between both methods with a precision of 1 % at a confidence level of 95%. In total 110 patients were included in the trial. Mainly two types of statistical analysis were carried out, in the first analysis all the patients included in the study were considered whereas in the second analysis the patients with doubtful RIA results were not included. Ideally the performance of a diagnostic tool is evaluated through the estimation of its sensitivity and specificity. Nevertheless, in the present study the reference procedure (RIA) can not be considered a gold standard diagnostic device. In such a setting the international regulations advise to use measurements of agreement to evaluate the diagnostic capacity of the new method. In the present study we evaluated the level of diagnostic agreement between the DETEC-PC and the RIA using the Kappa statistics. Additionally, the confidence interval for the Kappa statistics and the corresponding significant test for the present of agreement were also computes. The obtained

Anesthesia for radiologic procedures

International Nuclear Information System (INIS)

Forestner, J.E.

1987-01-01

Anesthetic techniques for neurodiagnostic studies and radiation therapy have been recently reviewed, but anesthetic involvement in thoracic and abdominal radiology has received little attention. Patient reactions to radiologic contrast media may be of concern to the anesthesiologist, who is often responsible for injecting these agents during diagnostic procedures, and thus is included in this discussion. Finally, the difficulties of administering anesthesia for magnetic resonance imaging (MRI) scans are outlined, in an effort to help anesthesiologist to anticipate problems with this new technologic development. Although there are very few indications for the use of general anesthesia for diagnostic radiologic studies in adults, most procedures performed with children, the mentally retarded, or the combative adult require either heavy sedation or general anesthesia. In selecting an anesthetic technique for a specific procedure, both the patient's disease process and the requirements of the radiologist must be carefully balanced

Gonad shielding in diagnostic radiology

International Nuclear Information System (INIS)

Anon.

1975-01-01

The use of gonad shielding is an important radiation protection technique, intended to reduce unnecessary x-ray exposure of the gonads of patients from diagnostic x-ray procedures. The types of gonad shields in use are discussed as are the types of diagnostic examinations that should include gonad shielding. It was found that when properly used, most shields provided substantial gonad dose reductions

A retrospective study of relevant diagnostic procedures in vulvodynia

DEFF Research Database (Denmark)

Petersen, Christina Damsted; Kristensen, Ellids; Lundvall, Lene

2009-01-01

OBJECTIVE: To identify objective clinical signs of vulvodynia and determine specific diagnostic tests for vulvodynia in women referred to a vulvar outpatient clinic for vulval complaints. STUDY DESIGN: A retrospective study was performed of the medical records of 201 consecutive Danish patients s...

Advantages of digital imaging for radiological diagnostic

International Nuclear Information System (INIS)

Trapero, M. A.; Gonzalez, S.; Albillos, J. C.; Martel, J.; Rebollo, M.

2006-01-01

The advantages and limitations of radiological digital images in comparison with analogic ones are analyzed. We discuss three main topics: acquisition, post-procedure manipulation, and visualization, archive and communication. Digital acquisition with computed radiology systems present a global sensitivity very close to conventional film for diagnostic purposes. However, flat panel digital systems seems to achieve some advantages in particular clinical situations. A critical issue is the radiation dose-reduction that can be accomplished without reducing image quality nor diagnostic exactitude. The post-procedure manipulation allows, particularly in multiplanar modalities like CT or MR, to extract all implicit diagnostic information in the images: Main procedures are multiplanar and three-dimensional reformations, dynamic acquisitions, functional studies and image fusion. The use of PACS for visualization, archive and communication of images, improves the effectiveness and the efficiency of the workflow, allows a more comfortable diagnosis for the radiologist and gives way to improvements in the communication of images, allowing tele consulting and the tele radiology. (Author) 6 refs

Development of electromagnetic induction diagnostics technology for condition based maintenance

International Nuclear Information System (INIS)

Mawatari, Shingo; Oeda, Kaoru; Yatogi, Hideo; Fukuchi, Taira; Ueno, Tadashi

2008-01-01

In ROKKASHO Reprocessing Plant (below, called 'RRP'), we have applied Condition Based Maintenance to rotating equipment with vibration diagnostics technology. However, a few rotating equipment are difficult to diagnose definitely, because have structural problems which exercise vibrational noise to peripheral and be impossible to install vibratory sensor. Electromagnetic induction diagnostics technology which measure magnetic fields to eddy current which is induced to rotary through static magnetic field, diagnose deterioration behavior such as abrasion and crack. As a result, it has possibilities to clear above problems. Therefore, we started our basic researches with this technology for Condition Based Maintenance. In this paper, it introduces basic data about 'Non-seal pump' that have installed in RRP. As a result, this technology is a possibility that be able to detect Condition Based Maintenance. (author)

Design Guidance for Computer-Based Procedures for Field Workers

Energy Technology Data Exchange (ETDEWEB)

Oxstrand, Johanna [Idaho National Lab. (INL), Idaho Falls, ID (United States); Le Blanc, Katya [Idaho National Lab. (INL), Idaho Falls, ID (United States); Bly, Aaron [Idaho National Lab. (INL), Idaho Falls, ID (United States)

2016-09-01

Nearly all activities that involve human interaction with nuclear power plant systems are guided by procedures, instructions, or checklists. Paper-based procedures (PBPs) currently used by most utilities have a demonstrated history of ensuring safety; however, improving procedure use could yield significant savings in increased efficiency, as well as improved safety through human performance gains. The nuclear industry is constantly trying to find ways to decrease human error rates, especially human error rates associated with procedure use. As a step toward the goal of improving field workers’ procedure use and adherence and hence improve human performance and overall system reliability, the U.S. Department of Energy Light Water Reactor Sustainability (LWRS) Program researchers, together with the nuclear industry, have been investigating the possibility and feasibility of replacing current paper-based procedures with computer-based procedures (CBPs). PBPs have ensured safe operation of plants for decades, but limitations in paper-based systems do not allow them to reach the full potential for procedures to prevent human errors. The environment in a nuclear power plant is constantly changing, depending on current plant status and operating mode. PBPs, which are static by nature, are being applied to a constantly changing context. This constraint often results in PBPs that are written in a manner that is intended to cover many potential operating scenarios. Hence, the procedure layout forces the operator to search through a large amount of irrelevant information to locate the pieces of information relevant for the task and situation at hand, which has potential consequences of taking up valuable time when operators must be responding to the situation, and potentially leading operators down an incorrect response path. Other challenges related to use of PBPs are management of multiple procedures, place-keeping, finding the correct procedure for a task, and relying

Design Transformations for Rule-based Procedural Modeling

KAUST Repository

Lienhard, Stefan; Lau, Cheryl; Mü ller, Pascal; Wonka, Peter; Pauly, Mark

2017-01-01

We introduce design transformations for rule-based procedural models, e.g., for buildings and plants. Given two or more procedural designs, each specified by a grammar, a design transformation combines elements of the existing designs to generate new designs. We introduce two technical components to enable design transformations. First, we extend the concept of discrete rule switching to rule merging, leading to a very large shape space for combining procedural models. Second, we propose an algorithm to jointly derive two or more grammars, called grammar co-derivation. We demonstrate two applications of our work: we show that our framework leads to a larger variety of models than previous work, and we show fine-grained transformation sequences between two procedural models.

Design Transformations for Rule-based Procedural Modeling

KAUST Repository

Lienhard, Stefan

2017-05-24

We introduce design transformations for rule-based procedural models, e.g., for buildings and plants. Given two or more procedural designs, each specified by a grammar, a design transformation combines elements of the existing designs to generate new designs. We introduce two technical components to enable design transformations. First, we extend the concept of discrete rule switching to rule merging, leading to a very large shape space for combining procedural models. Second, we propose an algorithm to jointly derive two or more grammars, called grammar co-derivation. We demonstrate two applications of our work: we show that our framework leads to a larger variety of models than previous work, and we show fine-grained transformation sequences between two procedural models.

Diagnostic markers of urothelial cancer based on DNA methylation analysis

International Nuclear Information System (INIS)

Chihara, Yoshitomo; Hirao, Yoshihiko; Kanai, Yae; Fujimoto, Hiroyuki; Sugano, Kokichi; Kawashima, Kiyotaka; Liang, Gangning; Jones, Peter A; Fujimoto, Kiyohide; Kuniyasu, Hiroki

2013-01-01

Early detection and risk assessment are crucial for treating urothelial cancer (UC), which is characterized by a high recurrence rate, and necessitates frequent and invasive monitoring. We aimed to establish diagnostic markers for UC based on DNA methylation. In this multi-center study, three independent sample sets were prepared. First, DNA methylation levels at CpG loci were measured in the training sets (tumor samples from 91 UC patients, corresponding normal-appearing tissue from these patients, and 12 normal tissues from age-matched bladder cancer-free patients) using the Illumina Golden Gate methylation assay to identify differentially methylated loci. Next, these methylated loci were validated by quantitative DNA methylation by pyrosequencing, using another cohort of tissue samples (Tissue validation set). Lastly, methylation of these markers was analyzed in the independent urine samples (Urine validation set). ROC analysis was performed to evaluate the diagnostic accuracy of these 12 selected markers. Of the 1303 CpG sites, 158 were hyper ethylated and 356 were hypo ethylated in tumor tissues compared to normal tissues. In the panel analysis, 12 loci showed remarkable alterations between tumor and normal samples, with 94.3% sensitivity and 97.8% specificity. Similarly, corresponding normal tissue could be distinguished from normal tissues with 76.0% sensitivity and 100% specificity. Furthermore, the diagnostic accuracy for UC of these markers determined in urine samples was high, with 100% sensitivity and 100% specificity. Based on these preliminary findings, diagnostic markers based on differential DNA methylation at specific loci can be useful for non-invasive and reliable detection of UC and epigenetic field defect

Diagnostic information management system for the evaluation of medical images

Energy Technology Data Exchange (ETDEWEB)

Higa, Toshiaki; Torizuka, Kanji; Minato, Kotaro; Komori, Masaru; Hirakawa, Akina

1985-04-01

A practical, small and low-cost diagnostic information management system has been developed for a comparative study of various medical imaging procedures, including ordinary radiography, X-ray computed tomography, emission computed tomography, and so forth. The purpose of the system is to effectively manage the original image data files and diagnostic descriptions during the various imaging procedures. A diagnostic description of each imaging procedure for each patient is made on a hand-sort punched-card with line-drawings and ordinary medical terminology and then coded and computerized using Index for Roentgen Diagnoses (American College of Radiology). A database management software (DB Master) on a personal computer (Apple II) is used for searching for patients' records on hand-sort punched-cards and finally original medical images. Discussed are realistic use of medical images and an effective form of diagnostic descriptions.

Diagnostic information management system for the evaluation of medical images

International Nuclear Information System (INIS)

Higa, Toshiaki; Torizuka, Kanji; Minato, Kotaro; Komori, Masaru; Hirakawa, Akina.

1985-01-01

A practical, small and low-cost diagnostic information management system has been developed for a comparative study of various medical imaging procedures, including ordinary radiography, X-ray computed tomography, emission computed tomography, and so forth. The purpose of the system is to effectively manage the original image data files and diagnostic descriptions during the various imaging procedures. A diagnostic description of each imaging procedure for each patient is made on a hand-sort punched-card with line-drawings and ordinary medical terminology and then coded and computerized using Index for Roentgen Diagnoses (American College of Radiology). A database management software (DB Master) on a personal computer (Apple II) is used for searching for patients' records on hand-sort punched-cards and finally original medical images. Discussed are realistic use of medical images and an effective form of diagnostic descriptions. (author)

A Personal Computer as Diagnostic Aid for Strabismus

OpenAIRE

Albicki, A.; Cohen, G.H.; Metz, H.S.

1984-01-01

This paper describes a microcomputer aided strabismus diagnostic system STRABCON. Two goals were achieved: at any time during the diagnostic process a list of plausible disorders are produced, and an optimal procedure for arriving at a final diagnosis is determined. This publication deals primarily with a microcomputer implementation of the STRABCON diagnostic system.

The need for culture sensitive diagnostic procedures

NARCIS (Netherlands)

Zandi, Tekleh; Havenaar, Johan M.; Limburg-Okken, Annechien G.; van Es, Hans; Sidali, Salah; Kadri, Nadia; van den Brink, Wim; Kahn, Rene S.

Objective We examine the procedural validity of a standardized instrument for the diagnosis of psychotic disorders in Morocco. Method Twenty-nine patients from Casablanca, Morocco, with a psychotic or mood disorder were examined using the Comprehensive Assessment of Symptoms and History (CASH) an

A flexible simulator for training an early fault diagnostic system

International Nuclear Information System (INIS)

Marsiletti, M.; Santinelli, A.; Zuenkov, M.; Poletykin, A.

1997-01-01

An early fault diagnostic system has been developed addressed to timely trouble shooting in process plants during any operational modes. The theory of this diagnostic system is related with the usage of learning methods for automatic generation of knowledge bases. This approach enables the conversion of ''cause→effect'' relations into ''effect→possible-causes'' ones. The diagnostic rules are derived from the operation of a plant simulator according to a specific procedure. Flexibility, accuracy and high speed are the major characteristics of the training simulator, used to generate the diagnostic knowledge base. The simulator structure is very flexible, being based on LEGO code but allowing the use of practically any kind of FORTRAN routines (recently also ACSL macros has been introduced) as plant modules: this permits, when needed, a very accurate description of the malfunctions the diagnostic system should ''known''. The high speed is useful to shorten the ''learning'' phase of the diagnostic system. The feasibility of the overall system has been assessed, using as reference plant the conventional Sampierdarena (Italy) power station, that is a combined cycle plant dedicated to produce both electrical and heat power. The hardware configuration of this prototype system was made up of a network of a Hewlett-Packard workstation and a Digital VAX-Station. The paper illustrates the basic structure of the simulator used for this diagnostic system training purpose, as well as the theoretical background on which the diagnostic system is based. Some evidence of the effectiveness of the concept through the application to Sampierdarena 40 MW cogeneration plant is reported. Finally an outline of an ongoing application to a WWER-1000 plant is given; the operating system is, in this case, UNIX. (author)

Towards increase of diagnostic efficacy in gynecologic OCT

Science.gov (United States)

Kirillin, Mikhail; Panteleeva, Olga; Eliseeva, Darya; Kachalina, Olga; Sergeeva, Ekaterina; Dubasova, Lyubov; Agrba, Pavel; Mikailova, Gyular; Prudnikov, Maxim; Shakhova, Natalia

2013-06-01

Gynecologic applications of optical coherence tomography (OCT) are usually performed in combination with routine diagnostic procedures: laparoscopy and colposcopy. In combination with laparoscopy OCT is employed for inspection of fallopian tubes in cases of unrecognized infertility while in colposcopy it is used to identify cervix pathologies including cancer. In this paper we discuss methods for increasing diagnostic efficacy of OCT application in these procedures. For OCT-laparoscopy we demonstrate independent criteria for pathology recognition which allow to increase accuracy of diagnostics. For OCT-colposcopy we report on application of device for controlled compression allowing to sense the elasticity of the inspected cervix area and distinguish between neoplasia and inflammatory processes.

MRI-based diagnostic imaging of the intratemporal facial nerve

International Nuclear Information System (INIS)

Kress, B.; Baehren, W.

2001-01-01

Detailed imaging of the five sections of the full intratemporal course of the facial nerve can be achieved by MRI and using thin tomographic section techniques and surface coils. Contrast media are required for tomographic imaging of pathological processes. Established methods are available for diagnostic evaluation of cerebellopontine angle tumors and chronic Bell's palsy, as well as hemifacial spasms. A method still under discussion is MRI for diagnostic evaluation of Bell's palsy in the presence of fractures of the petrous bone, when blood volumes in the petrous bone make evaluation even more difficult. MRI-based diagnostic evaluation of the idiopatic facial paralysis currently is subject to change. Its usual application cannot be recommended for routine evaluation at present. However, a quantitative analysis of contrast medium uptake of the nerve may be an approach to improve the prognostic value of MRI in acute phases of Bell's palsy. (orig./CB) [de

Degree of vertical integration between the undergraduate program and clinical internship with respect to lumbopelvic diagnostic and therapeutic procedures taught at the canadian memorial chiropractic college.

Science.gov (United States)

Vermet, Shannon; McGinnis, Karen; Boodham, Melissa; Gleberzon, Brian J

2010-01-01

The objective of this study was to determine to what extent the diagnostic and therapeutic procedures taught in the undergraduate program used for patients with lumbopelvic conditions are expected to be utilized by students during their clinical internship program at Canadian Memorial Chiropractic College or are being used by the clinical faculty. A confidential survey was distributed to clinical faculty at the college. It consisted of a list of diagnostic and therapeutic procedures used for lumbopelvic conditions taught at that college. Clinicians were asked to indicate the frequency with which they performed or they required students to perform each item. Seventeen of 23 clinicians responded. The following procedures were most likely required to be performed by clinicians: posture; ranges of motion; lower limb sensory, motor, and reflex testing; and core orthopedic tests. The following were less likely to be required to be performed: Waddell testing, Schober's test, Gillet tests, and abdominal palpation. Students were expected to perform (or clinicians performed) most of the mobilization (in particular, iliocostal, iliotransverse, and iliofemoral) and spinal manipulative therapies (in particular, the procedures referred to as the lumbar roll, lumbar pull/hook, and upper sacroiliac) taught at the college. This study suggests that there was considerable, but not complete, vertical integration between the undergraduate and clinical education program at this college.

Are the classic diagnostic methods in mycology still state of the art?

Science.gov (United States)

Wiegand, Cornelia; Bauer, Andrea; Brasch, Jochen; Nenoff, Pietro; Schaller, Martin; Mayser, Peter; Hipler, Uta-Christina; Elsner, Peter

2016-05-01

The diagnostic workup of cutaneous fungal infections is traditionally based on microscopic KOH preparations as well as culturing of the causative organism from sample material. Another possible option is the detection of fungal elements by dermatohistology. If performed correctly, these methods are generally suitable for the diagnosis of mycoses. However, the advent of personalized medicine and the tasks arising therefrom require new procedures marked by simplicity, specificity, and swiftness. The additional use of DNA-based molecular techniques further enhances sensitivity and diagnostic specificity, and reduces the diagnostic interval to 24-48 hours, compared to weeks required for conventional mycological methods. Given the steady evolution in the field of personalized medicine, simple analytical PCR-based systems are conceivable, which allow for instant diagnosis of dermatophytes in the dermatology office (point-of-care tests). © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Adaptive Technology Application for Vibration-Based Diagnostics of Roller Bearings on Industrial Plants

Directory of Open Access Journals (Sweden)

Mironov Aleksey

2014-09-01

Full Text Available Roller bearings are widely used in equipment of different applications; therefore, the issues related to the assessment of bearing technical state and localization of bearing faults are quite important and relevant. The reason is that technical state of a bearing is a critical component, which determines efficiency of a mechanism or equipment. For bearings inspection and diagnostics, various methods of vibration-based diagnostics are used. The adaptive technology for vibration-based diagnostics developed in „D un D centrs” is an effective tool for evaluation of technical state of bearings in operation compared to the existing SKF method.

X-ray medical diagnostics and thyroid cancer

International Nuclear Information System (INIS)

Tsenova, T.; Chobanova, N.; Pavlova, A; Bajrakova, A.

1998-01-01

An analytical epidemiological study for assessment of X-ray medical diagnosis as a risk factor for thyroid cancer (TC) has been carried out. The data from the investigation of 90 TC cases and 180 controls matched by sex and age are used. The risk assessment is based on the distribution of investigated persons according to thyroid gland irradiation (as an equivalent dose cumulated from the procedures) and the number of different procedures of organs and systems. There is a significantly increased risk for TC from diagnostic lung examinations; fluoroscopy (OR=3.49, 95% CI=1.66±7.39, p=0.0002) and radiography (OR=2.48, 95% CI=1.05±5.86, p=0.02) (author)

Radionuclide diagnostics in St. Petersburg: сurrent status and development challenges

Directory of Open Access Journals (Sweden)

I. A. Zvonova

2015-01-01

Full Text Available This work aims at radionuclide diagnostics analyses in the Russian Federation city of St. Petersburg over 2005–2014. The study covers trends and development challenges , availability of radionuclide diagnostics for population needs, exposure doses for patients.This work aims at radionuclide diagnostics analyses in the Russian Federation city of St. Petersburg over 2005–2014. The study covers trends and development challenges , availability of radionuclide diagnostics for population needs, exposure doses for patients.Materials and methods. The radionuclide diagnostics temporal and structural changes’ analysis was based on Federal state statistical observation forms No.3-DOZ for St. Petersburg and on the results of radionuclide diagnostics subdivision surveys with radiology physicians’ questionnaires on the amount and composition of conducted examinations, dosages of introduced radioactivity of radiopharmaceticals and patients’ doses.The results. Since the end of 1990s until 2012 the amount of radionuclide diagnostics procedures had been steadily reducing. 74000 procedures were conducted in 2005 and 35500 in 2012. The number of radionuclide diagnostics procedures per one thousand residents reduced from 16 to 7.2. Both indicators slightly grew in 2013. In 2014 the total number of radiodiagnostic proceduress amounted up to 42000 and 8.2 tests per 1000 residents. Since 2011 the diagnostic equipment was upgraded. Four medical institutions received SPECT (single photon emission computed tomography or SPECT/CT, two new PET ( positron emission tomographs – centers were set up, three medical institutions had acquired positron emission tomographs (PET and are conducting PET – diagnostics receiving radiofarmaceuticals from external PET – center. At the same time one a third of radiodiagnostic units still has been operating obsolete and depreciated equipment dating back to 1980–1990 .Inspection results indicated that St. Petersburg

Counseling Patients Exposed to Ionizing Radiation in Diagnostic Radiology During Pregnancy

International Nuclear Information System (INIS)

Brnic, Z.; Leder, N.I.; Popic Ramac, J.; Vidjak, V.; Knezevic, Z.

2013-01-01

There are many false assumptions regarding influence of radiation on pregnant patients and fetus during diagnostic procedures in spite of scientific facts based on studies (both in general population and among physicians). These false assumptions are mostly based on the idea that every diagnostic procedure that uses ionizing radiation is a cause for serious concern and consideration for artificial abortion as a possible solution. We have analysed the data of counselling of pregnant patients exposed to ionizing radiation during diagnostic procedures in University Hospital Merkur, during a period of four years. In this period we had 26 patients come in counselling due to exposure to ionizing radiation during pregnancy. Results show that most of these patients have been exposed to radiation between 2nd and 3rd week of gestation (36 %), between 4th and 5th week - 32 %; before 2nd week - 24%; and after 6th week of gestation less than 8 %. Average doses were: up to 0.01 cGy in 46.2 % patients; 0.01 - 0.15 cGy in 19.2 % patients; 0.2 - 1 cGy in 26.9 % and 1 cGy or more in 7.7 % of patients. No one of the counselled patients had a medical indication for abortion, even though in a small percentage of patients abortion was a personal subjective decision. Considering that there are no Croatian guidelines for counselling patients exposed to ionizing radiation during pregnancy, recommendation is to use International Commission on Radiological Protection (ICRP) guidelines for management of pregnant patients exposed to ionizing radiation.(author)

SENDS criteria from the diversification of MAST procedures. Implementation of preoperative simulation

International Nuclear Information System (INIS)

Rieger, B.

2015-01-01

Minimal access spinal technologies (MAST) lead to a diversification of surgical procedures, which requires careful selection of the procedure and outcome monitoring. For a rational selection of the procedure simulation, endoscopy, navigation, decompression and stabilization (SENDS) criteria can be derived from the development of the MAST procedures. Preoperative simulation has diagnostic and therapeutic values. The SENDS criteria can be verified indirectly via outcome control. Biomechanically meaningful diagnostic x-rays of the spinal segment to be surgically treated are currently carried out with the patient in inclination and reclination. Software-related preoperative simulation based on these x-ray images facilitates the selection and implementation of the MAST procedure. For preoperative simulation motion shots are needed in inclination, neutral position and reclination and the dimensions can be obtained using an x-ray ball or a computed tomography (CT) scan. The SENDS criteria are useful because established procedures based on these criteria reach a comparable outcome. Preoperative simulation appears to be a useful selection criterion. Preoperatively it is necessary to collate patient and segment information in order to provide each patient with individualized treatment. So far there is no evidence for a better outcome after preoperative simulation but a reduction of surgery time and intraoperative radiation exposure could already be demonstrated. Minimally invasive methods should be preferred if there is a comparable outcome. The establishment of new procedures has to be accompanied by the maintenance of a spine register. Minimally invasive surgical procedures should be individualized for each patient and segment. Mobility X-ray images should be prepared for use with the preoperative simulation as the information content significantly increases with respect to the MAST procedure. (orig.) [de

40 CFR 85.2222 - On-board diagnostic test procedures.

Science.gov (United States)

2010-07-01

... on-board diagnostic systems on 1996 and newer light-duty vehicles and light-duty trucks shall consist... the unset readiness code(s) in question may be issued a passing certificate without being required to... lit malfunction indicator light (MIL) must be failed, though setting the unset readiness flags in...

PC based diagnostic system for nitrogen production unit of HWP

International Nuclear Information System (INIS)

Lamba, D.S.; Rao, V.C.; Krishnan, S.; Kamaraj, T.; Krishnaswamy, C.

1992-01-01

The plant diagnostic system monitors the input data from local processing unit and tries to diagnose the cause of the failure. The system is a rule based application program that can perform tasks itself using fault tree model which displays the logical relationships between critical events and their possible ways occurrence, i.e. hardware failure, process faults and human error etc. Unit 37 Nitrogen Plant is taken as a prototype model for trying the plant diagnostics system. (author). 3 refs., 2 figs

A WAO - ARIA - GA²LEN consensus document on molecular-based allergy diagnostics.

Science.gov (United States)

Canonica, Giorgio Walter; Ansotegui, Ignacio J; Pawankar, Ruby; Schmid-Grendelmeier, Peter; van Hage, Marianne; Baena-Cagnani, Carlos E; Melioli, Giovanni; Nunes, Carlos; Passalacqua, Giovanni; Rosenwasser, Lanny; Sampson, Hugh; Sastre, Joaquin; Bousquet, Jean; Zuberbier, Torsten

2013-10-03

Molecular-based allergy (MA) diagnostics is an approach used to map the allergen sensitization of a patient at a molecular level, using purified natural or recombinant allergenic molecules (allergen components) instead of allergen extracts. Since its introduction, MA diagnostics has increasingly entered routine care, with currently more than 130 allergenic molecules commercially available for in vitro specific IgE (sIgE) testing.MA diagnostics allows for an increased accuracy in allergy diagnosis and prognosis and plays an important role in three key aspects of allergy diagnosis: (1) resolving genuine versus cross-reactive sensitization in poly-sensitized patients, thereby improving the understanding of triggering allergens; (2) assessing, in selected cases, the risk of severe, systemic versus mild, local reactions in food allergy, thereby reducing unnecessary anxiety for the patient and the need for food challenge testing; and (3) identifying patients and triggering allergens for specific immunotherapy (SIT).Singleplex and multiplex measurement platforms are available for MA diagnostics. The Immuno-Solid phase Allergen Chip (ISAC) is the most comprehensive platform currently available, which involves a biochip technology to measure sIgE antibodies against more than one hundred allergenic molecules in a single assay. As the field of MA diagnostics advances, future work needs to focus on large-scale, population-based studies involving practical applications, elucidation and expansion of additional allergenic molecules, and support for appropriate test interpretation. With the rapidly expanding evidence-base for MA diagnosis, there is a need for allergists to keep abreast of the latest information. The aim of this consensus document is to provide a practical guide for the indications, determination, and interpretation of MA diagnostics for clinicians trained in allergology.

Faults Diagnostics of Railway Axle Bearings Based on IMF’s Confidence Index Algorithm for Ensemble EMD

Science.gov (United States)

Yi, Cai; Lin, Jianhui; Zhang, Weihua; Ding, Jianming

2015-01-01

As train loads and travel speeds have increased over time, railway axle bearings have become critical elements which require more efficient non-destructive inspection and fault diagnostics methods. This paper presents a novel and adaptive procedure based on ensemble empirical mode decomposition (EEMD) and Hilbert marginal spectrum for multi-fault diagnostics of axle bearings. EEMD overcomes the limitations that often hypothesize about data and computational efforts that restrict the application of signal processing techniques. The outputs of this adaptive approach are the intrinsic mode functions that are treated with the Hilbert transform in order to obtain the Hilbert instantaneous frequency spectrum and marginal spectrum. Anyhow, not all the IMFs obtained by the decomposition should be considered into Hilbert marginal spectrum. The IMFs’ confidence index arithmetic proposed in this paper is fully autonomous, overcoming the major limit of selection by user with experience, and allows the development of on-line tools. The effectiveness of the improvement is proven by the successful diagnosis of an axle bearing with a single fault or multiple composite faults, e.g., outer ring fault, cage fault and pin roller fault. PMID:25970256

Sequencing-based breast cancer diagnostics as an alternative to routine biomarkers.

Science.gov (United States)

Rantalainen, Mattias; Klevebring, Daniel; Lindberg, Johan; Ivansson, Emma; Rosin, Gustaf; Kis, Lorand; Celebioglu, Fuat; Fredriksson, Irma; Czene, Kamila; Frisell, Jan; Hartman, Johan; Bergh, Jonas; Grönberg, Henrik

2016-11-30

Sequencing-based breast cancer diagnostics have the potential to replace routine biomarkers and provide molecular characterization that enable personalized precision medicine. Here we investigate the concordance between sequencing-based and routine diagnostic biomarkers and to what extent tumor sequencing contributes clinically actionable information. We applied DNA- and RNA-sequencing to characterize tumors from 307 breast cancer patients with replication in up to 739 patients. We developed models to predict status of routine biomarkers (ER, HER2,Ki-67, histological grade) from sequencing data. Non-routine biomarkers, including mutations in BRCA1, BRCA2 and ERBB2(HER2), and additional clinically actionable somatic alterations were also investigated. Concordance with routine diagnostic biomarkers was high for ER status (AUC = 0.95;AUC(replication) = 0.97) and HER2 status (AUC = 0.97;AUC(replication) = 0.92). The transcriptomic grade model enabled classification of histological grade 1 and histological grade 3 tumors with high accuracy (AUC = 0.98;AUC(replication) = 0.94). Clinically actionable mutations in BRCA1, BRCA2 and ERBB2(HER2) were detected in 5.5% of patients, while 53% had genomic alterations matching ongoing or concluded breast cancer studies. Sequencing-based molecular profiling can be applied as an alternative to histopathology to determine ER and HER2 status, in addition to providing improved tumor grading and clinically actionable mutations and molecular subtypes. Our results suggest that sequencing-based breast cancer diagnostics in a near future can replace routine biomarkers.

Cancer physics: diagnostics based on damped cellular elastoelectrical vibrations in microtubules.

Science.gov (United States)

Pokorný, Jiří; Vedruccio, Clarbruno; Cifra, Michal; Kučera, Ondřej

2011-06-01

This paper describes a proposed biophysical mechanism of a novel diagnostic method for cancer detection developed recently by Vedruccio. The diagnostic method is based on frequency selective absorption of electromagnetic waves by malignant tumors. Cancer is connected with mitochondrial malfunction (the Warburg effect) suggesting disrupted physical mechanisms. In addition to decreased energy conversion and nonutilized energy efflux, mitochondrial malfunction is accompanied by other negative effects in the cell. Diminished proton space charge layer and the static electric field around the outer membrane result in a lowered ordering level of cellular water and increased damping of microtubule-based cellular elastoelectrical vibration states. These changes manifest themselves in a dip in the amplitude of the signal with the fundamental frequency of the nonlinear microwave oscillator-the core of the diagnostic device-when coupled to the investigated cancerous tissue via the near-field. The dip is not present in the case of healthy tissue.

Modern diagnostic procedures in disorders of the thyroid gland

International Nuclear Information System (INIS)

Grebe, S.F.; Mueller, H.

1984-01-01

For functional diagnostics the FT4 index is calculated from the T4 and T3U values. Hyperthyroidism is suggested or borderline values an found, the T3 test is carried out. An index of free iodine hormones (IFIH) can be calculated. (IFIH=T4+30 x T3(μg/100 ml)/ST3U). Hypothyroidism and borderline cases require TSH evaluation or even a TRH test. T4 and T3 autoantibodies can cause high or low values in spite of euthyroidism or hypothyroidism. Difference in FT4 values are found if the kits used were not made by the same manufacturer. These values help to determine hyperthyroidism in pregnancy. The FT3 value is better than the TT3 value in determining T3 hyperthyroidism in borderline cases. Autonomy can be guaranteed by the 123 I short test or the 20-min 99 m Tc uptake test before and after administration of T4. Location diagnostics by scintigraphy after administration of 99 m Tc or radioiodine determine localization, size, shape, and distribution of functioning thyroid tissue and metastases by iodine accumulation. This is imaging of biochemical processes. By ultrasonography, a physical method, cysts, disintegration cysts or parenchymal nodes can be recognized. X-ray films of the trachea can determine stenosis caused by a struma. In addition to the exact proof of an intrathoracal struma (front and back mediastine), a retrotracheal or retroesophageal thyroid gland can be seen in CT. RIA determination of the tumor markers calcitonin and TG support the diagnostics of medullar and follicular or papillary thyroid carcinoma. (orig.) [de

Newborn Congenital Cytomegalovirus Screening Based on Clinical Manifestations and Evaluation of DNA-based Assays for In Vitro Diagnostics.

Science.gov (United States)

Fujii, Tomoyuki; Oka, Akira; Morioka, Ichiro; Moriuchi, Hiroyuki; Koyano, Shin; Yamada, Hideto; Saito, Shigeru; Sameshima, Hiroshi; Nagamatsu, Takeshi; Tsuchida, Shinya; Inoue, Naoki

2017-10-01

To establish a strategy for congenital cytomegalovirus (cCMV) screening and to establish confirmatory assays approved as in vitro diagnostics by the regulatory authorities, we evaluated the clinical risks and performance of diagnostic assays developed by commercial companies, since cCMV infection has significant clinical consequences. Newborns with clinical manifestations considered to be consequences of cCMV infection (n = 575) were screened for the presence of cytomegalovirus (CMV) DNA in urine specimens collected onto filter paper placed in their diapers using the polymerase chain reaction-based assay reported previously. Liquid urine specimens were obtained from all of 20 CMV-positive newborns and 107 of the CMV-negative newborns identified in the screening. We used these 127 specimens, as well as 12 from cCMV cases identified in a previous study and 41 from healthy newborns, to compare the performance of 2 commercial assays and 1 in-house assay. The risk-based screening allowed the identification of cCMV cases at least 10-fold more efficiently than our previous universal screening, although there appears to be a limit to the identification of asymptomatically infected newborns. Although CMV-specific IgM during pregnancy was found frequently in mothers of cCMV newborns, CMV-IgM alone is not an effective diagnostic marker. The urine-filter-based assay and the 3 diagnostic assays yielded identical results. Although risk-based and universal newborn screening strategies for cCMV infection each have their respective advantages and disadvantages, urine-filter-based assay followed by confirmatory in vitro diagnostics assays is able to identify cCMV cases efficiently.

Issues involved in a knowledge-based approach to procedure synthesis

International Nuclear Information System (INIS)

Hajek, B.K.; Khartabil, L.F.; Miller, D.W.

1992-01-01

Many knowledge-based systems (KBSs) have been built to assist human operators in managing nuclear power plant operating functions, such as monitoring, fault diagnosis, alarm filtering, and procedure management. For procedure management, KBSs have been built to display and track existing written procedures or to dynamically follow procedure execution by monitoring plant data and action execution and suggesting recovery steps. More recent works build KBSs able to synthesize procedures. This paper addresses and examines the main issues related to the implementation of on-line procedure synthesis using KBSs. A KBS for procedure synthesis can provide a more robust and effective procedural plan during accidents. Currently existing procedures for abnormal plant conditions, written as precompiled step sets based on the event and symptom approaches, are inherently not robust because anticipation of all potential plant states and associated plant responses is not possible. Thus, their failure recovery capability is limited to the precompiled set. Procedure synthesis has the potential to overcome these two problems because it does not require such precompilation of large sets of plant states and associated recovery procedures. Other benefits obtained from a complete procedure synthesis system are providing (a) a methodology for off-line procedure verification and (b) a methodology for the eventual automation of plant operations

Computer System For Diagnostics of Mobile Machinery Transmission

Directory of Open Access Journals (Sweden)

G. L. Antipenko

2004-01-01

Full Text Available A new method for diagnostics of mechanical transmissions of mobile machinery is proposed in the paper. The method presupposes an application of computing equipment and its purpose is to decrease labor-consumption of diagnostics procedure and increase diagnostics efficiency.The method is based on comparison of duration of impulse periods picked up at primary transducers which are installed at transmission input and output. A signal picked up at a flywheel ring gear is taken as a reference signal.While selecting clearances of one and then the direction in speed-up - braking transmission regime changes in number of reference impulses at output provide data on angular clearance value in every gearing. As data are supplied registration and processing of results and forecasting of residual resource are to be done with the help of a program on the basis of realized algorithms for every gearing.

Diagnostic and interventional radiology

Energy Technology Data Exchange (ETDEWEB)

Vogl, Thomas J. [Klinikum der Johann Wolfgang Goethe-Universitaet, Frankfurt am Main (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Reith, Wolfgang [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Klinik fuer Diagnostische und Interventionelle Neuroradiologie; Rummeny, Ernst J. (ed.) [Technische Univ. Muenchen Klinikum rechts der Isar, Muenchen (Germany). Inst. fuer Radiologie

2016-08-01

This exceptional book covers all aspects of diagnostic and interventional radiology within one volume, at a level appropriate for the specialist. From the basics through diagnosis to intervention: the reader will find a complete overview of all areas of radiology. The clear, uniform structure, with chapters organized according to organ system, facilitates the rapid retrieval of information. Features include: Presentation of the normal radiological anatomy Classification of the different imaging procedures according to their diagnostic relevance Imaging diagnosis with many reference images Precise description of the interventional options The inclusion of many instructive aids will be of particular value to novices in decision making: Important take home messages and summaries of key radiological findings smooth the path through the jungle of facts Numerous tables on differential diagnosis and typical findings in the most common diseases offer a rapid overview and orientation Diagnostic flow charts outline the sequence of diagnostic evaluation All standard procedures within the field of interventional radiology are presented in a clinically relevant and readily understandable way, with an abundance of illustrations. This is a textbook, atlas, and reference in one: with more than 2500 images for comparison with the reader's own findings. This comprehensive and totally up-to-date book provides a superb overview of everything that the radiology specialist of today needs to know.

Application of the Systematic Sensor Selection Strategy for Turbofan Engine Diagnostics

Science.gov (United States)

Sowers, T. Shane; Kopasakis, George; Simon, Donald L.

2008-01-01

The data acquired from available system sensors forms the foundation upon which any health management system is based, and the available sensor suite directly impacts the overall diagnostic performance that can be achieved. While additional sensors may provide improved fault diagnostic performance, there are other factors that also need to be considered such as instrumentation cost, weight, and reliability. A systematic sensor selection approach is desired to perform sensor selection from a holistic system-level perspective as opposed to performing decisions in an ad hoc or heuristic fashion. The Systematic Sensor Selection Strategy is a methodology that optimally selects a sensor suite from a pool of sensors based on the system fault diagnostic approach, with the ability of taking cost, weight, and reliability into consideration. This procedure was applied to a large commercial turbofan engine simulation. In this initial study, sensor suites tailored for improved diagnostic performance are constructed from a prescribed collection of candidate sensors. The diagnostic performance of the best performing sensor suites in terms of fault detection and identification are demonstrated, with a discussion of the results and implications for future research.

Survey of prenatal counselling practices regarding aneuploidy risk modification, invasive diagnostic procedure risks, and procedure eligibility criteria in Canadian centres.

Science.gov (United States)

Hull, Danna; Davies, Gregory; Armour, Christine M

2012-07-01

To explore prenatal practices related to aneuploidy screening, risk modification, and invasive diagnostic procedures across Canadian centres. We conducted a survey of members of the Canadian Association of Genetic Counsellors, the Canadian College of Medical Genetics, and the Canadian Society of Maternal Fetal Medicine, who provide direct counselling or management of prenatal patients in Canada. Eighty-two of 157 respondents indicated that their centre's definition of advanced maternal age was ≥ 35 years, with 33/157 respondents reporting an advanced maternal age definition of ≥ 40 years. The majority of respondents reported that prenatal serum screening for aneuploidy is provincially funded in their province or territory (121/147). The majority of respondents who reported that prenatal screening is not provincially funded (17/147) were from Quebec (14/17). Thirty-nine of 123 respondents reported that their centre defines increased nuchal translucency as ≥ 3.0 mm, whereas 49/123 reported a definition of ≥ 3.5 mm. Sixty-four of 150 respondents reported that the aneuploidy risk provided by serum screening is modified by a soft marker likelihood ratio, whereas 46/150 respondents reported that both age-related and serum screening risks are modified. Fifty-nine of 124 respondents reported that their centre will modify aneuploidy risk after a normal ultrasound; the most commonly cited negative likelihood ratio was 0.5. The most commonly reported procedure-related risk for chorionic villus sampling was 1/100 (123/147) and for amniocentesis was 1/200 (73/142). This study demonstrates inconsistencies in prenatal practices and access to screening programs across Canada. The information gained from this study will inform policy advisors developing prenatal practice guidelines at both the provincial and national levels.

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.

Evolution of diagnostic criteria for gestational diabetes mellitus

DEFF Research Database (Denmark)

Houshmand, Azadeh; Jensen, Dorte Møller; Mathiesen, Elisabeth R

2013-01-01

The establishment of universal diagnostic guidelines for gestational diabetes mellitus has been a long time coming. The lack of consensus and uniformity in procedures for diagnosing this disease has been a problem ever since its existence was recognized. The USA, European countries, and Australia...... criteria for gestational diabetes mellitus, based for the first time on perinatal outcome....... have each developed their own guidelines through the years, all based either on the maternal risk of subsequent diabetes, on arbitrary statistics, or on studies conducted on non-pregnant women. None of these guidelines have been based on risk for perinatal complications. Recently, the Hyperglycemia...

Beam diagnostics based on virtual instrument technology for HLS

International Nuclear Information System (INIS)

Sun Baogen; Lu Ping; Wang Xiaohui; Wang Baoyun; Wang Junhua; Gu Liming; Fang Jia; Ma Tianji

2009-01-01

The paper introduce the beam diagnostics system using virtual instrument technology for Hefei Light Source (HLS), which includes a GPIB bus-based DCCT measurement system to measure the beam DC current and beam life, a VXIbus-based closed orbit measurement system to measure the beam position, a PCIbus-based beam profile measurement system to measure the beam profile and emittance, a GPIB-LAN based bunch length system using photoelectric method, and a Ethernet-based photon beam position measurement system. The software is programmed by LabVIEW, which reduces much developing work. (authors)

Analysis of Chronic Temporomandibular Disorders Based on the Latest Diagnostic Criteria

Directory of Open Access Journals (Sweden)

Svechtarov V.

2015-05-01

Full Text Available The objective of this study is to analyze the distribution of the most common diagnoses observed in patients with chronic temporomandibular disorders, based on the new diagnostic criteria (DC/TMD adopted in 2014. The previous Research Diagnostic Criteria (RDC/TMD adopted in 1992, consisted of three main groups of eight diagnostic subgroups and is currently transformed into two main groups and twelve subgroups, respectively. All subgroups correspond to the nomenclature of the ICD-10. The new clinical diagnostic indices are also modified. The analysis showed a prevalence of Pain-Related TMD compared with that of intra-articular disorders in ratio 57.89% to 42.10%. In Pain-Related TMD arthralgia was represented in 55% of cases; local myalgia - in 12%, myofascial pain - in 18%, myofascial pain with referral - in 14%, headache attributed to TMD - in 1%. In Intra-articular TMD disc displacement with reduction was found in 23% of the cases, disc displacement with reduction with intermittent locking - in 3%, disc displacement without reduction with limited opening - in 25%, disc displacement without reduction and without limited opening - in 8%. Degenerative diseases were found in 14.28%, and hypermobility and subluxations - in 26.98%. These analyzes differ and can only partly be compared with previous analyzes based on RDC system. The changes in the diagnostic criteria require new clinical studies in order to refine the picture of temporomandibular pathology in accordance with the modern views on the matter.

Advanced monitoring, fault diagnostics, and maintenance of cryogenic systems

CERN Document Server

Girone, Mario; Pezzetti, Marco

In this Thesis, advanced methods and techniques of monitoring, fault diagnostics, and predictive maintenance for cryogenic processes and systems are described. In particular, in Chapter 1, mainstreams in research on measurement systems for cryogenic processes are reviewed with the aim of dening key current trends and possible future evolutions. Then, in Chapter 2, several innovative methods are proposed. A transducer based on a virtual ow meter is presented for monitoring helium distribution and consumption in cryogenic systems for particle accelerators [1]. Furthermore, a comprehensive metrological analysis of the proposed transducer for verifying the metrological performance and pointing out most critical uncertainty sources is described [2]. A model-based method for fault detection and early-stage isolation, able to work with few records of Frequency Response Function (FRF) on an unfaulty compressor, is then proposed [3]. To enrich the proposal, a distributed diagnostic procedure, based on a micro-genetic...

The impact of study design and diagnostic approach in a large multi-centre ADHD study. Part 1: ADHD symptom patterns

Directory of Open Access Journals (Sweden)

Roeyers Herbert

2011-04-01

Full Text Available Abstract Background The International Multi-centre ADHD Genetics (IMAGE project with 11 participating centres from 7 European countries and Israel has collected a large behavioural and genetic database for present and future research. Behavioural data were collected from 1068 probands with the combined type of attention deficit/hyperactivity disorder (ADHD-CT and 1446 'unselected' siblings. The aim was to analyse the IMAGE sample with respect to demographic features (gender, age, family status, and recruiting centres and psychopathological characteristics (diagnostic subtype, symptom frequencies, age at symptom detection, and comorbidities. A particular focus was on the effects of the study design and the diagnostic procedure on the homogeneity of the sample in terms of symptom-based behavioural data, and potential consequences for further analyses based on these data. Methods Diagnosis was based on the Parental Account of Childhood Symptoms (PACS interview and the DSM-IV items of the Conners' teacher questionnaire. Demographics of the full sample and the homogeneity of a subsample (all probands were analysed by using robust statistical procedures which were adjusted for unequal sample sizes and skewed distributions. These procedures included multi-way analyses based on trimmed means and winsorised variances as well as bootstrapping. Results Age and proband/sibling ratios differed between participating centres. There was no significant difference in the distribution of gender between centres. There was a significant interaction between age and centre for number of inattentive, but not number of hyperactive symptoms. Higher ADHD symptom frequencies were reported by parents than teachers. The diagnostic symptoms differed from each other in their frequencies. The face-to-face interview was more sensitive than the questionnaire. The differentiation between ADHD-CT probands and unaffected siblings was mainly due to differences in hyperactive

The impact of study design and diagnostic approach in a large multi-centre ADHD study. Part 1: ADHD symptom patterns.

LENUS (Irish Health Repository)

Muller, Ueli C

2011-04-07

Abstract Background The International Multi-centre ADHD Genetics (IMAGE) project with 11 participating centres from 7 European countries and Israel has collected a large behavioural and genetic database for present and future research. Behavioural data were collected from 1068 probands with the combined type of attention deficit\\/hyperactivity disorder (ADHD-CT) and 1446 \\'unselected\\' siblings. The aim was to analyse the IMAGE sample with respect to demographic features (gender, age, family status, and recruiting centres) and psychopathological characteristics (diagnostic subtype, symptom frequencies, age at symptom detection, and comorbidities). A particular focus was on the effects of the study design and the diagnostic procedure on the homogeneity of the sample in terms of symptom-based behavioural data, and potential consequences for further analyses based on these data. Methods Diagnosis was based on the Parental Account of Childhood Symptoms (PACS) interview and the DSM-IV items of the Conners\\' teacher questionnaire. Demographics of the full sample and the homogeneity of a subsample (all probands) were analysed by using robust statistical procedures which were adjusted for unequal sample sizes and skewed distributions. These procedures included multi-way analyses based on trimmed means and winsorised variances as well as bootstrapping. Results Age and proband\\/sibling ratios differed between participating centres. There was no significant difference in the distribution of gender between centres. There was a significant interaction between age and centre for number of inattentive, but not number of hyperactive symptoms. Higher ADHD symptom frequencies were reported by parents than teachers. The diagnostic symptoms differed from each other in their frequencies. The face-to-face interview was more sensitive than the questionnaire. The differentiation between ADHD-CT probands and unaffected siblings was mainly due to differences in hyperactive

A WAO - ARIA - GA2LEN consensus document on molecular-based allergy diagnostics

DEFF Research Database (Denmark)

Canonica, Giorgio Walter; Ansotegui, Ignacio J; Pawankar, Ruby

2013-01-01

Molecular-based allergy (MA) diagnostics is an approach used to map the allergen sensitization of a patient at a molecular level, using purified natural or recombinant allergenic molecules (allergen components) instead of allergen extracts. Since its introduction, MA diagnostics has increasingly ...

Beam-based alignment and tuning procedures for e+e- collider final focus systems

International Nuclear Information System (INIS)

Bulos, F.; Burke, D.; Helm, R.; Irwin, J.; Odian, A.; Roy, G.; Ruth, R.; Yamamoto

1991-01-01

For future linear colliders, with very small emittances and beam sizes and demanding tolerances on final focus system alignment and magnet errors, it becomes increasingly important to use the beam as a diagnostic tool. The authors report here procedures they have identified and will be implemented in the Final Focus Test Beam at SLAC incorporating (1) quadrupole strength changes, (2) central orbit modifications, (3) spot size measurements, and (4) beam stability monitoring

Research at ITER towards DEMO: Specific reactor diagnostic studies to be carried out on ITER

Energy Technology Data Exchange (ETDEWEB)

Krasilnikov, A. V.; Kaschuck, Y. A.; Vershkov, V. A.; Petrov, A. A.; Petrov, V. G.; Tugarinov, S. N. [Institution Project center ITER, Moscow (Russian Federation)

2014-08-21

In ITER diagnostics will operate in the very hard radiation environment of fusion reactor. Extensive technology studies are carried out during development of the ITER diagnostics and procedures of their calibration and remote handling. Results of these studies and practical application of the developed diagnostics on ITER will provide the direct input to DEMO diagnostic development. The list of DEMO measurement requirements and diagnostics will be determined during ITER experiments on the bases of ITER plasma physics results and success of particular diagnostic application in reactor-like ITER plasma. Majority of ITER diagnostic already passed the conceptual design phase and represent the state of the art in fusion plasma diagnostic development. The number of related to DEMO results of ITER diagnostic studies such as design and prototype manufacture of: neutron and γ–ray diagnostics, neutral particle analyzers, optical spectroscopy including first mirror protection and cleaning technics, reflectometry, refractometry, tritium retention measurements etc. are discussed.

Research at ITER towards DEMO: Specific reactor diagnostic studies to be carried out on ITER

Science.gov (United States)

Krasilnikov, A. V.; Kaschuck, Y. A.; Vershkov, V. A.; Petrov, A. A.; Petrov, V. G.; Tugarinov, S. N.

2014-08-01

In ITER diagnostics will operate in the very hard radiation environment of fusion reactor. Extensive technology studies are carried out during development of the ITER diagnostics and procedures of their calibration and remote handling. Results of these studies and practical application of the developed diagnostics on ITER will provide the direct input to DEMO diagnostic development. The list of DEMO measurement requirements and diagnostics will be determined during ITER experiments on the bases of ITER plasma physics results and success of particular diagnostic application in reactor-like ITER plasma. Majority of ITER diagnostic already passed the conceptual design phase and represent the state of the art in fusion plasma diagnostic development. The number of related to DEMO results of ITER diagnostic studies such as design and prototype manufacture of: neutron and γ-ray diagnostics, neutral particle analyzers, optical spectroscopy including first mirror protection and cleaning technics, reflectometry, refractometry, tritium retention measurements etc. are discussed.

Research at ITER towards DEMO: Specific reactor diagnostic studies to be carried out on ITER

International Nuclear Information System (INIS)

Krasilnikov, A. V.; Kaschuck, Y. A.; Vershkov, V. A.; Petrov, A. A.; Petrov, V. G.; Tugarinov, S. N.

2014-01-01

In ITER diagnostics will operate in the very hard radiation environment of fusion reactor. Extensive technology studies are carried out during development of the ITER diagnostics and procedures of their calibration and remote handling. Results of these studies and practical application of the developed diagnostics on ITER will provide the direct input to DEMO diagnostic development. The list of DEMO measurement requirements and diagnostics will be determined during ITER experiments on the bases of ITER plasma physics results and success of particular diagnostic application in reactor-like ITER plasma. Majority of ITER diagnostic already passed the conceptual design phase and represent the state of the art in fusion plasma diagnostic development. The number of related to DEMO results of ITER diagnostic studies such as design and prototype manufacture of: neutron and γ–ray diagnostics, neutral particle analyzers, optical spectroscopy including first mirror protection and cleaning technics, reflectometry, refractometry, tritium retention measurements etc. are discussed

Prenatal diagnostic procedures used in pregnancies with congenital malformations in 14 regions of Europe.

Science.gov (United States)

Garne, Ester; Loane, Maria; de Vigan, Catherine; Scarano, Gioacchino; de Walle, Hermien; Gillerot, Yves; Stoll, Claude; Addor, Marie-Claude; Stone, David; Gener, Blanca; Feijoo, Maria; Mosquera-Tenreiro, Carmen; Gatt, Miriam; Queisser-Luft, Annette; Baena, Neus; Dolk, Helen

2004-11-01

To investigate outcomes of ultrasound investigations (US) and invasive diagnostic procedures in cases of congenital malformations (CM), and to compare the use of invasive prenatal test techniques (amniocentesis (AC) versus chorionic villus sampling (CVS)) among European populations. Analysis of data from population-based registries of CM. 25 400 cases of CM recorded by 14 EUROCAT registries covering a total population of 1,013,352 births 1995-99. US were performed in 91% of cases, and positively detected CM in 35% of cases. AC was performed in 24% of the cases and CVS in 3% of cases. Thirty-eight percent of invasive tests gave positive results. Fifty-two percent of cases with maternal age > or = 35 years had an invasive test performed compared to 20% of cases with younger mothers. Considerable variation was found between registries in the uptake rate of invasive tests in cases with older maternal age and on the use of invasive tests with only four regions employing CVS techniques in at least a third of the cases having invasive tests. For chromosomal anomalies US gave positive results in 46% of cases with maternal age or = 35 years with US performed. Prenatal US was performed in 91% of all pregnancies with CM but the test was only positive in a third of the cases. There was large regional variation in the uptake rate of invasive tests with maternal age of 35 years or more. For every CVS carried out there were nine AC tests. US is an important tool in the prenatal diagnosis of chromosomal anomalies in Europe. Copyright 2004 John Wiley & Sons, Ltd.

[Diagnostic laparoscopy in acute abdomen].

Science.gov (United States)

Keller, R; Kleemann, M; Hildebrand, P; Roblick, U J; Bruch, H-P

2006-11-01

Acute abdomen is not a disease in itself but a description of a complex of symptoms combined with severe abdominal pain developed within a time frame of less than 24 h. All strategies for the management of acute abdomen underline the need for an interdisciplinary approach to diagnosis and therapy. This requires focused and intelligent use of efficient diagnostic procedures. Diagnostic laparoscopy may be a key to solving the diagnostic dilemma of unspecific acute abdomen. Furthermore, it allows not only direct inspection of the abdominal cavity but also surgical intervention, if needed. In particular the rate of negative laparotomies can be reduced.

Patient and staff doses in fluoroscopically guided invasive diagnostic and interventional urology procedures

International Nuclear Information System (INIS)

Ivanova, D.; Hristova-Popova, J.; Avramova-Cholakova, S.; Deyanova, Ts.; Dobrikov, R.

2015-01-01

Full text: The aim of this study is to evaluate patient and staff doses in fluoroscopically guided invasive diagnostic and interventional urology procedures. All the data were collected in the Emergency Hospital 'N. I. Pirogov'. While recording data for the patients, a real time dosimetry measurement of the medical staff was made. Air kerma-area product (KAP) was recorded for intravenous pyelogram (IVP), percutaneous nephrostomy (PN) and ureteral 'double-J' stenting. Patient data sex, age and weight were also taken. Staff doses were estimated with the system RaySafe i2. It contains four dosimeters, with a wireless connection to a real time display. The dosimeters were worn on the unprotected upper part of the body and measured the personal dose equivalent Hp(10). The mean KAP values for the procedures are: 3.21 Gy.cm 2 for IVP, 10.37 Gy.cm 2 for PN and 4.15 Gy.cm 2 for 'double-J' respectively. The highest staff dose for PN and 'double-J' is received by the urologist (160 μSv and 47.3 μSv, respectively), while for the IVP the radiographer has the highest exposure (20 μSv). Each member of the medical staff was on a different position in respect to the X-ray tube and the patient, which is the main reason for the differences in the staff doses. The variations in the mean patient and staff doses are mostly due to the interventions themselves, their complexity and the individual treatment of every patient. RaySafe i2 is very useful as guideline for making a choice of a better position and in the decreasing of radiation exposure to the staff

Modal-pushover-based ground-motion scaling procedure

Science.gov (United States)

Kalkan, Erol; Chopra, Anil K.

2011-01-01

Earthquake engineering is increasingly using nonlinear response history analysis (RHA) to demonstrate the performance of structures. This rigorous method of analysis requires selection and scaling of ground motions appropriate to design hazard levels. This paper presents a modal-pushover-based scaling (MPS) procedure to scale ground motions for use in a nonlinear RHA of buildings. In the MPS method, the ground motions are scaled to match to a specified tolerance, a target value of the inelastic deformation of the first-mode inelastic single-degree-of-freedom (SDF) system whose properties are determined by the first-mode pushover analysis. Appropriate for first-mode dominated structures, this approach is extended for structures with significant contributions of higher modes by considering elastic deformation of second-mode SDF systems in selecting a subset of the scaled ground motions. Based on results presented for three actual buildings-4, 6, and 13-story-the accuracy and efficiency of the MPS procedure are established and its superiority over the ASCE/SEI 7-05 scaling procedure is demonstrated.

Design and development of AXUV-based soft X-ray diagnostic camera for Aditya Tokamak

International Nuclear Information System (INIS)

Raval, Jayesh V.; Purohit, Shishir; Joisa, Y. Shankara

2015-01-01

The hot tokamak plasma emits Soft X-rays (SXR) in accordance with the temperature and density which are important to be studied. A silicon photo diode array (AXUV16ELG, Opto-diode, USA) based prototype SXR diagnostics is designed and developed for ADITYA tokamak for the study of SXR radial intensity profile, internal disruption (Saw-tooth crash), MHD instabilities. The diagnostic is having an array of 16 detector of millimeter dimension in a linear configuration. Absolute Extreme Ultra Violate (AXUV) detector offers compact size, improved time response with considerably good quantum efficiency in the soft X-ray range (200 eV to 10 keV). The diagnostic is designed in competence with the ADITYA tokamak protocol. The diagnostic design geometry allows detector view the plasma through a slot hole (0.5 cm X 0.05 cm), 10 μm Beryllium foil filter window, cutting off energies below 750 eV. The diagnostic was installed on Aditya vacuum vessel at radial port no 7 enabling the diagnostics to view the core plasma. The spatial resolution designed for diagnostic configuration is 1.3 cm at plasma centre. The signal generated from SXR detector is acquired with a dedicated single board computer based data acquisition system at 50 kHz. The diagnostic took observation for the ohmically heated plasma. The data was then processed to construct spatial and temporal profile of SXR intensity for Aditya plasma. This information was complimentary to the Silicon surface barrier detector (SBD) based array for the same plasma discharge. The cross calibration between the two was considerably satisfactory under the assumptions considered. (author)

Smartphone-Based Mobile Detection Platform for Molecular Diagnostics and Spatiotemporal Disease Mapping.

Science.gov (United States)

Song, Jinzhao; Pandian, Vikram; Mauk, Michael G; Bau, Haim H; Cherry, Sara; Tisi, Laurence C; Liu, Changchun

2018-04-03

Rapid and quantitative molecular diagnostics in the field, at home, and at remote clinics is essential for evidence-based disease management, control, and prevention. Conventional molecular diagnostics requires extensive sample preparation, relatively sophisticated instruments, and trained personnel, restricting its use to centralized laboratories. To overcome these limitations, we designed a simple, inexpensive, hand-held, smartphone-based mobile detection platform, dubbed "smart-connected cup" (SCC), for rapid, connected, and quantitative molecular diagnostics. Our platform combines bioluminescent assay in real-time and loop-mediated isothermal amplification (BART-LAMP) technology with smartphone-based detection, eliminating the need for an excitation source and optical filters that are essential in fluorescent-based detection. The incubation heating for the isothermal amplification is provided, electricity-free, with an exothermic chemical reaction, and incubation temperature is regulated with a phase change material. A custom Android App was developed for bioluminescent signal monitoring and analysis, target quantification, data sharing, and spatiotemporal mapping of disease. SCC's utility is demonstrated by quantitative detection of Zika virus (ZIKV) in urine and saliva and HIV in blood within 45 min. We demonstrate SCC's connectivity for disease spatiotemporal mapping with a custom-designed website. Such a smart- and connected-diagnostic system does not require any lab facilities and is suitable for use at home, in the field, in the clinic, and particularly in resource-limited settings in the context of Internet of Medical Things (IoMT).

Prodiag--a hybrid artificial intelligence based reactor diagnostic system for process faults

International Nuclear Information System (INIS)

Reifman, J.; Wei, T.Y.C.; Vitela, J.E.; Applequist, C. A.; Chasensky, T.M.

1996-01-01

Commonwealth Research Corporation (CRC) and Argonne National Laboratory (ANL) are collaborating on a DOE-sponsored Cooperative Research and Development Agreement (CRADA), project to perform feasibility studies on a novel approach to Artificial Intelligence (Al) based diagnostics for component faults in nuclear power plants. Investigations are being performed in the construction of a first-principles physics-based plant level process diagnostic expert system (ES) and the identification of component-level fault patterns through operating component characteristics using artificial neural networks (ANNs). The purpose of the proof-of-concept project is to develop a computer-based system using this Al approach to assist process plant operators during off-normal plant conditions. The proposed computer-based system will use thermal hydraulic (T-H) signals complemented by other non-T-H signals available in the data stream to provide the process operator with the component which most likely caused the observed process disturbance.To demonstrate the scale-up feasibility of the proposed diagnostic system it is being developed for use with the Chemical Volume Control System (CVCS) of a nuclear power plant. A full-scope operator training simulator representing the Commonwealth Edison Braidwood nuclear power plant is being used both as the source of development data and as the means to evaluate the advantages of the proposed diagnostic system. This is an ongoing multi-year project and this paper presents the results to date of the CRADA phase

Determining procedures for simulation-based training in radiology: a nationwide needs assessment.

Science.gov (United States)

Nayahangan, Leizl Joy; Nielsen, Kristina Rue; Albrecht-Beste, Elisabeth; Bachmann Nielsen, Michael; Paltved, Charlotte; Lindorff-Larsen, Karen Gilboe; Nielsen, Bjørn Ulrik; Konge, Lars

2018-01-09

New training modalities such as simulation are widely accepted in radiology; however, development of effective simulation-based training programs is challenging. They are often unstructured and based on convenience or coincidence. The study objective was to perform a nationwide needs assessment to identify and prioritize technical procedures that should be included in a simulation-based curriculum. A needs assessment using the Delphi method was completed among 91 key leaders in radiology. Round 1 identified technical procedures that radiologists should learn. Round 2 explored frequency of procedure, number of radiologists performing the procedure, risk and/or discomfort for patients, and feasibility for simulation. Round 3 was elimination and prioritization of procedures. Response rates were 67 %, 70 % and 66 %, respectively. In Round 1, 22 technical procedures were included. Round 2 resulted in pre-prioritization of procedures. In round 3, 13 procedures were included in the final prioritized list. The three highly prioritized procedures were ultrasound-guided (US) histological biopsy and fine-needle aspiration, US-guided needle puncture and catheter drainage, and basic abdominal ultrasound. A needs assessment identified and prioritized 13 technical procedures to include in a simulation-based curriculum. The list may be used as guide for development of training programs. • Simulation-based training can supplement training on patients in radiology. • Development of simulation-based training should follow a structured approach. • The CAMES Needs Assessment Formula explores needs for simulation training. • A national Delphi study identified and prioritized procedures suitable for simulation training. • The prioritized list serves as guide for development of courses in radiology.

The graphics-based human interface to the DISYS diagnostic/control guidance system at EBR-2

International Nuclear Information System (INIS)

Edwards, R.M.; Chavez, C.; Kamarthi, S.; Dharap, S.; Lindsay, R.W.; Staffon, J.

1990-01-01

An initial graphics based interface to the real-time DISYS diagnostic system has been developed using the multi-tasking capabilities of the UNIX operating system and X-Windows 11 Xlib graphics library. This system is interfaced to live plant data at the Experimental Breeder Reactor (EBR-2) for the Argon Cooling System of fuel handling operations and the steam plant. The interface includes an intelligent process schematic which highlights problematic components and sensors based on the results of the diagnostic computations. If further explanation of a faulted component is required, the user can call up a display of the diagnostic computations presented in a tree-like diagram. Numerical data on the process schematic and optional diagnostic tree are updated as new real-time data becomes available. The initial X-Windows 11 based interface will be further enhanced using VI Corporation DATAVIEWS graphical data base software. 5 refs., 6 figs

Contribution of 18F-FDG PET in the diagnostic assessment of fever of unknown origin (FUO): a stratification-based meta-analysis

International Nuclear Information System (INIS)

Besson, Florent L.; Chaumet-Riffaud, Philippe; Prigent, Alain; Durand, Emmanuel; Playe, Margot; Noel, Nicolas; Lambotte, Olivier; Goujard, Cecile

2016-01-01

The aim of this study was to quantify the contribution of FDG PET to the diagnostic assessment of fever of unknown origin (FUO), taking into account the diagnostic limitations resulting from the composite nature of this entity. The PubMed/MEDLINE database was searched from 2000 to September 2015. Original articles fulfilling the following criteria were included: (1) FUO as the initial diagnosis, (2) no immunosuppressed or nosocomial condition, (3) final diagnosis not based on PET, (4) a follow-up period specified, (5) adult population, and (6) availability of adapted data for calculation of odds ratios (ORs). ORs were computed for each study and then pooled using a random effects model. Stratification-based sensitivity analyses were finally performed using the following prespecified criteria: (a) study design, (b) PET device, (c) geographic area, and (d) follow-up period. A meta-analysis of the 14 included studies showed that normal PET findings led to an increase in the absolute final diagnostic rate of 36 % abnormal PET findings to an increase of 83 %, corresponding to a pooled OR of 8.94 (95 % CI 4.18 - 19.12, Z = 5.65; p < 0.00001). The design of the studies influenced the results (OR 2.92, 95 % CI 1.00 - 8.53 for prospective studies; OR 18,57, 95 % CI 7.57 - 45.59 for retrospective studies; p = 0.01), whereas devices (dedicated or hybrid), geographic area and follow-up period did not. Abnormal PET findings are associated with a substantially increased final diagnostic rate in FUO. Consequently, FDG PET could be considered for inclusion in the first-line diagnostic work-up of FUO. Further randomized prospective studies with standardized FDG PET procedures are warranted to confirm this first-line position. (orig.)

High-Throughput Array Instrument for DNA-Based Breast Cancer Diagnostics

National Research Council Canada - National Science Library

Swerdlow, Harold

2000-01-01

...) for breast-cancer diagnostics. These methods are based upon large numbers of discrete DNA spots placed on glass microscope slides typically, and hybridized to a probe derived from a tIssue or blood sample...

International differences in health care costs in Europe and the United States: Do these affect the cost-effectiveness of diagnostic strategies for pulmonary embolism?

International Nuclear Information System (INIS)

Erkel, A.R. van; Pattynama, P.M.T.; Hout, W.B. van den

1999-01-01

The aim of this study was to assess whether potential differences in costs for diagnostic procedures and treatment of pulmonary embolism (PE) among European and U. S. hospitals alter the optimal cost-effective diagnostic strategy for PE. A standardized questionnaire was used to obtain cost data for the diagnosis and treatment of PE in participating European and U. S. hospitals. Costs for diagnostic tests and treatment of PE were then calculated in a standardized manner for all participating hospitals, from the hospital perspective. Costs were used in an existing cost-effectiveness analysis (CEA) model to determine the most cost-effective diagnostic strategy in participating hospitals. There were considerable differences in costs for diagnostic and therapeutic procedures for PE among the participating centers. These differences, however, did not affect the most cost-effective strategy based on incremental cost-effectiveness. In all hospitals the most cost-effective strategy appeared to be ultrasound followed by helical CT. International differences in cost of diagnostic and therapeutic procedures certainly exist and should be considered before applying a published CEA. Nevertheless, despite these cost differences, the diagnostic strategy for PE of ultrasound followed by helical CT appears most cost-effective. (orig.)

Systematic construction of qualitative physics-based rules for process diagnostics

International Nuclear Information System (INIS)

Reifman, J.; Wei, T.Y.C.

1995-01-01

A novel first-principles-based expert system is proposed for on-line detection and identification of faulty component candidates during incipient off-normal process operations. The system performs function-oriented diagnostics and can be reused for diagnosing single-component failures in different processes and different plants through the provision of the appropriate process schematics information. The function-oriented and process-independent diagnostic features of the proposed expert system are achieved by constructing a knowledge base containing three distinct types of information, qualitative balance equation rules, functional classification of process components, and the process piping and instrumentation diagram. The various types of qualitative balance equation rules for processes utilizing single-phase liquids are derived and their usage is illustrated through simulation results of a realistic process in a nuclear power plant

Vision based flight procedure stereo display system

Science.gov (United States)

Shen, Xiaoyun; Wan, Di; Ma, Lan; He, Yuncheng

2008-03-01

A virtual reality flight procedure vision system is introduced in this paper. The digital flight map database is established based on the Geographic Information System (GIS) and high definitions satellite remote sensing photos. The flight approaching area database is established through computer 3D modeling system and GIS. The area texture is generated from the remote sensing photos and aerial photographs in various level of detail. According to the flight approaching procedure, the flight navigation information is linked to the database. The flight approaching area vision can be dynamic displayed according to the designed flight procedure. The flight approaching area images are rendered in 2 channels, one for left eye images and the others for right eye images. Through the polarized stereoscopic projection system, the pilots and aircrew can get the vivid 3D vision of the flight destination approaching area. Take the use of this system in pilots preflight preparation procedure, the aircrew can get more vivid information along the flight destination approaching area. This system can improve the aviator's self-confidence before he carries out the flight mission, accordingly, the flight safety is improved. This system is also useful in validate the visual flight procedure design, and it helps to the flight procedure design.

Radiation exposure in diagnostic medicine

International Nuclear Information System (INIS)

Haehnel, S.; Michalczak, H.; Reinoehl-Kompa, S.

1995-01-01

This volume includes the manuscripts of the papers read at the conference as well as a summary and assessment of its results. The scientific discussions were centred upon the following issues: - International surveys and comparisons of rdiation exposures in diagnostic radiology and nuclear medicine, frequency of the individual diagnostic procedures and age distribution of patients examined; - policies and regulations for the radiation protection of patients, charcteristic dosimetric values and practical usefulness of the effective dose concept during medical examinations; - assessments of the relative benefits and risks and measures to reduce the radiation exposure in the light of quality assurance aspects. The main objective of this conference not only was to evaluate the risks from diagnostic radiology and nuclear medicine but also to encourgage a critical analysis and adjustment of examination routines followed in everyday practice. Among the measures recommended were quality assurance, maintenace of international standards, development of guidelines, introduction of standard doses, improved training and professional education of personnel as well as surveys and analyses of certain examination procedures associated with substantial radiation exposure. (orig./MG) [de

Beam-based alignment and tuning procedures for e+e- collider final focus systems

International Nuclear Information System (INIS)

Bulos, F.; Burke, D.; Helm, R.; Irwin, J.; Odian, A.; Roy, G.; Ruth, R.; Yamamoto, N.

1991-05-01

For future linear colliders, with very small emittances and beam sizes and demanding tolerances on final focus system alignment and magnet errors, it becomes increasingly important to use the beam as a diagnostic tool. We report here procedures we have identified and will be implemented in the Final Focus Test Beam at SLAC incorporating (1) quadrupole strength changes, (2) central orbit modifications, (3) spot size measurements, and (4) beam stability monitoring. 3 refs., 4 figs., 3 tabs

Usability test of the ImPRO, computer-based procedure system

International Nuclear Information System (INIS)

Jung, Y.; Lee, J.

2006-01-01

ImPRO is a computer based procedure in both flowchart and success logic tree. It is evaluated on the basis of computer based procedure guidelines. It satisfies most requirements such as presentations and functionalities. Besides, SGTR has been performed with ImPRO to evaluate reading comprehension and situation awareness. ImPRO is a software engine which can interpret procedure script language, so that ImPRO is reliable by nature and verified with formal method. One bug, however, had hidden one year after release, but it was fixed. Finally backup paper procedures can be prepared on the same format as VDU in case of ImPRO failure. (authors)

Nuclear based diagnostics in high-power laser applications

Energy Technology Data Exchange (ETDEWEB)

Guenther, Marc; Sonnabend, Kerstin; Harres, Knut; Otten, Anke; Roth, Markus [TU Darmstadt, Institut fuer Kernphysik, Darmstadt (Germany); Vogt, Karsten; Bagnoud, Vincent [GSI Helmholtzzentrum fuer Schwerionenforschung, Darmstadt (Germany)

2010-07-01

High-power lasers allow focused intensities of >10{sup 18} W/cm{sup 2}. During the laser-solid interaction, an intense relativistic electron current is injected from the plasma into the target. One challenge is to characterize the electron dynamic close to the interaction region. Moreover, next generation high-power laser proton acceleration leads to high proton fluxes, which require novel, nuclear diagnostic techniques. We present an activation-based nuclear pyrometry for the investigation of electrons generated in relativistic laser-solid interactions. We use novel activation targets consisting of several isotopes with different photo-neutron disintegration thresholds. The electrons are decelerated inside the target via bremsstrahlung processes. The high-energy bremsstrahlung induces photo-nuclear reactions. In this energy range no disturbing low energy effects are important. Via the pyrometry the Reconstruction of the absolute yield, spectral and spatial distribution of the electrons is possible. For the characterization of proton beams we present a nuclear activation imaging spectroscopy (NAIS). The diagnostic is based on proton-neutron disintegration reactions of copper stacked in consecutive layers. An autoradiography of copper layers leads to spectrally and spatially reconstruction of the beam profile.

CAD-Based Shielding Analysis for ITER Port Diagnostics

Directory of Open Access Journals (Sweden)

Serikov Arkady

2017-01-01

Full Text Available Radiation shielding analysis conducted in support of design development of the contemporary diagnostic systems integrated inside the ITER ports is relied on the use of CAD models. This paper presents the CAD-based MCNP Monte Carlo radiation transport and activation analyses for the Diagnostic Upper and Equatorial Port Plugs (UPP #3 and EPP #8, #17. The creation process of the complicated 3D MCNP models of the diagnostics systems was substantially accelerated by application of the CAD-to-MCNP converter programs MCAM and McCad. High performance computing resources of the Helios supercomputer allowed to speed-up the MCNP parallel transport calculations with the MPI/OpenMP interface. The found shielding solutions could be universal, reducing ports R&D costs. The shield block behind the Tritium and Deposit Monitor (TDM optical box was added to study its influence on Shut-Down Dose Rate (SDDR in Port Interspace (PI of EPP#17. Influence of neutron streaming along the Lost Alpha Monitor (LAM on the neutron energy spectra calculated in the Tangential Neutron Spectrometer (TNS of EPP#8. For the UPP#3 with Charge eXchange Recombination Spectroscopy (CXRS-core, an excessive neutron streaming along the CXRS shutter, which should be prevented in further design iteration.

CAD-Based Shielding Analysis for ITER Port Diagnostics

Science.gov (United States)

Serikov, Arkady; Fischer, Ulrich; Anthoine, David; Bertalot, Luciano; De Bock, Maartin; O'Connor, Richard; Juarez, Rafael; Krasilnikov, Vitaly

2017-09-01

Radiation shielding analysis conducted in support of design development of the contemporary diagnostic systems integrated inside the ITER ports is relied on the use of CAD models. This paper presents the CAD-based MCNP Monte Carlo radiation transport and activation analyses for the Diagnostic Upper and Equatorial Port Plugs (UPP #3 and EPP #8, #17). The creation process of the complicated 3D MCNP models of the diagnostics systems was substantially accelerated by application of the CAD-to-MCNP converter programs MCAM and McCad. High performance computing resources of the Helios supercomputer allowed to speed-up the MCNP parallel transport calculations with the MPI/OpenMP interface. The found shielding solutions could be universal, reducing ports R&D costs. The shield block behind the Tritium and Deposit Monitor (TDM) optical box was added to study its influence on Shut-Down Dose Rate (SDDR) in Port Interspace (PI) of EPP#17. Influence of neutron streaming along the Lost Alpha Monitor (LAM) on the neutron energy spectra calculated in the Tangential Neutron Spectrometer (TNS) of EPP#8. For the UPP#3 with Charge eXchange Recombination Spectroscopy (CXRS-core), an excessive neutron streaming along the CXRS shutter, which should be prevented in further design iteration.

Advanced Laser-Based Techniques for Gas-Phase Diagnostics in Combustion and Aerospace Engineering.

Science.gov (United States)

Ehn, Andreas; Zhu, Jiajian; Li, Xuesong; Kiefer, Johannes

2017-03-01

Gaining information of species, temperature, and velocity distributions in turbulent combustion and high-speed reactive flows is challenging, particularly for conducting measurements without influencing the experimental object itself. The use of optical and spectroscopic techniques, and in particular laser-based diagnostics, has shown outstanding abilities for performing non-intrusive in situ diagnostics. The development of instrumentation, such as robust lasers with high pulse energy, ultra-short pulse duration, and high repetition rate along with digitized cameras exhibiting high sensitivity, large dynamic range, and frame rates on the order of MHz, has opened up for temporally and spatially resolved volumetric measurements of extreme dynamics and complexities. The aim of this article is to present selected important laser-based techniques for gas-phase diagnostics focusing on their applications in combustion and aerospace engineering. Applicable laser-based techniques for investigations of turbulent flows and combustion such as planar laser-induced fluorescence, Raman and Rayleigh scattering, coherent anti-Stokes Raman scattering, laser-induced grating scattering, particle image velocimetry, laser Doppler anemometry, and tomographic imaging are reviewed and described with some background physics. In addition, demands on instrumentation are further discussed to give insight in the possibilities that are offered by laser flow diagnostics.

Diagnostic imaging in medicine. 2. ed.

International Nuclear Information System (INIS)

Reba, R.C.; Goodenough, D.J.

1984-01-01

This book describes to practitioners the evolutionary progression of new non-invasive diagnostic imaging techniques. The utility of the procedures is also described in a series of state-of-the-art lectures given by outstanding international clinical investigators from NATO countries. Subjects of the papers include the following: advances in source and detector technology, acoustical imaging, NMR and microwave imaging, positron and single photon emission tomography, digital radiography and image processing and display techniques. Fundamental papers describing the theory of non-invasive procedures are included along with papers describing clinical examinations. Examples of utility and studies of diseases of the abdomen and pelvis, heart and lung, and central nervous system are included. Cost-effective and cost-benefit assessment of the new high technology procedures, as well as the use of diagnostic imaging techniques in developing countries are also presented. An index of leading topics completes the volume. (orig.)

Array-based sensing using nanoparticles: an alternative approach for cancer diagnostics.

Science.gov (United States)

Le, Ngoc D B; Yazdani, Mahdieh; Rotello, Vincent M

2014-07-01

Array-based sensing using nanoparticles (NPs) provides an attractive alternative to specific biomarker-focused strategies for cancer diagnosis. The physical and chemical properties of NPs provide both the recognition and transduction capabilities required for biosensing. Array-based sensors utilize a combined response from the interactions between sensors and analytes to generate a distinct pattern (fingerprint) for each analyte. These interactions can be the result of either the combination of multiple specific biomarker recognition (specific binding) or multiple selective binding responses, known as chemical nose sensing. The versatility of the latter array-based sensing using NPs can facilitate the development of new personalized diagnostic methodologies in cancer diagnostics, a necessary evolution in the current healthcare system to better provide personalized treatments. This review will describe the basic principle of array-based sensors, along with providing examples of both invasive and noninvasive samples used in cancer diagnosis.

Midazolam administration at a department of pediatric radiology: Conscious sedation for diagnostic imaging studies

International Nuclear Information System (INIS)

Madzik, J.; Marcinski, A.; Brzewski, M.; Jakubowska, A.; Roik, D.; Majkowska, Z.; Biejat, A.; Krzemien, G.

2006-01-01

The aims of the study were to evaluate the usefulness of midazolam administration for sedation prior to some diagnostic examinations in children and to present the requirements and rules for sedation in departments of pediatric radiology. From Oct. 2001 to Aug. 2005, two hundred children were investigated after conscious sedation with midazolam. The examinations were: voiding cystourethrography (129), voiding sonocystography (64), barium enema (3), ultrasonography (1), urography (1), X-ray of facial bone (1), and brain CT (1). The children's age-range was 4 months to 13 years 9 months. The decision for sedation was based on conversation with the child and/or parents, their experience with previous examinations, emotional status of the child, and exclusion of contraindications (renal insufficiency, hepatic failure, respiratory/circulatory insufficiency, allergy to benzodiazepines in anamnesis). Midazolam was given orally in a dose of 0.5 mg/kg body weight, 15-20 minutes before examination (already at the department of pediatric radiology). The parents were informed of the possible side effects and what to do after the procedure. All diagnostic procedures with conscious sedation were well tolerated by the children and accepted by the parents. The parents with experience from previous diagnostic procedures indicated that they would want their child to have midazolam again if the examination needed to be repeated. No significant complications were observed in the children receiving midazolam and few adverse effect on voiding during cystourethrography. In three children (2.5, 3, and 5 years old), paradoxical reactions occurred (psychomotor agitation) which disappeared spontaneously after some minutes and had no influence on the procedure. Application of midazolam for conscious sedation diminished anxiety and discomfort from diagnostic procedures and short anterograde amnesia protected the child's mind from painful experience. Conscious sedation should be widely used in

Children's exposure to diagnostic medical radiation and cancer risk: epidemiologic and dosimetric considerations

International Nuclear Information System (INIS)

Linet, Martha S.; Rajaraman, Preetha; Kim, Kwang pyo

2009-01-01

While the etiology of most childhood cancers is largely unknown, epidemiologic studies have consistently found an association between exposure to medical radiation during pregnancy and risk of childhood cancer in offspring. The relation between early life diagnostic radiation exposure and occurrence of pediatric cancer risks is less clear. This review summarizes current and historical estimated doses for common diagnostic radiologic procedures as well as the epidemiologic literature on the role of maternal prenatal, children's postnatal and parental preconception diagnostic radiologic procedures on subsequent risk of childhood malignancies. Risk estimates are presented according to factors such as the year of birth of the child, trimester and medical indication for the procedure, and the number of films taken. The paper also discusses limitations of the methods employed in epidemiologic studies to assess pediatric cancer risks, the effects on clinical practice of the results reported from the epidemiologic studies, and clinical and public health policy implications of the findings. Gaps in understanding and additional research needs are identified. Important research priorities include nationwide surveys to estimate fetal and childhood radiation doses from common diagnostic procedures, and epidemiologic studies to quantify pediatric and lifetime cancer risks from prenatal and early childhood exposures to diagnostic radiography, CT, and fluoroscopically guided procedures. (orig.)

Pediatric radiological diagnostics in suspected child abuse

International Nuclear Information System (INIS)

Erfurt, C.; Schmidt, U.; Hahn, G.; Roesner, D.

2009-01-01

Advanced and specialized radiological diagnostics are essential in the case of clinical suspicion of pediatric injuries to the head, thorax, abdomen, and extremities when there is no case history or when ''battered child syndrome'' is assumed on the basis of inadequate trauma. In particular, the aim of this sophisticated diagnostic procedure is the detection of lesions of the central nervous system (CNS) in order to initiate prompt medical treatment. If diagnostic imaging shows typical findings of child abuse, accurate documented evidence of the diagnostic results is required to prevent further endangerment of the child's welfare. (orig.) [de

RANZAR Body Systems Framework of diagnostic imaging examination descriptors

International Nuclear Information System (INIS)

Pitman, Alexander D.; Penlington, Lisa; Doromal, Darren; Vukolova, Natalia; Slater, Gregory

2014-01-01

A unified and logical system of descriptors for diagnostic imaging examinations and procedures is a desirable resource for radiology in Australia and New Zealand and is needed to support core activities of RANZCR. Existing descriptor systems available in Australia and New Zealand (including the Medicare DIST and the ACC Schedule) have significant limitations and are inappropriate for broader clinical application. An anatomically based grid was constructed, with anatomical structures arranged in rows and diagnostic imaging modalities arranged in columns (including nuclear medicine and positron emission tomography). The grid was segregated into five body systems. The cells at the intersection of an anatomical structure row and an imaging modality column were populated with short, formulaic descriptors of the applicable diagnostic imaging examinations. Clinically illogical or physically impossible combinations were ‘greyed out’. Where the same examination applied to different anatomical structures, the descriptor was kept identical for the purposes of streamlining. The resulting Body Systems Framework of diagnostic imaging examination descriptors lists all the reasonably common diagnostic imaging examinations currently performed in Australia and New Zealand using a unified grid structure allowing navigation by both referrers and radiologists. The Framework has been placed on the RANZCR website and is available for access free of charge by registered users. The Body Systems Framework of diagnostic imaging examination descriptors is a system of descriptors based on relationships between anatomical structures and imaging modalities. The Framework is now available as a resource and reference point for the radiology profession and to support core College activities.

RANZCR Body Systems Framework of diagnostic imaging examination descriptors.

Science.gov (United States)

Pitman, Alexander G; Penlington, Lisa; Doromal, Darren; Slater, Gregory; Vukolova, Natalia

2014-08-01

A unified and logical system of descriptors for diagnostic imaging examinations and procedures is a desirable resource for radiology in Australia and New Zealand and is needed to support core activities of RANZCR. Existing descriptor systems available in Australia and New Zealand (including the Medicare DIST and the ACC Schedule) have significant limitations and are inappropriate for broader clinical application. An anatomically based grid was constructed, with anatomical structures arranged in rows and diagnostic imaging modalities arranged in columns (including nuclear medicine and positron emission tomography). The grid was segregated into five body systems. The cells at the intersection of an anatomical structure row and an imaging modality column were populated with short, formulaic descriptors of the applicable diagnostic imaging examinations. Clinically illogical or physically impossible combinations were 'greyed out'. Where the same examination applied to different anatomical structures, the descriptor was kept identical for the purposes of streamlining. The resulting Body Systems Framework of diagnostic imaging examination descriptors lists all the reasonably common diagnostic imaging examinations currently performed in Australia and New Zealand using a unified grid structure allowing navigation by both referrers and radiologists. The Framework has been placed on the RANZCR website and is available for access free of charge by registered users. The Body Systems Framework of diagnostic imaging examination descriptors is a system of descriptors based on relationships between anatomical structures and imaging modalities. The Framework is now available as a resource and reference point for the radiology profession and to support core College activities. © 2014 The Royal Australian and New Zealand College of Radiologists.

Predicting the Uncertain Future of Aptamer-Based Diagnostics and Therapeutics.

Science.gov (United States)

Bruno, John G

2015-04-16

Despite the great promise of nucleic acid aptamers in the areas of diagnostics and therapeutics for their facile in vitro development, lack of immunogenicity and other desirable properties, few truly successful aptamer-based products exist in the clinical or other markets. Core reasons for these commercial deficiencies probably stem from industrial commitment to antibodies including a huge financial investment in humanized monoclonal antibodies and a general ignorance about aptamers and their performance among the research and development community. Given the early failures of some strong commercial efforts to gain government approval and bring aptamer-based products to market, it may seem that aptamers are doomed to take a backseat to antibodies forever. However, the key advantages of aptamers over antibodies coupled with niche market needs that only aptamers can fill and more recent published data still point to a bright commercial future for aptamers in areas such as infectious disease and cancer diagnostics and therapeutics. As more researchers and entrepreneurs become familiar with aptamers, it seems inevitable that aptamers will at least be considered for expanded roles in diagnostics and therapeutics. This review also examines new aptamer modifications and attempts to predict new aptamer applications that could revolutionize biomedical technology in the future and lead to marketed products.

Implementing an ultrasound-based protocol for diagnosingappendicitis while maintaining diagnostic accuracy

International Nuclear Information System (INIS)

Van Atta, Angela J.; Baskin, Henry J.; Maves, Connie K.; Dansie, David M.; Rollins, Michael D.; Bolte, Robert G.; Mundorff, Michael B.; Andrews, Seth P.

2015-01-01

The use of ultrasound to diagnose appendicitis in children is well-documented but not universally employed outside of pediatric academic centers, especially in the United States. Various obstacles make it difficult for institutions and radiologists to abandon a successful and accurate CT-based imaging protocol in favor of a US-based protocol. To describe how we overcame barriers to implementing a US-based appendicitis protocol among a large group of nonacademic private-practice pediatric radiologists while maintaining diagnostic accuracy and decreasing medical costs. A multidisciplinary team of physicians (pediatric surgery, pediatric emergency medicine and pediatric radiology) approved an imaging protocol using US as the primary modality to evaluate suspected appendicitis with CT for equivocal cases. The protocol addressed potential bias against US and accommodated for institutional limitations of radiologist and sonographer experience and availability. Radiologists coded US reports according to the probability of appendicitis. Radiology reports were compared with clinical outcomes to assess diagnostic accuracy. During the study period, physicians from each group were apprised of the interim US protocol accuracy results. Problematic cases were discussed openly. A total of 512 children were enrolled and underwent US for evaluation of appendicitis over a 30-month period. Diagnostic accuracy was comparable to published results for combined US/CT protocols. Comparing the first 12 months to the last 12 months of the study period, the proportion of children achieving an unequivocal US result increased from 30% (51/169) to 53% (149/282) and the proportion of children undergoing surgery based solely on US findings increased from 55% (23/42) to 84% (92/109). Overall, 63% (325/512) of patients in the protocol did not require a CT. Total patient costs were reduced by $30,182 annually. We overcame several barriers to implementing a US protocol. During the study period our

Implementing an ultrasound-based protocol for diagnosingappendicitis while maintaining diagnostic accuracy

Energy Technology Data Exchange (ETDEWEB)

Van Atta, Angela J. [University of Utah School of Medicine, Salt Lake City, UT (United States); Baskin, Henry J.; Maves, Connie K.; Dansie, David M. [Primary Children' s Hospital, Department of Radiology, Salt Lake City, UT (United States); Rollins, Michael D. [University of Utah School of Medicine, Department of Surgery, Division of Pediatric Surgery, Salt Lake City, UT (United States); Bolte, Robert G. [University of Utah School of Medicine, Department of Pediatrics, Division of Pediatric Emergency Medicine, Salt Lake City, UT (United States); Mundorff, Michael B.; Andrews, Seth P. [Primary Children' s Hospital, Systems Improvement, Salt Lake City, UT (United States)

2015-05-01

The use of ultrasound to diagnose appendicitis in children is well-documented but not universally employed outside of pediatric academic centers, especially in the United States. Various obstacles make it difficult for institutions and radiologists to abandon a successful and accurate CT-based imaging protocol in favor of a US-based protocol. To describe how we overcame barriers to implementing a US-based appendicitis protocol among a large group of nonacademic private-practice pediatric radiologists while maintaining diagnostic accuracy and decreasing medical costs. A multidisciplinary team of physicians (pediatric surgery, pediatric emergency medicine and pediatric radiology) approved an imaging protocol using US as the primary modality to evaluate suspected appendicitis with CT for equivocal cases. The protocol addressed potential bias against US and accommodated for institutional limitations of radiologist and sonographer experience and availability. Radiologists coded US reports according to the probability of appendicitis. Radiology reports were compared with clinical outcomes to assess diagnostic accuracy. During the study period, physicians from each group were apprised of the interim US protocol accuracy results. Problematic cases were discussed openly. A total of 512 children were enrolled and underwent US for evaluation of appendicitis over a 30-month period. Diagnostic accuracy was comparable to published results for combined US/CT protocols. Comparing the first 12 months to the last 12 months of the study period, the proportion of children achieving an unequivocal US result increased from 30% (51/169) to 53% (149/282) and the proportion of children undergoing surgery based solely on US findings increased from 55% (23/42) to 84% (92/109). Overall, 63% (325/512) of patients in the protocol did not require a CT. Total patient costs were reduced by $30,182 annually. We overcame several barriers to implementing a US protocol. During the study period our

Infectious Disease Management through Point-of-Care Personalized Medicine Molecular Diagnostic Technologies

Directory of Open Access Journals (Sweden)

Luc Bissonnette

2012-05-01

Full Text Available Infectious disease management essentially consists in identifying the microbial cause(s of an infection, initiating if necessary antimicrobial therapy against microbes, and controlling host reactions to infection. In clinical microbiology, the turnaround time of the diagnostic cycle (>24 hours often leads to unnecessary suffering and deaths; approaches to relieve this burden include rapid diagnostic procedures and more efficient transmission or interpretation of molecular microbiology results. Although rapid nucleic acid-based diagnostic testing has demonstrated that it can impact on the transmission of hospital-acquired infections, we believe that such life-saving procedures should be performed closer to the patient, in dedicated 24/7 laboratories of healthcare institutions, or ideally at point of care. While personalized medicine generally aims at interrogating the genomic information of a patient, drug metabolism polymorphisms, for example, to guide drug choice and dosage, personalized medicine concepts are applicable in infectious diseases for the (rapid identification of a disease-causing microbe and determination of its antimicrobial resistance profile, to guide an appropriate antimicrobial treatment for the proper management of the patient. The implementation of point-of-care testing for infectious diseases will require acceptance by medical authorities, new technological and communication platforms, as well as reimbursement practices such that time- and life-saving procedures become available to the largest number of patients.

Proteinuria: The diagnostic strategy based on urine proteins differentiation

Directory of Open Access Journals (Sweden)

Stojimirović Biljana B.

2004-01-01

Full Text Available Basal glomerular membrane represents mechanical and electrical barrier for passing of the plasma proteins. Mechanical barrier is composed of cylindrical pores and filtration fissure, and negative layer charge in exterior and interior side of basal glomerular membrane, made of heparan sulphate and sialoglicoproteine, provides certain electrical barrier. Diagnostic strategy based on different serum and urine proteins enables the differentiation of various types of proteinuria. Depending on etiology of proteinuria it can be prerenal, renal and postrenal. By analyzing albumin, armicroglobulin, immunoglobulin G and armacroglobulin, together with total protein in urine, it is possible to detect and differentiate causes of prerenal, renal (glomerular, tubular, glomerulo-tubular and postrenal proteinuria. The adequate and early differentiation of proteinuria type is of an immense diagnostic and therapeutic importance.

Variation in radiation doses in paediatric cardiac catheterisation procedures

International Nuclear Information System (INIS)

Al-Haj, A. N.; Lobriguito, A. M.; Rafeh, W.

2008-01-01

Paediatric cardiac catheterisation involves diagnostic and therapeutic procedures that range from simple to complex and can subject paediatric patients to varying radiation doses. The study aims to determine the variation in entrance doses in patients in terms of dose-area product (DAP) values and to investigate the methods for optimising radiation protection. A total of 190 paediatric patients belonging to age groups 0, 1, 5 and 10 y who underwent diagnostic and six selected therapeutic procedures at King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia) were included in the study. Therapeutic procedures include coarctation (COA), patent ductus arteriosus (PDA), radiofrequency ablation, pulmonary, embolisation and septostomy. Fluoroscopy and cine radiography were used in all procedures. Patient demography (weight, age, gender and height), radiographic technique factors, fluoroscopy and cine time, frame rate, and DAP values were taken from patients records. Effective doses for each procedure were estimated from the DAP values. The mean DAP per procedure were analysed for correlation with patient equivalent cylindrical diameter, weight, fluoroscopy time and number of frames. Factors influencing the variation in doses were investigated. Initial results show that PDA occlusion has the highest mean DAP value of 23.21 Gy-cm 2 , while the diagnostic and septostomy procedures have the lowest value of 7.77 and 6.95 Gy-cm 2 , respectively. (authors)

The evaluation of diagnostic medical exposures in the Czech Republic

International Nuclear Information System (INIS)

Petrova, K.; Klener, V.; Heribanova, A.; Husak, V.; Masopust, J.

1998-01-01

Surveys were performed in the Czech Republic to evaluate diagnostic medical exposures. The results are presented in 4 tables: (i) burden from the use of radiopharmaceuticals (examination, radiopharmaceutical, no. of procedures, average administered activity, conversion factor, collective effective dose); (ii) use of radiopharmaceuticals at nuclear medicine departments (type of examination, type of radiopharmaceutical, no. of departments, average administered activity); (iii) reference levels of administered activity specified for some diagnostic procedures for the adult patient (examination, radionuclide, chemical form, administered activity); and (iv) X-ray examinations (examination, annual no. of procedures, effective dose, age distribution, sex distribution). (P.A.)

The Downside of Diagnostic Imaging

Science.gov (United States)

An article about radiation exposure during computed tomography and nuclear imaging procedures and the risk of cancer. Several studies released in 2009 have helped to quantify the risk and the growing use of these diagnostic imaging methods.

Electronics and Algorithms for HOM Based Beam Diagnostics

Science.gov (United States)

Frisch, Josef; Baboi, Nicoleta; Eddy, Nathan; Nagaitsev, Sergei; Hensler, Olaf; McCormick, Douglas; May, Justin; Molloy, Stephen; Napoly, Olivier; Paparella, Rita; Petrosyan, Lyudvig; Ross, Marc; Simon, Claire; Smith, Tonee

2006-11-01

The signals from the Higher Order Mode (HOM) ports on superconducting cavities can be used as beam position monitors and to do survey structure alignment. A HOM-based diagnostic system has been installed to instrument both couplers on each of the 40 cryogenic accelerating structures in the DESY TTF2 Linac. The electronics uses a single stage down conversion from the 1.7 GHz HOM spectral line to a 20MHz IF which has been digitized. The electronics is based on low cost surface mount components suitable for large scale production. The analysis of the HOM data is based on Singular Value Decomposition. The response of the OM modes is calibrated using conventional BPMs.

Next generation diagnostic molecular pathology: critical appraisal of quality assurance in Europe.

Science.gov (United States)

Dubbink, Hendrikus J; Deans, Zandra C; Tops, Bastiaan B J; van Kemenade, Folkert J; Koljenović, S; van Krieken, Han J M; Blokx, Willeke A M; Dinjens, Winand N M; Groenen, Patricia J T A

2014-06-01

Tumor evaluation in pathology is more and more based on a combination of traditional histopathology and molecular analysis. Due to the rapid development of new cancer treatments that specifically target aberrant proteins present in tumor cells, treatment decisions are increasingly based on the molecular features of the tumor. Not only the number of patients eligible for targeted precision medicine, but also the number of molecular targets per patient and tumor type is rising. Diagnostic molecular pathology, the discipline that determines the molecular aberrations present in tumors for diagnostic, prognostic or predictive purposes, is faced with true challenges. The laboratories have to meet the need of comprehensive molecular testing using only limited amount of tumor tissue, mostly fixed in formalin and embedded in paraffin (FFPE), in short turnaround time. Choices must be made for analytical methods that provide accurate, reliable and cost-effective results. Validation of the test procedures and results is essential. In addition, participation and good performance in internal (IQA) and external quality assurance (EQA) schemes is mandatory. In this review, we critically evaluate the validation procedure for comprehensive molecular tests as well as the organization of quality assurance and assessment of competence of diagnostic molecular pathology laboratories within Europe. Copyright © 2014 Federation of European Biochemical Societies. Published by Elsevier B.V. All rights reserved.

Evaluation of Computer-Based Procedure System Prototype

Energy Technology Data Exchange (ETDEWEB)

Johanna Oxstrand; Katya Le Blanc; Seth Hays

2012-09-01

This research effort is a part of the Light-Water Reactor Sustainability (LWRS) Program, which is a research and development (R&D) program sponsored by Department of Energy (DOE), performed in close collaboration with industry R&D programs, to provide the technical foundations for licensing and managing the long-term, safe, and economical operation of current nuclear power plants. The LWRS program serves to help the U.S. nuclear industry adopt new technologies and engineering solutions that facilitate the continued safe operation of the plants and extension of the current operating licenses. The introduction of advanced technology in existing nuclear power plants may help to manage the effects of aging systems, structures, and components. In addition, the incorporation of advanced technology in the existing LWR fleet may entice the future workforce, who will be familiar with advanced technology, to work for these utilities rather than more newly built nuclear power plants. Advantages are being sought by developing and deploying technologies that will increase safety and efficiency. One significant opportunity for existing plants to increase efficiency is to phase out the paper-based procedures (PBPs) currently used at most nuclear power plants and replace them, where feasible, with computer-based procedures (CBPs). PBPs have ensured safe operation of plants for decades, but limitations in paper-based systems do not allow them to reach the full potential for procedures to prevent human errors. The environment in a nuclear power plant is constantly changing depending on current plant status and operating mode. PBPs, which are static by nature, are being applied to a constantly changing context. This constraint often results in PBPs that are written in a manner that is intended to cover many potential operating scenarios. Hence, the procedure layout forces the operator to search through a large amount of irrelevant information to locate the pieces of information

Cooperative research and development for artificial intelligence based reactor diagnostic system

International Nuclear Information System (INIS)

Reifman, J.; Wei, T.Y.C.; Abboud, R.G.; Chasensky, T.M.

1994-01-01

Artificial Intelligence (AI) techniques in the form of knowledge-based Expert Systems (ESs) have been proposed to provide on-line decision-making support for plant operators during both normal and emergency conditions. However, in spite of the great interest in these advanced techniques, their application in the diagnosis of large-scale processes has not yet reached its full potential because of limitations of the knowledge base. These limitations include problems with knowledge acquisition and the use of an event-oriented approach for process diagnosis. To investigate the capabilities of this two-level hierarchical knowledge structure, Commonwealth Research Corporation (CRC) and Argonne National Laboratory (ANL)are collaborating on a DOE-sponsored Cooperative Research and Development Agreement (CRADA) project to perform feasibility studies on the proposed diagnostic system. Investigations are being performed in the construction of a physics-based plant level process diagnostic ES and the characterization of component-level fault project is to develop a computer-based system using this Al approach to assist process plant operators during off-normal plant conditions. The proposed computer-based system will use T-H signals complemented by other non-T-H signals available in the data stream to provide the process operator with the component which most likely caused the observed process disturbance. To demonstrate the scale-up feasibility of the proposed diagnostic system it is being developed for use with the Chemical Volume Control System (CVCS) of a nuclear power plant. This is an ongoing multi-year project and the remainder of this paper presents a mid-term status report

Paediatric doses from diagnostic radiology in Victoria

International Nuclear Information System (INIS)

Boal, T.J.; Cardillo, I.; Einsiedel, P.F.

1998-01-01

This study examines doses to paediatric patients from diagnostic radiology. Measurements were made at 29 hospitals and private radiology practices in the state of Victoria. Entrance skin doses in air were measured for the exposure factors used by hospital radiology departments and private radiology practices for a standard size 1, 5, 10 and 15 year old child, for the following procedures: chest AP/PA, lat; abdomen AP; pelvis AP; lumbar spine AP, lat; and skull AP, lat. There was a large range of doses for each particular procedure and age group. Factors contributing to the range of doses were identified. Guidance levels for paediatric radiology based on the third quartile value of the skin entrance doses have been recommended and are compared with guidance levels. Copyright (1998) Australasian Physical and Engineering Sciences in Medicine

Advanced DNA-Based Point-of-Care Diagnostic Methods for Plant Diseases Detection

OpenAIRE

Lau, Han Yih; Botella, Jose R.

2017-01-01

Diagnostic technologies for the detection of plant pathogens with point-of-care capability and high multiplexing ability are an essential tool in the fight to reduce the large agricultural production losses caused by plant diseases. The main desirable characteristics for such diagnostic assays are high specificity, sensitivity, reproducibility, quickness, cost efficiency and high-throughput multiplex detection capability. This article describes and discusses various DNA-based point-of care di...

Electrical-Based Diagnostic Techniques for Assessing Insulation Condition in Aged Transformers

Directory of Open Access Journals (Sweden)

Issouf Fofana

2016-08-01

Full Text Available The condition of the internal cellulosic paper and oil insulation are of concern for the performance of power transformers. Over the years, a number of methods have been developed to diagnose and monitor the degradation/aging of the transformer internal insulation system. Some of this degradation/aging can be assessed from electrical responses. Currently there are a variety of electrical-based diagnostic techniques available for insulation condition monitoring of power transformers. In most cases, the electrical signals being monitored are due to mechanical or electric changes caused by physical changes in resistivity, inductance or capacitance, moisture, contamination or aging by-products in the insulation. This paper presents a description of commonly used and modern electrical-based diagnostic techniques along with their interpretation schemes.

Development and verification of symptom based emergency procedure support system

International Nuclear Information System (INIS)

Saijou, Nobuyuki; Sakuma, Akira; Takizawa, Yoji; Tamagawa, Naoko; Kubota, Ryuji; Satou, Hiroyuki; Ikeda, Koji; Taminami, Tatsuya

1998-01-01

A Computerized Emergency Procedure Guideline (EPG) Support System has been developed for BWR and evaluated using training simulator. It aims to enhance the effective utilization of EPG. The system identifies suitable symptom-based operating procedures for present plant status automatically. It has two functions : one is plant status identification function, and the other is man-machine interface function. For the realization of the former function, a method which identifies and prioritize suitable symptom-based operational procedures against present plant status has been developed. As man-machine interface, operation flow chart display has been developed. It express the flow of the identified operating procedures graphically. For easy understanding of the display, important information such as plant status change, priority of operating procedures and completion/uncompletion of the operation is displayed on the operation flow display by different colors. As evaluation test, the response of the system to the design based accidents was evaluated by actual plant operators, using training simulator at BWR Training Center. Through the analysis of interviews and questionnaires to operators, it was shown that the system is effective and can be utilized for a real plant. (author)

Hospital discharge diagnostic and procedure codes for upper gastro-intestinal cancer: how accurate are they?

Directory of Open Access Journals (Sweden)

Stavrou Efty

2012-09-01

Full Text Available Abstract Background Population-level health administrative datasets such as hospital discharge data are used increasingly to evaluate health services and outcomes of care. However information about the accuracy of Australian discharge data in identifying cancer, associated procedures and comorbidity is limited. The Admitted Patients Data Collection (APDC is a census of inpatient hospital discharges in the state of New South Wales (NSW. Our aim was to assess the accuracy of the APDC in identifying upper gastro-intestinal (upper GI cancer cases, procedures for associated curative resection and comorbidities at the time of admission compared to data abstracted from medical records (the ‘gold standard’. Methods We reviewed the medical records of 240 patients with an incident upper GI cancer diagnosis derived from a clinical database in one NSW area health service from July 2006 to June 2007. Extracted case record data was matched to APDC discharge data to determine sensitivity, positive predictive value (PPV and agreement between the two data sources (κ-coefficient. Results The accuracy of the APDC diagnostic codes in identifying site-specific incident cancer ranged from 80-95% sensitivity. This was comparable to the accuracy of APDC procedure codes in identifying curative resection for upper GI cancer. PPV ranged from 42-80% for cancer diagnosis and 56-93% for curative surgery. Agreement between the data sources was >0.72 for most cancer diagnoses and curative resections. However, APDC discharge data was less accurate in reporting common comorbidities - for each condition, sensitivity ranged from 9-70%, whilst agreement ranged from κ = 0.64 for diabetes down to κ  Conclusions Identifying incident cases of upper GI cancer and curative resection from hospital administrative data is satisfactory but under-ascertained. Linkage of multiple population-health datasets is advisable to maximise case ascertainment and minimise false

Quality Control in Diagnostic Radiology in the Netherlands (invited paper)

International Nuclear Information System (INIS)

Zoetelief, J.

1998-01-01

Application of the general principles of radiation protection to medical diagnostic radiology implies that each procedure using X rays or radionuclides is to be justified and optimised. Optimisation in diagnostic radiology implies that the radiation burden to the patient should be as low as possible, but compatible with the image quality necessary to obtain an adequate diagnosis or to guide treatment. Quality control of equipment is a prerequisite for achieving optimisation in diagnostic radiology. This was especially recognised for mammography as employed for breast cancer screening. Existing legislation in the Netherlands includes only a few criteria for equipment used in diagnostic radiology. In addition, the criteria are not all operational and measurement methods are lacking. Therefore, upon the initiative of the Dutch Ministry of Health, Welfare and Sports, the relevant professional societies, in collaboration with the former TNO Centre for Radiological Protection and Dosimetry, formulated eleven guidelines for quality control of equipment used in diagnostic radiology, including test procedures, test frequencies and limiting values. The implementation of quality control of equipment was included in the 1984 European Directive (84/466/Euratom) laying down basic measures for the radiation protection of persons undergoing medical examination or treatment. In the most recent European Directive on medical exposure (97/43/Euratom) the importance of quality control is stressed. In addition, the latter EC directive proposes the use of diagnostic reference levels for limiting the risks for patients undergoing diagnostic radiology. In the Netherlands preliminary reference levels for various procedures employed in diagnostic radiology are suggested. Finally, methods applied in the Netherlands for assessment of image quality are discussed. (author)

Situation awareness and trust in computer-based procedures in nuclear power plant operations

Energy Technology Data Exchange (ETDEWEB)

Throneburg, E. B.; Jones, J. M. [AREVA NP Inc., 7207 IBM Drive, Charlotte, NC 28262 (United States)

2006-07-01

Situation awareness and trust are two issues that need to be addressed in the design of computer-based procedures for nuclear power plants. Situation awareness, in relation to computer-based procedures, concerns the operators' knowledge of the plant's state while following the procedures. Trust concerns the amount of faith that the operators put into the automated procedures, which can affect situation awareness. This paper first discusses the advantages and disadvantages of computer-based procedures. It then discusses the known aspects of situation awareness and trust as applied to computer-based procedures in nuclear power plants. An outline of a proposed experiment is then presented that includes methods of measuring situation awareness and trust so that these aspects can be analyzed for further study. (authors)

Situation awareness and trust in computer-based procedures in nuclear power plant operations

International Nuclear Information System (INIS)

Throneburg, E. B.; Jones, J. M.

2006-01-01

Situation awareness and trust are two issues that need to be addressed in the design of computer-based procedures for nuclear power plants. Situation awareness, in relation to computer-based procedures, concerns the operators' knowledge of the plant's state while following the procedures. Trust concerns the amount of faith that the operators put into the automated procedures, which can affect situation awareness. This paper first discusses the advantages and disadvantages of computer-based procedures. It then discusses the known aspects of situation awareness and trust as applied to computer-based procedures in nuclear power plants. An outline of a proposed experiment is then presented that includes methods of measuring situation awareness and trust so that these aspects can be analyzed for further study. (authors)

Smartphone-Based Fluorescent Diagnostic System for Highly Pathogenic H5N1 Viruses

Science.gov (United States)

Yeo, Seon-Ju; Choi, Kyunghan; Cuc, Bui Thi; Hong, Nguyen Ngoc; Bao, Duong Tuan; Ngoc, Nguyen Minh; Le, Mai Quynh; Hang, Nguyen Le Khanh; Thach, Nguyen Co; Mallik, Shyam Kumar; Kim, Hak Sung; Chong, Chom-Kyu; Choi, Hak Soo; Sung, Haan Woo; Yu, Kyoungsik; Park, Hyun

2016-01-01

Field diagnostic tools for avian influenza (AI) are indispensable for the prevention and controlled management of highly pathogenic AI-related diseases. More accurate, faster and networked on-site monitoring is demanded to detect such AI viruses with high sensitivity as well as to maintain up-to-date information about their geographical transmission. In this work, we assessed the clinical and field-level performance of a smartphone-based fluorescent diagnostic device with an efficient reflective light collection module using a coumarin-derived dendrimer-based fluorescent lateral flow immunoassay. By application of an optimized bioconjugate, a smartphone-based diagnostic device had a two-fold higher detectability as compared to that of the table-top fluorescence strip reader for three different AI subtypes (H5N3, H7N1, and H9N2). Additionally, in a clinical study of H5N1-confirmed patients, the smartphone-based diagnostic device showed a sensitivity of 96.55% (28/29) [95% confidence interval (CI): 82.24 to 99.91] and a specificity of 98.55% (68/69) (95% CI: 92.19 to 99.96). The measurement results from the distributed individual smartphones were wirelessly transmitted via short messaging service and collected by a centralized database system for further information processing and data mining. Smartphone-based diagnosis provided highly sensitive measurement results for H5N1 detection within 15 minutes. Because of its high sensitivity, portability and automatic reporting feature, the proposed device will enable agile identification of patients and efficient control of AI dissemination. PMID:26877781

Smartphone-Based Fluorescent Diagnostic System for Highly Pathogenic H5N1 Viruses.

Science.gov (United States)

Yeo, Seon-Ju; Choi, Kyunghan; Cuc, Bui Thi; Hong, Nguyen Ngoc; Bao, Duong Tuan; Ngoc, Nguyen Minh; Le, Mai Quynh; Hang, Nguyen Le Khanh; Thach, Nguyen Co; Mallik, Shyam Kumar; Kim, Hak Sung; Chong, Chom-Kyu; Choi, Hak Soo; Sung, Haan Woo; Yu, Kyoungsik; Park, Hyun

2016-01-01

Field diagnostic tools for avian influenza (AI) are indispensable for the prevention and controlled management of highly pathogenic AI-related diseases. More accurate, faster and networked on-site monitoring is demanded to detect such AI viruses with high sensitivity as well as to maintain up-to-date information about their geographical transmission. In this work, we assessed the clinical and field-level performance of a smartphone-based fluorescent diagnostic device with an efficient reflective light collection module using a coumarin-derived dendrimer-based fluorescent lateral flow immunoassay. By application of an optimized bioconjugate, a smartphone-based diagnostic device had a two-fold higher detectability as compared to that of the table-top fluorescence strip reader for three different AI subtypes (H5N3, H7N1, and H9N2). Additionally, in a clinical study of H5N1-confirmed patients, the smartphone-based diagnostic device showed a sensitivity of 96.55% (28/29) [95% confidence interval (CI): 82.24 to 99.91] and a specificity of 98.55% (68/69) (95% CI: 92.19 to 99.96). The measurement results from the distributed individual smartphones were wirelessly transmitted via short messaging service and collected by a centralized database system for further information processing and data mining. Smartphone-based diagnosis provided highly sensitive measurement results for H5N1 detection within 15 minutes. Because of its high sensitivity, portability and automatic reporting feature, the proposed device will enable agile identification of patients and efficient control of AI dissemination.

Gene expression-based molecular diagnostic system for malignant gliomas is superior to histological diagnosis.

Science.gov (United States)

Shirahata, Mitsuaki; Iwao-Koizumi, Kyoko; Saito, Sakae; Ueno, Noriko; Oda, Masashi; Hashimoto, Nobuo; Takahashi, Jun A; Kato, Kikuya

2007-12-15

Current morphology-based glioma classification methods do not adequately reflect the complex biology of gliomas, thus limiting their prognostic ability. In this study, we focused on anaplastic oligodendroglioma and glioblastoma, which typically follow distinct clinical courses. Our goal was to construct a clinically useful molecular diagnostic system based on gene expression profiling. The expression of 3,456 genes in 32 patients, 12 and 20 of whom had prognostically distinct anaplastic oligodendroglioma and glioblastoma, respectively, was measured by PCR array. Next to unsupervised methods, we did supervised analysis using a weighted voting algorithm to construct a diagnostic system discriminating anaplastic oligodendroglioma from glioblastoma. The diagnostic accuracy of this system was evaluated by leave-one-out cross-validation. The clinical utility was tested on a microarray-based data set of 50 malignant gliomas from a previous study. Unsupervised analysis showed divergent global gene expression patterns between the two tumor classes. A supervised binary classification model showed 100% (95% confidence interval, 89.4-100%) diagnostic accuracy by leave-one-out cross-validation using 168 diagnostic genes. Applied to a gene expression data set from a previous study, our model correlated better with outcome than histologic diagnosis, and also displayed 96.6% (28 of 29) consistency with the molecular classification scheme used for these histologically controversial gliomas in the original article. Furthermore, we observed that histologically diagnosed glioblastoma samples that shared anaplastic oligodendroglioma molecular characteristics tended to be associated with longer survival. Our molecular diagnostic system showed reproducible clinical utility and prognostic ability superior to traditional histopathologic diagnosis for malignant glioma.

Cost Implications of Value-Based Pricing for Companion Diagnostic Tests in Precision Medicine.

Science.gov (United States)

Zaric, Gregory S

2016-07-01

Many interpretations of personalized medicine, also referred to as precision medicine, include discussions of companion diagnostic tests that allow drugs to be targeted to those individuals who are most likely to benefit or that allow treatment to be designed in a way such that individuals who are unlikely to benefit do not receive treatment. Many authors have commented on the clinical and competitive implications of companion diagnostics, but there has been relatively little formal analysis of the cost implications of companion diagnostics, although cost reduction is often cited as a significant benefit of precision medicine. We investigate the potential impact on costs of precision medicine implemented through the use of companion diagnostics. We develop a framework in which the costs of companion diagnostic tests are determined by considerations of profit maximization and cost effectiveness. We analyze four scenarios that are defined by the incremental cost-effectiveness ratio of the new drug in the absence of a companion diagnostic test. We find that, in most scenarios, precision medicine strategies based on companion diagnostics should be expected to lead to increases in costs in the short term and that costs would fall only in a limited number of situations.

Nordic working group for medical x-ray diagnostics: Diagnostic reference levels within xray diagnostics - experiences in the Nordic countries

International Nuclear Information System (INIS)

Leitz, W.; Groen, P.; Servomaa, A.; Einarsson, G.; Olerud, H.

2003-01-01

Medical x-ray diagnostics is one of the few applications of ionising radiation where people are irradiated on purpose. The strategy for radiation protection is also different compared to that in other areas that have the zero-alternative as its ultimate goal, meaning that no human beings at all are exposed in these practices. The focus in x-ray diagnostics concerning radiation protection is justification and optimisation. Optimisation implies that the examination is performed in such a way that the radiation dose is as small as possible without jeopardising the diagnostic security. X- ray diagnostics is a complex method where many technical parameters and methodology factors together are interacting in the determination of radiation dose and image quality. The optimisation process is not a simple and uncomplicated procedure, this difficulty is reflected in many international and national surveys showing a large spread of patient doses for one and the same type of examination. The concept diagnostic reference levels (DRL) has been introduced as a tool for reducing this wide distribution that is obviously indicating a lack of optimisation, and for cutting the highest radiation doses. In this presentation the concept for DRL and the experience gained in the Nordic countries with DRL are described. (orig.)

Development of a rule-based diagnostic platform on an object-oriented expert system shell

International Nuclear Information System (INIS)

Wang, Wenlin; Yang, Ming; Seong, Poong Hyun

2016-01-01

Highlights: • Multilevel Flow Model represents system knowledge as a domain map in expert system. • Rule-based fault diagnostic expert system can identify root cause via a causal chain. • Rule-based fault diagnostic expert system can be used for fault simulation training. - Abstract: This paper presents the development and implementation of a real-time rule-based diagnostic platform. The knowledge is acquired from domain experts and textbooks and the design of the fault diagnosis expert system was performed in the following ways: (i) establishing of corresponding classes and instances to build the domain map, (ii) creating of generic fault models based on events, and (iii) building of diagnostic reasoning based on rules. Knowledge representation is a complicated issue of expert systems. One highlight of this paper is that the Multilevel Flow Model has been used to represent the knowledge, which composes the domain map within the expert system as well as providing a concise description of the system. The developed platform is illustrated using the pressure safety system of a pressurized water reactor as an example of the simulation test bed; the platform is developed using the commercial and industrially validated software G2. The emulation test was conducted and it has been proven that the fault diagnosis expert system can identify the faults correctly and in a timely way; this system can be used as a simulation-based training tool to assist operators to make better decisions.

Diagnostic method for photovoltaic systems based on light I-V measurements

DEFF Research Database (Denmark)

Spataru, Sergiu; Sera, Dezso; Kerekes, Tamas

2015-01-01

, be it external, such as shading or soiling, or degradation or failure of the PV modules and balance-of-system components. This allows for performing preventive and/or reparative maintenance, thus minimizing further losses and costs. This article proposes a complete diagnostic method for detecting shading...... and analysis of the diagnostic parameters and logic was performed based on module level tests on standard crystalline silicon PV modules, and were optimized to detect even small partial shading and increase series-resistance losses. To demonstrate the practical application and operation of this method...

SU-D-209-05: Sensitivity of the Diagnostic Radiological Index of Protection (DRIP) to Procedural Factors in Fluoroscopy

Energy Technology Data Exchange (ETDEWEB)

Jones, A [UT MD Anderson Cancer Center, Houston, TX (United States); Pasciak, A [University of Tennessee Medical Center, Knoxville, TN (United States); Wagner, L [UT Medical School, Houston, TX (United States)

2016-06-15

Purpose: To evaluate the sensitivity of the Diagnostic Radiological Index of Protection (DRIP) to procedural factors in fluoroscopy in an effort to determine an appropriate set of scatter-mimicking primary beams (SMPB) to be used in measuring the DRIP. Methods: A series of clinical and factorial Monte Carlo simulations were conducted to determine the shape of the scattered X-ray spectra incident on the operator in different clinical fluoroscopy scenarios. Two clinical evaluations studied the sensitivity of the scattered spectrum to gantry angle and patient size while technical factors were varied according to measured automatic dose rate control (ADRC) data. Factorial evaluations studied the sensitivity of the scattered spectrum to gantry angle, field of view, patient size and beam quality for constant technical factors. Average energy was the figure of merit used to condense fluence in each energy bin to a single numerical index. Results: Beam quality had the strongest influence on the scattered spectrum in fluoroscopy. Many procedural factors affected the scattered spectrum indirectly through their effects on primary beam quality through ADRC, e.g., gantry angle and patient size. Lateral C-arm rotation, common in interventional cardiology, increased the energy of the scattered spectrum, regardless of the direction of rotation. The effect of patient size on scattered radiation depended on ADRC characteristics, patient size, and procedure type. Conclusion: The scattered spectrum striking the operator in fluoroscopy, and therefore the DRIP, is most strongly influenced by primary beam quality, particularly kV. Use cases for protective garments should be classified by typical procedural primary beam qualities, which are governed by the ADRC according to the impacts of patient size, anatomical location, and gantry angle. These results will help determine an appropriate set of SMPB to be used for measuring the DRIP.

Drawing-Based Procedural Modeling of Chinese Architectures.

Science.gov (United States)

Fei Hou; Yue Qi; Hong Qin

2012-01-01

This paper presents a novel modeling framework to build 3D models of Chinese architectures from elevation drawing. Our algorithm integrates the capability of automatic drawing recognition with powerful procedural modeling to extract production rules from elevation drawing. First, different from the previous symbol-based floor plan recognition, based on the novel concept of repetitive pattern trees, small horizontal repetitive regions of the elevation drawing are clustered in a bottom-up manner to form architectural components with maximum repetition, which collectively serve as building blocks for 3D model generation. Second, to discover the global architectural structure and its components' interdependencies, the components are structured into a shape tree in a top-down subdivision manner and recognized hierarchically at each level of the shape tree based on Markov Random Fields (MRFs). Third, shape grammar rules can be derived to construct 3D semantic model and its possible variations with the help of a 3D component repository. The salient contribution lies in the novel integration of procedural modeling with elevation drawing, with a unique application to Chinese architectures.

A Laser-Based Diagnostic Suite for Hypersonic Test Facilities, Phase I

Data.gov (United States)

National Aeronautics and Space Administration — In this SBIR effort, Los Gatos Research (LGR) proposes to develop a suite of laser-based diagnostics for the study of reactive and non-reactive hypersonic flows....

Quality control procedures of dental diagnostic radiology systems; Elaboracao de um procedimento para controle de qualidade em sistemas de radiodiagnostico odontologico

Energy Technology Data Exchange (ETDEWEB)

Andrade, Paula Serra Sasaki

2007-07-01

This work presents quality control reference procedures for dental diagnostic radiology systems, following the recommendations of the Publication 453 of the Brazilian Health Ministry (PF453), to be applied in dental clinics, in order to achieve an improvement in the radiological image qualities and the patient dose reduction. All tests were applied in an intraoral X rays system, following the methodology developed and the requirements of the PF 453. In order to verify the best quality of the image in relation to the smaller exposition time an object test was also developed in this work. The use of this object allowed the reduction of the exposition time of 0.5 seconds, the maximum value of the linear region of the characteristic curve, for 0.2 seconds. The tested X rays system showed a very good agreement with the applied procedures, detaching the reduction of the skin entrance dose using the film-holding devices. However, the size of the field increased and exceeded the maximum value of 6 cm recommended in the standard. The importance of the quality control in dental diagnostic radiology systems is essential due to the constant use of X radiation in dental clinics. The PF453 recommends the frequency of at least two years for the constancy tests. However, it is suggested that the professional, surgeon-dentist, should be responsible for the internal control of the image quality obtained from the X rays device. This can be done through monthly exposures of the object test developed in this work. (author)

Patient dosimetry in diagnostic radiology

Directory of Open Access Journals (Sweden)

Ciraj-Bjelac Olivera F.

2003-01-01

Full Text Available The objective of this work is to assess patient organ doses, effective doses and entrance surface doses in conventional diagnostic radiology procedures for standard adult patient. The survey consists of measurements of doses delivered to 239 patients in nine types of X-ray examinations. Three types of data were collected: X-ray machine data, patient data, and output measurements. Entrance surface dose was assessed based on the survey data and subsequently, using conversion coefficients, the organ doses and effective doses were calculated. Values of the entrance surface dose and the effective dose were estimated to be 0.4 to 5.8 mGy and 0.03 to 3.00 mSv for different examinations. Derived doses were compared with recommended general diagnostic reference levels. The impact of examination parameters on dose values was discussed. Except for posterior-anterior chest examination, all estimated doses are lower than stated reference levels. Survey data are aimed at helping development of national quality control and radiation protection programmed for medical exposures.

Ultrasound diagnostics of thyroid diseases

International Nuclear Information System (INIS)

Kharchenko, Vladimir P.; Kotlyarov, Peter M.; Mogutov, Mikhail S.; Sencha, Alexander N.; Patrunov, Yury N.; Belyaev, Denis V.; Alexandrov, Yury K.

2010-01-01

This book is based on the authors' extensive practical experience in the use of modern ultrasound, and other radiological methods, in the diagnosis of thyroid diseases. The authors have analyzed more than 100,000 ultrasound examinations performed between 1995 and 2008 in patients with thyroid and parathyroid disease, as well as many thousands of diagnostic and therapeutic ultrasound-guided minimally invasive procedures. The opening chapters include discussion of current ultrasound techniques, pitfalls, and the specifics of ultrasound examination of the thyroid in children. Detailed attention is then devoted to findings in the normal thyroid and in the presence of diffuse and focal changes. Further chapters focus on such topics as ultrasound examination after thyroid surgery and ultrasound diagnosis of parathyroid disease, recurrent goiter, and neck masses. Ultrasound-guided minimally invasive techniques, such as fine-needle aspiration biopsy, percutaneous laser ablation, and ethanol and glucocorticoid injections, are considered in depth. This up-to-date and richly illustrated book will interest and assist specialists in ultrasound diagnostics, radiologists, endocrinologists, and neck surgeons. (orig.)

The use of Brainsuite iCT for frame-based stereotactic procedures

DEFF Research Database (Denmark)

Skjøth-Rasmussen, Jane; Jespersen, Bo; Brennum, Jannick

2015-01-01

BACKGROUND: Frame-based stereotactic procedures are the gold standard because of their superior stereotactic accuracy. The procedure used to be in multiple steps and was especially cumbersome and hazardous in intubated patients. A single-step procedure using intraoperative CT was created...

Mobile Diagnostics Based on Motion? A Close Look at Motility Patterns in the Schistosome Life Cycle

Directory of Open Access Journals (Sweden)

Ewert Linder

2016-06-01

Full Text Available Imaging at high resolution and subsequent image analysis with modified mobile phones have the potential to solve problems related to microscopy-based diagnostics of parasitic infections in many endemic regions. Diagnostics using the computing power of “smartphones” is not restricted by limited expertise or limitations set by visual perception of a microscopist. Thus diagnostics currently almost exclusively dependent on recognition of morphological features of pathogenic organisms could be based on additional properties, such as motility characteristics recognizable by computer vision. Of special interest are infectious larval stages and “micro swimmers” of e.g., the schistosome life cycle, which infect the intermediate and definitive hosts, respectively. The ciliated miracidium, emerges from the excreted egg upon its contact with water. This means that for diagnostics, recognition of a swimming miracidium is equivalent to recognition of an egg. The motility pattern of miracidia could be defined by computer vision and used as a diagnostic criterion. To develop motility pattern-based diagnostics of schistosomiasis using simple imaging devices, we analyzed Paramecium as a model for the schistosome miracidium. As a model for invasive nematodes, such as strongyloids and filaria, we examined a different type of motility in the apathogenic nematode Turbatrix, the “vinegar eel.” The results of motion time and frequency analysis suggest that target motility may be expressed as specific spectrograms serving as “diagnostic fingerprints.”

Diagnostic imaging in internal medicine

International Nuclear Information System (INIS)

Eisenberg, R.L.

1985-01-01

This book examines medical diagnostic techniques. Topics considered include biological considerations in the approach to clinical medicines; infectious diseases; disorders of the heart; disorders of the vascular system; disorders of the respiratory system; diseases of the kidneys and urinary tract; disorders of the alimentary tract; disorders of the hepatobiliary system and pancreas; disorders of the hematopoietic system; disorders of bone and bone mineralization; disorders of the joints, connective tissues, and striated muscles; disorders of the nervous system; miscellaneous disorders; and procedures in diagnostic imaging

The value of scintigraphy in skeleton diagnostics

International Nuclear Information System (INIS)

Wickenhauser, J.

1976-01-01

The complex topic of diagnostics of the numerous skeleton diseases was enriched by nuclear medicine, for it is now possible to complete the static picture of morphologic changes resulting from radiologic examinations by its functional component, shown in scintigraphy. This shows that maximal information can only be obtained if the results of skeleton scintigraphy are, according to their importance, integrated into the total picture of the diagnostical decision procedure the centre of which is taken by radiology as was always the case. Because of the different results they lead to, none of the methods can be replaced by another, but they can only complete one another. For the reasons mentioned, the isolated use of skeleton scintigraphy, as it is usual in many places, does not seem not purposeful. Using 8 cases, the author tried to show the problems of skeleton scintigraphy and its position in the diagnostical decision procedure in osteology. (orig.) [de

Diagnostic imaging in medicine. 2nd ed

Energy Technology Data Exchange (ETDEWEB)

Reba, R C; Goodenough, D J; Davidson, H F

1984-01-01

This book describes to practitioners the evolutionary progression of new non-invasive diagnostic imaging techniques. The utility of the procedures is also described in a series of state-of-the-art lectures given by outstanding international clinical investigators from NATO countries. Subjects of the papers include the following: advances in source and detector technology, acoustical imaging, NMR and microwave imaging, positron and single photon emission tomography, digital radiography and image processing and display techniques. Fundamental papers describing the theory of non-invasive procedures are included along with papers describing clinical examinations. Examples of utility and studies of diseases of the abdomen and pelvis, heart and lung, and central nervous system are included. Cost-effective and cost-benefit assessment of the new high technology procedures, as well as the use of diagnostic imaging techniques in developing countries are also presented. An index of leading topics completes the volume.

Characteristics of Headache After an Intracranial Endovascular Procedure: A Prospective Observational Study.

Science.gov (United States)

Zhang, Linjing; Wu, Xiancong; Di, Hai; Feng, Tao; Wang, Yunxia; Wang, Jun; Cao, Xiangyu; Li, Baomin; Liu, Ruozhuo; Yu, Shengyuan

2017-03-01

Two editions of the International Classification of Headache Disorders (ICHD) diagnostic criteria for "Headache attributed to an intracranial endovascular procedure" have been published, in 2004 and 2013. 1,2 Despite studies that have suggested that the former is not very practical, the ICHD-3 beta did not contain major changes. Moreover, so far no consensus exists regarding characteristics of headache after intracranial endovascular procedure. Thus, there is a need for sound suggestions to improve the ICHD-3 beta diagnostic criteria. Using a prospective design, we identified consecutive patients with unruptured intracranial aneurysms (UIAs) with neuroendovascular treatment from January 2014 to December 2014. In total, 73 patients were enrolled, and 58 patients ultimately completed the 6-month follow-up. After the procedure, five of the 29 patients (17.2%) with pre-existing headache experienced marked worsening after the procedure, while seven of the 29 patients without prior headache developed new-onset headache post-procedurally. The headaches started within 24 hours, with a mean duration of 24-72 hours. The headaches were moderate to severe. The eligibility of these events to be considered headaches caused by neuroendovascular procedures according to the ICHD-3 beta diagnostic criteria for designation was far from ideal. Most cases of markedly worsening headaches and new-onset headaches started within 24 hours and persisted longer than that specified in the ICHD-3 beta diagnostic criteria. Moreover, considering that some items are not very practical, the ICHD-3 beta diagnostic criteria should be revised in the light of recent literature reports. © 2016 American Headache Society.

Pulmonary infiltrates in non-HIV immunocompromised patients: a diagnostic approach using non-invasive and bronchoscopic procedures

Science.gov (United States)

Rano, A; Agusti, C; Jimenez, P; Angrill, J; Benito, N; Danes, C; Gonzalez, J; Rovira, M; Pumarola, T; Moreno, A; Torres, A

2001-01-01

%); and TBAS 35/55 (65%). Bronchoscopic techniques led to the diagnosis of pulmonary infiltrates in 59% of the cases in which they were used: FBAS 16/28 (57%), BAL 68/135 (51%), and PSB 30/125 (24%). The results obtained with the different techniques led to a change in antibiotic treatment in 93 cases (46%). Although changes in treatment did not have an impact on the overall mortality, patients with pulmonary infiltrates of an infectious aetiology in whom the change was made during the first 7 days had a better outcome (29% mortality) than those in whom treatment was changed later (71% mortality; p=0.001).
CONCLUSIONS—Non-invasive and bronchoscopic procedures are useful techniques for the diagnosis of pulmonary infiltrates in immunocompromised patients. Bronchial aspirates (FBAS and TBAS) and BAL have the highest diagnostic yield and impact on therapeutic decisions.

 PMID:11312407

Controlling radiation exposure during interventional procedures in childhood cancer patients

International Nuclear Information System (INIS)

Racadio, John M.

2009-01-01

Many pediatric cancer patients undergo multiple diagnostic and therapeutic radiologic procedures over the course of their illnesses and are therefore at high risk for radiation exposure. There are a variety of measures that radiologists can employ to reduce this risk. These include limiting the use of radiation whenever possible, using specific strategies to reduce radiation exposure during interventional procedures, using quality assurance programs to ensure compliance, and maintaining continuing staff radiation safety educational programs. Some of the diagnostic and therapeutic interventional radiologic procedures that are performed in pediatric oncology patients are discussed here, along with specific tips for managing radiation exposure. (orig.)

Design and implementation of a Macintosh-CAMAC based system for neutral beam diagnostics

International Nuclear Information System (INIS)

Wight, J.; Hong, R.M.; Phillips, J.C.; Lee, R.L.; Colleraine, A.P.; Kim, J.

1989-12-01

An automated personal computer based CAMAC data acquisition system is being implemented on the DIII-D neutral beamlines for certain diagnostics. The waterflow calorimetry (WFC) diagnostic is the first system to be upgraded. It includes data acquisition by a Macintosh II computer containing a National Instruments IEEE-488 card, and running their LabView software. Macintosh to CAMAC communications are carried out through an IEEE-488 crate controller. The Doppler shift spectroscopy, residual gas analysis, and armor tile infrared image diagnostics will be modified in similar ways. To reduce the demand for Macintosh CPU time, the extensive serial high-way data activity is performed by means of a new Kinetic Systems 3982 List sequencing Crate Controller dedicated to these operations. A simple Local Area Network file server is used to store data from all diagnostics together, and in a format readable by a standard commercial database. This reduces the problem of redundant data storage and allows simpler inter-diagnostic analysis. 3 refs., 4 figs

Integrated system fault diagnostics utilising digraph and fault tree-based approaches

International Nuclear Information System (INIS)

Bartlett, L.M.; Hurdle, E.E.; Kelly, E.M.

2009-01-01

With the growing intolerance to failures within systems, the issue of fault diagnosis has become ever prevalent. Information concerning these possible failures can help to minimise the disruption to the functionality of the system by allowing quick rectification. Traditional approaches to fault diagnosis within engineering systems have focused on sequential testing procedures and real-time mechanisms. Both methods have been predominantly limited to single fault causes. Latest approaches also consider the issue of multiple faults in reflection to the characteristics of modern day systems designed for high reliability. In addition, a diagnostic capability is required in real time and for changeable system functionality. This paper focuses on two approaches which have been developed to cater for the demands of diagnosis within current engineering systems, namely application of the fault tree analysis technique and the method of digraphs. Both use a comparative approach to consider differences between actual system behaviour and that expected. The procedural guidelines are discussed for each method, with an experimental aircraft fuel system used to test and demonstrate the features of the techniques. The effectiveness of the approaches is compared and their future potential highlighted

Diagnostic strategies for urinary tract infections in French general practice.

Science.gov (United States)

Kinouani, S; de Lary de Latour, H; Joseph, J-P; Letrilliart, L

2017-10-01

We aimed to describe the diagnostic management procedures for detection of urinary tract infections in general practice and their correlated factors. We analyzed data from the ECOGEN study on urinary tract infections, collected in France between November 2011 and April 2012. This national cross-sectional study was carried out in general practices. Data was coded according to the International Classification of Primary Care. A total of 340 consultations or home visits were held for urinary tract infections. The five most frequent diagnostic procedures were (in descending order) clinical examination (67.6%), urine cytobacteriological examination (UCBE) (47.9%), urine dipstick test (15.6%), blood test (8.5%), and imaging (6.5%). No urine dipstick test or UCBE was performed in 43% of cases. Factors correlated with diagnostic procedures were age and gender of patients, annual number of consultations held by family physicians, and duration of consultation. Family physicians did not comply with guidelines on diagnostic management for detection of urinary tract infections. We hypothesized that this non-compliance could be due to the family physicians' environment and characteristics, and to clinical practice guidelines. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Virtual standards of vibration-based defects diagnostics in railway industry

Directory of Open Access Journals (Sweden)

Vladimir TETTER

2009-01-01

Full Text Available The issues related to testing the functionality stated by producers of vibration-based diagnostic equipment have been considered. The introduction of virtual standards of defects found in bearing and geared assemblies of rolling stock is offered. The variants of virtual standards realization have been considered.

The simple analytical method for scattered radiation calculation in contrast X-ray diagnostic techniques

Energy Technology Data Exchange (ETDEWEB)

Markovic, S; Pavlovic, R [Inst. of Nuclear Science Vinca, Belgrade (Yugoslavia). Radiation and Environmental Protection Lab.; Boreli, F [Fac. of Electrical Engineering, Belgrade (Yugoslavia)

1996-12-31

In realization of radiation protection measures for medical staff present during diagnostic procedures, the necessary condition is knowledge of the space - energy distributions of the scattered radiation from the patient. In this paper, the simple calculation procedure for the scattered radiation field of the actual diagnostic energies is presented. Starting from the single Compton scattering model and using the justified transformations the final equations in elementary form are derived. For numerical calculations the computer code ANGIO was created. The calculated results were confirmed by detailed dosimetric measurements of the scattered field around patient (the water phantom) in SSDL in the Institute of nuclear sciences `Vinca`, Belgrade. These results are good base for assessment of irradiation. The main irradiation source for the physician and the other members of the medical team is the back scattered radiation from patient - albedo. (author). 3 figs., 3 refs.

Piezo-sensor self-diagnostics using electrical impedance measurements.

Energy Technology Data Exchange (ETDEWEB)

Park, G. H. (Gyu Hae); Farrar, C. R. (Charles R.); Rutherford, A. C. (Amanda C.); Robertson, A. N. (Amy N.)

2004-01-01

This paper present the piezoelectric sensor self-diagnostic procedure that performs in-situ monitoring of the operational status of piezoelectric materials (PZT) used for sensors and actuators in structural health monitoring (SHM) applications. The use of active-sensing piezoelectric materials has received considerable attention in the SHM community. A critical aspect of the piezoelectric active-sensing technologies is that usually large numbers of distributed sensors and actuators are needed to perform the required monitoring process. The sensor/actuator self-diagnostic procedure, where the sensors/actuators are confirmed to be functioning properly during operation, is therefore a critical component to successfully complete the SHM process and to minimize the false indication regarding the structural health. The basis of this procedure is to track the changes in the capacitive value of piezoelectric materials resulting from the sensor failure, which is manifested in the imaginary part of the measured electrical admittances. Furthermore, through the analytical and experimental investigation, it is confirmed that the bonding layer between the PZT and a host structure significantly contributes to the measured capacitive values. Therefore, by monitoring the imaginary part of the admittances, one can quantitatively assess the degradation of the mechanical/electrical properties of the PZT and its attachment to a host structure. This paper concludes with an experimental example to demonstrate the feasibility of the proposed sensor-diagnostic procedure.

Advanced DNA-Based Point-of-Care Diagnostic Methods for Plant Diseases Detection

Directory of Open Access Journals (Sweden)

Han Yih Lau

2017-12-01

Full Text Available Diagnostic technologies for the detection of plant pathogens with point-of-care capability and high multiplexing ability are an essential tool in the fight to reduce the large agricultural production losses caused by plant diseases. The main desirable characteristics for such diagnostic assays are high specificity, sensitivity, reproducibility, quickness, cost efficiency and high-throughput multiplex detection capability. This article describes and discusses various DNA-based point-of care diagnostic methods for applications in plant disease detection. Polymerase chain reaction (PCR is the most common DNA amplification technology used for detecting various plant and animal pathogens. However, subsequent to PCR based assays, several types of nucleic acid amplification technologies have been developed to achieve higher sensitivity, rapid detection as well as suitable for field applications such as loop-mediated isothermal amplification, helicase-dependent amplification, rolling circle amplification, recombinase polymerase amplification, and molecular inversion probe. The principle behind these technologies has been thoroughly discussed in several review papers; herein we emphasize the application of these technologies to detect plant pathogens by outlining the advantages and disadvantages of each technology in detail.

A Ribeiroia spp. (Class: Trematoda) - Specific PCR-based diagnostic

Science.gov (United States)

Reinitz, David M.; Yoshino, T.P.; Cole, Rebecca A.

2007-01-01

Increased reporting of amphibian malformations in North America has been noted with concern in light of reports that amphibian numbers and species are declining worldwide. Ribeiroia ondatrae has been shown to cause a variety of types of malformations in amphibians. However, little is known about the prevalence of R. ondatrae in North America. To aid in conducting field studies of Ribeiroia spp., we have developed a polymerase chain reaction (PCR)-based diagnostic. Herein, we describe the development of an accurate, rapid, simple, and cost-effective diagnostic for detection of Ribeiroia spp. infection in snails (Planorbella trivolvis). Candidate oligonucleotide primers for PCR were designed via DNA sequence analyses of multiple ribosomal internal transcribed spacer-2 regions from Ribeiroia spp. and Echinostoma spp. Comparison of consensus sequences determined from both genera identified areas of sequence potentially unique to Ribeiroia spp. The PCR reliably produced a diagnostic 290-base pair (bp) product in the presence of a wide concentration range of snail or frog DNA. Sensitivity was examined with DNA extracted from single R. ondatrae cercaria. The single-tube PCR could routinely detect less than 1 cercariae equivalent, because DNA isolated from a single cercaria could be diluted at least 1:50 and still yield a positive result via gel electrophoresis. An even more sensitive nested PCR also was developed that routinely detected 100 fg of the 290-bp fragment. The assay did not detect furcocercous cercariae of certain Schistosomatidae, Echinostoma sp., or Sphaeridiotrema globulus nor adults of Clinostomum sp. or Cyathocotyle bushiensis. Field testing of 137 P. trivolvis identified 3 positives with no overt environmental cross-reactivity, and results concurred with microscopic examinations in all cases. ?? American Society of Parasitologists 2007.

Glycosylation-Based Serum Biomarkers for Cancer Diagnostics and Prognostics.

Science.gov (United States)

Kirwan, Alan; Utratna, Marta; O'Dwyer, Michael E; Joshi, Lokesh; Kilcoyne, Michelle

2015-01-01

Cancer is the second most common cause of death in developed countries with approximately 14 million newly diagnosed individuals and over 6 million cancer-related deaths in 2012. Many cancers are discovered at a more advanced stage but better survival rates are correlated with earlier detection. Current clinically approved cancer biomarkers are most effective when applied to patients with widespread cancer. Single biomarkers with satisfactory sensitivity and specificity have not been identified for the most common cancers and some biomarkers are ineffective for the detection of early stage cancers. Thus, novel biomarkers with better diagnostic and prognostic performance are required. Aberrant protein glycosylation is well known hallmark of cancer and represents a promising source of potential biomarkers. Glycoproteins enter circulation from tissues or blood cells through active secretion or leakage and patient serum is an attractive option as a source for biomarkers from a clinical and diagnostic perspective. A plethora of technical approaches have been developed to address the challenges of glycosylation structure detection and determination. This review summarises currently utilised glycoprotein biomarkers and novel glycosylation-based biomarkers from the serum glycoproteome under investigation as cancer diagnostics and for monitoring and prognostics and includes details of recent high throughput and other emerging glycoanalytical techniques.

The IHS diagnostic X-ray equipment radiation protection program

International Nuclear Information System (INIS)

Knapp, A.; Byrns, G.; Suleiman, O.

1994-01-01

The Indian Health Service (IHS) operates or contracts with Tribal groups to operate 50 hospitals and approximately 165 primary ambulatory care centers. These facilities contain approximately 275 medical and 800 dental diagnostic x-ray machines. IHS environmental health personnel in collaboration with the Food and Drug Administration's (FDA) Center for Devices and Radiological Health (CDRH) developed a diagnostic x-ray protection program including standard survey procedures and menu-driven calculations software. Important features of the program include the evaluation of equipment performance collection of average patient entrance skin exposure (ESE) measurements for selected procedures, and quality assurance. The ESE data, collected using the National Evaluation of X-ray Trends (NEXT) protocol, will be presented. The IHS Diagnostic X-ray Radiation Protection Program is dynamic and is adapting to changes in technology and workload

Utility of 18FDG-PET/CT in breast cancer diagnostics – a systematic review

DEFF Research Database (Denmark)

Warning, Karina; Hildebrandt, Malene; Christensen, Bent

2011-01-01

as a primary diagnostic procedure in breast cancer; but it has the potential to be useful for the detection of distant metastases and for monitoring response to chemotherapy in breast cancer patients. PET/CT should still be regarded as a supplement to conventional diagnostic procedures such as CT and MRI....

Diagnostic criteria for headache attributed to temporomandibular disorders.

Science.gov (United States)

Schiffman, Eric; Ohrbach, Richard; List, Thomas; Anderson, Gary; Jensen, Rigmor; John, Mike T; Nixdorf, Donald; Goulet, Jean-Paul; Kang, Wenjun; Truelove, Ed; Clavel, Al; Fricton, James; Look, John

2012-07-01

We assessed and compared the diagnostic accuracy of two sets of diagnostic criteria for headache secondary to temporomandibular disorders (TMD). In 373 headache subjects with TMD, a TMD headache reference standard was defined as: self-reported temple headache, consensus diagnosis of painful TMD and replication of the temple headache using TMD-based provocation tests. Revised diagnostic criteria for Headache attributed to TMD were selected using the RPART (recursive partitioning and regression trees) procedure, and refined in half of the data set. Using the remaining half of the data, the diagnostic accuracy of the revised criteria was compared to that of the International Headache Society's International Classification of Headache Diseases (ICHD)-II criteria A to C for Headache or facial pain attributed to temporomandibular joint (TMJ) disorder. Relative to the TMD headache reference standard, ICHD-II criteria showed sensitivity of 84% and specificity of 33%. The revised criteria for Headache attributed to TMD had sensitivity of 89% with improved specificity of 87% (p headache that is changed with jaw movement, function or parafunction and (2) provocation of that headache by temporalis muscle palpation or jaw movement. Having significantly better specificity than the ICHD-II criteria A to C, the revised criteria are recommended to diagnose headache secondary to TMD.

Children's exposure to diagnostic medical radiation and cancer risk: epidemiologic and dosimetric considerations

Energy Technology Data Exchange (ETDEWEB)

Linet, Martha S.; Rajaraman, Preetha [National Cancer Institute, Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Bethesda, MD (United States); Kim, Kwang pyo [National Cancer Institute, Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Bethesda, MD (United States); Kyung Hee University, Department of Nuclear Engineering, Yongin-si, Gyeonggi (Korea)

2009-02-15

While the etiology of most childhood cancers is largely unknown, epidemiologic studies have consistently found an association between exposure to medical radiation during pregnancy and risk of childhood cancer in offspring. The relation between early life diagnostic radiation exposure and occurrence of pediatric cancer risks is less clear. This review summarizes current and historical estimated doses for common diagnostic radiologic procedures as well as the epidemiologic literature on the role of maternal prenatal, children's postnatal and parental preconception diagnostic radiologic procedures on subsequent risk of childhood malignancies. Risk estimates are presented according to factors such as the year of birth of the child, trimester and medical indication for the procedure, and the number of films taken. The paper also discusses limitations of the methods employed in epidemiologic studies to assess pediatric cancer risks, the effects on clinical practice of the results reported from the epidemiologic studies, and clinical and public health policy implications of the findings. Gaps in understanding and additional research needs are identified. Important research priorities include nationwide surveys to estimate fetal and childhood radiation doses from common diagnostic procedures, and epidemiologic studies to quantify pediatric and lifetime cancer risks from prenatal and early childhood exposures to diagnostic radiography, CT, and fluoroscopically guided procedures. (orig.)

Assessment of creep-fatigue damage using the UK strain based procedure

International Nuclear Information System (INIS)

Bate, S.K.

1997-01-01

The UK strain based procedures have been developed for the evaluation of damage in structures, arising from fatigue cycles and creep processes. The fatigue damage is assessed on the basis of modelling crack growth from about one grain depth to an allowable limit which represents an engineering definition of crack formation. Creep damage is based up on the exhaustion of available ductility by creep strain accumulation. The procedures are applicable only when level A and B service conditions apply, as defined in RCC-MR or ASME Code Case N47. The procedures require the components of strain to be evaluated separately, thus they may be used with either full inelastic analysis or simplified methods. To support the development of the UK strain based creep-fatigue procedures an experimental program was undertaken by NNC to study creep-fatigue interaction of structures operating at high temperature. These tests, collectively known as the SALTBATH tests considered solid cylinder and tube-plate specimens, manufactured from Type 316 stainless steel. These specimens were subjected to thermal cycles between 250 deg. C and 600 deg. C. In all the cases the thermal cycle produces tensile residual stresses during dwells at 600 deg. C. One of the tube-plate specimens was used as a benchmark for validating the strain based creep fatigue procedures and subsequently as part of a CEC co-operative study. This benchmark work is described in this paper. A thermal and inelastic stress analysis was carried out using the finite element code ABAQUS. The inelastic behaviour of the material was described using the ORNL constitutive equations. A creep fatigue assessment using the strain based procedures has been compared with an assessment using the RCC-MR inelastic rules. The analyses indicated that both the UK strain based procedures and the RCC-MR rules were conservative, but the conservatism was greater for the RCC-MR rules. (author). 8 refs, 8 figs, 4 tabs

Qualitative Event-Based Diagnosis: Case Study on the Second International Diagnostic Competition

Science.gov (United States)

Daigle, Matthew; Roychoudhury, Indranil

2010-01-01

We describe a diagnosis algorithm entered into the Second International Diagnostic Competition. We focus on the first diagnostic problem of the industrial track of the competition in which a diagnosis algorithm must detect, isolate, and identify faults in an electrical power distribution testbed and provide corresponding recovery recommendations. The diagnosis algorithm embodies a model-based approach, centered around qualitative event-based fault isolation. Faults produce deviations in measured values from model-predicted values. The sequence of these deviations is matched to those predicted by the model in order to isolate faults. We augment this approach with model-based fault identification, which determines fault parameters and helps to further isolate faults. We describe the diagnosis approach, provide diagnosis results from running the algorithm on provided example scenarios, and discuss the issues faced, and lessons learned, from implementing the approach

Radiation safety and quality control assurance in X-ray diagnostics 1998

International Nuclear Information System (INIS)

Servomaa, A.

1998-03-01

The report is based on a seminar course of lectures 'Radiation safety and quality assurance in X-ray diagnostics 1998' organized by the Radiation and Nuclear Safety Authority (STUK) in Finland. The lectures included actual information on X-ray examinations: methods of quality assurance, methods of measuring and calculating patient doses, examination frequencies, patient doses, occupational doses, and radiation risks. Paediatric X-ray examinations and interventional procedures were the most specific topics. The new Council Directive 97/43/Euratom on medical exposure, and the European Guidelines on quality criteria for diagnostic radiographic images, were discussed in several lectures. Lectures on general radiation threats and preparedness, examples of radiation accidents, and emergency preparedness in hospitals were also included. (editor)

Opto-electronic DNA chip-based integrated card for clinical diagnostics.

Science.gov (United States)

Marchand, Gilles; Broyer, Patrick; Lanet, Véronique; Delattre, Cyril; Foucault, Frédéric; Menou, Lionel; Calvas, Bernard; Roller, Denis; Ginot, Frédéric; Campagnolo, Raymond; Mallard, Frédéric

2008-02-01

Clinical diagnostics is one of the most promising applications for microfluidic lab-on-a-chip or lab-on-card systems. DNA chips, which provide multiparametric data, are privileged tools for genomic analysis. However, automation of molecular biology protocol and use of these DNA chips in fully integrated systems remains a great challenge. Simplicity of chip and/or card/instrument interfaces is amongst the most critical issues to be addressed. Indeed, current detection systems for DNA chip reading are often complex, expensive, bulky and even limited in terms of sensitivity or accuracy. Furthermore, for liquid handling in the lab-on-cards, many devices use complex and bulky systems, either to directly manipulate fluids, or to ensure pneumatic or mechanical control of integrated valves. All these drawbacks prevent or limit the use of DNA-chip-based integrated systems, for point-of-care testing or as a routine diagnostics tool. We present here a DNA-chip-based protocol integration on a plastic card for clinical diagnostics applications including: (1) an opto-electronic DNA-chip, (2) fluid handling using electrically activated embedded pyrotechnic microvalves with closing/opening functions. We demonstrate both fluidic and electric packaging of the optoelectronic DNA chip without major alteration of its electronical and biological functionalities, and fluid control using novel electrically activable pyrotechnic microvalves. Finally, we suggest a complete design of a card dedicated to automation of a complex biological protocol with a fully electrical fluid handling and DNA chip reading.

Entropy-Based Clutter Rejection for Intrawall Diagnostics

Directory of Open Access Journals (Sweden)

Raffaele Solimene

2012-01-01

Full Text Available The intrawall diagnostic problem of detecting localized inhomogeneities possibly present within the wall is addressed. As well known, clutter arising from masonry structure can impair detection of embedded scatterers due to high amplitude reflections that wall front face introduces. Moreover, internal multiple reflections also can make it difficult ground penetrating radar images (radargramms interpretation. To counteract these drawbacks, a clutter rejection method, properly tailored on the wall features, is mandatory. To this end, here we employ a windowing strategy based on entropy measures of temporal traces “similarity.” Accordingly, instants of time for which radargramms exhibit entropy values greater than a prescribed threshold are “silenced.” Numerical results are presented in order to show the effectiveness of the entropy-based clutter rejection algorithm. Moreover, a comparison with the standard average trace subtraction is also included.

Pre-examination factors affecting molecular diagnostic test results and interpretation: A case-based approach.

Science.gov (United States)

Payne, Deborah A; Baluchova, Katarina; Peoc'h, Katell H; van Schaik, Ron H N; Chan, K C Allen; Maekawa, Masato; Mamotte, Cyril; Russomando, Graciela; Rousseau, François; Ahmad-Nejad, Parviz

2017-04-01

Multiple organizations produce guidance documents that provide opportunities to harmonize quality practices for diagnostic testing. The International Organization for Standardization ISO 15189 standard addresses requirements for quality in management and technical aspects of the clinical laboratory. One technical aspect addresses the complexities of the pre-examination phase prior to diagnostic testing. The Committee for Molecular Diagnostics of the International Federation for Clinical Chemistry and Laboratory Medicine (also known as, IFCC C-MD) conducted a survey of international molecular laboratories and determined ISO 15189 to be the most referenced guidance document. In this review, the IFCC C-MD provides case-based examples illustrating the value of select pre-examination processes as these processes relate to molecular diagnostic testing. Case-based examples in infectious disease, oncology, inherited disease and pharmacogenomics address the utility of: 1) providing information to patients and users, 2) designing requisition forms, 3) obtaining informed consent and 4) maintaining sample integrity prior to testing. The pre-examination phase requires extensive and consistent communication between the laboratory, the healthcare provider and the end user. The clinical vignettes presented in this paper illustrate the value of applying select ISO 15189 recommendations for general laboratory to the more specialized area of Molecular Diagnostics. Copyright © 2016 Elsevier B.V. All rights reserved.

Health Risks of Diagnostic Radiology

International Nuclear Information System (INIS)

Al-Oraby, M.N.A.

2014-01-01

Exposure to ionizing radiation during diagnostic radiologic procedures carries small but real risks. Children, young adults and pregnant women are especially vulnerable. Exposure of patients to diagnostic energy levels of ionizing radiation should be kept to the minimum necessary to provide useful clinical information and allay patients concerns about radiation-related risks. Computerized Tomography (CT) accounts for two thirds of the cumulative patient dose from diagnostic radiological procedures and the cumulative dose from CT is rising as technological advances increase the number of indications and the capabilities of CT. Carcinogenesis and teratogenesis are the main concerns with ionizing radiation. The risk increases as the radiation dose increases. There is no minimum threshold and the risk is cumulative: a dose of 1 mSv once a year for 10 years is equivalent to a single dose of 10 mSv. Whenever practical, choose an imaging test that uses less radiation or no radiation and lengthen the periods between follow-up imaging tests. Some patients may avoid screening mammography because of fear of radiation-induced cancer, yet this test uses a very small radiation dose (0.6 mSv, much less than the annual dose from background radiation, 3.6 mSv). (author)

Strategies to Enhance Online Learning Teams. Team Assessment and Diagnostics Instrument and Agent-based Modeling

Science.gov (United States)

2010-08-12

Strategies to Enhance Online Learning Teams Team Assessment and Diagnostics Instrument and Agent-based Modeling Tristan E. Johnson, Ph.D. Learning ...REPORT DATE AUG 2010 2. REPORT TYPE 3. DATES COVERED 00-00-2010 to 00-00-2010 4. TITLE AND SUBTITLE Strategies to Enhance Online Learning ...TeamsTeam Strategies to Enhance Online Learning Teams: Team Assessment and Diagnostics Instrument and Agent-based Modeling 5a. CONTRACT NUMBER 5b. GRANT

On the neutron noise diagnostics of pressurized water reactor control rod vibrations. 1. periodic vibrations

International Nuclear Information System (INIS)

Pazsit, I.; Glockler, O.

1983-01-01

Based on the theory of neutron noise arising from the vibration of a localized absorber, the possibility of rod vibration diagnostics is investigated. It is found that noise source characteristics, namely rod position and vibration trajectory and spectra, can be unfolded from measured neutron noise signals. For the localization process, the first and more difficult part of the diagnostics, a procedure is suggested whose novelty is that it is applicable in case of arbitrary vibration trajectories. Applicability of the method is investigated in numerical experiments where effects of background noise are also accounted for

Gonad shielding in diagnostic radiology

International Nuclear Information System (INIS)

1975-06-01

The use of gonad shielding is an important radiation protection technique, intended to reduce unnecessary x-ray exposure of the gonads of patients from diagnostic x-ray procedures. This pamphlet will provide physicians and radiologic technologists with information which will aid their appropriate use of gonad shielding

Diagnosing Appendicitis: Evidence-Based Review of the Diagnostic Approach in 2014

Science.gov (United States)

Shogilev, Daniel J.; Duus, Nicolaj; Odom, Stephen R.; Shapiro, Nathan I.

2014-01-01

Introduction Acute appendicitis is the most common abdominal emergency requiring emergency surgery. However, the diagnosis is often challenging and the decision to operate, observe or further work-up a patient is often unclear. The utility of clinical scoring systems (namely the Alvarado score), laboratory markers, and the development of novel markers in the diagnosis of appendicitis remains controversial. This article presents an update on the diagnostic approach to appendicitis through an evidence-based review. Methods We performed a broad Medline search of radiological imaging, the Alvarado score, common laboratory markers, and novel markers in patients with suspected appendicitis. Results Computed tomography (CT) is the most accurate mode of imaging for suspected cases of appendicitis, but the associated increase in radiation exposure is problematic. The Alvarado score is a clinical scoring system that is used to predict the likelihood of appendicitis based on signs, symptoms and laboratory data. It can help risk stratify patients with suspected appendicitis and potentially decrease the use of CT imaging in patients with certain Alvarado scores. White blood cell (WBC), C-reactive protein (CRP), granulocyte count and proportion of polymorphonuclear (PMN) cells are frequently elevated in patients with appendicitis, but are insufficient on their own as a diagnostic modality. When multiple markers are used in combination their diagnostic utility is greatly increased. Several novel markers have been proposed to aid in the diagnosis of appendicitis; however, while promising, most are only in the preliminary stages of being studied. Conclusion While CT is the most accurate mode of imaging in suspected appendicitis, the accompanying radiation is a concern. Ultrasound may help in the diagnosis while decreasing the need for CT in certain circumstances. The Alvarado Score has good diagnostic utility at specific cutoff points. Laboratory markers have very limited

Double- vs. single-balloon enteroscopy: single center experience with emphasis on procedural performance.

Science.gov (United States)

Lenz, Philipp; Roggel, Moritz; Domagk, Dirk

2013-09-01

This study aims to compare double- (DBE) and single-balloon enteroscopy (SBE) in small bowel disorders with respect to procedural performance and clinical impact. This retrospective analysis at a tertial referral center included 1,052 DBEs and 515 SBEs performed in 904 patients over 7 years. Procedural and patients' characteristics were precisely analyzed. Significantly more patients with anemia and gastrointestinal bleeding were investigated by DBE (P recent years of enteroscopy (2008-2011), no difference in small bowel visualization could be observed. The anal insertion depths and complete enteroscopy rates (CER) were comparable. Procedure times were significantly shorter within the SBE procedure (oral: 50 vs. 40 min; anal: 55 vs. 46 min, P Diagnostic yield was significantly higher in the SBE, compared to the DBE group (61.7 vs. 48.2 %; P diagnostic tools and proved to be indispensable in the daily gastroenterological practice. The lower insertion depths, but higher diagnostic yield, of SBE may reflect the more focused selection of patients scheduled for small bowel diagnostics in recent years.

Implementing Computer-Based Procedures: Thinking Outside the Paper Margins

Energy Technology Data Exchange (ETDEWEB)

Oxstrand, Johanna; Bly, Aaron

2017-06-01

In the past year there has been increased interest from the nuclear industry in adopting the use of electronic work packages and computer-based procedures (CBPs) in the field. The goal is to incorporate the use of technology in order to meet the Nuclear Promise requirements of reducing costs and improve efficiency and decrease human error rates of plant operations. Researchers, together with the nuclear industry, have been investigating the benefits an electronic work package system and specifically CBPs would have over current paper-based procedure practices. There are several classifications of CBPs ranging from a straight copy of the paper-based procedure in PDF format to a more intelligent dynamic CBP. A CBP system offers a vast variety of improvements, such as context driven job aids, integrated human performance tools (e.g., placekeeping and correct component verification), and dynamic step presentation. The latter means that the CBP system could only display relevant steps based on operating mode, plant status, and the task at hand. The improvements can lead to reduction of the worker’s workload and human error by allowing the work to focus on the task at hand more. A team of human factors researchers at the Idaho National Laboratory studied and developed design concepts for CBPs for field workers between 2012 and 2016. The focus of the research was to present information in a procedure in a manner that leveraged the dynamic and computational capabilities of a handheld device allowing the worker to focus more on the task at hand than on the administrative processes currently applied when conducting work in the plant. As a part of the research the team identified type of work, instructions, and scenarios where the transition to a dynamic CBP system might not be as beneficial as it would for other types of work in the plant. In most cases the decision to use a dynamic CBP system and utilize the dynamic capabilities gained will be beneficial to the worker

Systematic review of proposed definitions of nocturnal polyuria and population-based evidence of their diagnostic accuracy.

Science.gov (United States)

Olesen, Tine Kold; Denys, Marie-Astrid; Vande Walle, Johan; Everaert, Karel

2018-02-06

Background Evidence of diagnostic accuracy for proposed definitions of nocturnal polyuria is currently unclear. Purpose Systematic review to determine population-based evidence of the diagnostic accuracy of proposed definitions of nocturnal polyuria based on data from frequency-volume charts. Methods Seventeen pre-specified search terms identified 351 unique investigations published from 1990 to 2016 in BIOSIS, Embase, Embase Alerts, International Pharmaceutical Abstract, Medline, and Cochrane. Thirteen original communications were included in this review based on pre-specified exclusion criteria. Data were extracted from each paper regarding subject age, sex, ethnicity, health status, sample size, data collection methods, and diagnostic discrimination of proposed definitions including sensitivity, specificity, positive and negative predictive value. Results The sample size of study cohorts, participant age, sex, ethnicity, and health status varied considerably in 13 studies reporting on the diagnostic performance of seven different definitions of nocturnal polyuria using frequency-volume chart data from 4968 participants. Most study cohorts were small, mono-ethnic, including only Caucasian males aged 50 or higher with primary or secondary polyuria that were compared to a control group of healthy men without nocturia in prospective or retrospective settings. Proposed definitions had poor discriminatory accuracy in evaluations based on data from subjects independent from the original study cohorts with findings being similar regarding the most widely evaluated definition endorsed by ICS. Conclusions Diagnostic performance characteristics for proposed definitions of nocturnal polyuria show poor to modest discrimination and are not based on sufficient level of evidence from representative, multi-ethnic population-based data from both females and males of all adult ages.

Sagittal reconstruction computed tomography in metrizamide cisternography. Useful diagnostic procedure for malformations in craniovertebral junction and posterior fossa

Energy Technology Data Exchange (ETDEWEB)

Mochizuki, H.; Okita, N.; Fujii, T.; Yoshioka, M.; Saito, H. (Tohoku Univ., Sendai (Japan). School of Medicine)

1982-08-01

We studied the sagittal reconstruction technique in computed tomography with metrizamide. Ten ml of metrizamide, 170 mg iodine/ml in concentration, were injected by lumbar puncture. After diffusion of the injected metrizamide, axial computed tomograms were taken by thin slice width (5 mm) with overlapped technique. Then electrical sagittal reconstruction was carried out by optioned software. Injection of metrizamide, non-ionic water soluble contrast media, made clear contrasts among bone, brain parenchyma and cerebrospinal fluid with computed tomography. Sagittal reconstruction technique could reveal more precise details and accurate anatomical relations than ordinary axial computed tomography. This technique was applied on 3 cases (Arnold-Chiari malformation, large cisterna magna and partial agenesis cerebellar vermis), which demonstrated a useful diagnostic procedure for abnormalities of craniovertebral junction and posterior fossa. The adverse reactions of metrizamide were negligible in our series.

Experimental and numerical studies on liquid wicking into filter papers for paper-based diagnostics

International Nuclear Information System (INIS)

Liu, Zhi; Hu, Jie; Zhao, Yimeng; Qu, Zhiguo; Xu, Feng

2015-01-01

Paper-based diagnostics have shown promising potential applications in human disease surveillance and food safety analysis at the point-of-care (POC). The liquid wicking behavior in diagnostic fibrous paper plays an important role in development of paper-based diagnostics. In the current study, we performed experimental and numerical research on the liquid wicking height and mass with three width strips into filter paper. The effective porosity could be conveniently measured in the light of the linear correlation between wicking height and mass by the experimental system. A modified model with considering evaporation effect was proposed to predict wicking height and mass. The predicted wicking height and mass using the evaporation model was much closer to the experimental data compared with the model without evaporation. The wicking speed initially decreased significantly and then maintained at a constant value at lower level. The evaporation effect tends to reduce the wicking flow speed. More wicking mass could be obtained at larger strip width but the corresponding reagent loss became significant. The proposed model with evaporation paved a way to understanding the fundamental of fluid flow in diagnostic paper and was essential to provide meaningful and useful reference for the research and development of paper-based diagnostics devices. - Highlights: • A model with considering evaporation was proposed to predict wicking height and mass. • Flow characteristics of filter paper were experimentally and theoretically studied. • Effective porosity could be conveniently measured by the experimental platform. • The evaporation effect tended to reduce the wicking flow speed

Guidance levels for diagnostic radiology in Romania

International Nuclear Information System (INIS)

Iacob, O.; Diaconescu, C.

2002-01-01

Over two decades surveys of radiological practice in Romania have demonstrated wide variations in patient dose levels between different hospitals. Local and national investigations revealed poor performances as well as of radiological equipment, darkroom procedure or technology of investigation. Hitherto, the annual collective effective dose to the population of Romania from diagnostic medical exposures attained a value of 13,820 manSv. Since the annual frequencies of radiological examinations remain unchanged over last ten years, this value is mostly attributed to the individual dose levels in different X-ray procedures. Notwithstanding the huge benefits to patients, the reduction of unnecessary exposures and individual doses are our principal concern and the establishment of national reference dose levels should solve this problem. British experience demonstrated that reference doses are a practical tool in this purpose and the adoption of national reference dose values indicated an overall improvement in patient exposure. Even the local of reference dose values proved a useful way to achieve patient dose reduction. In meantime the optimization of patient protection, each X-ray examination should be conducted with lowest necessary dose to achieve the clinical aim. This paper presents the first approach to establish local reference dose levels for some diagnostic examinations based on the measurements made in six (from the eighth of Eastern territory of Romania) districts, invited to cooperate in this end

Field-based systems and advanced diagnostics

International Nuclear Information System (INIS)

Eryurek, E.

1998-01-01

Detection and characterization of anomalies in an industrial plant provide improved plant availability and plant efficiency thus yielding increased economic efficiency. Traditionally, detection of process anomalies is done at a high-level control system through various signal validation methods. These signal validation techniques rely on data from transmitters, which measure related process variables. Correlating these signals and deducing anomalies often is a very time consuming and a difficult task. Delays in detecting these anomalies can be costly during plant operation. Conventional centralized approaches also suffer from their dependence on detailed mathematical models of the processes. Smart field devices have the advantage of providing the necessary information directly to the control system as anomalies develop during operation of the processes enabling operators to take necessary steps to either prevent an unnecessary shut down before the problem becomes serious or schedule maintenance on the problematic loop. Fisher-Rosemount's PlantWeb TM architecture addresses 'Enhanced Measurement, Advanced Diagnostics and Control in the Field'. PlantWeb TM builds open process management systems by networking intelligent field devices, scalable control and systems platforms, and integrated modular software. A description of PlantWeb TM and how it improves various process conditions and reduces operating cost of a plant as well as a high level description of 'Enhanced Measurement, Advanced Diagnostics and Control in the Field', will be provided in this paper. PlantWeb TM is the trademark for Fisher-Rosemount's new field-based architecture that uses emerging technologies to utilize the power of intelligent field devices and deliver critical process and equipment information to improve plant performance. (author)

Comparative guide to emerging diagnostic tools for large commercial HVAC systems

Energy Technology Data Exchange (ETDEWEB)

Friedman, Hannah; Piette, Mary Ann

2001-05-01

This guide compares emerging diagnostic software tools that aid detection and diagnosis of operational problems for large HVAC systems. We have evaluated six tools for use with energy management control system (EMCS) or other monitoring data. The diagnostic tools summarize relevant performance metrics, display plots for manual analysis, and perform automated diagnostic procedures. Our comparative analysis presents nine summary tables with supporting explanatory text and includes sample diagnostic screens for each tool.

Activity and longevity of antibody in paper-based blood typing diagnostics

Science.gov (United States)

Henderson, Clare A.; McLiesh, Heather; Then, Whui L.; Garnier, Gil

2018-05-01

Paper-based diagnostics provide a low-cost, reliable and easy to use mode of blood typing. The shelf-life of such products, however, can be limited due to the reduced activity of reagent antibodies sorbed on the paper cellulose fibres. This study explores the effects of ageing on antibody activity for periods up to twelve months on paper and in solution under different ageing and drying conditions - air-dried, lyophilised and kept as a liquid. Paper kept wet with undiluted antibody is shown to have the longest shelf-life and the clearest negatives. Antibody diluted with bovine serum albumin (BSA) protects against the lyophilisation process, however, beyond nine months ageing, false positives are seen. Paper with air-dried antibodies is not suitable for use after one month ageing. These results inform preparation and storage conditions for the development of long shelf-life blood grouping paper-based diagnostics.

Activity and Longevity of Antibody in Paper-Based Blood Typing Diagnostics

Directory of Open Access Journals (Sweden)

Clare A. Henderson

2018-05-01

Full Text Available Paper-based diagnostics provide a low-cost, reliable and easy to use mode of blood typing. The shelf-life of such products, however, can be limited due to the reduced activity of reagent antibodies sorbed on the paper cellulose fibers. This study explores the effects of aging on antibody activity for periods up to 12 months on paper and in solution under different aging and drying conditions—air-dried, lyophilized, and kept as a liquid. Paper kept wet with undiluted antibody is shown to have the longest shelf-life and the clearest negatives. Antibody diluted with bovine serum albumin (BSA protects against the lyophilization process, however, beyond 9 months aging, false positives are seen. Paper with air-dried antibodies is not suitable for use after 1 month aging. These results inform preparation and storage conditions for the development of long shelf-life blood grouping paper-based diagnostics.

Development of a diagnostic protocol for dizziness in elderly patients in general practice: a Delphi procedure.

NARCIS (Netherlands)

Maarsingh, O.R.; Dros, J.; Weert, H.C. van; Schellevis, F.G.; Bindels, P.J.; Horst, H.E. van der

2009-01-01

BACKGROUND: Dizziness in general practice is very common, especially in elderly patients. The empirical evidence for diagnostic tests in the evaluation of dizziness is scarce. Aim of our study was to determine which set of diagnostic tests should be part of a diagnostic protocol for evaluating

Smartphone-Based Fluorescent Diagnostic System for Highly Pathogenic H5N1 Viruses

OpenAIRE

Yeo, Seon-Ju; Choi, Kyunghan; Cuc, Bui Thi; Hong, Nguyen Ngoc; Bao, Duong Tuan; Ngoc, Nguyen Minh; Le, Mai Quynh; Hang, Nguyen Le Khanh; Thach, Nguyen Co; Mallik, Shyam Kumar; Kim, Hak Sung; Chong, Chom-Kyu; Choi, Hak Soo; Sung, Haan Woo; Yu, Kyoungsik

2016-01-01

Field diagnostic tools for avian influenza (AI) are indispensable for the prevention and controlled management of highly pathogenic AI-related diseases. More accurate, faster and networked on-site monitoring is demanded to detect such AI viruses with high sensitivity as well as to maintain up-to-date information about their geographical transmission. In this work, we assessed the clinical and field-level performance of a smartphone-based fluorescent diagnostic device with an efficient reflect...

Evaluating Utility in Diagnostic Decision Making.

Science.gov (United States)

Harber, Jean R.

1981-01-01

The utility of the procedures special educators apply in making decisions about the identification of handicapped individuals has not been thoroughly studied. The paper examines the utility of diagnostic decision making from the perspective of receiver operating curve analysis. (Author)

Selective Sequential Zero-Base Budgeting Procedures Based on Total Factor Productivity Indicators

OpenAIRE

A. Ishikawa; E. F. Sudit

1981-01-01

The authors' purpose in this paper is to develop productivity-based sequential budgeting procedures designed to expedite identification of major problem areas in bugetary performance, as well as to reduce the costs associated with comprehensive zero-base analyses. The concept of total factor productivity is reviewed and its relations to ordinary and zero-based budgeting are discussed in detail. An outline for a selective sequential analysis based on monitoring of three key indicators of (a) i...

Diagnostic radiology dosimetry: status and trends

International Nuclear Information System (INIS)

Rivera M, T.

2015-10-01

Full text: Medical radiation is by far the largest man-made source of public exposure to ionizing radiation. Since 1970 the expression of protection standards shifted from a dose- to a risk-based approach, with dose limits established to yield risks to radiation workers comparable with those for workers in other safe industries. Another hand, worldwide interest in patient dose measurement was stimulated by the publication of Patient Dose Reduction in Diagnostic Radiology by the UK National Radiological Protection Board (NRPB). In response to heightened awareness of the importance of patient dose contributed by radiology procedures, there has been a general trend to effect control of patient doses by applying the principles of optimization coupled with an increase in regulatory enforcement. In this sense, thermoluminescent dosimetry (TLD) has been actively proposed in the last 3 decades thanks to their successful applications in diagnostic radiology. At the same time, it is emerged as the best radiation dosimetry method. The present work presents advantages of thermoluminescent dosimetry for X-ray beams measurements and its optimization. (Author)

Diagnostic radiology dosimetry: status and trends

Energy Technology Data Exchange (ETDEWEB)

Rivera M, T., E-mail: trivera@ipn.mx [IPN, Centro de Investigacion en Ciencia Aplicada y Tecnologia Avanzada, Av. Legaria 694, 11500 Mexico D. F. (Mexico)

2015-10-15

Full text: Medical radiation is by far the largest man-made source of public exposure to ionizing radiation. Since 1970 the expression of protection standards shifted from a dose- to a risk-based approach, with dose limits established to yield risks to radiation workers comparable with those for workers in other safe industries. Another hand, worldwide interest in patient dose measurement was stimulated by the publication of Patient Dose Reduction in Diagnostic Radiology by the UK National Radiological Protection Board (NRPB). In response to heightened awareness of the importance of patient dose contributed by radiology procedures, there has been a general trend to effect control of patient doses by applying the principles of optimization coupled with an increase in regulatory enforcement. In this sense, thermoluminescent dosimetry (TLD) has been actively proposed in the last 3 decades thanks to their successful applications in diagnostic radiology. At the same time, it is emerged as the best radiation dosimetry method. The present work presents advantages of thermoluminescent dosimetry for X-ray beams measurements and its optimization. (Author)

The Increase of Operational Safety of Ships by Improving Diagnostic Methods for Marine Diesel Engine

Directory of Open Access Journals (Sweden)

Kazimierz Witkowski

2017-06-01

Full Text Available This article shows the importance of the diagnostic improvement methods of marine engines to boost the economy and safety of operation of marine cargo ships. The need to implement effective diagnostic methods is justified by presenting statistical data of marine diesel engines failure and the cost of their operation. Based on the own research has been proven, for the chosen example, that indicator diagrams and analysis of indicated parameters have limited utility in the diagnosis of damages of marine engine, although this is a method commonly used in operational practice. To achieve greater diagnostic effectiveness, when, based on indicator diagrams, are calculated and then the characteristics of heat release is analyzed - net of heat release characteristics and the intensity of the heat release, it was demonstrated. This procedure is particularly effective in the diagnosis of damage of injection system components marine diesel engine.

Mixture-based gatekeeping procedures in adaptive clinical trials.

Science.gov (United States)

Kordzakhia, George; Dmitrienko, Alex; Ishida, Eiji

2018-01-01

Clinical trials with data-driven decision rules often pursue multiple clinical objectives such as the evaluation of several endpoints or several doses of an experimental treatment. These complex analysis strategies give rise to "multivariate" multiplicity problems with several components or sources of multiplicity. A general framework for defining gatekeeping procedures in clinical trials with adaptive multistage designs is proposed in this paper. The mixture method is applied to build a gatekeeping procedure at each stage and inferences at each decision point (interim or final analysis) are performed using the combination function approach. An advantage of utilizing the mixture method is that it enables powerful gatekeeping procedures applicable to a broad class of settings with complex logical relationships among the hypotheses of interest. Further, the combination function approach supports flexible data-driven decisions such as a decision to increase the sample size or remove a treatment arm. The paper concludes with a clinical trial example that illustrates the methodology by applying it to develop an adaptive two-stage design with a mixture-based gatekeeping procedure.

Screen printed paper-based diagnostic devices with polymeric inks.

Science.gov (United States)

Sun, Ju-Yen; Cheng, Chao-Min; Liao, Ying-Chih

2015-01-01

A simple and low-cost fabrication method for paper-based diagnostic devices (PBDDs) is described in this study. Street-available polymer solutions were screen printed onto filter papers to create hydrophobic patterns for fluidic channels. In order to obtain fully functional hydrophobic patterns for fluids, the original polymer solutions were diluted with butyl acetate to yield a suitable viscosity range between 30-200 cP for complete patterning on paper. Typical pH and glucose tests with color indicators were performed on the screen printed PBDDs. Images of the PBDDs were analyzed by computers to obtain calibration curves for pH between 2 and 12 and glucose concentration ranging from 10-1000 mmol dm(-3). Detection of formaldehyde in acetone was also carried out to show the possibility of using this PBBD for analytical detection with organic solvents. An exemplar PBDD with simultaneous pH and glucose detection was also used to demonstrate the feasibility of applying this technique for realistic diagnostic applications.

Extracellular gadolinium-based contrast media: Differences in diagnostic efficacy

Energy Technology Data Exchange (ETDEWEB)

Molen, Aart J. van der [Department of Radiology C-2S, Leiden University Medical Centre, Albinusdreef 2, NL-2333 ZA Leiden (Netherlands)], E-mail: molen@lumc.nl; Bellin, Marie-France [Universite Paris-Sud XI, AP-HP, Service de Radiologie, Hopital Paul Brousse, 12-14 Avenue Paul Vaillant Couturier, F-94804 Villejuif Cedex (France)

2008-05-15

Since the introduction of the first gadolinium-based contrast agent (Gd-CA) in 1988 it has become clear that these agents significantly improve the diagnostic efficacy of MRI. Studies on single agents have shown that, in comparison to unenhanced sequences, all agents help to improve the detection and delineation of lesions which can alter diagnosis in up to 40% of patients. Doubling or tripling the standard dose of 0.1 mmol/kg body weight may be beneficial for selected indications (e.g. brain perfusion, equivocal single dose study in MRI for brain metastasis, small vessel MR angiography). A more limited number of studies have compared the various agents. These studies do not show clinically significant differences in diagnostic efficacy between the various extracellular Gd-CA. Agents with higher concentration or protein binding may be relatively better suitable for selected applications (e.g. perfusion MRI). The higher relaxivity agents may be used in somewhat lower doses than the extracellular agents.

Extracellular gadolinium-based contrast media: Differences in diagnostic efficacy

International Nuclear Information System (INIS)

Molen, Aart J. van der; Bellin, Marie-France

2008-01-01

Since the introduction of the first gadolinium-based contrast agent (Gd-CA) in 1988 it has become clear that these agents significantly improve the diagnostic efficacy of MRI. Studies on single agents have shown that, in comparison to unenhanced sequences, all agents help to improve the detection and delineation of lesions which can alter diagnosis in up to 40% of patients. Doubling or tripling the standard dose of 0.1 mmol/kg body weight may be beneficial for selected indications (e.g. brain perfusion, equivocal single dose study in MRI for brain metastasis, small vessel MR angiography). A more limited number of studies have compared the various agents. These studies do not show clinically significant differences in diagnostic efficacy between the various extracellular Gd-CA. Agents with higher concentration or protein binding may be relatively better suitable for selected applications (e.g. perfusion MRI). The higher relaxivity agents may be used in somewhat lower doses than the extracellular agents

Radiation safety in nuclear medicine procedures

International Nuclear Information System (INIS)

Cho, Sang Geon; Kim, Ja Hae; Song, Ho Chun

2017-01-01

Since the nuclear disaster at the Fukushima Daiichi Nuclear Power Plant in 2011, radiation safety has become an important issue in nuclear medicine. Many structured guidelines or recommendations of various academic societies or international campaigns demonstrate important issues of radiation safety in nuclear medicine procedures. There are ongoing efforts to fulfill the basic principles of radiation protection in daily nuclear medicine practice. This article reviews important principles of radiation protection in nuclear medicine procedures. Useful references, important issues, future perspectives of the optimization of nuclear medicine procedures, and diagnostic reference level are also discussed

Radiation safety in nuclear medicine procedures

Energy Technology Data Exchange (ETDEWEB)

Cho, Sang Geon; Kim, Ja Hae; Song, Ho Chun [Dept. of Nuclear Medicine, Medical Radiation Safety Research Center, Chonnam National University Hospital, Gwangju (Korea, Republic of)

2017-03-15

Since the nuclear disaster at the Fukushima Daiichi Nuclear Power Plant in 2011, radiation safety has become an important issue in nuclear medicine. Many structured guidelines or recommendations of various academic societies or international campaigns demonstrate important issues of radiation safety in nuclear medicine procedures. There are ongoing efforts to fulfill the basic principles of radiation protection in daily nuclear medicine practice. This article reviews important principles of radiation protection in nuclear medicine procedures. Useful references, important issues, future perspectives of the optimization of nuclear medicine procedures, and diagnostic reference level are also discussed.

Improvement of Railroad Roller Bearing Test Procedures & Development of Roller Bearing Diagnostic Techniques. Volume 2.

Science.gov (United States)

1982-04-01

A comprehensive review of existing basic diagnostic techniques applicable to the railcar roller bearing defect and failure problem was made. Of the potentially feasible diagnostic techniques identified, high frequency vibration was selected for exper...

Power System Transient Diagnostics Based on Novel Traveling Wave Detection

Science.gov (United States)

Hamidi, Reza Jalilzadeh

Modern electrical power systems demand novel diagnostic approaches to enhancing the system resiliency by improving the state-of-the-art algorithms. The proliferation of high-voltage optical transducers and high time-resolution measurements provide opportunities to develop novel diagnostic methods of very fast transients in power systems. At the same time, emerging complex configuration, such as multi-terminal hybrid transmission systems, limits the applications of the traditional diagnostic methods, especially in fault location and health monitoring. The impedance-based fault-location methods are inefficient for cross-bounded cables, which are widely used for connection of offshore wind farms to the main grid. Thus, this dissertation first presents a novel traveling wave-based fault-location method for hybrid multi-terminal transmission systems. The proposed method utilizes time-synchronized high-sampling voltage measurements. The traveling wave arrival times (ATs) are detected by observation of the squares of wavelet transformation coefficients. Using the ATs, an over-determined set of linear equations are developed for noise reduction, and consequently, the faulty segment is determined based on the characteristics of the provided equation set. Then, the fault location is estimated. The accuracy and capabilities of the proposed fault location method are evaluated and also compared to the existing traveling-wave-based method for a wide range of fault parameters. In order to improve power systems stability, auto-reclosing (AR), single-phase auto-reclosing (SPAR), and adaptive single-phase auto-reclosing (ASPAR) methods have been developed with the final objectives of distinguishing between the transient and permanent faults to clear the transient faults without de-energization of the solid phases. However, the features of the electrical arcs (transient faults) are severely influenced by a number of random parameters, including the convection of the air and plasma

SELDI-TOF-based serum proteomic pattern diagnostics for early detection of cancer.

Science.gov (United States)

Petricoin, Emanuel F; Liotta, Lance A

2004-02-01

Proteomics is more than just generating lists of proteins that increase or decrease in expression as a cause or consequence of pathology. The goal should be to characterize the information flow through the intercellular protein circuitry that communicates with the extracellular microenvironment and then ultimately to the serum/plasma macroenvironment. The nature of this information can be a cause, or a consequence, of disease and toxicity-based processes. Serum proteomic pattern diagnostics is a new type of proteomic platform in which patterns of proteomic signatures from high dimensional mass spectrometry data are used as a diagnostic classifier. This approach has recently shown tremendous promise in the detection of early-stage cancers. The biomarkers found by SELDI-TOF-based pattern recognition analysis are mostly low molecular weight fragments produced at the specific tumor microenvironment.

Why and how did Israel adopt activity-based hospital payment? The Procedure-Related Group incremental reform.

Science.gov (United States)

Brammli-Greenberg, Shuli; Waitzberg, Ruth; Perman, Vadim; Gamzu, Ronni

2016-10-01

Historically, Israel paid its non-profit hospitals on a perdiem (PD) basis. Recently, like other OECD countries, Israel has moved to activity-based payments. While most countries have adopted a diagnostic related group (DRG) payment system, Israel has chosen a Procedure-Related Group (PRG) system. This differs from the DRG system because it classifies patients by procedure rather than diagnosis. In Israel, the PRG system was found to be more feasible given the lack of data and information needed in the DRG classification system. The Ministry of Health (MoH) chose a payment scheme that depends only on inhouse creation of PRG codes and costing, thus avoiding dependence on hospital data. The PRG tariffs are priced by a joint Health and Finance Ministry commission and updated periodically. Moreover, PRGs are believed to achieve the same main efficiency objectives as DRGs: increasing the volume of activity, shortening unnecessary hospitalization days, and reducing the gaps between the costs and prices of activities. The PRG system is being adopted through an incremental reform that started in 2002 and was accelerated in 2010. The Israeli MoH involved the main players in the hospital market in the consolidation of this potentially controversial reform in order to avoid opposition. The reform was implemented incrementally in order to preserve the balance of resource allocation and overall expenditures of the system, thus becoming budget neutral. Yet, as long as gaps remain between marginal costs and prices of procedures, PRGs will not attain all their objectives. Moreover, it is still crucial to refine PRG rates to reflect the severity of cases, in order to tackle incentives for selection of patients within each procedure. Copyright © 2016 The Author(s). Published by Elsevier Ireland Ltd.. All rights reserved.

Simulation-based diagnostics and control for nuclear power plants. Final report, April 15, 1992--April 14, 1995

International Nuclear Information System (INIS)

Lee, J.C.

1995-07-01

The objective of the project was to develop and test a simulation-based diagnostics and control guidance system that can be used to diagnose and manage off-normal transient events in nuclear power plants. The research has focused on developing two diagnostic approaches suitable for detection and identification of faults involving multiple components, subject to uncertainties in system modeling and observations. The first approach is based on a fuzzy logic framework that can diagnose binary failures using a single-failure diagnostic knowledge base. Construction of the binary-failure knowledge base is accomplished through the use of macroscopic conservation relationships and a fuzzy inference structure is developed to determine the magnitude of faults and the associated certainty. In the second diagnostic approach, an adaptive Kalman filter algorithm is derived to yield information on the type and magnitude of feasible component transitions that can account for system observations. To obtain the likelihood of feasible component failures or degradations, a general probabilistic formulation is developed where statistical distributions associated with component reliability data are explicitly represented. Testing of the diagnostic algorithms has been performed through the analysis of simulated transient events for light water reactor systems. Preliminary studies have been conducted to develop Monte Carlo algorithms for flexible control of transient events

Diagnostic value of performing endocervical curettage at the time of colposcopy procedure; a systematic review

Directory of Open Access Journals (Sweden)

Shabnam Imannezhad

2016-03-01

Full Text Available Introduction: The importance of high-grade cervical intraepithelial neoplasia (CIN as a precursor to invasive cervical cancer suggests a considerable need for accurate screening of the patients for the risk of these lesions. This systematic review aimed to study the diagnostic significance of endocervical curettage (ECC at the time of colposcopy in the detection of CIN 2, 3, and preinvasive lesions.Methods: PubMed was searched to obtain the relevant articles based on the following search term: (endocervical curettage OR ECC AND colposcopy. The most relevant articles were included after studying the title, abstract, and full text of the obtained articles at initial search. Only English language articles published after 1992 with at least 500 patients were included in this study.Result: Among 300 articles identified by the first search, only seven articles were in line with the purpose of this systematic review. Majority of the included studies were retrospective observational studies.Conclusion: Performing ECC has higher sensitivity in women older than 40 years and those with unsatisfactory colposcopy results. However exact diagnostic usefulness of ECC at the time of colposcopy needs to be investigated in further studies.

Diagnostic radiation and pregnancy

International Nuclear Information System (INIS)

Collins, L.; Fitzgerald, P.

1983-01-01

Accidental irradiation of the embryo or fetus in the first trimester is a problem which will occasionally occur. The value of a proper estimation of the radiation dose is emphasised. Very rarely does a single diagnostic procedure result in a uterine dose as high as 50 mGy. An accidental irradiation should rarely be cause for termination of a pregnancy

Beam-Based Diagnostics of RF-Breakdown in the Two-Beam Test-Stand in CTF3

CERN Document Server

Johnson, M

2007-01-01

The general outline of a beam-based diagnostic method of RF-breakdown, using BPMs, at the two-beam test-stand in CTF3 is discussed. The basic components of the set-up and their functions in the diagnostic are described. Estimations of the expected error in the measured parameters are performed.

Office-based deep sedation for pediatric ophthalmologic procedures using a sedation service model.

Science.gov (United States)

Lalwani, Kirk; Tomlinson, Matthew; Koh, Jeffrey; Wheeler, David

2012-01-01

Aims. (1) To assess the efficacy and safety of pediatric office-based sedation for ophthalmologic procedures using a pediatric sedation service model. (2) To assess the reduction in hospital charges of this model of care delivery compared to the operating room (OR) setting for similar procedures. Background. Sedation is used to facilitate pediatric procedures and to immobilize patients for imaging and examination. We believe that the pediatric sedation service model can be used to facilitate office-based deep sedation for brief ophthalmologic procedures and examinations. Methods. After IRB approval, all children who underwent office-based ophthalmologic procedures at our institution between January 1, 2000 and July 31, 2008 were identified using the sedation service database and the electronic health record. A comparison of hospital charges between similar procedures in the operating room was performed. Results. A total of 855 procedures were reviewed. Procedure completion rate was 100% (C.I. 99.62-100). There were no serious complications or unanticipated admissions. Our analysis showed a significant reduction in hospital charges (average of $1287 per patient) as a result of absent OR and recovery unit charges. Conclusions. Pediatric ophthalmologic minor procedures can be performed using a sedation service model with significant reductions in hospital charges.

Office-Based Deep Sedation for Pediatric Ophthalmologic Procedures Using a Sedation Service Model

Directory of Open Access Journals (Sweden)

Kirk Lalwani

2012-01-01

Full Text Available Aims. (1 To assess the efficacy and safety of pediatric office-based sedation for ophthalmologic procedures using a pediatric sedation service model. (2 To assess the reduction in hospital charges of this model of care delivery compared to the operating room (OR setting for similar procedures. Background. Sedation is used to facilitate pediatric procedures and to immobilize patients for imaging and examination. We believe that the pediatric sedation service model can be used to facilitate office-based deep sedation for brief ophthalmologic procedures and examinations. Methods. After IRB approval, all children who underwent office-based ophthalmologic procedures at our institution between January 1, 2000 and July 31, 2008 were identified using the sedation service database and the electronic health record. A comparison of hospital charges between similar procedures in the operating room was performed. Results. A total of 855 procedures were reviewed. Procedure completion rate was 100% (C.I. 99.62–100. There were no serious complications or unanticipated admissions. Our analysis showed a significant reduction in hospital charges (average of $1287 per patient as a result of absent OR and recovery unit charges. Conclusions. Pediatric ophthalmologic minor procedures can be performed using a sedation service model with significant reductions in hospital charges.

Patients with environment-related disorders: comprehensive results of interdisciplinary diagnostics.

Science.gov (United States)

Brand, Serge; Heller, Pia; Bircher, Andreas J; Braun-Fahrleander, Charlotte; Huss, Anke; Niederer, Markus; Schwarzenbach, Simone; Waeber, Roger; Wegmann, Lukas; Kuechenhoff, Joachim

2009-03-01

Researchers dealing with environmental illnesses face complex diagnostic and methodological difficulties. Poor objective findings contrast with high subjective suffering and a firm belief that environmental exposure is the only source of complaints. The Basel pilot research project established a multi-modal assessment procedure and assessed complaints attributed to the environment. Medical, psychological and environmental findings were evaluated as to their pathogenic validity. Furthermore, patients were pooled into distinguishable subgroups in order to formulate more appropriate therapy strategies. Sixty-three patients took part in the threefold diagnostic approach (medical examination, psychiatric exploration, environmental analysis) of a mixed qualitative/quantitative study. Interdisciplinary case conferences allowed a consensus rating of the aetiological relevance of the findings to be reached. The discrepancy between self-rating and experts' judgement was exploited for subgroup formation. About 50% of the patients' symptoms could be attributed to psychiatric causes. Based on self-rating and experts' judgement, four subgroups were distinguished with differing medical, psychiatric and environmental aetiologies, personality traits and interactional competencies. Patients with environment-related disorders form a heterogeneous group. An interdisciplinary assessment and a comparison between self- and experts' judgements enable a more differentiated psychotherapeutic procedure and may enhance future treatment success.

Bacterial clonal diagnostics as a tool for evidence-based empiric antibiotic selection.

Science.gov (United States)

Tchesnokova, Veronika; Avagyan, Hovhannes; Rechkina, Elena; Chan, Diana; Muradova, Mariya; Haile, Helen Ghirmai; Radey, Matthew; Weissman, Scott; Riddell, Kim; Scholes, Delia; Johnson, James R; Sokurenko, Evgeni V

2017-01-01

Despite the known clonal distribution of antibiotic resistance in many bacteria, empiric (pre-culture) antibiotic selection still relies heavily on species-level cumulative antibiograms, resulting in overuse of broad-spectrum agents and excessive antibiotic/pathogen mismatch. Urinary tract infections (UTIs), which account for a large share of antibiotic use, are caused predominantly by Escherichia coli, a highly clonal pathogen. In an observational clinical cohort study of urgent care patients with suspected UTI, we assessed the potential for E. coli clonal-level antibiograms to improve empiric antibiotic selection. A novel PCR-based clonotyping assay was applied to fresh urine samples to rapidly detect E. coli and the urine strain's clonotype. Based on a database of clonotype-specific antibiograms, the acceptability of various antibiotics for empiric therapy was inferred using a 20%, 10%, and 30% allowed resistance threshold. The test's performance characteristics and possible effects on prescribing were assessed. The rapid test identified E. coli clonotypes directly in patients' urine within 25-35 minutes, with high specificity and sensitivity compared to culture. Antibiotic selection based on a clonotype-specific antibiogram could reduce the relative likelihood of antibiotic/pathogen mismatch by ≥ 60%. Compared to observed prescribing patterns, clonal diagnostics-guided antibiotic selection could safely double the use of trimethoprim/sulfamethoxazole and minimize fluoroquinolone use. In summary, a rapid clonotyping test showed promise for improving empiric antibiotic prescribing for E. coli UTI, including reversing preferential use of fluoroquinolones over trimethoprim/sulfamethoxazole. The clonal diagnostics approach merges epidemiologic surveillance, antimicrobial stewardship, and molecular diagnostics to bring evidence-based medicine directly to the point of care.

Mathematical calibration procedure of a capacitive sensor-based indexed metrology platform

International Nuclear Information System (INIS)

Brau-Avila, A; Valenzuela-Galvan, M; Herrera-Jimenez, V M; Santolaria, J; Aguilar, J J; Acero, R

2017-01-01

The demand for faster and more reliable measuring tasks for the control and quality assurance of modern production systems has created new challenges for the field of coordinate metrology. Thus, the search for new solutions in coordinate metrology systems and the need for the development of existing ones still persists. One example of such a system is the portable coordinate measuring machine (PCMM), the use of which in industry has considerably increased in recent years, mostly due to its flexibility for accomplishing in-line measuring tasks as well as its reduced cost and operational advantages compared to traditional coordinate measuring machines. Nevertheless, PCMMs have a significant drawback derived from the techniques applied in the verification and optimization procedures of their kinematic parameters. These techniques are based on the capture of data with the measuring instrument from a calibrated gauge object, fixed successively in various positions so that most of the instrument measuring volume is covered, which results in time-consuming, tedious and expensive verification and optimization procedures. In this work the mathematical calibration procedure of a capacitive sensor-based indexed metrology platform (IMP) is presented. This calibration procedure is based on the readings and geometric features of six capacitive sensors and their targets with nanometer resolution. The final goal of the IMP calibration procedure is to optimize the geometric features of the capacitive sensors and their targets in order to use the optimized data in the verification procedures of PCMMs. (paper)

Mathematical calibration procedure of a capacitive sensor-based indexed metrology platform

Science.gov (United States)

Brau-Avila, A.; Santolaria, J.; Acero, R.; Valenzuela-Galvan, M.; Herrera-Jimenez, V. M.; Aguilar, J. J.

2017-03-01

The demand for faster and more reliable measuring tasks for the control and quality assurance of modern production systems has created new challenges for the field of coordinate metrology. Thus, the search for new solutions in coordinate metrology systems and the need for the development of existing ones still persists. One example of such a system is the portable coordinate measuring machine (PCMM), the use of which in industry has considerably increased in recent years, mostly due to its flexibility for accomplishing in-line measuring tasks as well as its reduced cost and operational advantages compared to traditional coordinate measuring machines. Nevertheless, PCMMs have a significant drawback derived from the techniques applied in the verification and optimization procedures of their kinematic parameters. These techniques are based on the capture of data with the measuring instrument from a calibrated gauge object, fixed successively in various positions so that most of the instrument measuring volume is covered, which results in time-consuming, tedious and expensive verification and optimization procedures. In this work the mathematical calibration procedure of a capacitive sensor-based indexed metrology platform (IMP) is presented. This calibration procedure is based on the readings and geometric features of six capacitive sensors and their targets with nanometer resolution. The final goal of the IMP calibration procedure is to optimize the geometric features of the capacitive sensors and their targets in order to use the optimized data in the verification procedures of PCMMs.

78 FR 59701 - Medicare Program; Approval of Accrediting Organization for Suppliers of Advanced Diagnostic...

Science.gov (United States)

2013-09-27

...] Medicare Program; Approval of Accrediting Organization for Suppliers of Advanced Diagnostic Imaging... accredit suppliers seeking to furnish the technical component (TC) of advanced diagnostic imaging services... advanced diagnostic imaging (ADI) service and establish procedures to ensure that the criteria used by an...

Optimization of a middle atmosphere diagnostic scheme

Science.gov (United States)

Akmaev, Rashid A.

1997-06-01

A new assimilative diagnostic scheme based on the use of a spectral model was recently tested on the CIRA-86 empirical model. It reproduced the observed climatology with an annual global rms temperature deviation of 3.2 K in the 15-110 km layer. The most important new component of the scheme is that the zonal forcing necessary to maintain the observed climatology is diagnosed from empirical data and subsequently substituted into the simulation model at the prognostic stage of the calculation in an annual cycle mode. The simulation results are then quantitatively compared with the empirical model, and the above mentioned rms temperature deviation provides an objective measure of the `distance' between the two climatologies. This quantitative criterion makes it possible to apply standard optimization procedures to the whole diagnostic scheme and/or the model itself. The estimates of the zonal drag have been improved in this study by introducing a nudging (Newtonian-cooling) term into the thermodynamic equation at the diagnostic stage. A proper optimal adjustment of the strength of this term makes it possible to further reduce the rms temperature deviation of simulations down to approximately 2.7 K. These results suggest that direct optimization can successfully be applied to atmospheric model parameter identification problems of moderate dimensionality.

Galactography: the diagnostic procedure of choice for nipple discharge

International Nuclear Information System (INIS)

Tabar, L.; Dean, P.B.; Pentek, Z.

1983-01-01

Galactogrpahy was performed in 204 women with a nipple discharge and the secretion confirmed histopathologically. All 116 intraductal tumors (papilloma, papillomatosis, carcinoma), which were associated with a serous or bloody discharge, were detected preoperatively. A palpable mass had little diagnostic significance, and exfoliative cytology was positive in only 11% (2/18) of the patients with carcinoma. The authors recommend that all patients with a spontaneous bloody or serous discharge from a single lactiferous orifice undergo galactography in addition to physical, cytological, and mammographic examination. Intraductal injection of methylene blue dye will demonstrate the affected duct system to the surgeon and can often make surgery less radical or even unnecessary

Application of neural networks and neutron noise for diagnostics of reactor internals vibration

International Nuclear Information System (INIS)

Garis, N.S.; Pazsit, I.; Gloeckler, O.

1995-01-01

It has long been known that vibration of reactor internals, in particular excessive vibrations of control rods, can be detected via the neutron noise they induce. Noise measurements are actually suitable to determine important diagnostic parameters such as the location of the vibrating rod and the vibration amplitude. An algorithm was earlier elaborated for this purpose, which is based on inversion of the expression describing the neutron noise as a function of vibration parameters. This inversion procedure is nevertheless complicated and not always unique. It was investigated whether a properly trained neural network can perform the inversion more effectively. It was found that artificial neural networks can be trained effectively to perform vibration diagnostics from neutron noise data fast, effectively and reliably. The present paper gives a description of the development and use of the neural networks for purposes of vibration diagnostics

Evaluation of Flight Deck-Based Interval Management Crew Procedure Feasibility

Science.gov (United States)

Wilson, Sara R.; Murdoch, Jennifer L.; Hubbs, Clay E.; Swieringa, Kurt A.

2013-01-01

Air traffic demand is predicted to increase over the next 20 years, creating a need for new technologies and procedures to support this growth in a safe and efficient manner. The National Aeronautics and Space Administration's (NASA) Air Traffic Management Technology Demonstration - 1 (ATD-1) will operationally demonstrate the feasibility of efficient arrival operations combining ground-based and airborne NASA technologies. The integration of these technologies will increase throughput, reduce delay, conserve fuel, and minimize environmental impacts. The ground-based tools include Traffic Management Advisor with Terminal Metering for precise time-based scheduling and Controller Managed Spacing decision support tools for better managing aircraft delay with speed control. The core airborne technology in ATD-1 is Flight deck-based Interval Management (FIM). FIM tools provide pilots with speed commands calculated using information from Automatic Dependent Surveillance - Broadcast. The precise merging and spacing enabled by FIM avionics and flight crew procedures will reduce excess spacing buffers and result in higher terminal throughput. This paper describes a human-in-the-loop experiment designed to assess the acceptability and feasibility of the ATD-1 procedures used in a voice communications environment. This experiment utilized the ATD-1 integrated system of ground-based and airborne technologies. Pilot participants flew a high-fidelity fixed base simulator equipped with an airborne spacing algorithm and a FIM crew interface. Experiment scenarios involved multiple air traffic flows into the Dallas-Fort Worth Terminal Radar Control airspace. Results indicate that the proposed procedures were feasible for use by flight crews in a voice communications environment. The delivery accuracy at the achieve-by point was within +/- five seconds and the delivery precision was less than five seconds. Furthermore, FIM speed commands occurred at a rate of less than one per minute

CBDS: Constraint-based diagnostic system for malfunction identification in the nuclear power plant

International Nuclear Information System (INIS)

Ha, J.

1992-01-01

Traditional rule-based diagnostic expert systems use the experience of experts in the form of rules that associate symptoms with underlying faults. A commonly recognized failing of such systems is their narrow range of expertise and their inability to recognize problems outside this range of expertise. A model base diagnostic system isolating malfunctioning components-CBDS, the Constraint based Diagnostic System-has been developed. Since the intended behavior of a device is more predictable than unintended behaviors (faults), a model based system using the intended behavior has a potential to diagnose unexpected malfunctions by considering faults as open-quotes anything other than the intended behavior.close quotes As a knowledge base, the CBDS generates and decomposes a constraint network based on the structure and behavior model, which are represented symbolically in algebraic equations. Behaviors of generic components are organized in a component model library. Once the library is available, actual domain knowledge can be represented by declaring component types and their connections. To capture various plant knowledge, the mixed model was developed which allow the use of different parameter types in one equation by defining various operators. The CBDS uses the general idea of model based diagnosis. It detects a discrepancy between observation and prediction using constraint propagation, which carriers and accumulates the assumptions when parameter values are deduced. When measured plant parameters are asserted into a constraint network and are propagated through the network, a discrepancy will be detected if there exists any malfunctioning component. The CBDS was tested in the Recirculation Flow Control System of a BWR, and has been shown to be able to diagnose unexpected events

A laser-spectroscopy complex for fluorescent diagnostics and photodynamic therapy of age-related macula degeneration

Science.gov (United States)

Shevchik, S. A.; Meerovich, Gennadii A.; Budzinskaya, M. V.; Ermakova, N. A.; Kharnas, Sergey S.; Loschenov, Victor B.

2004-06-01

A laser-spectroscopy complex was developed for fluorescent diagnostics and photodynamic therapy of age related macula degeneration using the Russian photosensitizer Photosense. The complex is based on slit lamp which was additionally equipped with an optical adapter, and the video adapter allows to combine the procedure of photodynamic therapy and the control of its carrying in the frame work of one procedure. The sensitivity and spatial resolution of the complex were investigated using a special test object. The availability of the developed complex and Photosense itself was examined on experimental animals.

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

The effect of sampling, diagnostic criteria and assessment procedures on the observed prevalence of DSM-III-R personality disorders among treated alcoholics.

Science.gov (United States)

Verheul, R; Hartgers, C; Van den Brink, W; Koeter, M W

1998-03-01

OBJECTIVE. In a recent review of empirical studies on the prevalence of DSM-III-R personality disorders among substance abusers, wide ranges of prevalence rates for overall Axis II, antisocial personality disorder (APD) and borderline personality disorder (BPD) were shown. Utilizing subsamples from within a single study population, the current report explores the effect of sampling, diagnostic criteria and assessment procedures on the observed prevalence of DSM-III-R personality disorders among treated alcoholics. Personality disorders were assessed with the Personality Diagnostic Questionnaire Revised (PDQR) at two times of measurement (Time 1 n = 459; Time 2 n = 90). In addition, APD was measured with the Composite International Diagnostic Interview (CIDI; n = 587). Finally, an unselected subgroup (n = 136) was interviewed with the International Personality Disorder Examination (IPDE). There were few differences between inpatients or outpatients or between males and females. Using the IPDE, the exclusion of substance-related pathology did not affect the prevalence estimate. However, the prevalence rates according to the PDQR varied greatly across age groups. In a representative subsample (n = 109), the prevalence rates also varied greatly across assessment methods (PDQR, 52% vs IPDE, 31%). The prevalence estimate of APD according to the CIDI was related to setting, gender, age group and the applied time-frame. These findings indicate the examined factors to be necessary qualifiers of prevalence estimates and, consequently, support the use of a multiple-criteria/multimethod assessment battery in research as well as in clinical work.

Automated extraction of knowledge for model-based diagnostics

Science.gov (United States)

Gonzalez, Avelino J.; Myler, Harley R.; Towhidnejad, Massood; Mckenzie, Frederic D.; Kladke, Robin R.

1990-01-01

The concept of accessing computer aided design (CAD) design databases and extracting a process model automatically is investigated as a possible source for the generation of knowledge bases for model-based reasoning systems. The resulting system, referred to as automated knowledge generation (AKG), uses an object-oriented programming structure and constraint techniques as well as internal database of component descriptions to generate a frame-based structure that describes the model. The procedure has been designed to be general enough to be easily coupled to CAD systems that feature a database capable of providing label and connectivity data from the drawn system. The AKG system is capable of defining knowledge bases in formats required by various model-based reasoning tools.

A Tuning Procedure for ARX-based MPC of Multivariate Processes

DEFF Research Database (Denmark)

Olesen, Daniel; Huusom, Jakob Kjøbsted; Jørgensen, John Bagterp

2013-01-01

We present an optimization based tuning procedure with certain robustness properties for an offset free Model Predictive Controller (MPC). The MPC is designed for multivariate processes that can be represented by an ARX model. The stochastic model of the ARX model identified from input-output data...... is modified with an ARMA model designed as part of the MPC-design procedure to ensure offset-free control. The MPC is designed and implemented based on a state space model in innovation form. Expressions for the closed-loop dynamics of the unconstrained system is used to derive the sensitivity function...... to a constraint on the maximum of the sensitivity function. The latter constraint provides a robustness measure that is essential for the procedure. The method is demonstrated for two simulated examples: A Wood-Berry distillation column example and a cement mill example....

LC-HRMS Metabolomics for Untargeted Diagnostic Screening in Clinical Laboratories: A Feasibility Study

Directory of Open Access Journals (Sweden)

Bertrand Rochat

2018-06-01

Full Text Available Today’s high-resolution mass spectrometers (HRMS allow bioanalysts to perform untargeted/global determinations that can reveal unexpected compounds or concentrations in a patient’s sample. This could be performed for preliminary diagnosis attempts when usual diagnostic processes and targeted determinations fail. We have evaluated an untargeted diagnostic screening (UDS procedure. UDS is a metabolome analysis that compares one sample (e.g., a patient with control samples (a healthy population. Using liquid chromatography (LC-HRMS full-scan analysis of human serum extracts and unsupervised data treatment, we have compared individual samples that were spiked with one xenobiotic or a higher level of one endogenous compound with control samples. After the use of different filters that drastically reduced the number of metabolites detected, the spiked compound was eventually revealed in each test sample and ranked. The proposed UDS procedure appears feasible and reliable to reveal unexpected xenobiotics (toxicology or higher concentrations of endogenous metabolites. HRMS-based untargeted approaches could be useful as preliminary diagnostic screening when canonical processes do not reveal disease etiology nor establish a clear diagnosis and could reduce misdiagnosis. On the other hand, the risk of overdiagnosis of this approach should be reduced with mandatory biomedical interpretation of the patient’s UDS results and with confirmatory targeted and quantitative determinations.

Assessment of patient doses and image quality in X-ray diagnostics in Norway

International Nuclear Information System (INIS)

Olerud, H.M.

1998-01-01

Results from other industrialized countries indicate that the annual number of diagnostic procedures approaches one for every member of the population, and in many cases the individual radiation doses are higher than from any other human activity. Furthermore, the doses to patients for the same type of examination differ widely from place to place, suggesting that there is a considerable potential for dose reduction. This motivated an investigation of the diagnostic use of X-rays in Norway. The trends in the number of X-ray examinations performed annually have been studied. The patient doses (all diagnostics) and image quality (mammography and computed tomography) have been assessed for various radiological procedures. This form the basis for the assessment of total collective effective dose (CED) from X-rays in Norway, and further risk estimates. The radiological practice has then been evaluated according to the radiation protection principles of justification and optimisation. Based on the 1993 examination frequency, the total CED was assessed to 3400 manSv (0.78 mSv/inhabitant). It is estimated that this radiation burden may cause about 100 excess cancer deaths annually. The frequency of CT examination has doubled every fifth year, and did in 1993 represent 7% of the total number of examinations and 30% of the total CED. 129 refs

Assessment of patient doses and image quality in X-ray diagnostics in Norway

Energy Technology Data Exchange (ETDEWEB)

Olerud, H M

1998-06-01

Results from other industrialized countries indicate that the annual number of diagnostic procedures approaches one for every member of the population, and in many cases the individual radiation doses are higher than from any other human activity. Furthermore, the doses to patients for the same type of examination differ widely from place to place, suggesting that there is a considerable potential for dose reduction. This motivated an investigation of the diagnostic use of X-rays in Norway. The trends in the number of X-ray examinations performed annually have been studied. The patient doses (all diagnostics) and image quality (mammography and computed tomography) have been assessed for various radiological procedures. This form the basis for the assessment of total collective effective dose (CED) from X-rays in Norway, and further risk estimates. The radiological practice has then been evaluated according to the radiation protection principles of justification and optimisation. Based on the 1993 examination frequency, the total CED was assessed to 3400 manSv (0.78 mSv/inhabitant). It is estimated that this radiation burden may cause about 100 excess cancer deaths annually. The frequency of CT examination has doubled every fifth year, and did in 1993 represent 7% of the total number of examinations and 30% of the total CED. 129 refs.